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1

Delayed traumatic intracranial hematoma  

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CT was performed serially within 24 hours after head injury in 64 patients having Glasgow Coma Scale of 14 or less or cranial fracture shown on roentgenogram. Delayed traumatic extradural hematoma was observed within 7-12 hours after head injury in 6 cases (9.4%). This was prominent in the frontal and occipital regions (67%). Good recovery was seen in 83.3%. Delayed traumatic intracerebral hematoma was observed within 6-24 hours after head injury in 17 cases (26.6%). This higher incidence was related to contre coup injury. Conservative treatment was possible in 14 of the 17 patients (82.4%), showing good recovery in 70%. (Namekawa, K.)

1984-01-01

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Delayed epidural hematoma after mild head injury  

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Background. Traumatic delayed epidural hematoma (DEH) can be defined as insignificant or not seen on the initial CT scan performed after a trauma but seen on the subsequent CT scan as a “massive” epidural bleeding. Case report. We presented two cases of traumatic DEH after mild head injury. Both patients were conscious and without neurological deficit on the admission. Initial CT scan did not reveal intracranial hematoma. Repeated CT scan, that was performed after neurological deteriorati...

Radulovi? Danilo; Janoševi? Vesna; Raki? Miodrag; ?urovi? Branko; Slavik Eugen; Laki?evi? Novak

2005-01-01

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Delayed epidural hematoma after mild head injury  

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Full Text Available Background. Traumatic delayed epidural hematoma (DEH can be defined as insignificant or not seen on the initial CT scan performed after a trauma but seen on the subsequent CT scan as a “massive” epidural bleeding. Case report. We presented two cases of traumatic DEH after mild head injury. Both patients were conscious and without neurological deficit on the admission. Initial CT scan did not reveal intracranial hematoma. Repeated CT scan, that was performed after neurological deterioration, revealed epidural hematoma in both cases. The patients were operated with a favorable surgical outcome. Conclusion. Traumatic DEH could occur in the patients with head injuries who were conscious on the admission with a normal initial CT scan finding. Early detection of DEH and an urgent surgical evacuation were essential for a good outcome.

Radulovi? Danilo

2005-01-01

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Delayed epidural hematoma demonstrated by computed tomography: case report.  

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A case of delayed visualization of an acute parietal epidural hematoma by computed tomography (CT) in a child is presented. The initial CT 21/2 hours after injury was negative. After neurological deterioration, a repeat CT scan 8 hours postinjury demonstrated a parietal epidural hematoma and a small cerebellar hematoma. The case demonstrates the need for a high level of vigilance in head trauma patients even in the face of an initially negative CT scan. PMID:7099397

Rappaport, Z H; Shaked, I; Tadmor, R

1982-04-01

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Delayed traumatic intracranial hematoma. In view of serial CT examinations  

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CT was performed serially within 24 hours after head injury in 64 patients having Glasgow Coma Scale of 14 or less or cranial fracture shown on roentgenogram. Delayed traumatic extradural hematoma was observed within 7-12 hours after head injury in 6 cases (9.4%). This was prominent in the frontal and occipital regions (67%). Good recovery was seen in 83.3%. Delayed traumatic intracerebral hematoma was observed within 6-24 hours after head injury in 17 cases (26.6%). This higher incidence was related to contre coup injury. Conservative treatment was possible in 14 of the 17 patients (82.4%), showing good recovery in 70%.

Tomita, Hiroki (Tokyo Medical and Dental Univ. (Japan). School of Medicine)

1984-03-01

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Delayed spinal extradural hematoma following thoracic spine surgery and resulting in paraplegia: a case report  

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Full Text Available Abstract Introduction Postoperative spinal extradural hematomas are rare. Most of the cases that have been reported occured within 3 days of surgery. Their occurrence in a delayed form, that is, more than 72 hours after surgery, is very rare. This case is being reported to enhance awareness of delayed postoperative spinal extradural hematomas. Case presentation We report a case of acute onset dorsal spinal extradural hematoma from a paraspinal muscular arterial bleed, producing paraplegia 72 hours following surgery for excision of a spinal cord tumor at T8 level. The triggering mechanism was an episode of violent twisting movement by the patient. Fresh blood in the postoperative drain tube provided suspicion of this complication. Emergency evacuation of the clot helped in regaining normal motor and sensory function. The need to avoid straining of the paraspinal muscles in the postoperative period is emphasized. Conclusion Most cases of postoperative spinal extradural hematomas occur as a result of venous bleeding. However, an arterial source of bleeding from paraspinal muscular branches causing extradural hematoma and subsequent neurological deficit is underreported. Undue straining of paraspinal muscles in the postoperative period after major spinal surgery should be avoided for at least a few days.

Parthiban Chandra JKB

2008-05-01

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[Case of renal subcapsular hematoma caused by flexible transurethral lithotripsy].  

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A 39-year-old man with macroscopic hematuria was admitted to our hospital. A stone, 5 mm in diameter was detected in the right ureteropelvic junction after abdominal computed tomography and plain abdominal radiography. We performed flexible transurethral lithotripsy (f-TUL) and crushed the stone and extracted almost all stone fragments without any complications. However, almost immediately after the operation, the patient began to complain about pain in the right back. In the results of abdominal plain computed tomography right renal subcapsular hematoma was detected. Because active bleeding was not observed in the results of enhanced computed tomography, only conservative treatment was performed. The patient was discharged from the hospital on day 11 of hospitalization. One month after the operation, plain computed tomography was performed and diminished subcapsular hematoma was detected. Renal subcapsular hematoma is assumed to be a unique complication of extracorporeal shock wave lithotripsy. This is the first report of a case of renal subcapsular hematoma caused by f-TUL. The onset of renal subcapsular hematoma following f-TUL could have been caused either because the laser fiber thrust into the renal lithiasis unintentionally or because the internal pressure of the renal pelvis increased substantially during the operation. PMID:24113753

Watanabe, Ryuta; Inada, Kouji; Azuma, Kouji; Yamashita, Yokihiko; Oka, Akihiro

2013-09-01

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Axillary artery injury combined with delayed brachial plexus palsy due to compressive hematoma in a young patient: a case report  

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Abstract Introduction Axillary artery injury in the shoulder region following blunt trauma without association with either shoulder dislocation or fracture of the humeral neck has been previously reported. Axillary artery injury might also be accompanied with brachial plexus injury. However, delayed onset of brachial plexus palsy caused by a compressive hematoma associated with axillary injury after blunt trauma in the shoulder region has been rarely reported. In previous rep...

Murata Keiichi; Maeda Manabu; Yoshida Atsushi; Yajima Hiroshi; Okuchi Kazuo

2008-01-01

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HEMATOMA SUBCAPSULAR HEPATICO POR FASCIOLASIS HEPATIC SUBCAPSULAR HEMATOMA CAUSED BY FASCIOLIASIS  

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Full Text Available La fasciolasis hepática es una zoonosis mundialmente difundida, sobre todo en los países productores de ganado; causada por la fasciola hepática. Se manifiesta por dolor abdominal, fiebre, náuseas y vómitos, baja de peso, diarrea, palidez, malestar general e hipereosinofilia. El diagnóstico es inmunológico y también puede hacerse por recuento de huevos en heces. El hematoma subcapsular e intraparenquimatoso hepático es una complicación rara de la fasciolasis humana pero se debe tener un alto índice de sospecha uniendo epidemiología, clínica, laboratorio e imaginologia para un adecuado diagnóstico y tratamiento. El propósito de reportar estos casos es dar a conocer una patología poco frecuente en la literatura, con una casuística de cuatro pacientes tratados en el lapso de dos años, todos referidos del Departamento de Cajamarca: Hepatic fasciolasis is a worldwide spread zoonoses mainly affecting cattle-raising countries. It is caused by the trematode Fasciola hepática and it is characterized by abdominal pain, fever, nausea and vomitus, weight loss, diahrrea, paleness, general malaise, and hypereosinophilia. Immunological diagnosis as well as stool eggs count may be performed. Hepatic subcapsular and intraparenchymatous hematoma is an infrequent complication of human fascioliasis. Nevertheless, for establishing a proper diagnosis and treatment, any suspicion of its presence must be carefully discarded through, clinical epidemiology, laboratory and imaging exams and procedures. The aim of this study is to expand knowledge on this unfrequently dealt pathology in medical literature by presenting four case reports related to patients undergoing a two-year treatment. All of them had been referred from Departamento de Cajamarca, Peru

Humberto Rosas L

2008-01-01

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HEMATOMA SUBCAPSULAR HEPATICO POR FASCIOLASIS / HEPATIC SUBCAPSULAR HEMATOMA CAUSED BY FASCIOLIASIS  

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Full Text Available SciELO Chile | Language: Spanish Abstract in spanish La fasciolasis hepática es una zoonosis mundialmente difundida, sobre todo en los países productores de ganado; causada por la fasciola hepática. Se manifiesta por dolor abdominal, fiebre, náuseas y vómitos, baja de peso, diarrea, palidez, malestar general e hipereosinofilia. El diagnóstico es inmun [...] ológico y también puede hacerse por recuento de huevos en heces. El hematoma subcapsular e intraparenquimatoso hepático es una complicación rara de la fasciolasis humana pero se debe tener un alto índice de sospecha uniendo epidemiología, clínica, laboratorio e imaginologia para un adecuado diagnóstico y tratamiento. El propósito de reportar estos casos es dar a conocer una patología poco frecuente en la literatura, con una casuística de cuatro pacientes tratados en el lapso de dos años, todos referidos del Departamento de Cajamarca Abstract in english : Hepatic fasciolasis is a worldwide spread zoonoses mainly affecting cattle-raising countries. It is caused by the trematode Fasciola hepática and it is characterized by abdominal pain, fever, nausea and vomitus, weight loss, diahrrea, paleness, general malaise, and hypereosinophilia. Immunological [...] diagnosis as well as stool eggs count may be performed. Hepatic subcapsular and intraparenchymatous hematoma is an infrequent complication of human fascioliasis. Nevertheless, for establishing a proper diagnosis and treatment, any suspicion of its presence must be carefully discarded through, clinical epidemiology, laboratory and imaging exams and procedures. The aim of this study is to expand knowledge on this unfrequently dealt pathology in medical literature by presenting four case reports related to patients undergoing a two-year treatment. All of them had been referred from Departamento de Cajamarca, Peru

Humberto, Rosas L; Carlos, Fiestas F; Richard, Torres M; Giorgio, Aita C; David, Lozada M.

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Expanding hematoma of the abdominal walI caused by spontaneous rupture of a deep circumflex iliac artery: report of a case treated by coil embolization  

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Abdominal wall hematoma is a rare but well-known disease, usually caused by trauma or, on rare occasions, occurring spontaneously. Hematomas of the rectus sheath and the anterolateral abdominal wall are commonly associated with injury to the inferior epigastric artery and the deep circumflex iliac artery, respectively. The diagnosis of spontaneously developed abdominal wall hematoma is sometimes delayed, due its clinical manifestations being similar to those of other causes of the acute abdomen. CT and angiography can be helpful in the diagnosis of the hematoma and the injured vessel. Herein, we report on a rare case of a spontaneously developed anterolateral abdominal wall hematoma treated with microcoil embolization of the left deep circumflex iliac artery.

Baik, Jun Hyun; Park, Young Ha; Jeon, Jung Soo; Hwang, Sung Soo; Ihn, Yon Kwon [College of Medicine, The Catholic Univ. of Korea, Seoul (Korea, Republic of)

2004-06-01

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Axillary artery injury combined with delayed brachial plexus palsy due to compressive hematoma in a young patient: a case report  

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Full Text Available Abstract Introduction Axillary artery injury in the shoulder region following blunt trauma without association with either shoulder dislocation or fracture of the humeral neck has been previously reported. Axillary artery injury might also be accompanied with brachial plexus injury. However, delayed onset of brachial plexus palsy caused by a compressive hematoma associated with axillary injury after blunt trauma in the shoulder region has been rarely reported. In previous reports, this condition only occurred in old patients with sclerotic vessels. We present a case of a young patient who suffered axillary artery injury associated with brachial plexus palsy that occurred tardily due to compressive hematoma after blunt trauma in the shoulder region without association of either shoulder dislocation or humeral neck fracture. Case presentation A 16-year-old male injured his right shoulder in a motorbike accident. On initial physical evaluation, the pulses on the radial and ulnar arteries in the affected arm were palpable. Paralysis developed later from 2 days after the injury. Functions in the right arm became significantly impaired. Angiography showed complete occlusion of the axillary artery. Magnetic resonance imaging demonstrated a mass measuring 4 × 5 cm that was suspected to be a hematoma compressing the brachial plexus in a space between the subscapular muscle and the pectoralis minor muscle. Surgery was performed on the third day after injury. In intraoperative observations, the axillary artery was occluded with thrombus along 5 cm; a subscapular artery was ruptured; the brachial plexus was compressed by the hematoma. After evacuation of the hematoma, neurolysis of the brachial plexus, and revascularization of the axillary artery, the patient had an excellent functional recovery of the affected upper limb, postoperatively. Conclusion Surgeons should be aware that axillary artery injuries may even occur in young people after severe blunt trauma in the shoulder region and can be associated with secondary brachial plexus injury due to a hematoma. For treatment in cases with progressive nervous deficit after trauma, not only reconstruction of the injured artery but also immediate evacuation of the hematoma, and exploration of the brachial plexus are necessary to avoid irreversible neurological damage.

Yajima Hiroshi

2008-03-01

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Hematoma subcapsular por Fasciolasis / Liver subcapsular hematoma caused by Fasciola hepática. Report of one case  

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Full Text Available SciELO Chile | Language: Spanish Abstract in spanish Presentamos el caso de una paciente de sexo femenino de 60 años de edad, ingresada en nuestro centro hospitalario por cuadro agudo de dolor abdominal en hipocondrio derecho asociado a vómitos y fiebre. Destaca la presencia de leucocitosis con eosinofilia de 56%. La tomografía computanzada abdominal [...] muestra una colección subcapsular hepática. Durante su evolución presenta abdomen agudo, realizándose una laparoscopía exploratoria que confirma un hematoma subcapsular con presencia de hemopentoneo de escasa cuantía. La serología confirma infección por fasciola hepática. Se realizó su tratamiento con triclabendazol en monodosis. Además, realizamos una revisión de la literatura nacional e internacional sobre el tema, sus manifestaciones clínicas, métodos diagnósticos y tratamiento. Abstract in english We report a 60 years oíd female admitted for pain in the right upper quadrant of the abdomen, vomiting and fever. Initial laboratory showed leukocytosis with 56% of eosinophils. An abdominal CAT sean showed a subcapsular fluid collection in the liver. The patient was operated and the presence of a s [...] ubcapsular hematoma was confirmed. Blood serological tests were positive for Fasciola hepática. The patient was treated with tricabendazole and after one year of follow up, is in good conditions.

MORALES G, JUAN L; ARRIAGADA H, RENATO; SALAS G, LUIS; MORALES A, CARLOS; FUENTES A, FELIPE; SANTANA, ROBERTO.

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A rare cause of duodenal obstruction: Intramural hematoma  

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Full Text Available Small bowel obstruction due to intramural hematoma secondary to anticoagulant therapy is a rare complication. Other risk factors include hemophilia, idiopathic thrombocytopenic purpura, leukemia, lymphoma, myeloma, chemotherapy, vasculitis, pancreatitis, and pancreatic cancer. The presentation of patients is usually with abdominal pain, nause and vomiting. The patients who were admitted to the emergency clinic with acute abdominal pain and had a history of anticoagulant use with prolonged international normalized ratios should alert to search for intraabdominal hematoma. Herein, we present a patient who was admitted to the emergency clinic with acute abdominal pain, severe nausea and vomiting, and diagnosed by abdominal computed tomography. [Cukurova Med J 2014; 39(3.000: 650-653

Gokcen Coban

2014-06-01

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Intramuscular Hematomas Caused by Anticoagulant Therapy: Is Advanced  

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Full Text Available Oral anticoagulant therapy (OAT is very effective in the prevention of cerebralembolism, especially in certain cardiac diseases. Hematomas are the majorcomplication of OAT. It may threaten the patient’s life by bleeding into the vitalstructures. Herein, we describe four patients with hematomas in the psoas,quadriceps, pectoral, or rectus abdominis muscles accompanied by anemiaduring warfarin therapy for atrial fibrillation and artificial heart valves. Computedtomography and magnetic resonance imaging helped us establish a definitivediagnosis in each case. Our patients were three women and one man. Theirinternational normalized ratios were within the therapeutic range during thisperiod. They suffered from minor traumas, such as falls or a hit while takingwarfarin therapy. All anticoagulation treatments were discontinued for approximately1 week after the episode of bleeding. Although conservative managementwas sufficient for three patients, one patient had surgical decompression due toa rectus abdominis hematoma with retroperitoneal hemorrhage. There were noepisodes of bleeding or other complications after starting oral anticoagulanttherapy during the follow-up. The common aspects of our cases were older ageand a history of minor trauma. As a result, we suggest that special attentionneeds to be paid to the patients under anticoagulant therapy, especially those atan advanced age, and to warn them avoid trauma. (Archives of Neuropsychiatry2010; 47: 267-70

Nilgün ÇINAR

2010-09-01

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Hematoma retroperitoneal de causa infrecuente: A propósito de un caso Retroperitoneal hematoma of unusual cause: A case report  

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Full Text Available El hematoma retroperitoneal espontáneo (HRE se define como una colección hemática espontánea, situada en cualquiera de los compartimentos retroperitoneales. Dentro de las causas más frecuentes se encuentran las roturas de aneurisma de aorta abdominal, tumores renales y suprarrenales, entre otras. Habitualmente es difícil realizar el diagnóstico al ingreso del paciente, ya que la presentación clínica es variable y puede simular otros cuadros de dolor abdominal o lumbar. Las técnicas de imagen, especialmente la angiografía, tomografía computada y resonancia magnética, son una herramienta fundamental en el diagnóstico y manejo oportuno del cuadro. Presentamos el caso de un varón de 56 años de edad con diagnóstico de VIH en tratamiento, que debutó como un cuadro de dolor y masa abdominal palpable. Luego de un acabado estudio de imágenes, se diagnosticó un HRE cuyo estudio histológico reveló un Linfoma de Burkitt.The spontaneous retroperitoneal hematoma (SRH is defined as a spontaneous hematic collection located in any of the retroperitoneal compartments. The most frequently encountered cause of retroperitoneal hemorrhage is a ruptured abdominal aortic aneurysm, followed by renal and adrenal tumors, along with some other less common causes. Performing accurate diagnosis of patients at admission has proven to be difficult, given that the clinical presentation is ample and variable and may mimic other pictures of abdominal or lower back pain. Imaging techniques, mainly angiography, computed tomography, and MR Imaging, represent a fundamental tool for both timely diagnosis and proper management of the condition. We report the case of a 56-year-old male patient with diagnosis of HIV, who presented with a history of abdominal pain and palpable abdominal mass. After a thorough imaging evaluation, patient was diagnosed with retroperitoneal hematoma, whose histological analysis revealed a Burkitt lymphoma.

Daniel Álvarez G

2012-01-01

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Hematoma retroperitoneal de causa infrecuente: A propósito de un caso / Retroperitoneal hematoma of unusual cause: A case report  

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Full Text Available SciELO Chile | Language: Spanish Abstract in spanish El hematoma retroperitoneal espontáneo (HRE) se define como una colección hemática espontánea, situada en cualquiera de los compartimentos retroperitoneales. Dentro de las causas más frecuentes se encuentran las roturas de aneurisma de aorta abdominal, tumores renales y suprarrenales, entre otras. H [...] abitualmente es difícil realizar el diagnóstico al ingreso del paciente, ya que la presentación clínica es variable y puede simular otros cuadros de dolor abdominal o lumbar. Las técnicas de imagen, especialmente la angiografía, tomografía computada y resonancia magnética, son una herramienta fundamental en el diagnóstico y manejo oportuno del cuadro. Presentamos el caso de un varón de 56 años de edad con diagnóstico de VIH en tratamiento, que debutó como un cuadro de dolor y masa abdominal palpable. Luego de un acabado estudio de imágenes, se diagnosticó un HRE cuyo estudio histológico reveló un Linfoma de Burkitt. Abstract in english The spontaneous retroperitoneal hematoma (SRH) is defined as a spontaneous hematic collection located in any of the retroperitoneal compartments. The most frequently encountered cause of retroperitoneal hemorrhage is a ruptured abdominal aortic aneurysm, followed by renal and adrenal tumors, along w [...] ith some other less common causes. Performing accurate diagnosis of patients at admission has proven to be difficult, given that the clinical presentation is ample and variable and may mimic other pictures of abdominal or lower back pain. Imaging techniques, mainly angiography, computed tomography, and MR Imaging, represent a fundamental tool for both timely diagnosis and proper management of the condition. We report the case of a 56-year-old male patient with diagnosis of HIV, who presented with a history of abdominal pain and palpable abdominal mass. After a thorough imaging evaluation, patient was diagnosed with retroperitoneal hematoma, whose histological analysis revealed a Burkitt lymphoma.

Daniel, Álvarez G; Giancarlo, Schiappacasse F; Marcelo, Castro S; Jeannie, Slater M.

18

An oblique muscle hematoma as a rare cause of severe abdominal pain: a case report  

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Full Text Available Abstract Background Abdominal wall hematomas are an uncommon cause of acute abdominal pain and are often misdiagnosed. They are more common in elderly individuals, particularly in those under anticoagulant therapy. Most abdominal wall hematomas occur in the rectus sheath, and hematomas within the oblique muscle are very rare and are poorly described in the literature. Here we report the case of an oblique muscle hematoma in a middle-aged patient who was not under anticoagulant therapy. Case presentation A 42-year-old Japanese man presented with a painful, enlarging, lateral abdominal wall mass, which appeared after playing baseball. Abdominal computed tomography and ultrasonography showed a large soft tissue mass located in the patient’s left internal oblique muscle. A diagnosis of a lateral oblique muscle hematoma was made and the patient was treated conservatively. Conclusion Physicians should consider an oblique muscle hematoma during the initial differential diagnosis of pain in the lateral abdominal wall even in the absence of anticoagulant therapy or trauma.

Shimodaira Masanori

2013-01-01

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Pathophysiological study of chronic subdural hematoma and communicating hydrocephalus with delayed MRI using Gd-DTPA (Magnevist)  

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Concerning the pathophysiology of chronic subdural hematoma and communicating hydrocephalus, recent studies have been made, but no definitive conclusion has yet been attained. To study their complicated mechanisms, we examined a delayed MRI which was performed 4 hours after the intravenous injection of Gd-diethylenetriaminepentaacetic acid (Gd-DTPA) on 5 cases of subdural hygroma, 3 cases of chronic subdural hematoma after irrigation, one case of hydrocephalus with glioblastoma, and one case of Parkinson syndrome. In every case of subdural hygroma, it was certified that Gd-DTPA was leaked into the cavity of the subdural space. This is perhaps because the outer and inner membranes of the subdural hygroma consist of fibroblasts and of capillary vessels with fenestration; the leakage of blood composition through this fenestration may promote the growth of the membrane and the cavity. The leakage of Gd-DTPA decreased after irrigation, and it did not recur. In the case of hydrocephalus with gioblastoma, there was leakage of Gd-DTPA into the ventricles surrounding the tumor. This may be because of the destruction of the blood-cerebrospinal fluid barrier; perhaps this is associated with the cause of the communicating hydrocephalus. (author).

Shinoura, Nobusada; Kondo, Tatsuya; Yamakawa, Kenta; Makiuchi, Tsuneo; Fujii, Kyoichi; Yoshioka, Masumi (National Medical Center of Hospital, Tokyo (Japan))

1991-06-01

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Pathophysiological study of chronic subdural hematoma and communicating hydrocephalus with delayed MRI using Gd-DTPA (Magnevist)  

International Nuclear Information System (INIS)

Concerning the pathophysiology of chronic subdural hematoma and communicating hydrocephalus, recent studies have been made, but no definitive conclusion has yet been attained. To study their complicated mechanisms, we examined a delayed MRI which was performed 4 hours after the intravenous injection of Gd-diethylenetriaminepentaacetic acid (Gd-DTPA) on 5 cases of subdural hygroma, 3 cases of chronic subdural hematoma after irrigation, one case of hydrocephalus with glioblastoma, and one case of Parkinson syndrome. In every case of subdural hygroma, it was certified that Gd-DTPA was leaked into the cavity of the subdural space. This is perhaps because the outer and inner membranes of the subdural hygroma consist of fibroblasts and of capillary vessels with fenestration; the leakage of blood composition through this fenestration may promote the growth of the membrane and the cavity. The leakage of Gd-DTPA decreased after irrigation, and it did not recur. In the case of hydrocephalus with gioblastoma, there was leakage of Gd-DTPA into the ventricles surrounding the tumor. This may be because of the destruction of the blood-cerebrospinal fluid barrier; perhaps this is associated with the cause of the communicating hydrocephalus. (author)

1991-01-01

 
 
 
 
21

Re-estimation of acute subdural hematoma in children caused by trivial household head trauma  

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The objective of this study was to identify characteristics of acute subdural hematoma in children caused by a trivial household head trauma from a modem neurosurgical and medicolegal standpoint. We performed a retrospective study of 25 children younger than 48 months hospitalized for acute subdural hematoma from December 1, 1993, through February 28, 2003. Inclusion criteria were as follows: acute subdural hematoma caused by trivial household trauma and a history of trauma corroborated by a caretaker, absence of physical injuries consistent with child abuse, fundoscopic examinations performed by a pediatric ophthalmologist, absence of fractures on general bone survey, and child abuse ruled out by long-term follow-up (more than 5 years). Twenty-one of the patients were boys, and 4 were girls. The patients ranged in age from 6 to 17 months, with an average age of 8.5 months. In 17 of 25 patients trauma had been caused by falls to the floor while standing with support or while sitting. Most of the patients were admitted to the hospital because of generalized convulsions or seizures that had developed soon after a trivial household trauma. Fifteen of the 25 (60%) patients had retinal or preretinal hemorrhage and 9 patients had bilateral retinal hemorrhage. Computed tomography showed fluid-type acute subdural hematomas at the frontal convexity or in the interhemispheric fissure in 18 of 25 (72%) patients. Fourteen of 25 (56%) patients had pre-existing external hydrocephalus (enlargements of the subarachnoid space). The long-term outcomes included normal mental development (IQ?80) in 18 cases, mild mental retardation (IQ<80) in 7 cases, and epilepsy in 3 cases. Acute subdural hematoma in children caused by trivial household trauma is a clinical entity distinct from acute subdural hematoma caused by child abuse or shaken-baby syndrome. (author)

2006-06-01

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Post lumbar puncture spinal subarachnoid hematoma causing paraplegia : a short report.  

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Full Text Available A 53 year old male underwent total excision of a large sphenoidal wing meningioma. Patient was treated with cephalosporins and phenytoin for postoperative meningitis. Three weeks after surgery, a follow up lumbar puncture was done. The patient became paraplegic over a few hours. Imaging of the dorsolumbar spine and other investigations demonstrated a large intraspinal hematoma caused by thrombocytopenia which was probably drug induced. After normalising the platelet count surgical evacuation of the spinal subarachnoid hematoma was done. Relevant literature is reviewed.

Pai S

2002-07-01

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Retroperitoneal hematoma compressing a single functioning kidney: an unusual cause of obstructive renal failure.  

Science.gov (United States)

We report a case of a retroperitoneal hematoma occurring in a patient under anticoagulation therapy for deep-venous thrombosis and presenting as an anuric acute renal failure. A coexisting polycythemia vera led to misdiagnosis that could have been life-threatening. A woman, known for polycythemia vera and a single functioning right kidney, was admitted with mild abdominal pain in a context of recent deep venous thrombosis under low-molecular weight heparin. Clinical examination revealed hepatomegaly associated with polycythemia vera. Biochemical evaluation disclosed an acute renal failure, and renal ultrasonography showed no dilation of the renal pelvis. Retroperitoneal hematoma resulted in shock, progressive anemia and obstructive renal failure, related to renal pelvic compression. A right renal indwelling catheter was introduced to restore urine flow after one hemodialysis session, and an inferior vena cava filter was placed because of anti-coagulation contra-indication. However, pulmonary embolism occurred, so that oral anticoagulants were introduced. The hematoma resorbed spontaneously, and a year after this episode, the patient is still alive and well. Retroperitoneal hematoma is a rare cause of obstructive acute renal failure and a life-threatening complication of anti-coagulation therapy. PMID:17542341

Monge, M; Vaida, I; Modeliar, S S; Solanilla, A; Airapetian, N; Presne, C; Makdassi, R; Fournier, A; Choukroun, G

2007-05-01

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Hematoma and abscess formation caused by Mycoplasma hominis following cesarean section  

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Full Text Available Hisato Koshiba1,2, Akemi Koshiba1,2, Yasushi Daimon3, Toshifumi Noguchi1,2, Kazuhiro Iwasaku2, Jo Kitawaki21Department of Obstetrics and Gynecology, Kyoto Prefectural Yosanoumi Hospital, Kyoto, Japan; 2Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan; 3Department of Clinical Laboratory, Kyoto Prefectural Yosanoumi Hospital, Kyoto, JapanAbstract: Mycoplasma species cannot be identified by routine bacteriological culture methods and are resistant to common antimicrobial agents. Mycoplasma hominis usually colonizes the lower urogenital tract and causes pyelonephritis, pelvic inflammatory disease, chorioamnionitis, rupture of fetal membranes, preterm labor, postpartum fever, postabortal fever, and neonatal infection. This organism is highly prevalent in cervicovaginal cultures of sexually active women. M. hominis, M. genitalis, Ureaplasma urealyticum, and U. parvum may invade and infect placental and fetal tissues, leading to adverse pregnancy outcomes. M. hominis occasionally causes nongenitourinary infection of the blood, wounds, central nervous system, joints, or respiratory tract. We present a case of a 27-year-old woman who developed abdominal wound hematoma and abscess after cesarean section. The wound was drained, but her high fever persisted, in spite of antibiotic treatment using flomoxef sodium and imipenem•cilastatin sodium. Because the exudate exhibited M. hominis growth in an anaerobic environment, we administered the quinolone ciprofloxacin. This therapy resolved her fever, and her white blood cell count and C-reactive protein level diminished to the normal ranges. To our knowledge, there are four published articles regarding the isolation of M. hominis from postcesarean incisions. Based on the current study and the literature, infection by this pathogen may cause hematoma formation with or without abscess after cesarean section or in immunosuppressed postoperative patients. In such cases, physicians may need to suspect Mycoplasma infection and initiate appropriate antibacterial treatment as soon as possible in order to avoid persistent fever.Keywords: Mycoplasma hominis, cesarean section, hematoma, abscess

Hisato Koshiba, Akemi Koshiba

2011-01-01

25

MR imaging of hyperacute intracranial hematomas  

International Nuclear Information System (INIS)

A modification of the gradient-recalled-echo (GRE) pulse sequence, which we called hematoma sensitive GRE, was compared with CT and spin-echo (SE) MR images for patients suffering from parenchymal hemorrhage in the hyperacute stage (within 6 hours). In the hyperacute stage, CT was most sensitive to hematoma, and hematomas were visualized more clearly on GRE than SE. Hematomas and the surrounding tissues were almost isointense relative to white matter on T1-weighted images (WI), and hyperintense on T2-WI of SE. But they were visualized at different intensity from each other on GRE. Hematomas were hyperintense including hypointensity, and plasma was more hyperintense (similar to cerebrospinal fluid), and edematous tissue was slightly hyperintense relative to white matter. The changes of tissue surrounding hematoma were not detected on CT. Hematomas were iso- or hyperintense on SE in the acue stage, and were slightly hyperintense including hypointense areas with a surrounding hypointense rim on GRE. The change of intensity of hematoma was delayed on GRE compared to SE. This phenomenon was caused by lack of sensitivity to the intracellular methemoglobin. Thus it is possible to visualize the contents of hematoma on GRE in the acute stage. (author)

1990-01-01

26

Spontaneous Rectus Sheath Hematoma  

Directory of Open Access Journals (Sweden)

Full Text Available Abdominal wall pathology is a frequently overlooked cause of acute abdomen. Increasing use of antiplatelet and anticoagulant therapies has led to an increase in the incidence of spontaneous rectus sheath hematoma (RSH. A high index of suspicion is needed for diagnosis as it can closely mimic other causes of acute abdomen. Herein, we report a case of RSH presenting with abdominal pain in which there was a significant delay in diagnosis. We wish to highlight the need to increase awareness among primary and emergency physicians about considering RSH in the initial differential diagnoses of abdominal pain. [West J Emerg Med. 2010; 11(1:76-79].

Alla, Venkata M

2010-02-01

27

Hemiparesis Caused by Cervical Spontaneous Spinal Epidural Hematoma: A Report of 3 Cases  

Science.gov (United States)

We report three cases of spontaneous spinal epidural hematoma (SSEH) with hemiparesis. The first patient was a 73-year-old woman who presented with left hemiparesis, neck pain, and left shoulder pain. A cervical MRI scan revealed a left posterolateral epidural hematoma at the C3–C6 level. The condition of the patient improved after laminectomy and evacuation of the epidural hematoma. The second patient was a 62-year-old man who presented with right hemiparesis and neck pain. A cervical MRI scan revealed a right posterolateral dominant epidural hematoma at the C6-T1 level. The condition of the patient improved after laminectomy and evacuation of the epidural hematoma. The third patient was a 60-year-old woman who presented with left hemiparesis and neck pain. A cervical MRI scan revealed a left posterolateral epidural hematoma at the C2–C4 level. The condition of the patient improved with conservative treatment. The classical clinical presentation of SSEH is acute onset of severe irradiating back pain followed by progression to paralysis, whereas SSEH with hemiparesis is less common. Our cases suggest that acute cervical spinal epidural hematoma should be considered as a differential diagnosis in patients presenting with clinical symptoms of sudden neck pain and radicular pain with progression to hemiparesis.

Nakanishi, Kinya; Nakano, Naoki; Uchiyama, Takuya; Kato, Amami

2011-01-01

28

Hemiparesis Caused by Cervical Spontaneous Spinal Epidural Hematoma: A Report of 3 Cases  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We report three cases of spontaneous spinal epidural hematoma (SSEH) with hemiparesis. The first patient was a 73-year-old woman who presented with left hemiparesis, neck pain, and left shoulder pain. A cervical MRI scan revealed a left posterolateral epidural hematoma at the C3–C6 level. The condition of the patient improved after laminectomy and evacuation of the epidural hematoma. The second patient was a 62-year-old man who presented with right hemiparesis and neck pain. A cervical MRI ...

Nakanishi, Kinya; Nakano, Naoki; Uchiyama, Takuya; Kato, Amami

2011-01-01

29

Hematoma espinal / Spinal hematoma  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish El hematoma epidural espinal es un hallazgo poco frecuente en la práctica médica. Se presenta un caso de una paciente portadora en la región dorsal, donde su forma de presentación también se consideró muy inhabitual y confusa; esta debutó con un dolor precordial con irradiación del brazo izquierdo, [...] la espalda y el estómago, instaurándose después una mielitis transversa dorsal. Se presenta el resultado de la resonancia magnética nuclear dorsal, con consideraciones diagnósticas de los diferentes tipos de hematomas espinales. Se realizó una laminectomía desde D3 a D6 y se evacuó un extenso hematoma epidural desde D1 a D8. Abstract in english Epidural spinal hematoma is an infrequent finding in medical practice. A case of a female patient suffering from a pain in the dorsal region, with its way of presentation was also considered as an unusual and confuse occurrence; it started with precordial pain irradiating left arm, back and stomach, [...] establishing a dorsal transverse myelitis. The result of a nuclear magnetic resonance is presented with diagnostic considerations of different types of spinal hematomas. A laminectomy from D3 to D6 was performed and a large epidural hematoma from D1 to D8 was evacuated.

García Medina, Antonio Javier; Giniebra Marín, Grecia María; Bermejo Sánchez, Juan Carlos.

30

Hematoma espinal Spinal hematoma  

Directory of Open Access Journals (Sweden)

Full Text Available El hematoma epidural espinal es un hallazgo poco frecuente en la práctica médica. Se presenta un caso de una paciente portadora en la región dorsal, donde su forma de presentación también se consideró muy inhabitual y confusa; esta debutó con un dolor precordial con irradiación del brazo izquierdo, la espalda y el estómago, instaurándose después una mielitis transversa dorsal. Se presenta el resultado de la resonancia magnética nuclear dorsal, con consideraciones diagnósticas de los diferentes tipos de hematomas espinales. Se realizó una laminectomía desde D3 a D6 y se evacuó un extenso hematoma epidural desde D1 a D8.Epidural spinal hematoma is an infrequent finding in medical practice. A case of a female patient suffering from a pain in the dorsal region, with its way of presentation was also considered as an unusual and confuse occurrence; it started with precordial pain irradiating left arm, back and stomach, establishing a dorsal transverse myelitis. The result of a nuclear magnetic resonance is presented with diagnostic considerations of different types of spinal hematomas. A laminectomy from D3 to D6 was performed and a large epidural hematoma from D1 to D8 was evacuated.

Antonio Javier García Medina

2013-04-01

31

Hematoma suprarrenal Suprarrenal hematoma  

Directory of Open Access Journals (Sweden)

Full Text Available La hemorragia suprarrenal asintomática del neonato es relativamente frecuente y muchas veces se detecta como una calcificación local después de que se resuelve el hematoma. La forma sintomática es rara y, a menudo, se debe a un trauma obstétrico relacionado con la macrosomía fetal, la presentación podálica, la diabetes materna o la hipoxia perinatal. Las manifestaciones clínicas son, principalmente, una masa abdominal y anemia importante; el diagnóstico se confirma con la imaginología. Se presentan dos casos de hematoma suprarrenal derecho tratados en el Hospital Universitario de Cartagena, ambos relacionados con un parto traumático y acompañados de cefalohematomas; uno de ellos presentó sangrado gastrointestinal alto y el otro infección del hematoma suprarrenal. El diagnóstico se comprobó con la ecografía abdominal y se verificó con la tomografía. El tratamiento fue médico y no se requirió cirugía a pesar de la anemia severa que presentó uno de los pacientes. Neonatal asymptomatic suprarrenal hemorrhage is relatively frequent; sometimes it is detected only after resolution when a calcification is found; symptomatic forms are rare; most times hemorrhage and hematoma are due to an obstetric trauma and are related to macrosomia, breech presentation, maternal diabetes and neonatal hypoxia. Clinical picture is characterized by abdominal mass and anemia; diagnosis is confirmed by imagenology. Two patients with suprarrenal hematoma from the University Hospital at Cartagena, Colombia, are presented. Both were related with traumatic delivery and cephalohematoma; one of them had oral and gastric bleeding and the othersuffered hematoma infection; diagnosis was done with abdominal ecography and CAT. Both patients recovered with medical treatment.

Concepción Guardo B.

1996-04-01

32

MR demonstration of a unilateral olivary hypertrophy caused by pontine tegmental hematoma  

International Nuclear Information System (INIS)

Two patients with unilateral olivary hypertrophy (OH) following a pontine tegmental hematoma are presented. Both showed palatal myoclonus and one patient showed an extremity myorhythmia on the opposite side of OH. The magnetic resonance (MR) examination demonstrated an abnormal unilateral hyperintense lesion in the ventral part of medulla oblongata on T2-weighted images. The MR findings were highly suggestive of the pathological nature of the lesion, showing the value of MR. (orig.)

1990-01-01

33

Hematoma traumático del psoas  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish Los hematomas del psoas se suelen observar en pacientes con hemofilia u otras discrasias sanguíneas y como complicación de tratamientos anticoagulantes. Con menor frecuencia se pueden ver en personas sanas, debido a la rotura traumática del músculo. Por similares causas se producen hematomas del mús [...] culo ilíaco. La parálisis del nervio femoral es la complicación más grave y frecuente de ambas afecciones. Es habitual denominar a estos cuadros como hematomas del iliopsoas y considerarlos en conjunto por las características anatómicas, etiológicas, patológicas y clínicas que presentan. Describimos el caso de un niño de 12 años y 8 meses de edad, sin coagulopatía conocida, que padeció un hematoma del psoas de origen traumático. Abstract in english Psoas hematomas are usually seen in patients with hemophilia or other blood dyscrasias, and as a complication of anticoagulant treatments. With less frequency they may be found in healthy persons as a result of traumatic muscle rupture. Similar causes produce hematomas in the iliac muscle. The paral [...] ysis of the femoral nerve is the most serious and frequent complication in both conditions. These clinical pictures are often referred to as iliopsoas hematoma and they are generally considered together owing to the anatomic, etiologic, pathologic and clinical features that present. We describe a boy of 12 years and 8 month old, with no coagulopathy, who suffered a psoas hematoma of traumatic origin.

Roberto, Rocco; Laura, Benedetti; Cecilia, Pannocchia; Horacio, Miscione.

34

Hemophilia and child abuse as possible causes of epidural hematoma: case report / Hemofilia e abuso infantil como possíveis causas de hematoma extradural: relato de caso  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese INTRODUÇÃO: Traumatismo crânio-encefálico é importante conseqüência de abuso infantil. Mecanismos fisiopatológicos específicos do abuso infantil são responsáveis pela ''whiplash shaken-baby syndrome'', o que favoreceria o aparecimento de hemorragias intracranianas. RELATO DE CASO: Relatamos o caso d [...] e uma criança que desenvolveu hematoma extradural após trauma de pequena intensidade. Foi feito diagnóstico inicial de abuso infantil, mas investigações subseqüentes levaram ao diagnóstico de hemofilia A. CONCLUSÃO: Embora o hematoma extradural não esteja intimamente relacionado com abuso infantil, esta etiologia deve ser sempre considerada quando o mecanismo de trauma relatado estiver fora de proporção com as lesões encontradas. Abstract in english INTRODUCTION: Head trauma is an important consequence of child abuse. Specific pathophysiological mechanisms in child abuse are responsible for the ''whiplash shaken-baby syndrome'', which would favour the occurrence of intracranial hemorrhages. CASE REPORT: We report the case of a child who develop [...] ed epidural hematoma following minor-intensity head trauma. Initial diagnosis of child abuse was made, but subsequent investigation led to the diagnosis of hemophilia A. CONCLUSION: Even though epidural hematoma is not closely associated with child abuse, this aethiology must always be considered when the reported trauma mechanism is out of proportion to the magnitude of the encountered lesions.

Fernando Campos Gomes, Pinto; Fabrizio Frutos, Porro; Liliana, Suganuma; Ricardo Bragança de Vasconcellos, Fontes; Almir Ferreira de, Andrade; Raul, Marino Jr.

35

Elevated blood pressure causes larger hematoma in a rat model of intracerebral hemorrhage.  

Science.gov (United States)

Hypertension has been recognized as an independent risk factor for intracerebral hemorrhage (ICH). The objective of this study was to assess the effect of chronically elevated blood pressure on amount of hematoma in a rat model of ICH. A total of 46 rats were divided into two groups-normotensive group (n?=?18) and spontaneously hypertensive group (n?=?28). To induce ICH, we delivered 2 ?L of collagenase solution (0.1 U/1 ?L normal saline) into the striatum. Each animal's brain was removed 24 h post-surgery for spectrophotometric hemoglobin assay. Equal or unequal variance t tests were performed to assess changes in variables between the hypertensive and normotensive groups. Tissue analysis revealed a statistically significant difference in optical density percent change at 540-nm wavelength for the hypertensive vs. the normotensive group (261.47?±?103.68 and 133.33?±?58.53, p?hematoma and corresponding functional impairments due to ICH among hypertensive vs. normotensive rats. PMID:24323831

Bhatia, Prerana M; Chamberlain, Ryan; Luo, Xianghua; Hartley, Eliza W; Divani, Afshin A

2012-12-01

36

Occlusive intraluminal hematoma  

Energy Technology Data Exchange (ETDEWEB)

We report an unusual case of a 10-month-old girl who developed partial small-bowel obstruction caused by an intraluminal hematoma within the terminal ileum. Passage of bright red blood through her rectum prompted radiologic evaluation with computed tomography, barium enema, and ultrasound. These revealed an avascular right lower-quadrant mass within the lumen of the terminal ileum. An exploratory laparotomy was performed, and a large obstructing hematoma was removed. (orig.)

Zangan, Steven M.; Yousefzedah, David K. [Department of Radiology, The University of Chicago Hospitals, 5841 South Maryland Avenue, MC 2026, Chicago, IL 60637 (United States)

2004-07-01

37

Causes of delay in road construction projects in Malawi  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english A study was conducted to identify the causes of delay in completing road construction projects in Malawi. A literature review was done which yielded 72 typical causes of delay, and a questionnaire was sent to client, contractor and consultant representatives in Malawi. The results were analysed usin [...] g the Relative Importance Index (RII) and Spearman's Rank Correlation Coefficients, which indicated that the top ten causes of delay in Malawi are: shortage of fuel, insufficient contractor cash-flow, shortage of foreign currency for importation of materials and equipment, slow payment procedures adopted by the client in making progress payments, insufficient equipment, delay in relocating utilities, shortage of construction materials, delay in paying compensation to land owners, shortage of technical personnel, and delay in site mobilisation. The causes of delay are significant and should be given attention by client organisations, consultants and contractors to enable the timely completion of projects in future. It should also be noted that most of the causes of delay are not unique to Malawi, and have been observed in other southern African countries such as South Africa, Botswana and Swaziland. Recommendations are made to prevent similar causes of delay in future.

M J, Kamanga; W J v d M, Steyn.

38

Imperative Causes of Delays in Construction Projects from Developers’ Outlook  

Directory of Open Access Journals (Sweden)

Full Text Available Project delays in the construction industry are a universal or large-scale observable fact affecting not only the construction industry but the overall economy of countries as well. As far as the Malaysian construction industry is concerned, project delays are common problems in the construction industry, particularly in housing development. The objective of this study is to evaluate and identify the causes and the consequences of project delays in private housing development projects in Malaysia, and the remedies that can minimize these delays. The top ten causes of delays are weather conditions, poor site conditions, poor site management, incomplete documents, lack of experience, financial problems, contract modifications, delay in the approval of major variations, contractor coordination problems with other parties, and construction mistakes and defective works. It has been analysed that the causes of the delays point to the contractor factors, which contribute to the major factors that cause project delays in private housing development projects. The consequences of the delays include time overrun, cost overrun, differences in opinion, negotiations, legal actions and total abandonment. Herewith are presented some recommendations to minimize these project delays.

Othuman Mydin M.A.

2014-03-01

39

Hyperextension and rotation of head causing internal carotid artery laceration with basilar subarachnoid hematoma.  

Science.gov (United States)

Hyperextension of the head can cause injury to the vessels at the base of the brain. These lacerations are believed to be caused by stretching of the vessels due to the abrupt movement of the head and rotational acceleration of the brain within the cranium, and they usually occur in the intracranial portions of the vessels, producing a subarachnoid hemorrhage. This is the case of a 35-year-old man who received a blow to the face that forcefully hyperextended and rotated his head to the left. Autopsy revealed an intracranial right internal carotid laceration extending from a calcified atherosclerotic plaque. This unusual injury may be due to a combination of blunt force applied to the head and the alteration of the vessel's structural and functional capacities secondary to atherosclerosis. PMID:14640286

Kindelberger, David; Gilmore, Kristin; Catanese, Charles A; Armbrustmacher, Vernon W

2003-11-01

40

Renal subcapsular hematoma after percutaneous transfemoral angiography.  

Science.gov (United States)

Vascular complications after percutaneous angiography include hematoma, pseudoaneurysm, arteriovenous fistula, thromboembolism, arterial laceration and infection. Hematomas may occur in the groin, thigh, retroperitoneal, intraperitoneal, or abdominal wall. A 54-year-old female underwent percutaneous transfemoral angiography for the evaluation of cerebral aneurysm. Renal subcapsular hematoma developed 3 hours after the procedure. Renal subcapsular hematoma after percutaneous angiography is very rare. We investigated the possible causes of renal subcapsular hematoma. To avoid this rare complication, we need to perform guide-wire passage carefully from the beginning of the procedure under full visual monitoring. PMID:24653804

Yi, Jin-Seok; Lee, Hyung-Jin; Lee, Hong-Jae; Yang, Ji-Ho

2014-02-01

 
 
 
 
41

Posterior Fossa Epidural Hematomas  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Posterior fossa epidural hematomas are much less common than supratentorial epidural hematomas. The incidence of posterior fossa epidural hematomas among intracranial epidural hematomas has been reported to be 4-7%. Seven cases of posttrau-matic posterior fossa epidural hematomas diagnosed by computed tomography (CT) are reported with radiological and clinical findings. This study consisted of 7 posterior fossa epidural hematoma cases, out of 585 severe head trauma patients admitted and hospi...

Shakeri Bavil, M.

2008-01-01

42

Transcatheter Embolization for Delayed Hemorrhage Caused by Blunt Splenic Trauma  

International Nuclear Information System (INIS)

Although the exact benefit of adjunctive splenic artery embolization (SAE) in the nonoperative management (NOM) of patients with blunt splenic trauma has been debated, the role of transcatheter embolization in delayed splenic hemorrhage is rarely addressed. The purpose of this study was to evaluate the effectiveness of SAE in the management of patients who presented at least 3 days after initial splenic trauma with delayed hemorrhage. During a 24-month period 4 patients (all male; ages 19-49 years) presented with acute onset of pain 5-70 days after blunt trauma to the left upper quadrant. Two had known splenic injuries that had been managed nonoperatively. All had computed axial tomography evidence of active splenic hemorrhage or false aneurysm on representation. All underwent successful SAE. Follow-up ranged from 28 to 370 days. These cases and a review of the literature indicate that SAE is safe and effective for NOM failure caused by delayed manifestations of splenic arterial injury.

2010-08-01

43

Provision of hearing aids: does specialist assessment cause delay?  

Digital Repository Infrastructure Vision for European Research (DRIVER)

OBJECTIVE--To identify the main delay in the provision of hearing aids for people with impaired hearing and identify possible problems and short-comings caused by a community based hearing aid dispensing service. DESIGN--Prospective cohort analysis based on data collected from patients on the duration of hearing impairment, from the referral letters in respect of the general practitioners' findings on otoscopy, and from the ear, nose, and throat assessment in the clinic with respect to the ou...

1989-01-01

44

A parametric model for time delay common-cause failures  

International Nuclear Information System (INIS)

The significance of dependent failures in risk and reliability analysis has been demonstrated in almost all probabilistic risk assessments of nuclear power plants as well as in reports of reactor operating experiences. Among the different types of dependent failures, common cause failure (CCF), which is the failure of several redundant components due to the same shared cause, other than functional causes, has been shown to make a major contribution to the risk of nuclear power plant accidents. Although different studies resulted in introducing different methods for CCF analysis, a wide accepted method for analysis of certain classes of CCFs is still lacking. One of the main reasons is that existing methods for the treatment of CCFs do not distinguish between the different types of CCF events and, therefore, in some instances do not properly represent the data. Recognizing the need for more realistic models, this study has been performed to introduce a new method for estimating system unavailability due to a specific class of CCFs. Operating experience has shown that there is, certainly, a class of CCF that has the characteristics of time delay CCF. Therefore, in order to obtain more realistic estimates for unavailability of redundant systems, comparable models should be applied to the data. Application of the proposed model based on some specific set of assumed time delay data illustrates the inconsistencies of some of the existing models when applied to time delay CCF data and the significance of the proposed model

1990-06-01

45

Nuclear power plant delays: probable causes and resolutions  

International Nuclear Information System (INIS)

The nuclear power industry in the United States is experiencing technological as well as construction and operation problems in nuclear facilities. Delays in completing many of the present-day nuclear power plants under construction have been an acutely felt problem in recent years. For example, Long Island Lighting Company's (LILCO's) Shoreham Plant is 10 years behind schedule; the delay in Consumers Power Company's Midland plant in Michigan was 9 years at the time the project was cancelled. Delays and repairs have led to cost overruns of significant magnitudes. A study released by the energy information administration of the Department of Energy showed that 36 of the 47 nuclear plants surveyed cost at least twice as much as initially projected, while 13 of them were four times higher. An extreme example is LILCO's Shoreham Plant. This plant is expected to be completed at a cost of $4 billion, or 15 times the original estimates. It is the intent of this paper to review past research done on the factors that cause these delays, to indicate their relative importance and impact on the nuclear industry, and to describe possible resolutions that are either currently being implemented or that have been proposed for future use

1985-05-03

46

Pseudosepsis: rectus sheath hematoma mimicking septic shock.  

Science.gov (United States)

There are many noninfectious disorders in the critical care unit (CCU) that mimic sepsis. Pseudosepsis is the term applied to noninfectious disorders that mimic sepsis. Fever/leukocytosis is not diagnostic of infection but frequently accompanies a wide variety of noninfectious disorders. When fever/leukocytosis and hypotension are present, sepsis is the presumptive diagnosis until proven otherwise. After empiric therapy for sepsis is initiated, the clinician should rule out the noninfectious causes of pseudosepsis. The most common causes of pseudosepsis in the CCU setting are pulmonary embolism, myocardial infarction, gastrointestinal hemorrhage, overzealous diuretic therapy, acute pancreatitis, relative adrenal insufficiency, and (rarely) rectus sheath hematoma. Rectus sheath hematoma may occur secondary to trauma/anticoagulation therapy and may present as an acute surgical abdomen mimicking sepsis. Rectus sheath hematoma should be considered when other causes of pseudosepsis or sepsis fail to explain persistent hypotension unresponsive to fluids/pressors. The diagnosis of rectus sheath hematoma is by abdominal ultrasound or computed tomography scan. If the abdominal computed tomography scan is negative for other intra-abdominal pathology and other causes of pseudosepsis are eliminated, then the diagnosis of pseudosepsis caused by rectus sheath hematoma is confirmed by demonstrating a hematoma in the rectus sheath. Treatment of rectus sheath hematoma is surgical drainage and ligation of any bleeding vessels. Evacuation of the rectus sheath hematoma rapidly reverses the patient's hypotension and is curative. We describe a case of pseudosepsis caused by rectus sheath hematoma in an elderly man with hypotension unresponsive to fluids/pressors and mimicking septic shock. Clinicians should be aware that rectus sheath hematoma is a rare but important cause of pseudosepsis in patients in the CCU. PMID:17137947

Hamid, Naveed S; Spadafora, Philip F; Khalife, Michael E; Cunha, Burke A

2006-01-01

47

[Subdural hematoma after dural puncture: fateful complication of epidural anesthesia].  

Science.gov (United States)

Subdural hematoma may occur as rare, although intervention- specific complications of accidental dural puncture by neuroaxial block. Bleeding may be caused by rapid cerebrospinal fluid loss related to traction on fragile intracranial bridging veins. This article reports a case of postdural puncture headache in a 43-year-old woman after accidental dural puncture during attempted placement of an epidural catheter for induction of abortion. Bed rest, analgesics, theophylline and hydration were to no avail and only a blood patch improved the headaches. The patient presented 7 weeks later with headache and left-sided hemiplegia. Magnetic resonance imaging showed a right frontoparietal subdural intracranial hematoma which had to be surgically evacuated. The patient recovered completely. Intracranial hematoma is a rare but serious complication of central neuroaxial block. According to current German jurisdiction this risk must be addressed when informed consent is obtained. Intracranial hematoma should be considered in the differential diagnosis of atypical headache and neurological signs (e.g. focal motor and sensory deficits and seizures) following neuroaxial block and adequate image diagnostics should be carried out without delay. PMID:23558719

Schott, M; Gehrke, A; Gaab, M; Jantzen, J-P

2013-05-01

48

Drought in Africa caused delayed arrival of European songbirds.  

