We need to have a high index of suspicion for subdural hemorrhage (SDH) post-lumbar puncture in hematological patients given their increased risk and the significant morbidity and mortality associated with SDHs.

A high index of suspicion is required to pick up cases of subdural empyema in clinical practice. CT scan may be normal in the initial stages. Early neurosurgical intervention is desirable to reduce mortality and morbidity in this condition.

although imperforate hymen is a rare condition, it is the most common obstructive anomaly of the female genital tract. the early diagnosis of this condition requires a high index of suspicion in newborns and in females without a history of menarche. hydronephrosis is a known but rare complication of an imperforate hymen. hereby we preset 2 cases of premenstrual adolescent with urinary retention...

To cite: Nazarian S, Narayanan A, Chang S. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2015212239 DESCRIPTION Obturator herniae are a rare type of abdominal wall herniae, with an incidence of 0.7–1%. They have a high mortality rate of up to 40% due to strangulation, and patients often present with nonspecific symptoms. The clinical presentation varies, dependi...

BACKGROUND Niemann-Pick disease Type C (NP-C) is difficult to diagnose due to heterogeneous and nonspecific clinical presentation. The NP-C Suspicion Index (SI) was developed to identify patients with a high likelihood of NP-C; however, it was less reliable in patients aged <4 years. METHODS An early-onset NP-C SI was constructed following retrospective chart review of symptom presentation in...

Bleeding disorders can present at any age and vary in their severity. Haemophilia, which is characterised by its x-linked recessive inheritance, can present with a spontaneous mutation and therefore no family history will be evident. Three cases of trauma induced thigh haematomas as an initial presenting feature for people with haemophilia are discussed. The cases highlight the importance of a ...

Bladder pain syndrome is a subset of chronic pelvic and diagnosis exclusion. It can significantly reduce quality life requires clinicians to have high index suspicion provide prompt evidence-based multidisciplinary management patients prevent ongoing distress.

Given the fact that, in the ‘constricting differential . . . ’, the successful management hinged crucially on the identification of the constrictive component of pericarditis, the latter component typically characterized by marked elevation of the jugular venous pressure (JVP), it would be useful to know how elevated that parameter was in the subject of the case report. In one series, 75% of 62...

Sir, Notwithstanding the implication that a high clinical suspicion of tuberculosis should be a precondition for 'a request for acid fast bacilli and tuberculosis culture' in suspected (but not confirmed) malignant pleural effusion, 1 stigmata documented in malignant pleural effusion, such as the involvement of the entire hemithorax, 1 bilateral effusions, 2 lymphocyte predominance, 1,2 haemoth...