Open Access Case Report

Spontaneous Spinal Epidural Hematoma Presenting as Acute Paraplegia

Krishnan Balagopal, G. Sreekumar, Sanju M. Libu, Amalu Joy

Asian Journal of Case Reports in Medicine and Health, Page 13-17

Background: Spontaneous spinal epidural hematoma is a rare condition which can have disabling neurological complications. Prompt timely surgical management may promote recovery even in severe cases. Timely recognition and diagnosis is essential for proper treatment.

Objective: To describe a case of spontaneous spinal epidural hematoma with acute presentation which was treated surgically with good outcomes.

Presentation of Case: We report a 66-year-old man with a four hour history of sudden severe upper back pain, followed by complete weakness and numbness over the bilateral lower limbs. A spinal magnetic resonance imaging scan was performed and revealed a posterior epidural hematoma of the cervicothoracic spine. He underwent an emergency decompressive laminectomy of the spine and hematoma evacuation. Just after surgery, his lower extremity movements improved. After 4 weeks, significant improvement in weakness and ambulation with assistance was resumed. The diagnosis of spontaneous spinal epidural hematoma must be considered in patients presenting with acute onset of back pain along with symptoms of compression of the spinal cord. Early recognition of the problem, proper investigations and diagnosis and prompt surgical treatment may result in significant improvement even in severe cases.

Open Access Case Study

A Case Report on Diffuse Large B-cell Lymphoma of the Stomach

Tatevik Aloyan, Armen Gevorgyan, Anna Khachpanyan, Knkush Hakobyan, Anush Vahanyan

Asian Journal of Case Reports in Medicine and Health, Page 1-5

The purpose of this paper is to present a rare case of a young female who was diagnosed with gastric diffuse large B-cell lymphoma (DLBCL) and was successfully treated with concomitant eradication therapy and immunochemotherapy.

The importance of Helicobacter pylori (HP)-eradication therapy in various histological forms of gastric DLBCL and the potential to replace the immunochemotherapy or to be combined with it in selected patients remain the matter of further research.

Open Access Case Study

Pleural Effusion as Manifestation of IgG4 Related Disease

N. Kallel, N. Mahmoud, S. Charfi, N. Moussa, R. Gargouri, N. Bahloul, I. Yangui

Asian Journal of Case Reports in Medicine and Health, Page 6-12

Immunoglobulin G4-related disease is a very rare and little known sclerosing inflammatory disease. This pathology has been reported in various organs. Of these, there are only 9  reports describing pleuritis as IgG4-related disease with no other organ involevement. We report the original observation of an isolated pleural effusion as manifestation of IgG4 related disease in a 60-year-old woman. We suggest the possibility to includ IgG4 related disease in the differential diagnosis of unexplained pleuritis. Our observation is distinguished by the isolated nature of pleural involvement and the spontaneous regression of pleural effusion.

Open Access Case Study

Bilateral Sudden Sensorineural Hearing Loss Post-COVID-19 “A Case Report”

Sultan Mohammed Alanazy

Asian Journal of Case Reports in Medicine and Health, Page 18-22

Background: Sudden sensorineural hearing loss (SSNHL) is an otolaryngological emergency that requires early diagnosis and management. In most cases, the cause is unknown; however, viral infection is the most likely causative factor. The early start of steroids is a cornerstone of treatment and good prognosis. Despite the extensive study about the presentations of COVID-19, there are few case reports about hearing loss after coronavirus infection.

Case Presentation: This case report presents the first case of SSNHL following COVID-19 in Saudi Arabia for which other causes of hearing loss were excluded by physical examination and imaging. Course of steroid given to the patient without improvement in the hearing.

Conclusions: It is important to pay more attention to hearing status following COVID-19. This will result in early diagnosis, management and improved prognosis.

Open Access Case Study

Atypical Presentation of Myocardial Ischaemia as Referred Pain to Jaw in a Young Adult-A Case Report

H. T. D. W. Ariyarathne, S. R. Hulathduwa

Asian Journal of Case Reports in Medicine and Health, Page 23-28

Ischaemic Heart Disease (IHD) accounts for the highest mortality rate among the non-communicable diseases across the globe. In the developed countries the incidence of IHD has shown a slow decline over the past two decades. It is traditionally considered as a disease of the elderly though clinicians and pathologists experience more and more younger individuals getting affected by the condition since last few decades due to a variety of reasons. IHD has a variety of presentations some of which could lead to diagnostic difficulties unless due caution is exercised. Isolated referred pain to teeth, jaw or craniofacial region is one such rare presentation for which many theories have been put forward to explain the mechanism though none is conclusive. When a patient complains of an unusual pain in the craniofacial region or the jaw, the remote possibility of its cardiac origin should always be born in mind. Otherwise it could not only lead to unnecessary dental interventions but also it could unduly delay the diagnosis and treatment of a more serious health condition sometimes leading to severe morbidity or even death. This case illustrates a situation where a young male suffering from intermittent tooth pain/jaw pain for over a period of three months, seeking dental treatment including extractions and restorations from a qualified dental surgeon, suddenly collapsed and died at workplace after complaining of excruciating tooth-pain. The cause of death was established after meticulous post mortem examination as IHD due to coronary thrombosis.