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1

Delayed angiography in the investigation of intracerebral hematomas caused by small arteriovenous malformations  

International Nuclear Information System (INIS)

We reviewed the clinical and radiological features of ten patients with small arteriovenous malformations that caused intracerebral hematomas. In six patients, angiography showed a small nidus (less than 1 cm in diameter) with a shunt at the site of the hematoma, and in four only an early-filling vein was evident. Six patients had only delayed angiography (4 weeks or more after the ictus). In three, angiography within 2 days of the ictus failed to reveal the cause of the bleed, but repeat angiography showed an early-filling vein in two, and a nidus with shunting in one. In only one patient did early angiography reveal the malformation. MRI was obtained in eight patients, and in two prominent vessels were evident in the wall of the hematoma cavity. In investigation of an unexplained intracerebral hematoma, MRI may be useful to exclude a neoplasm or cavernoma, although the latter may be not be evident in the presence of a recent hematoma. We suggest early MRI and angiography for investigation of an unexplained, nonhypertensive intracerebral bleed, with follow-up MRI and dealyed angiography if the initial studies fail to reveal the cause. (orig.)

2

Delayed angiography in the investigation of intracerebral hematomas caused by small arteriovenous malformations  

Energy Technology Data Exchange (ETDEWEB)

We reviewed the clinical and radiological features of ten patients with small arteriovenous malformations that caused intracerebral hematomas. In six patients, angiography showed a small nidus (less than 1 cm in diameter) with a shunt at the site of the hematoma, and in four only an early-filling vein was evident. Six patients had only delayed angiography (4 weeks or more after the ictus). In three, angiography within 2 days of the ictus failed to reveal the cause of the bleed, but repeat angiography showed an early-filling vein in two, and a nidus with shunting in one. In only one patient did early angiography reveal the malformation. MRI was obtained in eight patients, and in two prominent vessels were evident in the wall of the hematoma cavity. In investigation of an unexplained intracerebral hematoma, MRI may be useful to exclude a neoplasm or cavernoma, although the latter may be not be evident in the presence of a recent hematoma. We suggest early MRI and angiography for investigation of an unexplained, nonhypertensive intracerebral bleed, with follow-up MRI and dealyed angiography if the initial studies fail to reveal the cause. (orig.)

Willinsky, R.A. (Dept. of Radiology, Toronto Hospital, Western Div., Toronto, ON (Canada) Univ. of Toronto, Brain Vascular Malformation Study Group, ON (Canada)); Fitzgerald, M. (Dept. of Radiology, Toronto Hospital, Western Div., Toronto, ON (Canada)); TerBrugge, K. (Dept. of Radiology, Toronto Hospital, Western Div., Toronto, ON (Canada) Univ. of Toronto, Brain Vascular Malformation Study Group, ON (Canada)); Montanera, W. (Dept. of Radiology, Toronto Hospital, Western Div., Toronto, ON (Canada)); Wallace, M. (Div. of Neurosurgery, Dept. of Surgery, Toronto Hospital, Western Div., ON (Canada) Univ. of Toronto, Brain Vascular Malformation Study Group, ON (Canada))

1993-04-01

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Delayed extradural hematoma : a case report.  

OpenAIRE

Three patients of delayed extradural hematoma (EDH) were seen in the last one year among forty eight consecutively treated cases of EDH. All the three hematomas were evacuated. Awareness of this entity and a high degree of vigilance are strongly recommended to detect such cases. Repeat CT should always be done, especially after decompression by either surgical or medical means, recovery from shock or whenever there is evidence of even minimal bleeding under a skull fracture on initial CT scan.

Alappat J; Baiju; Praveen; Jayakumar.K.; Sanalkumar P

2002-01-01

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Delayed extradural hematoma: a case report.  

Science.gov (United States)

Three patients of delayed extradural hematoma (EDH) were seen in the last one year among forty eight consecutively treated cases of EDH. All the three hematomas were evacuated. Awareness of this entity and a high degree of vigilance are strongly recommended to detect such cases. Repeat CT should always be done, especially after decompression by either surgical or medical means, recovery from shock or whenever there is evidence of even minimal bleeding under a skull fracture on initial CT scan. PMID:12391460

Alappat, J P; Baiju; Praveen; Jayakumar, K; Sanalkumar, P

2002-09-01

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Delayed extradural hematoma : a case report.  

Directory of Open Access Journals (Sweden)

Full Text Available Three patients of delayed extradural hematoma (EDH were seen in the last one year among forty eight consecutively treated cases of EDH. All the three hematomas were evacuated. Awareness of this entity and a high degree of vigilance are strongly recommended to detect such cases. Repeat CT should always be done, especially after decompression by either surgical or medical means, recovery from shock or whenever there is evidence of even minimal bleeding under a skull fracture on initial CT scan.

Alappat J

2002-07-01

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Delayed orbital hematoma after lateral canthoplasty.  

Science.gov (United States)

A 76-year-old man was referred to the oculoplastic surgery service with a retrobulbar hemorrhage 1 day after intraocular surgery. A canthotomy and inferior cantholysis was performed. The patient then developed a new orbital hematoma in the region of the canthotomy 14 days later. The patient was treated conservatively with warm compresses and close observation with continued resolution of the secondary hematoma. Visual complications from the secondary hematoma may have been avoided by delaying closure of the initial canthotomy wound. Ophthalmologists should be aware of the risk of bleeding after lateral canthal procedures, particularly in patients who have already presented with ocular or periocular hemorrhagic complications. A brief review of orbital hemorrhage following eyelid surgery is provided. PMID:20683370

Kim, David Y; Lelli, Gary J

2010-01-01

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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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Spontaneous rectus sheath hematoma: an unusual cause of gross hematuria.  

Science.gov (United States)

The diagnosis of a spontaneous rectus sheath hematoma, even in anticoagulated patients, requires a high index of suspicion. Gross hematuria is also not infrequent in anticoagulated patients. Although urinary symptoms from a rectus sheath hematoma have been described, generally it would not be considered a common cause of gross hematuria in this population. We report here on 2 cases of spontaneous rectus sheath hematoma spontaneously fistulizing into the bladder and causing gross hematuria. PMID:24139341

Sandoval, Otto; Kinkead, Thomas

2013-12-01

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Delayed incidental diagnosis of postoperative extradural hematoma following ventriculoperitoneal shunt.  

Science.gov (United States)

Ventriculo peritoneal (VP) shunt uncommonly complicates as intracranial hematomas which can still occur in patients with a functioning VP shunt leading to a delay in the diagnosis which can be extremely dangerous and lead to adverse outcomes. We report a case of an incidental diagnosis of delayed post-operative EDH following VP shunt in an young adult patient with a right cerebellar lesion and highlight the need for meticulous post-operative neurological examination. PMID:25552861

Byrappa, Vinay; Redhu, Shruti; Varadarajan, Bhadrinarayan

2015-01-01

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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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Low Molecular Weight Heparin Induced Delayed Traumatic Clival Subdural Hematoma Associated With Isolated Abducens Nerve Palsy in a Child  

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Full Text Available Traumatic clival subdural hematoma is a very rare clinical entity. This rarity can result in delayed or missed diagnoses. Although several hypotheses are proposed to explain this lesion, the exact pathophysiology remains to be unknown.We present a case of low-molecular-weight heparin induced clival subdural hematoma, extending to the left cerebellopontine angle and causing left abducens nerve palsy which occured six days after trauma.

Mehmet Faik ÖZVEREN

2012-06-01

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Intracerebral Hematoma Caused by Ruptured Traumatic Pseudoaneurysm of the Middle Meningeal Artery : A Case Report  

OpenAIRE

Hematomas caused by ruptured traumatic pseudoaneurysms of the middle meningeal artery (MMA) usually present with extradural hematomas, whereas intradural intraparenchymal hematomas are extremely rare. We report a case of traumatic pseudoaneurysm of the MMA giving rise to an intracerebral hematoma after head trauma. A 70-year-old man suffered a massive intracerebral temporoparietal hemorrhage after a head injury. CT angiogram of the brain revealed a large hematoma in the right middle cranial f...

Lim, Dong-ho; Kim, Tae-sun; Joo, Sung-pil; Kim, Soo Han

2007-01-01

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Analysis of infantile subdural hematoma caused by abuse  

International Nuclear Information System (INIS)

We report infantile subdural hematoma caused by abuse. Between January 2006 and December 2009, 10 cases of definite and highly suspicious abusive subdural hematoma in infants were treated at Nara Medical University Hospital. The mean age was 5.4 months. On CT examination, severe cerebral swelling was seen in 8 (80%) and wide spreading cerebral ischemia and atrophy in 9 (90%). Retinal hemorrhage was commonly seen in this series (90%). Subdural drainage and/or subdural-peritoneal shunt surgeries were performed in 6 cases, and intensive combined therapy of mild hypothermia and barbiturate was adapted in 7 cases. Favorable outcome was achieved in only 3 cases. In spite of aggressive treatment, clinical outcome are still bad. In our series, assailants were predominantly not father but mother. There were various and complex factors for child abuse. Cautious insight and suspicion are necessary to detect abusive injuries in infants. It is very important to endeavor to prevent recurrences of abusive injuries. (author)

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Severe upper airway obstruction due to delayed retropharyngeal hematoma formation following blunt cervical trauma  

OpenAIRE

Abstract Background We report a case of severe upper airway obstruction due to a retropharyngeal hematoma that presented nearly one day after a precipitating traumatic injury. Retropharyngeal hematomas are rare, but may cause life-threatening airway compromise. Case presentation A 50 year-old man developed severe dyspnea with oropharyngeal airway compression due to retropharyngeal hematoma 20 hours after presenting to the emergency department. The patient also h...

Ciceri David P; Artz Katie S; Puana Rudolph B; Ponzo John A; Lazott Laurie W; Culp William C

2007-01-01

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

Scientific Electronic Library Online (English)

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  

Energy Technology Data Exchange (ETDEWEB)

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

International Nuclear Information System (INIS)

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

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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  

OpenAIRE

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 hem...

Juan Morales, L. G.; Renato Arriagada, H.; Luis Salas, G.; Carlos Morales, A.; Felipe Fuentes, A.; ROBERTO SANTANA

2009-01-01

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Arteriovenous malformation: An unusual cause of rectus sheath hematoma, following laparoscopic cholecystectomy  

OpenAIRE

Rectus sheath hematoma (RSH) is an accumulation of blood in the rectus abdominis muscle sheath, secondary to several conditions which may cause the epigastric vessel rupture or muscular tear, but mostly affecting patients undergoing anticoagulation therapy.

Dellaportas, D.; Athanasopoulos, P. G.; Lykoudis, P.; Manta, A.; Koutoulidis, V.; Chatziioannou, A. N.; Polymeneas, G.; Theodosopoulos, T.

2011-01-01

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

Scientific Electronic Library Online (English)

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.

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

2009-02-01

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

Directory of Open Access Journals (Sweden)

Full Text Available 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.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 subcapsular 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.

JUAN L MORALES G

2009-02-01

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Delayed duodenal obstruction after intramural hematoma in a patient with paroxysmal nocturnal hemoglobinuria: A case report  

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CONCLUSION: We report a rare intestinal obstruction case caused by stricture at the level of ligamentum Treitz with PNH. The possibility simply has to be borne in mind that strictures can be occurring at hematoma, ischemia or inflammation site of gastrointestinal tract.

Tugan Tezcaner

2014-01-01

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

International Nuclear Information System (INIS)

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 hydrocephalents 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)

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Spontaneous rectus sheath hematoma  

OpenAIRE

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 amon...

Alla, Venkata M.; Karnam, Showri M.; Kaushik, Manu; Porter, Joann

2003-01-01

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An unusual cause of the acute abdomen: computed tomography angiography findings of the intestinal intramural hematoma  

International Nuclear Information System (INIS)

Full text: Introduction: The intestinal intramural hematoma is a rare abdominal emergency condition resulting from submucosal or subserosal hemorrhage. The various causes of this condition are anticoagulant therapy, trauma, surgery, biopsy and spontaneous. The most common cause of this condition is blunt abdominal trauma. Objectives and tasks: In this report we aimed to present computed tomography (CT) angiography findings of the intestinal wall hematoma which is an unusual cause of acute abdomen. Materials and methods: A 67-year-old man presented to our emergency department complaining of severe abdominal pain, nausea and vomiting. The physical examination revealed right upper quadrant and epigastric abdominal tenderness. Sonographic examination revealed free fluid in the right paracolic area and minor pelvis. Due to these findings, the patient underwent CT angiography examination with suspicion of acute intestinal ischemia. Results: Diffuse atherosclerotic calcified plaques in the abdominal aorta and moderate degree stenosis proximal celiac truncus were determined on CT angiography images. Mesenteric arterial system was patent. On CT images most remarkable finding was diffuse wall thickening reaching up to 1.5 cm at the widest part in small intestinal segments. These findings were seen in the right half of abdomen and pelvis, approximately 12 cm and 20 cm small intestinal segment, respectively. The patient was using warfarin and acetylsalicylic acid medication due t and acetylsalicylic acid medication due to heart valve replacement surgery. This history and CT angiography findings were consistent with intestinal mural hematoma. Conclusion: In the differential diagnosis of the acute abdomen, intestinal intramural hematoma must be kept in mind, especially in patients using anticoagulant drugs. In such cases, CT angiographic examination is rapid, effective and reliable method in both determination of the vascular abnormality and evaluation of the intestinal wall pathologies

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Two cases of subdural hematoma with niveau formation on CT. A study of the cause of niveau formation  

Energy Technology Data Exchange (ETDEWEB)

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.

Shimizu, Satoshi; Fukuda, Atsuhiro; Sato, Masaharu; Kohama, Akitsugu (Kawasaki Medical School, Kurashiki, Okayama (Japan))

1984-04-01

31

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

32

Radionuclide imaging of a rectus sheath hematoma caused by insulin injections  

International Nuclear Information System (INIS)

CT scanning, MRI, and ultrasonography are the imaging procedures of choice for the study of rectus sheath hematomas. A rectus sheath hematoma was evaluated scintigraphically after the intravenous administration of Tc-99m labeled RBC, which confirmed the hematoma, demonstrated the sites of bleeding, and revealed continued bleeding

33

Radionuclide imaging of a rectus sheath hematoma caused by insulin injections  

Energy Technology Data Exchange (ETDEWEB)

CT scanning, MRI, and ultrasonography are the imaging procedures of choice for the study of rectus sheath hematomas. A rectus sheath hematoma was evaluated scintigraphically after the intravenous administration of Tc-99m labeled RBC, which confirmed the hematoma, demonstrated the sites of bleeding, and revealed continued bleeding.

Monsein, L.H.; Davis, M. (Johns Hopkins Medical Institutions, Baltimore, MD (USA))

1990-08-01

34

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

35

Hematoma postraumático en riñón patológico / Postraumatic hematoma in pathological kidney  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Presentamos un caso de hematoma postraumático en un riñón tumoral. El diagnóstico del hematoma fue realizado mediante escáner abdominal pero no así el tipo tumoral. Fue necesario la revisión quirúrgica y posterior estudio patológico para demostrar un angiomiolipoma como causante del hematoma renal. [...] Abstract in english We want to present a case of postraumatic hematoma in a tumoral kidney. The diagnosis of the hematoma was made by abdominal scanner but not the tumor type. It was necessary the chirurgycal review and patological study to demostrate an angiomyolipoma as the cause of the kidney hematoma. [...

M., Allué López; D., Pascual Regueiro; A., García de Jalón Martínez; P., Serrano Frago; P., Gil Martínez; L.A., Rioja Sanz.

2003-01-01

36

Expanding traumatic intracerebral contusion/hematoma  

OpenAIRE

Background and Aims: Delayed traumatic hematomas and expansion of already detected hematomas are not uncommon. Only few studies are available on risk factors of expanding hematomas. A prospective study was aimed to find out risk factors associated with such traumatic lesions. Materials and Methods: Present study is based on 262 cases of intracerebral hematomas / contusions out of which 43 (16.4%) hematomas expanded in size. computerized tomography (CT) scan was done in...

Yadav Yad; Basoor Abhijeet; Jain Gaurav; Nelson Adam

2006-01-01

37

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.)

38

Life-Threatening Neonatal Epidural Hematoma Caused by Precipitous Vaginal Delivery  

Science.gov (United States)

Patient: Male, 0 Final Diagnosis: Epidural hematoma Symptoms: Apnea Medication: — Clinical Procedure: Craniotomy Specialty: Pediatrics and Neonatology Objective: Unusual clinical course Background: Neonatal in-hospital falls occur relatively frequently, although they are likely underreported. Significant intracranial head trauma from a fall or birth injury is not common in the immediate newborn period. Furthermore, intracranial bleeding requiring surgical intervention is exceedingly rare. We present an unusual case of an inhospital fall in the delivery room requiring neurosurgical intervention. Case Report: A term infant, appropriate for gestational age, delivered precipitously from a maternal standing position. The vertex neonate struck the linoleum floor after an approximate 80-cm fall, landing headfirst. The physical and neurological exams were initially normal, and skull films did not demonstrate an obvious fracture. The baby was closely observed, undergoing continuous cardiorespiratory monitoring. After the patient had an episode of apnea, a scalp hematoma was noted. A computed tomography (CT) scan revealed a left parietal fracture with an acute epidural hematoma, which required emergent craniotomy. The infant had an unremarkable post-operative course and had a normal neurodevelopmental assessment at 15 months of age. Conclusions: Close, continuous observation is recommended for infants following an in-hospital fall or after significant birth trauma. A high degree of suspicion for intracranial hemorrhage must be maintained. Fall prevention strategies should focus on careful baby handling by the convalescing mother. PMID:25633886

Josephsen, Justin B.; Kemp, Joanna; Elbabaa, Samer K.; Al-Hosni, Mohamad

2015-01-01

39

Subdural hematoma  

Science.gov (United States)

... blood collection, and how quickly treatment is obtained. Acute subdural hematomas present the greatest challenge, with high rates of death and injury. Subacute and chronic subdural hematomas have better outcomes in most cases, ...

40

Hematoma espinal Spinal hematoma  

OpenAIRE

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 ...

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

2013-01-01

41

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.

2006-12-01

42

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.

1023-10-01

43

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  

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Full Text Available 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 developed 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.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 de 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.

Fernando Campos Gomes Pinto

2003-12-01

44

Life-threatening neonatal epidural hematoma caused by precipitous vaginal delivery.  

Science.gov (United States)

Background Neonatal in-hospital falls occur relatively frequently, although they are likely underreported. Significant intracranial head trauma from a fall or birth injury is not common in the immediate newborn period. Furthermore, intracranial bleeding requiring surgical intervention is exceedingly rare. We present an unusual case of an in-hospital fall in the delivery room requiring neurosurgical intervention. Case Report A term infant, appropriate for gestational age, delivered precipitously from a maternal standing position. The vertex neonate struck the linoleum floor after an approximate 80-cm fall, landing headfirst. The physical and neurological exams were initially normal, and skull films did not demonstrate an obvious fracture. The baby was closely observed, undergoing continuous cardiorespiratory monitoring. After the patient had an episode of apnea, a scalp hematoma was noted. A computed tomography (CT) scan revealed a left parietal fracture with an acute epidural hematoma, which required emergent craniotomy. The infant had an unremarkable post-operative course and had a normal neurodevelopmental assessment at 15 months of age. Conclusions Close, continuous observation is recommended for infants following an in-hospital fall or after significant birth trauma. A high degree of suspicion for intracranial hemorrhage must be maintained. Fall prevention strategies should focus on careful baby handling by the convalescing mother. PMID:25633886

Josephsen, Justin B; Kemp, Joanna; Elbabaa, Samer K; Al-Hosni, Mohamad

2015-01-01

45

Delayed chromosomal instability caused by large deletion  

International Nuclear Information System (INIS)

Full text: There is accumulating evidence that genomic instability, manifested by the expression of delayed phenotypes, is induced by X-irradiation but not by ultraviolet (UV) light. It is well known that ionizing radiation, such as X-rays, induces DNA double strand breaks, but UV-light mainly causes base damage like pyrimidine dimers and (6-4) photoproducts. Although the mechanism of radiation-induced genomic instability has not been thoroughly explained, it is suggested that DNA double strand breaks contribute the induction of genomic instability. We examined here whether X-ray induced gene deletion at the hprt locus induces delayed instability in chromosome X. SV40-immortalized normal human fibroblasts, GM638, were irradiated with X-rays (3, 6 Gy), and the hprt mutants were isolated in the presence of 6-thioguanine (6-TG). A 2-fold and a 60-fold increase in mutation frequency were found by 3 Gy and 6 Gy irradiation, respectively. The molecular structure of the hprt mutations was determined by multiplex polymerase chain reaction of nine exons. Approximately 60% of 3 Gy mutants lost a part or the entire hprt gene, and the other mutants showed point mutations like spontaneous mutants. All 6 Gy mutants show total gene deletion. The chromosomes of the hprt mutants were analyzed by Whole Human Chromosome X Paint FISH or Xq telomere FISH. None of the point or partial gene deletion mutants showed aberrations of X-chromosome, however total gene deletion mutants induced tranr total gene deletion mutants induced translocations and dicentrics involving chromosome X. These results suggest that large deletion caused by DNA double strand breaks destabilizes chromosome structure, which may be involved in an induction of radiation-induced genomic instability

46

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.

47

Imperative Causes of Delays in Construction Projects from Developers’ Outlook  

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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

48

Experimental epidural hematoma causes cerebral infarction and activates neocortical glial and neuronal genesis in adult guinea pigs.  

Science.gov (United States)

Epidural hematoma (EDH) is a type of life-threatening traumatic brain injury. Little is known about the extent to which EDH may cause neural damage and regenerative response in the cerebral cortex. Here we attempted to explore these issues by using guinea pigs as an experimental model. Unilateral EDH was induced by injection of 0.1 ml autologous blood into the extradural space, with experimental effects examined at 7, 14, 30, and 60 days postlesion. An infarct developed in the cortex deep to the EDH largely after 7 days postlesion, with neuronal death occurred from layers I to V in the central infarct region, as evidenced by loss of immunoreactivity (IR) for neuron-specific nuclear antigen (NeuN). Glial fibrillary acidic protein (GFAP) IR appeared as a cellular band surrounding the infarct and extending into the periinfarct cortex along the pia. Doublecortin (DCX) IR emerged in these same areas, with labeled cells appearing as astrocytic and neuronal profiles. DCX/GFAP colocalization was found in these regions commonly at 7 and 14 days postlesion, whereas DCX/NeuN-colabeled neurons were detectable at 30 and 60 days postlesion. Subpopulations of GFAP-, DCX-, or NeuN-immunoreactive cells colocalized with the endogenous proliferative marker Ki-67 or bromodeoxyuridine (BrdU) after pulse-chase with this birth-dating marker. The results suggest that experimental EDH can cause severe neuronal loss, induce significant glial activation, and promote a certain degree of local neuronal genesis in adult guinea pig neocortex. These findings point to potential therapeutic targets for improving neuronal recovery in clinical management of EDH. PMID:23151870

Pan, Aihua; Li, Ming; Gao, Jun-Yan; Xue, Zhi-Qin; Li, Zhiyuan; Yuan, Xian-Yui; Luo, Duan-Wu; Luo, Xue-Gang; Yan, Xiao-Xin

2013-02-01

49

A rare cause of intraabdominal hematoma: rupture of mesenteric artery branch aneurysm.  

Science.gov (United States)

Superior mesenteric artery (SMA) aneurysm is the third most common splanchnic artery aneurysm. Unlike other splanchnic artery aneurysm, isolated aneurysms of the SMA branches are rare. They are usually asymptomatic and difficult to detect until they rupture and cause abdominal pain and hypovolemic shock. Thus, most cases are diagnosed after the occurrence of complications. In this report, we described a 76-year-old woman who had two saccular aneurysms in the superior mesenteric arterial branch(es). One of them was ruptured and partly thrombosed. The patient had acute renal failure secondary to massive intraabdominal hemorrhage. PMID:24617176

Gunduz, Y; Sipahi, S; Kara, R; Tamer, A

2013-01-01

50

Imperative Causes of Delays in Construction Projects from Developers’ Outlook  

OpenAIRE

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 Mala...

Othuman Mydin M.A.; Md, Sani N.; Taib M.; Mohd Alias N.

2014-01-01

51

Hematoma Vulvar  

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Full Text Available Paciente de Sexo femenino de 29 anos de edad acudio a consulta externa del Hospital “German Urquidi” por dolor y molestia en region peri vulvar, diagnosticándose “hematoma vulvar” de causa obstétrica (Laceracion de trayecto, mala técnica de sutura de episiotomia.

Andrea W. Choque Campero

2012-06-01

52

Expanding traumatic intracerebral contusion/hematoma  

Directory of Open Access Journals (Sweden)

Full Text Available Background and Aims: Delayed traumatic hematomas and expansion of already detected hematomas are not uncommon. Only few studies are available on risk factors of expanding hematomas. A prospective study was aimed to find out risk factors associated with such traumatic lesions. Materials and Methods: Present study is based on 262 cases of intracerebral hematomas / contusions out of which 43 (16.4% hematomas expanded in size. computerized tomography (CT scan was done in all the patients at the time of admission and within 24 hours of injury. Repeat CT scan was done within 24 hours, 4 days and 7 days. Midline shift if any, prothrombin time, activated partial thromboplastin time, bleeding time, clotting time and platelet counts, Glasgow coma scale at admission and discharge and Glasgow outcome score at 6 months follow up were recorded. Results: Twenty six percent, 11.3 and 0% patients developed expanding hematoma in Glasgow Coma scale (GCS of 8 and below, 9-12 and 13-15 respectively. The chances of expanding hematomas were higher in patients with other associated hematomas (17.4% as compared to isolated hematoma (4.8% (Fisher?s exact results P =0.216. All the cases of expanding hematoma had some degree of midline shift and considerably higher proportion had presence of coagulopathy. The results of logistic regression analysis showed GCS, midline shift and coagulopathy as significant predictors for the expanding hematoma. Thirty nine patients (90.7% of the total expanding hematomas developed within 24 hours of injury. Conclusions: Enlargement of intracerebral hematomas is quite common and majority of them expand early after the injury. These lesions were common in patients with poor GCS, associated hematomas, associated coagulopathy and midline shift.

Yadav Yad

2006-01-01

53

[Partial paralysis of the right lumbar plexus caused by a traumatic hematoma of the ileo-psoas muscle].  

Science.gov (United States)

The authors show a case of paralysis of right femoral nerve, subsequent to extrinsic compression due to traumatic hematoma of ileo-psoas muscle. What emerges from the revitwing of the international literature, as well as from the personal experience is both a complete nosographic framing and the necessity for an early surgical intervention. PMID:4017141

Ginanneschi, U; Capus, L; Smrekar, V; Dell'Antonio, A; Fabiani, P; Visintin, A

1985-04-01

54

Subungual frictional hematoma due to overriding toe  

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Full Text Available We report a male patient of 77 years with subungual frictional hematoma secondary to the deformity of his toe (overriding toe, this finding was incidental during his examination due to the presence of seborrheic keratosis on the scalp.Subungual hematomas of the nails are common it could be cause by major and minor trauma predominantly on the big toe, the different toe deformity predispose to have subungual frictional hematoma like in the present clinical case.

Chang Patricia

2011-07-01

55

Subungual frictional hematoma due to overriding toe  

OpenAIRE

We report a male patient of 77 years with subungual frictional hematoma secondary to the deformity of his toe (overriding toe), this finding was incidental during his examination due to the presence of seborrheic keratosis on the scalp.Subungual hematomas of the nails are common it could be cause by major and minor trauma predominantly on the big toe, the different toe deformity predispose to have subungual frictional hematoma like in the present clinical case.

Chang Patricia

2011-01-01

56

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.

57

Nonsurgical treatment of chronic subdural hematoma  

International Nuclear Information System (INIS)

Sequential changes of clinical symptoms and computed tomography (CT) scans were investigated in 20 patients of chronic subdural hematoma treated by osmotherapy utilizing intravenous 20 % mannitol 1,000 ml daily for 2 weeks. Plain, contrast enhancement, and 4-hour-delayed contrast enhancement CT scans were taken once every week for 4 weeks from the start of the treatment and then once every month until hematoma disappeared. Though the clinical symptoms aggravated slightly in 4 cases during the first or second week, all the cases became asymptomatic at the end of the treatment and showed no recurrence thereafter. Sequential changes in CT scans are summarized as follows. 1) Plain CT scans showed that the hematoma started to reduce in size rapidly after termination of the treatment. Density of hematoma decreased sequentially, although it increased transiently in 9 cases. After treatment, the hematoma disappeared after 3 months in 18 cases, after 4 months in one case, and 5 months in one case. 2) In contrast enhancement CT, two types of contrast enhancement were observed: ribbon-like cortical enhancement and linear enhancement beneath the hematoma. These enhancement effects were seen in 80 % of cases (cortical enhancement in 70 %, linear enhancement in 10 %) before the treatment. The cortical enhancement decreased through the treatment and disappeared in 2 months after the treatment. 3) The contrast enhancement effects within the hematoma cavity (evaluated as the relative ematoma cavity (evaluated as the relative increase of the CT numbers in the 4-hour-delayed contrast enhancement CT scans) were closely related to the hematoma reduction rate; the more marked and lasting the enhancement effects, the more delayed was the hematoma to be reduced by osmotherapy. (J.P.N.)