Science.gov (United States)

Despite an overall advancement in breeding area arrival, one of the latest spring arrivals in northwest Europe since 1950 of several trans-Saharan songbird species occurred in 2011. Year-round tracking of red-backed shrikes and thrush nightingales revealed that the cause of the delay was a prolongation of stopover time during spring migration at the Horn of Africa, which was affected by extreme drought. Our results help to establish a direct link at the individual level between changes in local climate during migration and arrival and breeding condition in Europe thousands of kilometers further north. PMID:23224549

Tøttrup, A P; Klaassen, R H G; Kristensen, M W; Strandberg, R; Vardanis, Y; Lindström, Å; Rahbek, C; Alerstam, T; Thorup, K

2012-12-01

49

Bilateral intracerebellar calcification associated with cerebellar hematoma. Case report.  

Science.gov (United States)

A case of bilateral intracerebellar calcificaiton associated with cerebellar hematoma on the left side is reported. Clinical and microscopic examination failed to clarify the causes of calcification and hematoma. It is postulated that hemorrhage occurred from time to time through the fragile calcified vessel walls, since some portions of the organized hematoma were composed of massive erythrocytes. PMID:712397

Kawakami, Y; Nakao, Y; Tabuchi, K; Nosaka, Y; Ohmoto, T

1978-11-01

50

[Bilateral cerebellar hematoma after supratentorial glioma surgery].  

Science.gov (United States)

We present a case of bilateral hematoma in cerebellar hemispheres in a 30-year-old man after surgical treatment of extensive left frontal glioma. 16 hours after surgery the patient lost consciousness. An immediate CT revealed hematoma in both cerebellar hemispheres. The hematoma was subsequently removed via bilateral suboccipital craniectomy. After the operation the clinical status of the patient gradually improved - he was discharged in a good general condition. In the presented case the hematoma developed presumably as a consequence of extensive cerebrospinal fluid (CSF) loss (670 ml) via postoperative wound drainage. The resulting cerebellar displacement caused strain of the draining veins, affecting blood outflow, and causing parenchymal hemorrhage. In order to prevent the complication, massive CSF loss during and after operation should be avoided. Careful monitoring of the patient's condition in the postoperative period, even if the general status is good, is important because only an immediate intervention may prevent the development of irreversible consequences of cerebellar hematoma formation. PMID:15354240

Czepko, Ryszard; Kwinta, Borys; Uhl, Henryka; Urbanik, Andrzej; Libionka, Witold; Pietraszko, Wojciech

2004-01-01

51

Rectus Sheath Hematoma Mimicking Acute Abdominal Pain  

Directory of Open Access Journals (Sweden)

Full Text Available Abdominal sheat hematoma is a rare cause of acute abdominal disorders and may be misdiagnosed from other causes of abdominal pain. Early diagnosis is mandatory in order to avoid morbidity or unnecessary surgery. We describe a case of an 55-year-old men receiving anticoagulants who presented with typical clinical manifestations of acute surgical abdomen. A computed tomography scans demonstrated a right rectus sheath hematoma. The patient was treated conservatively with success. It is important to recognize this entity of rectus sheath hematoma among patients complaining of acute abdominal pain. [Cukurova Med J 2012; 37(4.000: 243-246

Huseyin Narci

2012-08-01

52

Hematoma epidural subagudo Subacute epidural hematoma  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Se presenta el caso de un paciente con hematoma epidural subagudo, temporoparietal derecho, secundario a una agresión física. En el cuadro clínico, a las 24 h, predominó la cefalea de intensidad moderada, con somnolencia y agitación psicomotora ligera. Las radiografías simples de cráneo no mostraron alteraciones. Los síntomas se mantuvieron a pesar del tratamiento médico, por lo que se realizó una tomografía axial simple de cráneo que mostró la presencia de un hematoma epidural s...

2011-01-01

53

Hematoma epidural subagudo / Subacute epidural hematoma  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se presenta el caso de un paciente con hematoma epidural subagudo, temporoparietal derecho, secundario a una agresión física. En el cuadro clínico, a las 24 h, predominó la cefalea de intensidad moderada, con somnolencia y agitación psicomotora ligera. Las radiografías simples de cráneo no mostraron [...] alteraciones. Los síntomas se mantuvieron a pesar del tratamiento médico, por lo que se realizó una tomografía axial simple de cráneo que mostró la presencia de un hematoma epidural subagudo temporoparietal derecho, con desplazamiento de estructuras de la línea media. Se realizó una craneotomía temporoparietal derecha para la evacuación del hematoma posterior. El paciente evolucionó satisfactoriamente y se recuperó por completo, tanto clínica como imaginológicamente. Abstract in english This is the case of a patient presenting with right temporoparietal subacute hematoma secondary to a physical act of aggression. In clinical picture at 24 hours there was predominance of headache of moderate intensity with drowsiness and slight psychomotor restlessness. The skull single radiographie [...] s didn't show alterations. Symptoms remained despite the medical treatment, thus a single skull axial tomography was carried out showing the presence of a right temporoparietal subacute epidural hematoma with displacement from the middle line structures. A right temporoparietal craniotomy was carried out to evacuation of the posterior hematoma. Patient evolved satisfactorily with a total recovery as much clinical as imaging.

Yvei, González Orlandi; Luis, Elizondo Barrier; Reinel, Junco Martín; Jorge, Rojas Manresa; Víctor, Duboy Limonta; Alberto, Pérez Villafuerte.

54

Chronic spinal subdural hematoma  

International Nuclear Information System (INIS)

Compared with spinal epidural hematomas, spinal subdural hematomas are rare; chronic forms are even more uncommon. These hematomas are associated not only with lumbar puncture and spinal trauma, but also with coagulopathies, vascular malformations and tumors. Compression of the spinal cord and the cauda equina means that the patients develop increasing back or radicular pain, followed by paraparesis and bladder and bowel paralysis, so that in most cases surgical decompression is carried out. On magnetic resonance imaging these hematomas present as thoracic or lumbar subdural masses, their signal intensity varying with the age of the hematoma. We report the clinical course and the findings revealed by imaging that led to the diagnosis in three cases of chronic spinal subdural hematoma. (orig.)

2008-10-01

55

Spinal epidural hematomas examined on MRI  

International Nuclear Information System (INIS)

Spinal epidural hematomas are rare pathology, caused by trauma or spontaneous. In clinical examination acute spinal cord compression is observed. MRI designations appear entirely particular. In sagittal projection, biconvex mass in the dorsal, or sometimes ventral part of the spinal canal is clearly visible. This is well delineated by the thecal sac from the cord and cauda equina. MRI investigations in 3 patients revealed corresponding with spinal bone injuries and cord edema epidural hematomas. Differential diagnosis must contain subdural hematoma and epidural neoplasms or abscess. (author)

1995-01-01

56

Magnetic resonance imaging of intracranial hematoma  

International Nuclear Information System (INIS)

A sequential MR scan was performed on 21 patients with intracranial hematoma, and simultaneously the T1 values of the hematomas were calculated. The T1 value of a hematoma was found to be longer than that of the white matter in the acute phase, but it soon becomes as short as that of the white matter (7 - 10 day after). After several days, the T1 value again gradually becomes longer. In the experiment, 30 ml of fresh blood (15 samples) were stored at room temperature, and a sequential MR scan and the calculation of the T1 were performed over a period of 20 days. In vitro, most of the T1 values were long, but there was much variation on the first day. A shortening of the T1 was observed as well in vivo, and after this shortening, no prolongation of the T1 was observed. Perhaps the shortening of T1 was caused by the denaturation of the hemoglobin to methemoglobin and by the coagulation of the blood. The lysis and absorption of the hematoma may, on the other hand, cause the prolongation of the T1 in vitro. For the diagnosis of intracranial hematoma, CT was found to be a method superior to MRI, especially in the acute phase. However, MRI gives us more information about hematoma (concerning the denaturation of the hemoglobin to methemoglobin, the lysis and absorption of the hematoma, the range of hemorrhagic tissue and edema, etc.) than does CT. An IR (T1-weighted) image shows a good contrast between the hematoma and the surrounding tissue (hemorrhagic tissue, edema) in the early phase. On the other hand, the SE (T2-weighted) image informs us of the lesion when the hematoma is low ? isodense on the CT in the chronic phase. (author)

1987-01-01

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Computed tomographic demonstration of a spontaneous subcapsular hematoma due to a small renal cell carcinoma  

International Nuclear Information System (INIS)

Computed tomography (CT) was able to demonstrate a small renal cell carcinoma as the cause of a spontaneous subcapsular hematoma. Angiographic and pathologic correlation were obtained. A review of the causes for nontraumatic renal subcapsular hematoma is included

1981-01-01

58

Obstructive uropathy secondary to rectus sheath hematoma.  

Science.gov (United States)

Rectus sheath hematoma (RSH) is uncommon and is often reported in the setting of anticoagulation or trauma. Typically RSH presents with localized or diffuse abdominal pain and a fixed abdominal wall mass, however, various presentations and complications have been reported depending on the setting and extent of the hematoma. We report a case of a rapidly expanding RSH causing obstructive anuria and hydronephrosis in addition to a review of literature on this rare presentation of RSH. PMID:23600103

Dangle, Pankaj P; Patel, Mitesh B; Terán, Marcos; Chehval, Micheal J

2013-01-01

59

Posterior Fossa Epidural Hematomas  

Directory of Open Access Journals (Sweden)

Full Text Available Posterior fossa epidural hematomas are much less common than supratentorial epidural hematomas. The incidence of posterior fossa epidural hematomas among intracranial epidural hematomas has been reported to be 4-7%. Seven cases of posttrau-matic posterior fossa epidural hematomas diagnosed by computed tomography (CT are reported with radiological and clinical findings. This study consisted of 7 posterior fossa epidural hematoma cases, out of 585 severe head trauma patients admitted and hospitalized in an 18-month period. The patients were evaluated regarding age, gender, type of trauma, cranial CT and Glasgow coma score in admittance, treatment and follow-up. Average age was 24.2 years and 85.7% of the cases were male. All cases had occipital fracture. Fifty-seven percent of the cases had only occipital fracture and posterior fossa epidural hematoma. All of the cases in this group were neurologically intact except for one who had a Glasgow coma score of 9 in admission. Two cases of this group were conservatively treated. In the others posterior fossa epidural hematomas got larger and they were treated surgically; these 2 cases recovered after surgery. Three of the 7 cases had the supratentorial region lesions; one of these cases died before operation. Two of them were treated surgically, one of them died and the other showed recovery after surgery.

2008-01-01

60

Acute bilateral extradural hematomas.  

Directory of Open Access Journals (Sweden)

Full Text Available The occurrence of bilateral extradural hematomas is an uncommon consequence of craniocerebral trauma and its incidence is variable in various studies ranging from 2-25%.1 We studied all cases of head injury brought to our institute over a period of 6 months and found the incidence of bilateral extradural hematomas to be 13.3%.

Ramzan A

2002-04-01

 
 
 
 
61

[Chronic traumatic cerebellar hematoma].  

Science.gov (United States)

Traumatic hematomas of the posterior cranial fossa are a rarity. The paper is concerned with clinical cases of chronic intracerebellar hematoma characterized by general cerebral and cerebellar symptoms. Early diagnosis and surgical intervention made it possible to attain a favourable outcome in the immediate postoperative period. PMID:2171260

Okladnikov, G I; Nesterenko, L Kh; Kurov, O M

1990-01-01

62

Posttraumatic cerebellar hematoma.  

Science.gov (United States)

A posttraumatic cerebellar hematoma in a 12-year-old boy is reported. It was observed by CT scan that the hematoma is discharged incompletely into the subdural space. The surgical treatment was successful with complete recovery. It is suggested that CT scan should be performed as soon as possible in cranial trauma with cerebellar signs. PMID:7128249

Fernández-Alvarez, E; Fábregues, I; Pineda, M; Costa, J; Lafuente, J

1982-01-01

63

Hypothesized cause of delayed hemolysis associated with intravenous artesunate.  

Science.gov (United States)

In recent publications, investigators described cases in which there was a delayed hemolysis following intravenous (IV) artesunate treatment. The delayed hemolysis event occurred at the nadir of blood hemoglobin concentration, i.e., at the time when blood hemoglobin concentration was switching from a progressive decline to a progressive increase. It is hypothesized that this nadir indicates the time when red cell production is resuming after having been arrested, the delayed hemolysis event is due to lysis of the first (aberrant) reticulocytes released once production is resumed and, therefore, that the hemolysis signals the resumption of red cell production. Since this delayed hemolysis has not been associated with a significant decrease in blood hemoglobin, the hemolytic event is not of particular concern even if it could be attributed to artesunate. More important than this hemolysis event was the preceding progressive anemia that lasted for up to 19 days. Both a decrease in reticulocyte production and a shortened life span of previously infected red cells likely contributed to the anemia. The question that remains to be answered is whether the progressive anemia that lasted 2-3 weeks in these patients was attributable solely to their severe malaria or was possibly enhanced and prolonged by the high plasma concentrations of artesunate associated with IV administration. Controlled clinical studies addressing this question may be needed. PMID:24370269

Clark, Robert L

2014-02-01

64

Hematoma intramural esofágico / Esophageal intramural hematoma  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish El hematoma intramural esofágico es infrecuente, existiendo pocos casos registrados en la literatura. Generalmente se presenta posterior a un trauma, por ejemplo asociado a procedimientos endoscópicos (escleroterapia), o en forma espontánea. La presentación clínica más frecuente es la tríada de dolo [...] r torácico, odinofagia/disfagia y/o hematemesis. Generalmente el tratamiento consiste en un manejo expectante con medidas de soporte habitual. Se exponen 2 casos clínicos presentados en nuestro centro durante el año 2009 y se realiza una revisión de la literatura. Abstract in english The most common presentation of esophageal hematoma is pain, dysphagia and hematemesis. We report two patients with the condition. A 77 years old female presenting with retrosternal pain and odynophagia after ingesting a pig bone. An upper gastrointestinal endoscopy showed a lineal hematoma, protrud [...] ing to the lumen in the upper portion of the esophagus. The patient was managed with nil per os (NPO) and parenteral hydration and discharged 72 hours later. An 87 years old male presenting with two episodes of hematemesis and weight loss, an upper gastrointestinal endoscopy showed a dissecting hematoma involving the entire esophageal wall. The patient was managed with NPO and hydration and discharged in good conditions 11 days after admission.

Lombardi A, Juan J; González M, Ignacio; Valdivieso A, Javiera; Correa L, Ismael; Heredia P, Carolina.

65

Hematoma intramural esofágico Esophageal intramural hematoma  

Directory of Open Access Journals (Sweden)

Full Text Available El hematoma intramural esofágico es infrecuente, existiendo pocos casos registrados en la literatura. Generalmente se presenta posterior a un trauma, por ejemplo asociado a procedimientos endoscópicos (escleroterapia, o en forma espontánea. La presentación clínica más frecuente es la tríada de dolor torácico, odinofagia/disfagia y/o hematemesis. Generalmente el tratamiento consiste en un manejo expectante con medidas de soporte habitual. Se exponen 2 casos clínicos presentados en nuestro centro durante el año 2009 y se realiza una revisión de la literatura.The most common presentation of esophageal hematoma is pain, dysphagia and hematemesis. We report two patients with the condition. A 77 years old female presenting with retrosternal pain and odynophagia after ingesting a pig bone. An upper gastrointestinal endoscopy showed a lineal hematoma, protruding to the lumen in the upper portion of the esophagus. The patient was managed with nil per os (NPO and parenteral hydration and discharged 72 hours later. An 87 years old male presenting with two episodes of hematemesis and weight loss, an upper gastrointestinal endoscopy showed a dissecting hematoma involving the entire esophageal wall. The patient was managed with NPO and hydration and discharged in good conditions 11 days after admission.

Juan J Lombardi A

2012-02-01

66

Isodense cerebellar hematoma.  

Science.gov (United States)

One week after chiropractic manipulations, a 60-year-old normotensive man suffered acute onset of vertigo, ataxia, and dysarthria. CT disclosed an isodense mass of the posterior fossa. Vertebral arteriography showed that the avascular mass arose from the right cerebellar hemisphere. Hydrocephalus developed, and suboccipital craniotomy revealed a large cerebellar hematoma due to a small arteriovenous malformation. A similar episode occurred 2 months later. CT isodense cerebellar hematomas should be considered before giving anticoagulant therapy. PMID:6684255

Jacome, D E

1983-09-01

67

Chronic constipation causing obstructive nephropathy in a delayed toddler.  

LENUS (Irish Health Repository)

Chronic constipation causing obstructive nephropathy is very rare in children. However, it can cause urinary tract obstruction with acute impairment of renal function with a need for emergent disimpaction. The authors discuss a 2 years 4 months old child who presented to our emergency department with acute renal failure due to faecal impaction.

Barrett, Michael Joseph

2012-01-01

68

Chronic constipation causing obstructive nephropathy in a delayed toddler.  

Science.gov (United States)

Chronic constipation causing obstructive nephropathy is very rare in children. However, it can cause urinary tract obstruction with acute impairment of renal function with a need for emergent disimpaction. The authors discuss a 2 years 4 months old child who presented to our emergency department with acute renal failure due to faecal impaction. PMID:22707680

Barrett, Michael Joseph; Macken, Sheila

2012-01-01

69

Delayed Epithelial Ingrowth Caused by Viral Conjunctivitis after LASIK  

Digital Repository Infrastructure Vision for European Research (DRIVER)

To report a patient who presented with epithelial ingrowth caused by viral keratoconjunctivitis 3 months after LASIK surgery. A 41-year-old man presented with decreased visual acuity in the right eye, which had developed about 3 weeks before. He had undergone LASIK surgery 3 months prior without complications. Two months after the surgery, he was treated for viral conjunctivitis. During the treatment period, filamentary keratitis developed, and a therapeutic bandage contact lens was applied f...

Jun, Roo Min; Suh, Wool; Kim, Eung Kweon

2008-01-01

70

[Subperiosteal hematoma of the orbit associated with subfrontal extradural hematoma].  

Science.gov (United States)

Subperosteal hematoma is rarely associated with extradural hematoma and orbital roof fracture. We report a case observed in a 16-year-old boy who developed exophthalmos, diplopia and visual loss after blunt head trauma. Computed tomography demonstrated the subperiosteal hematoma associated with a thin extradural hematoma and an orbital roof fracture. The hematomas were removed during the same procedure via fronto-orbito craniotomy. Surgery led to complete recovery without functional sequelae. We stress the importance of early diagnosis and treatment of post-traumatic exophthalmos. PMID:12053165

Naja, A; Chellaoui, A; Ibahioin, K; Benhaddou, M; Moutawakil, A; El Kamar, A; El Azhari, A; Amraoui, A

2002-05-01

71

Construction delays causing risks on time and cost - a critical review  

Directory of Open Access Journals (Sweden)

Full Text Available There is an increase in the number of construction projects experiencing extensive delays leading to exceeding initial time and cost budget.  This paper reviews 41 studies around the world which surveyed the delay factors and classified them into Groups.  The main purpose of this paper is to review literature, each of which have categorized the causes that are responsible for time delays and cost overrun in projects. The collected list has 113 causes for delays categorized in to 18 different groups.  Most of the researches have analysed the responses from the Questionnaire survey.    The collected data are used to rank the problem.  The data are further used to investigate and analyse Important Index, Frequency Index, Severity Index, Relative Important Index, Relative Importance Weight, Weighted Average, Mean, Standard Deviation and Variance.  The collective comparison has revealed that the ranking given by all the researchers is not the same.  Further each and every study has different rank ratings for the different group of the delays.  This review paper attempts to provide an updated compilation of the earlier studies on ranking of the delay causers, which are never similar and constant for universal projects.  It is concluded that a separate study is required for identifying the factors causing delay for projects operated in Sabah, East Malaysia.

Chidambaram Ramanathan

2012-03-01

72

Construction delays causing risks on time and cost - a critical review  

Directory of Open Access Journals (Sweden)

Full Text Available There is an increase in the number of construction projects experiencing extensive delays leading to exceeding initial time and cost budget.  This paper reviews 41 studies around the world which surveyed the delay factors and classified them into Groups.  The main purpose of this paper is to review literature, each of which have categorized the causes that are responsible for time delays and cost overrun in projects. The collected list has 113 causes for delays categorized in to 18 different groups.  Most of the researches have analysed the responses from the Questionnaire survey.    The collected data are used to rank the problem.  The data are further used to investigate and analyse Important Index, Frequency Index, Severity Index, Relative Important Index, Relative Importance Weight, Weighted Average, Mean, Standard Deviation and Variance.  The collective comparison has revealed that the ranking given by all the researchers is not the same.  Further each and every study has different rank ratings for the different group of the delays.  This review paper attempts to provide an updated compilation of the earlier studies on ranking of the delay causers, which are never similar and constant for universal projects.  It is concluded that a separate study is required for identifying the factors causing delay for projects operated in Sabah, East Malaysia.

Chidambaram Ramanathan

2012-02-01

73

Postraumatic delayed loss of vision  

International Nuclear Information System (INIS)

The imaging studies and clinical findings in 10 patients who suffered delayed vision loss beginning 1 day to 13 years after head trauma have been reviewed. Two different primary lesions could be identified: pseudoaneurysm of the internal carotid artery and carotid cavernous fistula. The pathologic changes associated with pseudoaneurysm included compression of the optic nerves and/or chiasm by arterial aneurysm and intracranial hematoma. Carotid cavernous fistula caused delayed vision loss by compression of the optic nerves and chiasm by saccular dilatation of the cavernous sinus and by abnormal orbital venous drainage with retinal venous stasis, retinal edema, and glaucoma

1989-12-01

74

Neurosurgic treatment of spontaneous and traumatic intracerebral hematomas  

Directory of Open Access Journals (Sweden)

Full Text Available In the period from 01.01.2000 until 31.12.2002 34 patients with spontaneous intracerebral hematoma (ICH and with deeply disturbed state of consciousness were operated in the Department of neurosurgery of the Urgent Center, Clinical Center of Serbia. In all operated patients the indication for surgery was given on the basis of CT scan of the brain, state of consciousness, defined Glasgow coma score (GCS and neurological status, but due to existing or threatening incarceration not even one patient was submitted to angiography of the blood vessels at the cerebral base, thus preoperatively we did not know the cause of the hemorrhage. Of 34 operated patients 22 or 64.7% died, and 12 or 35.3% survived. 14 patients were in the deepest phase of coma, where the preoperative GCS is from 3 to 5 points, and in the postoperative course only one survived, aged 25. The other survivors had somewhat less disturbed state of consciousness, they also were younger, CT scan of the brain was without blood in the chamber system. In the same period, in the Department of Neurosurgery of the Urgent Center, Clinical Center of Serbia 43 patients with traumatic intracerebral hematoma (TIH were operated; 9 patients survived, 34 died. Only 4 patients had acute TIH. All of them were in the terminal stage of incarceration, and despite being immediately submitted to surgery all of them died. The remaining 39 patients had, the so called delayed TIH where the secondary CT scan of the brain showed development of the traumatic intracerebral haematoma that was not verified on the incipient scanner. Indication for a repeated CT scan was given in 19 patients due to focal or general neurological deterioration. However in 20 patients subsequent neurological disturbances were not registered. Those that survived were younger patients, and they were not in the deepest stage of coma, most often they had a temporal localization of hematoma.

Ili? R.V.

2008-01-01

75

Benign cerebellar hematomas in children.  

Science.gov (United States)

Cerebellar hematoma is generally regarded as a rapidly progressive condition which necessitates prompt evacuation in most cases. Unlike adults, where hypertension is the most common etiological factor, children generally have underlying structural lesions (angiomas, tumors) that per se demand surgical intervention. While several reports describe nonsurgical management of cerebellar hematomas in adults, the spontaneous resolution of juvenile cerebellar hematomas is almost unknown. This paper describes a 16-year-old boy with a cerebellar hematoma of obscure etiology that was managed conservatively. This report indicates that nonsurgical treatment of cerebellar hematomas, once structural lesions have been excluded, may be attempted in neurologically stable children. PMID:3731170

Pozzati, E; Nasi, M T; Galassi, E; Fabrizi, A

1986-01-01

76

Hematoma epidural lumbar crónico espontáneo / Chronic spontaneous lumbar epidural hematoma  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Presentamos un caso excepcional de estenosis de canal lumbar con síndrome de cola de caballo por un hematoma crónico espontáneo en el espacio epidural L2-L3. Se trata de un varón de 53 años que, sin ninguna clase de antecedente patológico relacionado con el problema actual (traumatismos, punciones l [...] umbares, toma de antiagregantes o anticoagulantes), presenta una colección hemática epidural que va comprimiendo progresivamente la cola de caballo. Las pruebas de imagen mostraron una colección polilobulada, bien delimitada, que se interpretó como quiste sinovial. Tras la cirugía (laminectomía descompresiva y evacuación) se confirmó el diagnóstico con estudio histológico. Tras la operación se recuperó por completo la función neurológica. Abstract in english We report an exceptional case of cauda equina syndrome, caused by a chronic epidural hematoma of the lumbar spine, (L2-L3). A 53 year old man without history of trauma, lumbar punctures or antiagregant medication, suffered from progressive back pain and minor motor deficit in the legs. The etiology, [...] MRI, intraoperative findings and microscopical study are presented and discussed. After surgery there was a complete resolution of the clinical picture.

J.M., Belinchón; J., Campos; J., Merino; J.M., Gallego; C., Barcia.

77

Delayed intracerebral hemorrhage as demonstrated by CT scanning  

International Nuclear Information System (INIS)

Three patients are presented who developed delayed intracerebral hematomas after head injury. Two patients had essentially negative CT scans on admission and developed intracerebral hematomas within 24 h after injury. They required surgical treatment and had fatal outcomes. The third patient presented with an epidural hematoma on CT scan, developed an intracerebral hematoma 48 h after evacuation of the epidural hematoma, and did well with conservative management. (orig.)

1979-01-01

78

Hematoma hepático subcapsular por fasciola  

Scientific Electronic Library Online (English)

Full Text Available SciELO Peru | Language: Spanish Abstract in spanish Presentamos el caso de una mujer de 22 años de edad, natural de Huaraz con historia de dolor en hipocondrio derecho asociado a náuseas y vómitos que se intensifican tres dias antes de su admisión. Al examen se encuentra disminución del murmullo vesicular en la base del hemitórax derecho. El abdomen [...] es doloroso a la palpación en el epigastrio e hipocondrio derecho. El hígado se palpa a 3 cm debajo del reborde costal; Hemograma con eosinofilia severa. Se aprecia leve colestasis. Ecografía abdominal: Masa hepática heterogénea de 13 cm de diámetro en el lóbulo derecho. Tomografía axial computarizada: Masa subcapsular de 14x8 cm. Gammagrafía: Hígado con área hipocaptadora que muestra ausencia de perfusión al pool vascular. Se somete a laparotomía exploratoria y se encuentra hematoma subcapsular de 800 cc en segmento 6, 7 y 8, el cual se drena. En la evolución persite la eosinofilia y se obtiene Arco 2 positivo para Fasciola. Recibió triclabendazol, actualmente asintomática. Conclusión: La fase invasiva de la fasciolosis humana puede ocasionar hematoma hepático como una complicación rara. La triada de eosinofilia persistente, hepatomegalia dolorosa y fiebre prolongada, orienta a insistir en la búsqueda de fasciolasis en zonas endémicas. Abstract in english The case of a 22 year old woman from Huaraz is presented herein. She suffered from pain at right hypocondrium, associated to nausea and vomits, which intensified three days prior to admission. Upon examining her, a faded gallbladder murmur was found on the base of the right hemithorax. There is pain [...] in the abdomen when touched at the epigastrium and right hypocondrium. The liver is perceived 3 cm beneath the costal edge: White blood count with severe eosinophilia. Mild cholestasis is observed. Abdominal scan: Heterogeneous hepatic mass, with a 13 cm diameter in the right lobe. CAT scan: Subcapsular 14x8 cm mass. Scintiscan: Liver with a low absorption area showing absence of perfusion to the vascular pool. She undergoes an exploratory laparotomy and an 800 cc subcapsular hematoma is found in segment 6, 7 and 8, which is drained. Evolution evidences the persistence of eosinophilia and positive Arc-2 is obtained for Fasciola. She was administered Triclabendazol and is currently asymptomatic. Conclusion: The invasive stage of human fascioliasis may cause hepatic hematoma as a rare complication. The triad of persisting eosinophilia, painful hepatomegalia and prolonged fever leads to insist in the search of fascioliasis in endemic areas.

David, Loja Oropeza; José, Alvizuri Escobedo; Maricela, Vilca Vásquez; Roberto, Avilés Gonzaga; Mario, Sánchez Mercado.

79

Spontaneous ligamentum flavum hematoma in the lumbar spine  

Energy Technology Data Exchange (ETDEWEB)

Lumbar or sacral nerve root compression is most commonly caused by intervertebral disc degeneration and/or herniation. Less frequently, other extradural causes may be implicated, such as infection, neoplasm, epidural hematoma, or ligamentum flavum pathology. We present the case of a patient with spontaneous ligamentum flavum hematoma compressing the L4 nerve root, without antecedent trauma. Although exceedingly rare, the diagnosis of ligamentum flavum pathology in general, and that of ligamentum flavum hematoma in particular, should be considered on those rare occasions when the etiology of lumbar or sacral nerve root compressions appears enigmatic on radiological studies. Usually surgical treatment produces excellent clinical outcome. (orig.)

Keynan, Ory; Ashkenazi, Ely; Floman, Yizhar [Israel Spine Center at Assuta Hospital, Tel Aviv (Israel); Smorgick, Yossi [Israel Spine Center at Assuta Hospital, Tel Aviv (Israel); Assaf Harofeh Medical Center, Department of Orthopedic Surgery, Zerifin (Israel); Schwartz, Allan J. [Hadassah University Hospital, Department of Radiology, Section of Neuroradiology, Jerusalem (Israel)

2006-09-15

80

Arachnoid cysts with subdural hematoma or intracystic hemorrhage in children.  

Science.gov (United States)

Arachnoid cyst (AC) is a common congenital intracranial lesion in children. It may be complicated by subdural hematoma (SDH) and intracystic hemorrhage (ICH) to cause intracranial hypertension after minor head injury or spontaneously. However, because most bleeding after trauma is delayed, it is often overlooked. At the same time, it remains controversial for treatment of ACs complicated with SDH and ICH. So far, it lacks review, especially for pediatric patients who have ACs with SDH or ICH. Here, we report 3 pediatric cases in our department from 2010 to 2011. At the same time, we review 41 pediatric patients reported in the last 20 years. We conclude that a child with AC should be regularly followed up after minor head injury, and that therapy for children with complicated ACs should be more aggressive than for adults. The cyst wall should be resected, and communication between cyst and cerebral cistern should be established. PMID:24786991

Liu, Zhiyong; Xu, Peng; Li, Qiang; Liu, Hao; Chen, Ni; Xu, Jianguo

2014-05-01

 
 
 
 
81

Delayed Hepatic Adaptation to Weaning in ACBP(-/-) Mice Is Caused by Disruption of the Epidermal Barrier  

DEFF Research Database (Denmark)

We previously reported that mice deficient in acyl-CoA-binding protein (ACBP) display a delayed metabolic adaptation to weaning. This includes a delayed activation of the hepatic lipogenic gene program, which may result from hepatic accumulation of triacylglycerol and/or cholesteryl esters in the late suckling period. To further investigate the basis for this phenotype, we generated mice deficient in ACBP in hepatocytes (Alb-ACBP(-/-)) and keratinocytes (K14-ACBP(-/-)). Surprisingly, the delayed adaptation to weaning, including hepatic lipid accumulation, is caused by ACBP deficiency in the skin rather than in the liver. Similarly to ACBP(-/-) mice, K14-ACBP(-/-) mice exhibit an increased transepidermal water loss, and we show that the hepatic phenotype is caused specifically by the epidermal barrier defect, which leads to increased lipolysis in white adipose tissue. Our data demonstrate that an imperfect epidermal barrier leads to profound suppression of the hepatic SREBP gene program and lipid accumulation in the liver.

Neess, Ditte; Bek, Signe

2013-01-01

82

Delayed Hepatic Adaptation to Weaning in ACBP-/- Mice Is Caused by Disruption of the Epidermal Barrier.  

DEFF Research Database (Denmark)

We previously reported that mice deficient in acyl-CoA-binding protein (ACBP) display a delayed metabolic adaptation to weaning. This includes a delayed activation of the hepatic lipogenic gene program, which may result from hepatic accumulation of triacylglycerol and/or cholesteryl esters in the late suckling period. To further investigate the basis for this phenotype, we generated mice deficient in ACBP in hepatocytes (Alb-ACBP-/-) and keratinocytes (K14-ACBP-/-). Surprisingly, the delayed adaptation to weaning, including hepatic lipid accumulation, is caused by ACBP deficiency in the skin rather than in the liver. Similarly to ACBP-/- mice, K14-ACBP-/- mice exhibit an increased transepidermal water loss, and we show that the hepatic phenotype is caused specifically by the epidermal barrier defect, which leads to increased lipolysis in white adipose tissue. Our data demonstrate that an imperfect epidermal barrier leads to profound suppression of the hepatic SREBP gene program and lipid accumulation in the liver.

Pedersen, Ditte Neess; Bek, Signe

2013-01-01

83

Endoscopic evacuation of cerebellar hematoma in a term newborn.  

Science.gov (United States)

Intracerebellar hemorrhage is very rare in term infants and only severe cases with massive intracranial hemorrhage, posthemorrhagic hydrocephalus and clinical deterioration due to increased intracranial pressure require neurosurgical evacuation. In recent adult studies endoscopic hematoma evacuation has been shown as a rapid, effective, and safe technique. A term newborn hospitalized for meconium aspiration syndrome showed hypertonia, jitteriness and abnormal amplitude integrated electroencephalogram findings. He was diagnosed with cerebellar hematoma which caused hydrocephalus by cranial magnetic resonance imaging (MRI). The hematoma was successfully evacuated neuroendoscopically as the first case in literature to our knowledge. Neurologic, a-EEG and MRI findings resolved. PMID:23265617

Tanriverdi, Sema Rala; Turhan, Tuncer; Uygur, Ozgun; Koroglu, Ozge Altun; Yalaz, Mehmet; Kultursay, Nilgun

2013-10-01

84

Investigation of the Internal Stresses Caused by Delayed Ettringite Formation in Concrete.  

Science.gov (United States)

Delayed ettringite formation (DEF) in concrete has been identified in recent as a significant cause of deterioration in some of the reinforced concrete infrastructure in Texas. This report is part of a research project, TxDOT project 5218, to investigate ...

A. Thibonnier B. Burgher K. J. Folliard M. Thomas T. Ley

2008-01-01

85

Two cases of subdural hematoma with niveau formation on CT  

International Nuclear Information System (INIS)

The authors report a case of a bilateral chronic subdural hematoma with niveau formation and another rare case of an acute subdural hematoma with niveau formation on plain CT. The different mechanisms of the niveau formation in these cases are speculated about. The first case was a 75-year-old male who showed a drowsy state, urinary incontinence, and muscle weakness of the bilateral lower limbs. No definite history of head trauma could be found. A plain CT scan showed a bilateral-crescent type fluid collection with niveau formation, consisting of a low-density area in the upper part and a high-density area in the lower part. An operation showed bilateral, moderately encapsulated subdural hematomas; they were evacuated. The second case was a 61-year-old male with head trauma due to a fall from a ladder. On admission, neurological examination revealed a decerebrate posture, a deep coma, and anisocoria. A plain CT scan twenty hours after the onset showed a crescent-type fluid collection with niveau formation in the left fronto-parietal region. The operation showed an acute subdural hematoma containing xanthochromic fluid and coagulated blood. No capsule of hematoma could be seen. The incidence of niveau formation in chronic subdural hematomas is not low (5 - 20%); such niveau formation is thought to be caused by rebleeding into the hematoma and the spending of considerable time in the supine position. On the other hand, no case of an acute subdural hematoma with niveau formation has previously been reported. With regard to this mechanism of niveau formation, we speculate that the hematoma is mixed with cerebrospinal fluid from the arachnoidal tear caused by the head trauma; also, a considerable time in the supine position is necessary. (author)

1984-01-01

86

Retroperitoneal and rectus sheath hematomas.  

Science.gov (United States)

The retroperitoneum is rich in vascular structures and can harbor large hematomas, traumatic or spontaneous. The management of retroperitoneal hematomas depends on the mechanism of injury and whether they are pulsatile/expanding. Rectus sheath hematomas are uncommon abdominal wall hematomas secondary to trauma to the epigastric arteries of the rectus muscle. The common risk factors include anticoagulation, strenuous exercise, coughing, coagulation disorders, and invasive procedures on/through the abdominal wall. The management is largely supportive, with the reversal of anticoagulation and transfusions; angioembolization may be necessary. PMID:24267499

Kasotakis, George

2014-02-01

87

Pulmonary hypoplasia on preterm infant associated with diffuse chorioamniotic hemosiderosis caused by intrauterine hemorrhage due to massive subchorial hematoma: report of a neonatal autopsy case.  

Science.gov (United States)

A male infant born prematurely at 31 weeks of gestation weighed 789 g and had mildly brown-colored oral/tracheal aspirates at delivery. The amniotic fluid was also discolored, and its index was below 5. The patient died of hypoxemic respiratory and cardiac failure 2 hours after birth. The maternal profiles showed placenta previa and intrauterine growth restriction (IUGR) at 22 weeks of gestation, and revealed recurrent episodes of antenatal and substantial vaginal bleeding and oligohydramnios, indicating chronic abruption-oligohydramnios sequence. The thickened placenta, weighing 275 g, grossly displayed unevenness and diffuse opacity with green to brown discoloration in the chorioamniotic surface, and revealed chronic massive subchorial hematomas (Breus' mole) with old peripheral blood clot, circumvallation, and infarction. Microscopically, diffuse Berlin-blue staining-positive hemosiderin deposits were readily encountered in the chorioamniotic layers of the chorionic plate, consistent with diffuse chorioamniotic hemosiderosis (DCH) due to Breus' mole, accompanied by diffuse amniotic necrosis. At autopsy, an external examination showed several surface anomalies and marked pulmonary hypoplasia, 0.006 (less 0.012) of lung:body weight ratio. Since Breus' mole has a close relationship with intrauterine hemorrhage, resulting in DCH, IUGR, and/or pulmonary hypoplasia of the newborn, the present features might be typical. PMID:22827763

Yamada, Sohsuke; Marutani, Takamitsu; Hisaoka, Masanori; Tasaki, Takashi; Nabeshima, Atsunori; Shiraishi, Mika; Sasaguri, Yasuyuki

2012-08-01

88

Delayed splenic rupture: dating the sub-capsular hemorrhage as a useful task to evaluate causal relationships with trauma.  

Science.gov (United States)

The aim of the paper was to perform a chronological assessment of the phenomenon of delayed rupture of the spleen, to assess the phenomenological order about the sub-capsular hematoma transformation to determine the causal relationship with trauma as hypothetical cause of death. 80 cases of blunt trauma with splenic capsular hematoma and subsequent rupture of the spleen were evaluated: 38 had an acute rupture of the spleen, 42 presented a break in days or weeks after the traumatic injury. Time between the traumatic event and delayed rupture of the spleen is within a range of time from one day to more than one month. Data recorded included age, sex, type of trauma, injury severity score, grade of splenic injury, associated intra-abdominal injuries, pathologic specimen evaluation. Immunohistochemical investigation of perisplenic hematoma or laceration was performed utilizing polyclonal antibodies anti-fibrinogen, CD61 and CD68, and showed structural chronological differences of sub-capsular hematoma. Expression of modification and organization of erythrocytes, fibrinogen, platelets and macrophages provides an informative picture of the progression of reparative phenomena associated with sub-capsular hematoma and subsequent delayed splenic rupture. Sub-capsular splenic hematoma dating, which we divided into 4 phases, is representing a task in both clinical practice and forensic pathology. PMID:24378304

Riezzo, Irene; Di Battista, Benedetta; De Salvia, Alessandra; Cantatore, Santina; Neri, Margherita; Pomara, Cristoforo; Turillazzi, Emanuela; Fineschi, Vittorio

2014-01-01

89

Chronic encapsulated expanding hematoma in nonfunctioning pituitary adenoma.  

Science.gov (United States)

The diagnosis and treatment of pituitary macroadenomas with entire hematoma fluid accumulation are problematic. Such lesions are often difficult to completely resect, and recurrence is not uncommon. We present five cases of pituitary macroadenomas entirely composed of hematoma fluid and investigated their histopathology to clarify the mechanism of the hematoma fluid accumulation. Five patients with pituitary adenoma and significant intra-tumor hematoma underwent transsphenoidal resection and were retrospectively reviewed for their clinical status, findings on magnetic resonance imaging (MRI), intraoperative findings, and histopathology. The specific surgical techniques used to address these cases were also reviewed. All patients were diagnosed with nonfunctioning pituitary adenomas by histopathological examination. MRI showed all tumors extended to the cavernous sinus. Histopathology showed tumor tissues were located between the thick granulation tissue and the pseudocapsule of the tumor. The thick granulation tissues were composed of collagenous layers, neovascular vessels, and necrotic red blood cells, indicating repeat hemorrhage from the granulation tissues. The boundary between adenoma and normal pituitary gland was identified during surgical removal in four patients and was not identified in the other patient who showed a recurrence 2 years later. Clinical and histopathological findings indicate hematoma fluid accumulation in the present cases is caused by repeat hemorrhage from the reactive granulation tissues and can be regarded as a chronic encapsulated expanding hematoma. In these cases, the boundary between adenoma and normal pituitary gland should be identified before puncturing the hematoma fluid to minimize the risk of tumor recurrence. PMID:23345017

Sugawara, Takashi; Aoyagi, Masaru; Tanaka, Youji; Tamaki, Masashi; Kobayashi, Daisuke; Ohno, Kikuo

2013-07-01

90

[Simultaneous multiple hypertensive intracerebral hematoma].  

Science.gov (United States)

Hypertensive intracerebral hemorrhage (HIH) occurring simultaneously in different locations is rare. We encountered 11 such cases between January 1990 and November 2002. The diagnosis of all 11 cases was established by computed tomography, and the location of the hematomas was: cerebellum and basal ganglia in 5 cases, pons and basal ganglia in 4, and subcortex and basal ganglia in 2. Our patients were analyzed with respect to clinical characteristics, pathogenesis of multiple hematomas, and indication of operation. These patients represented 1% of all 1,069 patients we encountered with HIH. As past history, there were no characteristic disorders except hypertension. There were no characteristic initial symptoms suggesting that hemorrhage had occurred simultaneously. Both supra- and infra-tentorial hematomas were observed in 80% of the patients, and the size of the multiple hematomas was proportional in principle. Cerebellar hematomas were often mild, and pontine hematomas were often severe. The outcome in those patients whose neurological grading was 1 to 3 was good with conservative therapy or surgical treatment. The severity, treatment methods, and outcomes in these patients were similar to those in patients with single HIH, which suggests only a slight influence of multiple lesions on outcome. As for the possible mechanism of simultaneous multiple hemorrhages, we speculated that bleeding occurred simultaneously in the different regions, or that the initial bleeding was followed after a short time by secondary bleeding due to high intracranial pressure and circulatory disturbance. In patients with cerebellar hematoma, initial symptoms suggested the development of secondary hemorrhage after primary hemorrhage. The surgical treatment for multiple hematomas should be determined by the location and maximum axis of the hematoma. We proposed that cerebellar hematomas should be removed if the supra-tentorial hematoma is small. PMID:15148798

Shiomi, Naoto; Miyagi, Tomoya; Koga, Satomi; Karukaya, Takashi; Tokutomi, Takashi; Shigemori, Minoru

2004-03-01

91

Postoperative Spinal Epidural Hematoma: Risk Factor and Clinical Outcome  

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We report a series of epidural hematomas which cause neurologic deterioration after spinal surgery, and have taken risk factors and prognostic factors into consideration. We retrospectively reviewed the database of 3720 cases of spine operation in a single institute over 7 years (1998 April-2005 July). Nine patients who demonstrated neurologic deterioration after surgery and required surgical decompression were identified. Factors postulated to increase the postoperative epidural hematoma and...

2006-01-01

92

An Induced Hematoma in Caudoputamen Nuclei in Rats Causes Central Pain when the Thalamus is also Implicated and the Central Sensitization is Reversed with Gabapentin  

Directory of Open Access Journals (Sweden)

Full Text Available Problem statement: The objective of this study was to evaluate pain sensitisation in rats following the induction of an intracerebral hemorrhage by injecting a collagenase solution in the caudoputamen nucleus of the right basal ganglia and to evaluate gabapentin as an analgesic for central pain. Approach: Thirty male Sprague-Dawley rats weighing between 175-300 g were used. In a first experiment, 3 groups of 6 animals were used to evaluate pain threshold using the Hargreaves test (thermal sensitivity only. Following 3 days of behavioral testing (baseline values, animals in each group were injected intracerebrally either with 0.5, 1 or 2 ?L of a collagenase solution (0.5 U 2 ?L-1 Type VII collagenase inducing a hematoma in the right caudoputamen nucleus and/or thalamus. They were then tested for the next 9 consecutive days. In a second experiment, gabapentin was evaluated for the reversal of thermal hyperalgesia and mechanical allodynia (using von Frey filaments following the intracerebral injection of 3 ?L of the collagenase solution. Results: No pain-related behavioral changes were observed following injections with 0.5 and 1 ?L of the collagenase solution. However with 2 ?L, reaction times were significantly faster on days 3-7 in the right and left hind paws compared to baseline values. The lesion was localized only in the caudoputamen nucleus for animals receiving 0.5 and 1 ?L of collagenase whereas lesions extended in the ipsilateral thalamic nuclei (lateral-dorsal and lateral-posterior nuclei for animals receiving 2 ?L of collagenase. Gabapentin reversed mechanical allodynia and thermal hyperalgesia in animals with caudoputamen and thalamic lesions. Conclusion: These preliminary results suggest that central pain was induced in rats with a collagenase-induced intracerebral hemorrhage localized in the thalamus and that mechanical allodynia and thermal hyperalgesia were reduced with gabapentin treatment.

P. P. Lema

2012-01-01

93

Spinal epidural hematomas  

DEFF Research Database (Denmark)

During the period 1943-1985 six patients were operated for spinal epidural hematomas at the department of neurosurgery of the University Hospital of Arhus. It is essential to perform acute laminectomy in case of rapidly increasing neurological symptoms. In the case of slowly increasing symptoms operation may provide a good result even if it is performed a week after the onset of symptoms. It is important to watch patients with fracture/dislocations of the spine closely during the first weeks after a trauma. If they develop neurological symptoms the patients should immediately be transferred to the department of neurosurgery with a view of

Laursen, J; Fode, K

1987-01-01

94

MRI findings and hematoma contents of chronic subdural hematomas  

International Nuclear Information System (INIS)

Twenty-six cases of chronic subdural hematomas (CSDHs) were studied with special reference to the magnetic resonance image (MRI) findings and the biochemical analysis of the hematoma contents. There were 5 cases of bilateral CSDH. An apparent history of head trauma was obtained in 13 cases. All cases were evaluated preoperatively with both computed tomography (CT) and MRI. MRI was studied with both T1-weighted (spin echo, TR/TE 600/15) imaging (T1WI) and T2-weighted (spin echo, TR/TE 3,000/90) imaging (T2WI). A biochemical analysis of the hematoma contents was assayed with regard to hematocrit (HT), the total protein (TP), methemoglobin (Met-Hb), the total cholesterol (Tchol), triglyceride (TG), fibrin and fibrinogen degradation products (FDP), Fe, and osmolarity (Osm). The CT findings were divided into four groups: 5 cases of low-density, 7 cases of isodensity, 13 cases of high-density, and 5 cases of mixed-density hematomas. The MRI findings were also divided as 18 cases of high-, 4 cases of iso-, and 2 cases of low-signal-intensity hematomas on T1WI. On T2WI, 18 cases were high-, 4 cases were iso-, and 2 cases were low-signal-intensity hematomas. Twelve cases were high-signal-intensity hematomas on both T1WI and T2WI. In comparison with the CT and MRI findings, hematomas of low and isodensity on CT showed high signal intensities on T1WI except in one case. The high-density hematomas on CT showed a variable signal intensity on MRI. The results of the biochemical analysis of hematoma fluid were compared with the MRI findings. The Ht value showed no apparent correlation with the MRI findings; however, increased values of TP in hematomas tended to show higher signal intensities on T1WI. The most apparent correlation was seen between the Met-Hb ratio and T1WI MRI. All hematomas containing >10% Met-Hb showed high signal intensities on T1WI. The CT, the MRI, and the results of the biochemic analysis of hematoma contents were presented in 3 cases. (J.P.N.)

1991-01-01

95

Thyroid Gland Hematoma After Blunt Neck Trauma  

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Hemorrhage of a previously normal thyroid gland as a result of blunt trauma is a very rare condition. We report a case of blunt trauma that caused acute hemorrhage into the thyroid gland and presented with hoarseness. The diagnosis of thyroid gland hematoma was made with a combination of fiberoptic laryngoscopy, cervical computed tomography, and carotid angiography. The patient was treated conservatively, had a favorable course without further complications, and was discharged four days after...

2009-01-01

96

Causes of Delay in Patient Triage in the Emergency Departments of Tabriz Hospitals  

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Objectives: Organized triage has been useful method in immediate classification of large number of patients. Urgent intervention and evaluation of patients in Emergency Department result in shorter patient waiting time and, therefore, intensifying the quality of supervision. This study aimed at determining the causes of delays in patient triage in Emergency Departments (EDs) in the city of Tabriz.Methods: This descriptive study was conducted in 18 hospitals of Tabriz, Iran. A questionnaire de...

2011-01-01

97

A delayed frontorbital abscess caused by a penetrating nonmissile foreign body a bamboo stick  

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We report an interesting case of delayed frontal abscess caused by a penetrating nonmissile foreign body, a bamboo stick in a 1.5-year-old male child. A parietal craniotomy was performed, and the brain abscess was resected along with the foreign body without any damage to the surrounding brain tissue. He also received the appropriate antibiotics. The child made a good recovery.

Liu Wen-ke; Ma Lu; Mao Bo-yong

2009-01-01

98

A delayed frontorbital abscess caused by a penetrating nonmissile foreign body a bamboo stick  

Directory of Open Access Journals (Sweden)

Full Text Available We report an interesting case of delayed frontal abscess caused by a penetrating nonmissile foreign body, a bamboo stick in a 1.5-year-old male child. A parietal craniotomy was performed, and the brain abscess was resected along with the foreign body without any damage to the surrounding brain tissue. He also received the appropriate antibiotics. The child made a good recovery.

Liu Wen-ke

2009-01-01

99

Root cause analysis reports help identify common factors in delayed diagnosis and treatment of outpatients.  

Science.gov (United States)

Delays in diagnosis and treatment are widely considered to be threats to outpatient safety. However, few studies have identified and described what factors contribute to delays that might result in patient harm in the outpatient setting. We analyzed 111 root cause analysis reports that investigated such delays and were submitted to the Veterans Affairs National Center for Patient Safety in the period 2005-12. The most common contributing factors noted in the reports included coordination problems resulting from inadequate follow-up planning, delayed scheduling for unspecified reasons, inadequate tracking of test results, and the absence of a system to track patients in need of short-term follow-up. Other contributing factors were team-level decision-making problems resulting from miscommunication of urgency between providers and providers' lack of awareness of or knowledge about a patient's situation; and communication failures among providers, patients, and other health care team members. Our findings suggest that to support care goals in the Affordable Care Act and the National Quality Strategy, even relatively sophisticated electronic health record systems will require enhancements. At the same time, policy initiatives should support programs to implement, and perhaps reward the use of, more rigorous interprofessional teamwork principles to improve outpatient communication and coordination. PMID:23918480

Giardina, Traber Davis; King, Beth J; Ignaczak, Aartee P; Paull, Douglas E; Hoeksema, Laura; Mills, Peter D; Neily, Julia; Hemphill, Robin R; Singh, Hardeep

2013-08-01

100

Evaluation and establishment of a canine model of delayed splenic rupture using contrast-enhanced ultrasound  

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The aim of the present study was to establish a canine model of delayed splenic rupture (DSR). A total of 15 mongrel dogs were anesthetized and laparotomized. The hematomas were observed following an injection of heparin. The hematomas were ruptured. The severity of the spleen rupture was evaluated and the intra-abdominal free liquid was measured. The splenic hematomas in the dogs continued to form and the hematoma area gradually increased. The hematomas were ruptured after impacting the abdo...

Tian, Jiangke; Xie, Xia; Lv, Faqin; Yu, Tengfei; Wu, Rong; Zhang, Xinghua; Wang, Dong; Tang, Jie

2012-01-01

 
 
 
 
101

MRI findings in spinal subdural and epidural hematomas  

Energy Technology Data Exchange (ETDEWEB)

Background: Spinal hematomas are rare entities that can be the cause of an acute spinal cord compression syndrome. Therefore, an early diagnosis is of great importance. Patients and Methods: From 2001 to 2005 seven patients with intense back pain and/or acute progressive neurological deficit were studied via 1.5 T MRI (in axial and sagittal T1- and T2-weighted sequences). Follow-up MRI was obtained in six patients. Results: Four patients showed the MRI features of a hyperacute spinal hematoma (two spinal subdural hematoma [SSH] and two spinal epidural hematoma [SEH]), isointense to the spinal cord on T1- and hyperintense on T2-weighted sequences. One patient had an early subacute SEH manifest as heterogeneous signal intensity with areas of high signal intensity on T1- and T2-weighted images. Another patient had a late subacute SSH with high signal intensity on T1- and T2-weighted sequences. The final patient had a SEH in the late chronic phase being hypointense on T1- and T2-weighted sequences. Discussion: MRI is valuable in diagnosing the presence, location and extent of spinal hematomas. Hyperacute spinal hematoma and the differentiation between SSH and SEH are particular diagnostic challenges. In addition, MRI is an important tool in the follow-up in patients with conservative treatment.

Braun, Petra [Department of Radiology, Hospital La Plana, Ctra. De Vila-real a Borriana km. 0.5, 12540 Vila-real (Castello) (Spain)], E-mail: PetraBraun@gmx.de; Kazmi, Khuram [Department of Radiology, Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033 (United States); Nogues-Melendez, Pablo; Mas-Estelles, Fernando; Aparici-Robles, Fernando [Department of Radiology, La Fe Hospital, Avenida Campanar, 21, 46009 Valencia (Spain)

2007-10-15

102

[A case of hemifacial spasm associated with a cerebellar hematoma].  

