Case Study, Heart, Pediatric Services

Leadless pacemaker allows pediatric athlete to continue competing

The patient A 15-year-old female with congenital complete heart block needed a pacemaker battery change or pacemaker update. Congenital complete heart block leads to interruption of electrical signals between the top chambers of the heart and the bottom chambers of the heart. This often causes clinically significant slow heart rates and eventually requires implantation of…

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Adult Services, Case Study, Neuroscience

Sciatic neuropathy case study: 4-centimeter tumor discovered on sciatic nerve

The patient A 64-year-old woman tripped after “missing a step,” fracturing her left tibial plateau and resulting in deformity of the joint. This was managed conservatively, with a leg brace removing weight from the extremity. She developed persistent numbness and tingling in her left leg, as well as weakness. She was evaluated in the Norton…

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Adult Services, Case Study, Neuroscience, Spine

Spinal tumor case study: Mass blocked 90% of canal

The patient A 27-year-old female presented with five months of progressive quadriparesis and paresthesias affecting both upper and lower extremities. She initially presented to her primary care provider five months prior, while eight months pregnant, with weakness, numbness and tingling in her right upper extremity. The symptoms initially were thought to be a result of…

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Adult Services, Case Study, Neuroscience

Mechanical thrombectomy for middle cerebral artery stroke leads to discharge 2 days later with NIH Stroke Scale score of 0

Incident details:   Date: 4/26/2022 Patient: Male Age: 66 Arrival to emergency department:11 a.m. Tom L. Yao, M.D., endovascular neurosurgeon, Norton Neuroscience Institute   Nadeem A. Talpur, M.D. stroke neurologist, Norton Neuroscience Institute   Richard Carlisle, M.D., emergency medicine physician, Norton Brownsboro Hospital Presenting complaint Confusion, comprehension deficit, slurred and garbled speech Emergency medical services…

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Cancer, Case Study, Pediatric Services

Case study: Shunt relieves pressure from arachnoid brain cyst, allowing boy to continue leukemia treatment

The patient A 4-year-old boy presented to the hospital with fever, fatigue and weakness. He also complained of blurry vision. He had recently had nose bleeds and oral bleeding. A complete blood count showed pancytopenia, as well as blasts on his peripheral smear. A bone marrow aspiration and biopsy were performed. He was diagnosed with…

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Case Study, Neuroscience, Pediatric Services

Super-refractory status epilepticus case study

The patient A 6-year-old girl was admitted to Norton Children’s Hospital on May 11, 2020, with uncontrolled seizures that progressed to status epilepticus. The challenge After maximal medical intervention, neurosurgery was consulted on June 12, 2020. Her electroencephalogram (EEG) showed a possible seizure focus in the left central and posterior regions, but her MRI showed…

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Adult Services, Cancer, Case Study, Orthopedics

Freezing giant cell tumor of bone: Case study

The patient A 25-year-old woman presented with recurrent left second metacarpal giant cell tumor of bone. She previously was treated with extensive curettage, bone graft substitute placement and Kirschner wire fixation. Giant cell tumor of bone is a benign aggressive tumor with a high rate of local recurrence and development of lung metastases in approximately…

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Case Study, Orthopedics, Pediatric Services

Idiopathic scoliosis case study: Magnetic growing rods

The patient A female age 5 years and 11 months presented for evaluation of spinal deformity and back pain in September 2020 from a pediatrician referral. X-rays showed a 53-degree scoliosis curve in the thoracic spine and 42 degrees in the lumbar spine. An MRI was ordered to look for any other spino-neural axis abnormalities….

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Adult Services, Case Study, Heart & Vascular

Case study: Treating protamine anaphylaxis in adult congenital heart disease patient

The patient A 33-year-old male presented with a history of a bicuspid aortic valve. He had previously undergone two aortic valve replacements. The patient first underwent aortic valve replacement in 2009 due to severe aortic insufficiency. A porcine valve was selected due to the patient’s status as a competitive football player. The patient’s recovery for…

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Case Study, Heart, Pediatric Services

Case study: Reversing Fontan-related liver disease in a preteen

The patient A 12-year-old boy born with double-inlet left ventricle (DILV), mitral stenosis, left-sided superior vena cava coronary sinus and pulmonary stenosis: The patient had been through surgical palliation as a baby, leaving him with Fontan circulation. The challenge Over the past decade we’ve learned that single-ventricle Fontan circulation has significant impacts on the heart…

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Case Study, Endocrinology, Pediatric Services

Diabetes mellitus case study: Yo-yo glucose in active teen

The patient A teenage male with Type 1 diabetes mellitus, who is very active in sports and physical activity: He was having extreme difficulty with blood glucose control. The challenge Patient’s blood glucose levels often were high before activity. Lows would occur during activity or after. Treatment of lows often would cause a rebound high…

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Adult Services, Brain Tumor, Case Study

Case study: Awake brain tumor resection helps preserve healthy tissue

The patient A 39-year-old nursing student initially presented with complaints of a two-year history of intermittent numbness in the tips of the middle and ring finger on her left hand. Over the past six months, she developed episodic numbness in the left face and twitching in the left eye. An MRI scan demonstrated a brain…

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