58

Computerized tomography findings of acute traumatic epidural hematoma  

Energy Technology Data Exchange (ETDEWEB)

During four year period from April, 1977 to March, 1981, 53 cases with acute traumatic epidural hematoma had been encountered out of 430 acute head injured patients examined by computerized tomography (CT) within 24 hours after incurring the trauma. Besides the initial CT, the authors performed contrast enhanced CT (41 cases) and serial CT scanning (31 cases). There were 49 cases of epidural hematoma existing in the supratentorial region, Two cases infratentorial region and 2 cases in the both regions. Two cases of vertex epidural hematoma had been encountered, one of them required vertical scan technique. In 22 (41%) of the 53 patients, the initial CT showed evidence of other cerebral lesions. The most frequent lesion was pneumocephalus (11 cases), 3 cases of them existed in the epidural hematoma. There were also intracerebral hematoma (6 cases), subdural hematoma (4 cases), cerebral contusion (2 cases), intraventricular hemorrhage (2 cases) and 2 cases of them demonstrated ''diffuse traumatic cerebral injury''. During contrast enhanced CT, 11 cases out of 41 cases indicated several enhancement pattern. There were total enhancement of epidural hematoma (2 cases), partial enhancement of hematoma (2 cases) and enhancement of internal margin of hematoma (2 cases). Serial CT scans was performed in 36 out of the 53 patients. Common findings on the serial CT scans were decreased density collection in the subdural space such as subdural effusions or chronic subdural hematomas (8 cases) and enlargement of small epidural hematomas (3 cases). After evacuation of epidural hematoma, there were some cases showing the so-called ''delayed traumatic intracerebral hematoma'' (4 cases), appearance of other epidural hematoma (1 case) and development of small cerebral infarction in the basal ganglia. There was one case indicating appearance of a new epidural hematoma contra lateral to the side of evacuation of subdural hematoma. (J.P.N.).

Kobayashi, Shiro; Nakazawa, Shozo; Yokota, Hiroyuki; Yajima, Kouzo; Yano, Masami; Otsuka, Toshibumi

1984-12-01

59

Computerized tomography findings of acute traumatic epidural hematoma  

International Nuclear Information System (INIS)

During four year period from April, 1977 to March, 1981, 53 cases with acute traumatic epidural hematoma had been encountered out of 430 acute head injured patients examined by computerized tomography (CT) within 24 hours after incurring the trauma. Besides the initial CT, the authors performed contrast enhanced CT (41 cases) and serial CT scanning (31 cases). There were 49 cases of epidural hematoma existing in the supratentorial region, Two cases infratentorial region and 2 cases in the both regions. Two cases of vertex epidural hematoma had been encountered, one of them required vertical scan technique. In 22 (41%) of the 53 patients, the initial CT showed evidence of other cerebral lesions. The most frequent lesion was pneumocephalus (11 cases), 3 cases of them existed in the epidural hematoma. There were also intracerebral hematoma (6 cases), subdural hematoma (4 cases), cerebral contusion (2 cases), intraventricular hemorrhage (2 cases) and 2 cases of them demonstrated ''diffuse traumatic cerebral injury''. During contrast enhanced CT, 11 cases out of 41 cases indicated several enhancement pattern. There were total enhancement of epidural hematoma (2 cases), partial enhancement of hematoma (2 cases) and enhancement of internal margin of hematoma (2 cases). Serial CT scans was performed in 36 out of the 53 patients. Common findings on the serial CT scans were decreased density collection in the subdural space such as subdural effusions or chronic subdural hematomural effusions or chronic subdural hematomas (8 cases) and enlargement of small epidural hematomas (3 cases). After evacuation of epidural hematoma, there were some cases showing the so-called ''delayed traumatic intracerebral hematoma'' (4 cases), appearance of other epidural hematoma (1 case) and development of small cerebral infarction in the basal ganglia. There was one case indicating appearance of a new epidural hematoma contra lateral to the side of evacuation of subdural hematoma. (J.P.N.)

60

Provision of hearing aids: does specialist assessment cause delay?  

OpenAIRE

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...

Watson, C.; Crowther, J. A.

1989-01-01

61

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

62

Rectus Sheath Hematoma Mimicking Acute Abdominal Pain  

OpenAIRE

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...

Huseyin Narci; Emin Turk; Murat Ugur; Erdal Karagulle

2012-01-01

63

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.

2011-03-01

64

Bilateral assymetric epidural hematoma  

Science.gov (United States)

Background: Acute bilateral extradural hematoma is a rare presentation of head trauma injury. In sporadic cases, they represent 0.5–10% of all extradural hematomas. However, higher mortality rates have been reported in previous series. Case Description: The authors described the case of a 28-year-old male presenting head injury, comatose, Glasgow Coma Scale of 6, anisocoric pupils without puppilary light reflex. Computed tomography showed asymmetric bilateral epidural hematomas, effacement of the lateral ventricles and sulci, midline shift and a bilateral skull fracture reaching the vertex. Surgical evacuation was performed with simultaneous hematoma drainage. Patient was discharged on the 29th postoperative day with no neurological deficit. Conclusion: The correct approach on bilateral epidural hematomas depends on the volume, moment of diagnosis, and neurological deficit level. Simultaneous drainage of bilateral hematomas has been demonstrated to be an effective technique for it, which soon decreases the intracranial pressure and promotes an efficient resolution to the neurological damage. PMID:25657867

Pereira, Edmundo Luis Rodrigues; Rodrigues, Daniella Brito; Lima, Lorena Oliveira; Sawada, Luis Armando; Hermes, Mário de Nazareth

2015-01-01

65

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.)

66

Causes of cost increases and delays of the SNR-300  

International Nuclear Information System (INIS)

In summer 1981, the Federal Minister for Research and Technology ordered an ''investigation on the causes of cost increases and delays in the construction of SNR-300'' from a working team in Switzerland, in connection with the increase from 3.7 billion to 5 billion DM in the project costs for the fast breeder-prototype-nuclear power plant SNR 300. In June 1982, the Federal Ministry extended the order to DM 6.05 billion, the cost estimate by operators and producers which had been increased meanwhile and the new date for commissioning in July 1982. The investigation presented by the Fed. Min. for Research and Technology on 21. Sept. 82 analyses the causes, reviews the present project plants, also as compared with projects in other countries and contains, corresponding to the conclusions, recommendations for the remaining part of the project and, in addition to this, general recommendations for government-funded large research projects in the nuclear field. The article contains analyses and conclusions. (orig./UA)

67

Rectus sheath hematoma: three case reports  

OpenAIRE

Abstract Introduction Rectus sheath hematoma is an uncommon cause of acute abdominal pain. It is an accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric vessel or muscle tear. It could occur spontaneously or after trauma. They are usually located infraumblically and often misdiagnosed as acute abdomen, inflammatory diseases or tumours of the abdomen. Case presentation We reported three cases of rectus sheath hematoma...

Kapan Selin; Turhan Ahmet N; Alis Halil; Kalayci Mustafa U; Hatipoglu Sinan; Yigitbas Hakan; Aygun Ersan

2008-01-01

68

Hematoma espontâneo do músculo reto abdominal Spontaneous hematoma of the rectus sheath  

OpenAIRE

Spontaneous hematoma of the rectus sheath is a rare entity, which may be confused with the surgical causes of acute abdomen. We present a well succeeded conservative therapy in a woman in the 7th decade of life.

Leonardo Fernandes Valentim; Glauco de Lima Rodrigues; Renato de Medina Coeli

2005-01-01

69

Subacute epidural hematoma  

International Nuclear Information System (INIS)

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 radiographies 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. (author)

70

Owner and Contractor Perceptions Toward Factors Causing Delays in Structural and Finishing Works  

Directory of Open Access Journals (Sweden)

Full Text Available A construction project comprises of a number of work packages, which are subjected to delays. These delays may be caused by many on-site factors. The aim of this research is to represent owner and contractors perceptions towards delay factors that frequently occur in structural and finishing works. Data for analysis were gathered by distributing questionnaire. A total of 198 sets of questionnaire were gathered and used for subsequent analyses. In general, design changes during construction are perceived by respondents as the most frequent factor to cause delay in all structural and finishing works. The results also show that there are a number of differences between owner’s and contractor’s perceptions towards the occurrences of the factors. Whilst most contractors concern that information factors related to project design and scope frequently causing delays in construction works, owners consider many contractor originated factors, as most frequent delay causes.

Loanata V.R.

2010-01-01

71

Warfarin Overdose Induced Intramural Small-Bowel Hematoma (Case Report)  

OpenAIRE

Uncontrolled use of anticoagulants may cause bleeding. Warfarin- dependent spontaneous intramural hematoma of the small intestine is a rare complication. Although warfarin using patients with abdominal pain were usually treated medically, surgical interventions should be considered in selected cases with intestinal intramural hematoma. Here we present a patient who was treated surgically to bring to mind this rare condition.

Ersan Semerci; Orhan Veli Özkan2; Muyittin Temiz; Ahmet Aslan; ?brahim Yetim

2011-01-01

72

Hematoma esofágico espontáneo / Spontaneous esophageal hematoma  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish El hematoma espontáneo del esófago es una manifestación poco frecuente de lesión esofágica. El dolor torácico, la disfagia y la hematemesis son los síntomas más comunes de presentación, los cuales se resuelven espontáneamente en la mayoría de los casos. El conocimiento de esta patología es important [...] e para un manejo adecuado y evitar así las intervenciones quirúrgicas y tratamientos innecesarios Abstract in english Spontaneous intramural hematoma of the esophagus constitutes a rare spectrum of esophageal injuries. Chest pain, difficulty swallowing and hematemesis are the most common symptoms. They resolve spontaneously in most cases. Awareness of this condition is a vital guide for following up these cases and [...] for avoiding inappropriate treatment and unnecessary surgical intervention. We report the case of a patient who presented with chest pain and hematemesis

Javier Alberto, Preciado Aponte; Diego Mauricio, Aponte Martin.

2012-06-30

73

Anti-M causing delayed hemolytic transfusion reaction  

International Nuclear Information System (INIS)

A 52-year-old gravida 1, para 1 woman with M- red cells experienced a delayed hemolytic transfusion reaction and exhibited an anti-M antibody following the infusion of four units of M+ red cells. Measurements of erythrocyte survival using 51Cr-labeled donor M+ and M- red cells and in vitro studies of monocyte-macrophage phagocytosis of sensitized reagent red cells implicate anti-M in the pathogenesis of hemolysis

74

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

75

Pulsative hematoma: A penile fracture complication  

Directory of Open Access Journals (Sweden)

Full Text Available Background. Fracture of the penis is a direct blunt trauma of the erect or semi-erect penis. It can be treated by conservative or surgical means. Retrospective analyses of conservative penile fracture treatment reveal frequent immediate and later complications. Case report. We presented a 41- year-old patient with pulsative hematoma caused by an unusual fracture of the penis. Fracture had appeared 40 days before the admittance during a sexual intercourse. The patient was treated surgically. Conclusion. Pulsative hematoma (pulsative diverticulum is a very rare, early complication of a conservatively treated penile fracture. Surgical treatment has an advantage over surgical one, which was confirmed by our case report.

Nale ?or?e

2007-01-01

76

Nontraumatic intracranial epidural hematoma: a case report.  

Science.gov (United States)

An outwardly mummified and inwardly badly decomposed body was found in a garage. At autopsy, no injuries were detected. Apart from coronary heart disease, with an old myocardial scar and a hepatic steatosis, the most striking finding was a large intracranial epidural hemorrhage situated at the left frontal lobe. As a relevant traumatic genesis could be ruled out, we deemed this a nontraumatic epidural hematoma. This finding is extremely rare. Several underlying disorders have been discussed as causes of spontaneous epidural hematomas. In this presented case, the authors discuss possible etiological factors. PMID:17721172

Bolliger, Stephan A; Thali, Michael J; Zollinger, Ulrich

2007-09-01

77

Rectus sheath hematoma: three case reports  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Introduction Rectus sheath hematoma is an uncommon cause of acute abdominal pain. It is an accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric vessel or muscle tear. It could occur spontaneously or after trauma. They are usually located infraumblically and often misdiagnosed as acute abdomen, inflammatory diseases or tumours of the abdomen. Case presentation We reported three cases of rectus sheath hematoma presenting with a mass in the abdomen and diagnosed by computerized tomography. The patients recovered uneventfully after bed rest, intravenous fluid replacement, blood transfusion and analgesic treatment. Conclusion Rectus sheath hematoma is a rarely seen pathology often misdiagnosed as acute abdomen that may lead to unnecessary laparotomies. Computerized tomography must be chosen for definitive diagnosis since ultrasonography is subject to error due to misinterpretation of the images. Main therapy is conservative management.

Kapan Selin

2008-01-01

78

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

79

Traumatic (para)interhemispheric hematoma  

International Nuclear Information System (INIS)

One interhemispheric subdural hematoma and two parainterhemispheric intracerebral hematomas diagnosed with CT-scan (Hitachi) are reported. The clinical pictures and the mechanism of occurrence of hematoma in these particular regions are discussed. Because of the peculiar hematoma it is necessary to take CT-scan up to the vertex when monoparesis or hemiparesis of the leg, which is more prominent in the leg, are noticed after the head injury. Brain atrophy might be related to the occurrence of hematoma in these peculiar regions after the head injury. (author)

80

Intermodulation noise caused by large amplitude, long delay echoes  

Science.gov (United States)

Theoretical approaches to the problem of calculating the intermodulation noise caused by an echo in FM-FDM transmission systems are examined. The work of Lewin (1950), Albersheim and Schafer (1955), Medhurst and Small (1956), Bennet (1955), Murphy (1969), and Clayton and Bacon (1970) is discussed. The results obtained from the existing analytical calculation methods are presented as graphs in general form and compared against experimental data obtained from an ad-hoc set of measurements.

Quarta, P.

1981-04-01

81

Rectus sheath hematoma  

OpenAIRE

Abstract Abstract Rectus sheath hematoma (RSH) is a known complication of anticoagulation therapy and a source of potential morbidity and mortality. Early diagnosis and appropriate treatment may help to prevent complications including hemodynamic instability, the abdominal compartment syndrome or multiorgan dysfunction. Although the diagnosis can be made clinically, it can be confirmed with computed tomography of the abdomen. Most patients can b...

Osinbowale, Olusegun; Bartholomew, John R.

2008-01-01

82

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.

2005-12-01

83

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.

2003-04-01

84

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

85

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

86

Hematoma subdural crônico tratamento cirúrgico e resultados em 96 pacientes operados / Chronic subdural hematoma: surgical treatment and results in 96 operated patients  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Os autores apresentam os resultados cirúrgicos de 96 casos de hematoma subdural crônico operados por meio de orifícios de trépano ou pequenas trefinas: 78 pacientes (81,3%) foram considerados curados, 6 (6,2%) apresentaram seqüelas e 12 (12,5%) faleceram. Os óbitos de natureza neurocirúrgica foram r [...] elacionados à intensidade do comprometimento neurológico por ocasião da cirurgia. A idade avançada associada à presença de doenças sistêmicas também teve influência na mortalidade. Seqüelas neurológicas foram observadas principalmente em pacientes submetidos a reoperações por reacúmulo do hematoma e em portadores de lesões bilaterais. Os autores chamam a atenção para a ocorrência de hipotensão intracraniana associada a colapso cerebral. A importância do diagnóstico precoce e cirurgia imediata são enfatizadas. Abstract in english Ninety-six patients with chronic subdural hematoma were treated surgically and their clinical features presented in detail. Carotid angiography gave the correct diagnosis in all patients. CT scan was performed in 38 and was diagnostic in 92.1% of the cases. The clots were removed through burr-holes [...] or small trephines: 78 (81.3%) patients were cured, 6 (6.2%) had permanent disabilities and 12 (12.5%) died. Operative mortality was related to the degree of neurological impairment, advanced age and systemic diseases. Neurologic sequelae were mostly related to reoperations due to recurrence of the hematoma and bilateral clots, as well. Low intracranial pressure syndrome with brain colapse was seen in 3 cases and treated with lumbar injection of saline solution. The delay in diagnosis and operation as cause of bad outcome is stressed.

J. Francisco, Salomão; Renê D., Leibinger; José Carlos, Lynch.

1990-03-01

87

Hematoma subdural crônico tratamento cirúrgico e resultados em 96 pacientes operados Chronic subdural hematoma: surgical treatment and results in 96 operated patients  

Directory of Open Access Journals (Sweden)

Full Text Available Os autores apresentam os resultados cirúrgicos de 96 casos de hematoma subdural crônico operados por meio de orifícios de trépano ou pequenas trefinas: 78 pacientes (81,3% foram considerados curados, 6 (6,2% apresentaram seqüelas e 12 (12,5% faleceram. Os óbitos de natureza neurocirúrgica foram relacionados à intensidade do comprometimento neurológico por ocasião da cirurgia. A idade avançada associada à presença de doenças sistêmicas também teve influência na mortalidade. Seqüelas neurológicas foram observadas principalmente em pacientes submetidos a reoperações por reacúmulo do hematoma e em portadores de lesões bilaterais. Os autores chamam a atenção para a ocorrência de hipotensão intracraniana associada a colapso cerebral. A importância do diagnóstico precoce e cirurgia imediata são enfatizadas.Ninety-six patients with chronic subdural hematoma were treated surgically and their clinical features presented in detail. Carotid angiography gave the correct diagnosis in all patients. CT scan was performed in 38 and was diagnostic in 92.1% of the cases. The clots were removed through burr-holes or small trephines: 78 (81.3% patients were cured, 6 (6.2% had permanent disabilities and 12 (12.5% died. Operative mortality was related to the degree of neurological impairment, advanced age and systemic diseases. Neurologic sequelae were mostly related to reoperations due to recurrence of the hematoma and bilateral clots, as well. Low intracranial pressure syndrome with brain colapse was seen in 3 cases and treated with lumbar injection of saline solution. The delay in diagnosis and operation as cause of bad outcome is stressed.

J. Francisco Salomão

1990-03-01

88

Iatrogenic subdural hematoma mimicking acute epidural hematoma on computed tomography  

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Full Text Available Computed tomography images of the subdural and epiduralhematoma are well defined, crescent and lentiformshapes, respectively. However, it has been reported thatboth of them might mimic each other in rare instances. Literaturereveals seven reports subdural hematoma mimickingepidural. We are reporting a new case of subduralhematoma mimicking epidural hematoma radiologically,which occurred after evacuation of chronic subdural hematomawith burr-hole in a 75 years old man. J Clin ExpInvest 2013; 4 (3: 367-369Key words: Subdural hematoma, epidural hematoma,computed tomography, brain.

Hakan Ak

2013-09-01

89

[Mortality after surgical treatment of patients with hypertensive intracerebral hematomas].  

Science.gov (United States)

Authors summarized the experience of specialized neurosurgical clinic for treatment of patients with stroke. From 1998 till 2008 1035 patients with hypertensive intracerebral hematomas were examined and treated in the clinic. 635 patients were operated, 400 received conservative treatment. Volumes of hematomas varied from 3 to 130 ml. Mean volume of hematoma in the "surgical" group was 52.9 ml (SD = 23.1), in the "conservative" group -- 37.2 ml (SD = 22.9). Two types of indications for surgery were defined: a) indications for life-saving surgery; b) indications for surgical treatment, implying achievement of good functional result. Hematomas were removed using different techniques: craniectomy or craniotomy -- 123 patients; minimally-invasive craniotomy and limited encephalotomy -- 78; puncture aspiration -- 65; puncture aspiration combined with local fibrinolysis (prourokinase) -- 291; combined procedures (including endoscopic) -- 49; external ventricular drainage -- 29. 30-days mortality in the "surgical" group was 29%, in the "conservative" group -- 38.7%. Critical volumes of hematomas of different localization with maximal effect on mortality were distinguished. Main causes of lethal outcome in the "surgical" group were the following: pulmonary artery thomboembolism -- 21.5%, pneumonia -- 29%, recurrent hemorrhage -- 19.5%. Therefore, surgical management of hypertensive intracerebral hematomas in selected groups of patients is associated with lower rate of mortality, in comparison with conservative management. Basically, it refers to the patients in severe condition, with volumes of hematoma above critical limits specific for certain localization. PMID:19507308

Saribekian, A S; Ponomarev, V A; Poliakova, L N; Romen, V A

2009-01-01

90

Systemic 5-fluorouracil treatment causes a syndrome of delayed myelin destruction in the central nervous system  

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Full Text Available Abstract Background Cancer treatment with a variety of chemotherapeutic agents often is associated with delayed adverse neurological consequences. Despite their clinical importance, almost nothing is known about the basis for such effects. It is not even known whether the occurrence of delayed adverse effects requires exposure to multiple chemotherapeutic agents, the presence of both chemotherapeutic agents and the body's own response to cancer, prolonged damage to the blood-brain barrier, inflammation or other such changes. Nor are there any animal models that could enable the study of this important problem. Results We found that clinically relevant concentrations of 5-fluorouracil (5-FU; a widely used chemotherapeutic agent were toxic for both central nervous system (CNS progenitor cells and non-dividing oligodendrocytes in vitro and in vivo. Short-term systemic administration of 5-FU caused both acute CNS damage and a syndrome of progressively worsening delayed damage to myelinated tracts of the CNS associated with altered transcriptional regulation in oligodendrocytes and extensive myelin pathology. Functional analysis also provided the first demonstration of delayed effects of chemotherapy on the latency of impulse conduction in the auditory system, offering the possibility of non-invasive analysis of myelin damage associated with cancer treatment. Conclusions Our studies demonstrate that systemic treatment with a single chemotherapeutic agent, 5-FU, is sufficient to cause a syndrome of delayed CNS damage and provide the first animal model of delayed damage to white-matter tracts of individuals treated with systemic chemotherapy. Unlike that caused by local irradiation, the degeneration caused by 5-FU treatment did not correlate with either chronic inflammation or extensive vascular damage and appears to represent a new class of delayed degenerative damage in the CNS.

Han Ruolan

2008-04-01

91

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

92

Hematoma espontâneo do músculo reto abdominal Spontaneous hematoma of the rectus sheath  

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Full Text Available Spontaneous hematoma of the rectus sheath is a rare entity, which may be confused with the surgical causes of acute abdomen. We present a well succeeded conservative therapy in a woman in the 7th decade of life.

Leonardo Fernandes Valentim

2005-06-01

93

Hematoma espontâneo do músculo reto abdominal / Spontaneous hematoma of the rectus sheath  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese [...] Abstract in english Spontaneous hematoma of the rectus sheath is a rare entity, which may be confused with the surgical causes of acute abdomen. We present a well succeeded conservative therapy in a woman in the 7th decade of life. [...

Leonardo Fernandes, Valentim; Glauco de Lima, Rodrigues; Renato de Medina, Coeli.

2005-06-01

94

Postoperative Spinal Epidural Hematoma: Risk Factor and Clinical Outcome  

OpenAIRE

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...

Yi, Seong; Yoon, Do Heum; Kim, Keung Nyun; Kim, Sang Hyun; Shin, Hyun Chul

2006-01-01

95

Diagnosis of epidural hematoma by brain scan and perfusion study: case report  

International Nuclear Information System (INIS)

By using the arterial and venous phases of an anterior cerebral perfusion study, which showed downward displacement of the sagittal sinus, and the finding of a rim on the delayed scans, the specific diagnosis of epidural hematoma was established

96

Retrospective analysis of operative treatment of a series of 100 patients with subdural hematoma.  

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This retrospective study of medical records, surgical protocols, patient observation cards, and imaging files of 100 patients treated for subdural hematoma analyzed the type of hematoma, patient age and sex, operative technique, neurological status, cause of injury, duration of hospital stay, mortality rate, and the number of and reasons for reoperations to determine the effects on treatment outcomes. The time between the head injury and onset of neurological symptoms was analyzed versus the type of hematoma determined from computed tomography (CT) scans. Acute hematomas accounted for 38% of the cases, with subacute hematomas representing 20%, and chronic ones accounting for 42%. In trauma patients, the mean time interval between the injury and onset of neurological symptoms was 0.38 days for acute hematomas, 13.8 days for subacute hematomas, and 23.75 days for chronic hematomas. Repeat surgery was carried out in 26% of the cases. Improvement was obtained in 44% of cases, deterioration in 20%, and no change in neurological status in 36%. Timing of the operations was between 15:00 and 23:00 in 45%, between 23:00 and 7:00 in 33%, and between 7:00 and 15:00 in 22%. The classification of hematomas based on CT presentation corresponds to the classification based on the time elapsed between injury and onset of symptoms, and appears to be appropriate and useful in everyday practice. No preceding injury was identified in 31.6% of acute hematomas, 50% of subacute hematomas, and 61.9% of chronic hematomas. Analysis of reoperations indicates that trepanation may be superior to craniotomy as primary surgery for subacute and chronic hematomas. Subdural hematoma surgeries take place at all times of the day, with most carried out outside the usual working hours. PMID:23358166

Godlewski, Bartosz; Pawelczyk, Agnieszka; Pawelczyk, Tomasz; Ceranowicz, Katarzyna; Wojdyn, Maciej; Radek, Maciej

2013-01-01

97

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

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Full Text Available 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.

Ditte Neess

2013-12-01

98

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

99

Pulsative hematoma: A penile fracture complication  

OpenAIRE

Background. Fracture of the penis is a direct blunt trauma of the erect or semi-erect penis. It can be treated by conservative or surgical means. Retrospective analyses of conservative penile fracture treatment reveal frequent immediate and later complications. Case report. We presented a 41- year-old patient with pulsative hematoma caused by an unusual fracture of the penis. Fracture had appeared 40 days before the admittance during a sexual intercourse. The patient was treated surgically. C...

Nale ?or?e; Mi?i? Sava

2007-01-01

100

Spontaneous epidural hematoma at lumbar facet joint: a case report  

Energy Technology Data Exchange (ETDEWEB)

Spontaneous epidural hematomas (SEHs) of the lumbar spine are rare. The pathogenesis is not entirely clear, but several reports have suggested that bleeding originating in the venous epidural plexus is the cause. This is the second report of a SEH thought to be the result of facet joint hemorrhage with no previous synovial cyst formation. A magnetic resonance image revealed a mass beginning in the left epidural space and continuing through to the left L5-S1 facet joint. Surgically, the epidural hematoma, which was covered by a very thin translucent membrane, was visualized directly. A histopathological examination revealed the wall of the epidural hematoma to be composed of very thin fibrous connective tissue with no synovium lining. The purpose of this study was to report a case of an epidural hematoma originated from lumbar facet joint, diagnosed by radiological examination, and to present a review of the subject literature.

Chung, Seung Eun; Lee, Sang Ho; Jo, Byung June; Yoon, Deug Hee; Paeng, Sung Suk [Wooridul Spine Hospital, Seoul (Korea, Republic of); Kim, Tae Hong [Inje University College of Medicine, Seoul (Korea, Republic of)

2005-10-15

101

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-de>1WI 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.)

102

[Experimental justification of approaches to pharmacological correction of delayed disorders caused by acute ethylene glycol poisoning].  

Science.gov (United States)

The development of delayed disorders caused by acute ethylene glycol poisoning has been studied in experiments on male rats. These disorders include chronic renal failure and secondary combined immunodeficiency status of the "circulus vitiosus" type. Urgent pharmacological correction was shown to be necessary shortly after the poisoning. The experimental therapy (administration of immunomodulators with various mechanisms of action in addition to conventional antidote treatment with ethanol) resulted in the restoration of nonspecific resistance and both cellular and humoral immunity. Reduction of the urinary system damage after the administration of immunomodulators was observed. The results demonstrated the importance of multiagent immunotherapy for the correction of delayed effects of acute ethylene glycol poisoning. PMID:23323331

Liubishin, M M; Sivak, K V; Savateeva-Liubimova, T N

2012-01-01

103

The Carrier's Liability for Damage Caused by Delay in International Air Transport  

Science.gov (United States)

Delay in the air transport occurs when passengers, baggage or cargo do not arrive at their destination at the time indicated in the contract of carriage. The causes of delay in the carriage of passengers are booking errors or double booking, delayed departure of aircraft, incorrect information regarding the time of departure, failure to land at the scheduled destination and changes in flight schedule or addition of extra landing stops. Delay in the carriage of baggage or cargo may have different causes: no reservation, lack of space, failure to load the baggage or cargo at the right place, or to deliver the covering documents at the right place. The Montreal Convention of 1999 Article 19 provides that 'The carrier is liable for damage occasioned by delay in the carriage by air of passengers, baggage or cargo. Nevertheless, the carder shall not be liable for damage occasioned by delay if it proves that it and its servants and agents took all measures that could reasonably be required to avoid the damage or that it was impossible for it or them to take such measures'. The Montreal Convention Article 22 provides liability limits of the carrier in case of delay for passengers and their baggage and for cargo. In the carriage of persons, the liability of the carrier for each passenger is limited to 4,150 SDR. In the carriage of baggage, the liability of the carrier is limited to 1,000 SDR for each passenger unless a special declaration as to the value of the baggage has been made. In the carriage of cargo, the liability of the carrier is limited to 17 SDR per kilogram unless a special declaration as to the value of the cargo has been made. The Montreal Convention Article 19 has shortcomings: it is silent on the duration of the liability for carriage,andit does not make any distinction between persons and good. It does not give any indication concerning the circumstances to be taken into account in cases of delay, and about the length of delay. In conclusion, it is desirable to define the period of carriage with accuracy, and to insert the word 'unreasonable' in Article 19.

