Initially, the case was managed by bed rest, hydration and steroidal therapy, but after 3 weeks of conservative treatment with limited benefit on the orthostatic headache, the SIH syndrome was successfully managed with the application of lumbar epidural blood patch (EBP) using approximately 28 mL of autologous blood, resulting in immediate relief of clinical symptoms.
Infectious mononucleosis was suspected, and the case was managed conservatively without antibiotics for 13 days after admission.
Nearly 75% of the cases were managed in non-affiliated university centre.
All the cases were managed as inpatients for a minimum of 5 weeks and followed up for at least 16 weeks after removal of pins.
In 60% of the cases, the treatment of choice was stereotactically guided aspiration, while 30% of the cases were managed through open craniotomy excision.
The former rate has been reported when the cases are managed by non-specialists and the latter when the cases are in the hands of highly experienced specialist surgeons.
Four hundred and seventy grade III IDC-NST, diagnosed between 1975 and 1991, were identified from the patient database at the Hedley Atkins/Imperial Cancer Research Fund Breast Pathology Laboratory, Guy's Hospital (London, UK), where all the cases were managed.
None of the cases were managed with medical treatments and, apart from the two hysteroscopic resections, no other minimally invasive non-surgical techniques (uterine artery embolization, magnetic resonance guided focused ultrasound) was employed.
"When (students are) shadowing me (it is possible) to model a sense of vocation…if my list has finished early and a colleague's is running late (as an example of teamwork) I'll take cases from him and do them for him so that (the cases) are managed appropriately and (promptly)".
(Student focus group 3) "When (students are) shadowing me (it is possible) to model a sense of vocation…if my list has finished early and a colleague's is running late (as an example of teamwork) I'll take cases from him and do them for him so that (the cases) are managed appropriately and (promptly)".
The three revised stories each reflected a different severity of croup and different healthcare experiences: the mild case was managed at home; the moderate case was seen in the ED and discharged home; and, the severe case was hospitalized for two days.
