Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0016199 (flank pain)
 2,189 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Aortic dissection is a frequently devastating diagnosis classically associated with severe chest pain.We present a case of painless aortic dissection with anterograde amnesia. An 84-year-old man was brought to the emergency department by ambulance, when his wife noted that he developed acute onset complete loss of short-term memory. Medical history was notable for a 4.5-cm fusiform thoracic aortic root aneurysm. On arrival,he denied pain or syncope.On examination, he was mildly hypotensive(110/59 mm Hg); and there were no murmurs, pulse deficits, or focal neurologic deficits. During his stay, he developed left flank pain. Chest radiography demonstrated subtle mediastinal widening and obscuration of the aortic knob compared with previous films. Computed tomography revealed an extensive intimal flap consistent with an aortic dissection involving the sinus of Valsalva and left renal artery. The patient subsequently developed acute onset chest pain after which he became unresponsive. Echocardiography demonstrated tamponade physiology.The family decided to transition to comfort care measures, and the patient died soon after.We identified 7 other cases in the literature of aortic dissection cases with presentations consistent with transient global amnesia,5 of which without neurologic deficits and 3 of which without pain. This case highlights the imperative of a thorough history and high index of suspicion for this catastrophic diagnosis in patients with transient global amnesia who otherwise might be expected to have an excellent prognosis and little need for diagnostic work-up.
 ...
PMID:A sinister cause of anterograde amnesia: painless aortic dissection. 2564 52

Transient global amnesia (TGA) is typified by an abrupt and transient anterograde amnesia, "with repetitive questioning and often variable retrograde amnesia persisting up to 24 hours." A 54-year-old male presented to our emergency department with paroxysms of left-sided flank pain, suggestive of renal colic. Computed tomography (CT) of the abdomen/pelvis revealed a three-millimeter left ureterovesicular-junction calculus. Pain control proved difficult, necessitating multiple doses of opioid and non-opioid analgesia. Subsequently, the patient developed repetitive questioning and perseveration with anterograde amnesia with a negative CT brain and unremarkable further workup. He experienced a complete resolution of symptoms within a 24-hour period, with a discharge diagnosis of TGA secondary to nephrolithiasis. This is the third case of TGA attributed to nephrolithiasis in the medical literature.
 ...
PMID:Temporary Memory Steal: Transient Global Amnesia Secondary to Nephrolithiasis. 3044 20