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Báo cáo hóa học: " Pituitary apoplexy can mimic acute meningoencephalitis or subarachnoid haemorrhage"

Tuyển tập các báo cáo nghiên cứu về hóa học được đăng trên tạp chí hóa hoc quốc tế đề tài : Pituitary apoplexy can mimic acute meningoencephalitis or subarachnoid haemorrhage | Sadek et al. International Journal of Emergency Medicine 2011 4 63 http www.intjem.eom content 4 1 63 o International Journal of Emergency Medicine a SprlngerOpen Journal CASE REPORT Open Access Pituitary apoplexy can mimic acute meningoencephalitis or subarachnoid haemorrhage Ahmed-Ramadan Sadek1 2 Stephen Gregory3 and Thiagarajan Jaiganesh4 Abstract Pituitary apoplexy is an uncommon but life-threatening condition that is often overlooked and underdiagnosed. We report a 45-year-old man who presented to our emergency department with a sudden onset headache acute confusion signs of meningeal irritation and ophthalmoplegia. An initial diagnosis of acute meningoencephalitis was made which was amended to pituitary apoplexy following thorough investigation within the emergency department. A 45-year-old man was brought to our emergency department by ambulance with a history of sudden onset of frontal headache and acute confusion. His wife provided the history. There was no significant past medical history of diabetes hypertension recent travel abroad exposure to sick contacts involvement in outdoor pursuits such as hiking cave diving or trauma. He worked in a bank and had been well until 24 h prior to the onset of sudden headache which was gradually worsening in nature and associated with increasing confusion. The patient s wife reported that he had neither experienced any fevers night sweats or coryzal symptoms nor received any recent vaccinations. He was not on any regular medications. He was a non-smoker and occasionally consumed alcohol. There was no significant family history. On examination in the ED his temperature was 37.6 C his pulse was 110 min and he was normotensive and normoglycaemic. A macular blanching rash was noted over the patient s trunk. The patient was disoriented to time and place. Neurological examination revealed reduced GCS 11 15-E3 M6 V2 marked neck stiffness a positive Kernig s sign and a right sixth nerve palsy. A provisional diagnosis of .