Background: CT Head imaging for patients with altered mental status is a common procedure that many clinicians utilize to establish a diagnosis. As health care costs rise, practitioners are becoming more conscious about ordering costly imaging studies that are unlikely to change management. The purpose of the study is to determine when obtaining CT imaging [...]

Case Presentation: An 11 year old boy was admitted to the hospital due to 4 days of headache and vomiting. He described the pain as constant, sharp, occipital/frontal in location, and worse in the morning and overnight, specifically with laying down. Treatment with ibuprofen and acetaminophen had not provided relief. 6 months prior to this [...]

Case Presentation: A 5 year old boy presented with a 6 month history of headache (“my brain hurts”), vertigo, nausea and vomiting. No neurologic deficits noted on exam. MRI brain showed acute posterior circulation stroke involving the left cerebellar hemisphere and corpora medullaris. MRA head and neck were normal. Extensive work up evaluating for coagulopathic, [...]

Case Presentation: A 75-year-old male presented to our institution with lethargy and unremitting headache of several weeks duration. His history was significant for squamous cell carcinoma of the lung status post lobectomy with recurrence 4 years later being treated with palliative radiation, chronic obstructive pulmonary disease (COPD), and hypertension. He described his headache as daily, [...]

Case Presentation: Mr. M is a 66 year old man with a history of a kidney transplant and extensive coronary disease with a recent myocardial infarction and code blue arrest 2 months prior to admission. He presented to an outside facility with altered mental status and seizures attributed to severe hyponatremia (Na 115). The patient [...]

Case Presentation: A 41-year-old female with a history of hypertension, depression, and alcohol abuse presented to the emergency department with right facial swelling and pain after biting her cheek the previous night. The patient first noticed a small, unconcerning “red bump” on her cheek that was minimally painful earlier that morning. She was admitted to [...]

Case Presentation: Mr Z is a 54 year-old gentleman with no past medical history. He presented with chronic headache for 5 months that occurred daily, worst over the right frontal region, radiated down his neck, and was aggravated by neck movements. There was associated right ear tinnitus and hearing loss. He was evaluated 3 months [...]