Science.gov (United States)

This is a report of a hemifacial spasm associated with a cerebellar hematoma. A 60 year-old female was admitted to our hospital due to severe vertigo and nausea. On admission, the neurological examination showed drowsy conscious level, cerebellar sign dominant on the left side, and left hemifacial spasm. CT scans disclosed a large hematoma in the left cerebellar hemisphere. An angiography revealed a dominant left PICA, but showed neither vascular malformation nor aneurysm. An emergency removal of the hematoma was carried out by using suboccipital craniectomy. Three days after the surgery, the patient's left hemifacial spasm disappeared completely. She had never suffered from left hemifacial spasm prior to this cerebellar bleeding. The hemifacial spasm was thought to be due to either the compression of the left facial nerve by the PICA which had been displaced by the cerebellar hematoma, or to the fact that the nucleus of the left facial nerve might have been stimulated by the hematoma, and the hemifacial spasm might have been caused as a result of the stimulation. The total removal of the hematoma and the postoperative CSF leakage might have decompressed the facial nerve. It was considered that this might be similar to microvascular decompression. PMID:7845513

Hirano, A; Ochi, S; Kanno, K

1994-12-01

103

Habitat fragmentation causes immediate and time-delayed biodiversity loss at different trophic levels.  

Science.gov (United States)

Intensification or abandonment of agricultural land use has led to a severe decline of semi-natural habitats across Europe. This can cause immediate loss of species but also time-delayed extinctions, known as the extinction debt. In a pan-European study of 147 fragmented grassland remnants, we found differences in the extinction debt of species from different trophic levels. Present-day species richness of long-lived vascular plant specialists was better explained by past than current landscape patterns, indicating an extinction debt. In contrast, short-lived butterfly specialists showed no evidence for an extinction debt at a time scale of c. 40 years. Our results indicate that management strategies maintaining the status quo of fragmented habitats are insufficient, as time-delayed extinctions and associated co-extinctions will lead to further biodiversity loss in the future. PMID:20337698

Krauss, Jochen; Bommarco, Riccardo; Guardiola, Moisès; Heikkinen, Risto K; Helm, Aveliina; Kuussaari, Mikko; Lindborg, Regina; Ockinger, Erik; Pärtel, Meelis; Pino, Joan; Pöyry, Juha; Raatikainen, Katja M; Sang, Anu; Stefanescu, Constantí; Teder, Tiit; Zobel, Martin; Steffan-Dewenter, Ingolf

2010-05-01

104

Prevention of Hematomas and Seromas  

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Hematoma and seroma formation in surgical wounds has negative effects on wound healing and subsequent morbidity to patients. This is of particular pertinence in cosmetic procedures in which the patient has chosen to undergo surgery electively. Over the past several decades there has been considerable interest in the use of ancillary techniques to assist in closing wounds and achieving hemostasis to prevent hematoma and seroma formation. These techniques include application of tissue sealants ...

2006-01-01

105

Surgical management of intracerebral hematomas  

Energy Technology Data Exchange (ETDEWEB)

Traditional and recent developments in the management of spontaneous intracranial hematomas are reviewed. A comprehensive account of the epidemiological characteristics worldwide with an etiological analysis including prevention and prophylaxis introduce the size and clinical significance of this neurological problem. The usefulness and limitations of the available diagnostic methods are described. Most of the emphasis, however, is placed on the management and medicosurgical treatment of intracranial hematomas in correlation with their clinical presentation and localization. 80 references.

Tsementzis, S.A.

1985-04-01

106

Selective learning impairment of delayed reinforcement autoshaped behavior caused by low doses of trimethyltin.  

Science.gov (United States)

The organometal neurotoxin trimethyltin (TMT), induces impaired learning and memory for various tasks. However, administration is also associated with other "non-specific" behavioral changes which may be responsible for effects on conditioned behaviors. To determine if TMT treatment causes a specific learning impairment, three experiments were done using variations of a delay of reinforcement autoshaping task in which rats learn to associate the presentation and retraction of a lever with the delivery of a food pellet reinforcer. No significant effects of TMT treatment were found with a short (4 s) delay of reinforcement, indicating that rats were motivated and had the sensorimotor capacity for learning. When the delay was increased to 6 s, 3.0 or 6.0 mg TMT/kg produced dose-related reductions in behaviors directed towards the lever. Performance of a group given 7.5 mg TMT/kg, while still impaired relative to controls, appeared to be better than the performance of groups given lower doses. This paradoxical effect was investigated with a latent inhibition paradigm, in which rats were pre-exposed to the Skinner boxes for several sessions without delivery of food reinforcement. Control rats showed retardation of autoshaping when food reinforcement was subsequently introduced. Rats given 7.5 mg TMT/kg exhibited elevated levels of lever responding during pre-exposure and autoshaping sessions. The results indicate that 7.5 mg TMT/kg produces learning impairments which are confounded by hyperreactivity to the environment and an inability to suppress behavior toward irrelevant stimuli. In contrast, low doses of TMT cause learning impairments which are not confounded by hyperreactivity, and may prove to be useful models for studying specific associational dysfunctions. PMID:3124161

Cohen, C A; Messing, R B; Sparber, S B

1987-01-01

107

Acute tentorial subdural hematoma as a false-positive in indium-111 leukocyte scintigraphy  

International Nuclear Information System (INIS)

A case of acute tentorial subdural hematoma detected by In-111 leukocyte scintigraphy and confirmed by CT brain scan is herein described. White blood cells are an integral part of the blood pool and labeled white cells freely leave the intravascular space in case of active bleeding. Acute hemorrhage and hematoma can thus be a cause of a false-positive study

1985-01-01

108

LATE GESTATIONAL EXPOSURE TO THE FUNGICIDE PROCHLORAZ DELAYS THE ONSET OF PARTURITION AND CAUSES REPRODUCTIVE MALFORMATIONS IN MALE RAT OFFSPRING  

Science.gov (United States)

Late gestational exposure to the fungicide prochloraz delays the onset of parturition and causes reproductive malformations in male rat offspring. Nigel C. Noriega, Joseph Ostby, Christy Lambright, Vickie S. Wilson, and L. Earl Gray Jr., Prochloraz (PZ) is an imidazol...

109

Bannayan-Riley-Ruvalcaba syndrome: a cause of extreme macrocephaly and neurodevelopmental delay.  

LENUS (Irish Health Repository)

BACKGROUND: Bannayan-Riley-Ruvalcaba syndrome (BRRS) is an autosomal dominant condition characterised by macrocephaly, developmental delay and subtle cutaneous features. BRRS results from mutations in the PTEN gene. In adults, PTEN mutations cause Cowden syndrome where, in addition to the macrocephaly, there is a higher risk of tumour development. Diagnosis of BRRS is often delayed as presentation can be variable, even within families. AIMS: To identify characteristics of this condition which might facilitate early diagnosis. Prompt diagnosis not only avoids unnecessary investigations in the child but potentially identifies heterozygote parents who are at risk of tumour development. METHODS AND RESULTS: Six children with a PTEN mutation were identified. All had extreme macrocephaly. Four parents and a male sibling were found to have a PTEN mutation on subsequent testing. Affected parents had extreme macrocephaly and a history of thyroid adenoma, or breast or skin lesions. All six children had presented to medical attention before the age of 2.5 years (3\\/6 were investigated as neonates), but the median age at diagnosis was 5 years. Four of the children had multiple investigations prior to identification of a PTEN mutation. CONCLUSION: BRRS should be considered in children with extreme macrocephaly as it is the most consistent clinical feature seen, particularly where there is a family history of macrocephaly.

Lynch, N E

2012-02-01

110

Computed tomography of epidural hematomas  

International Nuclear Information System (INIS)

Computed tomography was carried out in 24 patients with epidural hematomas. The development of symptoms was noted as was the clinical state on admission and after treatment. The clinical picture was correlated to the size of the hematomas and to presence and size of associated intracranial lesions. All patients with epidural hematomas but without other intracranial lesions, had either a symptom-free interval or a latent period after the initial trauma. More than 40 per cent of patients with associated intracranial lesions also had a free interval or a latent period. The clinical state on admission was of limited prognostic value unless the pain reactions were extinguished, which indicated a bad prognosis. Shearing injury of the white matter was also unfavourable. Three patients died, constituting a mortality of 12.5 per cent in the present series. (Auth.)

1981-01-01

111

Whole Spontaneous Spinal Epidural Hematoma  

Science.gov (United States)

A 26-year-old male who had no underlying disease, including coagulopathy, underwent thoracotomy and bleeding control due to hemothorax. On the fifth postoperative day, paralysis of both lower limbs occurred. Urgent spine magnetic resonance imaging showed a massive anterior spinal epidural hematoma from C2 to L1 level with different signal intensities, which was suspected to be staged hemorrhage. Hematoma evacuation with decompressive laminectomy was performed. The patient's neurologic deterioration was recovered immediately, and he was discharged without neurological deficits. A drug history of naftazone, which could induce a drug-induced platelet dysfunction, was revealed retrospectively. To our knowledge, this is the first report of whole spontaneous spinal epidural hematoma in a young patient, with a history of hemorrhoid medication.

Yoon, Kyeong-Wook; Song, Jae Gyok; Ryu, Jae-Wook

2014-01-01

112

MRI of subacute intracranial hematomas  

International Nuclear Information System (INIS)

Subacute hematomas consisting of intracellular methemoglobin (MetHb) become hypointense on T2 weighted spin-echo (SE) images using high-field magnetic resonance. This effect results from diffusion of proton through local field gradients created by MetHb and is called preferential T2 proton relaxation enhancement (PT2PRE). Gradient-echo acquisition (GEA) can depict hematomas to be more hypointense, because the acquisition is sensitive to field inhomogeneity. In this paper, the difference between SE and GEA images of subacute hematomas was studied experimentally using intracellular MetHb suspension. Although T2* decay curves were expected to decline faster than T2 decay curves, no significant differences were observed between them. This result suggests that PT2PRE cannot be increased significantly by GEA. T2 obtained with multiple-echo technique is generally inaccurate and smaller than T2 obtained with single-echo techqnie, but the results showed in a case of intracellular MetHb they were almost similar. This is because mutiple 180deg pulses partly correct the dephasing of proton resulting from its diffusion. As contrast of hematomas is dependent on differences of signal intensities between hematomas and surrounding tissues, it means that multiple-echo technique depicts the lesion less conspicuously than single-echo technique and GEA. GEA images (TR=200 msec/TE=15 msec) showed hypointense rim (boundary effect) at the margin of intracellular MetHb suspension with a hematocrit of larger than 30%, and with TE of 40 msec boundary effect could be seen even at a hematocrit of 15%. On the contrary, SE images (TR=2500 msec/TE=80 msec) hardly showed boundary effect. In conclusion, GEA can depict subacute hematomas to be more hypointense than SE using multiple-echo, because multiple 180deg pulses are not used and boundary effect is present. (author)

1990-01-01

113

Cerebral venous sinus thrombosis in an adult patient presenting as headache and acute subdural hematoma.  

Science.gov (United States)

We report a 55-year-old man with cerebral venous sinus thrombosis presenting as acute subdural hematoma. He was treated with an intravenous infusion of heparin sodium and the occluded superior sagittal sinus was recanalized. According to our literature review, acute subdural hematoma caused by cerebral venous sinus thrombosis is relatively rare, and only a single case has reported thus far. We speculate that dehydration was the reason for cerebral venous sinus thrombosis in the present case, and the sudden rise in intracranial pressure in addition to hemodynamic stress caused by cerebral venous sinus thrombosis resulted in the collapse of a bridging vein and caused an acute subdural hematoma. PMID:21185743

Takahashi, Satoshi; Shinoda, Jun; Hayashi, Takuro

2012-05-01

114

Construction delays causing risks on time and cost - a critical review  

Digital Repository Infrastructure Vision for European Research (DRIVER)

There is an increase in the number of construction projects experiencing extensive delays leading to exceeding initial time and cost budget.  This paper reviews 41 studies around the world which surveyed the delay factors and classified them into Groups.  The ...

Chidambaram Ramanathan; Narayanan, S. P.; Idrus, Arazi B.

2012-01-01

115

Spontaneous retropharynegeal hematoma: A case report and literature overview  

International Nuclear Information System (INIS)

A spontaneous retropharyngeal hematoma is a rare condition with a difficult diagnostic. This disease may rapidly progress to an airway obstruction. The author reports about a case of a 56-year-old man with an acute onset of sore throat, dysphonia and dyspnea. A retropharyngeal high attenuated soft tissue density could be seen on the neck CT. A rapid improvement of the retropharyngeal abnormality was seen on the 3 days follow-up MR imaging. Signal changes caused by blood products which were visible on the MRI images suggested the diagnosis of retropharyngeal hematoma. The patient was conservatively managed.

2014-02-01

116

Spontaneous retropharynegeal hematoma: A case report and literature overview  

Energy Technology Data Exchange (ETDEWEB)

A spontaneous retropharyngeal hematoma is a rare condition with a difficult diagnostic. This disease may rapidly progress to an airway obstruction. The author reports about a case of a 56-year-old man with an acute onset of sore throat, dysphonia and dyspnea. A retropharyngeal high attenuated soft tissue density could be seen on the neck CT. A rapid improvement of the retropharyngeal abnormality was seen on the 3 days follow-up MR imaging. Signal changes caused by blood products which were visible on the MRI images suggested the diagnosis of retropharyngeal hematoma. The patient was conservatively managed.

Ryu, Ji Hwa [Dept. of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

2014-02-15

117

Postoperative Dissecting Ventricular Septal Hematoma: Recognition and Treatment  

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Dissecting ventricular septal hematoma (DVSH) rarely occurs after repair of a ventricular septal defect (VSD) but can lead to serious complications such as septal rupture, myocardial rupture, cardiogenic shock, heart block, outflow obstruction, cardiac tamponade, abscess transformation, and death. This paper describes the diagnosis and management of acute, severe, left ventricular outflow tract obstruction caused by the development of a DVSH after VSD repair.

Mart, Christopher R.; Kaza, Aditya K.

2011-01-01

118

Mechanical ventilation causes pulmonary mitochondrial dysfunction and delayed alveolarization in neonatal mice.  

Science.gov (United States)

Hyperoxia inhibits pulmonary bioenergetics, causing delayed alveolarization in mice. We hypothesized that mechanical ventilation (MV) also causes a failure of bioenergetics to support alveolarization. To test this hypothesis, neonatal mice were ventilated with room air for 8 hours (prolonged) or for 2 hours (brief) with 15 ?l/g (aggressive) tidal volume (Tv), or for 8 hours with 8 ?l/g (gentle) Tv. After 24 hours or 10 days of recovery, lung mitochondria were examined for adenosine diphosphate (ADP)-phosphorylating respiration, using complex I (C-I)-dependent, complex II (C-II)-dependent, or cytochrome C oxidase (C-IV)-dependent substrates, ATP production rate, and the activity of C-I and C-II. A separate cohort of mice was exposed to 2,4-dinitrophenol (DNP), a known uncoupler of oxidative phosphorylation. At 10 days of recovery, pulmonary alveolarization and the expression of vascular endothelial growth factor (VEGF) were assessed. Sham-operated littermates were used as control mice. At 24 hours after aggressive MV, mitochondrial ATP production rates and the activity of C-I and C-II were significantly decreased compared with control mice. However, at 10 days of recovery, only mice exposed to prolonged-aggressive MV continued to exhibit significantly depressed mitochondrial respiration. This was associated with significantly poorer alveolarization and VEGF expression. In contrast, mice exposed to brief-aggressive or prolonged-gentle MV exhibited restored mitochondrial ADP-phosphorylation, normal alveolarization and pulmonary VEGF content. Exposure to DNP fully replicated the phenotype consistent with alveolar developmental arrest. Our data suggest that the failure of bioenergetics to support normal lung development caused by aggressive and prolonged ventilation should be considered a fundamental mechanism for the development of bronchopulmonary dysplasia in premature neonates. PMID:23980609

Ratner, Veniamin; Sosunov, Sergey A; Niatsetskaya, Zoya V; Utkina-Sosunova, Irina V; Ten, Vadim S

2013-12-01

119

Postoperative course of chronic subdural hematoma  

International Nuclear Information System (INIS)

1) Fourty cases of chronic subdural hematoma were operated on by trephination, irrigation and external drainage. Postoperative neurological recovery and decrease of hematoma cavity on CT scan were followed. 2) Operation were effective for recovery of neurological grade in 28 cases, moderately effective in 7 cases and not effective in 5 cases. 3) Withinthe tenth postoperative day, more than half residual hematoma cavity existed in 53% of examined cases. After that, more than half residual cavity existed in only 17%. 4) Preoperative feature of neurologically unimproved cases were no definite history of head trauma and water like low density of hematoma cavity. Postoperative feature was persistence of more than three fourth of residual hematoma cavity on CT scan. 5) A group of unimproved cases described above are thought to have a feature of subdural hygroma rather than subdural hematoma. When possibility of subdural hygroma is high in preoperative differential diagnosis, indication of operation should be different from chronic subdural hematoma. (author)

1983-01-01

120

Neonatal Infected Subgaleal Hematoma: An Unusual Complication of Early-onset E. coli Sepsis.  

Science.gov (United States)

Subgaleal hematoma (SGH) is an uncommon but potentially lethal medical emergency in newborns. Delay in diagnosis may lead to mortality and morbidity. Infection of an SGH is extremely rare. We report an infected SGH with abscess formation as a complication of early-onset Escherichia coli sepsis in a term neonate. The patient was discovered to have SGH soon after birth. Early-onset E. coli sepsis developed on Day 3 of life. The SGH became infected, with abscess formation 1 week later. The infected SGH was probably due to direct hematogenous spreading of sepsis. The patient was successfully treated without complications. Clinicians should be aware that SGH is a potential site of infection and infection may be caused either by direct hematogenous extension or from traumatic scalp lesions. Appropriate antibiotic treatment and surgical debridement are necessary when an infected SGH occurs. PMID:23597516

Chang, Hung-Yang; Cheng, Kun-Shan; Liu, Yu-Peng; Hung, Hsiao-Fang; Fu, Hua-Wen

2013-04-13

 
 
 
 
121

Blunt trauma as a suspected cause of delayed constrictive pericarditis: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Introduction Constrictive pericarditis is a heterogeneous disease with many causes. Traumatic hemopericardium is an uncommon initiating cause. We report the case of a man developing constrictive pericarditis after blunt chest trauma, in order to highlight an approach to diagnosing the condition and to raise awareness of the possibility of this condition developing after blunt trauma. Case presentation A 72-year-old Caucasian man presented initially to our outpatient clinic with a one-year history of progressively worsening dyspnea, and recent onset of edema of the legs. He was later taken to the emergency department and admitted to hospital. He had previously received unsuccessful treatment from his local primary physicians for suspected respiratory disorder and cellulitis of his legs. Echocardiography showed evidence of pericardial constriction, and computed tomography revealed nodular, lobulated thickening of the pericardium and pleura bilaterally. Interventional biopsies were taken, but gave inconclusive results. Thus, as pericarditis and/or advanced malignancy were suspected, diagnostic video-assisted thoracoscopic surgery was performed to take biopsies from the abnormal lung and pericardial tissue. Examination of these supported the diagnosis of pericarditis, as acute and chronic inflammation and fibrous thickening were found, with no evidence of malignancy. Our patient underwent cardiac catheterization, which revealed three-vessel coronary artery disease. Emergency total pericardiectomy and coronary bypass were performed. Having excluded other common initiating factors, we considered that a blunt trauma that our patient had previously sustained to his chest was the potential cause of the constrictive pericarditis. Conclusion This was an interesting case of blunt chest trauma followed by progressive pericardial and pleural thickening. Subsequent development of chronic constrictive pericarditis occurred, requiring treatment by surgical pericardiectomy, as the clinical course of constrictive pericarditis is usually progressive without surgical intervention. Diagnosis of constrictive pericarditis remains challenging. Although uncommon, blunt trauma should be considered as a possible initiating cause. Delayed presentation of constrictive pericarditis should also be considered as a possible morbidity in a patient who has sustained blunt chest trauma. Our case also highlights the importance of performing echocardiography promptly in patients experiencing ongoing symptoms of congestive heart failure to allow earlier diagnosis of constrictive pericarditis or other cardiac disorders, and avoid unnecessary treatments.

Arabia Francisco A

2011-02-01

122

On the Computation of Group Delay Corrections Caused by Radio Source Structure  

Science.gov (United States)

The authors developed a structure algorithm for the computation of phase- and group delay corrections to geodetic VLBI observations. For some of the sources, i.e. 3C 454.3, 3C 273B and 3C 345 the corrections are in the range of several hundered picosecs of group delay.

Campbell, J.; Schuh, H.; Zeppenfeld, G.

123

Complete nonsurgical resolution of a spontaneous spinal epidural hematoma.  

Science.gov (United States)

Spontaneous spinal epidural hematomas (SSEH) are heralded by spinal pain and progressive cord compression syndromes which may lead to permanent neurological disability or death if emergent neurosurgical intervention is delayed. It therefore must be considered early in the differential diagnosis of acute spinal cord compression syndrome. A case of spontaneous spinal epidural hematoma presenting as an acute myelopathy in a clarinet player who chronically used a nonsteroidal anti-inflammatory medication is presented. The case was remarkable for the rare complete spontaneous resolution of neurological function. Approximately 250 cases of SSEH have been reported in the medical literature, although only a handful of these patients have recovered spontaneously. This is the sixth report of such an event. The etiologies, contributing factors, disease progression, and treatment recommendations are discussed. PMID:8768163

Silber, S H

1996-07-01

124

Is human fracture hematoma inherently angiogenic?  

LENUS (Irish Health Repository)

This study attempts to explain the cellular events characterizing the changes seen in the medullary callus adjacent to the interfragmentary hematoma during the early stages of fracture healing. It also shows that human fracture hematoma contains the angiogenic cytokine vascular endothelial growth factor and has the inherent capability to induce angiogenesis and thus promote revascularization during bone repair. Patients undergoing emergency surgery for isolated bony injury were studied. Raised circulating levels of vascular endothelial growth factor were seen in all injured patients, whereas the fracture hematoma contained significantly higher levels of vascular endothelial growth factor than did plasma from these injured patients. However, incubation of endothelial cells in fracture hematoma supernatant significantly inhibited the in vitro angiogenic parameters of endothelial cell proliferation and microtubule formation. These phenomena are dependent on a local biochemical milieu that does not support cytokinesis. The hematoma potassium concentration is cytotoxic to endothelial cells and osteoblasts. Subcutaneous transplantation of the fracture hematoma into a murine wound model resulted in new blood vessel formation after hematoma resorption. This angiogenic effect is mediated by the significant concentrations of vascular endothelial growth factor found in the hematoma. This study identifies an angiogenic cytokine involved in human fracture healing and shows that fracture hematoma is inherently angiogenic. The differences between the in vitro and in vivo findings may explain the phenomenon of interfragmentary hematoma organization and resorption that precedes fracture revascularization.

Street, J

2012-02-03

125

Cerebellar hematoma following transsphenoidal surgery.  

Science.gov (United States)

Cerebellar hemorrhage after supratentorial surgery is a very infrequent complication. Most cases occur following aneurysm or brain tumor surgery, or evacuation of extracerebral collections. The underlying mechanism of formation of these hematomas is unclear. We present an example of cerebellar hemorrhage following transsphenoidal resection of a pituitary adenoma. To our knowledge, this is the first case reported of hemorrhage in the posterior fossa after a transsphenoidal approach. PMID:15902894

Miranda, P; Alén, J F; Rivas, J; Pérez, A; Ramos, A

2005-04-01

126

Acute intracranial hematoma formation following excision of a cervical subdural tumor: a report of two cases and literature review.  

Science.gov (United States)

An intracranial hematoma is a rare, yet significant, complication following spinal surgery. The authors describe two cases with acute intracranial hematoma formation after excision of a cervical subdural schwannoma. One was a 14-year-old girl who developed bilateral intracranial extradural hematomas immediately following excision of the C4 subdural schwannoma. The other was a 59-year-old woman who had an acute cerebellar hematoma after removal of the C2-C5 subdural schwannoma. During the surgeries of both cases, spinal dura was partially removed together with the tumor and the dural sac could not be repaired, resulting in large amounts of intraoperative CSF loss and persistent postoperative CSF leakage. Both patients failed to regain consciousness from anesthesia after surgery, and a cranial CT scan identified large intracranial hematomas. Urgent hematoma evacuation was ultimately performed to save the patients. Based on the authors' experience and literature review, a conclusion was drawn that considerable CSF leakage and a sharp decrease of CSF pressure are common features during the excision of a spinal subdural tumor, which may lead to acute intracranial hematomas. Continual postoperative monitoring in patients with this condition should be of a very high priority. A CT or MRI should be immediately investigated to exclude intracranial hematomas for any patient with delayed emergence from anesthesia following spinal surgery. Hematoma evacuation is indispensable once an intracranial hematoma is identified in the patient who fails to regain consciousness from anesthesia post surgery. Furthermore, the possible pathophysiological mechanisms responsible for the formation of an intracranial hematoma after spinal procedures, particularly after manipulations of a cervical subdural tumor, are discussed. PMID:23848602

Ma, Xuexiao; Zhang, Yan; Wang, Ting; Li, Guizhi; Zhang, Guoqing; Khan, Hassan; Xiang, Hongfei; Chen, Bohua

2014-01-01

127

Ruptura dos vasa vasorum e hematoma intramural da aorta: um paradigma em mudança Rupture of vasa vasorum and intramural hematoma of the aorta: a changing paradigm  

Directory of Open Access Journals (Sweden)

Full Text Available A ruptura dos vasa vasorum tem sido reconhecida como uma das causas do hematoma intramural da aorta há 90 anos. Esta breve revisão apresenta sistematicamente a fisiologia desses vasos e o seu papel na fisiopatologia das alterações parietais da aorta que ocorrem na hipertensão arterial, na arteriosclerose e na síndrome aórtica aguda. A hipótese defendida aqui é a de que a ruptura dos vasa vasorum ocorre como um fenômeno secundário e não como um dos fatores causais na fisiopatologia do hematoma intramural.Rupture of vasa varorum has been recognized as one cause of intramural hematoma of the aorta for 90 years. This brief revision presents systematically, the physiology of these vessels and its role in the physiopathology of the alterations in the aortic wall secondary to hypertension, arteriosclerosis and in Acute Aortic Syndrome. The hypothesis is that rupture of vasa vasorum is a secondary phenomenon and not one causal factor in the physiopathology of intramural hematoma.

Adamastor Humberto Pereira

2010-06-01

128

Spontaneous subdural hematoma of the thoracolumbar region with massive recurrent bleed  

Directory of Open Access Journals (Sweden)

Full Text Available Spinal subdural hematoma is a rare disorder and can be caused by abnormalities of coagulation, blood dyscrasias, lumbar puncture, trauma, underlying neoplasm, and arteriovenous malformation. We discuss an unusual case of an elderly woman who presented with spontaneous spinal subdural hematoma and developed massive rebleeding on the third day following initial evacuation of hematoma. This case illustrates that a patient with routine normal coagulation profile and adequate hemostasis can still harbor platelet dysfunction (in present case due to polycythemia and later on can manifest as rebleeding and neurological deterioration.

Cincu Rafael

2009-01-01

129

Spinal epidural hematomas examined on MRI; Krwiaki nadtwardowkowe, wewnatrzkanalowe w badaniu metoda MR  

Energy Technology Data Exchange (ETDEWEB)

Spinal epidural hematomas are rare pathology, caused by trauma or spontaneous. In clinical examination acute spinal cord compression is observed. MRI designations appear entirely particular. In sagittal projection, biconvex mass in the dorsal, or sometimes ventral part of the spinal canal is clearly visible. This is well delineated by the thecal sac from the cord and cauda equina. MRI investigations in 3 patients revealed corresponding with spinal bone injuries and cord edema epidural hematomas. Differential diagnosis must contain subdural hematoma and epidural neoplasms or abscess. (author) 8 refs, 3 figs

Rejnowski, G.; Poniatowska, R.; Kozlowski, P. [Zaklad Neuroradiologii, Inst. Psychiatrii i Neurologii, Warsaw (Poland)

1995-12-31

130

Chronic intradiploic hematoma in patients with coagulopathy.  

Science.gov (United States)

Intradiploic hematomas occur rarely. They have been reported in patients with and without coagulation disorders. The presentation of intradiploic hematomas varies depending on their location and the severity of the coagulopathy. We describe a patient with a huge hemicranial chronic intradiploic hematoma. Surgery involved opening the thinned outer table and evacuation of a jelly-like material and an organized clot, leaving behind the inner table. The rarity of this disease, possible pathogenesis and related surgical aspects are discussed. PMID:20537896

Dange, Nitin; Mahore, Amit; Avinash, K M; Joshi, Vijay; Kawale, Juhi; Goel, Atul

2010-08-01

131

Clinical and Pathological Characteristics of Organized Hematoma  

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Objective. To study the clinical and pathological characteristics of patients with organized hematoma with malignant features in maxillary sinuses. Subjects and Methods. This was a retrospective study of five patients who were treated surgically for organized hematoma. The preoperative CT and MRI findings were studied clinically. The expressions of CD31, CD34, and periostin in surgical samples were investigated by immunohistochemistry. Results. The clinical features of organized hematoma, suc...

Ohta, Nobuo; Watanabe, Tomoo; Ito, Tsukasa; Kubota, Toshinori; Suzuki, Yusuke; Ishida, Akihiro; Aoyagi, Masaru; Matsubara, Atsushi; Izuhara, Kenji; Kakehata, Seiji

2013-01-01

132

Posterior fossa subdural hematoma mimicking intracerebellar hemorrhage.  

Science.gov (United States)

Subdural hematomas of the posterior fossa are very rare and most cases are related to head injury. The influence of anticoagulation in cases of spontaneous development is well known. Although diagnosis is easily achieved by CT sean, atypical forms may lead to the wrong diagnosis of cerebellar hematoma. We present a case of a posterior fossa acute subdural hematoma occurring in an anticoagulated patient who was preoperatively misdiagnosed as an intracerebellar hemorrhage. PMID:14710308

Miranda, P; Alday, R; Lagares, A; Pérez, A; Lobato, R D

2003-12-01

133

[Spontaneous cerebellar hematoma in adults. 44 cases].  

Science.gov (United States)

Spontaneous cerebellar hematomas account for 10 p. 100 of all spontaneous intra-cranial hemorrhages. In this series of 44 cases, 3 clinico-pathological groups are described on the basis of clinical and pathological data (small, middle and massive hematomas). The mortality rate was high (50 p. 100). Nevertheless, early and direct draining of the hematomas provides the best chances of survival. PMID:2237092

Guillermain, P; Lena, G; Reynier, Y; Vincentelli, F; Jazzar, A

1990-01-01

134

Theatre delay for emergency general surgical patients: a cause for concern?  

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The delay involved in operating on emergency general surgical patients is often excessive. This problem has been examined prospectively in a district general hospital with a catchment population of 450,000. Over a 16-week period, the details of 204 consecutive general surgical emergency operations were recorded and analysed. Following essential resuscitation, the median delay in operating on emergency general surgical patients was 3 h. Eighty-eight patients had to wait in excess of 1 h, with ...

1990-01-01

135

Endovascular treatment of an acute ascending aortic intramural hematoma?  

Science.gov (United States)

INTRODUCTION Herein, we present a case of an elderly gentleman who presented with an extensive intramural hematoma of the aorta which was treated with a percutaneous placement of an endovascular stent. PRESENTATION OF CASE A 79-year-old male with a history of hypertension presented to the emergency department because of sudden onset of substernal chest pain radiating to his back. A chest computerized tomography scan was performed that demonstrated a Type A aortic wall intramural hematoma involving the arch and ascending aorta dissecting both antegrade and retrograde from a penetrating ulcer located in the descending aorta, immediately distal to the left subclavian artery. No dissection flap was noted. The patient opted for an endovascular approach. He was treated with the placement of a stent just distal to the left subclavian artery, with good results noted on follow-up exam performed 3 months later. DISCUSSION The treatment of a Type A IMH lacks consensus, but the majority do favor surgical management. The data are limited; however, there are reports of patients with Type A intramural hematoma treated with descending aortic endograft at the site of the culprit ulcerated plaque, with satisfactory results. CONCLUSION In a select group of patients, an endovascular approach for the treatment of a Type A aortic wall intramural hematoma caused by an ulcerated plaque may be a viable treatment option.

White, Candace; LaPietra, Angelo; Santana, Orlando; Burke, William; Beasley, Robert; Conde, Cesar; Lamelas, Joseph

2014-01-01

136

MR imaging and clinical findings of spontaneous spinal epidural hematoma  

International Nuclear Information System (INIS)

To describe the MR imaging and clinical findings of spontaneous spinal epidural hematoma. The MR and clinical findings in six patients (M:F=3D4:2;adult:child=3D3:3) with spontaneous spinal epidural hematoma were reviewed. Five patients without any predisposing factor which might cause the condition and one with acute myelogenous leukemia were included. Emergency surgery was performed in two patients, and the other four were managed conservatively. The epidural lesion involved between three and seven vertebrae (mean:4.5), and relative to the spinal cord was located in the posterior-lateral (n=3D4), anterior (n=3D1), or right lateral (n=3D1) area. The hematoma was isointense (n=3D1) or hyperintense (n=3D5) with spinal cord on T1-weighted images, and hypointense (n=3D2) or hyperintense (n=3D4) on T2-weighted images. It was completely absorbed in four of five patients who underwent follow-up MR imaging, but not changed in one. The clinical outcome of these patients was complete recovery (n=3D4), spastic cerebral palsy (n=3D1), or unknown (n=3D1). Because of the lesion's characteristic signal intensity; MR imaging is very useful in the diagnosis and evaluation of spontaneous spinal epidural hematoma. (author)

2000-01-01

137

Unoperated giant cerebellar hematoma: Case report  

Directory of Open Access Journals (Sweden)

Full Text Available The treatment of patients with spontaneous intracerebellar hematoma (SIH still remains controversial. Computerized tomography (CT offers early and accurate diagnosis of SIH, the size and location of SIH can be precisely defined. The main prognostic factors affecting the outcome are the clinical state of the patient on admission, the size and localization of the hematoma, compression of brain-stem, and the presence of intraventricular hematoma and hydrocephalus. In this report, a 62 year old female patient with a giant cerebellar hematoma who was treated medically was presented.

Gezen, F.

2005-01-01

138

Intracerebral hematoma following removal of chronic subdural hematoma. Report of two cases.  

Science.gov (United States)

Two cases of intracerebral hemorrhage consequent to surgery planned for homolateral chronic subdural hematoma are reported. Both patients were treated conservatively and made a satisfactory recovery. The pathological events leading to the formation of an intracerebral hematoma following the evacuation of a chronic subdural hematoma still remain undefined. PMID:2624018

Turtas, S; Orunesu, G

1989-01-01

139

Hematoma subgaleal crónico en un lactante: Presentación de un caso / Chronic subgaleal hematoma in a child: Case report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Los hematomas subgaleales neonatales son colecciones sanguinolentas, localizadas entre la galea y el tejido conectivo epicraneal; con frecuencia son infradiagnosticados, y en la mayoría de las ocasiones guardan relación con determinados procedimientos obstétricos como el uso de fórceps o ventosa. En [...] general tienen poco volumen y suelen solucionarse espontáneamente. Ocasionalmente pueden alcanzar gran tamaño y ponen en riesgo la vida del recién nacido; excepcionalmente tienden a la cronificación siendo necesario para su tratamiento emplear procedimientos quirúrgicos. Exponemos el caso de una paciente menor de un año de edad que presenta un hematoma subgaleal secundario a parto asistido con ventosa y que precisó tratamiento quirúrgico. Abstract in english Neonatal subgaleal hematomas are under-diagnosed collections of blood beneath the galea, often caused by certain obstetric procedures such as use of forceps or vacuum. They generally have low volume and often resolve spontaneously. Occasionally, they can achieve a large volume and may endanger the l [...] ive of the affected newborns. Rarely, they become chronic and exceptionally they may require surgical treatment. We report the case of a child under one year of age who was referred to our department because of a subgaleal hematoma secondary to vacuum-assisted delivery that required surgical treatment.

Santín-Amo, J.M.; Gelabert-González, M.; Villa-Fernández, J.M.; Castro-Bouzas, D.; Serramito-García, R.; García-Allut, A..

140

Causes of Delay in Diagnosis of Smear-Positive Pulmonary Tuberculosis Patients Referred to the Tuberculosis Center of Zahedan  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Tuberculosis is now the major cause of mortality in the world. This study has tried to identify the factors affecting the diagnosis of this disease by determining the relationship between delay in diagnosis and factors associated with patient and health system.Materials and Methods: This research was a cross-sectional study conducted on smear positive pulmonary tuberculosis patients referred to the tuberculosis center in the first half of 2008. Required information was completed through patient records and patient interviews.Results: A total 98 patients were studied including 42 males and 56 females. Average age of patients was 51.6±19.57. Average delay in diagnosis was 2.8±1.78 months. The average delay of patients and health system was respectively 2.6±1.76 months and 6±4.27days. Data analysis showed that there is no relationship between the delay in diagnosis and individual variables such as age, gender, occupation, etc., and examination of sputum smears at the first visit. However, there is a significant relationship between patient delay with different factors such as education (p=0.03, marital status (p=0.03, existence of hospital or medical centers in the residence (p=0.02, distance to the medical center (p=0.02 and between health system delay and residence in the city (p=0.01, distance to this medical center (p=0.03 and obtaining chest X-ray (CXR in the first visit (p=0.003.Conclusion: The results showed that with the increase of literacy, the establishment of new hospitals and health centers in remote areas and suburbs as well as chest X-ray in the first visit, the amount of delay in diagnosis can be reduced.

Mosayeb Shahriyar

2012-08-01

 
 
 
 
141

Acute subdural hematoma from bridging vein rupture: a potential mechanism for growth.  

Science.gov (United States)

Most acute subdural hematomas (ASDHs) develop after rupture of a bridging vein or veins. The anatomy of the bridging vein predisposes to its tearing within the border cell layer of the dura mater. Thus, the subdural hematoma actually forms within the dura. The hematoma grows by continued bleeding into the border cell layer. However, the venous pressure would not be expected to cause a large hematoma. Therefore, some type of mechanism must account for the hematoma's expansion. Cerebral venous pressure (CVP) has been demonstrated in animal models to be slightly higher than intracranial pressure (ICP), and CVP tracks the ICP as pressure variations occur. The elevation of CVP as the ICP increases is thought to result from an increase in outflow resistance of the terminal portion of the bridging veins. This probably results from a Starling resistor model or, less likely, from a muscular sphincter. A hypothesis is derived to explain the mechanism of ASDH enlargement. Tearing of one or more bridging veins causes these vessels to bleed into the dural border cell layer. Subsequent ICP elevation from the ASDH, cerebral swelling, or other cause results in elevation of the CVP by increased outflow resistance in the intact bridging veins. The increased ICP causes further bleeding into the hematoma cavity via the torn bridging veins. Thus, the ASDH enlarges via a positive feedback mechanism. Enlargement of an ASDH would cease as blood within the hematoma cavity coagulates. This would stop the dissection of the dural border cell layer, and pressure within the hematoma cavity would equalize with that in the torn bridging vein or veins. PMID:24313607

Miller, Jimmy D; Nader, Remi

2014-06-01

142

Pathological intracranial extradural hematoma in a 10-year-old child  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A nontraumatic spontaneous extradural hematoma, in a fully conscious 10-year-old male child, caused by a solitary eosinophilic granuloma of calvarium presented as a case of localized painful swelling of the head, which rapidly expanded and decreased in size. A plain CT-scan of the head with bone window revealed eroded right parietal bone with subperiosteal debris and extradural hematoma of mixed density. Immediate evacuation of the extradural clot and complete excision of the lesion was perfo...

Bhat Abdul; Jain Ashish; Kirmani A; Nizami Furqan

2010-01-01

143

[Spontaneous cerebellar hematoma with a favorable course].  

Science.gov (United States)

Echo-eg, EEG, dopplerography and computer-aided tomography of the brain were employed to examine 8 patients with spontaneous cerebellar hematomas. Clinically, minor intracerebellar hematomas are characterized by acutely occurring intensive systemic dizziness, nausea, moderate coordination disorders without consciousness derangement or pyramidal and sensible disturbances. It is demonstrated that cerebellar hemorrhages may run a favourable course without any surgical treatment. PMID:1647098

Mironov, N V; Arkhipov, S L; Gavrilov, E S; Iakhno, N N

1991-01-01

144

Antiplatelet antibody may cause delayed transfusion-related acute lung injury  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Yoshitaro Torii1, Toshiki Shimizu1, Takashi Yokoi1, Hiroyuki Sugimoto1, Yuichi Katashiba1, Ryotaro Ozasa1, Shinya Fujita1, Yasushi Adachi2, Masahiko Maki3, Shosaku Nomura11The First Department of Internal Medicine, Kansai Medical University, Osaka, 2Department of Clinical Pathology, Toyooka Hospital, Hyogo, 3First Department of Pathology, Kansai Medical University, Osaka, JapanAbstract: A 61-year-old woman with lung cancer developed delayed transfusion-related acute lung injury (TRALI) syndro...

Torii Y; Shimizu T; Yokoi T; Sugimoto H; Katashiba Y; Ozasa R; Fujita S; Adachi Y; Maki M; Nomura S

2011-01-01

145

Delayed diagnosis of traumatic diaphragmatic hernia may cause colonic perforation: a case report  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Early diagnosis of diaphragmatic rupture after traumas may be difficult, and delayed diagnosis may result in increased morbidity and mortality. This paper describes the case of a 32-year-old man who experienced a traffic accident and had diagnosis of traumatic diaphragmatic hernia nearly four months later. The patient was referred to our emergency room suffering from ileus symptoms. Physical examination demonstrated an apparent abdominal distention, tenderness at the upper abdominal quadrants...

Ozkan, Orhan Veli; Semerci, Ersan; Yetim, Ibrahim; Davran, Ramazan; Diner, Guvenc; Paltaci, Ilhan

2009-01-01

146

Error in delayed neutron analysis caused by presence of rare earth elements  

International Nuclear Information System (INIS)

Certain elements such as the rare earths have been known to interfere with the reading of delayed neutron analysis (DNS) for other elements. An attempt to show changes in the DNA readings for a standard concentration of uranium by varying concentration of several rare earth elements was carried out. The elements studied were lanthanum, cerium, neodymium, samarium and gadolinium. All except cerium were found to decrease the actual reading. Cerium, on the other hand increased the reading

1993-06-01

147

Stream of dark matter as a possible cause of the opera clocks' synchronization signals delay  

CERN Document Server

A stream of weakly interacting massive particles (WIMPs) gravitationally scattered outwards within the Earth yields a delay, \\delta t \\simeq 60 ns, in good agreement with the results of the OPERA experiment. Conversely, the OPERA experiment may be seen as the unveiling of the first hint of a dark matter particle probed with the photons of the GPS communication signals and using the neutrino beam of the CNGS as a velocity standard. Our analysis yields the true neutrino velocity, V_{\

Mbelek, Jean Paul

2012-01-01

148

Inactivation of IL11 Signaling Causes Craniosynostosis, Delayed Tooth Eruption, and Supernumerary Teeth  

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Craniosynostosis and supernumerary teeth most often occur as isolated developmental anomalies, but they are also separately manifested in several malformation syndromes. Here, we describe a human syndrome featuring craniosynostosis, maxillary hypoplasia, delayed tooth eruption, and supernumerary teeth. We performed homozygosity mapping in three unrelated consanguineous Pakistani families and localized the syndrome to a region in chromosome 9. Mutational analysis of candidate genes in the regi...

Nieminen, Pekka; Morgan, Neil v; Fenwick, Aime?e l; Parmanen, Satu; Veistinen, Lotta; Mikkola, Marja l; Van der spek, Peter j; Giraud, Andrew; Judd, Louise; Arte, Sirpa; Brueton, Louise a; Wall, Steven a; Mathijssen, Irene m J.; Maher, Eamonn r; Wilkie, Andrew o M.

2011-01-01

149

Delayed neurotoxicity in the wild mallard duckling caused by the organophosphorus insecticides cyanofenphos and leptophos.  

Science.gov (United States)

The susceptibility of wild mallard ducklings to the delayed neurotoxic effect of the neurotoxic organophosphorus insecticides cyanofenphos and leptophos was evaluated following a daily dosing regimen. Ducklings were treated daily with either cyanofenphos or with leptophos at different dose levels for 90 days, or until they died, or became paralyzed. A control group of ducklings given corn oil at 1 ml/kg daily for 90 days was used for comparison. All treated birds were observed daily for any clinical signs of neurotoxicity during the course of this study. All of the surviving ducklings that were treated with cyanofenphos at 4 mg/kg/day or leptophos at 10 mg/kg/day developed clinical signs of delayed neurotoxicity after 7 to 11 weeks of intoxication. Symptoms included leg weakness, ataxia, severe ataxia and paralysis. The observed clinical signs were confirmed by histological changes found in the spinal cords of the treated birds. These changes were of the type associated with organophosphorus-induced delayed neuropathy (OPIDN). These results demonstrate that wild mallard ducklings are susceptible to OPIDN and this avian species can be used in screening organophosphorus compounds for such effect. PMID:2430007

Soliman, S A; Ahmed, N S; el-Gendy, K S; el-Bakary, A S; el-Sebae, A H

1986-10-01

150

Subacute phase treatment of subperiosteal hematoma of the orbit with epidural hematoma in the frontal cranial fossa: Case report  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Subperiosteal hematoma of the orbit is one of the rare lesions that cause exophthalmos after craniomaxillofacial trauma. Presently, there is no consensus for how to treat this disease. Although some reports have suggested a conservative type of therapy, others have recommended surgical treatments be done during the early stages. Case presentation This case report provides details on the clinical course of a 9-year-old girl with subperiosteal ...

Mikami Taro; Maegawa Jiro; Kuroda Mayu; Yamamoto Yasushi; Yasumura Kazunori

2012-01-01

151

Hematoma retrofaríngeo secundário a pequeno trauma contuso no pescoço: relato de caso / Retropharyngeal hematoma secondary to minor blunt neck trauma: case report / Hematoma retrofaríngeo secundario a un pequeño trauma contundente en el cuello: relato de caso  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese JUSTIFICATIVA E OBJETIVOS: O desenvolvimento de hematoma retrofaríngeo após trauma contuso é uma ocorrência rara. Porém, uma lesão ocupando espaço nessa área pode ser fatal, o que exige rápida avaliação e tratamento. Esse tipo de hematoma é clinicamente importante devido à proximidade entre o espaço [...] retrofaríngeo e a via aérea superior. Qualquer edema nesse espaço pode causar uma protuberância da parede posterior da faringe de encontro às vias aéreas e obstruí-las. RELATO DE CASO: Paciente do sexo feminino, 86 anos, que caiu de uma altura de 1,5 m e bateu o pescoço na escada, foi admitida em nosso Departamento de Traumatologia. Tomografia computadorizada e radiografia dos tecidos moles do pescoço foram feitas e mostraram uma grande massa retrofaríngea que se estendia da base do crânio até o nível dos pulmões. A paciente ficou em observação e o tamanho do hematoma diminuiu espontaneamente nos sete dias subsequentes; contudo, devido a uma infecção pulmonar, a paciente foi a óbito no décimo dia. Este relato enfatiza que a drenagem precoce do hematoma retrofaríngeo poderia ter sido considerada neste caso. Embora seja de ocorrência rara, o hematoma retrofaríngeo é um problema que pode ser encontrado em serviços de emergência. Abstract in spanish JUSTIFICATIVA Y OBJETIVOS: El desarrollo del hematoma retrofaríngeo posterior al trauma contundente es un hecho raro. Sin embargo, una lesión que ocupa un espacio en esa área puede ser fatal, lo que exige una rápida evaluación y el tratamiento adecuado. Ese tipo de hematoma es clínicamente important [...] e debido a la cercanía entre el espacio retrofaríngeo y la vía aérea superior. Cualquier hinchazón en ese espacio puede causar una protuberancia de la pared posterior de la faringe contra las vías aéreas y obstruirlas. RELATO DE CASO: Paciente del sexo femenino, de 86 años, que se cayó de una altura de 1,5 m y se dio con la escalera en el cuello. Fue admitida en nuestro Departamento de Traumatología. Se realizaron la tomografía computadorizada y la radiografía de los tejidos suaves del cuello, lo que arrojó una gran masa retrofaríngea que se extendía desde la base del cráneo hasta el nivel de los pulmones. La paciente permaneció en observación y el tamaño del hematoma se redujo espontáneamente en los siete días posteriores; sin embargo, y debido a una infección pulmonar, la paciente falleció al décimo día. Ese relato nos muestra que el drenaje rápido del hematoma retrofaríngeo podría haber sido considerado en ese caso. Y aunque sea de una baja incidencia, el hematoma retrofaríngeo es un problema que puede ser encontrado en los servicios de emergencia. Abstract in english BACKGROUND AND OBJECTIVES: The development of a retropharyngeal hematoma following a blunt trauma is a rare occurrence. However, a spaceoccupying lesion in this area can be life-threatening and requires rapid assessment and treatment. This is clinically important because of the close proximity of th [...] e retropharyngeal space to the upper airway. Any swelling in the the posterior pharyngeal space may prompt it to bulge anteriorly into the airway and cause its obstruction. CASE REPORT: A 86-year-old woman fell from a height of 1.5 m and hit her neck on stairs and was admitted to our trauma department. A computerized tomography scan and a lateral neck x-ray to observe the soft tissue revealed a large retropharyngeal mass extending from the base of the skull down to the level of the lung. The patient was kept under observation and the hematoma reduced spontaneously in the following seven days although the patient died on the tenth day from pulmonary infection. The report emphasizes that early drainage of a retropharyngeal hematoma should be considered in similar cases. Although rarely encountered, retropharyngeal hematoma is a problem that can be faced in an emergency department.

Senel, Ahmet Can; Gunduz, Abdul Kadir.

152

Hematoma retrofaríngeo secundário a pequeno trauma contuso no pescoço: relato de caso Hematoma retrofaríngeo secundario a un pequeño trauma contundente en el cuello: relato de caso Retropharyngeal hematoma secondary to minor blunt neck trauma: case report  

Directory of Open Access Journals (Sweden)

Full Text Available JUSTIFICATIVA E OBJETIVOS: O desenvolvimento de hematoma retrofaríngeo após trauma contuso é uma ocorrência rara. Porém, uma lesão ocupando espaço nessa área pode ser fatal, o que exige rápida avaliação e tratamento. Esse tipo de hematoma é clinicamente importante devido à proximidade entre o espaço retrofaríngeo e a via aérea superior. Qualquer edema nesse espaço pode causar uma protuberância da parede posterior da faringe de encontro às vias aéreas e obstruí-las. RELATO DE CASO: Paciente do sexo feminino, 86 anos, que caiu de uma altura de 1,5 m e bateu o pescoço na escada, foi admitida em nosso Departamento de Traumatologia. Tomografia computadorizada e radiografia dos tecidos moles do pescoço foram feitas e mostraram uma grande massa retrofaríngea que se estendia da base do crânio até o nível dos pulmões. A paciente ficou em observação e o tamanho do hematoma diminuiu espontaneamente nos sete dias subsequentes; contudo, devido a uma infecção pulmonar, a paciente foi a óbito no décimo dia. Este relato enfatiza que a drenagem precoce do hematoma retrofaríngeo poderia ter sido considerada neste caso. Embora seja de ocorrência rara, o hematoma retrofaríngeo é um problema que pode ser encontrado em serviços de emergência.JUSTIFICATIVA Y OBJETIVOS: El desarrollo del hematoma retrofaríngeo posterior al trauma contundente es un hecho raro. Sin embargo, una lesión que ocupa un espacio en esa área puede ser fatal, lo que exige una rápida evaluación y el tratamiento adecuado. Ese tipo de hematoma es clínicamente importante debido a la cercanía entre el espacio retrofaríngeo y la vía aérea superior. Cualquier hinchazón en ese espacio puede causar una protuberancia de la pared posterior de la faringe contra las vías aéreas y obstruirlas. RELATO DE CASO: Paciente del sexo femenino, de 86 años, que se cayó de una altura de 1,5 m y se dio con la escalera en el cuello. Fue admitida en nuestro Departamento de Traumatología. Se realizaron la tomografía computadorizada y la radiografía de los tejidos suaves del cuello, lo que arrojó una gran masa retrofaríngea que se extendía desde la base del cráneo hasta el nivel de los pulmones. La paciente permaneció en observación y el tamaño del hematoma se redujo espontáneamente en los siete días posteriores; sin embargo, y debido a una infección pulmonar, la paciente falleció al décimo día. Ese relato nos muestra que el drenaje rápido del hematoma retrofaríngeo podría haber sido considerado en ese caso. Y aunque sea de una baja incidencia, el hematoma retrofaríngeo es un problema que puede ser encontrado en los servicios de emergencia.BACKGROUND AND OBJECTIVES: The development of a retropharyngeal hematoma following a blunt trauma is a rare occurrence. However, a spaceoccupying lesion in this area can be life-threatening and requires rapid assessment and treatment. This is clinically important because of the close proximity of the retropharyngeal space to the upper airway. Any swelling in the the posterior pharyngeal space may prompt it to bulge anteriorly into the airway and cause its obstruction. CASE REPORT: A 86-year-old woman fell from a height of 1.5 m and hit her neck on stairs and was admitted to our trauma department. A computerized tomography scan and a lateral neck x-ray to observe the soft tissue revealed a large retropharyngeal mass extending from the base of the skull down to the level of the lung. The patient was kept under observation and the hematoma reduced spontaneously in the following seven days although the patient died on the tenth day from pulmonary infection. The report emphasizes that early drainage of a retropharyngeal hematoma should be considered in similar cases. Although rarely encountered, retropharyngeal hematoma is a problem that can be faced in an emergency department.

Ahmet Can Senel

2012-10-01

153

Evaluation and establishment of a canine model of delayed splenic rupture using contrast-enhanced ultrasound.  

Science.gov (United States)

The aim of the present study was to establish a canine model of delayed splenic rupture (DSR). A total of 15 mongrel dogs were anesthetized and laparotomized. The hematomas were observed following an injection of heparin. The hematomas were ruptured. The severity of the spleen rupture was evaluated and the intra-abdominal free liquid was measured. The splenic hematomas in the dogs continued to form and the hematoma area gradually increased. The hematomas were ruptured after impacting the abdominal wall. The spleens were damaged, and conventional ultrasonography showed intra-abdominal free liquid. These conditions were demonstrated via computed tomography scanning. A DSR canine model was established successfully. PMID:22710316

Tian, Jiangke; Xie, Xia; Lv, Faqin; Yu, Tengfei; Wu, Rong; Zhang, Xinghua; Wang, Dong; Tang, Jie

2012-09-01

154

Efficacy of delayed decompression of lumbar disk herniation causing cauda equina syndrome.  

