Cerebral Venous Thrombosis

Cerebral venous thrombosis (CVT) is a rare disorder involving occlusion of the venous sinus (most commonly superior sagittal and lateral sinuses) .  CVT is a very difficult diagnosis with a highly variable onset that may include visual, neurologic or even infectious like symptoms.  Predisposing factors include:

  • Cancer
  • Pregnancy
  • Local infections (otitis media, sinusitis, cellulitis)
  • Hypercoagulable states
  • Trauma
  • Drugs (ecstasy, androgens, OCPs)
  • Compression of venous sinus (tumor, abscess)

Suspect CVT in patients presenting with headache, signs of increased ICP, or focal neurologic deficits, especially if any of above predisposing factors are present.  Do not use a D-dimer to rule out CVT. The workup includes, an MRI and MRV unless there is a contraindication, then… Read more

Many new updates

We are always working to make bedside knowledge more accessible and quickly available for clinicians and healthcare providers in emergency settings for free.

We keep all content free because were realize how important information and knowledge sharing is to daily clinical practice and because our users are our patrons and keep everything running.Read more

The diagnosis formerly known as ALTE

The AAP has formally changed the name of ALTE to Brief Unexplained Event (BRUE). The definition has also been formalized with more specific criteria and suggestions to empower the clinician to base the diagnosis on their suspicion rather than relying only on the caregiver’s history.

BRUE is an event occurring in an infant <1 year of age when an observer reports a sudden, brief (<1 min), and now resolved episode of ≥1 of the following without explanation:

  • Cyanosis or pallor
  • Absent, decreased, or irregular breathing
  • Marked change in tone (hyper- or hypotonia)
  • Altered level of responsiveness
  • Must have returned to baseline
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UTox and cross reactivity

Many non illicit drugs cross react with common drugs screened on the traditional urine drug screen.

  • NSAIDs can cause false positive cannabinoid screens
  • Sertraline can cause a benzo false positive
  • Most benzodiazepine screens look for oxazepam which is a metabolite of diazepam and chlordiazepoxide. Therefore, lorazepam, alprazolam, and clonazepam are commonly missed.

What is the detection interval for marijuana on a UDS?Read more