Lee, Kang Bin

2003-01-01

104

Muscle hematoma: A critically important complication of alcoholic liver cirrhosis  

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Full Text Available An iliopsoas hematoma can occur either spontaneously or secondary to trauma or bleeding tendency due to hemophilia and anticoagulant therapy. Although liver cirrhosis is commonly associated with coagulopathy, iliopsoas hematoma is very rare. We herein, present a case of bilateral iliopsoas hematoma in a patient with alcoholic cirrhosis, and review the literature on muscle hematoma associated with cirrhosis. A 56-year-old man with alcoholic cirrhosis was admitted in a state of shock with anemia. The cause of anemia could not be detected, and the patient was treated conservatively. The site of bleeding was not detected with either gastroduodenal endoscopy or upper abdominal computed tomography, the latter of which did not include the iliopsoas muscle. He died on the 10th day of admission and bilateral iliopsoas hematomas were found on autopsy. An iron stain was positive in the iliopsoas muscle. Eight cases of muscle hematoma associated with cirrhosis, including the present case, were found in a review of the literature. Four of these cases involved the rectus abdominis muscle, 3 involved the iliopsoas muscle and 1 involved combined muscles. Alcoholic cirrhosis accounted for 75% of the cases. One case (12.5% was associated with virus-related cirrhosis, and another with combined virus- and alcohol-related cirrhosis. The mortality rate was 75% despite early diagnosis and low risk scores for cirrhosis. Muscle hematoma in patients with cirrhosis is closely related to alcoholism, and the mortality rate of the condition is extremely high. In conclusion, muscle hematoma should be recognized as an important complication of cirrhosis.

Chiyo Sugiyama, Akifumi Akai, Noriyoshi Yamakita, Tsuneko Ikeda, Keigo Yasuda

2009-09-01

105

[A case of infected subdural hematoma accompanied by cerebral infarction].  

Science.gov (United States)

Infected subdural hematoma(ISH)is a rare disease caused by hematogenous infection of a preexisting subdural hematoma. We report a rare case of ISH accompanied by cerebral infarction. A 76-year-old man who had suffered a closed head injury 3 months before presented fever, headache and left hemiparesis during the medical treatment of acute cholangitis and obstructive jaundice with pancreatic cancer at the department of surgical gastroenterology. At the consultation, computed tomography(CT)scan indicated right chronic subdural hematoma. We performed a burr hole opening surgery on the same day. Abscess and hematoma was aspirated from the subdural space, and methicillin-resistant Staphylococcus aureus(MRSA)was detected in this specimen. Thus the diagnosis of the infected subdural hematoma was confirmed. However, despite the antibiotics therapy, follow-up CT showed a low-density area close to the residual abscess, which suggested cerebral infarction. Cerebral angiography showed a vasospasm at the cortical segment of the right middle cerebral artery near the residual abscess. Eventually we carried out a small craniotomy to evacuate the abscess. Our case showed that prompt surgical treatment is required in case of ISH and the whole hematoma and abscess should be removed as soon as possible with an image diagnosis and an additional surgical operation. PMID:23648657

Fujii, Norio; Naito, Yuichiro; Takanashi, Shigehiko; Ueno, Toshiaki; Nakagomi, Tadayoshi

2013-05-01

106

MRI findings in spinal subdural and epidural hematomas  

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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

107

MRI findings in spinal subdural and epidural hematomas  

International Nuclear Information System (INIS)

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

108

The MR imaging findings in spontaneous spinal epidural hematoma  

International Nuclear Information System (INIS)

Objective: To evaluate MR findings and clinical features in patients with spontaneous spinal epidural hematoma (SSEH). Methods: Eight patients (5 men, 3 women; aged 16 - 50 years) with SSEH underwent MR imaging during 1994 - 2001, including 7 cases without history of trauma or coagulation disorders and 1 case with history of hypertension. MR imaging was performed from 4 hours to 3 days after the onset of symptoms in all 8 patients with surgical and pathologic diagnosis. Results: The hematomas were in lateral posterior or posterior epidural space, including 3 cases in cervical vertebra, 2 cases in thoracic vertebra, 2 cases in cervical and thoracic junction region, and 1 case in thoracic and lumbar part. The MRI confirmed an encapsulated hematoma caused by arteriovenous malformation in 1 case and two hematomas associated with disc herniation. The signal intensity of the hematoma varied with the hematoma age, but T1-weighted images reflected its typical signal changes. Sagittal and coronal T1-weighted images revealed isointense (7 cases) and slight high-intense (1 case) signal; Sagittal and axial T2-weighted images revealed mixed-intensity (6 cases) and mixed high-intensity (2 cases). Conclusion: MR imaging has an important value on localization, identification, and differential diagnosis of the lesion, therefore, it is the most helpful diagnostic tool for this condition

109

Chronological evaluation of the occurrence and growth of traumatic intracerebral hematomas  

International Nuclear Information System (INIS)

Recently several papers have reported the chronological evaluation of traumatic intracerebral hematomas, but the time interval of the follow-up CT in such papers were too long to evaluate the occurrence and growth of such traumatic intracerebral hematomas exactly. For the purpose of clarifying this problem, we frequently performed serial CT's immediately after the onset of head injury in cases of brain contusion. As a result, we found that 80 % of the traumatic intracerebral hematomas (more than 3 cm in diameter) appeared within 12 hours after the injury and also that 80 % of them reached their largest size within 12 hours after the injury. We could not find any case whose hematoma could not be found by a CT taken within 24 hours after injury, but could be demonstrated by a CT taken later. We also discuss ''delayed traumatic intracerebral hematomas'' on the basis of our results. (author)

110

Hyperglycaemia and ketosis in a non-diabetic patient--an unusual cause of delayed recovery.  

Science.gov (United States)

We report a case of hyperglycaemia and ketosis developing in a non-diabetic patient who underwent a neurosurgical procedure under general anaesthesia. A 52-year-old non-diabetic female patient underwent excision of acoustic neuroma under general anaesthesia. Pancreatic function was not disturbed and she received a single dose of dexamethasone (8 mg) and paracetamol (1 g). Delayed recovery from anaesthesia occurred. On investigation, she was found to have hyperglycaemia and ketosis. She was further managed on the line of diabetic ketoacidosis. After 24 hours, when blood glucose had normalised and ketosis abated, she could be weaned from mechanical ventilation and extubated. The patient did not receive any drugs known to cause such a condition. To the best of our knowledge, hyperglycaemia and ketosis developing in a non-diabetic patient causing delayed recovery and extubation is here reported for the first time. PMID:25078770

Pawar, Sundeep T; Nath, Soumya S; Ansari, Farrukh

2014-01-01

111

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

112

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

OpenAIRE

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 landsca...

Krauss, Jochen; Bommarco, Riccardo; Guardiola, Moise?s; Heikkinen, Risto K.; Helm, Aveliina; Kuussaari, Mikko; Lindborg, Regina; O?ckinger, Erik; Pa?rtel, Meelis; Pino, Joan; Po?yry, Juha; Raatikainen, Katja M.; Sang, Anu; Stefanescu, Constanti?; Teder, Tiit

2010-01-01

113

Intramural aortic hematomas  

International Nuclear Information System (INIS)

Intramural hematomas (IMH) are regarded as a hemorrhage into the aortic wall. In general a traumatic form can be differentiated from a spontaneous non-traumatic. There is a predisposition of IMH with arterial hypertension and mesoectodermal dysplastic syndromes. The diagnosis is established with the clinical presentation in combination with the findings of different imaging modalities. Acute and subacute discomfort associated with a tendency of collaps are considered as typical presenting complaints. A semicircular or concentric thickening of the aortic wall with the absence of blood flow or a dissection membran are typical findings in transesophageal echocardiography, computed tomography and magnetic resonance tomography. From a differential diagnostic point of view a distinction from atherosclerotic wall changes, intraluminal thrombi and inflammatory aortic diseases is essential. The IMH is considered as an early presentation of aortic dissection, put into and treated according to the Stanford classification. In the course of natural history an IMH can disappear, rupture or progress into a classic aortic dissection. (orig.)

114

Iatrogenic subdural hematoma mimicking acute epidural hematoma on computed tomography  

OpenAIRE

Computed tomography images of the subdural and epiduralhematoma are well defined, crescent and lentiformshapes, respectively. However, it has been reported thatboth of them might mimic each other in rare instances. Literaturereveals seven reports subdural hematoma mimickingepidural. We are reporting a new case of subduralhematoma mimicking epidural hematoma radiologically,which occurred after evacuation of chronic subdural hematomawith burr-hole in a 75 years old man. J Clin ExpInvest 2013; 4...

Hakan Ak; Sadiye Yolcu; Tugay Atalay; Naciye K??

2013-01-01

115

Bruising of the esophagus as a cause of gastrointestinal bleeding in a case of heatstroke / Hematomas esofágicos como causa de hemorragia digestiva en un caso de golpe de calor  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: English Abstract in spanish Las alteraciones de la coagulación son una complicación frecuente en el golpe de calor grave, y pueden ser causa de hemorragia digestiva. Presentamos el caso de un varón de 26 años que fue admitido en nuestro hospital por un cuadro de hipertermia, asociado con encefalopatía y coagulación intravascul [...] ar diseminada tras exposición solar prolongada. Presentó hematemesis por la que fue diagnosticado de múltiples hematomas esofágicos que ocupaban los tercios superior e inferior del órgano, en ausencia de otras lesiones en estómago y duodeno. Tras el tratamiento de soporte y la resolución de la patología subyacente, desaparecieron las lesiones endoscópicas, normalizándose la mucosa esofágica. Abstract in english Alterations in blood clotting are a frequent complication of serious heatstroke and may result in gastrointestinal bleeding. We report the case of a 26-year-old man who was admitted to our hospital with symptoms of hyperthermia associated with encephalopathy and disseminated intravascular coagulatio [...] n (DIC) after prolonged exposure to sunlight. He presented hematemesis, after which he was diagnosed with having a bruising of the esophagus that took up the upper and lower thirds, there being no other lesions in the stomach or duodenum. After supportive treatment and following the resolution of the underlying pathology, the endoscopy-revealed injuries healed with a complete normalization of the esophageal mucosa. Esophageal submucosal bruising is an exceptional cause of hematemesis in serious heatstroke not previously described in the literature.

A. J., Lucendo Villarín; G., Carrión Alonso; A., Kassem; R., Pajares Villarroya; N., Manceñido Marcos; R., Rey Sanz.

2005-08-01

116

Bruising of the esophagus as a cause of gastrointestinal bleeding in a case of heatstroke Hematomas esofágicos como causa de hemorragia digestiva en un caso de golpe de calor  

Directory of Open Access Journals (Sweden)

Full Text Available Alterations in blood clotting are a frequent complication of serious heatstroke and may result in gastrointestinal bleeding. We report the case of a 26-year-old man who was admitted to our hospital with symptoms of hyperthermia associated with encephalopathy and disseminated intravascular coagulation (DIC after prolonged exposure to sunlight. He presented hematemesis, after which he was diagnosed with having a bruising of the esophagus that took up the upper and lower thirds, there being no other lesions in the stomach or duodenum. After supportive treatment and following the resolution of the underlying pathology, the endoscopy-revealed injuries healed with a complete normalization of the esophageal mucosa. Esophageal submucosal bruising is an exceptional cause of hematemesis in serious heatstroke not previously described in the literature.Las alteraciones de la coagulación son una complicación frecuente en el golpe de calor grave, y pueden ser causa de hemorragia digestiva. Presentamos el caso de un varón de 26 años que fue admitido en nuestro hospital por un cuadro de hipertermia, asociado con encefalopatía y coagulación intravascular diseminada tras exposición solar prolongada. Presentó hematemesis por la que fue diagnosticado de múltiples hematomas esofágicos que ocupaban los tercios superior e inferior del órgano, en ausencia de otras lesiones en estómago y duodeno. Tras el tratamiento de soporte y la resolución de la patología subyacente, desaparecieron las lesiones endoscópicas, normalizándose la mucosa esofágica.

A. J. Lucendo Villarín

2005-08-01

117

Surgical management of posttraumatic intraorbital hematoma.  

Science.gov (United States)

Retrobulbar hematoma is a rare condition but represents a diagnostic and therapeutic emergency. It occurs in between 0.3% and 3.5% of facial traumas and can be caused by direct or indirect injury of the orbit; they can be classified into intraorbital and subperiosteal hematoma. We describe 4 different cases of posttraumatic retrobulbar hematoma treated at the Unit of Maxillofacial Surgery of the Novara Major Hospital between January 2005 and December 2009, each different from the others for morphologic aspects, and we discuss its diagnosis and management. Surgery decompression of the orbit is recommended when visual deficit arises and when there is no response to pharmacologic therapy. Several techniques for orbital decompression have been proposed. The lateral canthotomy and/or the inferior cantholysis are the 2 techniques most practiced. Anterior-chamber paracentesis is effective, but it is rarely indicated for frequent complications such as cataract formation, herniation of the iris, infection, and trauma to the canal of Schlemm. Other procedures including transantral ethmoidectomy, transantral sphenoidectomy, and transfrontal craniotomy are described. PMID:22337467

Brucoli, Matteo; Arcuri, Francesco; Giarda, Mariangela; Benech, Rodolfo; Benech, Arnaldo

2012-01-01

118

Quantum error correction may delay, but also cause, entanglement sudden death  

CERN Document Server

Dissipation may cause two initially entangled qubits to evolve into a separable state in a finite time. This behavior is called entanglement sudden death (ESD). We study to what extent quantum error correction can combat ESD. We find that in some cases quantum error correction can delay entanglement sudden death but in other cases quantum error correction may cause ESD for states that otherwise do not suffer from it. Our analysis also shows that fidelity may not be the best measure to compare the efficiency of different error correction codes since the fidelity is not directly coupled to a state's remaining entanglement.

Sainz, Isabel

2008-01-01

119

Spontaneous intraorbital hematoma: case report  

Directory of Open Access Journals (Sweden)

Full Text Available Vinodan Paramanathan, Ardalan ZolnourianQueen's Hospital NHS Foundation Trust, Burton on Trent, Staffordshire DE13 0RB, UKAbstract: Spontaneous intraorbital hematoma is an uncommon clinical entity seen in ophthalmology practice. It is poorly represented in the literature. Current evidence attributes it to orbital trauma, neoplasm, vascular malformations, acute sinusitis, and systemic abnormalities. A 65-year-old female presented with spontaneous intraorbital hematoma manifesting as severe ocular pains, eyelid edema, proptosis, and diplopia, without a history of trauma. Computer tomography demonstrated a fairly well defined extraconal lesion with opacification of the paranasal sinuses. The principal differential based on all findings was that of a spreading sinus infection and an extraconal tumor. An unprecedented finding of a spontaneous orbital hematoma was discovered when the patient was taken to theater. We discuss the rarity of this condition and its management.Keywords: hemorrhage, ophthalmology, spontaneous, intra-orbital, hematoma

Vinodan Paramanathan

2010-12-01

120

Prevention of Hematomas and Seromas  

OpenAIRE

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 ...

Bullocks, Jamal; Basu, C. Bob; Hsu, Patrick; Singer, Robert

2006-01-01

121

Surgical management of intracerebral hematomas  

International Nuclear Information System (INIS)

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

122

Spontaneous retroperitoneal hematoma from rupture of an aneurysm of the ovarian artery following delivery.  

Science.gov (United States)

We describe a case involving spontaneous retroperitoneal hematoma caused by rupture of an aneurysm of the right ovarian artery 4 days after delivery in a multiparous woman. Diagnosis was achieved by arteriography. Bleeding was stopped by embolization via selective arteriography. Hematoma was drained by lomboscopy. The pathophysiological mechanisms underlying development and treatment of these aneurysms are discussed. PMID:10398743

Guillem, P; Bondue, X; Chambon, J P; Lemaitre, L; Bounoua, F

1999-07-01

123

Traumatic posterior fossa epidural hematoma  

International Nuclear Information System (INIS)

In this paper three acute cases and two subacute cases are reported. CT findings in acute cases show two different types. ''Type I'' shows crescent or lenticular high density area which is not enhanced after contrast infusion. ''Type II'' shows lenticular low density area with membranous high density region in its medial side after contrast infusion. In subacute cases plain CT scan shows lenticular iso or low density area with membranous high density region in its medial side. Forty five cases of posterior fossa epidural hematoma in the review of literature of this country are discussed. Disturbances of the consciousness are the most predominant symptoms in acute cases, while in subacute cases cerebellar signs, vomiting, headache and choked disc are noted. Angiographical examinations may not always be valuable in collecting the direct information of the existence of the epidural hematoma. Liquor cavity in the posterior fossa which is thought to serve as a buffer action of hematoma is about 20 ml, so we discuss about the volume of hematoma, especially of 20 ml, associated with clinical course and prognosis. Volume of epidural hematoma is one of the most important factors affecting clinical course and prognosis. In summary of these our experiences, we again emphasize the value of CT scan as the rapid, noninvasive, accurate radiological examination in the diagnosis of traumatic posterior fossa epidural hematoma. (author)

124

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; Öckinger, Erik; Pärtel, Meelis; Pino, Joan; Pöyry, Juha; Raatikainen, Katja M; Sang, Anu; Stefanescu, Constantí; Teder, Tiit; Zobel, Martin; Steffan-Dewenter, Ingolf

2010-01-01

125

Assessment of Influential Causes of Construction Project Delay in Malaysian Private Housing from Developer’s Viewpoint  

OpenAIRE

Project delay in the construction industry is a universal or large-scale observable fact affecting not only the construction industry but the overall economy of countries too. The objective of this study is to evaluate and identify the causes and consequences of project delays in the private housing development projects in Malaysia and the remedies that can minimize these delays. An online questionnaire survey has been carried out to collect the data and this included 76 respondents from mult...

Othuman Mydin M.A.; Md, Sani N.; Agus Salim N.A.; Mohamed Alias N.

2014-01-01

126

Pathogenesis of chronic subdural hematoma  

International Nuclear Information System (INIS)

Ten cases of chronic subdural hematoma that were followed by a sequential study with CT from an early posttraumatic period to evolution of chronic subdural hematoma were reported. In four of these 10 cases, the initial CT showed thin subdural collections of high density suggesting acute subdural hematoma. Two weeks later, the density of subdural collections reduced, but their volumes increased. Clinical symptoms such as headache and disorientation occurred three or four weeks later. Preoperative CT showed similar huge subdural collections of low density and marked mass effect. These cases underwent surgery from 24 to 44 days after injury, and development of neomenbranes was confirmed. In the remaining six cases, the initial CT showed thin subdural collections of low density suggesting subdural hygroma. In five of the six cases, the density of the subdural collections was slightly higher than that of cerebrospinal fluid, and in one case, an area of spotted high density was shown. It was suggested that these were mixtures with blood. Follow-up CT scans revealed that the subdural collections increased in size but remained at a uniformly low density for the first month after the head injury, and then the increase in density occurred. Operations were performed 55 to 76 days after injury, and operative findings were not different from those of common chronic subdural hematoma. From these investigations, it was suggested that there were two types of evolution of chronic subdere two types of evolution of chronic subdural hematoma. One is the development from acute subdural hematomas, and the other from subdural hygromas. It is supposed that blood and cerebrospinal fluid are very important factors in the evolution of subdural collections into chronic subdural hematomas. (J.P.N.)

127

Thyroid Gland Hematoma After Blunt Neck Trauma  

Directory of Open Access Journals (Sweden)

Full Text Available 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 admission.[West J Emerg Med. 2009;10(4:247-249.

Saylam, Baris

2009-11-01

128

A chronic intracerebral fluid hematoma.  

Science.gov (United States)

Intracerebral hematoma usually resolves and a chronic fluid hematoma is rare. We describe a rare case of intracerebral fluid hematoma. This report describes a case of intracerebral fluid hematoma mimicking a brain tumor and discusses the characteristics of this condition. A 70-year-old woman had a six-month history of memory disturbance. Computed tomography scan showed a low-density lesion with a partial high-density area in the right frontal lobe. MRI revealed a lesion of the main cystic portion showing high intensity on both T1 and T2 weighted images with a low-intensity solid portion in the anteromedial side. The lesion was adjacent to the lateral ventricle. Craniotomy was carried out and the lesion was removed. Pathological examination of the solid portion revealed that the diagnosis was reactive changes due to intracerebral hemorrhage. In our case, there was a possibility that the hematoma was diluted with cerebrospinal fluid, and coagulation might have been prevented. PMID:24750708

Nomura, Motohiro; Miyashita, Katsuyoshi; Tamase, Akira; Kamide, Tomoya; Mori, Kentaro; Kitamura, Yoshihisa; Seki, Shunsuke; Shima, Hiroshi; Yanagimoto, Kunio

2014-04-01

129

Assessment of Influential Causes of Construction Project Delay in Malaysian Private Housing from Developer’s Viewpoint  

Directory of Open Access Journals (Sweden)

Full Text Available Project delay in the construction industry is a universal or large-scale observable fact affecting not only the construction industry but the overall economy of countries too. The objective of this study is to evaluate and identify the causes and consequences of project delays in the private housing development projects in Malaysia and the remedies that can minimize these delays. An online questionnaire survey has been carried out to collect the data and this included 76 respondents from multiple developers’ companies around Malaysia. From the survey, a total of 28 causes and 6 consequences of project delays had been identified from four different factors of delays; such as client factors, consultant factors, contractor factors and external factors, by which the contractor factor being the major contributor to this problem.The top ten causes of the delays are due to weather conditions, poor site conditions, poor site management, incomplete documents, lack of experience, financial problems, contract modifications, delay in approving of major variations, contractor coordination problem with other parties and construction mistakes and defective works. The consequences of the delays would contribute to time overrun, cost overrun, different in opinions, negotiations, legal actions and total abandonment.

Othuman Mydin M.A.

2014-01-01

130

Sickle cell disease with orbital infarction and epidural hematoma  

International Nuclear Information System (INIS)

Although bone infarction is a common feature in sickle cell disease, the involvement of the orbit is an unusual complication. Intracranial bleeding is another uncommon and serious complication. Few cases of orbital infarction alone have been reported. We report imaging findings (CT, bone scan, MRI) in a 16-year-old boy with sickle cell disease with orbital infarction and epidural hematoma. The precise cause of epidural hematoma is not well known, but it is probably related to vaso-occlusive episodes and the tearing of small vessels. (orig.)

131

Sickle cell disease with orbital infarction and epidural hematoma  

Energy Technology Data Exchange (ETDEWEB)

Although bone infarction is a common feature in sickle cell disease, the involvement of the orbit is an unusual complication. Intracranial bleeding is another uncommon and serious complication. Few cases of orbital infarction alone have been reported. We report imaging findings (CT, bone scan, MRI) in a 16-year-old boy with sickle cell disease with orbital infarction and epidural hematoma. The precise cause of epidural hematoma is not well known, but it is probably related to vaso-occlusive episodes and the tearing of small vessels. (orig.)

Naran, A.D.; Fontana, L. [Dept. of Diagnostic Radiology, New York Methodist Hospital, Brooklyn, NY (United States)

2001-04-01

132

Ultrasound diagnosis of rectus sheath hematoma  

International Nuclear Information System (INIS)

6 cases of rectus sheath hematoma were correctly diagnosed by ultrasound. 2 cases had bilateral rectus sheath hematoma and 4 cases were unilateral. On ultrasound finding, relatively well defined oval or spindle like cystic mass situated in the area of rectus muscle on all cases. Ultrasound examination may give more definite diagnosis and extension rectus sheath hematoma and also helpful to follow up study of hematoma

133

Ultrasound diagnosis of rectus sheath hematoma  

Energy Technology Data Exchange (ETDEWEB)

6 cases of rectus sheath hematoma were correctly diagnosed by ultrasound. 2 cases had bilateral rectus sheath hematoma and 4 cases were unilateral. On ultrasound finding, relatively well defined oval or spindle like cystic mass situated in the area of rectus muscle on all cases. Ultrasound examination may give more definite diagnosis and extension rectus sheath hematoma and also helpful to follow up study of hematoma.

Hwang, M. S.; Chang, J. C.; Rhee, C. B. [Yeung Nam University Hospital, Seoul (Korea, Republic of)

1984-06-15

134

Renal Cell Carcinoma Metastasis from Biopsy Associated Hematoma Disruption during Robotic Partial Nephrectomy  

Science.gov (United States)

We describe a case in which a patient with a past medical history of ovarian cancer received a diagnostic renal biopsy for an incidentally discovered renal mass. During left robotic partial nephrectomy (RPN), a perinephric hematoma was encountered. The hematoma was not present on preoperative imaging and was likely a result of the renal biopsy. The renal cell carcinoma (RCC) and the associated hematoma were widely excised with negative surgical margins. On follow-up imaging at five months postoperatively, a recurrent renal mass at the surgical resection bed and several new nodules in the omentum were detected. During completion left robotic total nephrectomy and omental excision, intraoperative frozen sections confirmed metastatic RCC. We believe that a hematoma seeded with RCC formed as a result of the renal biopsy, and subsequent disruption of the hematoma during RPN caused contamination of RCC into the surrounding structures.

2014-01-01

135

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

136

HEMATOMA OF THE PROXIMAL NAIL FOLD. REPORT OF 41 CASES  

Directory of Open Access Journals (Sweden)

Full Text Available Background: The proximal fold is an important part of the nail apparatus it contributes to the formation of the nail plate and through the cuticle acts as an impermeable barrier protecting it from any cause.Objective: To know the proximal nail fold hematoma caused by the use of pulse oximeter.Material and Methods: A descriptive study was conducted in 41 patients with proximal nail hematoma secondary to the use of oximetry in patients hospitalized in the Intermediate and Intensive Care Unit at the Hospital General de Enfermedades from December 1, 2007 to December 31, 2010.Results: We studied 41 patients with proximal nail fold hematoma secondary to the use of oximeter, 30 (73.1% were males and 11 (26.8% females. The numbers of fingers affected by pulse oximeter were in one digit. 30 (73.1% cases, in two digits 6 (14.6%, in three digits 3 (7.3%, in 4 digits 1 (2.4% and in 5 digits 1 (2.4% case. The most affected proximal nail fold was right index: 24 (58.5%, right middle 11 (26.8%, right ring 6 (14.6%, left index 12 (29.2%, and left middle 6 (14.6% cases.Conclusions: Hematomas of the proximal nail fold may be caused by different traumatisms. The use of pulse oximeter is one of them.

Chang Patricia

2011-04-01

137

Patient delay is the main cause of treatment delay in acute limb ischemia: an investigation of pre- and in-hospital time delay.  

DEFF Research Database (Denmark)

Abstract BACKGROUND: The prognosis of acute limb ischemia is severe, with amputation rates of up to 25% and in-hospital mortality of 9-15%. Delay in treatment increases the risk of major amputation and may be present at different stages, including patient delay, doctors´ delay and waiting time in the emergency department. It is important to identify existing problems in order to reduce time delay. The aim of this study was to collect data for patients with acute limb ischemia and to evaluate the time delay between the different events from onset of symptoms to specialist evaluation and further treatment with focus on pre-hospital and in-hospital time delays. METHODS: We conducted a prospective cross-sectional cohort study including all patients suspected with acute limb ischemia who were admitted to the emergency department of a community hospital in a six months period. Temporal delay in the different phases between the time of occurrence of symptoms and completion of treatment was recorded prospectively. All patients who underwent intervention had a 30 days follow-up with regard to major amputation of the leg and survival. RESULTS: A total of 42 patients (21 men and 21 women) age 73 (20-95) years (median (range)) was identified. From onset of symptoms to first contact with a doctor the time for all patients were 24 (0-1200) hours. Thirty patients needed immediate intervention. In the group of fourteen patients who had immediate operation, the median time from vascular evaluation to revascularization was 324.5 (122-873) minutes and in the group of eight patients that went through an imaging procedure before an operation the median delay was 822 (494-1185) minutes from specialist assessment to revascularization. The median time for revascularization among four patients, who were treated with arterial thrombolysis was 5621 (1686-8376) minutes. At 30 days follow up, six patients had had the ischemic limb amputated above the ankle and four patients had died. CONCLUSIONS: We found that the largest time delay was between onset of symptoms and first contact to a medical doctor. A greater public awareness is needed, so as to facilitate urgent revascularisation and improve outcomes. KEYWORDS: ALI; Acute limb ischemia; Diagnostic packages; Fast track department; Patient delay; Treatment delay

Londero, Louise Skovgaard; NØrgaard, Birgitte

2014-01-01

138

[Chronic subdural hematoma: diagnostic imaging studies].  

Science.gov (United States)

CT-scan is able to provide the diagnosis of chronic subdural hematoma in more than 90% of the cases. It usually shows a peri-cerebral fluid collection along the convexity, with a convex outer border, and an irregular concave inner border. The density of the collection depends on the age of the hematoma. The main difficulties, in term of diagnosis, result from bilateral isodense chronic subdural hematoma, and differential diagnosis between hematoma, hygroma, and empyema. Some rare localisations can sometimes be seen (posterior fossa, skull base...). A double density with a sedimentation level, or heterogeneity of the hematoma, can sometimes be seen too. Chronic subdural hematoma is demonstrated by MRI in almost 100% of the cases. The intensity of the collection, in T1 and T2 sequences, depends on the age of the hematoma. PMID:11915760

Guénot, M

2001-11-01

139

Control of the chaotic state caused by the curent-driven ion acoustic instabilit and dynamical behavior using delayed feedback  

CERN Document Server

Controlling chaos caused by the current-driven ion acoustic instability is attempted using the delayed continuous feedback method, i.e., the time-delay auto synchronization (TDAS) method introduced by Pyragas [Phys. Lett. A 170 (1992) 421.]. When the control is applied to the typical chaotic state, chaotic orbit changes to periodic one, maintaining the instability. The chaotic state is well controlled using the TDAS method. It is found that the control is achieved when a delay time is chosen near the unstable periodic orbit corresponding to the fundamental mode. Furthermore, when the delayed feedback is applied to a periodic nonlinear regime and arbitrary time delay is chosen, the periodic state is leaded to various motions including chaos. As a related topic, the synchronization between two instabilities of autonomous discharge tubes in a glow discharge is studied. Two tubes are settled independently and interacting each other through the coupler consisted of variable resister and capacitor. When the value o...