Science.gov (United States)

Cauda equina syndrome (CES) is a rare but serious neurosurgical emergency that can have devastating long-lasting neurologic consequences. Compression of the cauda equina can result in paralysis of bowel and bladder function. Such compression has been considered the only absolute indication for surgery in cases of lumbar disk disease. Therefore, it is extremely important that physicians be aware of the condition so that a surgeon is consulted before neurological damage becomes permanent. This article reports the results of delayed surgical decompression in cases of lumbar disk herniation with CES. The study group comprised 14 patients (11 men and 3 women) with a mean age of 48 years (range, 36-57 years). Clinical presentation was chronic low back pain, sciatica, and impaired sphincter function. All patients had a fenestration at the affected level and site, and the disk fragments were excised and the disk space cleared. The surgeries were performed 1 to 3 months after onset of sphinctric disturbance. Postoperatively, all patients were relieved of back and/or leg pain and showed sensory improvement. Twelve patients regained full control of urination and defecation. Lower extremity strength improved in 9 patients. The classical presentation of CES is not obvious. Even if surgery is performed late due to delayed presentation, significant improvement in neurologic and bladder function can still be expected. PMID:24679201

Aly, Tarek A; Aboramadan, Mohamed Osama

2014-02-01

155

Smad6/Smurf1 overexpression in cartilage delays chondrocyte hypertrophy and causes dwarfism with osteopenia  

Science.gov (United States)

Biochemical experiments have shown that Smad6 and Smad ubiquitin regulatory factor 1 (Smurf1) block the signal transduction of bone morphogenetic proteins (BMPs). However, their in vivo functions are largely unknown. Here, we generated transgenic mice overexpressing Smad6 in chondrocytes. Smad6 transgenic mice showed postnatal dwarfism with osteopenia and inhibition of Smad1/5/8 phosphorylation in chondrocytes. Endochondral ossification during development in these mice was associated with almost normal chondrocyte proliferation, significantly delayed chondrocyte hypertrophy, and thin trabecular bone. The reduced population of hypertrophic chondrocytes after birth seemed to be related to impaired bone growth and formation. Organ culture of cartilage rudiments showed that chondrocyte hypertrophy induced by BMP2 was inhibited in cartilage prepared from Smad6 transgenic mice. We then generated transgenic mice overexpressing Smurf1 in chondrocytes. Abnormalities were undetectable in Smurf1 transgenic mice. Mating Smad6 and Smurf1 transgenic mice produced double-transgenic pups with more delayed endochondral ossification than Smad6 transgenic mice. These results provided evidence that Smurf1 supports Smad6 function in vivo.

Horiki, Mitsuru; Imamura, Takeshi; Okamoto, Mina; Hayashi, Makoto; Murai, Junko; Myoui, Akira; Ochi, Takahiro; Miyazono, Kohei; Yoshikawa, Hideki; Tsumaki, Noriyuki

2004-01-01

156

Hematoma hepático subcapsular en el puerperio  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish El hematoma hepático subcapsular es una complicación infrecuente y grave durante la gestación o el período puerperal. Esta patología generalmente se relaciona con preeclampsia o síndrome de HELLP. Su diagnóstico debe confirmarse por tomografía axial computarizada. La precocidad del diagnóstico y tra [...] tamiento es importante para evitar la ruptura del hematoma. Abstract in english Subcapsular hepatic hematoma is a rare and severe complication during pregnancy or postpartum period. This condition is usually related to preeclampsia or HELLP syndrome. Its diagnosis must be confirmed by abdominal computed tomography. An early diagnosis and treatment are important to avoid hematom [...] a rupture.

Belén, Carazo H; Manuel Ángel, Romero C; Cristina, Puebla M; Amelia, Sanz M; Beatriz, Rojas P.

157

Spontaneous perforation of an intramural rectal hematoma: Report of a case  

Directory of Open Access Journals (Sweden)

Full Text Available Spontaneous hematomas are rare and most occur secondary to hematologic disorders or during anticoagulant therapy. Most spontaneous hematomas occur above the sigmoid colon, and rarely in the rectum. Herein we present the case of a patient with a spontaneous perforating hematoma of the rectum who presented with severe abdominal pain after a bloody stool. The hemoglobin level decreased by 33 g/L within 20 h. An abdominal sonogram showed a hydrops in the lower abdomen with a maximum depth of 7.0 cm. A hematoma, 8 cm × 6 cm × 5 cm in size, was noted intra-operatively in the rectosigmoid junction, with a 1.5-cm perforation in the hematoma and active hemorrhage. Thus, a partial rectectomy and sigmoidostomy were performed. Three months later, a second operative procedure to re-establish intestinal continuity was performed. The patient is in good condition 12 mo after the last surgery. In addition to this case, the causes of spontaneous perforating hematomas and the treatment are discussed.

Zhu-Lin Li

2012-01-01

158

Delayed diagnosis of traumatic diaphragmatic hernia may cause colonic perforation: a case report.  

Science.gov (United States)

Early diagnosis of diaphragmatic rupture after traumas may be difficult, and delayed diagnosis may result in increased morbidity and mortality. This paper describes the case of a 32-year-old man who experienced a traffic accident and had diagnosis of traumatic diaphragmatic hernia nearly four months later. The patient was referred to our emergency room suffering from ileus symptoms. Physical examination demonstrated an apparent abdominal distention, tenderness at the upper abdominal quadrants, rebound, and defense. Thoraco-abdominal X-rays and computerized tomography imaging demonstrated intestinal segments with air-fluid levels in thorax. Laparotomy was performed after a preoperative diagnosis of a strangulated-diaphragmatic hernia. At abdominal exploration, it was found that transverse colon and omentum entered into thorax through diaphragmatic defect located at the left diaphragm. Herniating colon segment was complicated with ischemic necrosis and perforation. In conclusion, colon necrosis and perforation may develop when early diagnosis of diaphragmatic ruptures are missed. PMID:19918552

Ozkan, Orhan Veli; Semerci, Ersan; Yetim, Ibrahim; Davran, Ramazan; Diner, Guvenc; Paltaci, Ilhan

2009-01-01

159

Concomitant occurrence of subfrontal extradural hematoma and orbital subperiosteal hematoma: A rare entity  

Directory of Open Access Journals (Sweden)

Full Text Available Subfrontal extradural hematomas are uncommon, similar are orbital subperiosteal hematomas. Co-occurrence of both following head trauma is very rare. We describe co-occurrence of sub frontal extradural and orbital subperiosteal hematomas in four patients. The presenting symptoms were proptosis and visual complaints. Diagnosis was confirmed on computed tomography in three patients and magnetic resonance imaging in one patient. Frontal craniotomy and superior orbitotomy with evacuation of hematoma resulted in complete resolution of proptosis and visual symptoms. We emphasize on the early diagnosis of this rare condition and also emergency treatment to prevent permanent visual loss.

Nayak Naren

2010-01-01

160

Concomitant occurrence of subfrontal extradural hematoma and orbital subperiosteal hematoma: a rare entity.  

Science.gov (United States)

Subfrontal extradural hematomas are uncommon, similar are orbital subperiosteal hematomas. Co-occurrence of both following head trauma is very rare. We describe co-occurrence of sub frontal extradural and orbital subperiosteal hematomas in four patients. The presenting symptoms were proptosis and visual complaints. Diagnosis was confirmed on computed tomography in three patients and magnetic resonance imaging in one patient. Frontal craniotomy and superior orbitotomy with evacuation of hematoma resulted in complete resolution of proptosis and visual symptoms. We emphasize on the early diagnosis of this rare condition and also emergency treatment to prevent permanent visual loss. PMID:20739812

Nayak, Naren; Diyora, Batuk; Kamble, Hanmant; Modgi, Rahul; Sharma, Alok

2010-01-01

 
 
 
 
161

Treatment of patients with spontaneous intracranial hematomas  

Directory of Open Access Journals (Sweden)

Full Text Available Spontaneous intracerebral haemorrhage is a common cause of stroke especially in the young. The term "spontaneous intracerebral haemorrhage" refers to bleeding without coincident trauma. About 80% of this haemorrhage occur supratentorial in the basal nuclei and they are associated with hypertension. Etiological factors range from congenital vascular malformations (aneurysmas, AVM, cavernomas to acquired and degenerative vascular and brain conditions. In primary intracerebral hemorrhage arterial hypertension and consequent vascular changes are the major etiological factors. In secondary- nonhypertensive hemorrhage cause may be associated with aneurysms, AVM, tumors, coagulation disorders. Contemporary diagnosis imaging (CT, MRI and neurological evaluation, allow early diagnosis and effective medical and/or surgical therapy in a majority patients. Without treatment, the risk of mortality and morbidity is high. Medical management involves normalization of blood pressure, reduction of intracranial pressure, control of brain edema and prevention of seizures. In design for operative treatment must be include age of the patient, hematoma size and location, clinical condition, the level of consciousness and patient outcome. The role of surgery remains controversial.

Raki? M.Lj.

2008-01-01

162

Cutaneous manifestation of renal hematoma after ESWL.  

Science.gov (United States)

A 73 year-old patient with history of arterial hypertension and regular treatment with antiplatelet agents who presented with an hypotensive episode after extracorporeal shock-wave lithotripsy (ESWL) was diagnosed of right renal hematoma. PMID:24369192

Elizalde-Benito, Francisco-Xavier; Elizalde-Benito, Ángel-Gabriel; Urra-Palos, María; Elizalde-Amatria, Angel-Gabriel

2013-12-01

163

Ligamentum flavum hematoma. Report of two cases.  

Science.gov (United States)

Two patients presenting with signs and symptoms suggestive of nerve root compression secondary to extradural masses were found to have ligamentum flavum hematomas. Both patients had neurological deficits preoperatively and regained normal function postoperatively. There was no significant antecedent injury in either case. The symptom course was longer than that for spontaneous epidural hematoma. In one case, there was remodeling of bone, initially suggesting either infection or tumor. PMID:1738036

Sweasey, T A; Coester, H C; Rawal, H; Blaivas, M; McGillicuddy, J E

1992-03-01

164

Surgical management of spontaneous spinal epidural hematoma  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Spontaneous spinal epidural hematoma (SSEH) is a rare disease entity; its causative factors and the factors determining the outcome are still controversial. We reviewed our clinical experiences and analyzed the various factors related to the outcome for SSEH. We investigated 14 patients (11 men and 3 women) who underwent hematoma removal for SSEH from April 1998 to August 2004. We reviewed age, gender, hypertension, anticoagulant use and the preoperative neurological status using the Japanese...

Shin, Jun-jae; Kuh, Sung-uk; Cho, Yong-eun

2006-01-01

165

Sodium bicarbonate treatment prevents gastric emptying delay caused by acute exercise in awake rats.  

Science.gov (United States)

Physical exercise, mainly after vigorous activity, may induce gastrointestinal dysmotility whose mechanisms are still unknown. We hypothesized that physical exercise and ensuing lactate-related acidemia alter gastrointestinal motor behavior. In the present study, we evaluated the effects of short-term exercise on gastric emptying rate in awake rats subjected to 15-min swimming sessions against a load equivalent to 5% of their body weight. After 0, 10, or 20 min of exercise testing, the rats were gavage fed with 1.5 ml of a liquid test meal (0.5 mg/ml of phenol red in 5% glucose solution) and euthanized 10 min postprandially to measure fractional gastric dye recovery. In addition to inducing acidemia and increasing blood lactate levels, acute exercise increased (P < 0.05) gastric retention. Such a phenomenon presented a positive correlation (P < 0.001) between blood lactate levels and fractional gastric dye recovery. Gastric retention and other acidbase-related changes were all prevented by NaHCO3 pretreatment. Additionally, exercise enhanced (P < 0.05) the marker's progression through the small intestine. In anesthetized rats, exercise increased (P < 0.05) gastric volume, measured by a balloon catheter in a barostat system. Compared with sedentary control rats, acute exercise also inhibited (P < 0.05) the contractility of gastric fundus strips in vitro. In conclusion, acute exercise delayed the gastric emptying of a liquid test meal by interfering with the acid-base balance. PMID:24557800

Silva, Moisés T B; Palheta-Junior, Raimundo C; Sousa, Daniel F; Fonseca-Magalhães, Patrícia A; Okoba, Willy; Campos, Caio P S; Oliveira, Ricardo B; Magalhães, Pedro J C; Santos, Armenio A

2014-05-01

166

Delayed diagnosis of meningitis caused by beta-haemolytic group G. Streptococcus in an older woman.  

Science.gov (United States)

A case of meningitis caused by group G beta-hemolytic Streptococcus (dysgalactiae, subspecies equisimilis) is reported in an 83-year-old woman. Streptococci species other than Streptococcus pneumoniae are seldom found in patients with acute bacterial meningitis, therefore, our discussion is focused on this rare organism. The question of the diagnosis of meningitis in the elderly is also addressed. PMID:11728766

Luyx, C; Vanpee, D; Glupczynski, Y; Swine, C; Gillet, J B

2001-11-01

167

Upper Thoracic Myelopathy Caused by Delayed Neck Extensor Weakness in Myotonic Dystrophy  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Myotonic dystrophy is the most common autosomal dominant myopathy in adults. Our patient, a 41 year-old female suffering from myotonic muscular dystrophy, developed upper thoracic myelopathy due to hypertrophy of the ligamentum flavum and the posterior longitudinal ligament. She had a typical hatchet face and ptosis with "head hanging forward" appearance caused by neck weakness. Motor weakness, sensory changes and severe pain below T4 level, along with urinary incontinence began 3 months ago....

Son, Han Kyeong; Cha, Young Sun; Suh, Hwi; Ki, Chang-seok; Shin, Yong Beom

2012-01-01

168

Full thickness burn caused by exposure to giant hogweed: delayed presentation, histological features and surgical management.  

LENUS (Irish Health Repository)

We report the case of a 10-year-old boy with a full thickness chemical burn on his right pretibial area due to phytophotodermatitis (PPD) following contact with giant hogweed (Heracleum mantegazzianum). Although cutaneous burns due to plants are a well-established cause of chemical burn, previous reports described partial thickness burns that healed with conservative measures. This patient presented to our unit two weeks after the initial injury with an established full thickness burn. Debridement and split thickness skin grafting was required. We presented the histological features of the debrided skin specimen and discussed potential factors leading to this unexpected full thickness injury.

Chan, Jeffrey C Y

2012-02-01

169

Acetylcholinesterase and neuropathy target esterase inhibitions in neuroblastoma cells to distinguish organophosphorus compounds causing acute and delayed neurotoxicity.  

Science.gov (United States)

The differential inhibition of the target esterases acetylcholinesterase (AChE) and neuropathy target esterase (NTE, neurotoxic esterase) by organophosphorus compounds (OPs) is followed by distinct neurological consequences in exposed subjects. The present study demonstrates that neuroblastoma cell lines (human SH-SY5Y and murine NB41A3) can be used to differentiate between neuropathic OPs (i.e., those inhibiting NTE and causing organophosphorus-induced delayed neuropathy) and acutely neurotoxic OPs (i.e., those highly capable of inhibiting AChE). In these experiments, concentration-response data indicated that the capability to inhibit AChE was over 100x greater than the capability to inhibit NTE for acutely toxic, nonneuropathic OPs (e.g., paraoxon and malaoxon) in both cell lines. Inhibition of AChE was greater than inhibition of NTE, without overlap of the concentration-response curves, for OPs which are more likely to cause acute, rather than delayed, neurotoxic effects in vivo (e.g., chlorpyrifos-oxon, dichlorvos, and trichlorfon). In contrast, concentrations inhibiting AChE and NTE overlapped for neuropathy-causing OPs. For example, apparent IC50 values for NTE inhibition were less than 9.6-fold the apparent IC50 values for AChE inhibition when cells were exposed to the neuropathy-inducing OPs diisopropyl phosphorofluoridate, cyclic tolyl saligenin phosphate, phenyl saligenin phosphate, mipafox, dibutyl dichlorovinyl phosphate, and di-octyl-dichlorovinyl phosphate. In all cases, esterase inhibition occurred at lower concentrations than those needed for cytoxicity. These results suggest that either mouse or human neuroblastoma cell lines can be considered useful in vitro models to distinguish esterase-inhibiting OP neurotoxicants. PMID:9268605

Ehrich, M; Correll, L; Veronesi, B

1997-07-01

170

Rapamycin treatment causes developmental delay, pigmentation defects, and gastrointestinal malformation on Xenopus embryogenesis  

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Research highlights: {yields} Does famous anti-aging drug rapamycin work from the beginning of life? The answer is yes. {yields} This study shows that developmental speed of frog embryo was dose-dependently decreased by rapamycin treatment. {yields} In additions, morphogenetic effects such as less pigmentations and gut malformation are occurred by rapamycin. -- Abstract: Rapamycin is a drug working as an inhibitor of the TOR (target of rapamycin) signaling pathway and influences various life phenomena such as cell growth, proliferation, and life span extension in eukaryote. However, the extent to which rapamycin controls early developmental events of amphibians remains to be understood. Here we report an examination of rapamycin effects during Xenopus early development, followed by a confirmation of suppression of TOR downstream kinase S6K by rapamycin treatment. First, we found that developmental speed was declined in dose-dependent manner of rapamycin. Second, black pigment spots located at dorsal and lateral skin in tadpoles were reduced by rapamycin treatment. Moreover, in tadpole stages severe gastrointestinal malformations were observed in rapamycin-treated embryos. Taken together with these results, we conclude that treatment of the drug rapamycin causes enormous influences on early developmental period.

Moriyama, Yuki [Graduate School of Science and Technology, Shizuoka University, 836 Ohya, Suruga-ku, Shizuoka 422-8529 (Japan); Ohata, Yoshihisa [Department of Education (Sciences), Shizuoka University, 836 Ohya, Suruga-ku, Shizuoka 422-8529 (Japan); Mori, Shoko [Graduate School of Science and Technology, Shizuoka University, 836 Ohya, Suruga-ku, Shizuoka 422-8529 (Japan); Matsukawa, Shinya [Department of Education (Sciences), Shizuoka University, 836 Ohya, Suruga-ku, Shizuoka 422-8529 (Japan); Michiue, Tatsuo [Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902 (Japan); Asashima, Makoto [Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902 (Japan); Research Center for Stem Cell Engineering, National Institute of Advanced Industrial Science and Technology (AIST), 1-1-1 Baien, Tsukuba, Ibaraki 305-8562 (Japan); Kuroda, Hiroki, E-mail: ehkurod@ipc.shizuoka.ac.jp [Graduate School of Science and Technology, Shizuoka University, 836 Ohya, Suruga-ku, Shizuoka 422-8529 (Japan); Department of Education (Sciences), Shizuoka University, 836 Ohya, Suruga-ku, Shizuoka 422-8529 (Japan)

2011-01-28

171

Rapamycin treatment causes developmental delay, pigmentation defects, and gastrointestinal malformation on Xenopus embryogenesis  

International Nuclear Information System (INIS)

Research highlights: ? Does famous anti-aging drug rapamycin work from the beginning of life? The answer is yes. ? This study shows that developmental speed of frog embryo was dose-dependently decreased by rapamycin treatment. ? In additions, morphogenetic effects such as less pigmentations and gut malformation are occurred by rapamycin. -- Abstract: Rapamycin is a drug working as an inhibitor of the TOR (target of rapamycin) signaling pathway and influences various life phenomena such as cell growth, proliferation, and life span extension in eukaryote. However, the extent to which rapamycin controls early developmental events of amphibians remains to be understood. Here we report an examination of rapamycin effects during Xenopus early development, followed by a confirmation of suppression of TOR downstream kinase S6K by rapamycin treatment. First, we found that developmental speed was declined in dose-dependent manner of rapamycin. Second, black pigment spots located at dorsal and lateral skin in tadpoles were reduced by rapamycin treatment. Moreover, in tadpole stages severe gastrointestinal malformations were observed in rapamycin-treated embryos. Taken together with these results, we conclude that treatment of the drug rapamycin causes enormous influences on early developmental period.

2011-01-28

172

Spontaneous acute subdural hematoma contralateral to an arachnoid cyst / Hematoma subdural agudo espontâneo contralateral a cisto aracnóideo  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Os cistos aracnóideos (CA) são coleções liquóricas extra-cerebrais e intra-aracnóideas de origem desconhecida. Correspondem a 1% de todas as lesões expansivas intracranianas não traumáticas e têm nítido predomínio na fossa média (50%). Até 25% destes cistos são achados incidentais sendo que a maiori [...] a dos pacientes é assintomática. Crises epilépticas, sinais de hipertensão intracraniana, déficits neurológicos focais, macrocrania, atraso no desenvolvimento e abaulamento da calota craniana são os principais sinais e sintomas da lesão. A ruptura dos CA, assim como seu sangramento, são situações raras, geralmente associadas a traumas e acometem adultos jovens. O risco de hemorragia em pacientes com CA não excede 0,04% ao ano. É descrito caso de paciente de dez anos de idade que subitamente apresentou sinais de hipertensão intracraniana secundários a hematoma subdural agudo espontâneo, contralateral a volumoso CA de fossa média. Três fatores foram de relevância neste paciente: a ocorrência de sinais e sintomas espontaneamente, especialmente em um menino; presença de hematoma subdural agudo exclusivamente contralateral ao CA; e a boa evolução com o tratamento conservador. Abstract in english Arachnoid cysts (AC) are extra-cerebral cerebrospinal fluid collections of unknown origin. They correspond to 1% of all intracranial nontraumatic space-occupying lesions and appear more frequently in the middle fossa (50%). More than 25% of these cysts are incidental findings and the majority of pat [...] ients are asymptomatic. Seizures, intracranial hypertension signs, neurological deficits, macrocrania, developmental delay and bulging of the skull are the main signs and symptoms of the lesion. AC rupture and bleeding are rare, usually occurring in young adults and associated with trauma. The risk of hemorrhage does not exceed 0.04% / year. We describe the case of a ten-year-old boy who presented with acute signs of intracranial hypertension secondary to a spontaneous acute subdural hematoma, contralateral to an AC of the middle fossa. Three factors were significant in this case: signs and symptoms occurred spontaneously; the presence of an acute subdural hematoma exclusively contralateral to the AC; successful outcome of the conservative treatment.

José Gilberto de Brito, Henriques; Geraldo, Pianetti Filho; Karina Santos Wandeck, Henriques; Luiz Fernando, Fonseca; Renato Pacheco de, Melo; Márcia Cristina da, Silva; José Augusto, Malheiros.

173

Spontaneous acute subdural hematoma contralateral to an arachnoid cyst Hematoma subdural agudo espontâneo contralateral a cisto aracnóideo  

Directory of Open Access Journals (Sweden)

Full Text Available Arachnoid cysts (AC are extra-cerebral cerebrospinal fluid collections of unknown origin. They correspond to 1% of all intracranial nontraumatic space-occupying lesions and appear more frequently in the middle fossa (50%. More than 25% of these cysts are incidental findings and the majority of patients are asymptomatic. Seizures, intracranial hypertension signs, neurological deficits, macrocrania, developmental delay and bulging of the skull are the main signs and symptoms of the lesion. AC rupture and bleeding are rare, usually occurring in young adults and associated with trauma. The risk of hemorrhage does not exceed 0.04% / year. We describe the case of a ten-year-old boy who presented with acute signs of intracranial hypertension secondary to a spontaneous acute subdural hematoma, contralateral to an AC of the middle fossa. Three factors were significant in this case: signs and symptoms occurred spontaneously; the presence of an acute subdural hematoma exclusively contralateral to the AC; successful outcome of the conservative treatment.Os cistos aracnóideos (CA são coleções liquóricas extra-cerebrais e intra-aracnóideas de origem desconhecida. Correspondem a 1% de todas as lesões expansivas intracranianas não traumáticas e têm nítido predomínio na fossa média (50%. Até 25% destes cistos são achados incidentais sendo que a maioria dos pacientes é assintomática. Crises epilépticas, sinais de hipertensão intracraniana, déficits neurológicos focais, macrocrania, atraso no desenvolvimento e abaulamento da calota craniana são os principais sinais e sintomas da lesão. A ruptura dos CA, assim como seu sangramento, são situações raras, geralmente associadas a traumas e acometem adultos jovens. O risco de hemorragia em pacientes com CA não excede 0,04% ao ano. É descrito caso de paciente de dez anos de idade que subitamente apresentou sinais de hipertensão intracraniana secundários a hematoma subdural agudo espontâneo, contralateral a volumoso CA de fossa média. Três fatores foram de relevância neste paciente: a ocorrência de sinais e sintomas espontaneamente, especialmente em um menino; presença de hematoma subdural agudo exclusivamente contralateral ao CA; e a boa evolução com o tratamento conservador.

José Gilberto de Brito Henriques

2007-12-01

174

Cough-induced internal oblique hematoma.  

Science.gov (United States)

Violent or sustained cough can be associated with serious musculoskeletal complications. We report a case of a cough-induced internal oblique hematoma in an obese 73-year-old woman who was not receiving antithrombotic therapy. She had no history of trauma and presented with acute worsening pain in the right flank. She had been coughing continuously for the past month and had severe cough 2 days before the onset of pain. Ultrasonography revealed a hypoechoic mass in the right lateral abdominal wall. Unenhanced computed tomography of the abdomen showed a 7 cm × 7 cm × 4 cm hematoma in the right internal oblique muscle. The patient was managed conservatively without blood transfusion. Acute abdominal pain together with an abdominal painful mass, particularly in patients with cough, should alert physicians to the possibility of an abdominal wall hematoma. PMID:23723625

Kodama, Koichi; Takase, Yasukazu; Yamamoto, Hiroki; Noda, Toru

2013-04-01

175

CT-guided stereotactic evacuation of hypertensive intracerebral hematomas  

International Nuclear Information System (INIS)

Computerized tomography (CT) is now effective not only for definite diagnosis and location of intracerebral hematomas but also for coordination of the center of a hematoma. CT-guided stereotactic evacuation of hypertensive intracerebral hematoma was performed in 51 cases: 34 of basal ganglionic hematoma with or without ventricular perforation, 11 of subcortical hematoma, 3 of thalamic hematoma and 3 of cerebellar hematoma. Three dimensional CT images or biplane CT images were taken to determine the coordinates of the target point, which was the center of the hematoma. Then, a silicon tube (O.D. 3.5 phi, I.D. 2.1 phi) was inserted into the center of the hematoma through a burr-hole under local anesthesia, and the liquid or solid hematoma was aspirated as completely as possible with a syringe. Urokinase (6,000 I.U./5 ml saline) was administered through this silicon tube every 6 or 12 hours for several days until the hematoma had drained out competely. The silicon tube was taken out when repeated CT scanning revealed no hematoma. The results of clinical follow-ups indicated that this procedure is as good as, or rather better than conventional microsurgery with evacuation of hematoma under direct vision. Moreover this CT-guided stereotactic approach for evacuation of the hematoma has the following advantages: 1) the procedure is simple and safe, 2) operation can be performed under local anesthesia, and 3) the hematoma is drained out completely with the aid of urokinase. This surgery seems indicated as an emergency treatment for high-age or high risk patients and also as a routine surgery for intracerebral hematomas in patients showing no herination signs. (author)

1983-01-01

176

Hematoma in the cervical ligamentum flavum. Report of a case and review of the literature  

Energy Technology Data Exchange (ETDEWEB)

Hematoma of the cervical ligamentum flavum is very rare, and its pathogenesis is unknown. We describe a case of ligamentum flavum hematoma in the cervical spine causing severe myelopathy. Postoperative histological examination suggested it was the result of the rupture of a hemangioma or of an arteriovenous malformation in the ligamentum flavum. After removal of the lesion, the patient's condition immediately improved. Review of all three reported cases, including this one, showed that complete resection of the mass resulted in immediate relief of symptoms of incomplete paraplegia. The findings of magnetic resonance imaging (MRI) of the hematoma may vary with time, and they may show no characteristic intensity. However, MRI of this case revealed that the tissues surrounding the mass were enhanced with gadolinium diethylene triamine penta-acetic acid, and an area of homogeneous iso-intensity was clearly surrounded by a low-intensity area (flavum) on T2-weighed short-tau inversion recovery images. These findings could be characteristic of the ligamentum flavum hematoma and might help in the differentiation from a cervical epidural hematoma. (orig.)

Tamura, Tatsuya; Sakai, Toshinori; Sairyo, Koichi; Katoh, Shinsuke; Yasui, Natsuo [The University of Tokushima Graduate School, Department of Orthopedics, Institute of Health Biosciences, Tokushima (Japan); Takao, Shoichiro [The University of Tokushima Graduate School, Department of Radiology, Institute of Health Biosciences, Tokushima (Japan); Kagawa, Seiko [The University of Tokushima Graduate School, Department of Human Pathology, Institute of Health Biosciences, Tokushima (Japan)

2010-03-15

177

On the pathogenesis of traumatic intracerebral hematoma with a sequential study of computerized tomography  

International Nuclear Information System (INIS)

A sequential study with computerized tomography (CT scan) of two cases of traumatic intracerebral hematoma is reported. Case 1 was a 69-year-old man who had a head injury. The initial CT scan, taken 1 hour after his injury, showed a left temporal salt-and-pepper appearance, which proved to be a cerebral contusion. The CT scan 4.5 hours after his injury showed a left temporal high density area instead. An operation was performed, and a massive intracerebral hematoma was observed. Case 2 was a 61-year-old man who was also admitted because of a head injury. The initial CT scan, taken 1 hour after his injury, revealed several bifrontal intracerebral hemorrhagic spots in the low-density areas, suggesting contusion. A secondary CT scan (23 hours) demonstrated that the traumatic intracerebral hematoma had developed into a posttraumatic cerebral contusion. The operation disclosed a hematoma surrounded by contusion. These cases prove that traumatic intracerebral hematoma is often caused by cerebral contusion. (author)

1981-01-01

178

Paraplegia following epidural analgesia: A potentially avoidable cause?  

Science.gov (United States)

Neurological deficit is an uncommon but catastrophic complication of epidural anesthesia. Epidural hematomas and abscesses are the most common causes of such neurological deficit. We report the case of a patient with renal cell carcinoma with lumbar vertebral metastasis who developed paraplegia after receiving thoracic epidural anesthesia for a nephrectomy. Subsequently, on histo-pathological examination of the laminectomy specimen, the patient was found to have previously undiagnosed thoracic vertebral metastases which led to a thoracic epidural hematoma. In addition, delayed reporting of symptoms of neurological deficit by the patient may have impacted his outcome. Careful pre-operative investigation, consideration to using alternative modalities of analgesia, detailed patient counseling and stringent monitoring of patients receiving central neuraxial blockade is essential to prevent such complications.

Doctor, Jeson R.; Ranganathan, Priya; Divatia, Jigeeshu V.

2014-01-01

179

[Spontaneous primary hematomas of the cerebellum].  

Science.gov (United States)

Spontaneous cerebellar hematoma is a well-defined radio-clinical entity. It may occur, not only in patients with risk factors (hypertension for instance), but also in those who have no specific etiologic factors. Onset is usually sudden. The characteristic clinical triad consists of alterations in consciousness, peripheral facial palsy and various oculomotor disorders. Poor prognosis factors related to the size and localization of the hematoma can be determined by computed tomography. We believe that surgery is indispensable in hydrocephalus as well as in increasing or secondary onset of alterations in consciousness. PMID:6318324

Forgeau, Y; Mussini, J M; Ponge, T; Bricout, H

1983-11-17

180

Delay in diagnosis and treatment of soft tissue Sarcomas ( STS): Causes of late intervention and their role in prognosis. a prospective, multidisciplinary group study.  

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Background: STS are 1% of malignant tumors in adults. Rarity, heterogeneity in presentation, low expertise in Primary Care Physicians (PCP) or in general hospitals, organisation problems in Specialized Centres may cause a delay in both diagnosis and treatment. Aim of this study is to acknowledge the barriers to optimal care and the consequences of the delay on prognosis. Methods: Patients with STS of the extremities, trunk, retroperitoneum treated and followed from 1999 to 2011 by the ...

Brach Del Prever, Elena Maria

2012-01-01

 
 
 
 
181

Subarachnoid hemorrhage and intracereebral hematoma following lumboperitoneal shunt for pseudotumor cerebri : a rare complication.  

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Full Text Available Placement of lumboperitoneal (LP shunt as a surgical treatment for benign intracranial hypertension (BIH is generally a safe procedure, with complications like mechanical failure, overdrainage and infections. Subarachnoid hemorrhage and intracerebral hematoma were seen after lumboperitoneal shunt in a patient having BIH. These complications were the cause of the patient?s deterioration. After removal of the hematoma and performing a decompressive procedure, patient?s neurological condition improved. The clinical features, investigations and clinical course are described and the literature reviewed.

Suri A

2002-10-01

182

Urgent-setting magnetic resonance imaging allows triage of extensive penoscrotal hematoma following blunt trauma.  

Science.gov (United States)

Although uncommon, blunt trauma to the perineum may cause serious injury to the penis. Differentiation between penile fracture with torn tunica albuginea versus extratunical or cavernosal hematomas is crucial because the former condition needs early surgical repair to avoid future deformity and erectile dysfunction, whereas approach is conservative with even large penoscrotal hematomas with albugineal integrity. Urgent-setting magnetic resonance imaging including multiplanar images of the injured penoscrotal region allows precise identification or exclusion of presence, site, and extent of tears of the tunica albuginea, providing a consistent basis for therapeutic choice. PMID:24339670

Tonolini, Massimo

2013-10-01

183

Pathological intracranial extradural hematoma in a 10-year-old child  

Directory of Open Access Journals (Sweden)

Full Text Available A nontraumatic spontaneous extradural hematoma, in a fully conscious 10-year-old male child, caused by a solitary eosinophilic granuloma of calvarium presented as a case of localized painful swelling of the head, which rapidly expanded and decreased in size. A plain CT-scan of the head with bone window revealed eroded right parietal bone with subperiosteal debris and extradural hematoma of mixed density. Immediate evacuation of the extradural clot and complete excision of the lesion was performed to prevent the deterioration of the patient and to achieve the histological diagnosis for further management.

Bhat Abdul

2010-01-01

184

Pathological intracranial extradural hematoma in a 10-year-old child  

Science.gov (United States)

A nontraumatic spontaneous extradural hematoma, in a fully conscious 10-year-old male child, caused by a solitary eosinophilic granuloma of calvarium presented as a case of localized painful swelling of the head, which rapidly expanded and decreased in size. A plain CT-scan of the head with bone window revealed eroded right parietal bone with subperiosteal debris and extradural hematoma of mixed density. Immediate evacuation of the extradural clot and complete excision of the lesion was performed to prevent the deterioration of the patient and to achieve the histological diagnosis for further management.

Bhat, Abdul Rashid; Jain, Ashish Kumar; Kirmani, A. R.; Nizami, Furqan

2010-01-01

185

Acute subdural hematoma in young patient with moyamoya disease--case report.  

Science.gov (United States)

A 17-year-old boy with known moyamoya disease developed an acute subdural hematoma after a mild head trauma. He had been confined to a wheelchair with contracture in the upper and lower extremities due to juvenile rheumatoid arthritis since age 1 year. He had undergone encephalo-duro-arterio-synangiosis (EDAS) on the right and encephalo-myo-synangiosis (EMS) on the left at 13 years of age. He was admitted with headache, nausea, and vomiting after a fall from his wheelchair at age 17. Computed tomography on admission showed a large acute subdural hematoma in the right fronto-temporal region but no bleeding at the EDAS or EMS sites. Cerebral angiography 12 weeks after the head trauma revealed a remarkable reduction in the spontaneous transdural external-internal carotid anastomoses in the right frontal region. The acute subdural hematoma was probably caused by rupture of the spontaneous transdural anastomoses. PMID:1376864

Takeuchi, S; Ichikawa, A; Koike, T; Tanaka, R; Arai, H

1992-02-01

186

Repeated primary blast injury causes delayed recovery, but not additive disruption, in an in vitro blood-brain barrier model.  

Science.gov (United States)

Recent studies have demonstrated increased susceptibility to breakdown of the cerebral vasculature associated with repetitive traumatic brain injury. We hypothesized that exposure to two consecutive blast injuries would result in exacerbated damage to an in vitro model of the blood-brain barrier (BBB) compared with exposure to a single blast of the same severity. Contrary to our hypothesis, however, repeated mild or moderate primary blast delivered with a 24 or 72 h interval between injuries did not significantly exacerbate reductions in transendothelial electrical resistance (TEER) across a brain endothelial monolayer compared with sister cultures receiving a single exposure of the same intensity. Permeability of the barrier to a range of different-sized solutes remained unaltered after single and repeated blast, supporting that the effects of repeated blast on BBB integrity were not additive. Single blast exposure significantly reduced immunostaining of ZO-1 and claudin-5 tight junction proteins, but subsequent exposure did not cause additional damage to tight junctions. Although repeated blast did not further reduce TEER, the second exposure delayed TEER recovery in BBB cultures. Similarly, recovery of hydraulic conductivity through the BBB was delayed by a second exposure. Extending the interinjury interval to 72 h, the effects of multiple injuries on the BBB were found to be independent given sufficient recovery time between consecutive exposures. Careful investigation of the effects of repeated blast on the BBB will help identify injury levels and a temporal window of vulnerability associated with BBB dysfunction, ultimately leading to improved strategies for protecting warfighters against repeated blast-induced disruption of the cerebral vasculature. PMID:24372353

Hue, Christopher D; Cao, Siqi; Dale Bass, Cameron R; Meaney, David F; Morrison, Barclay

2014-05-15

187

FDG-PET imaging for chronic expanding hematoma in pelvis with massive bone destruction  

Energy Technology Data Exchange (ETDEWEB)

Chronic expanding hematoma is a rare presentation of a hematoma characterized by a persistent increase in size for more than a month after the initial hemorrhage. We present a 65-year-old man with a chronic expanding hematoma in his ilium who was receiving anticoagulant treatment. The patient had a delayed manifestation of a femoral neuropathy with massive bone destruction. 2-Deoxy-[{sup 18}F]fluoro-d-glucose (FDG) positron emission tomography (PET) imaging revealed an increased uptake in the rim of the mass in images acquired 1 h after FDG injection. FDG-PET scans were performed using a dedicated PET scanner (HeadtomeV/SET2400 W, Shimadzu, Kyoto, Japan), and the PET data for the most metabolically active region of interest (ROI) were analyzed. The maximum standardized uptake value (SUVmax) was set to a cut-off point of 3.0 to distinguish between benign and malignant lesions. The SUVmax of the patient's lesion was 3.10, suggesting a malignant lesion. The characteristics of FDG-PET images of chronic expanding hematomas, including the uptake of FDG in the peripheral rim of the mass as a result of inflammation, should be recognized as a potential interpretive pitfall in mimicking a sarcoma. (orig.)

Hamada, Kenichiro [Osaka University Graduate School of Medicine, Department of Nuclear Medicine and Tracer Kinetics, Suita, Osaka (Japan); Osaka University Graduate School of Medicine, Department of Orthopaedic Surgery, Suita, Osaka (Japan); Myoui, Akira; Ueda, Takafumi; Tamai, Noriyuki; Yoshikawa, Hideki [Osaka University Graduate School of Medicine, Department of Orthopaedic Surgery, Suita, Osaka (Japan); Higuchi, Ichiro; Hatazawa, Jun [Osaka University Graduate School of Medicine, Department of Nuclear Medicine and Tracer Kinetics, Suita, Osaka (Japan); Inoue, Atsuo [Osaka University Graduate School of Medicine, Department of Radiology, Suita, Osaka (Japan)

2005-12-01

188

Bilateral isodense epidural hematoma: case report Hematoma epidural isodenso bilateral: relato de caso  

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We present a case of a severe head injuried 23 year-old male patient. The initial CT scan disclosed bilateral epidural hematoma, isodense with the brain, thus being a pitfall in diagnosis. Brief case report, image and literature rewiew are presented.Apresentamos o caso de um homem de 23 anos com traumatismo craniano grave. A TC de crânio demonstrou um volumoso hematoma epidural bilateral, isodenso com o cérebro, sendo uma armadilha ao diagnóstico. São apresentados um breve relato, est...

Rodrigo Mendonça; Lima, Telmo T. F.; Dini, Leandro I.; Krebs, Cla?udio L. L.

2005-01-01

189

Computed tomographic findings of intramural hematoma  

International Nuclear Information System (INIS)

The CT findings of eleven patients with intramural hematoma of the gastrointestinal tract are presented. The most frequent site of intramural hematoma was duodenum(7/11). followed jejunum(2/11), ascending colon(2/11), stomach(1/11), and rectum(1/11). Blunt abdominal trauma was the prime etiologic factor(7/11). others included pancreatitis, iatrogenic and unknown. Intramural hematoma showed three patterns of CT characteristics: intramural mass(8/11), thickened bowel wall(1/11), and both(2/11). There were variable attenuation value of 10 cases of intramural mass; homogenous hyperdensity or hypodensity in each 3 cases, inhomogeneous or mixed density in 4 cases. Also there were peripheral lucent halo(1/10), pseudocapsule or dense rim(5/10), crescentic hyperdensity(2/10) and central hyperdense area(4/10). Associated CT features were hemoperitoneum(4), mesenteric infiltration, fatty liver, pancreatic confusion, and chronic pancreatitis. CT is the most accurate method in establishing the diagnosis or intramural hematoma, evaluating the extent of bleeding and its effect on adjacent organs, demonstrating regression after treatment, and detecting associating injury

1990-10-01

190

Computer Tomography of Intracranial Tumours and Hematomas.  

Science.gov (United States)

The value of computed tomography (CT) for the diagnosis of intracranial tumors and hematomas was investigated in a retrospective study comprising 220 patients. All C.T.scans are reviewed and described in detail. To assess the diagnostic accuracy, the orig...

J. T. J. Tans

1978-01-01

191

Spontaneous rectus sheath hematoma during rivaroxaban therapy.  

Science.gov (United States)

Rivaroxaban is an oral anticoagulant agent that directly inhibits Factor Xa and interrupts both the intrinsic and extrinsic pathway of the coagulation cascade and is currently indicated for use in patients for atrial fibrillation and prophylaxis of deep venous thrombosis. The present case reports of spontaneous rectus sheath hematoma during rivaroxaban therapy for atrial fibrillation in a 75-year-old woman. PMID:24987185

Kocayigit, Ibrahim; Can, Yusuf; Sahinkus, Salih; Ayd?n, Ercan; Vatan, Mehmet Bulent; K?l?c, Harun; Gunduz, Huseyin

2014-05-01

192

Ruptura dos vasa vasorum e hematoma intramural da aorta: um paradigma em mudança / Rupture of vasa vasorum and intramural hematoma of the aorta: a changing paradigm  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A ruptura dos vasa vasorum tem sido reconhecida como uma das causas do hematoma intramural da aorta há 90 anos. Esta breve revisão apresenta sistematicamente a fisiologia desses vasos e o seu papel na fisiopatologia das alterações parietais da aorta que ocorrem na hipertensão arterial, na arterioscl [...] erose e na síndrome aórtica aguda. A hipótese defendida aqui é a de que a ruptura dos vasa vasorum ocorre como um fenômeno secundário e não como um dos fatores causais na fisiopatologia do hematoma intramural. Abstract in english Rupture of vasa varorum has been recognized as one cause of intramural hematoma of the aorta for 90 years. This brief revision presents systematically, the physiology of these vessels and its role in the physiopathology of the alterations in the aortic wall secondary to hypertension, arteriosclerosi [...] s and in Acute Aortic Syndrome. The hypothesis is that rupture of vasa vasorum is a secondary phenomenon and not one causal factor in the physiopathology of intramural hematoma.

Adamastor Humberto, Pereira.

193

Hematomas renales tras Litotricia Extracorpórea por Ondas de Choque: LEOCH / Renal hematomas after extracorporeal shock-wave lithotripsy: ESWL  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Introducción: La introducción de la fragmentación por ondas de choque en el campo de la litiasis urinaria es una de las mayores aportaciones terapéuticas en la historia de la urología. Es el método de elección para el tratamiento de la mayoría de los cálculos de ubicación renal y ureteral, ya que es [...] un método poco invasivo y con bajo número de complicaciones; pero su aplicación no está totalmente exenta de efectos adversos. Produce traumatismo o lesión más o menos importante en los órganos que atraviesan las ondas de choque, incluido el riñón, donde pueden producir desde una pequeña contusión a hematomas renales con diferente resolución y tratamiento. Material y métodos: Realizamos una revisión de 4.815 litotricias que se han realizado en nuestro servicio, exponiendo siete casos en los que se diagnosticó hematomas renales subcapsulares o perirrenales, con su evolución, manejo y tratamiento. Resultados: Después de las complicaciones urológicas (dolor, obstrucción e infección), las colecciones hemáticas renales y perirrenales ocupan el primer lugar en orden de frecuencia en cuanto a efectos adversos de las ondas de choque, relacionándose fundamentalmente con la potencia de energía aplicada y con el incremento de edad del paciente. Conclusiones: Entre los años 1992-2007 se realizaron 4.815 litotricias con un total de 7 casos de hematomas graves, que representan menos del 1%. El manejo suele ser conservador si bien en ocasiones es necesario el drenaje quirúrgico o incluso la nefrectomía. Abstract in english Introduction: The use of fragmentation due to shock- waves as a treatment of urinary stone was one of the most important therapeutics findings in the history of urology. It´s the first election treatment for most of the calculus at renal and urethral location due to the fact that it is a low invasiv [...] e treatment and it has a few number of complications, but this method also has a few negative side effects, it can caused a more or less important traumatic lesion at the organs which crosses the shock- waves, including the kidney where it can caused a small contusion or renal hematoma with different resolution and treatment. Material and method: We reviewed 4815 extracorporeal shock-wave lithotripsy that we performed in our department in which we found six cases with subcapsular and perirrenal hematoma which we followed up and treated. Results: After the urological complications (pain, obstruction and infection) the renal and perirrenal hematic collections are the most frequent adverse effects of shock- waves used in lithotripsy, these are related to the power of energy used and patient age. Conclusions: Between the years 1992-2007 we performed 4.815 extracorporeal shock-wave lithotripsy finding seven cases of severe hematoma, less then 1%.Treatment of these complications is usually not aggressive though sometimes it is necessary to perform surgical drainage and even nephrectomy.

Héctor, Pastor Navarro; Pedro, Carrión López; Jesús, Martínez Ruiz; José Mª, Pastor Guzmán; Mariano, Martínez Martín; Julio A., Virseda Rodríguez.

194

Successful disintegration, dissolution and drainage of intracholedochal hematoma by percutaneous transhepatic intervention  

Directory of Open Access Journals (Sweden)

Full Text Available Hemobilia is a rare biliary complication of liver transplantation. The predominant cause of hemobilia is iatrogenic, and it is often associated with traumatic operations, such as percutaneous liver intervention, endoscopic retrograde cholangiopancreatography, cholecystectomy, biliary tract surgery, and liver transplantation. Percutaneous transhepatic cholangiography and liver biopsy are two major causes of hemobilia in liver transplant recipients. Hemobilia may also be caused by coagulation defects. It can form intracholedochal hematomas, causing obstructive jaundice. Herein we describe a patient with an intracholedochal hematoma resulting in significant obstructive jaundice after liver transplantation for fulminant hepatic failure. Previous studies have shown that percutaneous transhepatic manipulation is a major cause of hemobilia after liver transplantation, but in our case, percutaneous transhepatic intervention was used to relieve the biliary obstruction and dissolve the biliary clot, with a good outcome.

Jian-Jie Qin

2012-01-01

195

Tissue Plasminogen Activator Induced Delayed Edema in Experimental Porcine Intracranial Hemorrhage: Reduction with Plasminogen Activator Inhibitor-1 Administration  

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Hematoma puncture and subsequent clot lysis with recombinant tissue plasminogen activator (rtPA) emerged as an alternative therapy for spontaneous intracerebral hemorrhage (ICH) and is associated with delayed edema possibly counteracting the beneficial effects of hematoma volume reduction. We hypothesized that immediate reversal of rtPA activity after clot lysis and hematoma drainage diminishes edema formation. To test this hypothesis, we administered plasminogen activator inhibitor (PAI)-1 a...

Keric, Naureen; Maier, Gerrit; Samadani, Uzma; Kallenberg, Kai; Dechent, Peter; Brueck, Wolfgang; Heuer, Jan; Rohde, Veit

2012-01-01

196

Spinal Epidural Hematoma After Thrombolysis for Deep Vein Thrombosis with Subsequent Pulmonary Thromboembolism: A Case Report  

International Nuclear Information System (INIS)

A 38-year-old male was initially admitted for left leg swelling. He was diagnosed as having deep vein thrombosis (DVT) in the left leg and a pulmonary thromboembolism by contrast-enhanced chest computed tomography (CT) with delayed lower extremity CT. The DVT was treated by thrombolysis and a venous stent. Four hours later, he complained of severe back pain and a sensation of separation of his body and lower extremities; he experienced paraplegia early in the morning of the following day. Magnetic resonance imaging showed a spinal epidural hematoma between T11 and L2, which decompressed following surgery. We, therefore, report a case of a spinal epidural hematoma after thrombolysis in a case of DVT with a pulmonary thromboembolism

2006-06-01

197

[Spontaneous cerebellar hematoma. Analysis of 23 cases].  

Science.gov (United States)

A series of 23 patients with spontaneous cerebellar hematoma is analysed retrospectively. Several degrees of consciousness impairment, and headache occurred in all; 12 patients presented motor deficits among the more important clinical signs. Arterial hypertension (69.5%) and diabetes (34%) stand out in the pathological background, and their association was frequent (30%). Computerized tomography (CT) disclosing severe ventricular dilatation (69.5%) associated or not with intraventricular presence of blood is considered as an unsatisfactory prognosis sign, and indicative for emergency therapy. Emergency external ventricular draining is the best indication for the majority of these cases. Posterior fossa craniectomy for emptying the hematoma may be the indication in severe cases. Death and morbidity in this pathology are high as yet. However, CT contribution for diagnosis is quicker and better than benefits obtained through other methods. Results observed in the present series are illustrative on this statement, when compared to data of other series diagnosed through other methods. PMID:3408383

Rial, J P; Vilalta, J; Guitart, J M; Rubio, E

1988-03-01

198

Hematoma subdural crónico: Análisis de 95 casos  

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El Hematoma Subdural crónico es una patología relativamente frecuente que predomina en adultos  mayores. Es de inicio insidioso, su diagnóstico se basa en el cuadro clínico y estudios radiológicos como la tomografía axial computarizada (TAC), el manejo es predominantemente quirúrgico y su pronóstico es bueno. Se analiza en el presente estudio, una muestra de 95 expedientes clínicos de pacientes con dicho diagnóstico, síntomas iniciales, TAC pre y post diagnóstico, tratamiento y e...

2012-01-01

199

Clopidogrel-induced Spontaneous Spinal Epidural Hematoma  

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The hemorrhagic side effects associated with the use of clopidogrel are within the acceptable range and occur mainly at skin or gastrointestinal sites. We report a case of spontaneous spinal epidural hematoma (SSEH) in a 60-yr-old woman who was treated with clopidogrel for frequent transient ischemic attacks. To our knowledge, this is the second reported case of clopidogrel-induced SSEH. The patient's symptoms and past history of clopidogrel use suggested the diagnosis and made the procedure ...

2007-01-01

200

Initial hematoma pressure and clinical recurrence of chronic subdural hematoma in cases where percutaneous subdural tapping was performed  

International Nuclear Information System (INIS)

Percutaneous subdural tapping for chronic subdural hematoma (CSDH) can measure initial hematoma pressure, which cannot be measured using burr-hole craniotomy. Initial hematoma pressure has not been discussed as a risk factor for recurrence. We evaluated the clinical features for recurrence, which included initial hematoma pressure. The study involved 71 unilateral CSDH cases whose initial hematoma pressure was measured using percutaneous subdural tapping. Clinical recurrence was identified in 19 cases (23%). Age, sex, neurological grading, alcohol consumption, presence of head injury, hypertension, diabetes mellitus, antiplatelet, anticoagulant medication, hematoma volume on computed tomography (CT) images, and initial hematoma pressure were compared between non-recurrence and recurrence groups. The initial hematoma pressure was 12.6±4.5 cmH2O in the non-recurrence group, and 15.5±6.2 cmH2O in the recurrence group (p<0.05). The other factors did not differ significantly except hematoma volume on CT images (92±45 ml in the non-recurrence group and 123±43 ml in the recurrence group, p<0.05). Cases with high initial hematoma pressure should be closely observed. (author)

2012-04-01

 
 
 
 
201

Idiopathic adrenal hematoma masquerading as neoplasm.  

Science.gov (United States)

We report herein a case of idiopathic adrenal hematoma. A 59-year-old Japanese man was referred to our hospital for evaluation of a 7.0 cm mass in the right upper abdominal cavity. The tumor was suspected to originate from either the posterior segment of the liver or the right adrenal gland. His chief complaint was weight loss of 8 kg over the previous 6 months. He had no past medical history and took no medications, including no anticoagulants. Laboratory data were almost normal except for a slight elevation of PIVKA-II. The origin of the tumor was found to be the adrenal gland, as angiography revealed the blood supply to the mass to derive from the right superior and inferior adrenal arteries. A fine needle biopsy of the lesion was unable to confirm the diagnosis. Open right adrenalectomy was performed. The histopathological findings of the surgical specimen revealed a hematoma with normal adrenal tissue. In the absence of any obvious etiology, the diagnosis was idiopathic adrenal hematoma. PMID:22679406

Sasaki, Kazuki; Yamada, Terumasa; Gotoh, Kunihito; Kittaka, Hirotada; Takahashi, Hidenori; Yano, Masahiko; Ohigashi, Hiroaki; Ishikawa, Osamu

2012-01-01

202

[Diagnostic and treatment of hypertensive cerebellar hematomas].  

Science.gov (United States)

Authors analyzed the results of treatment of 56 patients with hypertensive cerebellar hemorrhages (volume 0,5-41 cm3). Brain stem symptoms were found in 45 (80%) of patients. The dislocation of brain stem was observed in 38 (68%) cases, occlusive hydrocephaly - in 22 (39%), intraventricular hemorrhage - in 26 (46%). Severity of state depended on character of disease course, presence of stem symptoms, awakening level, volume and localization of cerebellar hematoma, development of intraventricular hemorrhage, occlusive hydrocephaly and dislocation of brain stem. Thirty-six patients were operated. After the neurosurgical intervention, 22 (61%) patients were discharged without or with the minimal neurological deficit, 1 (3%) with marked disability and 13 (36%) patients died. In conclusion, the removal of hematoma is recommended in dislocation of brain stem and disturbance of consiousnes: the ventricular drainage - in occlusive hydrocephaly developed as a consequence of hemotamponade of IV ventricular. The surgical treatment is not recommended to patients with cerebellar hematomas with the volume less than 7 cm3. PMID:19491806

Krylov, V V; Dash'ian, V G; Murashko, A A; Burov, S A

2009-01-01

203

Hematoma subdural crónico calcificado. Reporte de un caso / Calcified chronic subdural hematoma. A case report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish El hematoma subdural crónico constituye una enfermedad frecuente en la práctica neuroquirúrgica cotidiana. Su diagnóstico se realiza actualmente de forma temprana en la mayoría de los pacientes, a partir de la introducción de las modernas técnicas de imagenología. Se presenta el caso de un enfermo d [...] e 84 años de edad con historia de cefalea, mutismo acinético y cuadriparesia, cuyo examen tomográfico mostró una colección extraxial supratentorial hemisférica derecha con calcificación masiva; se practicó la exéresis mediante una craneotomía y el estudio histopatológico confirmó el diagnóstico de hematoma subdural crónico. Se concluye que, al constituir la calcificación masiva del hematoma subdural crónico una rara forma de presentación imagenológica en la actualidad, deben contemplarse otras entidades en el diagnóstico diferencial como neoplasias y malformaciones vasculares intracraneales; por otro lado, aumenta la complejidad quirúrgica ya que es imprescindible la práctica de una craneotomía para la evacuación de la lesión. Abstract in english The chronic subdural hematoma constitutes a frequent disease in daily neurosurgical practice. Currently its diagnosis of premature form is performed in the majority of patients, since the introduction of imaging's modern techniques. An 84 years old patient with history of cephalea, akinetic mutism a [...] nd cuadriparesis, whose tomographic exam showed a right hemispheric supratentorial extraxial collection with massive calcification; the exeresis was performed by means of a craniotomy and the histopathological study confirmed the diagnosis of chronic subdural hematoma. It was concluded that, when constitute the massive calcification of the chronic subdural hematoma a rare form of imaging presentation at present, should contemplate another entities in the differential diagnostic like neoplasias and intracranial vascular malformations; In addition, increases the surgical complexity since it is essential the practice of a craniotomy for the evacuation of the lesion.

