No abstract

Acute compartment syndrome after muscle rupture, although rare, is a limb threatening condition, which warrants emergency treatment. The case of acute compartment syndrome secondary to a gastrocnemius muscle tear of the right lower leg, in a non-athlete is reported. To our knowledge, this is the only description of acute compartment syndrome due to muscle rupture in a non-athlete. (J Accid Emerg Med 1999;16:377-378)

Of 269 consecutive patients entered into a preoperative assessment programme for possible surgical treatment of epilepsy, 33 had intracranial recording (SEEG) with combined subdural and depth electrodes for the purpose of localising a suspected temporal site of seizure onset. The findings in these patients are analysed with particular reference to: 1) the criteria of selection for SEEG and their validity; 2) information on SEEG compared with that obtained by less invasive means, including foramen ovale telemetry; 3) information on the use of intracerebral electrodes compared with subdural placements; 4) possible predictors of failure of localisation by SEEG and of surgical outcome. It was concluded that SEEG had usefully contributed to the management of 690/o of the patients in whom it was used, establishing a previously unidentified site of seizure onset in 33%, correcting an erroneous localisation in 15%, and establishing inoperability in 21% of patients. No predictors of failure of SEEG or of surgery emerged; thus there was no evidence of unnecessary use of this procedure. Five patients were found with incorrect lateralisation of seizure onset on foramen ovale recording (of a total of 192 foramen ovale telemetries). Localisation of the ictal onset zone either by the distribution of inter-ictal discharges or by the initial ictal changes at subdural electrodes was unreliable, confirming the need for ictal, depth recordings. (7 Neurol Neurosurg Psychiatry 1994;57:58-65)

We report two cases of ACE inhibitor-associated angioedema and critical airway compromise, where the use of a selective bradykinin 2 receptor blocker resulted in rapid symptom resolution and prevented intubation to protect the airway.

The risk factors affecting intracranial haemorrhage in warfariniised patients are described and an attempt made to calculate the risk of haemorrhage in warfarinised patients with minor head injuries. Using the data from studies of patients with spontaneous haemorrhage while taking warfarin, guidelines for treatment and given and the likely outcome predicted. (7Accid Emerg Med 1998;15:159-161)