Adult Services, Cardiovascular, Case Study

Case study: Rapid diagnosis and treatment of rare giant cell myocarditis in cardiogenic shock

The patient   A 48-year-old male with a past medical history significant for malignant thymoma status post thymectomy and right lower lobe lobectomy, and myasthenia gravis, presented to Norton Women’s & Children’s Hospital emergency department with dyspnea on exertion (DOE). His CT was concerning for possible pulmonary embolism. His labs on this admission showed B-type natriuretic…

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Cardiovascular, Case Study, Pediatric Services

Case study: First in the region to place Impella RP Flex temporary ventricle support

The patient An 18-year-old male with a history of heart transplantation for cardiomyopathy after a durable ventricular assist device presented with progressive cardiac allograft vasculopathy (CAV) and severe diastolic graft failure. The patient presented to the cardiac intensive care unit after a recovered cardiac arrest in extremis with impending multiorgan failure. He initially underwent placement…

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Case Study, Neuroscience, Pediatric Services

Case study: Pediatric migraine patient with anxiety

Provider Team The patient The patient is a now 13-year-old girl with a history of anxiety and headaches dating back to approximately age 7, although she did not present to neurology until age 9. At that time, she was reporting approximately 15 out of 30 headache days per month and was meeting criteria for chronic…

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Adult Services, Case Study, Oncology/Hematology

Oropharyngeal cancer case study: Robotic-assisted tongue base resection

The patient A 75-year-old male presented with a left neck mass, referred by his community otolaryngologist. The patient reported a history of sleep apnea, cough and recurrent upper respiratory infections. Imaging and fine needle aspiration of the neck mass confirmed p16 positive squamous cell carcinoma (SCC). Positron emission tomography (PET)/CT demonstrated a hypermetabolic left level…

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Case Study, 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, Spine

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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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, 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, Case Study, Oncology/Hematology, 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, 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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