Ariel, Varela Hernández; Gretel, Mosquera Betancourt; Oscarlyns, Cardoso Núñez; Guillermo, Pardo Cardoso.

204

Hematoma Shape, Hematoma Size, Glasgow Coma Scale Score and ICH Score: Which Predicts the 30-Day Mortality Better for Intracerebral Hematoma?  

Science.gov (United States)

Purpose To investigate the performance of hematoma shape, hematoma size, Glasgow coma scale (GCS) score, and intracerebral hematoma (ICH) score in predicting the 30-day mortality for ICH patients. To examine the influence of the estimation error of hematoma size on the prediction of 30-day mortality. Materials and Methods This retrospective study, approved by a local institutional review board with written informed consent waived, recruited 106 patients diagnosed as ICH by non-enhanced computed tomography study. The hemorrhagic shape, hematoma size measured by computer-assisted volumetric analysis (CAVA) and estimated by ABC/2 formula, ICH score and GCS score was examined. The predicting performance of 30-day mortality of the aforementioned variables was evaluated. Statistical analysis was performed using Kolmogorov-Smirnov tests, paired t test, nonparametric test, linear regression analysis, and binary logistic regression. The receiver operating characteristics curves were plotted and areas under curve (AUC) were calculated for 30-day mortality. A P value less than 0.05 was considered as statistically significant. Results The overall 30-day mortality rate was 15.1% of ICH patients. The hematoma shape, hematoma size, ICH score, and GCS score all significantly predict the 30-day mortality for ICH patients, with an AUC of 0.692 (P?=?0.0018), 0.715 (P?=?0.0008) (by ABC/2) to 0.738 (P?=?0.0002) (by CAVA), 0.877 (PCAVA), and 0.912 (P<0.0001), respectively. Conclusion Our study shows that hematoma shape, hematoma size, ICH scores and GCS score all significantly predict the 30-day mortality in an increasing order of AUC. The effect of overestimation of hematoma size by ABC/2 formula in predicting the 30-day mortality could be remedied by using ICH score.

Wang, Chih-Wei; Liu, Yi-Jui; Lee, Yi-Hsiung; Hueng, Dueng-Yuan; Fan, Hueng-Chuen; Yang, Fu-Chi; Hsueh, Chun-Jen; Kao, Hung-Wen; Juan, Chun-Jung; Hsu, Hsian-He

2014-01-01

205

Arachnoid Cyst with Spontaneous Intracystic Hemorrhage and Chronic Subdural Hematoma  

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We report a case of arachnoid cyst in which subdural hematoma and intracystic hemorrhage developed spontaneously. Usually, arachnoid cysts are asymptomatic, but can become symptomatic because of cyst enlargement or hemorrhage, often after mild head trauma. Although they are sometimes combined with subdural hematoma, intracystic hemorrhage has rarely been observed. Our patient had a simultaneous subdural hematoma and intracystic hemorrhage without evidence of head trauma.

Hong, Joo-chul; Kim, Min-soo; Chang, Chul-hoon; Kim, Seong-ho

2008-01-01

206

Rapid Spontaneous Reduction of a Huge Intracerebral Hematoma  

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Rapid reduction of a large acute subdural hematoma has been frequently reported. In my knowledge, however, it was rarely reported that rapid spontaneous reduction occurred in large volume of spontaneous intracerebral hematoma (sICH). We describe a patient with a rapid spontaneous decrease in the volume of a large hematoma. A 73-year-old man presented semi-comatose mentality. Initial brain computed tomography (CT) revealed the huge sICH. An emergency operation was planned, but was not performe...

Han, Sung Hoon; Lee, Ho Kook; Moon, Jae Gon; Kim, Chang Hyun; Cho, Tack Geun

2012-01-01

207

[An autopsy case of Sjögren syndrome with organized and fresh subdural hemorrhage (hematoma)].  

Science.gov (United States)

An autopsy case of Sjögren syndrome with organized and fresh subdural hemorrhages (hematoma) is reported. A 49-year-old woman who had been suffering from Sjögren syndrome had gradually lost her consciousness and was taken to the hospital where she died several hours later. Subsequently a doctor found the subdural hematoma of unknown origin on her Brain CT. At autopsy, her skin was dry and all of her teeth were missing. There were sporadic cutaneous purpura and subcutaneous hemorrhages in her trunk and limbs. The histopathological examination revealed that the submandibular gland had no normal acini, and was replaced by fibrous and adipose tissues with numerous lymphocytes. There were signs of fibrosis with inflammation in her liver, kidneys and lungs. The thyroid gland showed thyroiditis. Serological findings showed a significant high level of antinuclear antibody, positive RA factor and high gamma-globulinemia. The autopsy revealed that her cause of death was acute subdural hematoma and uncal herniation. There were no external injuries on her head or face. It is suggested that her acute subdural hematoma according to the hemorrhagic tendency, affected by her Sjögren syndrome. PMID:7861643

Orihara, Y; Kubo, S; Kitamura, O; Tsuda, R; Hirose, W; Matsumoto, H; Nakasono, I

1994-12-01

208

Subarachnoid hematoma of the craniocervical junction and upper cervical spine after traumatic cerebral contusion: case report.  

Science.gov (United States)

Spinal subarachnoid hematoma (SSH) is a rare condition, more commonly occurring after lumbar puncture for diagnostic or anesthesiological procedures. It has also been observed after traumatic events, in patients under anticoagulation therapy or in case of arteriovenous malformation rupture. In a very small number of cases no causative agent can be identified and a diagnosis of spontaneous SSH is established. The lumbar and thoracic spine are the most frequently involved segments and only seven cases of cervical spine SSH have been described until now. Differential diagnosis between subdural and subarachnoid hematoma is complex because the common neuroradiological investigations, including a magnetic resonance imaging (MRI), are not enough sensitive to exactly define clot location. Actually, confirmation of the subarachnoid location of bleeding is obtained at surgery, which is necessary to resolve the fast and sometimes dramatic evolution of clinical symptoms. Nonetheless, there are occasional reports on successful conservative treatment of these lesions. We present a peculiar case of subarachnoid hematoma of the craniocervical junction, developing after the rupture of a right temporal lobe contusion within the adjacent arachnoidal spaces and the following clot migration along the right lateral aspect of the foramen magnum and the upper cervical spine, causing severe neurological impairment. After surgical removal of the hematoma, significant symptom improvement was observed. PMID:24067775

Di Rienzo, Alessandro; Iacoangeli, Maurizio; Alvaro, Lorenzo; Colasanti, Roberto; Moriconi, Elisa; Gladi, Maurizio; Nocchi, Niccolò; Scerrati, Massimo

2013-01-01

209

Bilateral isodense epidural hematoma: case report / Hematoma epidural isodenso bilateral: relato de caso  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Apresentamos o caso de um homem de 23 anos com traumatismo craniano grave. A TC de crânio demonstrou um volumoso hematoma epidural bilateral, isodenso com o cérebro, sendo uma armadilha ao diagnóstico. São apresentados um breve relato, estudo da imagem tomográfica e revisão da literatura. [...] Abstract in english We present a case of a severe head injuried 23 year-old male patient. The initial CT scan disclosed bilateral epidural hematoma, isodense with the brain, thus being a pitfall in diagnosis. Brief case report, image and literature rewiew are presented. [...

Mendonça, Rodrigo; Lima, Telmo T.F.; Dini, Leandro I.; Krebs, Cláudio L.L..

210

Rapid spontaneous resolution of an acute subdural hematoma: Case report  

International Nuclear Information System (INIS)

We present a case of acute subdural hematoma which was rapidly resolved without surgical intervention. This 31 year old man had a hematoma of which thickness was 9 mm and was paraplegic due to fracture-dislocation of thoracic spine at the level of TII-12 Rapid recovery of consciousness despite of sizable hematoma made to take a serial CT scanning instead of immediate surgical interventions. The hematoma was resolved within 4 hours without surgery. Possible mechanism of this rapid spontaneous resolution is discussed with brief review of the related literature

1989-10-01

211

Hematoma epidural cervical yatrogénico: Presentación de un caso clínico y revisión de la literatura / Iatrogenic cervical epidural hematoma: case report and review of the literature  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Introducción: En la literatura se recogen alrededor de 600 casos de hematomas epidurales espinales. En varios estudios, se afirma que la incidencia de paraparesia secundaria a anestesia epidural oscila entre 0,0005-0,02%. Se han descrito numerosas etiologías, incluyendo cirugía, traumatismos, antico [...] agulación, malformaciones arteriovenosas, embarazo, procesos hematológicos y punción lumbar. Los procedimientos anestésicos raquídeos y epidurales representan la décima causa más frecuente. Pero en combinación con el tratamiento anticoagulante, dichos procedimientos aumentan su incidencia hasta alcanzar la quinta causa. Publicamos un caso clínico de hematoma epidural cervical yatrogénico en el adulto y el buen resultado obtenido con tratamiento conservador. Caso clínico: Paciente varón de 80 años, que a las 2 horas de tratamiento analgésico de cervicoartrosis mediante infiltración epidural cervical desarrolla intensa cervicalgia y pérdida de fuerza en extremidades inferiores, mostrando paraplejia completa con arreflexia. En RM cervical se evidencia hematoma epidural entre los niveles C4 y T1. Es trasladado a nuestro centro para cirugía pero ante la rápida recuperación se decide tratamiento médico conservador. Al mes de seguimiento, la situación clínica es similar a la previa, sin secuelas con completa reabsorción del hematoma en RM control. Conclusión: Actualmente, la tendencia general es realizar cirugía en pacientes con hematoma espinal y empeoramiento neurológico importante durante las primeras horas. Sin embargo, se pueden obtener buenos resultados neurológicos con tratamiento conservador, en pacientes bien seleccionados con déficit parcial, incompleto y no progresivo. En el presente, no estamos en condiciones de decir qué tratamiento es el mejor para cada caso concreto. Abstract in english Background: Around 600 spinal epidural hematoma cases have been previously reported. Incidence of paraplegia after epidural anesthesia varies between 0,0005 and 0,02%. Several possible etiologies have been described in the literature, including surgery, trauma, anticoagulant therapy, arteriovenous m [...] alformations, pregnancy and lumbar puncture. Spinal and epidural anesthesic procedures represent the tenth most common cause. But in combination with anticoagulant therapy, the forementioned procedures increase its incidence until reaching the fifth most common etiological group. We report the case of an 80 year-old-man with a cervical epidural hematoma who had a good outcome with conservative management. Case report: 80 year-old-man that developed intense cervicalgia with lower limbs weakness showing complete paraplegia and arreflexia 2 hours after analgesic treatment with epidural cervical infiltration for cervicoartrosis. Cervical MRI showed epidural cervical hematoma between C4 and T1 levels. The patient is transferred to our facilities in order to perform surgery. But after showing fast recovery, medical conservative management was elected. After one month, the patient's condition has improved showing no neurological deficits and complete resorption is seen in MRI. Conclusions: Nowadays, trend is to perform surgery in patients with spinal hematoma and significant neurological deterioration during the first hours. However, good neurological outcomes can be achieved with conservative management, in well selected patients with non progressive, incomplete and partial deficits. Presently, we can not predict wich is the best treatment for each case.

I., Jusué-Torres; J.M., Ortega-Zufiria; M., Tamarit-Degenhardt; R., Navarro Torres; R., López-Serrano; J., Riqué-Dormido; P., Aragonés-Cabrerizo; J.C., Gómez-Angulo; P., Poveda-Nuñez; P., Jerez-Fernández; J. M. del, Pozo-García.

212

Immediate Extinction Causes a Less Durable Loss of Performance than Delayed Extinction following Either Fear or Appetitive Conditioning  

Science.gov (United States)

Five experiments with rat subjects compared the effects of immediate and delayed extinction on the durability of extinction learning. Three experiments examined extinction of fear conditioning (using the conditioned emotional response method), and two experiments examined extinction of appetitive conditioning (using the food-cup entry method). In…

Woods, Amanda M.; Bouton, Mark E.

2008-01-01

213

Aversive stimulus attenuates impairment of acquisition in a delayed match to position T-maze task caused by a selective lesion of septo-hippocampal cholinergic projections  

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Infusion of 192 IgG-saporin (SAP) into the medial septum (MS) of rats selectively destroys cholinergic neurons projecting to the hippocampus and impairs acquisition of a delayed matching to position (DMP) T-maze task. The present study evaluated whether introduction of a mild aversive stimulus 30 min prior to training would attenuate the deficit in DMP acquisition caused by the SAP lesions. Male Sprague–Dawley rats received medial septal infusions of either artificial cerebrospinal fluid or...

Fitz, Nicholas F.; Gibbs, Robert B.; Johnson, David A.

2006-01-01

214

Imaging diagnosis of longitudinal fissure subdural hematoma  

International Nuclear Information System (INIS)

Objective: To analyze the imaging characteristics of longitudinal fissure subdural hematoma(LFSH). Methods: CT and MRI images of 11 patients with LFSH were retrospectively analyzed. Results: On CT scan, LFSH was shown as a girdle-shaped high density parafalcic area, which located in anterior longitudinal fissure in 5 cases, posterior longitudinal fissure in 4 cases, full longitudinal fissure in 2 cases. MRI of 2 cases showed hypointensity on T1-weighted images and isointensity on T2-weighted images. Conclusion: CT and MRI images are the most helpful for the correct diagnosis of LFSH. (authors)

2009-10-01

215

Idiopathic Adrenal Hematoma Masquerading as Neoplasm  

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We report herein a case of idiopathic adrenal hematoma. A 59-year-old Japanese man was referred to our hospital for evaluation of a 7.0 cm mass in the right upper abdominal cavity. The tumor was suspected to originate from either the posterior segment of the liver or the right adrenal gland. His chief complaint was weight loss of 8 kg over the previous 6 months. He had no past medical history and took no medications, including no anticoagulants. Laboratory data were almost normal except for a...

2012-01-01

216

[A case of cerebellar hematoma due to venous angioma presenting trigeminal dysfunction].  

Science.gov (United States)

With regard to the natural history of venous angioma, the risk of hemorrhage is reported to be relatively higher if the lesion exists in the posterior fossa. However a recent report of 100 cases of venous angioma concluded that the risk of hemorrhage was low, being only 0.22%/year. Although the true rate of hemorrhage is uncertain, we have encountered case of cerebellar hematoma due to venous angioma in the posterior fossa where the patient presented with trigeminal dysfunction and cerebellar ataxia, without any history of hypertension. We considered that venous angioma in the posterior fossa might cause cerebellar hemorrhage. After removal of the hematoma, the patient's symptoms were resolved. In the posterior fossa, a relatively higher volume of venous blood would cause venous congestion to occur more easily, leading to damage of the fragile wall of the angioma. PMID:10190157

Hayashida, O; Yamashita, T; Nagamitsu, T; Yasuda, H; Kamei, T

1999-03-01

217

Subgaleal hematoma presenting as a manifestation of Factor XIII deficiency  

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Extracranial hematoma without significant head trauma is uncommon. We discuss a 9-year-old girl who presented with sudden head swelling, bilateral proptosis, extraocular muscle palsy, and progressive visual disturbance after hair braiding. The diagnosis of a large subgaleal hematoma with extension into the superior aspect of the orbits was made, requiring surgical drainage. Hematologic workup revealed an underlying Factor XIII deficiency. (orig.)

Kim, Don; Taragin, Benjamin [Albert Einstein College of Medicine, Department of Radiology, Montefiore Medical Center, Bronx, NY (United States)

2009-06-15

218

Spontaneous subdural hematoma in a young adult with hemophilia  

Directory of Open Access Journals (Sweden)

Full Text Available We report a case of spontaneous acute subdural hematoma in a 30-year-old man, who was diagnosed with hemophilia during his hospital stay. He developed an extradural hematoma following evacuation of the acute SDH, which was also evacuated. He had a good outcome. Management of such a patient is discussed.

Agrawal D

2003-01-01

219

Prognostic factors in intraparenchymatous hematoma with ventricular hemorrhage  

International Nuclear Information System (INIS)

Intraventricular hemorrhage following intraparenchymatous hematoma is thought to be a frequent and often fatal event. Computerized tomography has proved to be valuable for their diagnosis. Hospital records of seventy-eight patients with intraparenchymatous hematoma and intraventricular hemorrhage diagnosed by computerized tomography were retrospectively reviewed to evaluate initial clinical features and CT findings in order to assess potential prognostic factors. (orig.)

1986-01-01

220

Subcapsular hematoma of the liver in a neonate: case report  

Energy Technology Data Exchange (ETDEWEB)

Subcapsular hematoma of the liver in the neonate is an uncommon clinical presentation, although these tumors are frequently found upon perinatal autopsy. We describe the sonographic and MR findings of a subcapsular hematoma of the liver in a neonate having a clinical history of an inserted umbilical venous catheter, necrotizing enterocolitis and sepsis, and we also include a review of the relevant literature.

Im, Soo Ah; Lim, Gye Yeon [The Catholic University of Korea, Seoul (Korea, Republic of)

2005-07-15

 
 
 
 
221

Delay in diagnosis of cancer as a patient safety issue - a root cause analysis based on a representative case report  

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Abstract Background It is well known in the literature that imaging has almost no value for diagnosis of superficial bladder cancer. However, wide gap exists between knowledge on diagnosis of bladder cancer and actual clinical practice. Case presentation Delay in diagnosis of bladder cancer in a male person with tetraplegia occurred because of reliance on negative flexible cystoscopy and single biopsy, negative ultrasound examination of urinary bladder, and comp...

Vaidyanathan Subramanian; Soni Bakul M; Singh Gurpreet; Hughes Peter L; Mansour Paul; Oo Tun

2011-01-01

222

Immediate extinction causes a less durable loss of performance than delayed extinction following either fear or appetitive conditioning  

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Five experiments with rat subjects compared the effects of immediate and delayed extinction on the durability of extinction learning. Three experiments examined extinction of fear conditioning (using the conditioned emotional response method), and two experiments examined extinction of appetitive conditioning (using the food-cup entry method). In all experiments, conditioning and extinction were accomplished in single sessions, and retention testing took place 24 h after extinction. In both f...

Woods, Amanda M.; Bouton, Mark E.

2008-01-01

223

Delay in diagnosis of cancer as a patient safety issue - a root cause analysis based on a representative case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background It is well known in the literature that imaging has almost no value for diagnosis of superficial bladder cancer. However, wide gap exists between knowledge on diagnosis of bladder cancer and actual clinical practice. Case presentation Delay in diagnosis of bladder cancer in a male person with tetraplegia occurred because of reliance on negative flexible cystoscopy and single biopsy, negative ultrasound examination of urinary bladder, and computerised tomography of pelvis. Difficulties in scheduling cystoscopy also contributed to a delay of nearly ten months between the onset of haematuria and establishing a histological diagnosis of vesical malignancy in this patient. The time interval between transurethral resection and cystectomy was 42 days. This delay was mainly due to scheduling of surgery. Conclusion We learn from this case that doctors should be aware of the limitations of negative flexible cystoscopy and single biopsy, cytology of urine, ultrasound examination of urinary bladder, and computed tomography of pelvis for diagnosis of bladder cancer in spinal cord injury patients. Random bladder biopsies must be considered under general anaesthesia when there is high suspicion of bladder cancer. Spinal cord injury patients with lesions above T-6 may develop autonomic dysreflexia; therefore, one should be extremely well prepared to prevent or manage autonomic dysreflexia when performing cystoscopy and bladder biopsy. Spinal cord injury patients, who pass blood in urine, should be accorded top priority in scheduling of investigations and surgical procedures.

Mansour Paul

2011-07-01

224

Cervical spine intradural-extramedullary hematoma presenting as ipsilateral hemiparesis  

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Full Text Available A 75-year-old Taiwanese man suffered from acute onset of right-sided extremity weakness while talking to his neighbors. He was transferred to the hospital within three-hour time after symptom onset. Initial acute ischemic cerebral infarct was diagnosed based on his symptom and cerebral computed tomography. Thrombolytic therapy was held after his symptom improved promptly and could not excluded other etiology. Thorough history taking unraveled previous Chinese medicine clinic visit because of neck sore. However, he received limited improvement after several times of massage treatment. Magnetic resnance imaging (MRI of the cervical spine demonstrated hematoma compressing right side intradural-extramedullary space at the C2/C3 level. Through his clinical course, muscle weakness was the sole neurological finding with sparing of sensory defects. Given the close anatomy relationship between sensory and motor lamina distribution in the cervical spinal cord, our patient presented a rare manifestation. Cases of cervical spine intradural-extramedullary hematoma are not often seen and only sporadic in the documented literature. We wish, through the report of this article, to inform the first- line physicians with the following information. Among the elderly, neck sore is a common symptom. Over- stretching or overt local massage is not suggested due to relatively fragile musculature. In the clinical diagnosis and localization of lesion, cerebral or cervical spine lesion could mimic with each other and manifest hemiparesis as their first symptom. Meticulous history taking, neurological/ physical examination and pertinent laboratory work-up should be done before initiation of intravenous thrombolytic therapy as it could cause catastrophic consequences if not used properly.

Chih Ming Lin

2011-07-01

225

Spontaneous iliopsoas muscle hematoma in a patient with von Willebrand disease: a case report  

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Abstract Introduction Iliopsoas hemorrhage is a serious complication of bleeding disorders that occurs most commonly in patients with hemophilia and less commonly in patients with von Willebrand disease. It causes severe pain, muscle dysfunction and occasionally femoral nerve palsy. We describe the case of a patient with von Willebrand disease type 3 with a large iliopsoas hematoma who was treated with a von Willebrand factor concentrate (Humate-P). Case presentation

Keikhaei Bijan; Soltani Shirazi Ahmad

2011-01-01

226

CT-guided stereotaxic evacuation of cerebellar hematoma  

International Nuclear Information System (INIS)

Stereotaxic lateral approach for cerebellar hematoma is presented using Leksell's CT-stereotaxic system. All of the procedures are performed in the CT room. Patient's head is turned to contralateral side of the hematoma 30 to 40"0 with slight flexion of the neck. Stereotaxic apparatus is secured to the head under local anesthesia. Hematoma is confirmed by computerized tomograms. Three dimensional coordinates of the target point (center of the hematoma) are measured from the vertical and diagonal rods of Leksell's system. Linear skin incision 4 cm in length is made on retromastoid area. Burr-hole is put on just lateral position of the target point, usually 5 to 6 cm posterior and 1 cm above from the external auditory meatus. Transverse or sigmoid sinus does not appeared through the burr-hole by this approach. Specially made Dandy's cannula (3.0 mm in diameter, 220 mm in length) is inserted into the target point, and manual evacuation of the hematoma is performed carefully using a syringe. Then Dandy's cannula is replaced by silastic drainage tube (3.5 mm in diameter), and 6,000 Units of Urokinase solved in 2 ml of saline is administered to the hematoma cavity. Dissolved hematoma is aspirated every 24 hours until the most of the hematoma is evacuated. We operated three cases of cerebellar hematoma by this method with favorable results. Advantages of this method are as follows: Operative invasion is minimal; The surgeon can cbeck the residual hematoma and position of the tip of cannula even at operation, if necessary. (author)

1985-01-01

227

Conservative treatment of a left atrial intramural hematoma after left atrial thrombus resection and concomitant mitral valve replacement - case report  

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Full Text Available Abstract Left atrial intramural hematoma is a seldom cause of left atrial mass. It has been described to occur spontaneously, after interventional procedures, after blunt chest trauma, or after aortocoronary bypass surgery. We present a case of mitral valve replacement together with the removal of a large intraatrial space-occupying lesion. Intraoperative transesophageal echocardiography confirmed a successful resection of this mass. Surprisingly, upon admission to ICU, transesophageal and transthoracic echocardiography revealed a recurrence of an intramural lesion, closest matching a hematoma, which was confirmed by contrast-enhanced computed tomography. Surgical intervention was thoroughly discussed but a conservative management was favoured. 3 months after surgery, a reassessed transthoracic echocardiography and computed tomography demonstrated an almost complete resolution of the pre-existing hematoma.

Schmitz Christoph

2011-04-01

228

Dominant-Negative Mutations in ?-II Spectrin Cause West Syndrome with Severe Cerebral Hypomyelination, Spastic Quadriplegia, and Developmental Delay  

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A de novo 9q33.3-q34.11 microdeletion involving STXBP1 has been found in one of four individuals (group A) with early-onset West syndrome, severe hypomyelination, poor visual attention, and developmental delay. Although haploinsufficiency of STXBP1 was involved in early infantile epileptic encephalopathy in a previous different cohort study (group B), no mutations of STXBP1 were found in two of the remaining three subjects of group A (one was unavailable). We assumed that another gene within ...

Saitsu, Hirotomo; Tohyama, Jun; Kumada, Tatsuro; Egawa, Kiyoshi; Hamada, Keisuke; Okada, Ippei; Mizuguchi, Takeshi; Osaka, Hitoshi; Miyata, Rie; Furukawa, Tomonori; Haginoya, Kazuhiro; Hoshino, Hideki; Goto, Tomohide; Hachiya, Yasuo; Yamagata, Takanori

2010-01-01

229

Hematoma epidural espinal espontâneo durante a gravidez: registro de um caso Spontaneous epidural spinal hematoma during pregnancy: a case report  

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Full Text Available Registro de caso de paciente no oitavo mês de gestação que desenvolveu hematoma epidural espinal espontâneo dorsolombar. A gravidez, determinando aumento da pressão intra-abdominal e, como consequência, aumento da pressão venosa no plexo epidural, poderia ter sido o fator desencadeante no hematoma- A paciente foi submetida a cirurgia precocemente, porém não apresentou recuperação do déficit sensitivo-motor. São discutidos aspectos clínicos, do tratamento cirúrgico, da evolução e da etiologia dos hematomas epidurals espinais espontâneos.A case of spontaneous dorso-lombar spinal epidural hematoma during pregnancy is reported. The hematoma was removed 8 hours after the onset of paraplegia, and there was no evidence of vascular malformation. The motor deficit remained unchanged post-operatively. The etiology, clinical findings and the value of early laminectomy are discussed.

Ivan Hack

1984-03-01

230

Hematoma epidural espinal espontâneo durante a gravidez: registro de um caso / Spontaneous epidural spinal hematoma during pregnancy: a case report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Registro de caso de paciente no oitavo mês de gestação que desenvolveu hematoma epidural espinal espontâneo dorsolombar. A gravidez, determinando aumento da pressão intra-abdominal e, como consequência, aumento da pressão venosa no plexo epidural, poderia ter sido o fator desencadeante no hematoma- [...] A paciente foi submetida a cirurgia precocemente, porém não apresentou recuperação do déficit sensitivo-motor. São discutidos aspectos clínicos, do tratamento cirúrgico, da evolução e da etiologia dos hematomas epidurals espinais espontâneos. Abstract in english A case of spontaneous dorso-lombar spinal epidural hematoma during pregnancy is reported. The hematoma was removed 8 hours after the onset of paraplegia, and there was no evidence of vascular malformation. The motor deficit remained unchanged post-operatively. The etiology, clinical findings and the [...] value of early laminectomy are discussed.

Hack, Ivan; Cademartori, Mario S.; Mamani, Rosendo S.; Beltrame, Carmen M.; Cademartori, Carlos G..

231

[What causes self-control failure in delayed-cost dilemma: the role of affective expectancy and regulatory resource].  

Science.gov (United States)

Two studies were conducted to examine the effect of affects on self-control behavior in delayed cost dilemma. Results of Study 1 suggested that long term negative affects such as regret and self-disgust might have facilitating effects on motivation of self-control if they were anticipated before delayed-cost dilemma situations, but inhibiting effects on self-efficacy of control when experienced after dilemma situations. Study 2 examined the effect of affect priming on self-control in eating behavior, as well as an interaction effect of anticipated affect and regulatory resource on it. Results indicated that participants who had enough regulatory resource succeeded in self-control, i.e. they ate less, regardless of the type of affect priming, but those who did not have sufficient resource and were not primed with long-term negative affects failed to control their behavior. It was argued that regulatory resource explanation of self-control should be expanded to the theory including anticipated affects. PMID:16862961

Yamaoka, Hiroshi; Karasawa, Kaori

2006-04-01

232

Subcapsular hepatic hematoma. Serious complication during pregnancy Hematoma subcapsular hepático. Grave complicación del embarazo  

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Full Text Available Subcapsular hepatic hematoma is a rare complication during pregnancy, but potentially lethal and usually related to severe pre-eclampsia or HELLP syndrome (hemolysis, elevated liver enzymes and diminished platelets. Maternal and perinatal mortality in these cases is high, hence the importance of early diagnosis and timely and multidisciplinary treatment. This paper is a review on the subject, held in Ebsco, Hinari and Sci databases.El hematoma subcapsular hepático es una complicación rara del embarazo, pero potencialmente letal, generalmente relacionada con pre-eclampsia grave o síndrome HELLP (hemólisis, enzimas hepáticas elevadas y plaquetas disminuidas. La mortalidad materna y perinatal en estos casos es elevada, de ahí la importancia del reconocimiento precoz y tratamiento oportuno y multidisciplinario. El presente trabajo constituye una revisión sobre el tema, realizada en las bases de dato Ebsco, Hinari y Scielo.

Viviana de la Caridad Sáez Cantero

2010-12-01

233

Misdiagnosed spontaneous intracranial hypotension complicated by subdural hematoma following lumbar puncture  

Science.gov (United States)

Introduction Spontaneous intracranial hypotension is an infrequent cause of secondary headache due to cerebrospinal fluid (CSF) hypovolemia. Objective To describe a case of headache revealing spontaneous intracranial hypotension complicated by subdural hematoma following lumbar puncture. Observation A 34-year-old man presented with acute postural headache. The first cerebral computed tomography scan was normal. Lumbar puncture showed hyperproteinorachy at 2 g/L with six lymphocytic cells. The headache became very intense. At admission, clinical examination was normal. Ophthalmological examination did not show any abnormalities. Encephalic magnetic resonance imaging (MRI) showed bilateral subdural hematoma with tonsillar descent simulating Chiari type I malformation. After surgical drainage and symptomatic treatment, the patient was discharged with no recurrence. Conclusion Spontaneous intracranial hypotension is associated with simple clinical presentation, orthostatic headache, and characteristic MRI findings. Misdiagnosed, it leads to unnecessary procedures.

Louhab, Nissrine; Adali, Nawal; Laghmari, Mehdi; Hymer, Wafae El; Ben Ali, Said Ait; Kissani, Najib

2014-01-01

234

Acute spontaneous cervical epidural hematoma mimicking cerebral stroke: a case report and literature review.  

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Spontaneous cervical epidural hematoma (SCEDH) is a rare disease, but can cause severe neurologic impairment. We report a case of a 68-year-old female who presented with sudden onset, posterior neck pain, right shoulder pain, and progressive right hemiparesis mimicking stroke with no trauma history. Initial brain CT and diffusion MRI performed to rule out brain lesion did not show any positive findings. Laboratory examination presented only severe thrombocytopenia (45,000/mm(3)). Subsequent cervical MRI revealed a cervical epidural mass lesion. We confirmed that it was pure hematoma through C5 unilateral total laminectomy and C6 partial hemilaminectomy. She achieved complete neurologic recovery with active rehabilitation. Early surgical decompression for SCEDH with neurologic impairment should be recommended for better outcome. PMID:24757481

Kim, Jin Kyu; Kim, Tae Hong; Park, Sang Keun; Hwang, Yong Soon; Shin, Hyung Shik; Shin, Jun Jae

2013-09-01

235

Hematoma cerebelar espontâneo: análise de 23 casos Spontaneous cerebellar hematoma: analysis of 23 cases  

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Full Text Available Uma série de 23 pacientes com hematoma espontâneo de cerebelo é analisada retrospectivamente, mostrando que: todos apresentavam algum grau de diminuição do nível de consciência e cefaléia; 12 apresentavam déficits motores dentre os sinais clínicos mais importantes. Dos antecedentes patológicos destacam-se hipertensão arterial (69,5% e diabetes (34%, havendo associação de ambos em 30% dos casos. Dos aspectos da tomografia computadorizada (TC mais relevantes a dilatação ventricular aguda, encontrada em 69,5% dos pacientes, associada ou não a presença de sangue intraventricular, é considerada sinal de mau prognóstico, indicando por si só terapêutica de urgência. A melhor abordagem cirúrgica para a maioria desses casos é a drenagem ventricular externa de urgência, reservando a craniectomia da fossa posterior para esvaziamento do hematoma para casos específicos. A mortalidade e a morbidade desta patologia é alta; porém, pela TC o diagnóstico se tornou mais rápido e eficiente. Os pacientes desta série puderam beneficiar-se deste procedimento, como se verifica quando comparados a pacientes de outras séries, diagnosticados por outros métodos.A series of 23 patients with spontaneous cerebellar hematoma is analysed retrospectively. Several degrees of conciousness impairment, and headache occurred in all; 12 patients presented motor deficits among the more important clinical signs. Arterial hypertension (69,5% and diabetes (34% stand out in the pathological background, and their association was frequent (30%. Computerized tomography (CT disclosing severe ventricular dilatation (69.5% associated or not with intraventricular presence of blood is considered as an unsactisfatory prognosis sign, and indicative for emergency therapy. Emergency external ventricular draining is the best indication for the majority of these cases. Posterior fossa craniectomy for emptying the hematoma may be the indication in severe cases. Death and morbidity in this pathology are high as yet. However, CT contribution for diagnosis is quicker and better than benefits obtained through other methods. Results observed in the present series are illustrative on this statement, when compared to data of other series diagnosed through other methods.

J. P. Rial

1988-03-01

236

Evolutionary Changes of Traumatic lntrahepatic Hematomas at Sonography  

International Nuclear Information System (INIS)

To evaluate the echo pattern of early stage intrahepatic hematoma and change of the echogenicity according to the time lapse. Twenty-four patents with blunt abdominal trauma underwent sonography. Intrahepatic hematomas were sonographic ally, clinically or operatively diagnosed. Sonograms were retrospectively reviewed by the three observers with consensus. We divided the time interval into 4 groups as follows; within 24 hours, 2 to 7 days, 8 to 30 days, and after one month. The echogenicity, shape and location of intrahepatic hematomas were analyzed. Intrapatic hematomas occurred in the right lobe of the liver in 91.6%, especially in the posterior segment. The margin of hematoma was irregular in 23 cases and well-defined in one case. The shape of intrahepatic hematoma was round in 75%. The echogenicity of hematoma was as follows: within24 hours, hyperechoic(6/14), mixed-echoic(6), hypoechoic(2): in 1?7 days, hyperechoir(1/10), mixed-echoic(6),hypoechoic(3): in 8?30 days, mixed-echoic(5/14), hypoechoic(9) respectively. Two cases were completely resolved.All 7 cases were hypoechoic on sonogram after 31 days. On available follow-up sonograms the lesion showed decreased echogenicity in 3 of 5 cases at 1?7 days interval, 7 of 12 cases at 8?30 days interval, and 5 of 6 cases after 1 month interval. The echogenicity of the early stage of intrahepatic hematoma was mainly hyperechoic or mixed-echoic. The echogenicity of hematoma decreased with time lapse

1995-06-01

237

Spontaneously Developed Pulmonary Arterial Intramural Hematoma That Mimicked Thromboembolism  

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A 65-year-old woman visited our hospital with a complaint of acute onset dyspnea and radiological manifestations of pulmonary thromboembolism. The patient underwent an exploratory surgery to find a whitish-blue colored mass occupying almost the whole lumen of the main pulmonary arteries. Based on the pathological and radiological findings, the patient was diagnosed to have a pulmonary arterial intramural hematoma. Intramural hematomas are usually observed in the walls of the aorta, and we believe that an isolated intramural hematoma in the pulmonary artery has not been described previously.

Kang, Eun Ju; Lee, Ki Nam [Dong-A University College of Medicine, Busan (Korea, Republic of); Kim, In; Chane, Jong Min; Kim, Gun Jik; Yang, Dong Heon; Lee, Jong Min [Kyungpook National University Hospital, Daegu (Korea, Republic of)

2012-07-15

238

Spontaneously Developed Pulmonary Arterial Intramural Hematoma That Mimicked Thromboembolism  

International Nuclear Information System (INIS)

A 65-year-old woman visited our hospital with a complaint of acute onset dyspnea and radiological manifestations of pulmonary thromboembolism. The patient underwent an exploratory surgery to find a whitish-blue colored mass occupying almost the whole lumen of the main pulmonary arteries. Based on the pathological and radiological findings, the patient was diagnosed to have a pulmonary arterial intramural hematoma. Intramural hematomas are usually observed in the walls of the aorta, and we believe that an isolated intramural hematoma in the pulmonary artery has not been described previously.

2012-07-01

239

Computerized tomography of chronic subdural hematoma extending to the tentorium  

International Nuclear Information System (INIS)

A case of chronic subdural hematoma extending to the cerebellar tentorium is presented. The clinical feature of this case was gait disturbance with trankial ataxia. An axial CT scan showed only a diffuse high-density area in the cerebellar tentorium, but a coronal CT scan revealed a characteristic high-density lesion just on the cerebellar tentorium. The hematoma was evacuated by opening a burrhole at the convex; the gait disturbance disappeared after this operation. The value of a coronal CT scan in this case is stressed, and the mechanism of gait disturbance in a chronic subdural hematoma is discussed. (author)

1987-01-01

240

Extensive retroperitoneal hematoma in blunt trauma  

International Nuclear Information System (INIS)

To report our experience of managing extensive retroperitoneal hematoma (RH) in patients with blunt trauma and to determine any associated factors affecting causation and mortality. In this retrospective observational study, patients diagnosed with extensive RH following blunt trauma admitted to King Saud Medical Complex, Riyadh, Kingdom of Saudi Arabia between January 2004 and December 2009 were included. Patient data were explored for injury severity score (ISS), associated injuries, location of hematoma, amount of blood transfusions, coagulation profile, operative management, hospital stay, and mortality. The outcomes in surviving and non-surviving patients were compared. Out of 290 patients presenting with RH, extensive RH was found in 46 patients (15.8%). The overall mortality was 32.6%. The pelvis was the most frequent location of RH in combination with lateral and central zones (65.2%). The lower extremity and pelvic fractures were the most common injury. Associated intra-peritoneal injuries were present in 39.1% patients. An exploratory laparotomy was performed in 58.7% patients (n=27). A high ISS (55.9 versus 35.5, p<0.0001), abnormal coagulation profile (odds ratio [OR] 7.8, 95% confidence interval [CI] 1.974-30.932, p=0.005, and associated chest injuries OR 5.94, 95% CI 1.528-23.19, p=0.014) were independent factors associated with mortality. Multiple musculoskeletal injuries in addition to intra-abdominal injuries and abnormal coagulation are major factors associated with the presence of extensive RH. High ISS, abnormal coagulation, and associated chest injuries are independent factors associated with mortality (Author).

2010-01-01

 
 
 
 
241

An increase in melatonin in transgenic rice causes pleiotropic phenotypes, including enhanced seedling growth, delayed flowering, and low grain yield.  

Science.gov (United States)

No previous reports have described the effects of an increase in endogenous melatonin levels on plant yield and reproduction. Here, the phenotypes of melatonin-rich transgenic rice plants overexpressing sheep serotonin N-acetyltransferase were investigated under field conditions. Early seedling growth of melatonin-rich transgenic rice was greatly accelerated, with enhanced biomass relative to the wild type (WT). However, flowering was delayed by 1 wk in the transgenic lines compared with the WT. Grain yields of the melatonin-rich transgenic lines were reduced by 33% on average. Other phenotypes also varied among the transgenic lines. For example, the transgenic line S1 exhibited greater height and biomass than the WT, while the S10 transgenic line showed diminished height and an increase in panicle numbers per plant. The expression levels of Oryza sativa homeobox1 (OSH1) and TEOSINTE BRANCHED1 (TB1) genes, two key regulators of meristem initiation and maintenance, were not altered in the transgenic lines. These data demonstrate that an alteration of endogenous melatonin levels leads to pleiotropic effects such as height, biomass, panicle number, flowering time, and grain yield, indicating that melatonin behaves as a signaling molecule in plant growth and reproduction. PMID:24571270

Byeon, Yeong; Back, Kyoungwhan

2014-05-01

242

Overexpression of Medicago SVP genes causes floral defects and delayed flowering in Arabidopsis but only affects floral development in Medicago  

Science.gov (United States)

The MADS-domain transcription factor SHORT VEGETATIVE PHASE plays a key role as a repressor of the transition to flowering and as a regulator of early floral development in Arabidopsis thaliana (Arabidopsis). However, no flowering-time repressors have been functionally identified in the model legume Medicago truncatula (Medicago). In this study, phylogenetic analysis of two closely-related MtSVP-like sequences, MtSVP1 and MtSVP2, showed that their predicted proteins clustered together within the eudicot SVP clade. To determine if the MtSVP-like genes have a role in flowering, they were functionally characterized in Medicago and Arabidopsis. Transcripts of both MtSVP genes were abundant and broadly expressed in vegetative tissues but were detected at much lower levels in flowers in Medicago. Over-expression of the MtSVP genes in Arabidopsis resulted in delayed flowering and flowers with many abnormal phenotypes such as leafy sepals, changes to floral organ number and longer pedicels than the wild type. By contrast, in transgenic Medicago, over-expression of MtSVP1 resulted in alterations to flower development, but did not alter flowering time, suggesting that MtSVP1 may not function to repress the transition to flowering in Medicago.

Jaudal, Mauren

2014-01-01

243

Overexpression of miR-30b in the Developing Mouse Mammary Gland Causes a Lactation Defect and Delays Involution  

Science.gov (United States)

Background MicroRNA (miRNA) are negative regulators of gene expression, capable of exerting pronounced influences upon the translation and stability of mRNA. They are potential regulators of normal mammary gland development and of the maintenance of mammary epithelial progenitor cells. This study was undertaken to determine the role of miR-30b on the establishment of a functional mouse mammary gland. miR-30b is a member of the miR-30 family, composed of 6 miRNA that are highly conserved in vertebrates. It has been suggested to play a role in the differentiation of several cell types. Methodology/Principal Findings The expression of miR-30b was found to be regulated during mammary gland development. Transgenic mice overexpressing miR-30b in mammary epithelial cells were used to investigate its role. During lactation, mammary histological analysis of the transgenic mice showed a reduction in the size of alveolar lumen, a defect of the lipid droplets and a growth defect of pups fed by transgenic females. Moreover some mammary epithelial differentiated structures persisted during involution, suggesting a delay in the process. The genes whose expression was affected by the overexpression of miR-30b were characterized by microarray analysis. Conclusion/Significance Our data suggests that miR-30b is important for the biology of the mammary gland and demonstrates that the deregulation of only one miRNA could affect lactation and involution.

Laubier, Johann; Passet, Bruno; Vilotte, Marthe; Castille, Johan; Laloe, Denis; Polyte, Jacqueline; Bouet, Stephan; Jaffrezic, Florence; Cribiu, Edmond-Paul; Vilotte, Jean-Luc; Le Provost, Fabienne

2012-01-01

244

Mouth-rinsing with chlorhexidine causes a delayed, temporary increase in the levels of oral viridans streptococci.  

Science.gov (United States)

The indigenous oral flora of 27 volunteers was monitored longitudinally over a 4-week period. Bacteria attached on buccal epithelial cells were counted by microscopy. Salivary bacterial colonies and the presence of alpha-hemolysis were examined after aerobic culturing on blood agar plates. The buccal and salivary bacterial counts were stably maintained in most subjects in the two repeated base-line samplings taken at 1-week intervals. Rinsing with a chlorhexidine mouthwash 45 min before sampling dramatically reduced the amount of epithelial cell-adherent bacteria. One day after the chlorhexidine rinse, however, the numbers of the epithelial cell-adherent bacteria exceeded the base-line level, and a similar decrease-increase pattern of changes was detected for the salivary alpha-hemolytic streptococcal counts. The non-hemolytic salivary bacterial counts were not affected by chlorhexidine. Subsequent weekly samplings showed no difference from the base-line samplings. The chlorhexidine-induced, delayed increase of viridans streptococci on oral epithelial surfaces should be considered a possible risk factor in medically compromised patients. PMID:7484104

Vaahtoniemi, L H; Karlqvist, K; Altonen, M; Räisänen, S

1995-08-01

245

Idiopathic intraparenchymal hematoma of the liver in a neonate  

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Hepatic hematomas in newborn infants are not frequently detected clinically, but are often found at perinatal autopsies. These hematomas of the liver are usually subcapsular in location. A variety of etiologies for such hematomas has been implicated, such as trauma, sepsis, and coagulopathies. We present a neonate who presented with jaundice and abdominal distention. Initial imaging studies revealed a large intraparenchymal lesion of the liver, which was at first thought to be suspicious for neoplasm; however, MRI showed the lesion to be hemorrhagic and follow-up sonographic studies showed total resolution of this lesion, compatible with hematoma. The intraparenchymal location and the idiopathic nature of this lesion distinguish this case from others previously reported. (orig.)

Amodio, John; Fefferman, Nancy; Rivera, Rafael; Pinkney, Lynne; Strubel, Naomi [Division of Pediatric Radiology, Department of Radiology, New York University Medical Center, 560 1st Avenue, New York, NY 10016 (United States)

2004-04-01

246

Differentiated surgical treatment of patients with hypertensive intracerebral hematomas  

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Full Text Available Hypertensive intracerebral hematoma is one of the most severe forms of cerebrovascular pathology, characterized by high lethality and disability. One of the objectives in providing assistance remains the development of new minimally invasive methods for the removal of hematomas. We have analyzed the results of surgical treatment of 176 patients with intracerebral hematoma. Patients from the 1st group were done open craniotomy. Patients from the 2nd group were performed the external ventricular drainage, also needle aspiration with fibrinolysis. Patients from the 3rd group were performed minimally invasive removal using the original device. Results of treatment were evaluated using Glasgow outcome scale. Lethality was observed in 1st group in 47.8% of cases, in 2nd group in 31.8%, in 3rd group in 29.7%. Minimally invasive technique reduced the postoperative mortality and improved treatment outcomes of patients with intracerebral hematoma.

Natalia Ivanova

2011-04-01

247

Significant Abdominal Wall Hematoma From an Umbilical Port Insertion  

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Laparoscopists consider the umbilical and ventral midline area to be “vascular safe.” On occasion, however, the insertion of the first trocar at the umbilical port may result in severe abdominal wall hematoma.

Marcovici, Iacob

2001-01-01

248

Acute pancreatitis secondary to intramural duodenal hematoma: Case report and literature review  

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Full Text Available Nontraumatic intramural duodenal hematoma (IDH is rare disease and it is generally related to coagulation abnormalities. Reports of nontraumatic IDH associated with pancreatic disease are relatively rare, and various conditions including acute or chronic pancreatitis are thought to be associated with nontraumatic IDH. However, the association between IDH and acute pancreatitis remains unknown. We report the case of a 45-year-old man who presented with vomiting and right hypochondrial pain. He had no medical history, but was a heavy drinker. The diagnosis of IDH was established by computed tomography, ultrasonography and endoscopy, and it was complicated by acute pancreatitis. The lesions resolved with conservative management. We discuss this case in the context of previously reported cases of IDH concomitant with acute pancreatitis. In our patient, acute pancreatitis occurred concurrently with hematoma, probably due to obstruction of the duodenal papilla, or compression of the pancreas caused by the hematoma. The present analysis of the published cases of IDH with acute pancreatitis provides some information on the pathogenesis of IDH and its relationship with acute pancreatitis.

Kazue Shiozawa, Manabu Watanabe, Yoshinori Igarashi, Yasushi Matsukiyo, Teppei Matsui , Yasukiyo Sumino

2010-07-01

249

Unilateral proptosis and extradural hematoma in a child with scurvy  

International Nuclear Information System (INIS)

We report a 3-year-old boy with unilateral proptosis, painful swelling of the right thigh and aphasia. He had radiographic evidence of scurvy in the limbs and bilateral frontal extradural hematomas with a mass lesion in the left orbit on MRI. He was treated with vitamin C and on follow-up 8 weeks later had recovered with no evidence of the orbital mass on clinical or radiological study. Scurvy manifesting as proptosis and extradural hematoma is rare. (orig.)

2007-09-01

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Intracerebral Hemorrhage Following Evacuation of a Chronic Subdural Hematoma  

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Burr hole drainage has been widely used to treat chronic subdural hematomas (SDH), and most of them are easily treated by simple trephination and drainage. However, various complications, such as, hematoma recurrence, infection, seizure, cerebral edema, tension pneumocephalus and failure of the brain to expand due to cerebro-cranial disproportion may develop after chronic SDH drainage. Among them, intracerebral hemorrhage after evacuation of a recurrent chronic SDH is very rare. Here, we repo...

Kim, Jong Kyu; Kim, Seok Won; Kim, Sung Hoon

2013-01-01

251

Pathomechanism of ring enhancement in intracerebral hematomas on CT  

International Nuclear Information System (INIS)

As a simulation of hypertensive intracerebral hematoma, about 3.5 ml of autologus venous blood were injected into an artificial cavity of a unilateral cerebral hemisphere in dogs. The cavity was made by the insertion and inflation of a balloon canula near the basal ganglia region of the dog. At the acute stage after the injection, the hematoma showed a round-shaped and homogeneous high density. 9 days later, a positive ring enhancement appeared around this high-density area in most of the cases. Subsequently, the hematoma changed into an isodensity with a tendency toward the concentric concentration of the ring enhancement and to the final low-density stage with a spotted enhancement in the center. That is our experimental intracerebral hematoma of the dog showed a pattern of the chronological course of the CT appearance quite similar to that of clinical cases of hypertensive intracerebral hematomas. At the onset of the ring enhancement, many new and immature capillaries were noted in the adjacent tissue of the hematoma, corresponding to the positive enhancement. The new capillaries were gradually shifted to the center of the hematoma; the enhancement also coincided with them. The ultrastructures of these new capillaries were examined electronmicroscopically. There was some resemblance to the capillaries of muscle with many pinocytotic vesicles and shallowed tight junctions. These experimental facts suggest that the enhancement phenomenon occurred in close relationship to the newly produced hypervascularization of the capillaries around the hematoma, which was a phenomenon of the healing process of the lesion. Therefore, the pathomechanism of the enhancement was thought to be involved the pooling of the contrast media in the increased vascular bed as well as a loss of blood brain barrier in these newly produced immature capillaries. (J.P.N.)

1980-01-01

252

Operative Laparoscopy and Vulvar Hematoma: An Unusual Association  

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Few cases of intraoperative or postoperative complications associated with laparoscopic adnexal surgery have been reported in the literature. We describe a case of laparoscopic abdominal vascular injury and persistent bleeding in the matrix of the ovary following laparoscopic cystectomy. During the first postsurgical day, the patient was syncopal. The physical examination showed a vulvar hematoma and minimal bleeding from a laparoscopic incision in the abdominal wall. Vulvar hematoma and an u...

Marcovici, Iacob; Shadigian, Elizabeth

2001-01-01

253

Extramedullary Hematopoiesis: An Unusual Finding in Subdural Hematomas  

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We present a case of a 59-year-old man who was found to have clusters of hyperchromatic, small, round nucleated cells within a subdural hematoma removed after a skull fracture. Immunohistochemistry study confirmed that the cells were hematopoietic components predominantly composed of normoblasts. In this paper, we describe the clinical and pathological findings. A brief review of published information on extramedullary hematopoiesis in subdural hematoma and the mechanisms of pathogenesis are ...

Li, Rong; Reddy, Vishnu V. B.; Palmer, Cheryl Ann

2011-01-01

254

Calf hematoma mimicking thrombophlebitis: sonographic and computed tomographic appearance  

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Five patients with calf hematomas presented with signs and symptoms suggesting thrombophlebitis, obscuring the correct diagnosis. Venography showed no venous thrombosis; further diagnostic studies using ultrasound and/or computed tomography provided the correct diagnosis in all patients. Ultrasound showed a hypoechoic mass clearly demarcated from surrounding soft tissue, while computed tomography showed a well-defined mass whose density depended on the age of the hematoma.

Giyanani, V.L.; Grozinger, K.T.; Gerlock, A.J. Jr.; Mirfakhraee, M.; Husbands, H.S.

1985-03-01

255

Acute Cervical Spinal Subdural Hematoma Not Related to Head Injury  

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We report an extremely rare case of traumatic cervical spinal subdural hematoma not related to intracranial injury. There has been no report on traumatic cervical spinal subdrual hematoma not related to intracranial injury. A 27-year-old female patient was admitted to our emergency room due to severe neck pain and right arm motor weakness after car collision. On admission, she presented with complete monoplegia and hypoesthesia of right arm. Magnetic resonance imaging (MRI) revealed subdural ...

2010-01-01

256

Intramural hematomas of the gastrointestinal system: a 5-year single center experience  

Science.gov (United States)

Purpose Although spontaneous intramural hematomas of the gastrointestinal tract are very rare, they may be observed with the use of oral anticoagulant, though less frequently in cases of hematological malignancy and other bleeding disorders. Cases diagnosed as spontaneous intramural hematoma have been assessed in our clinic. Methods The cases, which were diagnosed as spontaneous intramural hematoma in the gastrointestinal tract (SIHGT) following anamnesis, physical examination, biochemical, radiological and endoscopic findings from July 2008 to July 2012, have been assessed retrospectively. Results Seven out of 13 cases were women and the mean age was 65.1 years (34 to 82 years). The most frequent complaint on admission was abdominal pain. The most frequent location of SIHGT was the ileum (n = 8). Oral anticoagulant use was the most common cause of etiology (n = 12). In 10 cases, International normalized ratio values were higher than treatment range (2 to 3, where mechanical valve replacement was 2.5 to 3.5) and mean value was 7.6 (1.70 to 23.13). While 12 cases were discharged without problems with medical treatment, one case with acute myeloid leukemia died in the intensive care unit following cerebrovascular attack. Conclusion Spontaneus bleeding and hematomas that may arise in connection with bleeding diathesis may be fatal in cases with long-term oral anticoagulant treatment and insufficient follow-up. In management of these cases, it may be necessary to arrange conservative follow up and/or initialize low molecular weight heparin, and administer vitamin K as well as replace blood products and coagulation factors when indicated.