Fukuyama, T; Kawai, Y; Fukuyama, Takao; Wilke, Christian; Kawai, Yoshinobu

2004-01-01

140

Self-Administered Cocaine Causes Long-Lasting Increases in Impulsive Choice in a Delay Discounting Task  

OpenAIRE

Cocaine use is associated with high levels of impulsive choice (preference for immediate over delayed rewards), but it is not clear whether cocaine use causes elevated impulsive choice, or whether elevated impulsive choice is solely a predisposing factor for cocaine use. This study examined the effects of prior cocaine self-administration on rats performing a delay discounting task commonly used to measure impulsive choice. Male Long-Evans rats were implanted with intravenous catheters, and f...

Mendez, Ian A.; Simon, Nicholas W.; Hart, Nigel; Mitchell, Marci R.; Nation, Jack R.; Wellman, Paul J.; Setlow, Barry

2010-01-01

141

Inhibition of autophagy induction delays neuronal cell loss caused by dysfunctional ESCRT-III in frontotemporal dementia  

OpenAIRE

Autophagy is a conserved lysosomal protein degradation pathway whose precise roles in age-dependent neurodegenerative diseases remain largely unknown. Here we show that the autophagy inhibitor 3-methyladenine delays neuronal cell loss caused by dysfunctional ESCRT-III, either through loss of its essential component mSnf7-2 or ectopic expression of the disease protein CHMP2BIntron5, which is associated with frontotemporal dementia linked to chromosome 3 (FTD3). Neuronal loss was also delayed b...

Lee, Jin-a; Gao, Fen-biao

2009-01-01

142

Control of the chaotic state caused by the curent-driven ion acoustic instabilit and dynamical behavior using delayed feedback  

OpenAIRE

Controlling chaos caused by the current-driven ion acoustic instability is attempted using the delayed continuous feedback method, i.e., the time-delay auto synchronization (TDAS) method introduced by Pyragas [Phys. Lett. A 170 (1992) 421.]. When the control is applied to the typical chaotic state, chaotic orbit changes to periodic one, maintaining the instability. The chaotic state is well controlled using the TDAS method. It is found that the control is achieved when a del...

Fukuyama, Takao; Wilke, Christian; Kawai, Yoshinobu

2004-01-01

143

Evaluation of factors causing delayed graft function in live related donor renal transplantation  

Directory of Open Access Journals (Sweden)

Full Text Available To determine the incidence and determinants of delayed graft function due to post-transplant acute tubular necrosis in live related donor renal transplantation. This is a retrospective study of 337 recipients of live related donor renal graft performed between1986 and 2006. Of these recipients, 24 (7.1% subjects developed delayed graft function with no evidence of acute rejection, cyclosporin toxicity, vascular catastrophe or obstructive cause and had evidence of acute tubular necrosis (ATN Group. These subjects were compared with recipients (n= 313, 92.9% who had no clinical or biochemical evidence of ATN. Mean age, and gender distribution of recipients was similar in the two groups (ATN group 35.7 ± 8.3, non-ATN group 34.3 ± 7.5, P= 0.43. Gender distribution of the recipients (men 279, 89.1% vs. 21, 87.5%, P= 0.80 as well as donors (women 221, 70.6% vs. 18, 75.0%, P= 0.75 was also similar. In ATN group as compared with non-ATN group the donor age was significantly greater (56.6 ± 8.3 vs. 46.6 ± 11.2 years, P< 0.0001. There was marginal difference in pre-operative systolic BP (154.5 ± 18.3 vs. 147.4 ± 20.2 mm Hg, P= 0.077 and significant difference in diastolic BP (87.8 ± 9.5 vs. 83.4 ± 11.4 mmHg, P= 0.041. Incidence of multiple renal arteries was similar (16.7% vs. 7.3%, P= 0.22. The warm ischemia time was significantly greater in ATN group (33.3 ± 6.2 min as compared to non-ATN group (30.4 ± 5.7 min, P= 0.042. Duration of hospital stay was more in ATN group (19.9 ± 6.7 vs. 16.8 ± 8.4 days, P= 0.04 but there was no difference in 1 year survival (284 subjects, 90.7% vs. 21 subjects, 87.5%, P= 0.873. This study shows that greater donor age, higher baseline diastolic BP and greater warm ischemia time are major determinants of delayed graft function due to acute tubular necrosis after related donor renal transplantation.

Sharma A

2010-01-01

144

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

145

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

146

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

147

Intramural Hematoma of the Esophagus  

OpenAIRE

We report the case of a patient with an intramural hematoma of the esophagus. This rare condition is more common in elderly women and can be misdiagnosed as cardiovascular or other digestive emergent disease. The classical clinical triad includes chest pain, sudden dysphagia or odynophagia and minor hematemesis. Known precipitating factors are Valsalva maneuver, blunt, direct or iatrogenic injuries, but spontaneous cases have also been described. Chest imaging including computed tomography or...

Cao, Dahlia Thao; Reny, Jean-luc; Lanthier, Nicolas; Frossard, Jean-louis

2012-01-01

148

Interventricular septum hematoma during cineventriculography  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Intraseptal hematoma and subsequent myocardial infarction due to accidental contrast agent deposition complicating diagnostic cineventriculography is a previously undescribed complication of angiography. Case presentation A 61 year old man was admitted at intensive care unit because of unstable angina pectoris 1 hour after coronary angiography. Transthoracic contrast echocardiography showed a non-perfused area in the middle of interventricular septum with an increase of thickening up to 26 mm. Review of cineventriculography revealed contrast enhancement in the interventricular septum after contrast medium injection and a dislocation of the pigtail catheter tip. Follow up by echocardiography and MRI showed, that intramural hematoma has resolved after 6 weeks. After 8 weeks successful stent implantation in LAD was performed and after 6 month the patient had a normal LV-function without ischemic signs or septal thickening demonstrated by stressechocardiography. Conclusion A safe and mobile position of the pigtail catheter during ventriculography in the middle of the LV cavity should be ensured to avoid this potentially life-threatening complication. For assessment and absolute measurement of intramural hematoma contrast-enhanced echocardiography is more feasible than MRI and makes interchangeable results.

Melzer Christoph

2008-01-01

149

Pelvic hematoma resulting in obstructive uropathy.  

Directory of Open Access Journals (Sweden)

The use of anticoagulants, for whatever indication, may carry a high risk of hematoma formation following surgery. Obstructive uropathy is a very rare but possible example of complication secondary to an extensive pelvic hematoma. We describe a case of a patient with rheumatic heart disease and aortic valve replacement, who developed a massive postoperative pelvic hematoma following bilateral tubal ligation, resulting in bilateral ureteric obstructions. This was treated with bilateral ureteric stent through cystoscopy.

Ahmed A. Abdulwahab

2003-11-01

150

Determination of damages of photosynthetic metabolism caused by herbicides using a delayed fluorescence technique  

Science.gov (United States)

The structure and function of chloroplast in plant can be affected by herbicide, resulting in the decrease in photosynthetic capacity. The photosystem II (PSII) in plants is considered to be the primary site where light-induced delayed fluorescence (DF) is produced. In this study, a simple analytical model of DF has been developed to diagnose the damages of photosynthesis caused by herbicides based on the charge recombination theory. Using a home-made portable DF detection system, we have studied the effects of two different kinds of herbicides on decay kinetics of DF in soybean (Glycine max (L.), Jinghuang No. 3). Current investigations have demonstrated that the analytic equation of DF decay dynamics we proposed here can accurately determine the extent of damage of herbicides to photosynthetic metabolism and truly reflect the mechanism and site about which herbicides inhibit photosynthetic electron transport chain. Therefore, the decay kinetics of DF with proper calibration may provide a promisingly new and practical means for pharmacological analysis of herbicides and damage-diagnosis of photosynthetic metabolism. The DF technique could be potentially useful for detecting the effects of herbicide on plant performance in vivo and screening new generation of promising herbicides with low toxicity and superhigh efficiency.

Zhang, Lingrui; Xing, Da; Zhou, Xiaoming; Li, Qiang

2007-11-01

151

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

152

Intra-uterine hematoma in pregnancy.  

DEFF Research Database (Denmark)

In 60 patients with a live fetus and an intra-uterine hematoma (IUH) proven by ultrasonic scanning the outcome of pregnancy was spontaneous abortion in 12% and premature delivery in 10%. No correlation between the outcome of the pregnancy and the maximum size of the hematoma or the week of detection was found. A subplacentar localization of the hematoma was associated with a higher, but not statistically significant, incidence of spontaneous abortion than a subchorionic localization. Spontaneous abortion most often occurred in the first weeks after the formation of the hematoma. Udgivelsesdato: 1991-Jun-5

Glavind, K; NØhr, S

1991-01-01

153

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.

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

2011-06-01

154

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

OpenAIRE

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

155

A retropharyngeal–mediastinal hematoma with supraglottic and tracheal obstruction: The role of multidisciplinary airway management  

OpenAIRE

A 77-year-old man suffered hypoxemic cardiac arrest by supraglottic and tracheal airway obstruction in the emergency department. A previously unknown cervical fracture had caused a traumatic retropharyngeal-mediastinal hematoma. A lifesaving surgical emergency tracheostomy succeeded. Supraglottic and tracheal obstruction by a retropharyngeal-mediastinal hematoma with successful resuscitation via emergency tracheostomy after hypoxemic cardiac arrest has never been reported in a context of trau...

Birkholz Torsten; Ber Stefanie, Kr X. F.; Knorr Christian; Schiele Albert; Bumm Klaus; Schmidt Joachim

2010-01-01

156

Use of haemostatic matrix in management of rectus hematoma in an anticoagulated patient: a case report  

OpenAIRE

Rectus sheath hematoma may present as a painful mass in the anterior abdominal wall. The underlying reasons may vary, while anticoagulant use and thromboembolism prophylaxis are documented causes. Treatment is mostly conservative however interventional procedures can be required. We herein present a case of 76-year-old patient with an uncontrolled rectus hematoma despite surgical hemostasis. The patient was treated succesfully by applying hemostatic matrix (Floseal).

Kizilkanat, Kansav Tunc; Olcucuoglu, Engin; Kulacoglu, Hakan

2009-01-01

157

Spontaneous rectus sheath hematoma: two variant cases.  

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We present two variant cases of spontaneous rectus sheath hematoma (SRSH). A 71-year-old woman presented with ST elevation myocardial infarction and was found to have multivessel coronary artery disease. She was treated with aspirin, clopidogrel, eptifibatide, and heparin. Heparin was continued while preoperative workup for coronary artery bypass grafting was done. She developed a large 20x10 cm actively bleeding SRSH while on heparin. It was surgically evacuated. The second case represents an atypical cause of SRSH. A 64-year-old woman with Wegener's Granulomatosis presented with anemia and abdominal pain. Abdominal CT showed a large 22 cm SRSH without active bleeding that was treated conservatively. Both patients did well on follow-up. The incidence of SRSH is likely to increase in the coming years with the increasing use of antithrombotic agents for many disease processes. Clinicians should be aware of typical and atypical presentations of SRSH and its variant management options. PMID:25369220

Sivagnanam, Kamesh; Ladia, Vatsal; Bhavsar, Vedang; Summers, Jeffery; Paul, Timir

2014-01-01

158

Extracerebral hematoma and parenchymal lesion in computerized tomography of pediatric patients with severe head injury  

International Nuclear Information System (INIS)

Fifty children (13 years of age or under) with acute, severe head injury were analyzed, with special reference to the relations between initial computerized tomography (CT) findings, clinical severity, and outcome. The severity and the outcome were evaluated using the Glasgow Coma Scale (GCS) and Glasgow Outcome Scale (GOS), respectively, adoption of GCS scoring being restricted to patients 3 years of age or over. Twenty-three patients (46 %) showed extracerebral hematomas. The most common extracerebral hematoma was the acute subdural hematoma, which comprised 24 % of the cases; epidural hematomas were found in 9 cases (18 %). These figures coincided with the reported results of adult cases in severe head injury. All the epidural hematoma cases showed ''normal'' parenchymal lesion, and carried less clinical severity and better outcome. This might suggest that more trivial injury would cause the epidural hematoma in children than in adults. Hemispheric swelling was commonly seen in patients with acute subdural hematoma and was generally associated with low GCS scores (mean 4.8) and poor outcome (63 % mortality). Compared with that in adults, hemorrhagic lesion in children was less often associated with extracerebral hematoma, and the outcome and severity of the cases with this lesion depended mainly on the multiplicity and the location of the hemorrhage. Eleven cases fulfilled the criteria of diffuse cerebral swelling, namely, slit-like ventricles and obliterated perimesencephalic cisterns, and only one had an associated subdural hematoma. Forty-two patients (84 %) achieved a good recovery or a moderate disability. None were severely disabled or vegetative, and the overall mortality rate was 16 %. Patients with GCS scores of 3 to 5 were uniformly poor in outcome (60 % of mortality), regardless of parenchymal lesions, whereas those with GCS scores of 6 to 8 had only 8 % mortality. (J.P.N.)

159

Acute subdural hematoma requiring surgery in the subacute or chronic stage.  

Science.gov (United States)

The aim of this study was to clarify the clinical characteristics and pathophysiology of conservatively treated cases of acute subdural hematoma (ASDH) that ultimately require surgery in the subacute or chronic stage, and devise an appropriate form of management for them. A total of 50 patients with ASDH were admitted to our institution during a 5-year period. Hematoma removal in the subacute or chronic stage was performed in 8 patients. The ASDH had been caused by a fall in 5 patients. Five patients had been treated with antiplatelet agents. Fluid-attenuated inversion recovery magnetic resonance (MR) imaging demonstrated an irregularly shaped hematoma with gyrus patterns in 4 of 5 patients. Diffusion-weighted MR imaging demonstrated a two-layered hematoma structure in 3 of 4 patients. The hematoma was removed via a craniotomy, a small craniotomy, and a burr hole in 1, 1, and 6 patients, respectively. At surgery in the craniotomy case, a solid clot was located beneath the dura, and a liquid hematoma was located close to the brain. After hematoma removal, no inner membrane was observed on the brain surface. One patient had typical chronic subdural hematoma in the subacute stage, and 2 patients had so-called subacute subdural hematoma (SASDH) in the chronic stage. Although the majority of such cases can be treated by burr-hole surgery, a small craniotomy or craniotomy ought to be considered as a further surgical option if SASDH is diagnosed on the basis of clinical and radiological data, especially diffusion-weighted MR imaging. PMID:23708224

Izumihara, Akifumi; Yamashita, Katsuhiro; Murakami, Tomoyuki

2013-01-01

160

Non-traumatic Bilateral Orbital Subperiosteal Hematoma in a Person Who Attempted Suicide by Hanging.  

Science.gov (United States)

Orbital subperiosteal hematomas are rare and most often result from facial trauma; however, occurrence of these hematomas due to non-traumatic causes is extremely rare. Herein, we present the case of a 38-year-old man who was transferred to our emergency department because he became comatose after attempting suicide by hanging. He underwent computed tomography (CT) of the head and neck. CT findings revealed a bilateral orbital subperiosteal hematoma. We then performed magnetic resonance imaging (MRI) of the head for definite diagnosis of hematoma. There is no consensus regarding if this condition should be treated conservatively or surgically. Conservative management was selected for this patient because he was in deep coma. Some non-traumatic causes of orbital subperiosteal hematoma include weight lifting, coughing, vomiting, Valsalva maneuver, labor, and scuba diving. Sudden elevations in cranial pressure may be the mechanism underlying this condition. Although suicide attempt by hanging could have caused a sudden elevation in cranial pressure, this is the first report of the occurrence of this condition. Patients with orbital subperiosteal hematomas generally complain of blurred vision, eye pain, or exophthalmos. However, identifying this sign may be difficult in patients with disturbed consciousness. PMID:25248423

Sakurai, Keiji; Morita, Seiji; Otsuka, Hiroyuki; Sugita, Mariko; Taira, Takayuki; Nakagawa, Yoshihide; Inokuchi, Sadaki

2014-01-01

161

Diagnostic scintigraphic sign in epidural hematoma at the vertex: case report  

International Nuclear Information System (INIS)

Brain scintigraphy was described in a case of vertical (biparasagittal) epidural hematoma confirmed by contrast angiography. The anterior dynamic and static studies showed inferior displacement of the superior sagittal sinus, diagnostic of an epidural collection. Delayed static anterior and lateral images showed an increased vertical uptake with a crescentic and straight inner contour, respectively. A transaxial computed tomographic scan was negative

162

Solitary pulmonary nodule by pulmonary hematoma under warfarin therapy  

International Nuclear Information System (INIS)

Pulmonary hematoma is a rare cause of a pulmonary nodule. Mostly it results from penetrating or blunt chest injuries. The case of a patient is reported, whose chest X-ray showed a pulmonary nodule suspected of malignancy. This patient was maintained permanently on anticoagulants (warfarin derivates) after cardiac valve replacement with a prosthesis. A definite diagnosis could not be established by non-invasive methods. A needle biopsy of the lung was impracticable because of the location of the pulmonary lesion; an exploratory thoracotomy could not be carried out due to a general indication of nonoperability. Control examinations showed that the pulmonary nodule had vanished completely within four months. In consideration of the patient's clinical situation it can be concluded that the pulmonary lesion was caused by a hematoma of the lung. (orig.)

163

Inactivation of IL11 signaling causes craniosynostosis, delayed tooth eruption, and supernumerary teeth  

DEFF Research Database (Denmark)

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 region revealed that all affected children harbored homozygous missense mutations (c.662C>G [p.Pro221Arg], c.734C>G [p.Ser245Cys], or c.886C>T [p.Arg296Trp]) in IL11RA (encoding interleukin 11 receptor, alpha) on chromosome 9p13.3. In addition, a homozygous nonsense mutation, c.475C>T (p.Gln159X), and a homozygous duplication, c.916_924dup (p.Thr306_Ser308dup), were observed in two north European families. In cell-transfection experiments, the p.Arg296Trp mutation rendered the receptor unable to mediate the IL11 signal, indicating that the mutation causes loss of IL11RA function. We also observed disturbed cranial growth and suture activity in the Il11ra null mutant mice, in which reduced size and remodeling of limb bones has been previously described. We conclude that IL11 signaling is essential for the normal development of craniofacial bones and teeth and that its function is to restrict suture fusion and tooth number. The results open up the possibility of modulation of IL11 signaling for the treatment of craniosynostosis.

Nieminen, Pekka; Morgan, Neil V

2011-01-01

164

Systemic 5-fluorouracil treatment causes a syndrome of delayed myelin destruction in the central nervous system  

OpenAIRE

Abstract Background Cancer treatment with a variety of chemotherapeutic agents often is associated with delayed adverse neurological consequences. Despite their clinical importance, almost nothing is known about the basis for such effects. It is not even known whether the occurrence of delayed adverse effects requires exposure to multiple chemotherapeutic agents, the presence of both chemotherapeutic agents and the body's own response to cancer, prolonged damage to the blood-...

Han Ruolan; Yang Yin M; Dietrich Joerg; Luebke Anne; Mayer-Pröschel Margot; Noble Mark

2008-01-01

165

Spontaneous extracranial decompression of epidural hematoma  

International Nuclear Information System (INIS)

Epidural hematoma (EDH) is a common sequela of head trauma in children. An increasing number are managed nonsurgically, with close clinical and imaging observation. We report the case of a traumatic EDH that spontaneously decompressed into the subgaleal space, demonstrated on serial CT scans that showed resolution of the EDH and concurrent enlargement of the subgaleal hematoma. (orig.)

166

Intramural hematoma of the esophagus.  

Science.gov (United States)

We report the case of a patient with an intramural hematoma of the esophagus. This rare condition is more common in elderly women and can be misdiagnosed as cardiovascular or other digestive emergent disease. The classical clinical triad includes chest pain, sudden dysphagia or odynophagia and minor hematemesis. Known precipitating factors are Valsalva maneuver, blunt, direct or iatrogenic injuries, but spontaneous cases have also been described. Chest imaging including computed tomography or magnetic resonance imaging as well as upper gastrointestinal endoscopy are useful tools for diagnosis. The treatment is conservative and the prognosis usually excellent with complete resolution within a few weeks. PMID:23730267

Cao, Dahlia Thao; Reny, Jean-Luc; Lanthier, Nicolas; Frossard, Jean-Louis

2012-05-01

167

Vertex extradural hematoma in association with Paget?s disease of the skull  

Directory of Open Access Journals (Sweden)

Full Text Available Paget?s disease of skull usually causes neurological complications such as basilar invagination, cranial neuropathies, etc. Occurrence of extradural hematoma in association with Paget?s disease of skull is rare. A 48 year old man presented with headache and right upper limb weakness, two days after a fall from scooter. CT Scan of brain showed a large extradural hematoma at the vertex with the cranial vault showing features of Paget?s disease. At surgery, no skull fracture or injury to the superior sagittal sinus was evident. There was diffuse oozing from the inner table of the skull, which showed features of Paget?s disease. The extradural hematoma was evacuated and the patient made good recovery.He deteriorated a few hours after surgery. Follow up CT Scan showed diffuse brain swelling with minimal recollection of hematoma. Re-exploration showed a small recollection which was evacuated and the part of the oozing diseased skull was excised. The patient recovered completely. This is the first reported case of vertex extradural hematoma in association with the Paget?s disease of skull. The unusual features are the absence of skull fracture and injury to the superior sagittal sinus. The increased vascularity of the skull due to Paget?s disease has caused the hematoma by diffuse oozing from the inner table.

Ramesh V

2005-01-01

168

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.

Ahmet Can, Senel; Abdul Kadir, Gunduz.

2012-10-01

169

Spontaneous cervical epidural hematoma: Report of a case managed conservatively  

Directory of Open Access Journals (Sweden)

Full Text Available Spontaneous spinal epidural hematoma is a rare cause of acute spinal cord compression. A 25-year-old male presented with a history of sudden onset of complete quadriplegia with sensory loss below the neck along with loss of bowel and bladder control. He had no history of any constitutional symptoms. He reported 10 days later. He was managed conservatively and after two weeks of intensive rehabilitation he had complete neural recovery. The spontaneous recovery of neurological impairment is attributed to the spreading of the hematoma throughout the epidural space, thus decreasing the pressure with partial neural recovery. Conservative treatment is a fair option in young patients who present late and show neurological improvement. The neurological status on presentation will guide the further approach to management.

Halim Tariq

2008-01-01

170

Calcified chronic subdural hematoma: case report.  

Science.gov (United States)

Calcified or ossified chronic subdural hematoma is a rare entity that usually presents as a space-occupying lesion over the cerebral convexity. We report a case of calcified and ossified chronic subdural hematoma in an unusual location that has not been previously reported. A 24-year-old man with a history of tonic-clonic convulsions since 7 months of age was admitted because of increasing frequency and duration of seizures. Computed tomography and magnetic resonance imaging demonstrated a fusiform extra-axial lesion just above the tentorium and adjacent to the cerebral falx. A calcified and ossified chronic subdural hematoma was noted and was almost completely removed by craniotomy. Better seizure control was achieved by removal of the calcified chronic subdural hematoma. Calcified subdural hematoma, calcified epidural hematoma, calcified empyema, meningioma, calcified arachnoid cyst, and calcified convexity of the dura mater with acute epidural hematoma should be considered for the differential diagnosis of an extra-axial calcified lesion. PMID:10074745

Yan, H J; Lin, K E; Lee, S T; Tzaan, W C

1998-12-01

171

Ligamentum flavum hematoma in the rigid thoracic spinal segments: case report.  

Science.gov (United States)

Ligamentum flavum hematoma, a rare cause of spinal nerve root and canal compression, typically occurs in the mobile lumbar spine segments. A thoracic ligamentum flavum hematoma is extremely rare--only one such case of a thoracolumbar (T11-12) lesion has been reported. The thoracolumbar region with its floating ribs, however, is structurally and biomechanically similar to the lumbar spine and its mobility is greater than the higher thoracic levels. To the best of their knowledge, the authors report the first case of a ligamentum flavum hematoma in the region of the rigid thoracic spinal segments with the contiguous rib cage. A symptomatic T9-10 ligamentum flavum hematoma is described in the case of a 66-year-old woman with compensatory thoracic lordosis secondary to the lumbar degenerative kyphosis. The hematoma was removed and the diagnosis was histologically confirmed. The authors speculate that thoracic lordosis might have contributed to the development of the hematoma because the ligamentum flavum and the facet joint were subjected to greater axial stress than in individuals with normal spinal alignment. PMID:15871493

Miyakoshi, Naohisa; Shimada, Yoichi; Okada, Kyoji; Hongo, Michio; Kasukawa, Yuji; Itoi, Eui

2005-04-01

172

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

173

Self-administered cocaine causes long-lasting increases in impulsive choice in a delay discounting task.  

Science.gov (United States)

Cocaine use is associated with high levels of impulsive choice (preference for immediate over delayed rewards), but it is not clear whether cocaine use causes elevated impulsive choice, or whether elevated impulsive choice is solely a predisposing factor for cocaine use. This study examined the effects of prior cocaine self-administration on rats performing a delay discounting task commonly used to measure impulsive choice. Male Long-Evans rats were implanted with intravenous catheters, and following recovery, were trained to self-administer 30 mg/kg/day cocaine HCl (approx. 0.5 mg/kg/infusion) for 14 consecutive days (a control group received yoked intravenous saline infusions). Following three weeks of withdrawal, all rats were food-restricted and began training on the delay discounting task in standard operant chambers. On each trial, rats were given a choice between two levers. A press on one lever delivered a small food reward immediately, and a press on the other delivered a large food reward after a variable delay period. Rats that self-administered cocaine displayed greater impulsive choice (enhanced preference for the small immediate over the large delayed reward, as reflected by shorter indifference points) compared to controls, but were no different from controls on a "probabilistic discounting" task in which they chose between small certain and large uncertain rewards. These data suggest that self-administered cocaine can cause lasting elevations in impulsive choice, and that the high levels of impulsive choice observed in human cocaine users may be due in part to long-term effects of cocaine on brain function. PMID:20695646

Mendez, Ian A; Simon, Nicholas W; Hart, Nigel; Mitchell, Marci R; Nation, Jack R; Wellman, Paul J; Setlow, Barry

2010-08-01

174

Illustration of the impact of antiplatelet drugs on the genesis and management of chronic subdural hematoma.  

Science.gov (United States)

The case of a 76-year-old male with a large chronic subdural hematoma that showed total regression with the mere suspension of aspirin, its only apparent causal factor, and that of an 81 year-old male on aspirin and clopidogrel with a chronic subdural hematoma who succumbed after burr holes due to two simultaneous severe hemorrhagic complications (cerebellar hemorrhage and ipsilateral acute subdural hematoma) are presented. The cases may provide support for the following management strategies: (i) if conservative management and drug suspension are feasible, they may well be worth trying and lead to a favorable outcome; (ii) if a patient is at risk of developing a chronic subdural hematoma, namely because of a minor acute subdural hematoma, withdrawal of antiplatelet agents should be considered; (iii) if surgery is necessary, its delay allows for the metabolization of the drug and platelet renewal, thereby minimizing the risk of hemorrhage; (iv) if urgent burr holes are indicated, measures to improve platelet function should be undertaken. PMID:22030168

Mascarenhas, L

2012-02-01

175

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.

176

Occult, massive hematomas following antegrade femoral angioplasty  

International Nuclear Information System (INIS)

Small groin hematomas are not uncommon after percuatenous antegrade femoral angioplasty (PAFA) and are usually apparent clinically. The authors describe three patients of 235 who underwent PAFA, in whom occult, massive hemorrhage was detected after the procedure. All patients underwent fluoroscopically guided antegrade punctures, with adequate hemostasis achieved after the procedure. CT revealed extraperitoneal hematomas in two patients. One patient required surgical intervention with ligation of the inferior epigastric artery. The authors postulate that these hematomas arose due to inadvertent injury to a branch of the common femoral artery during the puncture. The radiologist should be aware of the chance occurrence of this occult, potentially life-threatening complication

177

4 cases of iliopsoas hematoma associated with hemophilia  

International Nuclear Information System (INIS)

Four patients were diagnosed as having iliopsoas hematoma associated with hemophilia by CT scanning. The site and disappearance of hematoma were observed on CT. It was suggested that hematoma occurs inside the iliacus or posoas muscle in cases of iliopsoas hematoma complicated by hemophilia or coagulation and that it occurs in the pelvic wall of the iliacus muscle in cases of iliopsoas hematoma uncomplicated by coagulation abnormality. (Namekawa, K.)

