Journal of Clinical Case Reports

Mobile phone battery blast injury was a rare thing in the past, however with technological advancement it’s on the rise. It usually involves the hand, face, eyes though can involves others too. The manifestation of hand injuries due to cellphone battery explosion commonly occurs with thenar muscle injury, 1^st web split, dislocation of CMC joint of thumb and amputations of other digits.

Background: Cryptococcal meningitis is a major opportunistic infection in individuals with HIV. The worldwide annual incidence is estimated to be approximately one million cases per year, with the most significant burden in sub-Saharan Africa. HIV-associated cryptococcal meningitis continues to have a high mortality rate despite widespread availability and use of HAART.

Case: 36-year-old male with a past medical history of AIDS and a CD4 count of 35 cells/mm³ presented with altered mental status initially thought to be related to using crystalline methamphetamine as reported by EMS. However, a lumbar puncture performed in the emergency department showed elevated CSF opening pressure of 29 cm H₂O and positive CSF and serum cryptococcal antigen. The patient was admitted and commenced treatment according to the current IDSA guideline but continued to have waxing and waning mental status. On the fourth day of admission, he complained of headache, had a witnessed seizure, and was taken emergently for a CT scan of the brain, which was negative for any acute intracranial process. The patient was planned for a repeat lumbar puncture but suffered a cardiac arrest before it could be done. He was intubated and transferred to the intensive care unit. CT brain follow-up showed anoxic encephalopathy, development of marked cerebral edema, and complete effacement of the basilar cisterns, suggestive of downward transtentorial herniation; he continued to deteriorate and expired on the seventh day of admission.

Objectives: 1) Describe a case of brain death secondary to increased intracranial pressure due to cryptococcal meningitis in a patient with HIV/ AIDS. 2) Explain the mechanisms of elevation in intracranial pressure in patients with cryptococcal meningitis. 3) Discuss the options for managing elevated intracranial pressure in patients with cryptococcal meningitis. 4) Create awareness in the medical community about the importance of prompt and efficient management of increased intracranial pressure in patients with cryptococcal meningitis.

Conclusion: This case highlights the importance of aggressive management of elevated intracranial pressure in cryptococcal meningitis. It reiterates the need for more data regarding the optimal timing and frequency of therapeutic lumbar puncture and the use of temporary lumbar drainage catheters and ventriculostomy to manage this potentially fatal complication.

Biomarkers of Alzheimer’s disease (AD) and other neurodegenerative disorders are most exploring areas of clinical research in Geriatric Psychiatry. Presently neuroimaging, blood and CSF biomarkers are expensive and invasive to perform and are considered impractical for research purpose. The retinal presents a readily accessible tissue for monitoring the brain and could potentially be used in combination with or as a substitute for current AD and other neurodegenerative disease biomarkers. Data on retinal involvement in AD and neurodegenerative diseases have been controversial and inconsistent. So, we are reporting a case of Choroideremia with neuropsychiatric presentations and complications.

Intermaxillary Fixation (IMF) is a standard component of the treatment of maxillary and mandibular fractures. Several techniques have been described, most of which involve the placement of wires around teeth. However, these approaches are limited in the setting of poor dentition or in patients who are partially edentulous, can be time consuming, and are associated with risks of mucosal, dental, and needle stick injuries. Bone supported devices such as bone supported arch bars have been described, but may be limited to minimally displaced and favourable fractures and do not exert a tension band effect. An alternative is the use of titanium arch bars fitted with eyelets for locking screw fixation directly to the maxilla and mandible. This device combines features of arch bars and bone supported devices, potentially yielding the advantages of both. This is a case report to convey our experience of bone supported arch bar on patient with reduced mouth opening and poor accessibility.

Gastrointestinal glomus tumours are rare and almost always occur in the stomach. Up to now, only a very few cases have been reported in small intestine. Here, we present the ninth case of small intestinal glomus tumour in English literature. The 30-year-old female was referred to our hospital with chief complaints of melena and fatigue. Oral balloon-assisted enteroscopy revealed a 2.0*2.0 cm mass in the jejunum. Partial enterectomy was then performed and postoperative pathology reported a benign glomus tumour. No further melena was observed and also no malignant transformation or recurrence was detected after surgery. In conclusion, together with the literature review, small intestinal glomus tumour is an extremely rare cause of gastrointestinal hemorrhage. Early diagnosis and treatment are important to improve the prognosis since the potential risk of malignancy.