Kones, Osman; Gonenc, Murat; Karabulut, Mehmet; Akarsu, Cevher; Gok, Ilhan; Bozkurt, M. Abdussamet; Ilhan, Mehmet; Al?s, Halil

2013-01-01

257

Spinal subarachnoid hematoma in a woman with HELLP syndrome: a case report  

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Full Text Available Abstract Introduction Subarachnoid hemorrhages of spinal origin are extremely rare during pregnancy. We present the case of a patient with hemolytic anemia, elevated liver enzymes and low platelet count (the so-called HELLP syndrome, a potentially life-threatening complication associated with pre-eclampsia, who presented with an idiopathic spinal subarachnoid hematoma. Case presentation At 29 gestational weeks, a 35-year-old Japanese woman was diagnosed with HELLP syndrome based on bilateral leg paralysis, diminished sensation and reflexes, and laboratory findings. The pregnancy was immediately brought to an end by Cesarean delivery. Post-operatively, an MRI scan revealed a space-occupying lesion in her thoracic spinal canal. Emergency decompression was followed by total laminectomy. A subarachnoid hematoma, partially extending as far as the ventral side, was removed. After thorough washing and drain placement, the operation was completed with the suturing of artificial dura mater. Eight months post-operatively, her lower extremity sensation had improved to a score of 8 out of 10, but improvements in her muscular strength were limited to slight gains in her toes. MRI scans taken two months post-operatively revealed edematous spinal cord changes within her medulla. Conclusions A subarachnoid hematoma during pregnancy is extremely rare, possibly due to increased coagulability during pregnancy. However, this complication is potentially devastating should a clot compress the spinal cord or cauda equina. While several causes of hematoma have been proposed, we speculate that the factors underlying hemorrhagic diathesis in our case were the decreased platelet count characteristic of HELLP syndrome and vascular fragility due to elevated estrogen levels, in addition to increased abdominal pressure during pregnancy and pressure from the gravid uterus resulting in ruptured vessels around the spinal cord. In cases displaying a progressive lesion and severe neurological signs, prompt decompression is crucial.

Fujimaki Hisako

2012-06-01

258

Chronic spinal subdural hematoma; Spinales chronisches subdurales Haematom  

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Compared with spinal epidural hematomas, spinal subdural hematomas are rare; chronic forms are even more uncommon. These hematomas are associated not only with lumbar puncture and spinal trauma, but also with coagulopathies, vascular malformations and tumors. Compression of the spinal cord and the cauda equina means that the patients develop increasing back or radicular pain, followed by paraparesis and bladder and bowel paralysis, so that in most cases surgical decompression is carried out. On magnetic resonance imaging these hematomas present as thoracic or lumbar subdural masses, their signal intensity varying with the age of the hematoma. We report the clinical course and the findings revealed by imaging that led to the diagnosis in three cases of chronic spinal subdural hematoma. (orig.) [German] Spinale subdurale Haematome sind im Vergleich zu epiduralen Haematomen selten, chronische Verlaufsformen noch seltener. Ursaechlich sind neben Lumbalpunktionen und traumatischen Verletzungen auch Blutgerinnungsstoerungen, Gefaessmalformationen und Tumoren. Aufgrund der Kompression von Myelon und Cauda equina kommt es zu zunehmenden Ruecken- oder radikulaeren Schmerzen mit anschliessender Paraparese sowie einer Darm- und Blasenstoerung, weshalb in den meisten Faellen eine operative Entlastung durchgefuehrt wird. Magnetresonanztomographisch stellen sich die Haematome meist als thorakale bzw. lumbale subdurale Raumforderungen dar, die Signalintensitaet variiert mit dem Blutungsalter. Wir berichten ueber den klinischen Verlauf und die bildgebende Diagnostik von 3 Patienten mit spinalen chronischen subduralen Haematomen. (orig.)

Hagen, T.; Lensch, T. [Radiologengemeinschaft, Augsburg (Germany)

2008-10-15

259

Treatment of cerebellar hematoma in The Netherlands. A questionnaire survey.  

Science.gov (United States)

A questionnaire was sent to Dutch neurosurgeons and neurologists in order to assess current management strategies for cerebellar hematoma. Seven patients were presented, using as determinants: size of hematoma, coma score, interval to clinical deterioration, hydrocephalus, comorbidity, anticoagulant treatment and age. Neurological management options were: no treatment, monitoring or referral for neurosurgery. Neurosurgical options were: no treatment, monitoring, hematoma evacuation, and/or external ventricular drainage. Ninety-seven of 161 (60%) neurologists, and 58 of 85 neurosurgeons (68%) responded. Only 20 respondents (13%) made use of a local guideline. Overall agreement was perfect in 1 case and moderate to high in the others, but chance-adjusted agreement (kappa) between pairs of neurologists and neurosurgeons who were matched for referral center was not statistically significant except in 1 case, a deeply comatose patient with a 4-cm hematoma. In an alert, slightly ataxic patient with a large (4.5-cm) hematoma, 84 neurologists (88%) decided not to refer the patient. The estimated time for transfer between centers was of no influence on this decision. We conclude that the management of cerebrellar hematoma can be improved upon by encouraging the use of local guidelines, and by promoting early referral to a center with neurosurgical facilities. PMID:11306766

Wessels, P H; ter Berg, J W; Spincemaille, G H; Dippel, D W

2001-01-01

260

Causes of developmental delay in children of 5 to 72 months old at the child neurology unit of Yaounde Gynaeco-Obstetric and Paediatric Hospital (Cameroon  

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Full Text Available Background: According to the World Health Organization, about 5% of children world-wide of 14-year-old and under have a moderate to severe developmental disability, and up to 15% of children under 5-year-old are developmentally delayed. Purpose: To determine the prevalence, socio-demographic profile, aetiologies, and the clinical presentation of developmental delay in children less than 6-year-old at the child neurology unit in a university-affiliated hospital in Yaounde. Materials and methods: It was a crosssectional descriptive study carried out in Yaounde Gynaeco-Obstetric and Paediatric Hospital (Cameroon from August to December 2012. Children aged between 5 - 72 months with a developmental quotient less than 70 were enrolled. Developmental delay (DD was diagnosed and classified using the Denver developmental screening test (DDST. Data concerning the child (age, gender, severity of DD, the mother (age, age at conception, educational level, marital status, history of pregnancy and delivery, perinatal and postnatal events, results of para-clinical explorations (EEG, CT-scan, genetic tests, the severity of DD and the probable or demonstrate cause of DD were recorded on a standardized questionnaire. The chisquare test was used to compare variables. Results: During the study period, 2171 children aged 5 - 72 months consulted the paediatric department of the hospital, 296 were examined at the child neurology unit of which 153 had a developmental quotient less than 70, giving a hospital prevalence of 7.0% and a prevalence of 51.7% at the child neurology unit. The mean age was 26.6 ± 18.0 months and there were 56% males. The main reason for consulting was tonus disorder (43.8% and the developmental area of parental concern was the motor domain (90.2%. Regarding the clinical presentation, 75.2% of our population were children with cerebral palsy. DD was severe, mild, moderate and profound respectively in 14.2%, 13.5%, 12.2%, and 11.1%. Gross DD represented 90.2% of all DD children. The causes of DD were hypoxic-ischemic encephalopathy (41.8%, epilepsy (13.7%, sequelae of meningitis (6.5%, sequelae of kernicterus (6.5%, and infectious embryofoetopathies (5.2%. Conclusion: Developmental delay is frequent in paediatric neurology, with perinatal disorders being the leading aetiologies in Cameroon. Prevention of perinatal hypoxic-ischemic encephalopathy risk factors needs to be reinforced.

Séraphin Nguefack

2013-08-01

 
 
 
 
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Hematoma cerebelar espontâneo: análise de 23 casos / Spontaneous cerebellar hematoma: analysis of 23 cases  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Uma série de 23 pacientes com hematoma espontâneo de cerebelo é analisada retrospectivamente, mostrando que: todos apresentavam algum grau de diminuição do nível de consciência e cefaléia; 12 apresentavam déficits motores dentre os sinais clínicos mais importantes. Dos antecedentes patológicos desta [...] cam-se hipertensão arterial (69,5%) e diabetes (34%), havendo associação de ambos em 30% dos casos. Dos aspectos da tomografia computadorizada (TC) mais relevantes a dilatação ventricular aguda, encontrada em 69,5% dos pacientes, associada ou não a presença de sangue intraventricular, é considerada sinal de mau prognóstico, indicando por si só terapêutica de urgência. A melhor abordagem cirúrgica para a maioria desses casos é a drenagem ventricular externa de urgência, reservando a craniectomia da fossa posterior para esvaziamento do hematoma para casos específicos. A mortalidade e a morbidade desta patologia é alta; porém, pela TC o diagnóstico se tornou mais rápido e eficiente. Os pacientes desta série puderam beneficiar-se deste procedimento, como se verifica quando comparados a pacientes de outras séries, diagnosticados por outros métodos. Abstract in english A series of 23 patients with spontaneous cerebellar hematoma is analysed retrospectively. Several degrees of conciousness impairment, and headache occurred in all; 12 patients presented motor deficits among the more important clinical signs. Arterial hypertension (69,5%) and diabetes (34%) stand out [...] in the pathological background, and their association was frequent (30%). Computerized tomography (CT) disclosing severe ventricular dilatation (69.5%) associated or not with intraventricular presence of blood is considered as an unsactisfatory prognosis sign, and indicative for emergency therapy. Emergency external ventricular draining is the best indication for the majority of these cases. Posterior fossa craniectomy for emptying the hematoma may be the indication in severe cases. Death and morbidity in this pathology are high as yet. However, CT contribution for diagnosis is quicker and better than benefits obtained through other methods. Results observed in the present series are illustrative on this statement, when compared to data of other series diagnosed through other methods.

Rial, J. P.; Vilalta, J.; Guitart, J.M.; Rúbio, E..

262

Hematoma escrotal como primera manifestación de hematoma retroperitoneal tras litotricia extracorpórea / Scrotal haematoma as a sign of renal hematoma after ESWL  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Describimos el caso de un paciente que a las 15 horas del tratamiento y fragmentación de una litiasis en el uréter proximal mediante litotricia extracorpórea presenta un hematoma escrotal indoloro como única manifestación de hematoma subcapsular. [...] Abstract in english We described the case of a patient who presented a large scrotal black discoloration 15 hours after successful extracorporeal lithotripsy of a proximal ureteral calculus. The patient did not present any other clinical symptoms as a sign of subcapsular haematoma. [...

Vega Vega, A.; Crespo Toral, F.; Rodríguez Lamelas, J.M..

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Hematoma após raquianestesia tratado conservadoramente: relato de caso e revisão da literatura / Conservative treatment of hematoma after spinal anesthesia: case report and literature review / Hematoma después de raquianestesia tratado conservadoramente: relato de caso y revisión de la literatura  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese JUSTIFICATIVA E OBJETIVOS: Durante a realização de anestesia espinal existe o risco de ocorrer sangramentos. A compressão do tecido nervoso, secundária à formação de hematoma, pode determinar o surgimento de lesão neurológica que se não for diagnosticada e tratada a tempo pode ser permanente. A iden [...] tificação dos fatores de risco, o diagnóstico e o tratamento precoce da compressão são importantes para o prognóstico do paciente. O objetivo deste trabalho foi descrever um caso de hematoma após raquianestesia tratado de forma conservadora e revisar os trabalhos na literatura. RELATO DO CASO: Paciente do sexo masculino, 73 anos, 65 kg, 1,67 m, estado físico ASA III. Foi submetido a raquianestesia para retirada de cateter de diálise peritoneal. Durante a realização da punção ocorreram parestesias no membro inferior direito. Foram injetados 15 mg de bupivacaína hiperbárica a 0,5% sem vasoconstritor. Vinte e quatro horas após a realização do bloqueio o paciente permanecia com anestesia em sela e com dor lombar, e 48 horas após o procedimento apresentou incontinência urinária. A ressonância nuclear magnética demonstrou existência de processo expansivo subaracnóideo, com compressão de raízes nervosas (L4 a S1). Após avaliação do neurocirurgião, instituiu-se tratamento conservador. O paciente recebeu alta hospitalar no 18° dia de pós-operatório, assintomático. CONCLUSÕES: O caso apresentado mostrou boa evolução com o tratamento conservador. Abstract in spanish JUSTIFICATIVA Y OBJETIVOS: Durante la realización de anestesia espinal existe el riesgo de que ocurran sangramientos. La compresión del tejido nervioso, secundaria a la formación de hematoma puede determinar el aparecimiento de lesión neurológica que, si no se diagnostica y se trata a tiempo, puede [...] ser permanente. La identificación de los factores de riesgo, el diagnóstico y el tratamiento precoz de la compresión son importantes para el pronóstico del paciente. El objetivo de este trabajo fue describir un caso de hematoma después raquianestesia tratado de forma conservadora y revisar los trabajos en la literatura. RELATO DEL CASO: Paciente del sexo masculino, 73 años, 65 kg, 1,67 m, estado físico ASA III. Fue sometido a raquianestesia para retirada de catéter de diálisis peritoneal. Durante la realización de la punción hubo parestesias en el miembro inferior derecho. Se inyectaron 15 mg de bupivacaína hiperbárica a 0,5% sin vasoconstrictor. Veinte y cuatro horas después de la realización del bloqueo el paciente permanecía con anestesia en silla de montar y con dolor lumbar, y 48 horas después del procedimiento presentó una incontinencia urinaria. La resonancia nuclear magnética demostró la existencia de un proceso expansivo subaracnoideo, con compresión de raíces nerviosas (L4 a S1). Después de la evaluación del neurocirujano, se empieza el tratamiento conservador. El paciente recibió alta hospitalaria el 18° día de postoperatorio asintomático. CONCLUSIÓN: El caso presentado mostró una buena evolución con el tratamiento conservador. Abstract in english BACKGROUND AND OBJECTIVES: Spinal anesthesia caries the risk of bleeding. Compression of nervous tissue secondary to the formation of a hematoma can cause neurological damage, which, if not diagnosed and treated in a timely fashion, can be permanent. The identification of risk factors, diagnosis, an [...] d early treatment are important for the prognosis. The objective of this report was to describe the case of a hematoma after spinal anesthesia treated conservatively, and review the literature. CASE REPORT: Male patient, 73 years old, 65 kg, 1.67 m, and ASA physical status III, underwent spinal anesthesia for removal of a peritoneal dialysis catheter. During the puncture, the patient experienced paresthesia of the right lower limb. Fifteen milligrams of 0.5% hyperbaric bupivacaine without vasoconstrictor were administered. Twenty-four hours later, saddl

Daniel, Segabinazzi; Betina Comiran, Brescianini; Felipe Gornicki, Schneider; Florentino Fernandes, Mendes.

264

Iliac hematoma mimicking neoplasm in adolescent athletes.  

Science.gov (United States)

Traumatic injuries of the hip and pelvis are common in child athletes and typically require minimal treatment. However, the presentation of such injuries can at times be clinically indistinguishable from the onset of a benign or malignant neoplastic process. In these circumstances, the orthopedic surgeon relies on modern diagnostic tools including imaging-predominantly magnetic resonance imaging (MRI) and computed tomography-and pathology studies. This article presents the cases of 2 adolescent boys with traumatic injuries to the hip, in which the threat of neoplasm could not be ruled out by in both initial imaging studies. In one case, biopsy could not conclusively rule out malignancy. In both cases, serial MRIs to monitor changes in lesion size proved valuable in determining treatment approach. The authors recommend a diagnostic algorithm to approach the differentiation of iliac hematoma from neoplasm and address the issue of waiting time in the diagnostic process. Early-and if necessary repeated-biopsy to rule out these conditions is advised, as conclusive pathologic findings are the only evidence that can rule out Ewing's sarcoma or an aneurysmal bone cyst. Given the morbidity of these conditions, the authors advocate this course of action to minimize distress to the patient and family members. Careful observation in combination with radiographic findings can yield a successful diagnosis, but the orthopedic surgeon must carefully weigh the increased risk of tumor growth against the need for biopsy. PMID:19226079

Carter, Timothy; Flik, Kyle; Boland, Patrick; Kennedy, John G

2008-11-01

265

Biochemical, histopathological and clinical evaluation of delayed effects caused by methamidophos isoforms and TOCP in hens: ameliorative effects using control of calcium homeostasis.  

Science.gov (United States)

This work evaluated the potential of the isoforms of methamidophos to cause organophosphorus-induced delayed neuropathy (OPIDN) in hens. In addition to inhibition of neuropathy target esterase (NTE) and acetylcholinesterase (AChE), calpain activation, spinal cord lesions and clinical signs were assessed. The isoforms (+)-, (±)- and (-)-methamidophos were administered at 50mg/kg orally; tri-ortho-cresyl phosphate (TOCP) was administered (500mg/kg, po) as positive control for delayed neuropathy. The TOCP hens showed greater than 80% and approximately 20% inhibition of NTE and AChE in hen brain, respectively. Among the isoforms of methamidophos, only the (+)-methamidophos was capable of inhibiting NTE activity (approximately 60%) with statistically significant difference compared to the control group. Calpain activity in brain increased by 40% in TOCP hens compared to the control group when measured 24h after dosing and remained high (18% over control) 21 days after dosing. Hens that received (+)-methamidophos had calpain activity 12% greater than controls. The histopathological findings and clinical signs corroborated the biochemical results that indicated the potential of the (+)-methamidophos to be the isoform responsible for OPIDN induction. Protection against OPIDN was examined using a treatment of 2 doses of nimodipine (1mg/kg, i.m.) and one dose of calcium gluconate (5mg/kg, i.v.). The treatment decreased the effect of OPIDN-inducing TOCP and (+)-methamidophos on calpain activity, spinal cord lesions and clinical signs. PMID:22974967

Emerick, Guilherme L; Ehrich, Marion; Jortner, Bernard S; Oliveira, Regina V; Deoliveira, Georgino H

2012-12-01

266

Hematoma extradural intrarraquidiano espontâneo: relato de caso / Spontaneous extradural spinal hematoma: case report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Relatamos o caso de uma mulher de 55 anos, hipertensa leve, em uso de beta bloqueador, que apresentou quadro súbito de síndrome de compressão medular, caracterizado por dor cervical intensa, evoluindo para tetraplegia com nível de sensibilidade em C4. Foi diagnosticado, por ressonância magnética, he [...] matoma intrarraquidiano extradural cervical , que foi aspirado cirurgicamente através de laminectomia. A paciente encontra-se em acompanhamento fisioterápico e evolui com melhora da motricidade e sensibilidade. Abstract in english We report a case of a 55-year-old woman, that has a mild hypertension, in use of a betablocker drugs, who had a sudden spinal cord compression syndrome with intense cervical pain, tetraplegia and sensitivity level in C4. Extradural spinal hematoma of the cervical spine was diagnosed by magnetic reso [...] nance. The patient underwent a laminectomy and aspiration of the hematoma. The patient is on physiotherapy and presents progressive motor and sensivity improvement.

TANURI, FABIANO DA CUNHA; GUERREIRO, NILTON EDUARDO; NAKANO, HIROSHI; HAMAMOTO, OSMI.

267

Hematoma epidural secundario a anestesia espinal: Tratamiento conservador / Epidural hematoma secondary to spinal anesthesia: Conservative treatment  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Introducción: El hematoma epidural secundario a una anestesia neuroaxial es una complicación poco frecuente, pero de gran trascendencia tanto por sus implicaciones clínicas como por las médico legales; según algunos autores su incidencia puede oscilar entre 1/190.000-1/200.000 para las punciones per [...] idurales y 1/320.000 en el caso de las espinales. El aspecto prioritario en su manejo terapéutico es el del diagnóstico y tratamiento precoz, antes de las 6-12 primeras horas. No obstante, en determinados pacientes como en el caso que presentamos puede no ser precisa la cirugía, resolviéndose el cuadro con tratamiento conservador. Caso clínico: Varón de 73 años, ASA IV, con antecedentes de cirrosis con hipertensión portal, hiperesplenismo, EPOC, obesidad, cardiopatía hipertensiva e insuficiencia tricuspídea. Se programa para alcoholización prostática al haber sido desechada la cirugía. En la analítica preoperatoria destacaba una actividad de protrombina del 80% y 90.000 plaquetas. Se realizaron varios intentos fallidos de punción espinal, finalmente fue precisa una anestesia general con ventilación espontánea mediante mascarilla laríngea, propofol, fentanilo y sevoflurano. A las 36 horas, comienza la clínica en forma de dolor intenso lumbar, sin irradiación y arreflexia cutáneo plantar, confirmándose en la RMN la presencia de un hematoma epidural de L1 a L4. Ante la ausencia de paraparesia flácida, afectación esfinteriana u otros signos sensitivo-motores y tras consulta con la Unidad de Raquis y con el Servicio de Neurología se decide tratamiento conservador y actitud expectante en forma de analgesia y monitorización neurológica estricta, clínica y radiológica. Evolucionando favorablemente en los siguientes días. Discusión: Determinadas condiciones clínicas pueden influir en la aparición de un hematoma tras la realización de un bloqueo regional central: heparinas de bajo peso molecular, punciones dificultosas, cirugía vertebral previa, hepatopatías, fármacos, etc. El tratamiento quirúrgico en forma de laminectomía descompresiva realizada de forma precoz suele ser necesario y es el tratamiento de elección en muchas ocasiones, pero en determinadas condiciones como la que nos ocupa, sin síntomas compresivos, sin un carácter progresivo o bien que estos disminuyan rápidamente, puede optarse por un tratamiento conservador en forma de analgesia y corticoterapia, siempre bajo un estricto control que permita actuar de forma rápida ante cualquier eventualidad negativa en su evolución. Abstract in english Introduction: Epidural hematoma secondary to neuroaxial anesthesia is a rare complication, but highly relevant due to its clinical and medico-legal implications. According to some authors, its incidence can reach 1/190,000-1/200,000 for peridural punctures and 1/320,000 for spinal punctures. Early d [...] iagnosis and treatment within the first 6-12 hours is the main aspect related to its therapeutic management. However, in some cases such as the one reported here, surgery is not required and the patient can be managed with a conservative treatment. Clinical case: A 73-year-old patient, ASA IV, with a history of cirrhosis associated to portal hypertension, hypersplenism, COPD, obesity, hypertensive cardiopathy and tricuspid failure. He was scheduled for prostate alcoholization after ruling out surgery. Preoperative blood analyses showed a prothrombin activity of 80% and 90,000 platelets. Several failed attempts of spinal puncture were done, but general anesthesia was finally required with spontaneous ventilation through laryngeal mudpack, propofol, fentanyl and sevoflurane. Clinical manifestations appeared after 36 hours, with non-irradiated severe lumbar pain and plantar cutaneous areflexia. The presence of epidural hematoma at the L1-L4 level was confirmed through NMR. Given the absence of flaccid paraparesis, sphincter involvement or other sensitive-motor signs and after consultation with the Rachis Unit a

Bermejo, M.; Castañón, E.; Fervienza, P.; Cosío, F.; Carpintero, M.; Díaz-Fernández, M. L..

268

Management of supratentorial epidural hematoma in children: report on 49 patients Tratamento de hematoma epidural supratentorial em crianças: avaliação em 49 pacientes  

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Full Text Available Traumatic head injury is a common cause of mortality and acquired neurological impairment in children. However, pediatric epidural hematomas (EDHs are not common and few series have studied the evolution of these patients. In this study, we present the results from a sample of patients with EDH with long-term follow-up. METHOD: Between January 2006 and December 2008, 49 patients with traumatic EDH were treated at our unit. Clinical course, radiological findings and outcomes were evaluated. Neurological status was assessed using the Glasgow Coma Scale (GCS. The patients' ages ranged from one day to 16 years. The mean follow-up was six months. RESULTS: On admission, most of the patients presented mild trauma and 57% had a GCS of 13-15. The most common symptom was irritability. The most frequent mechanisms of injury were: falling from a height in 29 cases and motor vehicle accidents in 16 cases. Three of these patients presented GCS 3, but only one died. We found a late neurological deficit in nine patients. CONCLUSION: These lesions may occur following mild head trauma and in alert children with nonfocal neurological examinations. However, in children presenting irritability with subgaleal hematomas and a history of loss of consciousness, skull computed tomography must be performed.Trauma craniocerebral é uma causa frequente de mortalidade e comprometimento neurológico adquirido em crianças. No entanto, hematomas epidurais (HED são raros em pacientes pediátricos, com poucas series estudando a evolução destes pacientes. Neste estudo, os autores apresentam os resultados de uma casuística de pacientes com HED acompanhados em longo prazo. MÉTODO: Entre janeiro de 2006 e dezembro de 2008, 49 pacientes com HED foram tratados em nossa unidade. Curso clínico, achados radiológicos, e resultados foram avaliados. O estado neurológico foi avaliado com o Glasgow Coma Scale (GCS. A idade variou de 1 dia a 16 anos. A média de acompanhamento foi de 6 meses. RESULTADOS: Na admissão, a maioria dos pacientes apresentava trauma leve e 57% estavam com GCS de 13-15. O sintoma mais comum foi irritabilidade. Os mecanismos de trauma mais frequentes foram queda de altura em 29 casos e acidentes de trânsito em 16 casos. Três destes pacientes apresentavam GCS 3, mas somente um morreu. Verificou-se déficit neurológico tardio em nove pacientes. CONCLUSÃO: Esta lesão pode ocorrer após traumas leves e em crianças alerta com exames neurológicos não focais. No entanto, em crianças com irritabilidade com hematoma subgaleal e história de perda de consciência, tomografia do crânio deve ser realizada.

Wellingson Silva Paiva

2010-12-01

269

Spontaneous subcapsular renal hematoma: A case report and review of literature  

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Full Text Available Spontaneous subcapsular renal hematoma is not a common entity. We report a 38-year-old lady presenting with sudden onset right flank pain with uncontrolled hypertension and she was found to have subcapsular collection in the right kidney on ultrasonography. Finding was confirmed on computed tomography. Except hypertension, no particular cause for the condition could be found. Symptoms and size of the collection decreased on conservative treatment. They completely disappeared on ultrasonography at 6 months follow-up. She was asymptomatic at 18 months follow-up.

Baishya Ramen

2011-01-01

270

Findings of subdural hematoma on Tc-99m-TRODAT-1 SPECT.  

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Chronic subdural hematoma (SDH) is difficult to diagnose by clinical manifestations only. Nonspecific neurologic symptoms and signs may lead physicians to make other diagnoses. Although head trauma is the most common cause, it may be considered insignificant or omitted due to its minor initial manifestations. We present a patient with an incidental finding of SDH on Tc-99m-TRODAT-1 SPECT that was originally done for evaluation of his Parkinsonism. This reminds us to be vigilant about other possible coincidental findings on routine examinations. PMID:19300060

Hsieh, Te-Chun; Kao, Chia-Hung; Wu, Yu-Chin; Wang, Chih-Hsiu; Yen, Kuo-Yang; Sun, Shung-Shung

2009-04-01

271

[Two cases of spontaneous intracranial hypotension with bilateral chronic subdural hematomas].  

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Spontaneous intracranial hypotension (SIH) is characterized by postural headaches without obvious cause and is occasionally related to chronic subdural hematomas (CSHs). Brain sag due to decrease in cerebrospinal fluid, and growing CSHs may occur secondary to a decrease in intracranial pressure. Therapy for this condition differs from that for mere traumatic CSHs and is controversial. We report 2 cases of CSH related to SIH. One patient required drainage of the CSHs and an epidural self-blood patch. Furthermore, this patient had to undergo reoperation for drainage of the CSHs. The other patient was cured after the first time the CSHs were drained. PMID:21301042

Umebayashi, Daisuke; Takado, Michiko; Osaka, Yasuhiko; Nakahara, Yoshikazu; Tenjin, Hiroshi

2011-02-01

272

Delayed presentation of traumatic intraperitoneal bladder rupture  

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A child with urine ascites as a delayed manifestation of post-traumatic intraperitoneal bladder rupture is presented. The diagnosis was suggested by abdominal CT scan and confirmed with a cystogram. While uncommon, late presentation of intraperitoneal bladder rupture following trauma may occur from masking of a primary laceration or development of secondary rupture at the site of a hematoma in the bladder wall. Since CT may be a primary diagnostic study performed following abdominal trauma, the radiologist should be aware of CT findings suggesting bladder rupture and of the possibility of delayed presentation of this injury. (orig.)

1986-01-01

273

Delayed presentation of traumatic intraperitoneal bladder rupture.  

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A child with urine ascites as a delayed manifestation of post-traumatic intraperitoneal bladder rupture is presented. The diagnosis was suggested by abdominal CT scan and confirmed with a cystogram. While uncommon, late presentation of intraperitoneal bladder rupture following trauma may occur from masking of a primary laceration or development of secondary rupture at the site of a hematoma in the bladder wall. Since CT may be a primary diagnostic study performed following abdominal trauma, the radiologist should be aware of CT findings suggesting bladder rupture and of the possibility of delayed presentation of this injury. PMID:3703604

Brown, D; Magill, H L; Black, T L

1986-01-01

274

Delayed presentation of traumatic intraperitoneal bladder rupture  

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A child with urine ascites as a delayed manifestation of post-traumatic intraperitoneal bladder rupture is presented. The diagnosis was suggested by abdominal CT scan and confirmed with a cystogram. While uncommon, late presentation of intraperitoneal bladder rupture following trauma may occur from masking of a primary laceration or development of secondary rupture at the site of a hematoma in the bladder wall. Since CT may be a primary diagnostic study performed following abdominal trauma, the radiologist should be aware of CT findings suggesting bladder rupture and of the possibility of delayed presentation of this injury.

Brown, D.; Magill, H.L.; Black, T.L.

1986-03-01

275

Supratentorial arachnoid cyst and associated subdural hematoma: neuroradiologic studies  

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CT and MR images of 8 patients with supratentorial arachnoid cyst complicated by subdural hematoma were studied and compared with those of 8 patients who developed nontraumatic subdural hematoma without arachnoid cyst. Ot the 8 patients with supratentorial arachnoid cyst, CT and MR disclosed temporal bulging and/or thinning of the temporal squama in all 6 patients with middle fossa arachnoid cysts, and the thinning of the calvaria was evident in another patient with a convexity cyst. Calvarial thinning at the site corresponding to interhemispheric arachnoid cyst was clearly depicted on coronal MR images. In contrast, none of the 8 young patients with nontraumatic subdural hematoma without arachnoid cyst had abnormal calvaria. Temporal bulging and thinning of the overlying calvaria were identified as diagnostic CT and MR features of arachnoid cyst with complicating intracystic and subdural hermorrhage. Radiologists should be aware of this association and should evaluate the bony structure carefully. (orig.)

1996-10-01

276

Spontaneous sternocleidomastoid muscle hematoma following thrombolysis for acute ischemic stroke.  

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Spontaneous or traumatic bleeding is a common complication of systemic thrombolysis in patients with acute ischemic stroke. We report the case of an 83y.o. woman with right facio-brachio-crural hemiparesis, left deviation of the head and aphasia who developed, after thrombolytic therapy, a spontaneous sternocleidomastoid muscle hematoma that regressed few days later. To our knowledge, this is the first case reported in the literature of asymptomatic and spontaneous skeletal muscle hematoma following thrombolysis for the treatment of acute ischemic stroke. The occurrence of lateral cervical tuberculosis lymphadenitis ipsilateral to sternocleidomastoid muscle hematoma may suggest a causal relationship between local chronic inflammation of active mycobacterial infection and thrombolysis-related extravasation. This case should suggest caution in thrombolytic treatment in patients with chronic immune dysregulation and vascular inflammation such as extra-pulmonary tuberculosis. PMID:24774751

Giannantoni, Nadia Mariagrazia; Della Marca, Giacomo; Broccolini, Aldobrando; Pilato, Fabio; Profice, Paolo; Morosetti, Roberta; Caliandro, Pietro; Frisullo, Giovanni

2014-06-15

277

Calcified Splenic Hematoma Presenting as a Pelvic Mass  

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Full Text Available The spleen is the most vulnerable visceral organ involved in blunt abdominal trauma;40% to 70% of patients with blunt splenic laceration can be managed with nonsurgicalmethods. A majority of hematomas of the spleen can heal and be absorbed within 2 to 3months; through an unknown mechanism in an unusual condition, the hematoma mayorganize and eventually calcify. Herein, we report on a senile female with blunt abdominaltrauma 6 years previous, who turned out to have a calcified splenic hematoma with clinicalpresentations of a palpable pelvic mass and intestinal obstruction. A total splenectomy,including the calcified mass, was performed. She experienced great clinical improvementpostoperatively. She was uneventfully discharged 1 week later

Yu-Pao Hsu

2002-05-01

278

CT-guided stereotactic evacuation of hypertensive intracerebral hematomas. A new operative approach  

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Computerized tomography (CT) is now effective not only for definite diagnosis and location of intracerebral hematomas but also for coordination of the center of a hematoma. CT-guided stereotactic evacuation of hypertensive intracerebral hematoma was performed in 51 cases: 34 of basal ganglionic hematoma with or without ventricular perforation, 11 of subcortical hematoma, 3 of thalamic hematoma and 3 of cerebellar hematoma. Three dimensional CT images or biplane CT images were taken to determine the coordinates of the target point, which was the center of the hematoma. Then, a silicon tube (O.D. 3.5 phi, I.D. 2.1 phi) was inserted into the center of the hematoma through a burr-hole under local anesthesia, and the liquid or solid hematoma was aspirated as completely as possible with a syringe. Urokinase (6,000 I.U./5 ml saline) was administered through this silicon tube every 6 or 12 hours for several days until the hematoma had drained out competely. The silicon tube was taken out when repeated CT scanning revealed no hematoma. The results of clinical follow-ups indicated that this procedure is as good as, or rather better than conventional microsurgery with evacuation of hematoma under direct vision. Moreover this CT-guided stereotactic approach for evacuation of the hematoma has the following advantages: 1) the procedure is simple and safe, 2) operation can be performed under local anesthesia, and 3) the hematoma is drained out completely with the aid of urokinase. This surgery seems indicated as an emergency treatment for high-age or high risk patients and also as a routine surgery for intracerebral hematomas in patients showing no herination signs.

Hondo, Hideki (Tokushima Univ. (Japan). School of Medicine)

1983-06-01

279

Dynamic/statis brain scintigraphy: an effective screening test for subdural hematoma  

International Nuclear Information System (INIS)

Dynamic /sup 99m/Tc-pertechnetate perfusion scintigraphy of the brain was coupled with the delayed static scan in 5,853 studies as a screening test for neurological disease. Of approximately 1,000 patients referred for investigation for possible subdural hematoma (SDH), 23 proved to have SDH at surgery. Their scintigraphic abnormalities were analyzed and classified. When neither study indicates abnormality, angiography is not required, as SDH is unlikely. When the scintigraphic appearance is characteristic of SDH, angiography or surgical exploration is mandatory, since SDH is probably present. When the scintigraphic findings are consistent with but not typical of SDH, the study remains useful as a screening procedure, but the decision to proceed with angiography is based primarily on the neurological course. (auth)

1975-01-01

280

Muscle hematomas: Uncommon but horrendous complication of cirrhosis liver.  

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Bleeding manifestations, usually cutaneous or gastrointestinal - are common in liver cirrhosis. Spontaneous intracerebral and intramuscular bleeds are reported uncommonly, often associated with gross hepatic dysfunction and severely deranged hemostatic parameters, and are often markers to imminent mortality. Male sex, alcoholic etiology, significant thrombocytopenia, severe coagulopathy, and advanced liver disease are common denominators in patients with spontaneous intramuscular bleed. We here report three cases of spontaneous muscle hematomas complicating hepatic cirrhosis. To the best of our knowledge, this is the largest single center series reporting spontaneous muscle hematomas complicating cirrhosis from the Indian subcontinent. PMID:24399469

Zacharia, George Sarin; Ray, Roji; Sivaprasad, Punnaveetil; Kolassery, Sandesh; Ramachandran, Thazhath Mavali

2014-05-01

 
 
 
 
281

[The clinical picture of acute epidural hematoma of traumatic origin].  

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An analysis of 100 observations permitted the authors to conclude that the basis of the clinical picture of acute epidural hematoma was the syndrome of intercranial hypertension manifesting itself in growing disturbances of consciousness, headaches, vomiting, bradycardia. The appearance of local neurological symptoms gives a possibility for a physician to orientate quickly in the pathological process localization. "A lucid period" and the initial syndrome of the acute brain dislocation often revealed in the manifestation of mydriase are typical of the clinical picture of epidural hematoma. PMID:1266498

Lebedev, V V; Musatova, I V

1976-01-01

282

Retrobulbar Hematoma in Blow-Out Fracture after Open Reduction  

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Full Text Available Retrobulbar hemorrhage, especially when associated with visual loss, is a rare but significant complication after facial bone reconstruction. In this article, two cases of retrobulbar hematoma after surgical repair of blow-out fracture are reported. In one patient, permanent loss of vision was involved, but with the other patient, we were able to prevent this by performing immediate decompression after definite diagnosis. We present our clinical experience with regard to the treatment process and method for prevention of retrobulbar hematoma using a scalp vein set tube and a negative pressure drainage system.

Ji Seon Cheon

2013-07-01

283

Intracranial Rhabdomyosarcoma Presented as Chronic Subdural Hematoma: A Case Report  

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Full Text Available Intracranial rhabdomyosarcoma is a very rare disorder. Subdural rhabdomyosarcoma has not been reported yet. It can be misdiagnosed with chronic subdural hematoma in CT images. Herein, we presented a 2.5-year-old boy with intractable chronic subdural hematoma who were treated with burr hole insertion, needle aspiration and shunting for about 2 years with partial resolution of his symptoms after each procedure. The final pathologic evaluation after extensive bilateral craniotomy revealed rhabdomyosarcoma. The role of CT and MRI in early diagnosis and management of this rare situation is discussed.

A. Mahdavi

2007-10-01

284

Four cases of ruptured cerebral aneurysm presenting acute subdural hematoma  

International Nuclear Information System (INIS)

Acute subdural hematoma (ASDH) due to ruptured cerebral aneurysm is relatively rare. In our institution, of the 210 patients with subarachnoid hemorrhage (SAM) seen between 2000 and 2006, only 6 (2.9%) revealed ASDH in association with cerebral aneurysm. The Hunt and Kosnik grade on admission was Grade III in 1, Grade IV in 3, Grade V in 2. Four patients with Grade III or IV underwent emergency hematoma removal and aneurysmal neck clipping. The outcome was good recovery in 3 and moderately disabled in 1 with Glasgow Outcome Scale. Two patients with Grade V treated conservatively died. We discuss the present cases with reference to a review of the literature. (author)

2007-07-01

285

Spontaneous Ligamentum Flavum Hematoma in the Rigid Thoracic Spine : A Case Report and Review of the Literature  

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Ligamentum flavum hematoma is a rare condition. Twenty cases including present case have been reported in English-language literature. Among them, only one case reported in pure thoracic spine. A 72-year-old man presented with thoracic myelopathy without precedent cause. Magnetic resonance images revealed a posterior semicircular mass which was located in T7 and T8 level compressing the spinal cord dorsally. T7-8 total laminectomy and extirpation of the mass was performed. One month later fol...

2008-01-01

286

A Case Report of Cerebral Venous Thrombosis in Polycythemia Vera Presenting with Intracranial and Spinal Subdural Hematoma  

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Spinal subdural hematoma (SDH) is a rare condition and can be caused by several factors. Concomitant cranial and spinal SDH is even much less common. We present a 77-year-old male patient with lower back pain, paraparesis, and urinary retention following a sudden onset headache. Imaging revealed concomitant cranial and spinal SDH related to cerebral venous thrombosis (CVT) associated with hemorrhagic venous infarct. Laboratory examinations were consistent with polycythemia vera. There was no ...

Sirin, Nermin Go?rkem; Yesilot, Nilufer; Ekizoglu, Esme; Keles, Nur; Tuncay, Rezzan; Coban, Oguzhan; Bahar, Sara Zarko

2010-01-01

287

Defence responses regulated by jasmonate and delayed senescence caused by ethylene receptor mutation contribute to the tolerance of petunia to Botrytis cinerea.  

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Ethylene and jasmonate (JA) have powerful effects when plants are challenged by pathogens. The inducible promoter-regulated expression of the Arabidopsis ethylene receptor mutant ethylene-insensitive1-1 (etr1-1) causes ethylene insensitivity in petunia. To investigate the molecular mechanisms involved in transgenic petunia responses to Botrytis cinerea related to the ethylene and JA pathways, etr1-1-expressing petunia plants were inoculated with Botrytis cinerea. The induced expression of etr1-1 by a chemical inducer dexamethasone resulted in retarded senescence and reduced disease symptoms on detached leaves and flowers or intact plants. The extent of decreased disease symptoms correlated positively with etr1-1 expression. The JA pathway, independent of the ethylene pathway, activated petunia ethylene response factor (PhERF) expression and consequent defence-related gene expression. These results demonstrate that ethylene induced by biotic stress influences senescence, and that JA in combination with delayed senescence by etr1-1 expression alters tolerance to pathogens. PMID:23437935

Wang, Hong; Liu, Gang; Li, Chunxia; Powell, Ann L T; Reid, Michael S; Zhang, Zhen; Jiang, Cai-Zhong

2013-06-01

288

Deletion of exon 20 of the Familial Dysautonomia gene Ikbkap in mice causes developmental delay, cardiovascular defects, and early embryonic lethality.  

Science.gov (United States)

Familial Dysautonomia (FD) is an autosomal recessive disorder that affects 1/3,600 live births in the Ashkenazi Jewish population, and leads to death before the age of 40. The disease is characterized by abnormal development and progressive degeneration of the sensory and autonomic nervous system. A single base pair substitution in intron 20 of the Ikbkap gene accounts for 98% of FD cases, and results in the expression of low levels of the full-length mRNA with simultaneous expression of an aberrantly spliced mRNA in which exon 20 is missing. To date, there is no animal model for the disease, and the essential cellular functions of IKAP--the protein encoded by Ikbkap--remain unknown. To better understand the normal function of IKAP and in an effort to generate a mouse model for FD, we have targeted the mouse Ikbkap gene by homologous recombination. We created two distinct alleles that result in either loss of Ikbkap expression, or expression of an mRNA lacking only exon 20. Homozygosity for either mutation leads to developmental delay, cardiovascular and brain malformations, accompanied with early embryonic lethality. Our analyses indicate that IKAP is essential for expression of specific genes involved in cardiac morphogenesis, and that cardiac failure is the likely cause of abnormal vascular development and embryonic lethality. Our results also indicate that deletion of exon 20 abolishes gene function. This implies that the truncated IKAP protein expressed in FD patients does not retain any significant biological function. PMID:22046433

Dietrich, Paula; Yue, Junming; E, Shuyu; Dragatsis, Ioannis

2011-01-01

289

Hematoma subdural crónico asociado a quiste aracnoideo: Presentación de 12 casos Chronic subdural hematoma associated with arachnoid cyst: Report of 12 cases  

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Objetivos. Analizar las características clínicas, neurológicas y resultado neurorradiológico de una serie de pacientes con quiste aracnoideo asociado a un hematoma subdural crónico. Pacientes y método. Revisamos retrospectivamente 12 casos de pacientes con quiste aracnoideo que presentaron como complicación un hematoma subdural crónico. Resultados. Entre enero de 1984 y abril de 2008, 12 pacientes (0.9%) de 1.253 casos con hematoma subdural crónico presentaban un quiste aracnoideo in...

2010-01-01

290

Spontaneous cervical epidural hematoma presenting as brown-sequard syndrome following repetitive korean traditional deep bows.  

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Spontaneous cervical epidural hematoma (SCEH) is an uncommon cause of acute nontraumatic myelopathy. SCEH presenting as Brown-Sequard syndrome is extremely rare. A 65-year-old man had motor weakness in the left extremities right after his mother's funeral. He received thrombolytic therapy under the impression of acute cerebral infarction at a local hospital. However, motor weakness of the left extremities became aggravated without mental change. After being transferred to our hospital, he showed motor weakness in the left extremities with diminished pain sensation in the right extremities. Diagnosis of SCEH was made by cervical magnetic resonance imaging. He underwent left C3 to C5 hemilaminectomy with hematoma removal. It is important for physicians to be aware that SCEH can be considered as one of the differential diagnoses of hemiplegia, since early diagnosis and management can influence the neurological outcome. We think that increased venous pressure owing to repetitive Korean traditional deep bows may be the cause of SCEH in this case. PMID:23526134

Seon, Hyo-Jeong; Song, Min-Keun; Han, Jae-Young; Choi, In-Sung; Lee, Sam-Gyu

2013-02-01

291

Pupillary sparing oculomotor palsy from acute subdural hematoma.  

Science.gov (United States)

An acute subdural hematoma presented as a partial third nerve palsy with complete pupillary sparing. The patient was alert and oriented, and except for a subtle hemisensory hypalgesia, there were no other neurologic signs. Preoperative diagnosis was made by CT scan and cerebral angiography. The patient underwent successful craniotomy and within six weeks after surgery, her third nerve palsy had completely resolved. PMID:6721349

Kavieff, R D; Miller, J A; Klepach, G L

1984-04-01

292

Fatal spontaneous rectus sheath hematoma in a patient with cirrhosis  

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Full Text Available Rectus sheath hematoma (RSH is an uncommon and often misdiagnosed condition. This well-described entity is typically self-limited. In rare cases, the condition may be fatal. We report a case of a patient with cirrhosis who died of progressive RSH and its subsequent complications.

McCarthy Danielle

2010-01-01

293

Massive scalp hematoma: An unusual presentation of valproic acid toxicity  

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Valproic acid (VPA) is a commonly used broad-spectrum antiepileptic drug especially in children, with various side-effects reported with its usage. Hematologic toxicity is dose related and intracranial bleeding complications have been reported. We are reporting a rare case of massive scalp hematoma requiring surgical intervention, following a trivial fall associated with high-VPA levels.

Bhaskar, Suryanarayanan; Sobti, S.; Singh, Amit K.

2012-01-01

294

Spontaneous cerebellar hematoma associated with chronic cerebellar stimulation. Case report.  

Science.gov (United States)

A 24-year-old man developed a spontaneous cerebellar hematoma 5 years after the implantation of cerebellar electrodes. No vascular malformations were found either intraoperatively or radiographically. The histopathological findings of the cerebellar tissue obtained at biopsy from the region surrounding the electrodes support the hypothesis of a causal relationship between the spontaneous cerebellar hemorrhage and chronic cerebellar stimulation. PMID:3490550

Zuccarello, M; Sawaya, R; Lukin, R; deCourten-Myers, G

1986-12-01

295

Spontaneous cerebellar hematoma in childhood. Presentation of a new case.  

Science.gov (United States)

In the present report, a case of spontaneous intracerebellar hematoma affecting a 8-year-old boy is related. This pathology is often associated with rupture of vascular malformations in posterior fossa and normally is quite rare in childhood. Authors support the necessity of surgical approach for favourable prognosis. PMID:3244032

Coraddu, M; Floris, F; Meleddu, V; Nurchi, G C

1988-01-01

296

Traumatic Hematoma in a Palmoplantar wart Mimicking Acral Lentiginous Melanoma  

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We describe a case where a secondary traumatic hematoma in a pre-existing palmoplantar wart of the sole was presenting a diagnostic dilemma where it simulated an acral lentiginous melanoma and was managed successfully with wide excision and local skin flap.

Nambi, G. I.; Rajeshwari, K. M.; Mehta, Sangita Sharma

2012-01-01

297

In vivo polymerization of poly(3,4-ethylenedioxythiophene) in the living rat hippocampus does not cause a significant loss of performance in a delayed alternation task  

Science.gov (United States)

After extended implantation times, traditional intracortical neural probes exhibit a foreign-body reaction characterized by a reactive glial sheath that has been associated with increased system impedance and signal deterioration. Previously, we have proposed that the local in vivo polymerization of an electronically and ionically conducting polymer, poly(3,4-ethylenedioxythiophene) (PEDOT), might help to rebuild charge transport pathways across the glial scar between the device and surrounding parenchyma (Richardson-Burns et al 2007 J. Neural Eng. 4 L6-13). The EDOT monomer can be delivered via a microcannula/electrode system into the brain tissue of living animals followed by direct electrochemical polymerization, using the electrode itself as a source of oxidative current. In this study, we investigated the long-term effect of local in vivo PEDOT deposition on hippocampal neural function and histology. Rodent subjects were trained on a hippocampus-dependent task, delayed alternation (DA), and implanted with the microcannula/electrode system in the hippocampus. The animals were divided into four groups with different delay times between the initial surgery and the electrochemical polymerization: (1) control (no polymerization), (2) immediate (polymerization within 5 min of device implantation), (3) early (polymerization within 3-4 weeks after implantation) and (4) late (polymerization 7-8 weeks after polymerization). System impedance at 1 kHz was recorded and the tissue reactions were evaluated by immunohistochemistry. We found that under our deposition conditions, PEDOT typically grew at the tip of the electrode, forming an ˜500 µm cloud in the tissue. This is much larger than the typical width of the glial scar (˜150 µm). After polymerization, the impedance amplitude near the neurologically important frequency of 1 kHz dropped for all the groups; however, there was a time window of 3-4 weeks for an optimal decrease in impedance. For all surgery-polymerization time intervals, the polymerization did not cause significant deficits in performance of the DA task, suggesting that hippocampal function was not impaired by PEDOT deposition. However, GFAP+ and ED-1+ cells were also found at the deposition two weeks after the polymerization, suggesting potential secondary scarring. Therefore, less extensive deposition or milder deposition conditions may be desirable to minimize this scarring while maintaining decreased system impedance.

Ouyang, Liangqi; Shaw, Crystal L.; Kuo, Chin-chen; Griffin, Amy L.; Martin, David C.

2014-04-01

298

CD36-Mediated Hematoma Absorption following Intracerebral Hemorrhage: Negative Regulation by TLR4 Signaling  

Science.gov (United States)

Promoting hematoma absorption is a novel therapeutic strategy for intracerebral hemorrhage (ICH); however, the mechanism of hematoma absorption is unclear. The present study explored the function and potential mechanism of CD36 in hematoma absorption using in vitro and in vivo ICH models. Hematoma absorption in CD36-deficient ICH patients was examined. Compared with patients with normal CD36 expression, CD36-deficient ICH patients had slower hematoma adsorption and aggravated neurologic deficits. CD36 expression in perihematomal tissues in wild-type mice following ICH was increased, whereas the hematoma absorption in CD36?/? mice was decreased. CD36?/? mice also showed aggravated neurologic deficits and increased TNF-? and IL-1? expression levels. The phagocytic capacity of CD36?/? microglia for RBCs was also decreased. Additionally, the CD36 expression in the perihematoma area after ICH in TLR4?/? and MyD88?/? mice was significantly increased, and hematoma absorption was significantly promoted, which was significantly inhibited by an anti-CD36 Ab. In vitro, TNF-? and IL-1? significantly inhibited the microglia expression of CD36 and reduced the microglia phagocytosis of RBCs. Finally, the TLR4 inhibitor TAK-242 upregulated CD36 expression in microglia, promoted hematoma absorption, increased catalase expression, and decreased the H2O2 content. These results suggested that CD36 mediated hematoma absorption after ICH, and TLR4 signaling inhibited CD36 expression to slow hematoma absorption. TLR4 inhibition could promote hematoma absorption and significantly improve neurologic deficits following ICH.

Fang, Huang; Chen, Jing; Lin, Sen; Wang, PengFei; Wang, YanChun; Xiong, XiaoYi

2014-01-01

299

Ruptured internal carotid artery aneurysm presenting as a sinonasal organized hematoma: conventional approach may endanger life.  

Science.gov (United States)

Sinonasal organized hematoma (SOH) is an uncommon benign entity with locally aggressive behavior. The conventional approach is complete resection. This approach, however, can cause massive hemorrhage and mortality in our patient due to a ruptured internal carotid artery (ICA) aneurysm hidden inside the SOH. To the best of our knowledge, this is the first case of a huge SOH with skull base invasion caused by a hidden ICA aneurysm, which usually would not be large enough to result in a sinonasal mass lesion. This case suggests that the possibility of an aneurysm should always be considered if a SOH is suspected, especially when it is huge and close to the ICA. Surgical resection may not be the first therapeutic choice unless the differential cause of a hidden aneurysm can be excluded. PMID:23253161

Kuo, Chin-Lung; Li, Wing-Yin; Luo, Chao-Bao; Ho, Ching-Yin

2014-01-01

300

Magnetic resonance imaging of hematomas in a 0.02 T magnetic field  

International Nuclear Information System (INIS)

One intramuscular calf hematoma, 2 ankle hematomas and 4 cephalhematomas were imaged at various ages in a low magnetic field (0.02 T). At least one spin echo (SE) multislice image and a series of inversion recovery images (IR) were made varying the inversion time for estimation of the relaxation time T1. T1 tended to shorten and T2 to stay unchanged. With an unsuitable pulse sequence the hematomas were not visible. They were best seen with short TIs. The images of one of the ankle hematomas and the calf hematoma were compared with sonographic findings. The appearances of the hematomas varied during aging with both imaging modalities. The hematomas were easier to detect with magnetic resonance imaging than with ultrasound, also when aging. (orig.)

1986-01-01

 
 
 
 
301

Coagulação intravascular disseminada e hematoma subdural: relato de caso Disseminated intravascular coagulation and subdural hematoma: a case report  

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Full Text Available Os autores apresentam caso de hematoma subdural agudo, evacuado na presença de coagulopatia, e fazem considerações necessárias para a compreensão da etiopatogenia da enfermidade.The authors present a case of acute subdural haematoma evacuated in the presence of a coagulopathy. Some elements necessary for the understanding of the etiopathogenesis of the disease are discussed.

C. E. Cavalcanti

1985-09-01

302

Detection of travel time delay caused by dilation of an artificial fracture due to pressurization; Jinko chika kiretsu kaatsu ni tomonau toka danseiha denpa jikan henka no kenshutsu  

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By revealing the relation between dilation of a subsurface fracture due to pressurization and travel time delay, it may be possible to measure the information as to the subsurface fracture system as a geothermal reservoir. In this study, field experiment was conducted to clarify the relation between the travel time delay of elastic waves and the dilation of fracture, pressure, and incident angles. The travel time delay of P-wave and S-wave tended to increase with the pressurization. When incident angle was about 90{degree} against the fracture, the increase was ranging between 0 and 0.2 ms. The magnitude of this delay could not be explained only by the opening of main fracture. It was considered that there were micro-crack zones around the main fracture. The difference of P-S delay depended on the pressurization and change of the pressure. The delay depended on the incident angle against the fracture. The delay of S-wave showed the polarized wave direction dependency. However, the obtained results might greatly depend on the analytical method and parameters. 4 refs., 10 figs.

Tanaka, K.; Moriya, H.; Asanuma, H.; Niitsuma, H. [Tohoku University, Sendai (Japan). Faculty of Engineering

1996-10-01

303

Rab7 Mutants Associated with Charcot-Marie-Tooth Disease Cause Delayed Growth Factor Receptor Transport and Altered Endosomal and Nuclear Signaling*  

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Rab7 belongs to the Ras superfamily of small GTPases and is a master regulator of early to late endocytic membrane transport. Four missense mutations in the late endosomal Rab7 GTPase (L129F, K157N, N161T, and V162M) cause the autosomal dominant peripheral neuropathy Charcot-Marie-Tooth type 2B (CMT2B) disease. As yet, the pathological mechanisms connecting mutant Rab7 protein expression to altered neuronal function are undefined. Here, we analyze the effects of Rab7 CMT2B mutants on epidermal growth factor (EGF)-dependent intracellular signaling and trafficking. Three different cell lines expressing Rab7 CMT2B mutants and stimulated with EGF exhibited delayed trafficking of EGF to LAMP1-positive late endosomes and lysosomes and slowed EGF receptor (EGFR) degradation. Expression of all Rab7 CMT2B mutants altered the Rab7 activation cycle, leading to enhanced and prolonged EGFR signaling as well as variable increases in p38 and ERK1/2 activation. However, due to reduced nuclear translocation of p38 and ERK1/2, the downstream nuclear activation of Elk-1 was decreased along with the expression of immediate early genes like c-fos and Egr-1 by the disease mutants. In conclusion, our results demonstrate that Rab7 CMT2B mutants impair growth factor receptor trafficking and, in turn, alter p38 and ERK1/2 signaling from perinuclear, clustered signaling endosomes. The resulting down-regulation of EGFR-dependent nuclear transcription that is crucial for normal axon outgrowth and peripheral innervation offers a crucial new mechanistic insight into disease pathogenesis that is relevant to other neurodegenerative diseases.