178

Atenolol prevents the formation of expansive hematoma after rhytidoplasty / O atenolol previne a formação de hematoma expansivo após ritidoplastia  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Objetivo: avaliar o uso perioperatório do atenolol na redução da incidência de hematoma pós-ritidoplastia. Métodos: entre janeiro de 2007 e fevereiro de 2013 foram randomizados 80 pacientes em dois grupos: Grupo A (n=26) recebeu atenolol perioperatório com objetivo de manter frequência de puls [...] o (FP) ± 60 por minuto, Grupo B (n=54) não recebeu atenolol. Ambos os grupos foram submetidos à mesma técnica anestésico-cirúrgica. A pressão arterial (PA) e FP, formação de hematoma e a necessidade de drenagem foram monitorizados. Houve seguimento até o 90º dia de pós-operatório. As variáveis foram analisadas entre os dois grupos utilizando-se o teste de ANOVA. As variáveis contínuas foram apresentadas como média (± Desvio-padrão) e as diferenças foram comparadas utilizando-se o t de Student. Foram considerados significantes os valores p Abstract in english Objective: To evaluate the perioperative use of atenolol in reducing the incidence of hematoma after rhytidoplasty. Methods: Between January 2007 and February 2013, 80 patients were randomized into two groups: Group A (n = 26) received perioperative atenolol in order to maintain heart rate (PR [...] ) around 60 per minute; Group B (n = 54) did not receive atenolol. Both groups underwent the same anesthetic and surgical technique. We monitored blood pressure (BP), HR, hematoma formation and the need for drainage. Patients were followed-up until the 90th postoperative day. The variables were compared between the groups using the ANOVA test. Continuous variables were presented as mean ± standard deviation and the differences were compared with the Student's t test. Values of p d" 0.05 were considered significant. Results: In group A the mean BP (110-70mmHg ± 7.07) and HR (64 / min ± 5) were lower (p d" 0.05) than in group B (135-90mmHg ± 10.6) and (76 / min ± 7.5), respectively. There were four cases of expansive hematoma in group B, all requiring reoperation for drainage, and none in group A (p d" 0,001). Conclusion: The perioperative use of atenolol caused a decrease in blood pressure and heart rate and decreased the incidence of expanding hematoma after rhytidectomy.

Amanda Castilho, Moreira; Marcio, Moreira; Sanderland José Tavares, Gurgel; Yasmin Castilho, Moreira; Eguimar Roberto, Martins; Raphael Chalbaud Biscaia, Hartmann; Djalma José, Fagundes.

2014-10-01

179

Anthropogenic noise causes body malformations and delays development in marine larvae  

Science.gov (United States)

Understanding the impact of noise on marine fauna at the population level requires knowledge about the vulnerability of different life-stages. Here we provide the first evidence that noise exposure during larval development produces body malformations in marine invertebrates. Scallop larvae exposed to playbacks of seismic pulses showed significant developmental delays and 46% developed body abnormalities. Similar effects were observed in all independent samples exposed to noise while no malformations were found in the control groups (4881 larvae examined). Malformations appeared in the D-veliger larval phase, perhaps due to the cumulative exposure attained by this stage or to a greater vulnerability of D-veliger to sound-mediated physiological or mechanical stress. Such strong impacts suggest that abnormalities and growth delays may also result from lower sound levels or discrete exposures during the D-stage, increasing the potential for routinely-occurring anthropogenic noise sources to affect recruitment of wild scallop larvae in natural stocks. PMID:24088868

de Soto, Natacha Aguilar; Delorme, Natali; Atkins, John; Howard, Sunkita; Williams, James; Johnson, Mark

2013-01-01

180

A rare cause of recurrent pneumonia: A delayed diagnosis of Bochdalek hernia  

OpenAIRE

The incidence of congenital diaphragmatic hernia is 1/5000 in live births and 1/2000 in stillbirths. Cases are usually term newborns. Most prominent symptom is respiratory distress. Other organ malformations may accompany. Mortality rate is about 40-50%. Here, we presented a girl 2.5 years-old admitted with recurrent pulmonary infections and treated with medications but diagnosis of congenital diaphragmatic hernia (Bochdalek hernia) was delayed.

Et Al, Sekmenli T.

2010-01-01

181

Delayed postoperative intracerebral abscess caused by Proprionibacterium acnes: case report and review of the literature.  

Science.gov (United States)

A case of delayed intracerebral abscess due to Proprionibacterium acnes (P. acnes), 18 months after an uneventful excision of a parasagittal haemangiopericytoma in a 61-year-old female is reported. This is highly unusual as cerebral abscess by P. acnes is rare and it occurred so late postoperatively in the absence of known risk factors. We propose the inclusion of cerebral abscess by P. acnes in the differential diagnosis of lesions that mimic tumour recurrences, after clean craniotomies. PMID:14579899

Barazi, S A; Gnanalingham, K K; Chopra, I; van Dellen, J R

2003-08-01

182

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

OpenAIRE

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 regio...

Nieminen, P.; Morgan, Nv; Fenwick, Al; Parmanen, S.; Veistinen, L.; Mikkola, Ml; Spek, Pj; Giraud, A.; Judd, L.; Arte, S.; Brueton, La; Wall, Sa; Mathijssen, Imj; Maher, Er; Wilkie, Aom

2011-01-01

183

Antiplatelet antibody may cause delayed transfusion-related acute lung injury  

Directory of Open Access Journals (Sweden)

Full Text Available 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 syndrome after transfusion of plasma- and leukoreduced red blood cells (RBCs for gastrointestinal bleeding due to intestinal metastasis. Acute lung injury (ALI recurred 31 days after the first ALI episode. Both ALI episodes occurred 48 hours after transfusion. Laboratory examinations revealed the presence of various antileukocyte antibodies including antiplatelet antibody in the recipient's serum but not in the donors' serum. The authors speculate that antiplatelet antibodies can have an inhibitory effect in the recipient, which can modulate the bona fide procedure of ALI and lead to a delay in the onset of ALI. This case illustrates the crucial role of a recipient's platelets in the development of TRALI.Keywords: delayed TRALI syndrome, recurrence, anti-platelet antibody

Torii Y

2011-09-01

184

Spontaneous disappearance of acute subdural hematoma on CT scan  

International Nuclear Information System (INIS)

We encountered a patient with a severe head injury complicated by DIC in whom the serial CT scans revealed the disappearance of the subdural hematoma. A 65-year-old man received a heavy blow to the head in a traffic accident. On admission, the patient was in a coma (Glasgow's coma scale: 5 points), showing anisocoria (right > left) and left hemiplegia. He later deteriorated in ataxic respiration and died 23 hours after the trauma. In a blood-coagulation examination done 2 hours after the trauma, the bleeding time was 9 minutes, the coagulation time was more than 60 minutes, the serum fibrinogen was less than 15 mg/dl, and the serum FDP was above 160 ug/ml; a diagnosis of DIC was thus made. CT scans 1 hour after the trauma showed acute subdural hematoma in the right cerebral hemisphere, a medial displacement of the lateral ventricles, and a traumatic subarachnoid hemorrhage. In CT scans taken 21 hours after the trauma, however, the subdural hematoma had disappeared, while a diffuse swelling of the cerebrum, mottled high-density areas along the cerebral sulci, and high-density areas in the posterior horns of the bilateral ventricles as well as in the cerebello-pontine angle were observed for the first time. These changes in the CT findings are considered to be due to the decrease in the viscosity of the subdural hematoma caused by the markedly enhanced activity of the fibrolytic system with DIC and by subsequent diffusion into intracranial spaces under the increased intracranial pressure associated with the development of cerebral edema. (author)

185

Secondary oxalosis: a cause of delayed recovery of renal function in the setting of acute renal failure.  

Science.gov (United States)

Oxalosis, or calcium oxalate deposition in the tissues, may develop in patients with inherited disorders of oxalate metabolism or can occur secondary to other diseases. In this study, a case of renal oxalosis probably secondary to excessive parenteral vitamin C administration in a patient with acute post-traumatic oliguric renal failure is reported. Oxalate deposits may have contributed to further worsening and delayed recovery of renal function. The elimination of the source of excess vitamin C and its presumed effect on oxalate production, together with enhanced removal of oxalate during aggressive dialysis, resulted in prompt recovery of renal function. Secondary oxalosis represents a possible cause of delayed recovery of renal function in patients with acute renal failure who are receiving vitamin C supplementation if excess dosage of that supplementation is given. Vitamin C supplementation, if utilized, should be carefully monitored in patients receiving artificial renal replacement therapy. PMID:8959621

Alkhunaizi, A M; Chan, L

1996-11-01

186

Dengue Fever with rectus sheath hematoma: a case report.  

Science.gov (United States)

Dengue fever, also known as breakbone fever, is an infectious tropical disease caused by the Dengue virus. It is associated with a number of complications, which are well documented. However, Dengue fever associated with rectus sheath hematoma (RSH) is a very rare complication. Only one case report has been published prior supporting the association of Dengue fever with RSH. We report a case of Dengue fever who presented with RSH and was successfully treated conservatively. RSH is also an uncommon cause of acute abdominal pain. It is accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric vessel or muscle tear. PMID:25161976

Sharma, Anurag; Bhatia, Sonia; Singh, Rajendra Pratap; Malik, Gaurav

2014-04-01

187

Traumatic hematomas in deep middle portion of the cerebrum case report  

International Nuclear Information System (INIS)

Recently we have encountered three cases of small traumatic hematoma in deep middle portion of the cerebrum. Patient 1: A 55-year-old male was admitted to our hospital 2-days after the traffic accident. CTscan showed small hematoma around septum pellucidi and fornix and in the posterior horn of left lateral ventricle. Patient 2: A 54-year-old male was admitted to our hospital a day after the head injury. CTscan showed hematoma in the supraventral portion of the third ventricle. Patient 3: A 27-year-old male was admitted to our hospital a day after the head injury. CTscan showed hematoma around quadrigeminal cistern and midbrain. Three cases reported here are traumatic hematomas without mass effect, which were pointed out only by autopsy. On traumatic hematoma in the deep middle portion of the brain we have only a few reports. On the mechanism of this bleeding Lindenberg and Kohno reported that the bleeding is caused by outward bending of the skull in injury. Lindenberg et al insisted that when traumatic force goes through corpus callosum over stretching of corpus callosum caused bleeding and that shearing force can damage septum pellucidi and fornix. Although these small hematomas are absorbed gradually functional prognosis is poor. Especially Korsakov syndrome and left hemiparesis in patient 1 shows no sign of recovery. In patient 2 and patient 3 decreased mental activity and hemiparesis have continued. Treatment of these cases cannot be surgical, as far as severe bres cannot be surgical, as far as severe brain edema does not appeared. (author)

188

Subperiosteal Hematoma of orbit an interesting case report and review of literature  

Directory of Open Access Journals (Sweden)

Full Text Available Subperiosteal Hematoma orbit is an uncommon disorder which may occur following injury to orbit. Ofcourse there are other causes that cause this condition as well. This condition has been reported in young adults. This case report discusses a patient who developed subperiosteal hematoma following trivial injury to orbit. Since this condition had occurred following trivial injury to orbit diagnosis was not made pre operatively. It was discovered only on the table. A high index of suspicion and an accurate history is necessary to identify this condition. This case is being reported not only for its rarity but also to stress the importance of eliciting accurate history.

Balasubramanian Thiagarajan

2014-08-01

189

Search for long-lived delayed neutron groups: photofission caused by fission-product gamma-rays  

International Nuclear Information System (INIS)

A search has been made for long-lived delayed neutron groups with half-lives greater than 55 s in the thermal neutron fission of 235U. The neutron counter used in these experiments was designed to allow one to distinguish between true delayed neutrons and neutrons produced by (?, n) reactions on D and Be impurities. The experimental results showed the existence of apparent delayed neutron groups with half-lives greater than 55 s and of very low intensity. These were shown to be neither true delayed neutrons, nor photoneutrons from D or Be but were prompt neutrons from the photofission of 238U and 235U. Photofission is produced by high energy ( > 4.5 MeV) gamma rays emitted from certain fission products. The intensity of the neutrons produced in this way decays with the half-lives of the fission products causing the photofission. The half-lives of the 'photofission groups' were 3.1, 17 and 111 min, with absolute yields of 1 x 10-8, 1 x 10-11 and 2 x 10-12 neutrons/fission respectively, under the best conditions. By surrounding the irradiated uranium sample with large amounts of 238U, 235U or 239Pu, it was possible to obtain relative photofission cross-sections for these nuclides. The values obtained were: 1.0, 1.4 and 10. 8 for 238U, 235U and 239Pu respectively, in agreement with known cross-sections. It is unlikely that photofission grouns. It is unlikely that photofission groups with t1/2 ? 3.1 min will, under any experimental or reactor conditions, be a significant fraction of the total delayed neutron yield. However, shorter-lived photofission groups (t1/2 239Pu, where the photofission cross-section is high and the delayed neutron yield is low compared to other nuclides. From the experimental results, upper limit values were calculated for the neutron branching ratios of 91Rb, 140Cs, 96Y, and 133Sb. These were: ? 0.7%, ? 0.1%, ? 5 x 10-6% and ? 3 x 10-6%, respectively. (author)

190

Search for Long-Lived Delayed Neutron Groups: Photofission Caused by Fission-Product Gamma-Rays  

International Nuclear Information System (INIS)

A search has been made for long-lived delayed neutron groups with half-lives greater than 55 s in the thermal neutron fission of 235U. The neutron counter used in these experiments was designed to allow one to distinguish between true delayed neutrons and neutrons produced by (?, n) reactions on D and Be impurities. The experimental results showed the existence of apparent delayed neutron groups with half-lives greater than 55 s and of very low intensity. These were shown to be neither true delayed neutrons, nor photoneutrons from D or Be but were prompt neutrons from the photofission of 238U and 235U. Photofission is produced by high energy ( > 4.5 MeV) gamma rays emitted from certain fission products. The intensity of the neutrons produced in this way decays with the half-lives of the fission products causing the photofission. The half-lives of the ''photofission groups'' were 3.1, 17 and 111 min, with absolute yields of 1 x 10-8, 1 x 10-11 and 2 x 10-12 neutrons/fission respectively, under the best conditions. By surrounding the irradiated uranium sample with large amounts of 238U, 235U or 239Pu, it was possible to obtain relative photofission cross-sections for these nuclides. The values obtained were: 1.0, 1.4 and 10.8 for 238U, 235U and 239Pu respectively, in agreement with known cross-sections. It is unlikely that photofission groups with t1/2 ? 3.1 min will, under any experimental or reactor conditions, be a significant fraction of the total delayed neutron yield. However, shorter-lived photofission groups (t1/2 239Pu, where the photofission cross-section is high and the delayed neutron yield is low compared to other nuclides. From the experimental results, upper limit values were calculated for the neutron branching ratios of 91Rb, 140Cs, 96Y, and 133Sb. These were: ? 0.7%, ? 0.1%, ? 5 x 10-6% and ? 3 x 10-6%, respectively. (author)

191

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

OpenAIRE

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 o...

Arabia Francisco A; Jaroszewski Dawn E; Anderson Eric M

2011-01-01

192

An Abscess Causing a Delayed Optic Neuropathy After Decompression for Thyroid Eye Disease  

OpenAIRE

Thyroid orbitopathy is the most common cause of proptosis in adults. It often requires surgical decompression to relieve proptosis, keratopathy, and/or optic neuropathy (1). Complications including diplopia, sinusitis, infraorbital hypesthesia, and cerebrospinal fluid leak have been reported (2–4). Mucocele formation or orbital abscess after decompression surgery are rare (5–9). To our knowledge, there are no reports of an orbital abscess causing a compressive optic neuropathy after decom...

Patel, Rakesh M.; Aakalu, Vinay K.; Joe, Stephanie; Setabutr, Pete

2013-01-01

193

[Cephalic index in the case of chronic subdural hematomas; a preliminary report].  

Science.gov (United States)

As a low cephalic index (cephalic index = breadth x 100/length), also called "dolichocephaly" has often been observed in patients with chronic subdural hematomas, the relation between the occurrence of chronic subdural hematoma and the cephalic index was investigated. 62 patients (male: 51, female: 11) with chronic subdural hematomas who were admitted during the past 5 years, and 62 patients (male: 51, female: 11) aged 40 years and over who visited the hospital for head injury which caused no intracranial hematoma, randomly sampled, as a control group, a total of 124 patients were studied for cephalic index on plain craniogram. The average cephalic index was 79.0 for males and 81.3 for females in the chronic subdural hematoma group, compared with 82.1 for males and 83.3 for females in the control group. The former index was lower than the latter for both sexes. Dolichocephaly was observed in 8 out of 51 males (15.7%) with chronic subdural hematomas while it was observed in only 1 out of 51 males (2.0%) in the control group. Since it has been reported that dolichocephaly depends on the development of arcus superciliaris and protuberantia occipitalis externa by the interaction between androgen and GH in males as well as time of closure of the cranial suture in childhood, and as androgen accelerates offensive behavior and GH stimulates the synthesis of collagen, the occurrence of chronic subdural hematoma is potentially related with sexual or individual variation in such endocrinic environments.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1542393

Sato, M; Kuwana, N; Kojima, Y; Tanaka, N

1992-02-01

194

Hematoma of a congenitally bicuspid aortic valve in a patient with polycythemia vera and the antiphospholipid antibody syndrome.  

Science.gov (United States)

We present a novel case of a hematoma involving a congenitally bicuspid aortic valve. The patient was a 47-year-old woman with polycythemia vera and antiphospholipid antibody syndrome. She was treated with anagrelide for thrombocytosis. The patient developed a valvular hematoma which caused clinically significant aortic stenosis and regurgitation. Consequently, the patient underwent surgery with insertion of a porcine bioprosthesis. Eighteen months postoperatively the patient developed a large prosthetic thrombus with severe aortic stenosis requiring reoperation. PMID:17138043

Webber, Geoffrey V; Fallon, John; Silbiger, Jeffrey J

2006-12-01

195

[Intramural hematomas of the aorta].  

Science.gov (United States)

Intramural hematomas (IMH) are regarded as a hemorrhage into the aortic wall. In general a traumatic form can de differentiated from a spontaneous non-traumatic. There is a predisposition of IMH with arterial hypertension and mesoectodermal dysplastic syndromes. The diagnosis is established with the clinical presentation in combination with the findings of different imaging modalities. Acute and subacute discomfort associated with a tendency of collaps are considered as typical presenting complaints. A semicircular or concentric thickening of the aortic wall with the absence of blood flow or a dissection membrane are typical findings in transesophageal echocardiography, computed tomography and magnetic resonance tomography. From a differential diagnostic point of view a distinction from atherosclerotic wall changes, intraluminal thrombi and inflammatory aortic diseases is essential. The IMH is considered as an early presentation of aortic dissection, put into and treated according to the Stanford classification. In the course of natural history an IMH can disappear, rupture or progress into a classic aortic dissection. PMID:11552379

Raab, B W; Vosshenrich, R; Fischer, U; Funke, M; Grabbe, E

2001-08-01

196

Cerebral perfusion changes in chronic subdural hematoma.  

Science.gov (United States)

Abstract Chronic subdural hematoma is a frequent disorder in the elderly. Although intensively investigated, numerous aspects, including the pathophysiology of clinical symptoms, remain unclear. Perfusion deficits are likely to induce the transient neurologic symptoms seen in chronic subdural hematoma (cSDH). The aim of the present study was to quantify cerebral perfusion impairment in cSDH. Before surgery, 34 patients were examined neurologically using the National Institutes of Health Stroke Scale (NIHSS) score and investigated by CT perfusion imaging. Hematoma volume, localization, and hematoma configuration were recorded. Clinical and radiological data were correlated. Mean hematoma volume was 91.8?cm(3) (16.2-241.6?cm(3), standard deviation [SD] 49.5). Whole brain mean transit time (MTT) was slightly elevated (mean 36.6?sec, SD 5.8). Hematoma volume and cerebral blood volume (CBV) in the underlying hemisphere correlated marginally but not significantly (p=0.067). Perfusion parameters determined in the area below the hematoma (ABH) and the corresponding contralateral cortex (MAC) were highly significantly different regarding cerebral blood flow (CBF) (mean 88.8 vs. 70.4, p<0.01) and CBV (mean 29.4 vs. 22.5, p<0.01). On the other hand, MTT and Tmax were almost equal between these areas (MTT means 35.0 vs. 34.8, (p)=0.914; tMax means 16.0 vs. 15.4, p=0.587). We conclude that local brain perfusion autoregulation is active in the cortical area below cSDH. CBV and CBF are significantly upregulated in the cortical area below cSDH indicating the effect of autoregulation in tissue at risk of ischemia. Cerebral autoregulation is intact in cSDH. Neurologic deficits are likely induced by borderline perfusion. PMID:23227943

Slotty, Philipp Jörg; Kamp, Marcel Alexander; Steiger, Steiger Hans-Jakob; Cornelius, Jan Frederick; Macht, Stephan; Stummer, Walter; Turowski, Bernd

2013-03-01

197

An Abscess Causing a Delayed Optic Neuropathy After Decompression for Thyroid Eye Disease  

Science.gov (United States)

Thyroid orbitopathy is the most common cause of proptosis in adults. It often requires surgical decompression to relieve proptosis, keratopathy, and/or optic neuropathy (1). Complications including diplopia, sinusitis, infraorbital hypesthesia, and cerebrospinal fluid leak have been reported (2–4). Mucocele formation or orbital abscess after decompression surgery are rare (5–9). To our knowledge, there are no reports of an orbital abscess causing a compressive optic neuropathy after decompression. We describe such a patient with both orbital abscess and mucoceles that was treated with intravenous antibiotics, steroids, and surgery. PMID:24144317

Patel, Rakesh M; Aakalu, Vinay K; Joe, Stephanie; Setabutr, Pete

2014-01-01

198

Reduction of ARNT in myeloid cells causes immune suppression and delayed wound healing.  

Science.gov (United States)

Aryl hydrocarbon receptor nuclear translocator (ARNT) is a transcription factor that binds to partners to mediate responses to environmental signals. To investigate its role in the innate immune system, floxed ARNT mice were bred with lysozyme M-Cre recombinase animals to generate lysozyme M-ARNT (LAR) mice with reduced ARNT expression. Myeloid cells of LAR mice had altered mRNA expression and delayed wound healing. Interestingly, when the animals were rendered diabetic, the difference in wound healing between the LAR mice and their littermate controls was no longer present, suggesting that decreased myeloid cell ARNT function may be an important factor in impaired wound healing in diabetes. Deferoxamine (DFO) improves wound healing by increasing hypoxia-inducible factors, which require ARNT for function. DFO was not effective in wounds of LAR mice, again suggesting that myeloid cells are important for normal wound healing and for the full benefit of DFO. These findings suggest that myeloid ARNT is important for immune function and wound healing. Increasing ARNT and, more specifically, myeloid ARNT may be a therapeutic strategy to improve wound healing. PMID:24990649

Scott, Christopher; Bonner, James; Min, Danqing; Boughton, Philip; Stokes, Rebecca; Cha, Kuan Minn; Walters, Stacey N; Maslowski, Kendle; Sierro, Frederic; Grey, Shane T; Twigg, Stephen; McLennan, Susan; Gunton, Jenny E

2014-08-15

199

Nontraumatic spinal epidural hematomas. MR features  

International Nuclear Information System (INIS)

Purpose: Spinal epidural hematoma (SEH) is a rare clinical entity with a bleak outcome. The aim of our study was to establish the value of MR findings in the diagnosis of nontraumatic SEH. Material and Methods: Seven patients with nontraumatic SEH were examined by MR at 1.5 T. Two patients were under anticoagulation therapy with heparin, and 2 others were taking salicylic acid. One patient had lupus erythematodes with a marked thrombocytopenia. One patient had a spinal arteriovenous malformation. Results: MR imaging permitted the accurate localization of extradural intraspinal expansive lesions which exhibited the characteristic signal intensities of blood. Five patients underwent laminectomy and evacuation of the hematoma. In the acute phase, the hematomas appeared isointense when compared with the spinal cord on T1-weighted images and hyperintense on T2-weighted images. Later the hematomas were hyperintense on T1-weighted images and showed signals identical to those of cerebrospinal fluid (CSF) on T2-weighted images. Conclusion: MR imaging established the exact diagnosis and localization of SEH in all cases. MR also can provide useful information about the age of the hematomas. (orig.)

200

Lateral abdominal wall hematoma as a rare complication after carotid artery stenting: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Abdominal wall hematoma is a rare and life-threatening complication after carotid artery stenting (CAS, but it can occur when activated clotting time is prolonged. We report a right lateral abdominal wall hematoma caused by rupture of the superficial circumflex iliac artery after CAS in a 72-year-old man with severe stenosis of the origin of the right internal carotid artery. We performed CAS for the targeted lesion while activated clotting time exceeded 300 seconds. After 2 hours, he complained of right lateral abdominal pain. Abdominal computed tomography revealed an extensive hematoma in the right lateral abdominal wall. Activated clotting time was 180 seconds at this point. Seven hours later, he developed hypotension and hemoglobin level dropped to 11.3 g/dl. Subsequent computed tomography showed enlargement of the hematoma. Emergent selective angiography of the external iliac artery revealed active bleeding from the right superficial circumflex iliac artery. Transcatheter arterial embolization with Gelfoam and microcoils was performed successfully. With more CAS procedures being performed, it is important for endovascular surgeons and radiologists to consider the possibility of abdominal wall hematoma in this situation.

Satomi Jyunichiro

2009-11-01

201

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

202

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

203

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. PMID:21559170

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

2010-01-01

204

A retropharyngeal-mediastinal hematoma with supraglottic and tracheal obstruction: The role of multidisciplinary airway management  

Directory of Open Access Journals (Sweden)

Full Text Available A 77-year-old man suffered hypoxemic cardiac arrest by supraglottic and tracheal airway obstruction in the emergency department. A previously unknown cervical fracture had caused a traumatic retropharyngeal-mediastinal hematoma. A lifesaving surgical emergency tracheostomy succeeded. Supraglottic and tracheal obstruction by a retropharyngeal-mediastinal hematoma with successful resuscitation via emergency tracheostomy after hypoxemic cardiac arrest has never been reported in a context of trauma. This clinically demanding case outlines the need for multidisciplinary airway management systems with continuous training and well-implemented guidelines. Only multidisciplinary staff preparedness and readily available equipments for the unanticipated difficult airway solved the catastrophic clinical situation.

Birkholz Torsten

2010-01-01

205

A retropharyngeal-mediastinal hematoma with supraglottic and tracheal obstruction: The role of multidisciplinary airway management.  

Science.gov (United States)

A 77-year-old man suffered hypoxemic cardiac arrest by supraglottic and tracheal airway obstruction in the emergency department. A previously unknown cervical fracture had caused a traumatic retropharyngeal-mediastinal hematoma. A lifesaving surgical emergency tracheostomy succeeded. Supraglottic and tracheal obstruction by a retropharyngeal-mediastinal hematoma with successful resuscitation via emergency tracheostomy after hypoxemic cardiac arrest has never been reported in a context of trauma. This clinically demanding case outlines the need for multidisciplinary airway management systems with continuous training and well-implemented guidelines. Only multidisciplinary staff preparedness and readily available equipments for the unanticipated difficult airway solved the catastrophic clinical situation. PMID:21063569

Birkholz, Torsten; Kröber, Stefanie; Knorr, Christian; Schiele, Albert; Bumm, Klaus; Schmidt, Joachim

2010-10-01

206

Hematoma of the proximal nail fold due to oximeter in a child  

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Full Text Available Boy 4 years old, hospitalized due to hemorrhagic chickenpox and sepsis during his clinical examination besides hemorrhagic crust, vesicles and bullous he has also a cutaneous red lesion localized at the right proximal nail fold of the big toenail (Fig. 1, dermatoscopic view of the lesion (Fig. 2. The diagnosis of hematoma of the proximal nail fold due to oximeter was done. The proximal nail fold hematomas due to oximeter are uncommon dermatoses at this level that are caused for the pressure of the oximeter and it has been seeing in patient in Unit Intensive or Intermediate Unit Care since 2007.

Patricia Chang

2014-01-01

207

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

Directory of Open Access Journals (Sweden)

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

208

Muscle hematoma: A critically important complication of alcoholic liver cirrhosis  

OpenAIRE

An iliopsoas hematoma can occur either spontaneously or secondary to trauma or bleeding tendency due to hemophilia and anticoagulant therapy. Although liver cirrhosis is commonly associated with coagulopathy, iliopsoas hematoma is very rare. We herein, present a case of bilateral iliopsoas hematoma in a patient with alcoholic cirrhosis, and review the literature on muscle hematoma associated with cirrhosis. A 56-year-old man with alcoholic cirrhosis was admitted in a state of shock with anemi...

Chiyo Sugiyama, Akifumi Akai

2009-01-01

209

An unusual cause of delayed presentation of laparoscopic common bile duct injury.  

