k********n
发帖数: 756 | 1 A 45 YOF PMH eclampsia no other risk factors presented with right carotid
dissection but left ischemic stroke in the motor strip.
Forgot to take a close exam on her skin. Therefore, I missed the
opportunities to impress attendings and peers.
The skin finding is Livedo Reticularis
What is the syndrom? |
a*********1
发帖数: 872 | 2 是Sneddon's syndrome吗？Livedo Reticularis+stroke , young female |
A*******s
发帖数: 9638 | 3 yes。
any pictures？
【在 a*********1 的大作中提到】
: 是Sneddon's syndrome吗？Livedo Reticularis+stroke , young female
|
A*******s
发帖数: 9638 | 4
【在 k********n 的大作中提到】
: A 45 YOF PMH eclampsia no other risk factors presented with right carotid
: dissection but left ischemic stroke in the motor strip.
: Forgot to take a close exam on her skin. Therefore, I missed the
: opportunities to impress attendings and peers.
: The skin finding is Livedo Reticularis
: What is the syndrom?
|
a*********1
发帖数: 872 | 5 here you go
【在 A*******s 的大作中提到】
: yes。
: any pictures？
|
m*********6
发帖数: 609 | 6 好厉害，在哪儿学的？usmle里从来没提到过吧
【在 a*********1 的大作中提到】
: 是Sneddon's syndrome吗？Livedo Reticularis+stroke , young female
|
S******9
发帖数: 2837 | 7 标准神经科出生
不一样的
【在 m*********6 的大作中提到】
: 好厉害，在哪儿学的？usmle里从来没提到过吧
|
k********n
发帖数: 756 | 8 Not as obvious as the above picture.
Patient is super active and tanned like hot chicks in LA. |
A*******s
发帖数: 9638 | 9 Livedo Reticularis is a non-specific skin condition. Nobody pays attention
to it until something has happened. |
a*********1
发帖数: 872 | 10 呵呵 现学现卖
【在 m*********6 的大作中提到】
: 好厉害，在哪儿学的？usmle里从来没提到过吧
|
|
|
k********n
发帖数: 756 | 11 I thought it was just translucent skin and suspected Ehlers Danlos type IV.
The attending walked into the room, took a peek, gave the DDx. I did not
believe it and placed the bet on the Dx. I lost a 6 pack beer. |
A*******s
发帖数: 9638 | 12 Man, you should not bet beer for this. Your PD will not be happy about it.
【在 k********n 的大作中提到】
: I thought it was just translucent skin and suspected Ehlers Danlos type IV.
: The attending walked into the room, took a peek, gave the DDx. I did not
: believe it and placed the bet on the Dx. I lost a 6 pack beer.
|
k********n
发帖数: 756 | 13 The attending asked me to place the bet. Maybe I should bet for a kiss? |
A*******s
发帖数: 9638 | 14 Then your LD will not be happy about it.
【在 k********n 的大作中提到】
: The attending asked me to place the bet. Maybe I should bet for a kiss?
|
V*****G
发帖数: 337 | 15 To have left motor strip ischemic stroke, left middle cerebral artery need
to be involved? Which can be from emboli, thrombosis, etc in left middle
cerebral artery. So this is another disease processes . Right cwould it be
possible for plaques to travel from right carotid dissection
Part to left middle cerebral artery through communicating arteries and
caused stroke?
【在 k********n 的大作中提到】
: A 45 YOF PMH eclampsia no other risk factors presented with right carotid
: dissection but left ischemic stroke in the motor strip.
: Forgot to take a close exam on her skin. Therefore, I missed the
: opportunities to impress attendings and peers.
: The skin finding is Livedo Reticularis
: What is the syndrom?
|
A*******s
发帖数: 9638 | 16 What baobao meant was that the stroke was not related to the dissection. The
mechanism was thought to be vasospasm. But the treatment was
anticoagulation.
Not sure about any updates or changes.
But I felt odd about this case. Are you guys overdiagnose dissections? :)
be
【在 V*****G 的大作中提到】
: To have left motor strip ischemic stroke, left middle cerebral artery need
: to be involved? Which can be from emboli, thrombosis, etc in left middle
: cerebral artery. So this is another disease processes . Right cwould it be
: possible for plaques to travel from right carotid dissection
: Part to left middle cerebral artery through communicating arteries and
: caused stroke?
|
V*****G
发帖数: 337 | 17 Here is my understanding about treatment of stroke, please correct me if I
was wrong.
1. For ischemic stroke, tpa if within 3 hours , otherwise supportive only.
No routine heparin regardless of dissection or not. But if there is A-fib,
can use heparin.
2. For homerrhagic stroke, control bp. Prevent increased icp, surgery if
indicated. R/o bleeding disease, No heparin.
3. Carrotid dissection is contradiction of heparin.
4. For vasospasm, give amlodipine, no beta blocker. Do we need heparin in
this case?
Thanks.
The
【在 A*******s 的大作中提到】
: What baobao meant was that the stroke was not related to the dissection. The
: mechanism was thought to be vasospasm. But the treatment was
: anticoagulation.
: Not sure about any updates or changes.
: But I felt odd about this case. Are you guys overdiagnose dissections? :)
:
: be
|
A*******s
发帖数: 9638 | 18 1. For ischemic stroke, tpa if within 3 hours , otherwise supportive only.
fib,
No heparin for most strokes, but for A-fib or dissection, it depends.
Correct.
No consensus. Even TPA was proven safe but no enough data.
Probably not. But Coumadin is recommended afterwards.
fib, |
V*****G
发帖数: 337 | 19 Thanks!
.
【在 A*******s 的大作中提到】
: 1. For ischemic stroke, tpa if within 3 hours , otherwise supportive only.
: fib,
: No heparin for most strokes, but for A-fib or dissection, it depends.
: Correct.
: No consensus. Even TPA was proven safe but no enough data.
: Probably not. But Coumadin is recommended afterwards.
: fib,
|
n**z
发帖数: 26 | 20 thanks for teaching us...at least me :P |