BasuRay, Soumik; Mukherjee, Sanchita; Romero, Elsa G.; Seaman, Matthew N. J.; Wandinger-Ness, Angela

2013-01-01

304

Spontaneous iliopsoas muscle hematoma in a patient with von Willebrand disease: a case report  

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Full Text Available Abstract Introduction Iliopsoas hemorrhage is a serious complication of bleeding disorders that occurs most commonly in patients with hemophilia and less commonly in patients with von Willebrand disease. It causes severe pain, muscle dysfunction and occasionally femoral nerve palsy. We describe the case of a patient with von Willebrand disease type 3 with a large iliopsoas hematoma who was treated with a von Willebrand factor concentrate (Humate-P. Case presentation A 20-year-old Iranian man was referred to our emergency ward because of the gradual onset of right flank pain. He was known to have been diagnosed with von Willebrand disease type 3 at age two years old. Magnetic resonance imaging showed a mass in the right iliopsoas muscle. The diagnosis of iliopsoas hemorrhage and partial femoral nerve palsy was established, and he responded to medical treatment. Conclusion We report a case of von Willebrand disease type 3 with spontaneous iliopsoas hematoma associated with femoral nerve palsy that was well managed with Humate-P treatment.

Soltani Shirazi Ahmad

2011-07-01

305

[Retroesophageal hematoma with severe dysfagia after streptokinase for the treatment of the axillosubclavian vein thrombosis].  

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We report the case of a 72 year-old man with advanced, stage IV, prostate cancer who underwent osteosynthesis of the cervical spine for nerve root decompression due to metastasis which was causing severe pain in his right upper limb. After three months in the hospital, he developed occlusive thrombosis of the right axillosubclavian vein as a complication of prolonged catheterization of the right subclavian vein for treatment of septicemia secondary to a hospital acquired pneumonia. The patient received thrombolytic therapy with IV streptokinase in the contralateral arm in the following dosage: 250,000 units in 15 minutes followed by 100,000 units per hour during five days. This led to total recanalization of the thrombus, with significant reduction of the arm edema. Twenty-four hours after the end of the thrombolytic therapy, the patient started to complain of dysfagia to solids and liquids and a contrasted esophagogram revealed extensive extrinsic compression of the esophagus due to a probable retroesophageal hematoma. The patient required enteral nutrition via nasoenteral tube during three months after which swallowing returned to normal and a repeat upper GI series confirmed that the hematoma had been reabsorbed, with normal passage of contrast through the esophagus. On late follow-up, the patient did not show evidence of any sequelae of deep venous thrombosis nor any residual dysfagia and is currently in use of elastic stockings and low molecular weight heparin. PMID:9567335

Baruzzi, A C; Gadelha, M E; Cirenza, C; Knobel, E

1997-08-01

306

CT guided stereotactic evacuation of hypertensive and traumatic intracerebral hematomas. Experiences with 35 cases  

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Recent advancement of CT system provides not only definite diagnosis and location of intracerebral hematoma but also coordinates of the center of the hematoma. Trials of stereotactic evacuation of the hematoma have been reported by some authors in the cases of subacute or chronic stages of hypertensive intracerebral hemorrhage. In this series, similar surgery has been performed in 33 cases of hypertensive intracerebral hematoma including 22 cases in acute stage, and 2 cases of traumatic hematoma. Clinical outcomes were investigated and the results were considered to be equivalent or rather better in the conventional microsurgery with evacuation of hematoma under direct vision. However, there still remained controversial problems in the cases of threatened herniation signs, because in these cases regular surgery with total evacuation of the hematoma at one time might have been preferable. The benefits of this CT guided stereotactic approach for the evacuation of the hematoma were thought to be as follow: 1) the procedure is simple and safe, 2) operation is readily performed under local anesthesia, and 3) the hematoma was drained out totally by means of urokinase activity. It is our impression that this surgery not only is indicated as emergency treatment for the patients of high-age or in high risk, but also can institute as a routine surgery for the intracerebral hematomas in patients showing no herniation sign.

Hondo, Hideki; Matsumoto, Keizo (Tokushima Univ. (Japan). School of Medicine)

1983-01-01

307

Diffuse dural gadolinium MRI enhancement associated with bilateral chronic subdural hematomas.  

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Chronic subdural hematomas (CSDHs) typically present with cognitive dysfunction and a history of trauma. Localized dural enhancement on postcontrast MRI scans associated with the surrounding membrane has been described in CSDH. We present an 83-year-old man with rapidly progressing cognitive dysfunction 4 weeks after head trauma related to a fall. MRI showed CSDHs, which in addition to localized dural gadolinium enhancement, showed a marked diffuse, symmetric, contiguous pachymeningeal enhancement of the supratentorial and infratentorial intracranial dural mater. Meningeal biopsy failed to disclose an infectious or neoplastic cause of the enhancement and instead showed fibrocollagenous change. We conclude that diffuse dural enhancement on MRI scans associated with CSDH cause does not necessarily indicate a superimposed process such as infection or malignancy. CSDH should be considered in the differential diagnosis of diffuse dural enhancement, especially when supported by appropriate clinical findings. PMID:15050219

Blitshteyn, Svetlana; Mechtler, Laszlo L; Bakshi, Rohit

2004-01-01

308

Characteristic MRI and MR Myelography Findings for the Facet Cyst Hematoma at T12-L1 Spine: A Case Report  

International Nuclear Information System (INIS)

A facet cyst is a very rare condition in the thoracolumbar spine and more so, hemorrhage into a cyst is extremely rare. We present a case of a facet cyst hematoma in the T12-L1 spine. A 69-year-old woman complained of chronic back pain with right lower extremity pain, and weakness for 3 years. MRI and MR myelography showed an extradural mass at the T12-L1 level with heterogeneous signal intensity on both T1-and T2-weighted images, which was continuous to the right T12-L1 facet joint. The neighboring facet joint showed severe degeneration on the CT scan. The mass a was simple hematoma covered with a thin fibrous membrane and connected with facet joint macroscopically and microscopically. The pathogenesis of the facet cyst hematoma is not clear but it can compress nerve roots or dura mater and cause radiculopathy or cauda equina syndrome. Surgical removal should be recommended for symptomatic relief.

2011-05-01

309

Characteristic MRI and MR Myelography Findings for the Facet Cyst Hematoma at T12-L1 Spine: A Case Report  

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A facet cyst is a very rare condition in the thoracolumbar spine and more so, hemorrhage into a cyst is extremely rare. We present a case of a facet cyst hematoma in the T12-L1 spine. A 69-year-old woman complained of chronic back pain with right lower extremity pain, and weakness for 3 years. MRI and MR myelography showed an extradural mass at the T12-L1 level with heterogeneous signal intensity on both T1-and T2-weighted images, which was continuous to the right T12-L1 facet joint. The neighboring facet joint showed severe degeneration on the CT scan. The mass a was simple hematoma covered with a thin fibrous membrane and connected with facet joint macroscopically and microscopically. The pathogenesis of the facet cyst hematoma is not clear but it can compress nerve roots or dura mater and cause radiculopathy or cauda equina syndrome. Surgical removal should be recommended for symptomatic relief.

Chung, Seung Eun [Dept of Diagnostic Radiology, Wooridul Spine Hospital, Seoul (Korea, Republic of); Lee, Sang Ho [Dept. of Neurosurgery, Wooridul Spine Hospital, Seoul (Korea, Republic of); Kim, Tae Hong [Dept. of Neurosurgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of); Choi, Gun [Dept. of Neurosurgery, Seoul Wooridul Hospital, Seoul (Korea, Republic of); Paeng, Sung Suk [Dept of Radiology, Wooridul Spine Hospital, Seoul (Korea, Republic of)

2011-05-15

310

Hematoma subdural agudo espontâneo e hemorragia intracerebral em paciente com microangiopatia trombótica gestacional / Spontaneous acute subdural hematoma and intracerebral hemorrhage in a patient with thrombotic microangiopathy during pregnancy  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Pré-eclâmpsia, síndrome HELLP (hemólise, elevação de enzimas hepáticas e plaquetopenia) e fígado gorduroso agudo da gestação são as principais causas de microangiopatia trombótica e disfunção hepática grave durante a gestação, representando um spectrum do mesmo processo patológico. Relatou-se aqui o [...] caso de uma gestante com 35 semanas internada em unidade de terapia intensiva no pós-operatório imediato de cesariana por morte fetal, com náuseas, vômitos e icterícia. Diagnosticaram-se pré-eclâmpsia pós-parto e fígado gorduroso agudo da gestação. Houve evolução tardia com hematoma subdural agudo e hemorragia intracerebral, sendo realizado tratamento neurocirúrgico. A paciente foi a óbito por anemia hemolítica refratária, com sangramento espontâneo em múltiplos órgãos. Pré-eclâmpsia, síndrome HELLP e fígado gorduroso agudo da gestação são processos patológicos que podem se sobrepor e se associar a complicações potencialmente fatais, como a hemorragia intracraniana aqui descrita. Sua detecção e diagnóstico precoces são fundamentais para a instituição de manejo adequado e sucesso do tratamento. Abstract in english Preeclampsia, HELLP syndrome (hemolysis, elevated liver enzymes, and low-platelet count), and acute fatty liver of pregnancy are the main causes of thrombotic microangiopathy and evere liver dysfunction during pregnancy and represent different manifestations of the same pathological continuum. The c [...] ase of a 35-week pregnant woman who was admitted to an intensive care unit immediately after a Cesarean section due to fetal death and the presence of nausea, vomiting, and jaundice is reported. Postpartum preeclampsia and acute fatty liver of pregnancy were diagnosed. The patient developed an acute subdural hematoma and an intracerebral hemorrhage, which were subjected to neurosurgical treatment. The patient died from refractory hemolytic anemia and spontaneous bleeding of multiple organs. Preeclampsia HELLP syndrome, and acute fatty liver of pregnancy might overlap and be associated with potentially fatal complications, including intracranial hemorrhage, as in the present case. Early detection and diagnosis are crucial to ensure management and treatment success.

Sâmia Yasin, Wayhs; Joise, Wottrich; Douglas Prestes, Uggeri; Fernando Suparregui, Dias.

311

Trombo aortico intraluminal e hematoma intramural apos manobra de ressuscitacao cardiopulmonar / Aortic luminal thrombus and intramural hematoma after cardiopulmonary resuscitation  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Descrevemos o caso de um paciente com hematoma intramural e trombo flutuante após ressuscitação cardiopulmonar. Esse homem, de 92 anos de idade, teve uma parada cardíaca causada por fibrilação atrial e testemunhas iniciaram imediatamente manobras manuais de ressuscitação cardiopulmonar. Ao ser admit [...] ido no hospital, o paciente apresentava-se em choque cardiogênico, sendo, então, imediatamente submetido a ecocardiografia transesofágica. Além de uma parede anterior acinética, o exame da aorta torácica descendente mostrou um hematoma intramural e um trombo intra-aórtico flutuante a uma distância de 40cm do arco dental. Não havia dissecção da aorta. O trombo foi atribuído à compressão aórtica durante a ressuscitação cardiopulmonar. Embora o trombo aórtico e o hematoma intramural não tenham se associado a qualquer complicação nesse paciente, a inserção de um balão intra-aórtico poderia ter levado a uma ruptura da aorta ou a eventos embólicos. Recomenda-se a realização de ecocardiografia transesofágica, quando disponível, antes da inserção de um balão intra-aórtico de contrapulsação em pacientes submetidos à ressuscitação cardiopulmonar. Abstract in english We describe the case of a patient with an intramural hematoma and floating thrombus after cardiopulmonary resuscitation. The 92-year old man had a cardiac arrest due to ventricular fibrillation and witnesses immediately initiated manual cardiopulmonary resuscitation. Transesophageal echocardiography [...] was performed immediately on hospital admission because the patient was in cardiogenic shock. In addition to an akinetic anterior wall, examination of the descending thoracic aorta demonstrated an intramural hematoma and a floating intra-aortic thrombus at a distance of 40cm from the dental arch. There was no aortic dissection. The thrombus was attributed to aortic compression during cardiopulmonary resuscitation. Although the aortic thrombus and intramural hematoma were not associated with any complications in this patient, insertion of an intra-aortic balloon may have led to aortic rupture or embolic events. Transesophageal echocardiography should be performed, when available, prior to insertion of an intra-aortic balloon for counterpulsation in patients who have undergone cardiopulmonary resuscitation.

David, Fagnoul; Antoine, Herpain; Jean-Louis, Vincent; Daniel, De Backer.

312

Biplane CT image of a vertex epidural hematoma  

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Recently, the detection of intracranial lesions has been greatly expedited by the advent of computed tomographic (CT) scans. Despite the overall accuracy of CT, however, the quantity of precise information on the mass lesions localized in the region of the vertex required on the basis of axial CT scans alone is not sufficient. With coronal scanning, much more information may be added to enable us to recognize the space extension of these lesions. Herein, we present biplane (axial and coronal) CT scans of a case of acute vertex epidural hematoma. A characteristic CT finding on the high-convexity axial plane was a diffuse high-density area in the bifrontoparietal region, with a bilateral diastatic fracture of the coronal suture. Meanwhile, on the coronal plane, an ''archform'' high-density area was detected at the vertex, with some extension to the temporal region; it was considered to be quite characteristic of this hematoma. Tortuous flax cerebri appeared upon compression from above. (author)

1982-01-01

313

Diplopia from Subacute Bilateral Subdural Hematoma after Spinal Anesthesia  

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Full Text Available Subdural hematoma (SDH is a rare, but life-threatening complication of spinal anesthesia. Subdural hematoma resulting from this procedure could present with vague symptoms such as chronic headache and could easily be missed. Chronic headache is one of the symptoms of chronic SDH in postpartum women. Diplopia as the presenting complaint in SDH secondary to peripartum spinal anesthesia has not, to our knowledge, been previously reported. Here, we report a case of diplopia secondary to postpartum subacute bilateral SDHs with transtentorial herniation after spinal anesthesia in a healthy primagravid 25-year-old woman. SDH can expand gradually and the initial symptoms might be subtle as in our case, despite critically high intracranial pressure. [West J Emerg Med. 2012;13(1:108–110.

Getaw Worku Hassen

2012-04-01

314

MR imaging evaluation of subdural hematomas in child abuse  

International Nuclear Information System (INIS)

MR imaging is the most accurate modality for determining the presence, number, and aging of subdural hematomas. Based on seven patients studied with CT and MR imaging, MR imaging should be the gold standard in child abuse evaluations. Since the history of child abuse is often ambiguous, MR imaging can assist in dating when the injury occurred. MR imaging in two perpendicular planes is needed, with one plane having both T1- and T2-weighted sequences. Chronic subdural hematomas on CT often have the same density as cerebrospinal fluid and may be misdiagnosed as atrophy or unrecognized. Therefore, the child may be returned into a dangerous situation and subjected to recurrent episodes of battering

1988-12-02

315

Eosinophilic Granuloma Presenting as an Epidural Hematoma and Cyst  

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Langerhans' cell histiocytosis (LCH) is a rare immunologic disorder characterized by histiocyte proliferation in multiple organ systems. Eosinophilic granuloma, a benign bone lesion, represents a focal form of LCH. We experienced a case of Langerhans' cell histiocytosis in a patient who presented with intracranial epidural hematoma and cyst on the midline of the frontal skull. A 10-year-old boy presented with a rapidly growing large scalp mass on the midline frontal area after mild head traum...

2008-01-01

316

Hematoma subdural crónico calcificado. Reporte de un caso  

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El hematoma subdural crónico constituye una enfermedad frecuente en la práctica neuroquirúrgica cotidiana. Su diagnóstico se realiza actualmente de forma temprana en la mayoría de los pacientes, a partir de la introducción de las modernas técnicas de imagenología. Se presenta el caso de un enfermo de 84 años de edad con historia de cefalea, mutismo acinético y cuadriparesia, cuyo examen tomográfico mostró una colección extraxial supratentorial hemisférica derecha con calcificaci...

2008-01-01

317

Intramural esophagic hematoma secondary to coumarinic anticoagulation: a case report  

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Esophagic Intramural Hematoma is an uncommon clinical condition, with a prognosis which is essentially benign. On most cases, a predisposing or precipitating factor may be seen, with the most common ones being the history of esophagic instrumentation, food impactations and thrombocytopenia. In the following manuscript, the authors present the case of a 54-years-old male with history of valve replacement surgery, who was treated at the Clinica Cardiovascular (Medellin, Colombia), with a clinic...

Quintero, A?lvaro M.; Gaviria, Mari?a E.; Balparda, Jon K.; Cuervo, He?ctor R.

2009-01-01

318

Spontaneous spinal epidural hematoma diagnosed by CT scan  

International Nuclear Information System (INIS)

A case of spinal epidural hematoma diagnosed by CT scan is reported. A 58-year-old man was admitted on June 18, 1984. He had had a sudden onset of severe low-back pain 7 days before admission and had developed paraparesis and numbness of the lower limbs 4 day before admission. Physical examination revealed weakness in the lower limbs, with the reflexes there decreased. The Babinski reflex and the Chaddock reflex were, however, present on both sides. Sensory disturbances were noted below L2. Urinary incontinence was present, too. Metrizamide myelography revealed an epidural mass which was located from the power part of T11 to the upper part of L2. A CT scan revealed a biconvex, relatively high-density mass in the posterior spinal canal. On the day of admission, a laminectomy was performed from T11 to L1, and the epidural hematoma was evacuated. The postoperative course was uneventful. Spinal epidural hematoma is uncommon. A CT scan can be used for an early diagnosis of this lesion. According to the review of the CT findings in 15 reported cases, including our case, CT reveals a smoothly marginated biconvex homogeneous density mass. The density of the hematoma decreases with the time. An acute type (within 3 days) is high-density, while a chronic type has a relatively high or isodensity. The acute type is easily differentiated from other epidural masses, such as a herniated disc, an epidural abscess, and an epidural tumor. On the other hand, the diagnosis of the chronic type is not always easy. (author)

1985-01-01

319

Hematoma of Rectus Sheath Following Subcutaneous Enoxaparin Injection  

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Full Text Available Anticoagulation drugs are frequently used to prevent deep vein thrombosis in high-risk patients. Subcutaneous low molecular weight heparin (LMWH is increasingly used in both hospitalized patients and outpatient settings. This necessitates familiarity of both health care providers and patients with such treatment and vigilance on possible complications. Here we present a case of hematoma of rectus sheath that occurred following subcutaneous injection of enoxaparin and was successfully treated with conservative management

Shahram Firoozbakhsh

2013-05-01

320

A case of chronic expanding hematoma resulting in fatal hemoptysis  

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An 80-year-old woman presented with a huge intrathoracic mass which had increased in size over 4 years. Computed tomography showed a thick calcified capsule and early-enhanced streaks inside the mass. Needle biopsy aspirated pure blood and fibrous connective tissue. F-18 fluorodeoxyglucose positron-emission tomography showed moderate FDG uptake at the periphery with central photon defects. Gallium-67 scintigraphy showed no abnormal uptake. On suspicion of chronic expanding hematoma, we recomm...

2012-01-01

 
 
 
 
321

Chronic expanding hematoma with bronchopleural fistula and empyema space.  

Science.gov (United States)

Chronic expanding hematoma of the thorax is not typically accompanied by a bronchopleural fistula or purulent lesion. We report an extremely rare case of chronic expanding hematoma with a bronchopleural fistula and empyema space in a 66-year-old man with a history of tuberculous pleurisy admitted because of fever and bloody sputa. Computed tomography and a magnetic resonance imaging revealed a huge mass and an air space in the right thorax. A fiber-optic bronchoscope examination showed hemorrhagic effusion from the apical bronchus of the right lower lobe. First, open-window thoracostomy was undertaken to control the septic state and to prevent aspiration of infected pleural fluid. At operation, air leakage was found at the most superior portion in the rear of the thoracic empyema space; this was thought to be from the bronchopleural fistula. Enterococcus casseliflavus was detected in cultures for bacteria of the effusion from the empyema space. After an improvement of his general condition, a radical operation, including the complete extirpation of the hematoma and intrathoracic muscle transposition using the latissimus dorsi muscle, was successfully performed. PMID:19597392

Tsubochi, Hiroyoshi; Sato, Nobuyuki; Imai, Tadashi

2009-06-01

322

Treatment of patients with spontaneous intracranial hematomas  

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Spontaneous intracerebral haemorrhage is a common cause of stroke especially in the young. The term "spontaneous intracerebral haemorrhage" refers to bleeding without coincident trauma. About 80% of this haemorrhage occur supratentorial in the basal nuclei and they are associated with hypertension. Etiological factors range from congenital vascular malformations (aneurysmas, AVM, cavernomas) to acquired and degenerative vascular and brain conditions. In primary intracerebral hemorrhag...

Jokovi? M.B.; Radulovi? D.V.; Tasi? G.M.; ?urovi? B.M.; Jovanovi? V.T.; Nikoli? I.M.; Slavik E.E.; Lj, Rakic? M.

2008-01-01

323

Hematoma epidurale in patients with delirium tremens  

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Full Text Available In this report we presented a case of diagnostic and therapeutic treatment of the patient with delirium tremens in the Psychiatric Ward of the Cantonal Hospital in Zenica. Neuroradiologic diagnostics had shown existance of epiduralhematoma. The patient was transfered to the Neurosurgery Ward for observation and treatment. Difficultieswith differential diagnostics were caused by already present state of delirium as well as an old neurological deficitrelated to right side hemiparesis.

S. Kasper

2005-08-01

324

Craneotomía limitada para el tratamiento de los hematomas traumáticos agudos en el adulto mayor  

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Fundamento: el tratamiento quirúrgico de los hematomas yuxtadurales traumáticos en el adulto mayor es un tema complejo y controversial por la elevada mortalidad que lo acompaña. Objetivo : presentar los resultados preliminares de la aplicación de la craneotomía limitada para la evacuación de los hematomas yuxtadurales traumáticos agudos en el adulto mayor. M étodo: estudio descriptivo de los resultados del tratamiento quirúrgico de los hematomas yuxtadurales traumáticos agudos en 19...

2011-01-01

325

Characterization of Intraventricular and Intracerebral Hematomas in Non-Contrast CT.  

Science.gov (United States)

Characterization of hematomas is essential in scan reading, manual delineation, and designing automatic segmentation algorithms. Our purpose is to characterize the distribution of intraventricular (IVH) and intracerebral hematomas (ICH) in NCCT scans, study their relationship to gray matter (GM), and to introduce a new tool for quantitative hematoma delineation. We used 289 serial retrospective scans of 51 patients. Hematomas were manually delineated in a two-stage process. Hematoma contours generated in the first stage were quantified and enhanced in the second stage. Delineation was based on new quantitative rules and hematoma profiling, and assisted by a dedicated tool superimposing quantitative information on scans with 3D hematoma display. The tool provides: density maps (40-85HU), contrast maps (8/15HU), mean horizontal/vertical contrasts for hematoma contours, and hematoma contours below a specified mean contrast (8HU). White matter (WM) and GM were segmented automatically. IVH/ICH on serial NCCT is characterized by 59.0HU mean, 60.0HU median, 11.6HU standard deviation, 23.9HU mean contrast, -0.99HU/day slope, and -0.24 skewness (changing over time from negative to positive). Its 0.1(st)-99.9(th) percentile range corresponds to 25-88HU range. WM and GM are highly correlated (R (2)=0.88; pdensity distributions is at 55.6±5.8HU with the corresponding GM/hematoma percentiles of 88(th)/40(th). Objective characterization of IVH/ICH and stating the rules quantitatively will aid raters to delineate hematomas more robustly and facilitate designing algorithms for automatic hematoma segmentation. Our two-stage process is general and potentially applicable to delineate other pathologies on various modalities more robustly and quantitatively. PMID:24976197

Nowinski, Wieslaw L; Gomolka, Ryszard S; Qian, Guoyu; Gupta, Varsha; Ullman, Natalie L; Hanley, Daniel F

2014-06-01

326

Calcified epidural hematoma in pediatric age group: A report of two cases  

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The authors present a rare case of calcified (ossified) chronic epidural hematoma developed in a six-and-a-half-year-old female patient who was operated for cerebellar astrocytoma 6 months earlier. There was no history of trauma. Ossified epidural hematoma was seen as an incidental finding in the follow-up in computed tomography scan after 6 months of primary glioma surgery. Ossified chronic epidural hematoma with thick collagenous wall and newly formed bone on dura was excised. The developme...

Trivedi, A.; Hiran, S.

2010-01-01

327

Percutaneous drainage of a postoperative intraspinal hematoma using a Tuohy needle  

International Nuclear Information System (INIS)

A 78-year-old man developed a large subdural hematoma extending from T12 to L3 levels following L3 laminectomy and L3-5 posterior spinal fusion. He had associated neurological signs and symptoms. MR imaging showed typical signal characteristics of a subacute intraspinal subdural hematoma. Percutaneous drainage was successfully performed under CT guidance by inserting a Tuohy needle through the L3 laminectomy defect. The catheter packaged with the Tuohy needle was inserted cranially into the hematoma and 30 ml of blood was aspirated. Follow-up MR imaging confirmed resolution of the hematoma and the patient made a rapid recovery. (orig.)

2003-10-01

328

Clinical application of CT-controlled stereotactic aspiration for intracerebral hematoma  

International Nuclear Information System (INIS)

Objective: To evaluate the clinical application of CT-controlled stereotactic aspiration for intracerebral hematoma. Methods: CT-guided stereotactic system was installed on the CT bed, and checked against a standard of the coordinate. According to controlled CT scan, the target can be adjusted at any time in the operation. 860 patients with cerebral hematoma underwent CT-controlled stereotactic aspiration. Of the 860 cases, basal ganglion hematoma was present in 408, thalamus and posterior limb of internal capsule hematoma in 136, cerebral lobe hematoma in 261, cerebellar hematoma in 5, ventricular hemorrhage in 10, midbrain and pons hemorrhage in 37, and medulla hemorrhage in 3. Results: Easy drainage of hematoma by aspiration was achieved in 586 cases, stickiness of hematoma with clearing away more than 50% was performed in 202 and less than 50% in 68. The operation duration ranged from 25 to 120 minutes (average 45 minutes). 693 cases survived and 167 cases died. According to the evaluation by active day life (ADL) after 3 months in survivors, ADL 1-2, ADL 3, ADL 4 and ADL 5 results were achieved in 378 cases, 166 cases, 107 cases, and 28 cases, respectively. In addition, 14 cases were lost beyond recall. Conclusion: CT-controlled stereotactic aspiration for intracerebral hematoma is a handy, less invasive, and safe procedure with high accuracy and curative effect, it is worth while popularizing the procedure

2002-05-01

329

Diagnóstico angiográfico dos hematomas subdurais: valor da fase venosa em incidência sagital / Angiographic diagnosis of subdural hematoma: value of the venous phase in saggital incidence  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Êste trabalho tem por fim demonstrar o valor da fase venosa em incidência sagital no diagnóstico angiográfico dos hematomas subdurais. Êle é baseado em 8 casos verificados cirürgicamente, dois dos quais com hematoma bilateral, compreendendo um total de 10 hematomas subdurals demonstrados pela angiog [...] rafia cerebral. Em 9 exemplares a elipse avascular que caracteriza essa entidade nosológica só apareceu na fase venosa; sòmente em um caso êsse sinal patognomônico foi claramente revelado na fase arterial em incidência ântero-posterior. O arteriograma mostra, apenas, às mais das vêzes, deslocamento da artéria cerebral anterior e seus ramos para o lado oposto àquele em que se encontra o hematoma, como acontece nos casos de lesões expansivas em geral. Menos freqüentemente os principais troncos arteriais do encéfalo não sofrem modificações no seu trajeto, apesar do espaço intracraniano ocupado pelos hematomas. A existência de hematoma subdural no interior de um hemicrânio sem desvio da artéria cerebral anterior, embora não implique necessàriamente na existência de outra coleção sangüínea do lado oposto, é altamente sugestiva dessa dupla lesão. A exploração bilateral nesses casos é, portanto, obrigatória. Dos três casos desta série em que a angiografia em um dos lados revelou a elipse avascular característica e artéria cerebral anterior com trajeto normal, a angiografia do lado oposto resultou positiva em dois dêles e negativa em um. Pôsto que alguns Serviços especializados não sejam dotados de equipamento para angiografia em séries, o autor recomenda o flebograma em incidência sagital como tempo obrigatório, mesmo que para tanto seja necessária nova injeção de contraste. Abstract in english This repport aims to demonstrate the value of the venous phase, in sagittal incidence, for the angiographic diagnosis of subdural hematoma. It is based on eight such cases, all of them with surgical confirmation. Six of the patients had unilateral hematomas and the remaining two had bilateral blood [...] collections. Ten subdural hematomas were, then, diagnosed by means of cerebral angiography. In only one instance the elliptical non vascularized area which constitutes the pathognomonic sign of the above referred nosological entity could be seen, under frontal projection, right in the arterial phase. In the other cases the specific diagnosis of subdural hematoma would not be achieved if the venous phase had not been taken in account. The arterial displacement seen in most cases of subdural hematoma gives no help for specific diagnosis; such a displacement may occur in any case of space-occupying lesion. Besides, existence of subdural hematomas with no arterial dislocation, is a known condition, mainly in that cases of bilateral subdural blood collections. On the other hand a single, unilateral hematoma with no shifting of the anterior cerebral artery to the opposite side is also suitable. In the last three cases of this series, there was no significant displacement of the anterior cerebral artery; the venous phase, in antero-posterior incidence, and further surgical exploration, showed the hematomas to be bilateral in two; in the third of these cases the anterior cerebral artery had a normal course, in spite of the space taken by a single hematoma. Thus, if the venous phase shows the characteristic picture of subdural hematoma - avascular area - with no displacement in the arterial phase, it does not mean necessarily that the hematoma is bilateral. Nevertheless angiography on opposite side must always be done. Since in angiographic diagnosis of subdural hematoma the accuracy of the venous phase, in sagittal projection seems to be proven, we think that the above mentioned step of the examination has to be done even if, in order to achieve it, a new injection of contrast may be required.

José, Zaclis; Rolando A., Tenuto.

330

Hematoma intraneural experimental em ratos: avaliação da recuperação funcional e histomorfometria neural / Experimental intraneural hematoma model in rats: evaluation of functional recovery and neural histomorphometry  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A formação do hematoma intraneural com comprometimento de nervos periféricos pode ocorrer após trauma ou coagulopatias. O tratamento expectante ou abordagem cirúrgica descompressiva ainda não estão definidos. Foram estudados 40 ratos da raça Wistar divididos em 4 grupos. No grupo A realizou-se injeç [...] ão intraneural de 0,2 ml de sangue autógeno no nervo ciático direito. No grupo B, após produção do hematoma, fez-se descompressão imediata com epineurotomia longitudinal. No grupo D realizamos liberação imediata do hematoma com neurólise interfascicular. No grupo C (CONTROLE) apenas realizou-se a exposição do nervo ciático sem formação de hematoma. A avaliação da função nervosa foi feita com o Índice de Função Ciática de Bain-Mackinnon-Hunter (IFC). O grupo A apresentou IFC inicial de -28,43, com recuperação funcional no 5º dia. A drenagem imediata desse hematoma através de uma epineurotomia longitudinal (B) determinou retorno da função ciática normal desde o 1º dia (IFC= -14,42). Tratando o hematoma através da neurólise interfascicular observamos um IFC inicial de -23,69 e retorno da função ciática normal no 3º dia. Os parâmetros histomorfométricos apontaram melhora dos parâmetros de isquemia após os 2 tipos de intervenção cirúrgica aplicadas neste estudo. Não houve diferença entre os tipos de intervenções aplicadas. Abstract in english Emergence of intraneural hematoma with involvement of peripheral nerves can occur after trauma or coagulation disorders. The decision for expectant management or decompressive surgical techniques is still controversial. Forty male Wistar rats were divided into 4 groups. In group A, an intraneural in [...] jection of autologous blood was provided at the right sciatic nerve. In group B, after the hematoma creation, a longitudinal epineurotomy was performed. In the group C (sham-operated), the sciatic nerve was exposed without hematoma. In group D. immediately after the hematoma creation, an interfascicular neurolysis was performed. Nerve function recovery was assessed using the Bain-Mackinnon-Hunter Sciatic Function Index (SFI). At the end of the study, the animals were sacrificed and a specimen of the sciatic nerve at compression midpoint was removed for morphometric analysis. Group A displayed an initial SFI of -28.43, with full functional recovery on the fifth day. Immediate drainage of the hematoma by longitudinal epineurotomy (group B) promoted recovery of normal sciatic function on the first day (SFI -14.42). Addressing the hematoma via interfascicular neurolysis resulted in an initial SFI of -23.69 and recovery of normal sciatic function on the third day. The morphometric variables indicated an improvement of ischemic parameters following both types of surgical intervention.

Gean Paulo, Scopel; José Carlos Marques, Faria; Fábio F., Busnardo; Hélio R. N., Alves; Simone Cristina, Orpheu; Marcus Castro, Ferreira.

331

Drosophila CENP-A Mutations Cause a BubR1- Dependent Early Mitotic Delay without Normal Localization of Kinetochore Components  

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The centromere/kinetochore complex plays an essential role in cell and organismal viability by ensuring chromosome movements during mitosis and meiosis. The kinetochore also mediates the spindle attachment checkpoint (SAC), which delays anaphase initiation until all chromosomes have achieved bipolar attachment of kinetochores to the mitotic spindle. CENP-A proteins are centromere-specific chromatin components that provide both a structural and a functional foundation for kinetochore formation...

Blower, Michael D.; Daigle, Tanya; Kaufman, Thom; Karpen, Gary H.

2006-01-01

332

The Experience in Nicaragua: Childhood Leukemia in Low Income Countries—The Main Cause of Late Diagnosis May Be “Medical Delay  

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Background. The event-free survival for pediatric leukemia in low-income Countries is much lower than in high-income countries. Late diagnosis, which is regarded as a contributing factor, may be due to “parental” or “medical” delay. Procedures. The present study analyses determinants of lag time from first symptoms to diagnosis of leukemia, comparing pediatric (0–16 years old) patients in two referral centers, one in Nicaragua and one in Italy. An observational retrospective study w...

Angelis, C.; Pacheco, C.; Lucchini, G.; Arguello, M.; Conter, V.; Flores, A.; Biondi, A.; Masera, G.; Baez, F.

2012-01-01

333

Optoacoustic detection and monitoring of blast-induced intracranial hematomas in rats  

Science.gov (United States)

Patients with acute intracranial hematomas often require surgical drainage within the first four hours after traumatic brain injury (TBI) to avoid death or severe neurologic disability. CT and MRI permit rapid, noninvasive diagnosis of hematomas, but can be used only at a major health-care facility. At present, there is no device for noninvasive detection and characterization of hematomas in pre-hospital settings. We proposed to use an optoacoustic technique for rapid, noninvasive diagnosis and monitoring of hematomas, including intracranial hematomas. Unlike bulky CT and MR equipment, an optoacoustic system can be small and easily transported in an emergency vehicle. In this study we used a specially-designed blast device to inflict TBI in rats. A near-infrared OPO-based optoacoustic system developed for hematoma diagnosis and for blood oxygenation monitoring in the superior sagittal sinus (SSS) in small animals was used in the study. Optoacoustic signals recorded simultaneously from the SSS and hematomas allowed for measurements of their oxygenations. The presence of hematomas was confirmed after the experiment in gross pictures of the exposed brains. After blast the hematoma signal and oxygenation increased, while SSS oxygenation decreased due to the blastinduced TBI. The increase of the oxygenation in fresh hematomas may be explained by the leakage of blood from arteries which have higher blood pressure compared to that of veins. These results indicate that the optoacoustic technique can be used for early diagnosis of hematomas and may provide important information for improving outcomes in patients with TBI or stroke (both hemorrhagic and ischemic).

Petrov, Andrey; Wynne, Karon E.; Prough, Donald S.; Dewitt, Douglas S.; Petrov, Yuriy; Petrov, Irene Y.; Parsley, Margaret A.; Esenaliev, Rinat O.

2014-03-01

334

Hematoma epidural lombar pós-cirurgico em paciente com leucemia: relato de caso Hematoma epidural lumbar posquirúrgico en paciente con leucemia: relato de caso Postoperative lumbar epidural hematoma in a patient with leukemia: case report  

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Full Text Available A ocorrência de hematoma epidural como complicação pós-cirúrgica é relativamente baixa. O reconhecimento dessa patologia no diagnóstico diferencial nas paraplegias pós-cirúrgicas imediatas e o tratamento precoce por meio de intervenção cirúrgica com a descompressão do canal são fatores que estão diretamente relacionados à melhora do quadro neurológico. Este relato de caso é de um hematoma epidural no pós-operatório imediato de descompressão por estenose do canal vertebral lombar em paciente com leucemia.La ocurrencia de hematoma epidural, como complicación posquirúrgica, es relativamente baja. El reconocimiento de esa patología, en el diagnóstico diferencial en las paraplejías posquirúrgicas inmediatas y el tratamiento precoz por medio de intervención quirúrgica con la descompresión del canal, son factores que se relacionan directamente con la mejoría del cuadro neurológico. Este relato de caso es de un hematoma epidural en el posoperatorio inmediato, después de descompresión, por estenosis, del canal vertebral lumbar en paciente con leucemia.The occurrence of epidural hematoma as a postoperative complication is relatively low. The recognition of this condition in the differential diagnosis in the immediate postoperative paraplegia and the early surgical decompression are directly related with neurological improvement. We report a case of epidural hematoma in the early postoperative period of surgical decompression of the lumbar spinal canal, in a patient with leukemia.

Wagner Pasqualini

2012-09-01

335

Hemobilia, intrahepatic hematoma and acute thrombosis with cavernomatous transformation of the portal vein after percutaneous thermoablation of a liver metastasis  

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A 53-year-old-man underwent US-guided percutaneous thermal ablation with a cooled-tip needle of three liver metastases from gastric cancer. Six days later, the patient was re-admitted for melena, scleral jaundice, and anemia. Abdominal US disclosed echogenic material in the gallbladder lumen (hemobilia) and a focal lesion with mixed echotexture in segment III (hepatic hematoma). On day 5 portal cavernomatosis was diagnosed at US and confirmed by color Doppler and a helical CT exam. The case described emphasizes that radio-frequency interstitial hyperthermia may cause not only traumatic injury of the liver parenchyma but also thermally mediated damage of vascular structures. (orig.)

Francica, G.; Marone, G.; D' Angelo, V. [Divisione di Gastroenterologia, Ospedale ' ' Cardinale Ascalesi' ' , Naples (Italy); Solbiati, L. [Divisione di Ecografia e Radiologia Interventistica, Ospedale Generale Busto Arsizio (Italy); Siani, A. [Servizio di Radiologia, Ospedale Civile ' ' S. Maria Delle Grazie' ' , Pozzuoli (Italy)

2000-06-01

336

Unilateral optic neuropathy following subdural hematoma: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Introduction Unilateral optic neuropathy is commonly due to a prechiasmatic affliction of the anterior visual pathway, while losses in visual hemifields result from the damage to brain hemispheres. Here we report the unusual case of a patient who suffered from acute optic neuropathy following hemispherical subdural hematoma. Although confirmed up to now only through necropsy studies, our case strongly suggests a local, microcirculatory deficit identified through magnetic resonance imaging in vivo. Case presentation A 70-year-old Caucasian German who developed a massive left hemispheric subdural hematoma under oral anticoagulation presented with acute, severe visual impairment on his left eye, which was noticed after surgical decompression. Neurologic and ophthalmologic examinations indicated sinistral optic neuropathy with visual acuity reduced nearly to amaurosis. Ocular pathology such as vitreous body hemorrhage, papilledema, and central retinal artery occlusion were excluded. An orbital lesion was ruled out by means of orbital magnetic resonance imaging. However, cerebral diffusion-weighted imaging and T2 maps of magnetic resonance imaging revealed a circumscribed ischemic lesion within the edematous, slightly herniated temporomesial lobe within the immediate vicinity of the affected optic nerve. Thus, the clinical course and morphologic magnetic resonance imaging findings suggest the occurrence of pressure-induced posterior ischemic optic neuropathy due to microcirculatory compromise. Conclusion Although lesions of the second cranial nerve following subdural hematoma have been reported individually, their pathogenesis was preferentially proposed from autopsy studies. Here we discuss a dual, pressure-induced and secondarily ischemic pathomechanism on the base of in vivo magnetic resonance imaging diagnostics which may remain unconsidered by computed tomography.

Witte Otto W

2010-01-01

337

Positron emission tomography in the evaluation of subdural hematomas  

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Fifteen patients with 21 subdural effusions were investigated both with transmission computer assisted tomography (CAT) and positron emission tomography (PET). The tracer in the emission studies was /sup 68/Ga-EDTA. Twelve lesions were visualized both with CAT and PET. Five lesions that were negative or doubtful on CAT were visualized with PET, whereas four lesions negative or doubtful on PET were demonstrated by CAT. The two methods complement each other due to the fact that they are based on different mechanisms: CAT mainly on attenuation of the fluid collection. PET on isotope accumulation, particularly in the hematoma membranes.

Ericson, K.; Bergstroem, M.; Eriksson, L.

1980-12-01

338

Extensive spinal epidural hematoma: a rare complication of aortic coarctation  

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Development of collateral circulation belongs among the typical signs of aortic coarctation. Cerebral or spinal artery aneurysm formation with increased risk of subarachnoid hemorrhage represent the most common neurovascular complication of this disease. We report a case of a 20-year-old sportsman who developed acute non-traumatic paraplegia as a result of extensive spinal epidural hemorrhage from collateral vessels accompanying aortic coarctation which was unrecognized up to that time. To the best of our knowledge, acute spinal epidural hematoma as a complication of aortic coarctation has not been previously reported. (orig.)

Zizka, J.; Elias, P.; Michl, A. [Dept. of Radiology, Charles University Hospital, Hradec Kralove (Czech Republic); Harrer, J. [Dept. of Cardiac Surgery, Charles University Hospital, Hradec Kralove (Czech Republic); Cesak, T. [Dept. of Neurosurgery, Charles University Hospital, Hradec Kralove (Czech Republic); Herman, A. [1. Dept. of Internal Medicine, Charles University Hospital, Hradec Kralove (Czech Republic)

2001-07-01

339

Intrahepatic hematoma: hepatic lesion in a newborn with high ?-fetoprotein level  

International Nuclear Information System (INIS)

Hepatic hematomas are relatively common in fetuses and neonates; most are subcapsular in location. Sometimes their imaging features can be non-specific, so differentiation from other aggressive lesions like hepatoblastoma can be difficult, especially if there is a concurrent high ?-fetoprotein level. We report a case of intrahepatic hematoma with a rising ?-fetoprotein level. (orig.)

2005-11-01

340

Intrahepatic hematoma: hepatic lesion in a newborn with high {alpha}-fetoprotein level  

Energy Technology Data Exchange (ETDEWEB)

Hepatic hematomas are relatively common in fetuses and neonates; most are subcapsular in location. Sometimes their imaging features can be non-specific, so differentiation from other aggressive lesions like hepatoblastoma can be difficult, especially if there is a concurrent high {alpha}-fetoprotein level. We report a case of intrahepatic hematoma with a rising {alpha}-fetoprotein level. (orig.)

Lam, Chiu Ying Flora; Chan, Kui Fai; Fan, Tsz Wo; Kwok, Chong Hei Philip; Chan, Chi Hum Susan; Tsang, Tsz Kan [Queen Elizabeth Hospital, Department of Radiology and Imaging, Hong Kong (China)

2005-11-01

 
 
 
 
341

Postoperative spinal epidural hematoma resulting in cauda equina syndrome: a case report and review of the literature  

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Spinal epidural hematoma is a well known complication of spinal surgery. Clinically insignificant small epidural hematomas develop in most spinal surgeries following laminectomy. However, the incidence of clinically significant postoperative spinal epidural hematomas that result in neurological deficits is extremely rare. In this report, we present a 33-year-old female patient whose spinal surgery resulted in postoperative spinal epidural hematoma. She was diagnosed with lumbar disc disease a...

Kaner, Tuncay; Sasani, Mehdi; Oktenoglu, Tunc?; Cirak, Bayram; Ozer, Ali Fahir

2009-01-01

342

Spontaneous idiopathic spinal epidural hematoma: two different presentations of the same disease / Hematoma epidural espinal espontáneo: dos diferentes presentaciones clínicas de la misma enfermedad / Hematoma epidural espinhal espontâneo: duas diferentes apresentações da mesma doença  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Os autores relatam dois casos de hematoma epidural espinhal espontâneo com diferentes apresentações clínicas e sua revisão da literatura. O primeiro paciente apresentava sinais e sintomas de compressão medular cervical, necessitando de laminectomia de urgência, enquanto no segundo paciente, que era [...] crônico, havia sintomatologia de lombociatalgia por compressão nervosa de evolução de cinco meses e com diagnóstico radiológico de cisto facetário. A intervenção cirúrgica precoce é o tratamento de escolha para os hematomas epidurais espinhais espontâneos. Os hematomas epidurais espinhais espontâneos, conforme a localização na coluna vertebral, diferem na apresentação clínica e no manejo. Na região lombar, o diagnóstico diferencial deve ser feito com patologias degenerativas. Abstract in spanish Fueron relatados dos casos de hematoma epidural espinal espontáneo con diferentes presentaciones clínicas sin factores precipitantes, y fue hecha una breve revisión de la literatura. Nuestro caso 1 tuvo un desarrollo agudo y mostró señales progresivas en la columna cervical que determinaron una lami [...] nectomía descompresiva de emergencia. Por otro lado, el segundo paciente, crónico, fue operado casi cinco meses después de los síntomas iniciales y el diagnóstico radiológico fue de un gran quiste sinovial. La intervención quirúrgica temprana es el tratamiento de elección para hematomas espontáneos epidurales espinales. El tratamiento quirúrgico representa la forma más común de terapia para todos los tipos de presentaciones clínicas. Debemos considerar que el tratamiento conservador (o no) sea más común en casos de presentación leve, principalmente en pacientes con hematoma espinal crónico. Para realizar un diagnóstico diferencial, los cirujanos deben recordar que los hematomas epidurales espinales espontáneos pueden tener distintas presentaciones clínicas según su ubicación. Abstract in english We report two cases of spontaneous spinal epidural hematoma with different clinical presentations without precipitating factors and a brief review of the literature. Our case first developed acute and had progressive cervical spinal cord signs that determined emergency decompressive laminectomy. On [...] the other hand, the second patient, who was chronic, was operated almost five months after the initial symptoms and the radiological diagnosis was a large facet cyst. Early surgical intervention is the chosen treatment for spontaneous spinal epidural hematomas. Spinal surgeons should bear in mind that spontaneous spinal epidural hematomas may have different clinical presentations according to their location in order to perform a differential diagnosis.

Asdrúbal, Falavigna; Orlando, Righesso; Alisson Roberto, Teles; Thiago, Hoesker.

343

Spontaneous idiopathic spinal epidural hematoma: two different presentations of the same disease Hematoma epidural espinal espontáneo: dos diferentes presentaciones clínicas de la misma enfermedad Hematoma epidural espinhal espontâneo: duas diferentes apresentações da mesma doença  

Directory of Open Access Journals (Sweden)

Full Text Available We report two cases of spontaneous spinal epidural hematoma with different clinical presentations without precipitating factors and a brief review of the literature. Our case first developed acute and had progressive cervical spinal cord signs that determined emergency decompressive laminectomy. On the other hand, the second patient, who was chronic, was operated almost five months after the initial symptoms and the radiological diagnosis was a large facet cyst. Early surgical intervention is the chosen treatment for spontaneous spinal epidural hematomas. Spinal surgeons should bear in mind that spontaneous spinal epidural hematomas may have different clinical presentations according to their location in order to perform a differential diagnosis.Fueron relatados dos casos de hematoma epidural espinal espontáneo con diferentes presentaciones clínicas sin factores precipitantes, y fue hecha una breve revisión de la literatura. Nuestro caso 1 tuvo un desarrollo agudo y mostró señales progresivas en la columna cervical que determinaron una laminectomía descompresiva de emergencia. Por otro lado, el segundo paciente, crónico, fue operado casi cinco meses después de los síntomas iniciales y el diagnóstico radiológico fue de un gran quiste sinovial. La intervención quirúrgica temprana es el tratamiento de elección para hematomas espontáneos epidurales espinales. El tratamiento quirúrgico representa la forma más común de terapia para todos los tipos de presentaciones clínicas. Debemos considerar que el tratamiento conservador (o no sea más común en casos de presentación leve, principalmente en pacientes con hematoma espinal crónico. Para realizar un diagnóstico diferencial, los cirujanos deben recordar que los hematomas epidurales espinales espontáneos pueden tener distintas presentaciones clínicas según su ubicación.Os autores relatam dois casos de hematoma epidural espinhal espontâneo com diferentes apresentações clínicas e sua revisão da literatura. O primeiro paciente apresentava sinais e sintomas de compressão medular cervical, necessitando de laminectomia de urgência, enquanto no segundo paciente, que era crônico, havia sintomatologia de lombociatalgia por compressão nervosa de evolução de cinco meses e com diagnóstico radiológico de cisto facetário. A intervenção cirúrgica precoce é o tratamento de escolha para os hematomas epidurais espinhais espontâneos. Os hematomas epidurais espinhais espontâneos, conforme a localização na coluna vertebral, diferem na apresentação clínica e no manejo. Na região lombar, o diagnóstico diferencial deve ser feito com patologias degenerativas.

Asdrúbal Falavigna

2010-09-01

344

Non-surgical management of intracranial subdural hematoma complicating spinal anesthesia Manejo no quirúrgico de hematoma subdural intracraneal tras anestesia espinal complicada  

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We report the case of a 29 year-old woman who presented a symptomatic intracranial subdural hematoma developing shortly after spinal anesthesia. The patient was fully conscious at clinical onset, and thus we treated her conservatively with an epidural autologous blood patch and close neurological observation. Given the clinical improvement the possibility of surgery was discauded in agreement with the neurosurgical team. Most cases of subdural hematoma appearing after spinal anesthesia are tr...

2007-01-01

345

Stereotactic fibrinolysis of spontaneous intracerebral hematoma using infusion of recombinant tissue plasminogen activator Fibrinólise com infusão de rtPA e drenagem estereotáxica de hematoma intracerebral espontâneo profundo  

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PURPOSE: The authors present a prospective study on 10 patients with stereotactic infusion of tissue plasminogen activator (rtPA) intraparenchimal hemorrhage. METHODS: Between 1999 and 2000, 10 patients with deep seated hematomas in the basal ganglia were selected for stereotactic infusion of rtPA and spontaneous clot drainage. RESULTS: All cases had about 80% reduction of the hematoma volume in the CT scan at the third day. The intracranial pressure was normalized by the third day too. There...

José Augusto Nasser; Asdrubal Falavigna; Márcio Bezerra; Victor Martinez; Gabriel Freitas; Armando Alaminos; Antônio Bonatelli; Fernando Ferraz

2002-01-01

346

Tratamiento con malla de poliglactina del hematoma subcapsular hepático roto Treatment of subcapsular liver hematoma using a polyglactine mesh  

Directory of Open Access Journals (Sweden)

Full Text Available En la mayoría de los enfermos el traumatismo hepático tiene un tratamiento médico. Esto se ve favorecido por el desarrollo de UCI y por el seguimiento estricto de las lesiones con estudios imagenológicos, fundamentalmente con TAC. El tratamiento quirúrgico se realiza en los pacientes con compromiso hemodinámico o cuando existen otras lesiones que ameritan una operación. Clásicamente, las lesiones hepáticas han sido tratadas con empaquetamiento del hígado con compresas. La malla de poliglactina cumple el mismo rol, pero tiene el beneficio de no necesitar ser retirada, lo que disminuiría la morbimortalidad. Presentamos 4 pacientes tratadas con malla de poliglactina luego de un traumatismo hepático, su evolución inmediata y alejada. Además se discuten aspectos de este tratamientoMost patients with subcapsular liver hematomas can be managed conservatively with a good hemodynamic and imaging monitoring. Surgery is reserved for patients with hemodynamic instability or when there are other lesions requiring surgical exploration. During surgery, liver lesions are usually wrapped with compresses. Polyglactine mesh has the same function, but does not require to be withdrawn, decreasing the risk for complications. We report four female patients with a ruptured subcapsular liver hematoma treated with polyglactine mesh wrapping. One patient was aged four days and had multiple malformations, one was aged 29 and had a HELLP syndrome, one was aged 34 years and had a lupus hepatitis and one aged 82 years and was in anticoagulant treatment. There was a mean of 2.3 surgical interventions in each patients and mean hospital stay was 17 days. One patient had to be admitted again due to a progression of the hematoma and was managed with selective arterial embolization. The newborn patient died of a respiratory infection, one month after discharge

JEAN MICHEL BUTTE B

2006-10-01

347

Psoas muscle hematoma secondary to a ruptured abdominal aortic aneurysm: case report  

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The diagnosis of a ruptured abdominal aortic aneurysm (RAAA) is usually made on the basis of the classic clinical presentation of hypotension, abdominal or back pain, and a pulsating abdominal mass. However, given the large differential diagnosis for abdominal or back pain, the diagnosis can be elusive in a stable patient. The importance of a rapid diagnosis of a RAAA is emphasized by the 32%-70% operative mortality rate and the 77%-94% overall mortality rate. The case reported here demonstrates unusual clinical and radiological findings in a patient with a RAAA. The patient presented with back pain and a progressive radiculopathy in the L4 distribution. The diagnosis of RAAA was delayed 6 weeks because of the investigation of a suspected nerve root entrapment. Consecutive computed tomographic (CT) imaging over a 6-day period showed the evolution of a psoas muscle hematoma secondary to a RAAA. This case emphasizes the importance of considering a RAAA in elderly patients with a prolonged history of back pain. (author)

Cumming, M.J.; Hall, A.J.; Burbridge, B.E. [University of Saskatchewan, Royal University Hospital, Dept. of Medical Imaging, Saskatoon, SK (Canada)

2000-10-01

348

Conditions supporting repair of potentially lethal damage cause a significant reduction of ultraviolet light-induced division delay in synchronized and plateau-phase Ehrlich ascites tumor cells  

International Nuclear Information System (INIS)

Repair of potentially lethal damage (PLD) induced by uv light in synchronized and in plateau-phase cultures of Ehrlich ascites tumor cells was studied by measuring cell survival. In particlar the influence of conditions supporting repair of PLD on growth kinetics was investigated. In synchronized G_1, S, or G_2 + M cells as well as in plateau-phase cells, uv light induced, almost exclusively, delay in the next S phase. A significant decrease of this delay was observed when the cells were incubated for 24 hr in balanced salt solution. Repair of PLD after uv irradiation was found to occur in plateau-phase cells and in cells in different phases of the cell cycle provided that after irradiation these were kept under conditions inhibiting cell multiplication (incubation in balanced salt solution or in conditioned medium). The repair time constant t_5_0 was significantly higher than those found for X irradiation (5-10 hr compared to 2 hr), and repair was not significantly inhibited by either 20 ?g/ml cycloheximide or 2 mM caffeine in 24 hr

1982-01-01

349

Bilateral chronic subdural hematomas of the posterior fossae.  