Science.gov (United States)

We describe an unusual case of a laparoscopic common bile duct (CBD) injury that presented with cholangitis 2 years after an apparently uneventful laparoscopic cholecystectomy. Preoperative ultrasound and endoscopic retrograde cholangiography suggested choledocholithiasis, showing proximal and intrahepatic duct dilatation with an inability to relieve the obstruction. At surgery, a lateral injury of the CBD wall with partial wall loss was found, adherent to an amorphous pigmented mass with the appearance of a knitted fabric causing CBD obstruction. The CBD was successfully reconstructed with a Roux-en-Y end-to-side hepaticojejunostomy, where the end of the Roux loop was anastomosed to the lateral CBD defect. PMID:12399869

Karayiannakis, A J; Polychronidis, A; Simopoulos, C

2003-01-01

210

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

211

Hematoma retroperitoneal espontáneo: Caso clínico Spontaneous retroperitoneal hematoma: Report of one case  

Directory of Open Access Journals (Sweden)

Full Text Available Spontaneous retroperitoneal hematoma is a rare condition. We report a 78 year-old man with progressive pain in his right thigh and hip lasting one week. The pain subsequently was associated with abdominal pain in the right lower quadrant. Physical examination revealed pain to deep palpation of the area, associated with a diffuse positive rebound pain. An abdominal and pelvis CT scan showed an extensive mesenteric hematoma. During surgery, a large retroperitoneal encapsulated hematoma, without evidence of active bleeding, was found and drained. Pathology confirmed the diagnosis and was negative for cancer (RevMéd Chile 2007; 135:1044-7

Carlos Alvarez Z

2007-08-01

212

Atypical CT findings of acute epidural hematomas  

International Nuclear Information System (INIS)

One of the classic CT findings is characterized by a lenticular high density in acute epidural hematomas. However, several atypical CT findings in acute epidural hematomas have been reported lately. We have ourselves met three cases of acute epidural hematomas, in which there were low-or isodensity spots within typical high-density areas. Case 1: a 74-year-old male, a victim of a traffic accident, showing a high degree of anemia (Ht: 14%, Hb: 2.8 g/dl.) secondary to massive subcutaneous hemorrhage resulting from traumatic DIC. His CT, taken 12 hours after the head injury, disclosed bubble-like low density spots in a typical high-density area. Case 2: a 9-month-old baby boy, who had fallen to the ground from a height of 25 cm, was also anemic on admission (Ht: 17%, Hb: 5.2 g/dl.). An initial CT-scan, 7 hours after head injury, again disclosed a huge low density spot in the center of a typical high-density area. Case 3: an 11-year-old girl, involved in a car accident. A CT-scan, taken 4.5 hours after head injury, showed a low-density spot in the center of a high-density area. In her case, however, there was no evidence of significant anemia. In these three cases, the CT findings were close to one another in appearance, namely, classic lenticular high-density areas, spotted with round low-or isodensity areas within those hematomas. The causative factors have been thought be one of the following: a markedly low hemoglobin value, a time difference in the coagulation proces time difference in the coagulation process within the same hematomas, or a possible leakage of CSF into the hematomas from a dural tear. It seemed that no single causative factor was responsible in these three cases; rather, it seems that multiple factors had progressed simultaneously. (author)

213

Acute-on-chronic subdural hematoma by spinal anesthesia in a patient with undiagnosed chronic subdural hematoma -A case report-.  

Science.gov (United States)

Subdural hematoma is a serious but rare complication of spinal anesthesia. A 70-year-old woman patient underwent elective total knee replacement under spinal anesthesia. At 4 days postoperatively, the patient complained of headache and vomiting. Brain computed tomography revealed an acute-on-chronic subdural hematoma with midline shift. The patient recovered completely after surgical decompression. We report a patient with an undiagnosed chronic subdural hematoma, who developed acute-on-chronic subdural hematoma after spinal anesthesia. PMID:21860755

Park, Il Bong; Moon, Soo Yeong; Kim, Yu Yil; Kwon, Young Eun; Lee, Jun Hak

2011-07-01

214

Mutations Affecting O-Glycosylation in Chlamydomonas reinhardtii Cause Delayed Cell Wall Degradation and Sex-Limited Sterility.  

Science.gov (United States)

We describe a mutation, gag-1, that affects in a temperature-dependent manner a specific type of O-glycosylation in the green alga Chlamydomonas reinhardtii. In the mutant, all the major glycoproteins, in particular cell wall proteins, show a decreased apparent molecular weight in polyacrylamide gels, and their antigenicity is affected. The mutant forms multicellular aggregates (palmelloid colonies) at the restrictive temperature due to the delayed release of the daughter cells from the mother cell wall after mitosis. In addition, the mutation causes sterility by preventing sexual agglutination. In contrast to the other phenotypes, the sterility phenotype is temperature independent, and it is expressed only by cells of the plus mating type. We show that imp-8, a previously described nonagglutinating sex-limited mutation, causes the same glycosylation defect and is allelic to gag-1. Thus, expression of mt+ agglutinability appears to require the specific type of O-glycosylation that is defective in these mutants. More generally, these observations show that a sex-limited phenotype can be caused by a mutation in a gene that is not itself sex limited in its expression. PMID:12228502

Vallon, O.; Wollman, F. A.

1995-06-01

215

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.

2010-06-01

216

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

Energy Technology Data Exchange (ETDEWEB)

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

217

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.

218

Contralateral acute subdural hematoma occurring after evacuation of subdural hematoma with coexistent contralateral subdural hygroma.  

Science.gov (United States)

Burr-hole craniostomy with closed-system drainage is a safe and effective method for the management of chronic subdural hematoma. However, contralateral acute subdural hematoma has been reported to be a rare and devastating complication. Only 3 cases have been described in the literature. Herein, we reported an 80-year-old male with chronic subdural hematoma and contralateral subdural hygroma. The burr-hole craniostomy with closed-system drainage was initially performed to treat the chronic subdural hematoma. Three days after surgery, weakness of the extremities developed, and contralateral acute subdural bleeding within the previous subdural hygroma was diagnosed by CT scan of the brain. The pathophysiological mechanism of this rare complication was discussed, and the relevant literature was also reviewed. PMID:24983286

Sun, Hsiao-Lun; Chang, Chih-Ju; Hsieh, Cheng-Ta

2014-07-01

219

Investigations into poly(3-hydroxybutyrate-co-3-hydroxyvalerate) surface properties causing delayed osteoblast growth.  

Science.gov (United States)

Osteoblast proliferation is sensitive to material surface properties. In this study, the proliferation of MC3T3 E1-S14 osteoblastic cells on poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) films with different surface characteristics was investigated with the aim of evaluating the cause of a lag in cell growth previously observed. The solvent-cast films were prepared using three different solvents/solvent mixtures which produced PHBV films with both a rough (at the air interface) and smooth (at the glass interface) surface. Investigation of the surface roughness by scanning electron and scanning probe microscopy revealed that the surfaces had features that were different in both average lateral size and average amplitude (Ra 20-200 nm). Water contact angles showed that all surfaces were hydrophobic in nature (thetaA in the range 69-82 degrees ). The lateral distribution of surface crystallinity of the films was evaluated by use of micro-attenuated total reflectance Fourier transform infrared (ATR-FT-IR) by determining the surface crystallinity index (CI) which was found to differ between samples. MC3T3-E1-S14 osteoblasts were cultured on the six surfaces and proliferation was determined. After 2 days, cell proliferation on all surfaces was significantly less than on the control substrate; however, after 4 days cell proliferation was optimal on three surfaces. It was concluded that the initial lag on all substrates was due to the hydrophobic nature of the substrates. The ability of the cells to recover on the materials was attributed to the degree of heterogeneity of the crystallinity and surface roughness: samples with a roughness of 80 nm were found to support cell proliferation. In addition, the lateral surface features influenced the proliferation of osteoblasts on the PHBV film surface. PMID:17931502

Keen, Imelda; Raggatt, Liza J; Cool, Simon M; Nurcombe, Victor; Fredericks, Peter; Trau, Matt; Grøndahl, Lisbeth

2007-01-01

220

MRI (1,5 T) of traumatic extracerebral hematomas  

International Nuclear Information System (INIS)

The advantages of magnetic resonance imaging (MRI) in the diagnosis of subacute and chronic traumatic extracerebral hematomas are described. The characteristic changes in signal intensity for hematomas depend on the magnetic properties of hemoglobin and its derivatives, which shorten the relaxation times and decrease the homogeneity of the local magnetic field. MRI is superior in detecting and depicting the extent of small hematomas adjacent to the skull. Changes in signal intensity with time allow rough estimation of the age of a hematoma. Small hemorrhages were often found (missed by CT) that were contralateral to chronic subdural hematomas. (orig.)

221

Type III Rectus Sheath Hematoma: A Case Report  

Directory of Open Access Journals (Sweden)

Full Text Available A rectus sheath hematoma occurs an accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric arteries or their branches or rectus muscle tear. The choice of effective treatment of rectus sheath hematoma and the decision to admit the patient to hospital depends on the degree of haemodynamic compromise, coagulation status as well as the type of the hematoma on abdominopelvic computerized tomography scans. In this article, we report a case of spontaneous rectus sheath hematoma presenting with acute abdominal pain associated with a palpable abdominal wall mass. Furthermore, diagnosis, classification, and management of rectus sheath hematoma in the emergency room are discussed.

Yalç?n GÖLCÜK

2012-01-01

222

CT findings of subdural hematomas: as a special references of atypical CT findings  

Energy Technology Data Exchange (ETDEWEB)

Subdural hematomas (SDH) are relatively common and the typical CT findings according to the age of them are well established. The CT findings of 82 patients with SDHs were reviewed and compared with the operative findings. The results were as follow: 1. The most common cause of SDHs was the direct trauma which was noted in 60 cases (73.2%). 2. The atypical CT findings of the mixed density were seen in 19 cases (23.2%), including acute SDH 7 cases (20%), subacute SDH 5 cases (41.7%), and chronic SDH 7 cases (20%). 3. The possible causes of the mixed density in acute SDH were unclotted blood in early stage of hematoma development or serum extruded during the early phase of clot retraction. But the possibility of cerebrospinal fluid within subdural space due to an arachnoid tear could not be excluded. 4. The possible causes of the mixed density in subacute and chronic SDH were serum extruded during the hematoma resolution and rebleeding. 5. Wall enhancement of hematomas was noted in 3 cases (25%) of subacute SDHs and 15 cases (42.9%) of chronic SDHs. 6. Most of SDHs was crescentic in shape, but lenticular in 4 cases (4.9%). Midline shift and compression of ventricles were proportional to the maximum thickness of SDHs. There were seen ipsilateral dilatation of ventricles in 9 cases (11.0%) and brain edema in 11 cases (13.4%)

Cho, Whi Yul; Chung, Tae Sub; Suh, Jung Ho; Kim, Dong Ik; Kim, Ki Whang; Park, Chang Yun [College of Medicine, Yonsei University, Seoul (Korea, Republic of)

1987-10-15

223

CT findings of subdural hematomas: as a special references of atypical CT findings  

International Nuclear Information System (INIS)

Subdural hematomas (SDH) are relatively common and the typical CT findings according to the age of them are well established. The CT findings of 82 patients with SDHs were reviewed and compared with the operative findings. The results were as follow: 1. The most common cause of SDHs was the direct trauma which was noted in 60 cases (73.2%). 2. The atypical CT findings of the mixed density were seen in 19 cases (23.2%), including acute SDH 7 cases (20%), subacute SDH 5 cases (41.7%), and chronic SDH 7 cases (20%). 3. The possible causes of the mixed density in acute SDH were unclotted blood in early stage of hematoma development or serum extruded during the early phase of clot retraction. But the possibility of cerebrospinal fluid within subdural space due to an arachnoid tear could not be excluded. 4. The possible causes of the mixed density in subacute and chronic SDH were serum extruded during the hematoma resolution and rebleeding. 5. Wall enhancement of hematomas was noted in 3 cases (25%) of subacute SDHs and 15 cases (42.9%) of chronic SDHs. 6. Most of SDHs was crescentic in shape, but lenticular in 4 cases (4.9%). Midline shift and compression of ventricles were proportional to the maximum thickness of SDHs. There were seen ipsilateral dilatation of ventricles in 9 cases (11.0%) and brain edema in 11 cases (13.4%)

224

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

OpenAIRE

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 r...

Viviana de la Caridad Sáez Cantero; María Teresa Pérez Hernández

2010-01-01

225

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.

2009-03-01

226

Subdural hematoma associated with dural metastatic tumor  

Energy Technology Data Exchange (ETDEWEB)

Two cases of subdural hematoma associated with dural metastasis are reported. The computed tomographic and angiographic features are presented. The possible pathogenetic mechanism is discussed. Our cases support the idea of obstruction of dural capillaries by neoplastic cells and subsequent subdural bleeding.

Vonofakos, D.; Marcu, H.; Zieger, A.

1980-12-01

227

Falciparum malaria presenting as subdural hematoma.  

Science.gov (United States)

Falciparum malaria is a common disease in tropical countries associated with myriad of complications that can be life-threatening. We hereby report an 85 year old male who was suffering from falciparum malaria and presented with subdural hematoma, an unusual complication of central nervous system secondary to severe thrombocytopenia. PMID:21751613

Chaudhary, S C; Sonkar, S K; Kumar, Vivek; Gupta, Abhinav

2011-05-01

228

Intramural hematoma of colon having traumatic origin  

International Nuclear Information System (INIS)

The author presents a case of intramural hematoma of colon having traumatic origin, which triggered intestinal occlusion and was successfully treated though a right hemicolectomy.This is a rare form of anatomo clinical traumatic affectation of colon.The importance of CAT scan in its diagnosis and treatment planning should be highlighted

229

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

2014-01-01

230

Hematoma subdural crónico: Una enfermedad del adulto mayor Chronic subdural hematoma: a disease of elderly people  

Directory of Open Access Journals (Sweden)

Full Text Available The lack of specificity and heterogeneity of the clinical picture of chronic subdural hematoma, hampers its diagnosis. Aim: To report the experience of a Neurosurgical Service in chronic subdural hematoma. Patients and methods: One hundred patients (77 male, mean age 77±13 years with chronic subdural hematoma were analyzed. Results: The main clinical presentations were mental status changes (50% and progressive focal neurological deficit (46%. Five cases presented as a transient neurological deficit. All patients were treated with burr hole drainage. Thirteen had recurrence of the hematoma and they were reoperated. The surgical mortality was 3%. Eighty seven patients were followed for a mean of 66 months. Eighty one of these had a complete recovery, 6 had permanent neurological deficit and 2 of these were unable to care for themselves. Bad prognosis was associated with the absence of a previous trauma to explain the hematoma and symptoms of dementia as the clinical presentation. Conclusions: Most patients with chronic subdural hematoma treated with burr hole drainage have a good outcome (Rev Méd Chile 2003; 131: 177-82

Patricio Tagle M

2003-02-01

231

Hematoma subdural crónico: Una enfermedad del adulto mayor / Chronic subdural hematoma: a disease of elderly people  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish [...] Abstract in english The lack of specificity and heterogeneity of the clinical picture of chronic subdural hematoma, hampers its diagnosis. Aim: To report the experience of a Neurosurgical Service in chronic subdural hematoma. Patients and methods: One hundred patients (77 male, mean age 77±13 years) with chronic subdur [...] al hematoma were analyzed. Results: The main clinical presentations were mental status changes (50%) and progressive focal neurological deficit (46%). Five cases presented as a transient neurological deficit. All patients were treated with burr hole drainage. Thirteen had recurrence of the hematoma and they were reoperated. The surgical mortality was 3%. Eighty seven patients were followed for a mean of 66 months. Eighty one of these had a complete recovery, 6 had permanent neurological deficit and 2 of these were unable to care for themselves. Bad prognosis was associated with the absence of a previous trauma to explain the hematoma and symptoms of dementia as the clinical presentation. Conclusions: Most patients with chronic subdural hematoma treated with burr hole drainage have a good outcome (Rev Méd Chile 2003; 131: 177-82)

Patricio, Tagle M; Francisco, Mery M; Gonzalo, Torrealba M; Sergio, Del Villar PM; Hans, Carmona V; Manuel, Campos P; Jorge, Méndez S; Ada, Chicharro C.

2003-02-01

232

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

233

Evaluation of Risk Factors for Rectus Sheath Hematoma.  

Science.gov (United States)

Rectus sheath hematoma (RSH) develops due to rupture of epigastric arteries or the rectus muscle. Although RSH incidence rate is low, it poses a significant diagnostic dilemma. We evaluated the risk factors for RSH, its presentation, management, and outcomes for 115 patients hospitalized with confirmed RSH by computed tomography scan between January 2005 and June 2009. More than three-fourth (77.4%) of the patients were on anticoagulation therapy, 58.3% patients had chronic kidney disease (CKD) stage ?3, 51.3% had abdominal injections, 41.7% were on steroids/immunosuppressant therapy, 37.4% had abdominal surgery/trauma, 33.9% had cough, femoral puncture was performed in 31.3% of patients, and 29.5% were on antiplatelet therapy. Rectus sheath hematoma was not an attributable cause in any of the 17 deaths. Mortality was significantly higher in patients with CKD stage ?3 (P = .03) or who required transfusion (P = .007). Better understanding of RSH risk factors will facilitate early diagnoses and improve management. PMID:25294636

Sheth, Heena S; Kumar, Rohit; DiNella, Jeannine; Janov, Cheryl; Kaldas, Hoda; Smith, Roy E

2014-10-01

234

Intramural esophageal hematoma after elective injection sclerotherapy / Hematoma intramural esofágico após escleroterapia eletiva de varizes  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese CONTEXTO: Apesar do fato de que a escleroterapia endoscópica de varizes esofágicas vem sendo largamente substituída pela técnica de ligadura elástica, a escleroterapia é ainda rotineiramente utilizada em muitas instituições, especialmente em países em desenvolvimento. O hematoma intramural esofágico [...] é uma complicação rara da escleroterapia e os fatores de risco para seu desenvolvimento ainda não estão completamente estabelecidos. OBJETIVO - Demonstrar a incidência do hematoma intramural esofágico pós-escleroterapia no Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, RJ, e discutir os possíveis fatores envolvidos. MÉTODOS: Este é um estudo retrospectivo observacional realizado no Hospital Universitário Clementino Fraga Filho, através da revisão dos prontuários médicos de todos os pacientes submetidos a escleroterapia endoscópica de varizes esofágicas entre abril de 2000 e novembro de 2005. Uma avaliação das características clínicas, laboratoriais e endoscópicas desses pacientes e dos descritos na literatura foi realizada. A revisão da literatura foi feita através de pesquisa no MEDLINE. RESULTADOS: Foram realizados 1.433 procedimentos de escleroterapia endoscópica de varizes esofágicas em 397 pacientes, com incidência de hematoma intramural esofágico de 4 casos (0,28%). Três dos quatro pacientes desenvolveram complicações adicionais e um falecimento foi consequência direta do hematoma intramural esofágico. Dezenove casos bem documentados de hematoma intramural esofágico foram descritos na literatura. Na maioria dos casos o hematoma intramural esofágico ocorreu a partir da quarta sessão de escleroterapia endoscópica de varizes esofágicas e distúrbios de coagulação estavam presentes. CONCLUSÃO: O hematoma intramural esofágico é complicação rara da escleroterapia e a incidência no hospital onde foi realizada esta pesquisa foi similar à observada na literatura. Este estudo sugere que essa complicação resulta de mucosa fragilizada por sessões previa de escleroterapia endoscópica de varizes esofágicas. Distúrbios da coagulação, apesar de não serem essenciais, podem contribuir para a formação e extensão do hematoma através da submucosa esofágica. Abstract in english CONTEXT: Although endoscopic esophageal variceal sclerotherapy has been largely supplanted by variceal band ligation, it is still performed routinely in many institutions, especially in developing countries. Intramural esophageal hematoma has been described as a rare complication of sclerotherapy. R [...] isk factors have not been completely established. OBJECTIVE: To demonstrate the incidence of post-sclerotherapy intramural esophageal hematoma in our hospital and discuss the possible factors involved. Methods - This is a retrospective observational study made at the "Hospital Universitário Clementino Fraga Filho", Rio de Janeiro, RJ, Brazil, reviewing the medical records of all esophageal variceal sclerotherapy procedures performed from April 2000 to November 2005. The evaluation of the clinical, laboratorial and endoscopic features in our patients and those reported in the literature was also done. Review of literature was performed through MEDLINE search. RESULTS: A total of 1,433 esophageal variceal sclerotherapy procedures were performed in 397 patients, with an intramural esophageal hematoma incidence of 4 cases (0.28%). Three of our patients developed additional complications, and one death was a direct consequence of a rupture of the hematoma. Nineteen well described cases were reported in the literature. Intramural esophageal hematoma occurred mostly after the forth esophageal variceal sclerotherapy session. Coagulation disturbances were present in the majority of cases. CONCLUSION: Intramural esophageal hematoma is a rare complication of esophageal variceal sclerotherapy and its incidence in our institution was similar to those observed in the literature. Our study suggests that this com

Hannah Pitanga, Lukashok; Carlos, Robles-Medranda; Marília de Andrade, Santana; Marcia Henriques Magalhães, Costa; Adriana de Almeida, Borges; Cyrla, Zaltmani.

2009-12-01

235

Symptomatic spinal epidural hematoma after lumbar spine surgery: the importance of diagnostic skills.  

Science.gov (United States)

Symptomatic spinal epidural hematoma (SEH) is a rare but serious complication that may occur after lumbar spine surgery. Prompt recognition of this complication depends on the diagnostic skills of perioperative nursing personnel, particularly postanesthesia care unit nurses. Analysis of a composite of patients undergoing spinal surgery suggests that neurological and functional outcomes of patients with symptomatic lumbar SEH often depend on the time interval between symptom onset and surgical evacuation of the hematoma. Clinicians should consider a diagnosis of symptomatic SEH if there is a change in the patient's neurological status during the first several hours after lumbar spine surgery. Suspicion of postoperative symptomatic SEH should prompt clinicians to notify the responsible surgeon without delay. PMID:25537329

Daniels, Alan H; Schiebert, Steven S; Palumbo, Mark A

2015-01-01

236

Benefits of Artcereb on the irrigation of chronic subdural hematoma  

International Nuclear Information System (INIS)

Chronic subdural hematoma is thought to be an easily treatable disease. However, its recurrence rate is approximately 10%, and such cases require re-operation. We compared the recurrance rate of chronic subdural hematoma with irrigation using either saline or the artificial cerebrospinal fluid Artcereb. We divided the patients into 2 groups. A total of 60 patients in the normal saline group (hematoma, n=58; bilateral hematoma, n=2) underwent irrigation with saline between March 2007 and July 2009. A total of 61 patients in the Artcereb group (hematoma, n=54; bilateral hematoma, n=7) underwent irrigation using Artcereb between August 2009 and May 2011. We performed irrigation via 1 burr hole with 500-1000 ml of either normal saline or Artcereb under local anesthesia and observed until recurrence or disappearance of the hematomas on CT scan. We researched the recurrence rate of the hematomas. Recurrence of the hematomas were observed in 8 cases (13%) in the normal saline group and 5 cases (8.2%) in the Artcereb group. No statistically significant differences were observed. Among those patients who did not receive anticoagulants, the recurrence rate was 6/54 (11%) in the normal saline group and 1/49 (2.0%) in the Artcereb group (p<0.10). Our study showed the possibility that the postoperative recurrence rate of chronic subdural hematoma was lower using Artcereb than saline for irrigation. (author)

237

Groin hematoma after electrophysiological procedures-incidence and predisposing factors  

DEFF Research Database (Denmark)

Abstract Objectives. We evaluated the incidence and predisposing factors of groin hematomas after electrophysiological (EP) procedures. Design. Prospective, observational study, enrolling consecutive patients after EP procedures (Atrial fibrillation: n = 151; Supraventricular tachycardia/Diagnostic EP: n = 82; Ventricular tachycardia: n = 18). Patients underwent manual compression for 10 min and 3 h post procedural bed rest. AF ablations were performed with INR 2-3, ACT > 300, and no protamine sulfate. Adhesive pressure dressings (APDs) were used if sheath size ? 10F; procedural time > 120 min; and BMI > 30. Patient-reported hematomas were recorded by a telephone follow-up after 2 weeks. Results. Hematoma developed immediately in 26 patients (10%) and after 14 days significant hematoma was reported in 68 patients (27%). Regression analysis on sex, age, BMI 25, ACT 300, use of APD, sheath size and number, and complicated venous access was not associated with hematoma, either immediately after the procedure or after 14 days. Any hematoma presenting immediately after procedures was associated with patient-reported hematomas after 14 days, odds ratio 18.7 (CI 95%: 5.00-69.8; P < 0.001). Conclusions. Any hematoma immediately after EP procedures was the sole predictor of patient-reported hematoma after 2 weeks. Initiatives to prevent groin hematoma should focus on the procedure itself as well as post-procedural care.

Dalsgaard, Anja Borgen; Jakobsen, Christina Spåbæk

2014-01-01

238

Age determination of subdural hematomas: survey among radiologists.  

Science.gov (United States)

Abusive head trauma is a severe form of child abuse. One important diagnostic finding is the presence of a subdural hematoma. Age determination of subdural hematomas is important to relate radiological findings to the clinical history presented by the caregivers. In court this topic is relevant as dating subdural hematomas can lead to identification of a suspect. The aim of our study is to describe the current practice among radiologists in the Netherlands regarding the age determination of subdural hematomas in children. This is a cross-sectional study, describing the results of an online questionnaire regarding dating subdural hematomas among pediatric and neuro-radiologists in the Netherlands. The questionnaire consisted of sociodemographic questions, theoretical questions and eight pediatric cases in which the participants were asked to date subdural hematomas based on imaging findings. Fifty-one out of 172 radiologists (30 %) filled out the questionnaire. The percentage of participants that reported it was possible to date the subdural hematoma varied between 58 and 90 % for the eight different cases. In four of eight cases (50 %), the age of the subdural hematoma as known from clinical history fell within the range reported by the participants. None of the participants was "very certain" of their age determination. The results demonstrate that there is a considerable practice variation among Dutch radiologists regarding the age determination of subdural hematomas. This implicates that dating of subdural hematomas is not suitable to use in court, as no uniformity among experts exists. PMID:24553773

Postema, F A M; Sieswerda-Hoogendoorn, Tessa; Majoie, C B L M; van Rijn, R R

2014-08-01

239

Exposure to low concentrations of hydrogen peroxide causes delayed endothelial cell death and inhibits proliferation of surviving cells.  

Science.gov (United States)

Cultured bovine aortic endothelial cells were briefly exposed to low concentrations of hydrogen peroxide (0.005 to 0.05 mmol/l). At these concentrations cells do not suffer immediate lysis, but a high proportion underwent delayed cell death over the next 24 h, with changes in nuclear morphology, the appearance of nucleosomal fragments in extracted nuclear DNA, and the appearance of numerous DNA strand breaks demonstrated by 3'OH in situ end-labelling compatible with apoptotic cell death. At the same time, there was marked inhibition of [3H]thymidine uptake, and inhibition of the incorporation of the thymidine analogue 5-bromo-2'deoxy-uridine into nuclear DNA. Cells which survived apoptosis showed inhibition of cell division on subsequent culture for up to 15 days, and there were striking morphological changes, with the formation of uninucleate or multinucleate giant cells. These effects may be relevant to the mechanisms by which brief exposure to oxidative stress causes progressive vessel wall damage. PMID:7605392

de Bono, D P; Yang, W D

1995-04-24

240

Inactivation of Pmc1 vacuolar Ca(2+) ATPase causes G(2) cell cycle delay in Hansenula polymorpha.  

Science.gov (United States)

The vacuolar Ca(2+) ATPase Pmc1 is involved in maintenance of a low Ca(2+) concentration in cytosol in yeast cells. Here we observed that increase of Ca(2+) cytosolic concentration in yeast Hansenula polymorpha due to inactivation of Pmc1 resulted in sensitivity to sodium dodecyl sulfate (SDS). To elucidate the mechanisms of the observed effect, a screening for mutations suppressing SDS sensitivity of the H. polymorpha pmc1 mutant was performed. As a result, three genes were identified. Two of them, designated as their Saccharomyces cerevisiae orthologs CCH1 and HOG1 encoded the plasma membrane voltage-gated high-affinity calcium channel and the MAP kinase involved in osmoregulation, respectively. The third gene, designated as WEE1, coded for the ortholog of Wee1/Swe1 kinase involved in cell cycle regulation by inhibiting of the G(2)/M transition. Detailed analysis of this mutant demonstrated that suppression of pmc1 SDS sensitivity by the wee1 mutation depended on an accompanying chromosomal rearrangement, whereas inactivation of WEE1 in the absence of this rearrangement caused SDS sensitivity. Expression of a chimeric protein containing an N-terminal portion of Wee1 in the pmc1 mutant led to abnormal morphology characteristic of G(2) delay. Our data indicate that cytosolic Ca(2+) rise causes SDS sensitivity in H. polymorpha through the activation of the Wee1 kinase, which is mediated by the Hog1 kinase. Wee1 has a dual role in the manifestation of SDS sensitivity in the H. polymorpha pmc1 mutant. Mechanisms of influence of the obtained mutations on the G(2)/M transition are discussed. PMID:22374675

Fokina, Anastasia V; Sokolov, Svyatoslav S; Kang, Hyun A; Kalebina, Tatyana S; Ter-Avanesyan, Michael D; Agaphonov, Michael O

2012-02-15

241

Spinal subdural hematoma mimicking epidural lipomatosis.  

Science.gov (United States)

We report a case of spinal subdural hematoma in the lumbar spine of a 75-year-old woman. Magnetic resonance imaging showed lesions of homogeneous high intensity in the spinal canal on both T?- and T?-weighted images, findings closely resembling those for epidural lipomatosis. Identification of 2-layered signal intensity surrounding the cauda equina on axial images is the key for accurate diagnosis. PMID:23037565

Kamo, Minobu; Watanabe, Yoshiyuki; Numaguchi, Yuji; Saida, Yukihisa

2012-01-01

242

Cough-induced internal oblique hematoma  

OpenAIRE

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...

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

2013-01-01

243

Clopidogrel-induced spontaneous pectoral hematoma  

OpenAIRE

Clopidogrel is an oral antiplatelet agent used in the treatment of coronary artery disease, peripheral vascular disease and cerebrovascular disease. Gastrointestinal symptomsincluding nausea, diarrhea and constipation are the common side effects ofthis drug. Serious side effects like intracranial hemorrhage and severe neutropenia were also reported but spontaneous pectoral hematoma due to the clopidogrel has not been reported previously. We present a case of large spontaneous pectoral hematom...

