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When reporting medication use, this patient initially left out that she had been taking Goody\u2019s powder (845 mg aspirin) for headaches, and long-term use led to metabolic encephalopathy. Despite a recent history of surgery, it is important to keep the differential diagnosis broad especially when there are signs of metabolic derangement.<\/jats:p>","DOI":"10.1136\/bcr-2017-222253","type":"journal-article","created":{"date-parts":[[2017,12,1]],"date-time":"2017-12-01T06:55:52Z","timestamp":1512111352000},"page":"bcr-2017-222253","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Unusual cause of encephalopathy after brain surgery"],"prefix":"10.1136","volume":"2017","author":[{"given":"Zayan","family":"Mahmooth","sequence":"first","affiliation":[{"name":"School of Medicine, Emory University, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7545-3069","authenticated-orcid":false,"given":"James G","family":"Malcolm","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Emory University, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy S","family":"Wetzel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Emory University, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faiz U","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Emory University, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,12,1]]},"reference":[{"key":"2025082701320453000_2017.nov30_2.bcr-2017-222253.1","doi-asserted-by":"publisher","DOI":"10.3810\/pgm.2009.07.2041"},{"key":"2025082701320453000_2017.nov30_2.bcr-2017-222253.2","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-003-0878-y"},{"key":"2025082701320453000_2017.nov30_2.bcr-2017-222253.3","unstructured":"Pakzaban P . Medscape. Chiari\u00a0malformation. 2016 http:\/\/emedicine.medscape.com\/article\/1483583-overview (cited 02 Feb 2017)."},{"key":"2025082701320453000_2017.nov30_2.bcr-2017-222253.4","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(83)90239-5"},{"key":"2025082701320453000_2017.nov30_2.bcr-2017-222253.5","doi-asserted-by":"crossref","first-page":"1536.e3","DOI":"10.1016\/j.ajem.2013.05.031","article-title":"Negative anion gap metabolic acidosis in salicylate overdose--a zebra!","volume":"31","author":"Kaul","year":"2013","journal-title":"Am J Emerg Med"},{"key":"2025082701320453000_2017.nov30_2.bcr-2017-222253.6","doi-asserted-by":"crossref","first-page":"1714.e3","DOI":"10.1016\/j.ajem.2015.03.042","article-title":"Normal anion gap salicylate poisoning","volume":"33","author":"Wright","year":"2015","journal-title":"Am J Emerg Med"},{"key":"2025082701320453000_2017.nov30_2.bcr-2017-222253.7","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1978.03630350019008"},{"key":"2025082701320453000_2017.nov30_2.bcr-2017-222253.8","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.neuro.2006.06.010","article-title":"Acute cerebral white matter damage in lethal salicylate intoxication","volume":"28","author":"Rauschka","year":"2007","journal-title":"Neurotoxicology"},{"key":"2025082701320453000_2017.nov30_2.bcr-2017-222253.9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1081\/CLT-120028740","article-title":"Position paper on urine alkalinization","volume":"42","author":"Proudfoot","year":"2004","journal-title":"J Toxicol Clin Toxicol"},{"key":"2025082701320453000_2017.nov30_2.bcr-2017-222253.10","unstructured":"Wax PM . Antidotes in Depth. In: Hoffman RS , Howland M , eds. Goldfrank\u2019s Toxicologic Emergencies. 10th edn. New York, NY: McGraw-Hill, 2015."},{"key":"2025082701320453000_2017.nov30_2.bcr-2017-222253.11","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.annemergmed.2015.03.031","article-title":"Extracorporeal treatment for salicylate poisoning: systematic review and recommendations from the EXTRIP workgroup","volume":"66","author":"Juurlink","year":"2015","journal-title":"Ann Emerg Med"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-222253","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T08:32:14Z","timestamp":1756283534000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-222253"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,1]]},"references-count":11,"alternative-id":["10.1136\/bcr-2017-222253"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-222253","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2017,12,1]]}}}