Science.gov (United States)

An 86-year-old female presented with rare bilateral chronic subdural hematomas (CSHs) of the posterior fossae which were successfully treated by surgical intervention. She had experienced mild head trauma one month before admission. She was transferred to our hospital because of consciousness disturbance and tetraparesis. Magnetic resonance (MR) imaging showed simultaneous occurrence of supratentorial and infratentorial CSHs. We tried to evacuate the CSHs of the bilateral posterior fossae because brainstem compression was markedly severe. Through bilateral burr-hole trepanations, chocolate-colored fluid, not containing clotted components, gushed out under great pressure. Postoperative course was uneventful. MR imaging revealed that the CSHs of the posterior fossae had completely disappeared and brainstem compression had also improved. The patient's neurological deficits were immediately improved after the operation. The patient was discharged one month after the operation for further rehabilitation. Trepanation and evacuation of the hematoma through the posterior fossa might be one of the therapeutic options for posterior fossa CSH, which is similar to supratentorial CSH. However, we considered that the emergency of this rare entity and the method of anesthesia were quite different from supratentorial CSH. PMID:23183077

Kurisu, Kota; Kawabori, Masahito; Niiya, Yoshimasa; Ohta, Yuzuru; Mabuchi, Shoji; Houkin, Kiyohiro

2012-01-01

350

MRI study for CT-guided stereotactic aspiration of intracerebral hematoma  

International Nuclear Information System (INIS)

Twenty-five patients with acute hypertensive intracerebral hematomas, diagnosed by computed tomography (CT), underwent CT-guided stereotactic aspiration. Magnetic resonance (MR) images were obtained immediately before aspiration, using T_1-weighted (TR=500 msec, TE=15 msec) and T_2-weighted (TR=2500 msec, TE=120 msec) sequences and a 0.5 Tesla MR system. On the basis of the MR images the hematomas were divided into peripheral, central, and core segments. The signal intensities were divided into seven grades based on the comparison with white matter. The sequential changes in each segment on the MR images were evaluated, and the ratio of hematoma removal vs. size of residual hematoma was assessed by preoperative MR imaging and pre-and post-operative CT. The hematomas were located in the putamen in 13 cases, the thalamus in 8, combined in 2, and subcortex in 2. The hematomas, targeted in their centers, were evacuated by the aspiration procedure alone, 1 to 12 days after onset (day 0=day of onset). The results were as follows : 1) The proportion of hematomas removed was high after day 4. 2) Sequential T_1-weighted images showed that the peripheral segments gradually increased in signal intensity, appearing as high-intensity rings that gradually filled and could be easily aspirated. 3) In those cases in which sequential T_2-weighted images showed the central segments gradually increasing in signal intensity, the hematomas were easily aspirated if the signal was either iso-intense or hyper-intense. 4) Several hematomas had a core that appeared as a high intensity signal on T1-weighted images and as a low intensity signal on T_2-weighted images; these hematomas could not be aspirated. (author)

1994-09-01

351

[CT-guided stereotaxic evacuation of cerebellar hematoma--lateral approach].  

Science.gov (United States)

Stereotaxic lateral approach for cerebellar hematoma is presented using Leksell's CT-stereotaxic system. All of the procedures are performed in the CT room. Patient's head is turned to contralateral side of the hematoma 30 to 40 degrees with slight flexion of the neck. Stereotaxic apparatus is secured to the head under local anesthesia. Hematoma is confirmed by computerized tomograms. Three dimensional coordinates of the target point (center of the hematoma) are measured from the vertical and diagonal rods of Leksell's system. Linear skin incision 4 cm in length is made on retromastoid area. Burr-hole is put on just lateral position of the target point, usually 5 to 6 cm posterior and 1 cm above from the external auditory meatus. Transverse or sigmoid sinus does not appeared through the burr-hole by this approach. Specially made Dandy's cannula (3.0 mm in diameter, 220 mm in length) is inserted into the target point, and manual evacuation of the hematoma is performed carefully using a syringe. Then Dandy's cannula is replaced by silastic drainage tube (3.5 mm in diameter), and 6,000 Units of Urokinase solved in 2 ml of saline is administered to the hematoma cavity. Dissolved hematoma is aspirated every 24 hours until the most of the hematoma is evacuated. We operated three cases of cerebellar hematoma by this method with favorable results. Advantages of this method are as follows: Operative invasion is minimal; The surgeon can check the residual hematoma and position of the tip of cannula even at operation, if necessary. PMID:3900786

Niizuma, H; Ohtsuki, T; Ohyama, H; Suzuki, J

1985-07-01

352

Hematomas intracerebral espontâneos estudo de 121 casos / Spontaneous intracerebral haematomas: a study of 121 cases  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Foram analisados retrospectivamente 121 pacientes com hematomas intracerebrais espontâneos (HIE): com média de idade de 53,4 ±14,8 anos, 62,8% do sexo masculino, tempo médio de sangramento na admissão de 36 horas (3 horas a 12 dias); 63,5% estavam acima de 7 na escala de Glasgow e 81,9% com grau igu [...] al ou maior que 3 na escala de Botterel. Os HIE eram: em gânglios da base em 45,5%, multilobares em 14,7%, lobares em 22,8%, no tronco cerebral em 4% e cerebelares em 2%. Seus diâmetros médios eram de 46,6 mm (16 a 33) e a área média de 1422,9 mm2 (60 a 4818). O LCR em 67 casos revelou pressão inicial média de 234 mmH20 (30 a 700) e concentrarão proteica média de 416,9 mg/dl (30 a 1960). O tratamento foi conservador em 107 casos e cirúrgico em 14. Sobreviveram 55,8% dos pacientes; a maioria dos que faleceram estava em grau acima de 3 na escala de Boterell e abaixo de 9 na de Glasgow. Houve correlação estatística entre a sobrevida e óbito com a escala de Glasgow e com a de Boterell, paralisia de músculos oculares, déficit motor, sinais de descerebração, broncopneumonia, diâmetro e área do hematoma; não houve relação estatística com uso de dexametasona, antifibrinolítico, anticonvulsivantes e diuréticos. O uso de manitol e a queda da pressão arterial nos primeiros dias tiveram relação com maior mortalidade Dos 14 casos submetidos a cirurgia, 11 faleceram. A principal complicação que levou a óbito foi broncopneumonia. São feitos comentários sobre a patogenia dos HIE, incidência atual, sinais clínicos» localização, tamanho, causas de óbito e tratamento empregado em relação ao prognóstico. Abstract in english Results are reported on the study of 121 patients commited by spontaneous intracerebral haematomas (HIE): mean age 53.4 years, 62.8% males, mean admission time of 36 hours (3 hours to 12 days) from onset; 63.5% were graded over 7 in the Glasgow scale and 81.9% were graded 3 or over in the Boterell s [...] cale. The HIE location was 45.5% in the basal ganglia, multilobar in 14.7%, lobar in 22.8%, brain stem in 4%, and cerebelum in 2%. The mean diameter was 46.6 mm (16-93) and mean area was 1422.9 mm2 (60-4818). CSF in 67 cases showed mean opening pressure of 234 mmH20 and mean protein content of 416.9 mg/dl. Treatment was conservative in 107 cases and surgical in 14; 55.8% cases survived. The majority of patients who died were graded 3 in the Boterell scale and below 9 in the Glasgow scale. It was found a statistical correlation between death and: low Glasgow and high Boterell scales grading, motor ocular nerve palsy, motor deficit, decerebration signs, broncopneumonia, large diameter and area of hematomas. No statistical correlation was found regarding survival and treatment with dexametasone, antifibrinolitics, anticonvulsivants, antihypertensive drugs and diuretics. Use of manitol, fall in the systolic blood pressure and surgical therapy increased the mortality rate. From 14 patients who underwent surgical drainage, 11 died. The main complication who lead to death was broncopneumonia. A discussion is made on HIE pathogenesis, localization, present day incidence, clinical findings, death causes, size of hematomas and type of treatment used.

Lineu Cesar, Werneck; Rosana Hermínia, Scola; Leila Elizabeth, Ferraz.

353

Hematoma intracoronário como manifestação de dissecção espontânea de artéria coronária / Intracoronary hematoma as a manifestation of spontaneous coronary artery dissection  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A dissecção espontânea de artéria coronária é um quadro de etiologia ainda não bem esclarecida. Diferentes estudos associam essa entidade a período gestacional, estresse físico, doenças do colágeno e vasculites. Em geral, os pacientes não apresentam os fatores de risco clássicos para doença arterial [...] coronária, o que torna obrigatória a suspeita dessa afecção, especialmente em adultos jovens com síndrome coronária aguda. Neste artigo relatamos o caso de paciente do sexo feminino, de 38 anos de idade, com síndrome coronária aguda sem supradesnivelamento do segmento ST e hematoma intracoronário sem dissecção aparente, diagnosticado pelo ultrassom intracoronário, em artéria coronária direita. Não existe, até o presente momento, consenso quanto à melhor forma de tratamento nesses casos. Abstract in english The etiology of spontaneous coronary artery dissection has not been well clarified. Different studies associate it to pregnancy, physical stress, collagen diseases and vasculitis. In general, patients do not have the classic risk factors for coronary artery disease, which makes mandatory the suspici [...] on of this condition, especially in young adults with acute coronary syndromes. We report the case of a 38-year-old female with non-ST segment elevation acute coronary syndrome and intracoronary hematoma with no apparent dissection, diagnosed by intravascular ultrasound, in the right coronary artery. There is no consensus so far on the best way to treat these cases.

Felipe, Maia; César, Medeiros; Cláudia, Matos; Leonardo, Duarte; Jacqueline Sampaio dos, Santos; Denilsom C., Albuquerque; Miguel A. N., Rati.

354

Hematoma subdural intracraniano: uma rara complicação após raquianestesia: relato de caso / Intracranial subdural hematoma: a rare complication following spinal anesthesia: case report / Hematoma subdural intracraneal: una rara complicación después de la raquianestesia: relato de caso  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese JUSTIFICATIVA E OBJETIVOS: O hematoma subdural intracraniano é uma complicação rara após raquianestesia. O diagnóstico é muitas vezes difícil porque os sintomas iniciais são os mesmos da cefaleia pós-punção da dura-máter. O objetivo é relatar o caso de um hematoma subdural diag nosticado precocement [...] e, após uma raquianestesia realizada com agulha de calibre fino e punção única. RELATO DO CASO: Paciente de 48 anos, ASA I, submetida a raquianestesia para cirurgia de correção de incontinência urinária. Foi realizada a raquianestesia com agulha 27G Quincke e punção única. A cirurgia foi sem intercorrências, e a paciente recebeu alta hospitalar. Após 48 horas da punção raquidiana, a paciente relatou cefaleia de início súbito, de forte intensidade, acometendo principalmente a região orbitária, mas também a região temporal, com melhora importante no decúbito dorsal e acompanhada de dois episódios de vômitos. Foi solicitada tomografia de crânio que revelou a presença de um hematoma subdural agudo frontotemporoparietal esquerdo. Foi indicado tratamento conservador com analgésicos, dexametasoma e hidantoína. Após 17 dias, apresentou quadro de cefaleia intensa, acompanhada de dormência e paresia do membro superior direito, e distúrbio da fala e comportamento. O hematoma foi drenado cirurgicamente. A paciente evoluiu bem sem sequelas. CONCLUSÕES: A cefaleia é a complicação mais frequente após raquianestesia e é considerada de evolução benigna. Faz com que diagnósticos potencialmente fatais, como o hematoma subdural, não sejam feitos em muitos casos, ou sejam tardios. Este caso descreve uma ocorrência rara, um hematoma subdural agudo após uma raquianestesia com agulha fina em uma paciente sem fatores de risco para sangramento Abstract in spanish JUSTIFICATIVA Y OBJETIVOS: El hematoma subdural intracraneal es una complicación rara posterior a la raquianestesia. El diagnóstico es en muchas ocasiones difícil, porque los síntomas iniciales son los mismos de la cefalea postpunción de la duramadre. El objetivo de este estudio, es relatar el caso [...] de un hematoma subdural diagnosticado rápidamente, y posterior a una raquianestesia realizada con una aguja de calibre fino y punción única. RELATO DEL CASO: Paciente de 48 años, ASA I, sometida a la raquianestesia para la cirugía de corrección de incontinencia urinaria. Fue realizada la raquianestesia con una aguja 27G Quincke y una punción única. La cirugía transcurrió sin problemas, y la paciente recibió alta. Después de 48 horas de efectuada la punción raquídea, la paciente relató cefalea de inicio súbito, de fuerte intensidad, afectando principalmente la región orbitaria, pero también la región temporal, con una mejoría importante en el decúbito dorsal, y acompañada de dos episodios de vómitos. Se le solicitó la tomografía de cráneo que arrojó un hematoma subdural agudo frontotemporoparietal izquierdo. Fue indicado un tratamiento conservador con analgésicos, dexametasoma e hidantoína. Después de 17 días, debutó con un cuadro de cefalea intensa, seguida de adormecimiento y paresia del miembro superior derecho, y un disturbio del habla y del comportamiento. El hematoma fue drenado quirúrgicamente. La paciente evolucionó bien y sin secuelas. CONCLUSIONES: La cefalea es la complicación más frecuente después de la raquianestesia y se le considera de evolución benigna. Ella logra que diagnósticos potencialmente fatales, como el hematoma subdural, se eviten en muchos casos o se hagan más tarde. Este caso describe una aparición rara, un hematoma subdural agudo posterior a una raquianestesia con una aguja fina en una paciente sin factores de riesgo para el sangramiento Abstract in english BACKGROUND AND OBJECTIVES: Intracranial subdural hematoma is a rare complication following spinal anesthesia. The diagnosis is usually difficult because initial symptoms are the same of post-dural puncture headache. The objecti

Flora Margarida Barra, Bisinotto; Roberto Alexandre, Dezena; Daniel Capucci, Fabri; Tania Mara Vilela, Abud; Livia Helena, Canno.

355

Craneotomía limitada para el tratamiento de los hematomas traumáticos agudos en el adulto mayor / Limited craniotomy as treatment of acute traumatic hematoma in the elderly  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Fundamento: el tratamiento quirúrgico de los hematomas yuxtadurales traumáticos en el adulto mayor es un tema complejo y controversial por la elevada mortalidad que lo acompaña. Objetivo: presentar los resultados preliminares de la aplicación de la craneotomía limitada para la evacuación de los hema [...] tomas yuxtadurales traumáticos agudos en el adulto mayor. Método: estudio descriptivo de los resultados del tratamiento quirúrgico de los hematomas yuxtadurales traumáticos agudos en 19 pacientes con 60 años y más, atendidos por el Servicio de Neurocirugía del Hospital Universitario Manuel Ascunce Domenech, en el período de enero de 2008 a diciembre de 2010. Resultados: en 17 pacientes la Tomografía Axial Computarizada de cráneo mostró la presencia de hematomas subdurales agudos hemisféricos. El 58.8 % de los pacientes con hematoma subdural agudo y el 100 % con hematomas intracerebrales fallecieron. Se realizaron 18 craneotomías limitadas, logró sobrevivir el 39 % de los pacientes. Conclusiones: la realización de la craneotomía limitada para la evacuación de este tipo de lesiones primarias, en esta serie, mostró resultados alentadores, poco menos de la mitad de los pacientes lograron sobrevivir con buen pronóstico por lo que se considera es una opción terapéutica a tener en cuenta pendiente de evaluar sus resultados en futuras investigaciones. Abstract in english The surgical treatment of traumatic hematomas in the elderly is a complex and controversial topic due to its associated high mortality rate. Objective: the purpose of this article is to present the preliminary findings on the use of limited craniotomy for the evacuation acute juxtadural traumatic he [...] matomas in the elderly. Method: a descriptive study on the surgical treatment results of acute juxtadural traumatic hematomas was conducted involving 19 elderly patients of 60 years and over treated in the Neurosurgical service at the University Hospital “Manuel Ascunce Domenech” from January 2008 to December 2010. Results: CAT scan results revealed the presence of acute hemispheric subdural hematomas in 17 patients. The 58,8 % of patients diagnosed with acute subdural hematoma as well as the 100 % of those with intracerebral hematomas died. Eighteen limited craniotomies were performed with a 39 % survival rate. Conclusion: this research reveals promising preliminary results for limited craniotomy as the treatment of choice for these primary lesions, owing to the fact that close to 40 % of patients who had this treatment survived with good prognosis what is considered as a therapeutic option pending to assess its results in future research.

Gretel, Mosquera Betancourt; Ariel, Varela Hernández; Denis, Suárez Monné; Yanmara, Bethartes Sotomayor.

356

Hematoma subdural crónico asociado a quiste aracnoideo: Presentación de 12 casos / Chronic subdural hematoma associated with arachnoid cyst: Report of 12 cases  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivos. Analizar las características clínicas, neurológicas y resultado neurorradiológico de una serie de pacientes con quiste aracnoideo asociado a un hematoma subdural crónico. Pacientes y método. Revisamos retrospectivamente 12 casos de pacientes con quiste aracnoideo que presentaron como comp [...] licación un hematoma subdural crónico. Resultados. Entre enero de 1984 y abril de 2008, 12 pacientes (0.9%) de 1.253 casos con hematoma subdural crónico presentaban un quiste aracnoideo intracraneal. La localización de los quistes fue en 10 casos en la fosa temporal y los otros dos en la convexidad. Los síntomas de presentación fueron cefalea en 6 pacientes (50%), seguidos por convulsiones (3 casos). En once pacientes se realizó agujero de trépano y drenaje del HSC, la paciente de más edad fue tratada de forma conservadora. Únicamente se trataron 3 quistes aracnoideos mediante craneotomía y fenestración, con resolución completa del quiste. Conclusiones. Los pacientes con quiste aracnoideo, sobre todo si esta localizado en la fosa temporal, tienen un mayor riesgo de sufrir un hematoma subdural crónico. La primera opción terapéutica es el drenaje del hematoma subdural y si persiste la sintomatología deberá tratarse el quiste aracnoideo. Abstract in english Introduction. We designed this study to investigate the clinical, neurological, and radiological outcome of patients with chronic subdural hematoma related to an intracranial arachnoid cysts. Patients and methods. Medical records of 12 cases of patients with arachnoids cyst complicated with chronic [...] subdural hematoma were retrospectively reviewed. Results. Between January 1984 and April 2008, 12 patients (0.9%) of 1.253 cases of chronic subdural hematoma surgically treated in our hospital had associated arachnoid cyst. Arachnoid cysts were located in the middle fossa (10 cases) and convexity (2 cases). The most frequent symptom was headache (6 cases), followed by seizures (3 cases). Eleven patients underwent burr hole and drainage; the oldest patient was treated conservatively. Conclusions. Patients with AC, especially when these are located in temporal fossa, appear to harbour a life-long risk of contracting subdural hematoma. Hematoma evacuation is adequate at first operation and if arachnoid cyst is symptomatic or preoperative symptoms persist, additional arachnoid cyst surgery should be considered.

M., Gelabert-González; D., Castro-Bouzas; A., Arcos-Algaba; J.M., Santín-Amo; L., Díaz-Cabanas; R., Serramito-García; E., Arán-Echabe; A., Prieto-González; A., García-Allut.

357

Hematoma retroesofágico com grave disfagia após estreptoquinase para tratamento da trombose venosa axilo-subclávia Severe dysfagia due to retroesophageal hematoma after thrombolytic therapy for right axillosubclavian vein thrombosis  

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Full Text Available Homem de 72 anos, portador de neoplasia de próstata estádio IV, submetido à osteossíntese da coluna cervical para descompressão metastática da raiz nervosa, responsável por dor intensa no membro superior direito. Após três meses da internação, apresentou trombose total da veia axilo-subclávia direita, complicação da cateterização prolongada da veia subclávia direita para controle de septicemia secundária a pneumonia hospitalar. Foi submetido a terapia trombolítica com estreptoquinase por via venosa, no membro superior contra-lateral, na dose de 250.000UI em 15min, seguida de 100.000UI/h durante cinco dias, com total recanalização do trombo e redução do edema. Após 24h do término da trombólise, apresentou disfagia a líquidos e o esofagograma mostrou extensa compressão extrínseca do esôfago, por provável hematoma retroesofágico. Necessitou de nutrição enteral durante três meses, quando ocorreu normalização da deglutição, reabsorção do hematoma retroesofágico e passagem adequada do contraste pelo esôfago. No seguimento evolutivo não apresentou seqüelas da trombose venosa profunda, não tem disfagia e permaneceu em uso profilático de meias elásticas e heparina de baixo peso molecular.We report the case of a 72 year-old man with advanced, stage IV, prostate cancer who underwent osteosynthesis of the cervical spine for nerve root decompression due to metastasis which was causing severe pain in his right upper limb. After three months in the hospital, he developed occlusive thrombosis of the right axillosubclavian vein as a complication of prolonged catheterization of the right subclavian vein for treatment of septicemia secondary to a hospital acquired pneumonia. The patient received thrombolytic therapy with IV streptokinase in the contralateral arm in the following dosage: 250,000 units in 15 minutes followed by 100,000 units per hour during five days. This led to total recanalization of the thrombus, with significant reduction of the arm edema. Twenty-four hours after the end of the thrombolytic therapy, the patient started to complain of dysfagia to solids and liquids and a contrasted esophagogram revealed extensive extrinsic compression of the esophagus due to a probable retroesophageal hematoma. The patient required enteral nutrition via nasoenteral tube during three months after which swallowing returned to normal and a repeat upper GI series confirmed that the hematoma had been reabsorbed, with normal passage of contrast through the esophagus. On late follow-up, the patient did not show evidence of any sequelae of deep venous thrombosis nor any residual dysfagia and is currently in use of elastic stockings and low molecular weight heparin.

Antonio Claudio do Amaral Baruzzi

1997-08-01

358

Hematoma retroesofágico com grave disfagia após estreptoquinase para tratamento da trombose venosa axilo-subclávia / Severe dysfagia due to retroesophageal hematoma after thrombolytic therapy for right axillosubclavian vein thrombosis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Homem de 72 anos, portador de neoplasia de próstata estádio IV, submetido à osteossíntese da coluna cervical para descompressão metastática da raiz nervosa, responsável por dor intensa no membro superior direito. Após três meses da internação, apresentou trombose total da veia axilo-subclávia direit [...] a, complicação da cateterização prolongada da veia subclávia direita para controle de septicemia secundária a pneumonia hospitalar. Foi submetido a terapia trombolítica com estreptoquinase por via venosa, no membro superior contra-lateral, na dose de 250.000UI em 15min, seguida de 100.000UI/h durante cinco dias, com total recanalização do trombo e redução do edema. Após 24h do término da trombólise, apresentou disfagia a líquidos e o esofagograma mostrou extensa compressão extrínseca do esôfago, por provável hematoma retroesofágico. Necessitou de nutrição enteral durante três meses, quando ocorreu normalização da deglutição, reabsorção do hematoma retroesofágico e passagem adequada do contraste pelo esôfago. No seguimento evolutivo não apresentou seqüelas da trombose venosa profunda, não tem disfagia e permaneceu em uso profilático de meias elásticas e heparina de baixo peso molecular. Abstract in english We report the case of a 72 year-old man with advanced, stage IV, prostate cancer who underwent osteosynthesis of the cervical spine for nerve root decompression due to metastasis which was causing severe pain in his right upper limb. After three months in the hospital, he developed occlusive thrombo [...] sis of the right axillosubclavian vein as a complication of prolonged catheterization of the right subclavian vein for treatment of septicemia secondary to a hospital acquired pneumonia. The patient received thrombolytic therapy with IV streptokinase in the contralateral arm in the following dosage: 250,000 units in 15 minutes followed by 100,000 units per hour during five days. This led to total recanalization of the thrombus, with significant reduction of the arm edema. Twenty-four hours after the end of the thrombolytic therapy, the patient started to complain of dysfagia to solids and liquids and a contrasted esophagogram revealed extensive extrinsic compression of the esophagus due to a probable retroesophageal hematoma. The patient required enteral nutrition via nasoenteral tube during three months after which swallowing returned to normal and a repeat upper GI series confirmed that the hematoma had been reabsorbed, with normal passage of contrast through the esophagus. On late follow-up, the patient did not show evidence of any sequelae of deep venous thrombosis nor any residual dysfagia and is currently in use of elastic stockings and low molecular weight heparin.

Antonio Claudio do Amaral, Baruzzi; Maria Emília Cardoso, Gadelha; Claudio, Cirenza; Elias, Knobel.

359

Hematoma del cordón umbilical: a propósito de un caso interesante Umbilical cord hematoma: an interesting case  

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Full Text Available Se presenta el caso de un recién nacido que presentó tumoración del cordón umbilical, de 3 x 4 cm, coloración rojo violácea, consistencia blanda, no dolorosa, a 1 cm de la pared abdominal. En su evolución se observó disminución gradual de tamaño, sangramiento escaso y como complicación se presentó un granuloma umbilical, con retardo en la caída del cordón (21 días. A los 45 días de edad el ombligo estaba normal. Se realiza una caracterización clínica de la patología y se ofrece una revisión actualizada sobre el tema.Authors present the case of a newborn presenting a 3 x 4 cm umbilical cord tumor of red-violet color, soft consistency and painless located at 1 cm of abdominal wall. During its evolution there was a gradual decrease size, low bleeding, and as a complication the presence of an umbilical granuloma and delay of fall cord (21 days. At 45 days the navel was normal. We performed a clinical catheterization of the pathology and also offer updated review on this matter.

Angelicia Crespo Campos

2009-06-01

360

Hematoma del cordón umbilical: a propósito de un caso interesante / Umbilical cord hematoma: an interesting case  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se presenta el caso de un recién nacido que presentó tumoración del cordón umbilical, de 3 x 4 cm, coloración rojo violácea, consistencia blanda, no dolorosa, a 1 cm de la pared abdominal. En su evolución se observó disminución gradual de tamaño, sangramiento escaso y como complicación se presentó u [...] n granuloma umbilical, con retardo en la caída del cordón (21 días). A los 45 días de edad el ombligo estaba normal. Se realiza una caracterización clínica de la patología y se ofrece una revisión actualizada sobre el tema. Abstract in english Authors present the case of a newborn presenting a 3 x 4 cm umbilical cord tumor of red-violet color, soft consistency and painless located at 1 cm of abdominal wall. During its evolution there was a gradual decrease size, low bleeding, and as a complication the presence of an umbilical granuloma an [...] d delay of fall cord (21 days). At 45 days the navel was normal. We performed a clinical catheterization of the pathology and also offer updated review on this matter.

Angelicia, Crespo Campos; Yanett, Sarmiento Portal; Martha Caridad, Valdés Díaz; Nuvia, Suárez García.

 
 
 
 
361

Altered chloroplast development and delayed fruit ripening caused by mutations in a zinc metalloprotease at the lutescent2 locus of tomato.  

Science.gov (United States)

The chloroplast is the site of photosynthesis in higher plants but also functions as the center of synthesis for primary and specialized metabolites including amino acids, fatty acids, starch, and diverse isoprenoids. Mutants that disrupt aspects of chloroplast function represent valuable tools for defining structural and biochemical regulation of the chloroplast and its interplay with whole-plant structure and function. The lutescent1 (l1) and l2 mutants of tomato (Solanum lycopersicum) possess a range of chlorophyll-deficient phenotypes including reduced rates of chlorophyll synthesis during deetiolation and enhanced rates of chlorophyll loss in leaves and fruits as they age, particularly in response to high-light stress and darkness. In addition, the onset of fruit ripening is delayed in lutescent mutants by approximately 1 week although once ripening is initiated they ripen at a normal rate and accumulation of carotenoids is not impaired. The l2 locus was mapped to the long arm of chromosome 10 and positional cloning revealed the existence of a premature stop codon in a chloroplast-targeted zinc metalloprotease of the M50 family that is homologous to the Arabidopsis (Arabidopsis thaliana) gene ETHYLENE-DEPENDENT GRAVITROPISM DEFICIENT AND YELLOW-GREEN1. Screening of tomato germplasm identified two additional l2 mutant alleles. This study suggests a role for the chloroplast in mediating the onset of fruit ripening in tomato and indicates that chromoplast development in fruit does not depend on functional chloroplasts. PMID:22623517

Barry, Cornelius S; Aldridge, Georgina M; Herzog, Gal; Ma, Qian; McQuinn, Ryan P; Hirschberg, Joseph; Giovannoni, James J

2012-07-01

362

Importance of computerized tomography for surgical treatment of intracranial hematomas  

International Nuclear Information System (INIS)

The improved treatment by using computerized tomography (CT) located operating theater and intensive care unit is reported in comparison of 3,382 patients with severe head injuries. By preoperative use of CT the frequency of diagnosed hermatomas was about the same (29.5% before CT; 27.0% with CT) but the preoperative diagnosed multiple hematomas were much more frequent (14.0% resp. 27.0%). The most important advantage however is the saving of time by CT in this localisation by which the chance of survival has increased from 54% to 69%. Without any doubt everywhere in neurotraumatology the CT should be situated as near as possible to the intensive care unit and to the operating theater and should be available 24 hours a day. (Author)

1982-01-01

363

[Non-surgical forms of cerebellar hematoma (author's transl)].  

Science.gov (United States)

Spontaneous cerebellar hemorrhage is a significant clinical entity because of its important incidence (more than 10 percent of intracranial hemorrhages) and its therapeutic possibilities. The diagnosis of this condition is difficult, but at the presnet time the Emi-scanner easily confirms the diagnosis. The surgical treatment was up until recently the only possible therapeutic approach, and it has been indiscriminately applied to all patients because of the high mortiality rate of this condition (80 percent). Two hypertensive patients who presented spontaneous cerebellar hematomas, verified by the scanner, were not submitted to surgery and both recovered spontaneously without sequelae. The existence of non-surgical forms of spontaneous cerebellar hemorrhage is discussed. Special attention is placed upon the variations in the level of consciousness and the presence or absence of acute hydrocephalus in the scanner in order to indicate the convenience of a surgical procedure. PMID:7366272

Jiménez García, M; Galdós Alcelay, L; Feijoo de Freixo, M

1980-02-10

364

Spontaneous perforation of an intramural rectal hematoma: Report of a case  

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Spontaneous hematomas are rare and most occur secondary to hematologic disorders or during anticoagulant therapy. Most spontaneous hematomas occur above the sigmoid colon, and rarely in the rectum. Herein we present the case of a patient with a spontaneous perforating hematoma of the rectum who presented with severe abdominal pain after a bloody stool. The hemoglobin level decreased by 33 g/L within 20 h. An abdominal sonogram showed a hydrops in the lower abdomen with a maximum depth of 7.0 ...

Zhu-Lin Li; Zhen-Jun Wang; Jia-Gang Han

2012-01-01

365

Detection and management of spontaneous intramural small bowel hematoma secondary to anticoagulant therapy.  

Science.gov (United States)

Intestinal hematoma, once considered a rare complication of anticoagulation, has recently been increasingly reported. Spontaneous small bowel hematomas most commonly involve the jejunum, followed by the ileum and duodenum. They occur in patients who receive excessive anticoagulation with vitamin K antagonists or who have additional risk factors for bleeding. Diagnosis can be readily identified with sonography and confirmed with computed tomography. Early diagnosis is crucial as most patients can be treated successfully without surgery. Conservative treatment is recommended for intramural intestinal hematomas, when other associated complications needing laparotomy have been excluded. PMID:23061706

Abdel Samie, Ahmed; Theilmann, Lorenz

2012-09-01

366

MR imaging of epidural hematoma in the lumbar spine  

International Nuclear Information System (INIS)

To bring attention to the MR imaging appearance of epidural hematoma (EDH) in the lumbar spine as a small mass often associated with disk herniation or an acute event. This paper will show our experience with this entity and describe criteria for its MR imaging appearance. Design and patients. Thirteen cases of prospectively diagnosed EDH of the lumbar spine were compared with 12 cases of prospectively diagnosed prominent epidural extrusion. Our criteria were retrospectively evaluated by the two authors for their presence or absence in each case. The chi-square test for nominal data was applied. MR imaging criteria utilized to distinguish EDH from disk herniation at our institution include: (1) signal different from disk, (2) high signal on T1-weighted images, either centrally or peripherally, (3) teardrop- or egg-shaped mass, in the sagittal plane, (4) size greater than half the vertebral body height in a craniocaudal dimension, (5) primarily retrosomatic epidural location, (6) plasticity - the mass is seen to conform closely to the contours of bone (e.g., in the lateral recess), (7) little or no disk space narrowing unless associated with disc herniation. Chi-square analysis demonstrated each criterion to significantly differentiate between EDH and extrusion. Only six of 13 EDH cases went to surgery in spite of their relatively large size. Two of six patients were diagnosed as having epidural clot consistent with hematoma at the time of surgery. The four patients who were not diagnosed at surgery revealed only small disk herniations or fragments of disk. The occurrence of EDH is more frequent than previously suspected. Spontaneous EDH is frequently associated with disk herniation and acute events such as sneezing or coughing. Most cases of spontaneous EDH will resolve prior to surgery with only the minority becoming chronic in order to be seen at surgery as an encapsulated mass. MR imaging can reliably identify EDH and distinguish between EDH and large disk extrusions. (orig.)

2002-12-01

367

Recurrent spontaneous breast hematoma: report of a case and review of the literature Hematoma espontâneo recorrente de mama: revisão da literatura e relato de caso  

Directory of Open Access Journals (Sweden)

Full Text Available BACKGROUND: Breast hematomas are common after traumas, surgeries, or contusions. They are rarely spontaneous, but they can occur spontaneously in patients with hematologic disease or with coagulation disorders. MATERIAL AND METHODS: The authors report a clinical case of a 48-year-old female with a 27-year history of paroxysmal nocturnal hemoglobinuria who underwent mammography screening because of a painless palpable moveable node in the upper inner quadrant of the right breast. RESULTS: Mammography showed a partially defined heterogeneous node of 35 mm without microcalcifications in the upper inner quadrant of the right breast which, associated with the clinical features, seemed to be an hematoma. Further mammography and ultrasound after 45 days showed retrocession of the lesion, and another mammography obtained after 60 days was normal. Seventy-five days after the first episode, the patient complained of another node with a skin bruise in the upper outer quadrant of the same breast, which seemed to be a recurrent hematoma. Two months later the mammography obtained was normal. CONCLUSION: Breast hematoma must be thought of as a differential diagnosis for a breast node, regardless of previous trauma or hematologic disorders.OBJETIVO: Os hematomas de mama são comuns após traumatismo, cirurgias ou contusões. Raramente são espontâneos, podendo ocorrer em pacientes com doença hematológica ou outras doenças associadas a distúrbios da coagulação sangüínea. MATERIAL E MÉTODOS: Os autores relatam o caso de paciente feminina, 48 anos, com diagnóstico e acompanhamento de Hemoglobinúria paroxística noturna há 27 anos, submetida a mamografia por apresentar em consulta de rotina nódulo palpável em quadrante superior interno (QSI da mama direita, móvel e indolor. RESULTADOS: A mamografia evidenciou nódulo heterogêneo, de 35 mm, em QSI da mama direita, de contorno parcialmente delimitado, sem microcalcificações, que correlacionado com a história clínica, sugeria o diagnóstico de hematoma. O controle evolutivo com mamografia e ecografia, após 45 dias mostrou substancial regressão da lesão e novo exame após 60 dias foi normal. Decorridos 75 dias do primeiro episódio, a paciente apresentou outro nódulo, agora associado a hematoma cutâneo, em quadrante superior externo da mesma mama, interpretado como novo hematoma. O controle clínico após dois meses do segundo episódio foi normal. CONCLUSÕES: A hipótese de hematoma deve ser considerada no diagnóstico diferencial de nódulo mamário, com ou sem história de trauma ou doença sistêmica associada.

Marilu Stimamiglio Kanegusuku

2001-12-01

368

Recurrent spontaneous breast hematoma: report of a case and review of the literature / Hematoma espontâneo recorrente de mama: revisão da literatura e relato de caso  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese OBJETIVO: Os hematomas de mama são comuns após traumatismo, cirurgias ou contusões. Raramente são espontâneos, podendo ocorrer em pacientes com doença hematológica ou outras doenças associadas a distúrbios da coagulação sangüínea. MATERIAL E MÉTODOS: Os autores relatam o caso de paciente feminina, 4 [...] 8 anos, com diagnóstico e acompanhamento de Hemoglobinúria paroxística noturna há 27 anos, submetida a mamografia por apresentar em consulta de rotina nódulo palpável em quadrante superior interno (QSI ) da mama direita, móvel e indolor. RESULTADOS: A mamografia evidenciou nódulo heterogêneo, de 35 mm, em QSI da mama direita, de contorno parcialmente delimitado, sem microcalcificações, que correlacionado com a história clínica, sugeria o diagnóstico de hematoma. O controle evolutivo com mamografia e ecografia, após 45 dias mostrou substancial regressão da lesão e novo exame após 60 dias foi normal. Decorridos 75 dias do primeiro episódio, a paciente apresentou outro nódulo, agora associado a hematoma cutâneo, em quadrante superior externo da mesma mama, interpretado como novo hematoma. O controle clínico após dois meses do segundo episódio foi normal. CONCLUSÕES: A hipótese de hematoma deve ser considerada no diagnóstico diferencial de nódulo mamário, com ou sem história de trauma ou doença sistêmica associada. Abstract in english BACKGROUND: Breast hematomas are common after traumas, surgeries, or contusions. They are rarely spontaneous, but they can occur spontaneously in patients with hematologic disease or with coagulation disorders. MATERIAL AND METHODS: The authors report a clinical case of a 48-year-old female with a 2 [...] 7-year history of paroxysmal nocturnal hemoglobinuria who underwent mammography screening because of a painless palpable moveable node in the upper inner quadrant of the right breast. RESULTS: Mammography showed a partially defined heterogeneous node of 35 mm without microcalcifications in the upper inner quadrant of the right breast which, associated with the clinical features, seemed to be an hematoma. Further mammography and ultrasound after 45 days showed retrocession of the lesion, and another mammography obtained after 60 days was normal. Seventy-five days after the first episode, the patient complained of another node with a skin bruise in the upper outer quadrant of the same breast, which seemed to be a recurrent hematoma. Two months later the mammography obtained was normal. CONCLUSION: Breast hematoma must be thought of as a differential diagnosis for a breast node, regardless of previous trauma or hematologic disorders.

Kanegusuku, Marilu Stimamiglio; Rodrigues, Dirceu; Urban, Linei Augusta B. Dellê; Romanus, Alexandre Bossmann; Pimenta, Rodrigo Peres; Assis, Michelle Gusmão de; Ferrari, Karla Alessandra.

369

Retroplacental hematoma associated to tubo ovarian abscess in 23 weeks of pregnancy. A case report. Hematoma retroplacentario asociado con absceso tubovárico en embarazo de 23 semanas. Reporte de un caso.  

Directory of Open Access Journals (Sweden)

Full Text Available A 30 year-old female patient with 23 weeks of pregnancy and with asthma antecedent is presented. She had treatment with bronchodilators. She came to the provincial medical emergency centre due to an intense pain with a sudden appearance in the lower abdomen, vomiting, shortness of breath, and sweating. The presence of a retroplacental hematoma caused due to a tubo-ovarian abscess associated to an abdominal peritonitis was corroborated. The way in which the disease was manifested and evolved is described.

Se presenta el caso de una paciente de 30 años, con edad gestacional de 23 semanas y antecedentes de asma bronquial para lo cual llevaba tratamiento con broncodilatadores. Acude al centro provincial de emergencia médica por presentar dolor de aparición súbita e intenso en bajo vientre, vómitos con restos de alimentos, falta de aire y sudoraciones. Se comprobó la presencia de un hematoma retroplacentario causado por un absceso tubovárico asociado a una peritonitis abdominal. Se describe la forma en que se manifestó la enfermedad y su evolución.

Alberto Jorge Fernández

370

#FakeNobelDelayReasons  

CERN Document Server

Tuesday’s hour-long delay of the Nobel Prize in Physics announcement was (and still is) quite the cause for speculation. But on the Twittersphere, it was simply the catalyst for some fantastic puns, so-bad-they're-good physics jokes and other shenanigans. Here are some of our favourite #FakeNobelDelayReasons.    

2013-01-01

371

Scintigraphic demonstration of intracranial communication between arachnoid cyst and associated subdural hematoma  

Energy Technology Data Exchange (ETDEWEB)

An arachnoid cyst found to have a communication to an associated subdural hematoma was demonstrated with the Tc-99m DTPA brain scintigraphy. Although arachnoid cysts are known to be silent, when a patient with an arachnoid cyst develops signs of increased intracranial pressure or neurological deficits, the presence of a complication, including subdural hematoma, intracystic hemorrhage or subdural hygroma, is highly suspected. In the present case, the patient with an arachnoid cyst had a subdural hematoma following minor head injury. Tc-99m DTPA brain scintigraphy showed abnormal accumulation of the tracer not only in the hematoma but in the arachnoid cyst. This observation suggested communication of the two lesions, which was confirmed at surgery.

Yokoyama, K.; Tonami, N.; Kimura, M.; Kinoshita, A.; Aburano, T.; Hisada, K.

1989-05-01

372

Scintigraphic demonstration of intracranial communication between arachnoid cyst and associated subdural hematoma  

International Nuclear Information System (INIS)

An arachnoid cyst found to have a communication to an associated subdural hematoma was demonstrated with the Tc-99m DTPA brain scintigraphy. Although arachnoid cysts are known to be silent, when a patient with an arachnoid cyst develops signs of increased intracranial pressure or neurological deficits, the presence of a complication, including subdural hematoma, intracystic hemorrhage or subdural hygroma, is highly suspected. In the present case, the patient with an arachnoid cyst had a subdural hematoma following minor head injury. Tc-99m DTPA brain scintigraphy showed abnormal accumulation of the tracer not only in the hematoma but in the arachnoid cyst. This observation suggested communication of the two lesions, which was confirmed at surgery

1989-01-01

373

A case of dural arteriovenous fistula presenting as acute subdural hematoma.  

Science.gov (United States)

Dural arteriovenous fistula (AVF) presenting with subdural hematoma is relatively rare. We report a case of dural AVF presenting as acute subdural hematoma (ASDH) and provide a review of the literature. A 56-year-old man presented with disturbance of consciousness. Computed tomography demonstrated a right ASDH and a small right occipital subcortical hematoma. Cerebral angiography showed a dural AVF on the occipital convexity draining into the cortical veins. Emergent endovascular embolization was immediately performed and the shunt flow disappeared. Hematoma removal and external decompression were safely conducted. Combined therapy successfully recovered the patient's consciousness level. This rare case of dural AVF presenting with ASDH was treated with combined treatments of endovascular and open surgery. PMID:24926261

Saito, Atsushi; Kawaguchi, Tomohiro; Sasaki, Tatsuya; Nishijima, Michiharu

2014-01-01

374

Compression syndrome of the inferior caval vein by intraabdominal hematomas following reanimation  

International Nuclear Information System (INIS)

The case report describes the diagnostic imaging of intrahepatic hematomas with caval compression and thrombosis, in particular the function of sonography, computed tomography and digital substraction angiography. Differential diagnosis and therapy are discussed. (orig.)

1986-01-01

375

Compression syndrome of the inferior caval vein by intraabdominal hematomas following reanimation  

Energy Technology Data Exchange (ETDEWEB)

The case report describes the diagnostic imaging of intrahepatic hematomas with caval compression and thrombosis, in particular the function of sonography, computed tomography and digital substraction angiography. Differential diagnosis and therapy are discussed.

Meents, H.; Steinhaeuser, U.

1986-06-01

376

Clinical evaluation of CT-guided stereotaxic evacuation of hypertensive intracerebral hematomas  

Energy Technology Data Exchange (ETDEWEB)

The clinical results of CT-guided stereotaxic evacuation of hypertensive intracerebral hematomas which had been done in our department during the last 16 months were evaluated. They included 18 cases; 8 of thalamic, 9 of putaminal and one of cerebellar hematoma. The patients were 11 males and 7 females, with an average age of 57. The time interval from oneset to surgery was 1-21 days, 9.5 days on average. The hematoma volume estimated on a CT scan was 6-35 ml and the average rate of hematoma removal by surgery was 75%. Intraoperative monitoring with ultrasonography and postoperative infusion of Urokinase increased the removal rate. In 14 cases, the mental ability and motor function improved within days after surgery and rehabilitation was started within a short period. However, the recovery in aged people was generally poor. Rebleeding occurred postoperatively in one case, necessitating a subsequent craniotomy. (author).

Kimura, Masato; Yoshinaga, Shiya; Nakayama, Yoshiya; Hirakawa, Toshihiko; Tanaka, Akira; Tomonaga, Masamichi (Fukuoka University Chikushi Hospital (Japan))

1989-09-01

377

Clinical evaluation of CT-guided stereotaxic evacuation of hypertensive intracerebral hematomas  

International Nuclear Information System (INIS)

The clinical results of CT-guided stereotaxic evacuation of hypertensive intracerebral hematomas which had been done in our department during the last 16 months were evaluated. They included 18 cases; 8 of thalamic, 9 of putaminal and one of cerebellar hematoma. The patients were 11 males and 7 females, with an average age of 57. The time interval from oneset to surgery was 1-21 days, 9.5 days on average. The hematoma volume estimated on a CT scan was 6-35 ml and the average rate of hematoma removal by surgery was 75%. Intraoperative monitoring with ultrasonography and postoperative infusion of Urokinase increased the removal rate. In 14 cases, the mental ability and motor function improved within days after surgery and rehabilitation was started within a short period. However, the recovery in aged people was generally poor. Rebleeding occurred postoperatively in one case, necessitating a subsequent craniotomy. (author)

1989-01-01

378

Antiplatelet pretreatment does not increase hematoma volume in experimental intracerebral hemorrhage  

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While oral anticoagulants are associated with greater hematoma expansion and higher mortality rates in patients with intracerebral hemorrhage (ICH), there is ongoing discussion whether pretreatment with antiplatelet drugs also worsens prognosis. Using an experimental model of ICH, we investigated the effects of antiplatelet pretreatment on hematoma volume and functional outcome. CD-1 mice were treated with acetyl-salicylic acid (ASA, 60?mg/kg per 24?hours), clopidogrel (22.5?mg/kg per 2...

Lauer, Arne; Schlunk, Frieder; Cott, Elizabeth M.; Steinmetz, Helmuth; Lo, Eng H.; Foerch, Christian

2011-01-01

379

Evacuación de hematomas intracerebrales mediante vaina endoscópica y vaina transparente. estudio experimental  

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[ES]La evacuación endoscópica se considera una alternativa a la craneotomía convencional en el tratamiento de los hematomas intracerebrales, sobre todo si se localizan en estructuras profundas. La valoración de la eficacia de la técnica y sus modificaciones en el animal experimental es fundamental como paso previo a la introducción en la clínica. Los objetivos del estudio fueron desarrollar en el cerdo un modelo de hematoma intracerebral, valorar la eficacia de la evacuación endoscóp...

2013-01-01

380

Comando volumen de la tomografía axial computadorizada para el pronóstico y tratamiento del hematoma intracraneal postraumático  

Directory of Open Access Journals (Sweden)

Full Text Available Se estudiaron 35 pacientes con hematomas intracraneales postraumáticos desde abril de 1995 a febrero de 1997, que fueron diagnosticados por tomografía axial computadorizada (TAC y a los cuales se le calculó por software con el comando volumen, el volumen de los hematomas. Se comparó el resultado con el volumen medio en el acto quirúrgico, no hubo diferencia estadística. Se analizaron otras variables como: la situación topográfica, localización, desplazamiento de las estructuras de la línea media, estado neurológico del paciente y la técnica quirúrgica utilizada. Se demostró que a mayor volumen del hematoma, el deterioro neurológico fue mayor, así como la mortalidad. Se vio esta relación más marcada en los procesos agudos (48,6 %. La craneotomía demostró ser de más valor que la trepanación simple. Se concluye que el comando volumen de la TAC es un procedimiento de gran confiabilidad en la valoración neurorradiológica, terapéutica y pronóstica de los hematomas intracraneales postraumáticos.35 patients with posttraumatic intracranial hematomas were studied from April, 1995, to February, 1997. These patients were diagnosed by computed axial tomography (CAT and the volumen of the hematomas was calculated by software with the volume command. The result was compared with the average volume during surgery and no statistical difference was observed. Some other variables as the topographic situation, localization, displacement of the structures of the mean line, the neurological status of the patient and the surgical technique used, were analyzed. It was proved that the larger the hematoma volume was the higher the neurological deterioration and mortality were. This relationship was more significant in the acute processes (48.6 %. Craniotomy proved to have more value than simple trepanation. It was concluded that the volume command of the computed axial tomography is a very reliable procedure in the neuroradiological, therapeutic and prognostic assessment of posttraumatic intracranial hematomas.

Tanía García Moreira

2001-03-01

 
 
 
 
381

Comando volumen de la tomografía axial computadorizada para el pronóstico y tratamiento del hematoma intracraneal postraumático  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se estudiaron 35 pacientes con hematomas intracraneales postraumáticos desde abril de 1995 a febrero de 1997, que fueron diagnosticados por tomografía axial computadorizada (TAC) y a los cuales se le calculó por software con el comando volumen, el volumen de los hematomas. Se comparó el resultado co [...] n el volumen medio en el acto quirúrgico, no hubo diferencia estadística. Se analizaron otras variables como: la situación topográfica, localización, desplazamiento de las estructuras de la línea media, estado neurológico del paciente y la técnica quirúrgica utilizada. Se demostró que a mayor volumen del hematoma, el deterioro neurológico fue mayor, así como la mortalidad. Se vio esta relación más marcada en los procesos agudos (48,6 %). La craneotomía demostró ser de más valor que la trepanación simple. Se concluye que el comando volumen de la TAC es un procedimiento de gran confiabilidad en la valoración neurorradiológica, terapéutica y pronóstica de los hematomas intracraneales postraumáticos. Abstract in english 35 patients with posttraumatic intracranial hematomas were studied from April, 1995, to February, 1997. These patients were diagnosed by computed axial tomography (CAT) and the volumen of the hematomas was calculated by software with the volume command. The result was compared with the average volum [...] e during surgery and no statistical difference was observed. Some other variables as the topographic situation, localization, displacement of the structures of the mean line, the neurological status of the patient and the surgical technique used, were analyzed. It was proved that the larger the hematoma volume was the higher the neurological deterioration and mortality were. This relationship was more significant in the acute processes (48.6 %). Craniotomy proved to have more value than simple trepanation. It was concluded that the volume command of the computed axial tomography is a very reliable procedure in the neuroradiological, therapeutic and prognostic assessment of posttraumatic intracranial hematomas.

Tanía, García Moreira; Paula, Rosales Silva; Abel, Andión Arrazola; René, Rodríguez Rivera; Eduardo, Bory Lescaille; Ferriol, Pérez Benítez.

382

Comando volumen de la tomografía axial computadorizada para el pronóstico y tratamiento del hematoma intracraneal postraumático  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Se estudiaron 35 pacientes con hematomas intracraneales postraumáticos desde abril de 1995 a febrero de 1997, que fueron diagnosticados por tomografía axial computadorizada (TAC) y a los cuales se le calculó por software con el comando volumen, el volumen de los hematomas. Se comparó el resultado con el volumen medio en el acto quirúrgico, no hubo diferencia estadística. Se analizaron otras variables como: la situación topográfica, localización, desplazamiento de las estructuras de l...

2001-01-01

383

Treatment of recurrent chronic subdural hematoma in a patient with Arachnoid cyst  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction. Arachnoid cysts are congenital fluid-filled compartments within the cerebrospinal fluid cisterns and major cerebral fissure, between two layers of the arachnoid membrane. They can develop anywhere within the subarachnoid space, most frequently located within the Sylvian fissure in the middle fossa. In young patients with the arachnoid cyst and history od head trauma chronic subdural hemathoma is present up to 4.6%. Case report. This is a case report of a 21 year old male, with left temporal lobe arachnoid cyst. Three months after minor head injury the patient was admitted to our clinic with chronic subdural hematoma compressing the surrounding tissue. The scull burr-hole trepanation was performed and the hematoma was drained. The control CT scan showed a reduced size of the chronic subdural hematoma with the smaller subdural collection of the fresh blood. Three weeks after the intervention the new CT scan showed the recurrence of the chronic subdural hematoma. The second trepanation was performed and the hematoma was drained. After the second operation, the patient was with no neurological disorders and subjective complaints. Three months after the second intervention, the control CT scan visualized only the arachnoid cyst in the temporal lobe, without the presence of the subdural hematoma. Conclusion. We conclude that a chronic subdural hematoma and reccurrent chronic subdural hematoma in patients with the arachnoid cyst in the fossa media should be drained by applying the method of burr-hole trepanation. In the patient with no subjective complaints and neurological disorders, the operative treatment of the arachnoid cyst is not considered necessary.

?ilvesi ?ula

2009-01-01

384

Chronic subdural hematoma associated with moyamoya phenomenon after radiotherapy for medulloblastoma  

International Nuclear Information System (INIS)

A 9-year-old boy had been diagnosed at the age of 9 months as having a cerebellar medulloblastoma and had received 40 Gy of radiation therapy to the brain after removal of the tumor. Cerebral angiography at the time of initial diagnosis did not show any evidence of occlusive disease involving the internal carotid circulation. At the age of 6 years, the patient developed generalized seizures. On examination, he was drowsy and had right hemiparesis. CT scan demonstrated a low-density area in the left frontal lobe. Cerebral angiography showed a marked narrowing of the bilateral internal carotid arteries with moyamoya vessels. The patient was treated medically with aspirin (100 mg/day) and anticonvulsants. His neurological deficits improved gradually. At the age of 8 years, there was no recurrence of the tumor although a slight left subdural hematoma was seen on CT scan. On August 10, 1993, at the age of 9 years, he was admitted for treatment of a developing subdural hematoma. MRI showed a chronic subdural hematoma with thick outer and inner membranes. Cerebral angiography showed occlusion of the left internal carotid artery which fed the right frontal lobe through moyamoya vessels, marked narrowing of the right internal carotid artery distal to the ophthalmic artery, moyamoya vessels at the base, and cortical revascularization througth the ophthalmic, posterior cerebral and middle meningeal arteries. Trepanation and aspiration of the hematoma were performed. The outer membrane of the hematoma was about 2 mm thick and the hematoma cavity was filled with a partially organized hematoma. In this case, we speculate that development of the chronic subdural hematoma involved the following factors: 1) transdural external-internal carotid anastomosis after radiation-induced cerebrovasculopathy; 2) repeated mild head trauma due to gait disturbance after removal of the cerebellar tumor; and 3) administration of acetylsalicylic acid. (author)

1994-04-01

385

Late Intrahepatic Hematoma Complicating Transjugular Intrahepatic Portosystemic Shunt for Budd-Chiari Syndrome  

International Nuclear Information System (INIS)

Late intrahepatic hematoma is a rare complication of the transjugular intrahepatic portosystemic shunt (TIPS) procedure. We describe a patient with Budd-Chiari syndrome (BCS), who presented with a large inrahepatic hematoma 13 days after TIPS. Review of the literature reveals only two previous cases, both occurring in patients with BCS and presenting after a similar time interval. This potentially serious complication appears to be specific for TIPS in BCS

2007-09-01