Cakar, Mehmet Akif; Kocayigit, Ibrahim; Aydin, Ercan; Demirci, Hakan; Gunduz, Huseyin

2012-01-01

244

Chronic subdural hematoma with sedimentation level on CT: correlation with clinical and operative findings  

International Nuclear Information System (INIS)

The purpose of this study is to correlate CT findings of the patients with chronic subdural hematoma(SDH) showing a sedimentation level with their clinical and operative findings. We selected 9 patients who showed a sedimentation level within the hematoma after reviewing the CT findings of 55 patients with SDH. We also analyzed their age, initial symptoms, cause of head injury, latent period, the level of consciousness on admission, CT findings, and operative findings. All of the 9 patients were aged persons(over 52 years). They had a history of acute exacerbation of neurologic symptoms. Five of them had an apparent history of head trauma more than one month before the exacerbation. The CT scans showed unilateral, crescent-shaped subdural fluid collection with a sedimentation level except a case of bilateral SDH and 2 cases of planoconvex-shaped SDH. The interface of the sedimentation level was sharp in 3 cases and indistinct in 6 cases. None had bleeding tendency and the hemoglobin level was slightly decreased in 2 patients. All patients revealed membrane of the hematoma during operation. The upper portion of the sedimentation was liquefied blood and the lower portion was fresh blood clots. We could observe fresh RBC's in the hematoma microscopically. A sedimentation level in chronic SDH was operatively proved to represent rebleeding, and was clinically manifested as an acute exacerbation of symptoms

245

Chronic subdural hematoma with sedimentation level on CT: correlation with clinical and operative findings  

Energy Technology Data Exchange (ETDEWEB)

The purpose of this study is to correlate CT findings of the patients with chronic subdural hematoma(SDH) showing a sedimentation level with their clinical and operative findings. We selected 9 patients who showed a sedimentation level within the hematoma after reviewing the CT findings of 55 patients with SDH. We also analyzed their age, initial symptoms, cause of head injury, latent period, the level of consciousness on admission, CT findings, and operative findings. All of the 9 patients were aged persons(over 52 years). They had a history of acute exacerbation of neurologic symptoms. Five of them had an apparent history of head trauma more than one month before the exacerbation. The CT scans showed unilateral, crescent-shaped subdural fluid collection with a sedimentation level except a case of bilateral SDH and 2 cases of planoconvex-shaped SDH. The interface of the sedimentation level was sharp in 3 cases and indistinct in 6 cases. None had bleeding tendency and the hemoglobin level was slightly decreased in 2 patients. All patients revealed membrane of the hematoma during operation. The upper portion of the sedimentation was liquefied blood and the lower portion was fresh blood clots. We could observe fresh RBC's in the hematoma microscopically. A sedimentation level in chronic SDH was operatively proved to represent rebleeding, and was clinically manifested as an acute exacerbation of symptoms.

Lee, Sung Hee; Lee, Hyeon Kyeong; Lee, Won Jae [College of Medicine, Dongguk University, Kyungju (Korea, Republic of)] (and others)

1994-03-15

246

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

247

[Postoperative hematomas after inguinal hernia repair].  

Science.gov (United States)

It was done the analysis of the results of 625 open and endoscopic prosthetic and autoplastic hernia repairs made in a planned and emergency basis during the period from 2005 to 2012. The autoplastic group was divided into three subgroups: the plastic by Bassini, Shouldays and Postempski. The prosthesis group was divided into open and endoscopic subgroups. The open prosthesis group was also divided into subgroups in accordance with the options of hernia sac preparation (excised, reseted, untouched) and the reconstruction of the posterior wall of the inguinal canal (without reconstruction, with a single-layer and double-layer plastic). It was noted hematocele scrotum - 19 (3.04%), hematoma of the spermatic cord - 16 (2.56%), wound infiltration with a hemorrhagic component - 13 (2.08%). It was not noted the hemorrhagic complications in the subgroups of open prosthesis without hernia sac preparation. Reducing surgical aggression against inguinal hernias during the operation can reduce the frequency of hematomas. The absence of a clear classification of hematomas brings to difficulties in assessment of the role of specific surgical techniques in the development of postoperative complications after surgery for inguinal hernias. PMID:24429713

Cherepanin, A I; Pokrovski?, K A; Povetkin, A P; Antonov, O N; Baulina, E A

2014-01-01

248

CORRELACIÓN CLÍNICO-TOMOGRÁFICA DEL HEMATOMA INTRAPARENQUIMATOSO  

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Full Text Available Se realizó un estudio transversal descriptivo a todos los pacientes con diagnóstico clínico y tomográfico de hematoma intraparenquimatoso espontáneo egresados de la Unidad de Cuidados Intermedios del Hospital Provincial Clínico Quirúrgico Docente ¿Manuel Ascunce Domenech¿ de Camagüey desde el 1ro de marzo de 2002 hasta el 28 de febrero de 2003, con el objetivo de correlacionar clínica e imagenológicamente los enfermos diagnosticados con hematoma intraparenquimatoso espontáneo. Esta dolencia fue más frecuente en hombres que en mujeres, en pacientes blancos y mayores de 60 años. Los antecedentes más frecuentes fueron la hipertensión arterial en el 86.5 %, seguidos por la enfermedad vascular isquémica y diferentes cardiopatías. Al 70.6 % de los pacientes no se le diagnosticó la enfermedad en el Servicio de Urgencia; la tomografía computarizada resultó útil en el diagnóstico y topografía en el 100 %; mientras que el estudio clínico permitió llegar al diagnóstico positivo en el 92.3 % y al topográfico en el 80.5 % de los pacientes. El método clínico y el estudio tomográfico del hematoma intraparenquimatoso fueron útiles en el diagnóstico y localización, y dentro de ellos los más frecuentes fueron las labores, putaminales y talámicos.

Eugenio de Zayas Alba

2004-01-01

249

Gastric intramural hematoma: A case report and literature review  

OpenAIRE

Intramural hematoma of the gastrointestinal tract is an uncommon occurrence, with the majority being localized to the esophagus or duodenum. Hematoma of the gastric wall is very rare, and has been described most commonly in association with coagulopathy, peptic ulcer disease, trauma, and amyloid-associated microaneurysms. A case of massive gastric intramural hematoma, secondary to anticoagulation therapy, and a gastric ulcer that was successfully managed with conservative therapy, is presente...

Dhawan, Vivek; Mohamed, Ahmed; Fedorak, Richard N.

2009-01-01

250

Type III Rectus Sheath Hematoma: A Case Report  

OpenAIRE

A rectus sheath hematoma occurs an accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric arteries or their branches or rectus muscle tear. The choice of effective treatment of rectus sheath hematoma and the decision to admit the patient to hospital depends on the degree of haemodynamic compromise, coagulation status as well as the type of the hematoma on abdominopelvic computerized tomography scans. In this article, we report a case of spontaneous ...

Go?lcu?k, Yalc??n; Oray, Deniz; Bademkiran, Ender

2012-01-01

251

Bilateral rectus sheath hematoma in kidney transplant patient: case study and literature review.  

Science.gov (United States)

Rectus sheath hematoma usually occurs unilateral but rare cases of bilateral hematoma have been reported. Herein we report the first case of spontaneous bilateral Rectus Sheath Hematoma in the kidney transplanted patient. PMID:24350093

Feizzadeh Kerigh, Behzad; Maddah, Ghodratolah

2013-09-01

252

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

253

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.

2011-08-01

254

Haploinsufficiency of HDAC4 causes brachydactyly mental retardation syndrome, with brachydactyly type E, developmental delays, and behavioral problems.  

Science.gov (United States)

Brachydactyly mental retardation syndrome (BDMR) is associated with a deletion involving chromosome 2q37. BDMR presents with a range of features, including intellectual disabilities, developmental delays, behavioral abnormalities, sleep disturbance, craniofacial and skeletal abnormalities (including brachydactyly type E), and autism spectrum disorder. To date, only large deletions of 2q37 have been reported, making delineation of a critical region and subsequent identification of candidate genes difficult. We present clinical and molecular analysis of six individuals with overlapping deletions involving 2q37.3 that refine the critical region, reducing the candidate genes from >20 to a single gene, histone deacetylase 4 (HDAC4). Driven by the distinct hand and foot anomalies and similar cognitive features, we identified other cases with clinical findings consistent with BDMR but without a 2q37 deletion, and sequencing of HDAC4 identified de novo mutations, including one intragenic deletion probably disrupting normal splicing and one intragenic insertion that results in a frameshift and premature stop codon. HDAC4 is a histone deacetylase that regulates genes important in bone, muscle, neurological, and cardiac development. Reportedly, Hdac4(-/-) mice have severe bone malformations resulting from premature ossification of developing bones. Data presented here show that deletion or mutation of HDAC4 results in reduced expression of RAI1, which causes Smith-Magenis syndrome when haploinsufficient, providing a link to the overlapping findings in these disorders. Considering the known molecular function of HDAC4 and the mouse knockout phenotype, taken together with deletion or mutation of HDAC4 in multiple subjects with BDMR, we conclude that haploinsufficiency of HDAC4 results in brachydactyly mental retardation syndrome. PMID:20691407

Williams, Stephen R; Aldred, Micheala A; Der Kaloustian, Vazken M; Halal, Fahed; Gowans, Gordon; McLeod, D Ross; Zondag, Sara; Toriello, Helga V; Magenis, R Ellen; Elsea, Sarah H

2010-08-13

255

Acute-on-chronic subdural hematoma by spinal anesthesia in a patient with undiagnosed chronic subdural hematoma -A case report-  

OpenAIRE

Subdural hematoma is a serious but rare complication of spinal anesthesia. A 70-year-old woman patient underwent elective total knee replacement under spinal anesthesia. At 4 days postoperatively, the patient complained of headache and vomiting. Brain computed tomography revealed an acute-on-chronic subdural hematoma with midline shift. The patient recovered completely after surgical decompression. We report a patient with an undiagnosed chronic subdural hematoma, who developed acute-on-chron...

Park, Il Bong; Moon, Soo Yeong; Kim, Yu Yil; Kwon, Young Eun; Lee, Jun Hak

2011-01-01

256

Identification of choriocarcinoma by the hCG beta-to-hCG proportion in patients with delayed diagnosis caused by contraceptive use.  

Science.gov (United States)

The use of contraceptives, especially subdermal implants and levonorgestrel-containing intrauterine device (IUD), often cause irregular bleeding. Thus, they may mask unsuspected choriocarcinoma, which also often presents with abnormal bleeding. Choriocarcinoma is mostly curable with combination chemotherapy, but delayed diagnosis can lead to treatment failure. Two cases of choriocarcinoma with considerable delay in diagnosis, due partly to contraceptive use, are reported. The proportion of human chorionic gonadotropin-beta (hCG beta) and total hCG immunoreactivity showed that the proportion of hCG beta was elevated at presentation in both cases. PMID:9649918

Vartiainen, J; Alfthan, H; Lehtovirta, P; Stenman, U H

1998-04-01

257

Magnetic resonance maging of epidural and subdural spinal hematomas  

International Nuclear Information System (INIS)

Epidural und subdural spinal hematomas were previously diagnosed by myelography and computed tomography (CT). Recent reports indicate that noninvasive detection is possible with magnetic resonance imaging. We report on nine patients who were investigated by magnetic resonance imaging (MR) prior to surgery for epidural and subdural spinal hematoma. The MR examinations were performed on 1.5-T and 1-T units. We used surface coils and employed T1-, PD-and T2-weighted spin echo sequences and a T2*-weighted gradient echo sequence. CT was available in four patients and myelography in two patients. Surgical correlation was available in all patients. The hematomas were located in the cervical spine (n=2), thoracic spine (n=6) and lumbar spine (n=2). They were epidural in five patients and subdural in four. Blinded reading correctly indentified all five epidural hematomas and three of the subdural hematomas; one subdural hematoma was misjudged as epidural. Peracute hematomas (<24 h) in three patients appeared isointense or slightly hyperintense on T1-weighted images and had mixed signal intensity on T2- and T2*-weighted images. Acute hematomas (1-3 days) in four patients were also isointense on T1-weighted images but were more hypointense on T2- and T2*-weighted images. Chronic heamatomas in two patients (7 days and 14 days) were hyperintense on all sequences. Differentiation between epi- and subdural hematomas required transverse T2*-weighted gradient echo sequences. Our resuleighted gradient echo sequences. Our results underline that MRI at 1 and 1.5 T is capable of identifying epidural and subdural spinal hematoma in the acute and peracute stage. MRI is superior to CT and myelography for the delineation of the craniocaudal extension in epidural and subdural spinal hematomas and should be the primary preoperative diagnostic method. (orig.)

258

Encapsulated acute subdural hematoma mimicking acute epidural hematoma on computed tomography.  

Science.gov (United States)

An 87-year-old woman presented with an atypical case of acute subdural hematoma (ASDH) manifesting as disturbance of consciousness and left hemiparesis. Computed tomography revealed a high density lentiform lesion in the right convexity, which was thought to be acute epidural hematoma preoperatively. Emergent decompressive craniotomy revealed an encapsulated solid fresh clot in the subdural space and a bleeding small cortical artery under the clot. The arachnoid membrane and the brain parenchyma were intact, and no other abnormal feature such as aneurysm or arteriovenous malformation was observed. The encapsulated ASDH was removed en bloc and the patient fully recovered. Histological examination confirmed that both the outer thicker and the inner membrane were fibrinous single structures without vasculature. The red blood cells constituting the clot in the capsule maintained their cell structure. The reported pathological mechanisms of lentiform ASDH are adhesion of the arachnoid membrane and the dura mater or intracapsular bleeding from sinusoidal vessels in the outer membrane of the chronic subdural hematoma. However, in our case, the arachnoid membrane had not adhered to the dura mater and the capsule was a fibrinous single structural membrane without vasculature, which probably resulted from a previous hematoma due to initial bleeding from the cortical artery. The possible mechanism in our case was that the re-bleeding dissected and flowed into the fibrinous single structural membrane, resulting in formation of the lentiform ASDH. PMID:23183078

Miki, Shunichiro; Fujita, Keishi; Katayama, Wataru; Sato, Masayuki; Kamezaki, Takao; Matsumura, Akira; Sakashita, Shingo

2012-01-01

259

Subdural Hematoma and Postdural Puncture Headache from Intrathecal Pump Placement Resolved with Lumbar Epidural Blood Patch  

OpenAIRE

Intrathecal drug delivery systems are commonly used in the management of chronic pain, cancer pain and neuromuscular disorders with muscle spasticity. The complications associated with in-trathecal pump placement include persistent cerebrospinal fluid (CSF) leak, hygroma, meningitis, and granuloma formation. A severe persistent CSF leak may cause postdural puncture headache along with acute intracranial subdural hematoma, which can be potentially life threatening. Surgical exploration with du...

Andrew Ng; Victor Romo; Dajie Wang

2014-01-01

260

Subcapsular hematoma of the liver in a neonate: case report  

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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

261

Subcapsular hematoma of the liver in a neonate: case report  

International Nuclear Information System (INIS)

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

262

Spontaneous subdural hematoma in a young adult with hemophilia  

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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

263

Treatment of acute traumatic epidural hematoma in infancy and childhood  

International Nuclear Information System (INIS)

The authors treated 22 cases of epidural hematoma diagnosed by CT scan. This study focused on the analysis of the time-course and development of epidural hematoma using a CT scan. The results are follows: 1. Severe cases must be treated by craniotomy and rapid removal of hematoma. We achieved a zero mortality rate in the cases of infants and children. 2. Normal CT findings were not unusual in cases where the patient was examined within 3 hours after the occurence of the injury. Conservative treatment was indicated for patients with a small amount of epidural hematoma. CT scanning at intervals of 6 hours and 30 hours after the occurence of the injury offer the best correlation in regard to the course of hematoma. 3. Operative treatment is required when the hematoma thickness, measured by CT scan, is more than 20 mm for infants and younger children or 30 mm for school aged children. However, eventhough the thickness of the hematoma maybe less than these guidelines, when progressive deterioration occurs after the CT scan, operative treatment must be considered. 4. Diffuse brain injury is a new clinical entity found by CT scanning. We classified this into 5 types. Of the 5 types, ''diffuse cerebral swelling'' was observed in the initial CT scan of two patients, however, epidural hematoma developed afterwards. Thus, patients with diffuse cerebral swelling with a skull fracture must be closely observed. (J.P.N.)

264

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

265

Delayed judgments of learning cause both a decrease in absolute accuracy (calibration) and an increase in relative accuracy (resolution).  

Science.gov (United States)

A version of the PRAM methodology that permits an analytical evaluation of judgment of learning (JOL) accuracy was used for the first time to assess absolute accuracy (specifically, calibration). Results are reported from a new experiment in which Swahili-English translation equivalents were studied, followed sometime later (either immediately, approximately 1 min, or approximately 8 min) by pre-JOL recall and JOLs, and followed eventually by final recall. The calibration accuracy for predicting final recall decreased as the delay between study and JOL increased, with the decrease being most dramatic when only items that were recalled at the time of the JOL were considered. In contrast, relative accuracy (as measured by an overall gamma) improved as the delay between study and JOL increased. Participants appear insensitive to the combined effects of the recallability of the items at the time of the JOLs and of the delay between JOL and testing on the accuracy of JOLs. PMID:17263076

Van Overschelde, James P; Nelson, Thomas O

2006-10-01

266

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

267

Longterm surgery of posttraumatic intracranial hematoma  

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Full Text Available Purpose. Research objective — studying of consequences of the operated traumatic intracranial hematomas in the remote period. Material. The nearest and remote results of the operated traumatic intracranial hematomas at 105 patients in terms from 6 months till 3 years are analyzed. During research the anamnesis was studied, neurologic investigation, and also research cognitive functions by means of scale MMSE, the test of drawing of hours, a scale of studying of alarm/depression HADS, learning of 5 words, scale quality of life SF-36. Results. It is established, that in the remote period the condition of the majority of patients gradually improves, at the same time, frequent enough and expressed consequences which are necessary for analyzing with the purpose of optimization of outcomes and the forecast at the given disease are observed. The special attention should be given again developing complications to which it is possible to carry epileptic seizures and behavioral-memorable infringements. Conclusion. Studying of the remote consequences of this heavy kind of craniocereberal trauma allows to optimize results of treatment and to provide complex medical, labor, social and family adaptation

Babochkin D.S.

2012-03-01

268

Acute Spontaneous Posterior Fossa Subdural Hematoma  

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Full Text Available Acute posterior fossa subdural hematomas are rare and most of them are trauma-related. Non-traumatic ones have been reported in patients who had idiopathic thrombocytopenic purpura or those who had been receiving anticoagulant therapy. We report on the case of 57-year-old Iranian man who developed sudden severe occipital headache, drowsiness, repeated vomiting, and instability of stance and gait. He was neither hypertensive nor diabetic. No history of head trauma was obtained and he denied illicit drug or alcohol ingestion. A preliminary diagnosis of acute intra-cerebellar hemorrhage was made. His CT brain scan revealed an acute right-sided, extra-axial, crescent-shaped hyperdense area at the posterior fossa. His routine blood tests, platelets count, bleeding time, and coagulation profile were unremarkable. The patient had spontaneous acute infratentorial subdural hematoma. He was treated conservatively and discharged home well after 5 days. Since then, we could not follow-up him, clinically and radiologically because he went back to Iran. Our patient?s presentation, clinical course, and imaging study have called for conservative management, as the overall presentation was relatively benign. Unless the diagnosis is entertained and the CT brain scan is well-interpreted, the diagnosis may easily escape detection.

Osama Shukir Muhammed Amin

2014-02-01

269

Hematoma subdural em Pediatria Diagnosticar e tratar precocemente / Subdural hematoma in pediatrics - Early diagnosis and treatment  

Scientific Electronic Library Online (English)

Full Text Available SciELO Portugal | Language: Portuguese Abstract in portuguese Introdução: O hematoma subdural agudo não traumático é uma entidade rara em Pediatria. A presença de sintomas neuro­lógicos de instalação aguda associada a anticoagulação obriga à exclusão desta entidade. Caso clínico: Apresentamos o caso de uma criança, do sexo masculino, de sete anos de idade, com [...] prótese mitral mecâ­nica, medicada com varfarina, que recorreu ao serviço de urgência por cefaleias intensas e progressivas, associadas a alteração no estado de consciência e convulsões. A nível laboratorial o INR (In­ternational Normalized Ratio) era de 4,2. Foi admitida na Unidade de Cuidados Intensivos Pediátricos (UCIP) em coma com aniso­coria. Iniciou ventilação mecânica, medidas anti-edema cerebral e antiepilépticos.O exame de imagem mostrou hematoma subdural agudo à esquerda, com desvio da linha média. Foi submetida a craniotomia descompressiva, 56 horas após o início da sintomato­logia, com recuperação clínica e actualmente sem sequelas. Conclusão: Este caso clínico ilustra a importância da sus­peição clínica de hematoma subdural em doentes anticoagula­dos, bem como a necessidade de optimização das condições cirúrgicas e da utilização das técnicas não invasivas na monitori­zação do nível de consciência. Abstract in english Introduction: Non-traumatic acute subdural hematoma is a rare entity in children. In the presence of acute neurological symptoms associated with long termanticoagulation, it is manda­tory to rule out this entity. Case report: We report the case of a seven-year-old boy, with mechanical mitral valve p [...] rosthesis under warfarin treat­ment, presenting severe and progressive headache associated with altered level of consciousness and seizures. Laboratory studies revealed a high value of International Normalized Ratio(INR: 4,2). He was admitted to the Pediatric Intensive Care Unit in a coma with anisocoria. He was mechanically ventilated and started on specific measures to reduce cerebral edemain ad­dition to anticonvulsants. Cranial computerized tomography (CT scan) revealed acute left subdural hematoma, with midline shift. Fifty-six hours after the onset of symptoms, he was submitted to decompressive craniectomy. There was progressive clinical re­covery with neurological and imaging improvement and an excel­lent outcome. Discussion: This case illustrates the importance of the clinical suspicion of a subdural hematoma in patients treated with anticoagulants, as well as the need of optimizing surgical condi­tions and the use of non invasive techniques for monitoring the level of consciousness.

Marisa, Carvalho; Ema, Leal; Margarida, Santos; José, Ramos; Luís, Távora; Deolinda, Barata.

2011-06-01

270

Subdural hematoma associated with skull and dural metastasis of gastric carcinoma: a case report.  

Science.gov (United States)

Skull bone metastasis from the gastric cancer is a rare. We reported a 52-year-old male proven to have stomach cancer and who underwent subtotal gastrectomy 5 months previously. Within the past 2 weeks, he experienced headache and dizziness followed by weakness of the left lower limb. A diagnosis of right chronic subdural hematoma (SDH) was made, and a burr hole was performed for drainage of the hematoma. However, 5 days later, the patient had sudden loss of consciousness without external evidence of trauma to the head. An emergency computed tomography (CT) scan revealed a high-density lesion consistent with an acute SDH on the right side. Histologically, metastasis of gastric adenocarcinoma was detected in both the dura mater and skull. It is suggested that the SDH was caused by the rupture of vessels in the metastasis or rupture of the inner dural vessels, possibly resulting from congestion of the outer vessels. PMID:24310465

Kuan-Yin, Tseng; Dueng-Yuan, Hueng; Hsin-I, Ma

2013-01-01

271

Idiopathic scrotal hematoma simulating a testicular torsion, in association with cryptorchidism: US findings  

Science.gov (United States)

Summary Background An acute scrotum concerns endoscrotal organs (testicles, spermatic cord, tunica vaginalis) and is characterized by pain, swelling and hyperemia of the hemi-scrotum. It represents one of the most common surgical emergencies in children often caused by testicular torsion; the diagnosis is mostly clinical but must be supported by ultrasonographic examination of the scrotal region in association with a colour Doppler study of the spermatic cord vessels and glandular parenchyma. An idiopathic scrotal hematoma is a very rare condition that can simulate it. Case Report A 3-day-old full-term baby, otherwise in good health, showed swelling and pain of the left inguinal-scrotal region. A testicular torsion was suspected, so the baby underwent an ultrasound examination of the testis and spermatic cord that showed a left scrotal hematoma with superior displacement of the didymus; the right testicle was located in the internal inguinal canal. Surgical intervention confirmed the sonographic diagnosis of left testicular hematoma and of the right cryptorchidism. Conclusions Although testicular torsion is the most frequent cause of acute scrotum, the possibility of a persistent idiopathic scrotal haematoma and/or haematoma secondary to a trauma of the inguino-scrotal region, must be always taken into account. US diagnosis can avoid unnecessary emergency surgical treatment, required in case of testicular torsion. PMID:25061495

Crisci, Vincenzina; Esposito, Ciro; Giurin, Ida; Vitale, Valerio; Vallone, Gianfranco

2014-01-01

272

Clinical studies on cerebral blood flow in chronic subdural hematoma  

International Nuclear Information System (INIS)

Cerebral blood flow (CBF) and clinical symptoms were examined between pre- and post-operations in twenty-four patients with unilateral chronic subdural hematoma. The following results were obtained by intravenous 133Xe method : 1. There was a reducing tendency of the CBF (hemisphere) on hematoma side, in most cases. While, the groups of headache and disturbances of consciousness did not give a laterality between hematoma and opposite side without the group of hemiparesis. 2. The absolute values of the CBF in the groups of headache and disturbances of consciousness were correlated with the clinical symptoms. In the group of hemiparesis, the laterality between hematoma and opposite side was correlated with the clinical symptoms. 3. In the group of hemiparesis, the F-flow (fast-flow) had sensitive reaction more than the ISI (initial slope index) with symptomatic improvement. 4. It was found that there was not an increase in the absolute value of the CBF, which was under the normal limit between pre- and post-operations in the case without improvement. By SPECT (Method of IMP), the following results were obtained : 1. There was the area of defect at the location of hematoma and the CBF tended to reduce at the subcortical white matter and at the basal ganglia of hematoma side. 2. The CBF of the contralateral hematoma side in the hemisphere of cerebellum was also tended to reduce. (author)

273

Haploinsufficiency of HDAC4 Causes Brachydactyly Mental Retardation Syndrome, with Brachydactyly Type E, Developmental Delays, and Behavioral Problems  

OpenAIRE

Brachydactyly mental retardation syndrome (BDMR) is associated with a deletion involving chromosome 2q37. BDMR presents with a range of features, including intellectual disabilities, developmental delays, behavioral abnormalities, sleep disturbance, craniofacial and skeletal abnormalities (including brachydactyly type E), and autism spectrum disorder. To date, only large deletions of 2q37 have been reported, making delineation of a critical region and subsequent identification of candidate ge...

Williams, Stephen R.; Aldred, Micheala A.; Kaloustian, Vazken M.; Halal, Fahed; Gowans, Gordon; Mcleod, D. Ross; Zondag, Sara; Toriello, Helga V.; Magenis, R. Ellen; Elsea, Sarah H.

2010-01-01

274

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

275

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

Directory of Open Access Journals (Sweden)

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

276

Tratamiento médico de un hematoma subdural crónico / Medical treatment of a chronic subdural hematoma  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se presenta una paciente portadora de un hematoma subdural crónico postraumático, que se trató médicamente y se logró su desaparición en el curso de varios meses, sin tratamiento quirúrgico y sin signos evolutivos de empeoramiento neurológico. La furosemida fue usada como medicamento básico en su tr [...] atamiento. Se adjuntan imágenes que confirman el valor de este punto de vista terapéutico. Abstract in english This is the case of a patient carrier of a post-traumatic chronic subdural hematoma clinically treated achieving its disappearance over some months without surgical treatment and evolutionary signs of neurologic worsening. The furosemide was used as basic drug in its treatment. The images confirming [...] the value of this point of therapeutical view are enclosed.

Antonio, Guevara Melcón; Ashley, Obregón Marín.

2012-03-01

277

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

OpenAIRE

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 peridurales 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, e...

Bermejo, M.; Castan?o?n, E.; Fervienza, P.; Cosi?o, F.; Carpintero, M.; Di?az-ferna?ndez, M. L.

2004-01-01

278

Dabigatran-related Intracerebral Hemorrhage Resulting in Hematoma Expansion  

DEFF Research Database (Denmark)

Warfarin-related intracerebral hemorrhage carries a particularly high risk of neurologic deterioration and death because of a high rate of hematoma expansion of about 50%. Novel oral anticoagulants (NOACs)-apixaban, dabigatran, and rivaroxaban-have a significantly smaller risk of intracerebral hemorrhage (ICH). However, two facts make this situation complicated: First, the risk of hematoma expansion is unknown for NOACs. Second, there is no specific antidote for neither of the NOACs. We present a case that suggests that hematoma expansion may occur after NOAC-related ICH.

Simonsen, Claus Z; Steiner, Thorsten

2014-01-01

279

Endoscopic burr hole evacuation of an acute subdural hematoma.  

