Posts in Neurology
Posterior Reversible Encephalopathy Syndrome (PRES) in the Emergency Department

68-year-old male with history of hypertension, chronic kidney disease presenting from home with wife at bedside for confusion and shaking movements. Per wife, the patient is independent at baseline. He walks, drives and still works. Yesterday, he complained of a mild headache and this morning she noticed he seemed more confused, described as asking repetitive questions and wandering around the house. Prior to coming into the emergency department, the patient had a one-minute episode of full body shaking. This has never happened before. He has no history of seizure activity. The shaking resolved on its own and the patient was very tired afterwards while awaiting the ambulance. ..

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A Real Pain in the Neck

A 17-year-old boy arrives to the trauma bay. He was the unhelmeted driver of a moped that collided with a truck going approximately 40 mph. He was thrown from the moped and lost consciousness. When EMS arrived on scene his GCS was 8, but it had improved during transport. In the trauma bay he has a GCS of 15 and his primary survey is intact. Vital signs are normal. Secondary survey reveals scattered abrasions and lacerations, as well as left anterior neck tenderness. His only complaint is pain in the left anterior neck…

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