Science.gov (United States)

Acute subdural hematoma evacuations frequently necessitate large craniotomies with extended operative times and high relative blood loss, which can lead to additional morbidity for the patient. While endoscopic minimally invasive approaches to chronic subdural collections have been successfully demonstrated, this technique has not previously been applied to acute subdural hematomas. The authors report their experience with an 87-year-old patient presenting with a large acute right-sided subdural hematoma successfully evacuated via an endoscopic minimally invasive technique. The operative approach is outlined, and the literature on endoscopic subdural collection evacuation reviewed. PMID:23962631

Codd, Patrick J; Venteicher, Andrew S; Agarwalla, Pankaj K; Kahle, Kristopher T; Jho, David H

2013-12-01

280

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)

281

Computed tomographic investigations on intraventricular hematomas  

International Nuclear Information System (INIS)

This work investigated in 106 patients with intraventricular hematomas all the known factors which can have an influence on prognosis: age, sex, anamnesis of the patients, size, extent and localization of the intracranial bleeding, underlying angiopathy and differences between arterial and venous and spontaneous and traumatic bleedings. It was shown that the state of mind was the deciding prognostic factor, whereby viligance was the cumulative expression of all other investigated influences. A computed tomography (CT) examination is deciding in the question of operative hydrocephalus care. In 13 patients it was further shown, how clearly CT results and brain dissection allowed themselves to be compared. The computed tomographic examination method is best suited to achieve even physiological and more extensive prognostic possibilities. (orig.)

282

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 factorsand 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).

283

Delayed Flood Recession in Central Yangtze Floodplains Can Cause Significant Food Shortages for Wintering Geese: Results of Inundation Experiment  

Science.gov (United States)

Carex meadows are critical habitat for wintering geese in the floodplains of the middle and lower reaches of Yangtze River, China. These meadows follow a growth cycle closely tied to the seasonal hydrological fluctuation: as water levels recede in the fall, exposed mudflats provide habitat for Carex spp. growth. The seasonal growth of Carex overlaps the arrival of wintering geese and provides an important food source for the migrants. Recent alterations to the Yangtze's hydrology, however, have disrupted the synchronous relationship between water levels, Carex growth and wintering geese at Dongting Lake. In October 2012, we carried out an outdoor mesocosm experiment to investigate potential impacts of delayed water recession on the germination and growth of Carex heterolepis, the dominant Carex species at Dongting Lake, to understand how changes in hydrology might impact wintering goose habitat. Results showed that the delayed flood recession exerted significant impact on the first growth cycle of Carex growth. Prolonged inundation significantly lowered the intrinsic growth rate ( P = 0.03) and maximum growth rates ( P = 0.02). It also took significantly longer time to reach the peak growth rate ( P = 0.04 and 0.05 for number of shoot and biomass, respectively). As a result, biomass accumulation was reduced by 45, 62 and 90 % for 10-day, 20-day and 30-day inundation treatments, respectively. These results indicate a severe risk of food shortage for wintering geese when water recession delayed. This potential risk should be taken into consideration when operating any hydrological control structures that alter the flood regimes in Dongting Lake.

Guan, Lei; Wen, Li; Feng, Duoduo; Zhang, Hong; Lei, Guangchun

2014-12-01

284

Changes in signal intensity of cerebral hematoma in magnetic resonance. Claves en la semiologia del hematoma cerebral en resonancia magnetica  

Energy Technology Data Exchange (ETDEWEB)

Magnetic resonance is highly sensitive for the detection of intraparenchymatous hemorrhage. The evolution of hematoma over time translates into changes in signal intensity. This means that we can determine when the hematoma presented and, in addition. follow its course. On the other hand, many intracranial processes developing association with hemorrhage, the recognition of which is, in some cases, of importance. We have studied 60 cerebral hematomas and have described the changes that will take place in their signal and the reasons for them. (author)

Galant, J.; Poyatos, C.; Marti-Bonmarti, L.; Martinez, J.; Ferrer, D.; Dualde, D.; Talens, A. (Universidad de Valencia (Spain). Facultad de Ciencias Quimicas)

1992-01-01

285

[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

286

Idiopathic intraparenchymal hematoma of the liver in a neonate  

International Nuclear Information System (INIS)

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.)

287

Idiopathic intraparenchymal hematoma of the liver in a neonate  

Energy Technology Data Exchange (ETDEWEB)

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

288

Hand-held instrument should relieve hematoma pressure  

Science.gov (United States)

Portable instrument relieves hematomas beneath fingernails and toenails without surgery. This device simplifies the operative procedure with an instant variable heating tip, adjustable depth settings and interchangeable tip sizes for cauterizing small areas and relieving pressurized clots.

Raggio, L. J.; Robertson, T. L.

1967-01-01

289

Diplopia from Subacute Bilateral Subdural Hematoma after Spinal Anesthesia  

OpenAIRE

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 postpart...

Getaw Worku Hassen; Hossein Kalantari

2012-01-01

290

Intracranial Rhabdomyosarcoma Presented as Chronic Subdural Hematoma: A Case Report  

OpenAIRE

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 rhabdo...

Mahdavi, A.; Sh. Yazdani; Sh. Kazmi; Nejat, F.; Mehdizadeh, M.; Monajemzadeh, M.

2007-01-01

291

Subdural Hematoma in Grave’s Disease Induced Thrombocytopenia.  

Directory of Open Access Journals (Sweden)

Full Text Available Subdural hematoma (SDH usually occurs secondary to trauma, in bleeding disorders it may occur spontaneously. It is a rare complication of immune thrombocytopenia. Here we report a case of 45 years female presenting with presenting with complaints of headache, palpitation and menorrhagia and later diagnosed to be a case of Grave's disease with thrombocytopenia with sub dural hematoma. No such case reports are available in literature.

Sunil Kumar

2013-01-01

292

Chronic Subdural Hematoma after Spontaneous Intracranial Hypotension : A Case Treated with Epidural Blood Patch on C1-2  

OpenAIRE

Spontaneous cerebrospinal fluid (CSF) leak is a recognized cause of spontaneous intracranial hypotension (SIH). Subdural hematoma (SDH) is a serious but rare complication of SIH. An autologous epidural blood patch at the CSF-leak site can effectively relieve SIH. We report a case of bilateral SDH with SIH caused by a CSF leak originating at the C1-2 level. A 55-year-old male complained of orthostatic headache without neurological signs. His symptoms did not respond to conservative treatments ...

Kim, Byung-won; Jung, Young-jin; Kim, Min-su; Choi, Byung-yon

2011-01-01

293

Primary enlarged craniotomy in organized chronic subdural hematomas.  

Science.gov (United States)

The aim of the study is to evaluate the efficacy of craniotomy and membranectomy as initial treatment of organized chronic subdural hematoma (OCSH). We retrospectively reviewed a series of 34 consecutive patients suffering from OCSH, diagnosed by magnetic resonance imaging (MRI) or contrast computer tomography (CCT) in order to establish the degree of organization and determine the intrahematomal architecture. The indication to perform a primary enlarged craniotomy as initial treatment for non-liquefied chronic subdural hematoma (CSDH) with multilayer loculations was based on the hematoma MRI appearance--mostly hyperintense in both T1- and T2-weighted images with a hypointense web- or net-like structure within the hematoma cavity. The reason why some hematomas evolve towards a complex and organized architecture remains unclear; the most common aspect to come to light was the "long standing" of the CSDHs which, in our series, had an average interval of 10 weeks between head injury and initial scan. Recurrence was found to have occurred in 2 patients (6% of cases) in the form of acute subdural hematoma. One patient died as the result of an intraventricular and subarachnoid haemorrhage, while 2 patients (6%) suffered an haemorrhagic stroke ipsilateral to the OCSH. Eighty-nine percent of cases had a good recovery, while 11% remained unchanged or worsened. In select cases, based on the MRI appearance, primary enlarged craniotomy seems to be the treatment of choice for achieving a complete recovery and a reduced recurrence rate in OCSH. PMID:24305027

Callovini, Giorgio Maria; Bolognini, Andrea; Callovini, Gemma; Gammone, Vincenzo

2014-01-01

294

Chronic spinal subdural hematoma; Spinales chronisches subdurales Haematom  

Energy Technology Data Exchange (ETDEWEB)

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

295

The analysis of initial cranial CT of early hematoma enlargement in spontaneous intracerebral hemorrhage  

Directory of Open Access Journals (Sweden)

Full Text Available Objective To investigate the predictive effect of initial cranial CT on early hematoma enlargement in spontaneous intracerebral hemorrhage. Methods Three hundred patients with spontaneous intracerebral hemorrhage within 6 hours after onset were studied. Chi-square test and logistic regression analysis were used to detect the related factors which may indicate hematoma enlargement. Results Sixty-one (20.33% patients presented hematoma enlargement on cranial CT. Single factor and multivariate regression analysis showed that the following factors were associated with early hematoma enlargement: early onset, uneven density hematoma, moderate and severe brain atrophy and hematoma located at the basal ganglia. Conclusion Early onset uneven density hematoma, moderate and severe brain atrophy, and hematoma at basal ganglia are the factors which may indicate early hematoma enlargement in patiens with spontaneous intracerebral hemorrhage.

BEI Yu-zhang

2012-06-01

296

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

Directory of Open Access Journals (Sweden)

Full Text Available 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 identificação 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.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.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, and 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, saddle anesthesia and lumbar pain persisted and, after 48 hours, the patient presented urinary incontinence. An MRI demonst

Daniel Segabinazzi

2007-04-01

297

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. [...

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

2008-03-01

298

A case of anemia caused by combined vitamin B12 and iron deficiency manifesting as short stature and delayed puberty  

OpenAIRE

Anemia caused by vitamin B12 deficiency resulting from inadequate dietary intake is rare in children in the modern era because of improvements in nutritional status. However, such anemia can be caused by decreased ingestion or impaired absorption and/or utilization of vitamin B12. We report the case of an 18-year-old man with short stature, prepubertal sexual maturation, exertional dyspnea, and severe anemia with a hemoglobin level of 3.3 g/dL. He had a history of small bowel resection from 5...

Song, Seung Min; Bae, Keun Wook; Yoon, Hoi-soo; Im, Ho Joon; Seo, Jong-jin

2010-01-01

299

Electroencephalographic findings in acute subdural hematoma.  

Science.gov (United States)

The aim was to determine the electroencephalographic (or electroencephalogram [EEG]) findings predictive of functional outcome in a subset of patients with acute subdural hematoma (SDH) with epileptiform activity on their EEG. Twenty-four patients who underwent evacuation for acute or acute-on-chronic SDH and with epileptiform activity on EEG were identified retrospectively. Their EEGs were reviewed and the findings categorized along with clinical information, the preoperative computed tomography (CT) scan, and functional outcome. Twenty-one patients (87%) had epileptiform discharges on EEG; 13 of them (62%) had midline epileptiform discharges and 9 of them (43%) had periodic lateralized epileptiform discharges (PLEDs). Both types of epileptiform discharges were significantly associated with the degree of midline shift on neuroimaging (P = 0.01, P = 0.04, respectively). Poor early outcomes were associated with the presence of bilateral (P = 0.03), midline (P = 0.04), and bilateral independent multifocal discharges (P = 0.09) on EEG. The EEG findings in this group of patients were complex. Epileptiform discharges were common, and specific types were associated with midline shift on neuroimaging and poor functional outcome at hospital discharge. Improvement in follow-up EEG examinations over time was predictive of good long-term functional outcome. PMID:22146350

Rudzinski, Leslie A; Rabinstein, Alejandro A; Chung, Seung Y; Wong-Kisiel, Lily C; Burrus, Tamika M; Lanzino, Giuseppe; Westmoreland, Barbara F

2011-12-01

300

Optimal management of hemophilic arthropathy and hematomas  

Directory of Open Access Journals (Sweden)

Full Text Available Sébastien Lobet,1,2 Cedric Hermans,1 Catherine Lambert1 1Hemostasis-Thrombosis Unit, Division of Hematology, 2Division of Physical Medicine and Rehabilitation, Cliniques Universitaires Saint-Luc, Brussels, Belgium Abstract: Hemophilia is a hematological disorder characterized by a partial or complete deficiency of clotting factor VIII or IX. Its bleeding complications primarily affect the musculoskeletal system. Hemarthrosis is a major hemophilia-related complication, responsible for a particularly debilitating chronic arthropathy, in the long term. In addition to clotting factor concentrates, usually prescribed by the hematologist, managing acute hemarthrosis and chronic arthropathy requires a close collaboration between the orthopedic surgeon and physiotherapist. This collaboration, comprising a coagulation and musculoskeletal specialist, is key to effectively preventing hemarthrosis, managing acute joint bleeding episodes, assessing joint function, and actively treating chronic arthropathy. This paper reviews, from a practical point of view, the pathophysiology, clinical manifestations, and treatment of hemarthrosis and chronic hemophilia-induced arthropathy for hematologists, orthopedic surgeons, and physiotherapists. Keywords: hemophilia, arthropathy, hemarthrosis, hematoma, physiotherapy, target joint

Lobet S

2014-10-01

301

Pathogenesis of chronic subdural hematoma. Sequential study with computerized tomography  

Energy Technology Data Exchange (ETDEWEB)

Ten cases of chronic subdural hematoma that were followed by a sequential study with CT from an early posttraumatic period to evolution of chronic subdural hematoma were reported. In four of these 10 cases, the initial CT showed thin subdural collections of high density suggesting acute subdural hematoma. Two weeks later, the density of subdural collections reduced, but their volumes increased. Clinical symptoms such as headache and disorientation occurred three or four weeks later. Preoperative CT showed similar huge subdural collections of low density and marked mass effect. These cases underwent surgery from 24 to 44 days after injury, and development of neomembranes was confirmed. In the remaining six cases, the initial CT showed thin subdural collections of low density suggesting subdural hygroma. In five of the six cases, the density of the subdural collections was slightly higher than that of cerebrospinal fluid, and in one case, an area of spotted high density was shown. It was suggested that these were mixtures with blood. Follow-up CT scans revealed that the subdural collections increased in size but remained at a uniformly low density for the first month after the head injury, and then the increase in density occurred. Operations were performed 55 to 76 days after injury, and operative findings were not different from those of common chronic subdural hematoma. From these investigations, it was suggested that there were two types of evolution of chronic subdural hematoma. One is the development from acute subdural hematomas, and the other from subdural hygromas. It is supposed that blood and cerebrospinal fluid are very important factors in the evolution of subdural collections into chronic subdural hematomas.

Taguchi, Y.; Nakamura, N.; Sato, J. (Jikei Univ., Tokyo (Japan). School of Medicine); Hasegawa, Y.

1982-04-01

302

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese 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. Abstract in english 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 wit [...] h 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.

Wellingson Silva, Paiva; Almir Ferreira de, Andrade; Luis, Mathias Júnior; Vinicius Monteiro de Paula, Guirado; Robson Luis, Amorim; Nadia Nader, Magrini; Manoel Jacobsen, Teixeira.

2010-12-01

303

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

304

Tratamento conservador dos hematomas extradurais laminares na infância Nonsurgical management of laminar extradural hematomas in children  

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Full Text Available Os autores relatam sua experiência com o tratamento conservador de 15 crianças com hematoma extradural (HED laminar traumático. Todas, por ocasião do diagnóstico, apresentavam-se neurologicamente estáveis e sem sinais de herniação intracraniana. Estes HED foram descobertos em períodos de 30 minutos e 5 dias depois do trauma, a maioria estando localizados na região parietal. OHED foi reabsorvido espontaneamente em todos os casos, num período que variou de 2 a 12 dias. Os critérios para seleção destes pacientes e os cuidados com essa modalidade de tratamento do HED são discutidos.We sucessfully treated by nonsurgical methods 15 children with laminar epidural hematomas (EH, with minimal neurological symptoms and no signs of brain herniation. These EH were discovered 30 minutes to 5 days after head injury. The majority were localized in the parietal region. All children recovered without surgery from 2 to 12 days after hospitalization and all had evidence on CT scan of spontaneous clot reabsortion. We discuss the criteria for patient selection for this kind of treatment on EH in children.

Orildo Ciquini Júnior

1992-12-01

305

Hematoma esofágico intramural: de la disección a la perforación / Intramural esophageal hematoma: Dissection of the perforation  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish El hematoma esofágico intramural es una entidad infrecuente, con pocos casos registrados en la literatura. Existen factores de riesgo que favorecen la aparición de esta condición como las náuseas y el vómito. Su presentación clínica más frecuente es la tríada de hematemesis, disfagia y dolor torácic [...] o. El tratamiento es conservador en la mayoría de los casos. En este trabajo presentamos nuestra experiencia en 7 casos recolectados durante los últimos 8 años, en los cuales se puede apreciar todo el espectro de la enfermedad desde la disección submucosa hasta la perforación del esófago Abstract in english Intramural esophageal hematomas are rare with few cases reported in the literature. Risk factors that affect the incidence of this condition include nausea and vomiting, but its most common clinical presentation is the triad of hematemesis, dysphagia and chest pain. Conservative treatment is best in [...] most cases. We present our experience in 7 cases collected during the last 8 years in which you can see the entire spectrum of the disease from submucosal dissection to perforation of the esophagus

Martin, Gómez Zuleta; Álvaro, Rodríguez Gómez; Amaranto, Siado.

2012-06-30

306

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

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Full Text Available 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 peridurales 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.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 diagnosis 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 and the Neurology Service, a conservative treatment and an expecting attitude were agreed

M. Bermejo

2004-11-01

307

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

308

MR imaging of shaken baby syndrome manifested as chronic subdural hematoma  

International Nuclear Information System (INIS)

Shaken baby syndrome (SBS) is a form of child abuse that can cause significant head injuries, of which subdural hematoma (SDH) is the most common manifestation. We report the MRI findings of chronic SDH in three cases of SBS, involving two-, three- and eight-month-old babies. The SDH signal was mostly low on T1-weighted images and high on T2-weighted images, suggesting chronic SDH. In chronic SDH, a focal high signal on T1-weighted images was also noted, suggesting rebleeding. Contrast-enhanced MRI revealed diffuse dural enhancement

309

Intramural aortic hematomas; Intramurale Haematome der Aorta  

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Intramural hematomas (IMH) are regarded as a hemorrhage into the aortic wall. In general a traumatic form can be differentiated from a spontaneous non-traumatic. There is a predisposition of IMH with arterial hypertension and mesoectodermal dysplastic syndromes. The diagnosis is established with the clinical presentation in combination with the findings of different imaging modalities. Acute and subacute discomfort associated with a tendency of collaps are considered as typical presenting complaints. A semicircular or concentric thickening of the aortic wall with the absence of blood flow or a dissection membran are typical findings in transesophageal echocardiography, computed tomography and magnetic resonance tomography. From a differential diagnostic point of view a distinction from atherosclerotic wall changes, intraluminal thrombi and inflammatory aortic diseases is essential. The IMH is considered as an early presentation of aortic dissection, put into and treated according to the Stanford classification. In the course of natural history an IMH can disappear, rupture or progress into a classic aortic dissection. (orig.) [German] Das intramurale Haematom (IMH) ist eine Einblutung in die Aortenwand. Grundsaetzlich kann zwischen traumatischer Genese und einer atraumatischen spontanen Form unterschieden werden. Praedisponierend sind arterielle Hypertension und mesoektodermale Dysplasiesyndrome. Die Diagnose ergibt sich aus der Klinik und den Befunden in den bildgebenden Verfahren. Zu den klinischen Symptomen zaehlen akut oder subakut auftretende Schmerzen, assoziiert mit einer Kollapsneigung. Typische Befunde in der transoesophagealen Echokardiographie, der Computer- oder der Magnetresonanztomographie sind eine halbmondfoermige oder konzentrische Wandverdickung der Aorta ohne Nachweis von Blutfluss oder einer Dissektionsmembran mit Dichtewerten bzw. Signalintensitaeten in Abhaengigkeit vom Alter der Einblutung. Differenzialdiagnostisch ist eine Abgrenzung gegenueber atherosklerotisch bedingten Wandveraenderungen, intraluminaeren Thromben, chronischen Aortendissektionen und entzuendlichen Aortenerkrankungen erforderlich. Das IMH wird als Fruehform einer Aortendissektion angesehen und entsprechend der Stanford-Klassifikation eingeteilt und behandelt. Im Verlauf koennen sich IMHs zurueckbilden, rupturieren oder in eine klassische Dissektion uebergehen. (orig.)

Raab, B.W.; Vosshenrich, R.; Fischer, U.; Funke, M.; Grabbe, E. [Goettingen Univ. (Germany). Abt. fuer Roentgendiagnostik

2001-08-01

310

A case of anemia caused by combined vitamin B12 and iron deficiency manifesting as short stature and delayed puberty Anemia  

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Full Text Available Anemia caused by vitamin B12 deficiency resulting from inadequate dietary intake is rare in children in the modern era because of improvements in nutritional status. However, such anemia can be caused by decreased ingestion or impaired absorption and/ or utilization of vitamin B12. We report the case of an 18-year-old man with short stature, prepubertal sexual maturation, exertional dyspnea, and severe anemia with a hemoglobin level of 3.3 g/dL. He had a history of small bowel resection from 50 cm below the Treitz ligament to 5 cm above the ileocecal valve necessitated by midgut volvulus in the neonatal period. Laboratory tests showed deficiencies of both vitamin B12 and iron. A bone marrow examination revealed dyserythropoiesis and low levels of hemosiderin particles, and a cytogenetic study disclosed a normal karyotype. After treatment with parenteral vitamin B12 and elemental iron, both anemia and growth showed gradual improvement. This is a rare case that presented with short stature and delayed puberty caused by nutritional deficiency anemia in Korea.

Seung Min Song

2010-05-01

311

Intracerebral hematoma following lumboperitoneal shunt insertion: a rare case report.  

Science.gov (United States)

Lumboperitoneal shunting is widely used for the surgical management of pseudotumor cerebri and other pathologies such as communicating hydrocephalus. Although it is a safe method, it could be associated with complications including subarachnoid hemorrhage, subdural and rarely intracerebral hematoma. A 44-year-old female applied to our clinic with complaints of severe headache, retroorbital pain and blurred vision. Lumbar puncture demonstrated cerebrospinal fluid opening pressure of cmH2O. A non-programmable lumboperitoneal shunt with two distal slit valves was inserted due to pseudotumor cerebri. She deteriorated shortly after surgery. Immediate cranial computed tomography scan revealed a right parietal intracerebral hematoma. Development of intracerebral hematoma following lumboperitoneal shunt is a rare complication. We discuss this rare event accompanied by the literature. PMID:21294099

Turkoglu, Erhan; Kazanci, Burak; Karavelioglu, Ergun; Sanli, Metin; Kazanci, Burcu; Sekerci, Zeki

2011-01-01

312

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

313

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

314

Enlarged cerebrospinal fluid spaces in infants with subdural hematomas  

International Nuclear Information System (INIS)

Computed tomography in 16 infants with subdural hematomas showed enlarged basal cisterns, a wide interhemispheric fissure, prominent cortical sulci, and varying degrees of ventricular enlargement. Radionuclide cisternography in eight of the 16 patients showed findings consistent with enlargement of the subarachnoid space rather than those of communicating hydrocephalus. Clinical findings and brief follow-up showed no convincing evidence for cerebral atrophy in 13 patients. These findings suggest that the enlarged subarachnoid space, which is encountered in some infants and may be a developmental variant, predisposes such infants to subdural hematomas

315

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

316

Dural metastases with subdural hematoma from prostate cancer / Hematoma subdural secundario a metástasis durales de cáncer de próstata  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: English Abstract in spanish Decribimos el caso de un paciente de 54 años de edad con cáncer de próstata avanzado con hematoma subdural no traumático secundario a metástasis durales. Había recibido previamente tratamiento hormonal y quimioterapia basada en docetaxel. En la resonancia magnética se mostraba el hematoma subdural e [...] n el contexto de metástasis leptomeníngeas y durales. Hay que destacar esta forma tan inusual de metástasis de un cáncer de próstata y el mal pronóstico que conlleva esta complicación. Abstract in english We reported a case of subdural effusion secondary to dural metastasis of prostatic cancer. A 54-year-old man was referred for headache, vomiting and gait disturbance. He had undergone hormonal therapy and docetaxel-based chemotherapy for prostatic cancer. The magnetic resonance imaging of the brain [...] showed extensive leptomeningeal carcinomatosis and cranial dural metastases, and subdural hematoma. This is a very rare situation and bad prognosis.

M., Cobo Dols; S., Gil Calle; E., Villar Chamorro; I., Ales Díaz; A., Montesa Pino; J., Alcaide García; V., Gutiérrez Calderón; F., Carabante Ocón; J. J., Bretón García; M., Benavides Orgaz.

2005-08-01

317

Hematoma subaracnoideo espinal tras punción lumbar en paciente con leucemia: Presentación de un caso y revisión de la literatura / Spinal subarachnoid hematoma after lumbar puncture in a patient with leukemia: Report of a case and review of the literature  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish La compresión mielo-radicular aguda secundaria a un hematoma subaracnoideo espinal (HSAE) es una complicación extremadamente rara tras una punción lumbar (PL). En el mecanismo de producción de estos hematomas han sido implicados diversos factores de riesgo, principalmente la presencia de trastornos [...] de la hemostasia en el paciente. Presentamos el caso de un varón de 20 años con leucemia aguda y trombocitopenia (26.000 plaquetas/mm³) que, tras ser sometido a una PL, desarrolló una paraparesia con imposibilidad para la bipedestación. La resonancia magnética (RM) demostró la presencia de un hematoma intradural ventral desde D12 hasta L4. Se realizó una laminectomía descompresiva de urgencia y se pudo evacuar parcialmente un hematoma localizado en el espacio subaracnoideo. Al cuarto día postoperatorio, el paciente consiguió caminar sin ayuda, pero falleció un mes después debido a complicaciones sistémicas de su enfermedad. Sólo se han encontrado 26 casos de HSAE tras PL en la revisión de la literatura que hemos realizado. Se han observado las siguientes características comunes a la mayoría de ellos: asociación con tratamientos anticoagulantes, asociación con trombocitopenia, aparición de síndrome compresivo mielo-radicular de forma retardada, necesidad de tratamiento quirúrgico, buen resultado funcional en la mitad de los pacientes, y corta esperanza de vida en aquellos con enfermedad previa grave. En pacientes leucémicos con tendencia a tener marcada trombocitopenia (quizás por debajo de 25.000 plaquetas/mm³), el riesgo de desarrollar un HSAE tras PL puede ser elevado. Abstract in english Acute myeloradicular compression due to a spinal subarachnoid hematoma (SSAH) after lumbar puncture (LP) is an extremely rare complication. Several risk factors have been involved in the production of these hematomas, mainly the presence of hemostasis disorders in the patient. We report the case of [...] a 20-year-old man with leukemia and thrombocytopenia (26,000 platelets/mm³) who, after undergoing a LP, developed paraparesis and became unable to stand. A magnetic resonance disclosed the presence of a ventral intradural hematoma from D12 to L4. An emergency decompressive laminectomy was performed and an hematoma located in the subarachnoid space was partially removed. On the fourth postoperative day, the patient was able to walk without assistance, but one month later, he died because of systemic complications of his disease. Only 26 cases of SSAH after LP have been found in the literature review we have performed. In most of them, the following common features have been observed: association with anticoagulant therapies, association with thrombocytopenia, delayed onset of compressive myeloradicular syndrome, need of surgical treatment, good functional outcome in half of patients, and short life expectancy for patients with previous serious illness. Risk for developing a SSAH after LP could be high in leukemia patients with a tendency to have severe thrombocytopenia (perhaps less than 25,000 platelets/mm³).

J., Ayerbe; D., Quiñones; E., Prieto; P., Sousa.

2005-10-01

318

Diffusion-weighted imaging provides support for secondary neuronal damage from intraparenchymal hematoma  

International Nuclear Information System (INIS)

It is controversial whether an intracerebral hematoma (ICH) causes ischemia of surrounding brain. By virtue of its high sensitivity to acute cerebral infarction, diffusion-weighted imaging (DWI) helps answer this question. We used this technique to assess the parenchyma surrounding ICH for restricted diffusion. Echoplanar DWI (b 1000 s/mm2) and conventional MRI sequences were performed in 30 subjects (symptom duration 7-75 h) with primary ICH, mean volume: 13±15 cm3. We calculated mean apparent diffusion coefficients (ADC) within high signal regions around the hematoma on DWI or T2-weighted images and within the ICH itself, comparing them to the contralateral brain. We used the Student's t -test to examine for differences between these regions and linear regression to relate changes to the age of the ICH. A thin rim of high signal on DWI and a wider rim on T2-weighted images surrounded all hematomas. The ADC within the rim on DWI showed a maximum reduction of 40%, in two patients imaged within 10 h of symptom onset. They rose during the first day (r2=0.84; P 2=0.5; P <0.03). The rim on T2-weighting showed a mean increase of 50% and ADC within the ICH were reduced by a mean of 38%; these variations showed no relationship with ICH age and no group showed any relationship with ICH size. The ADC within the three regions was significanC within the three regions was significantly different from each other. The presence of restricted diffusion in the parenchyma surrounding ICH provides support for secondary neuronal damage. (orig.)

319

Spinal Epidural Hematoma during Anticoagulant Therapy for Pulmonary Embolism: Postoperative Complications in a Patient with Lung Cancer.  

Science.gov (United States)

Spinal epidural hematoma (SEH) is rare but causes neurological disorders. Rapid diagnosis and treatment maximize neurological recovery. We present the case of SEH after lung cancer surgery under epidural and general anesthesia. A 64-year-old man underwent right upper lobectomy. Pulmonary embolism occurred on postoperative day 2. Anticoagulant therapy with fondaparinux and warfarin was started 2 hours after epidural catheter removal and he gradually recovered. On postoperative day 13, the level of prothrombin time-international normalized ratio reached 1.47 and fondaparinux administration was stopped. The next day, he developed back pain and paraplegia, and magnetic resonance imaging revealed a mass between Th4 and Th7 compressing the spinal cord. Emergency decompression laminectomy and hematoma evacuation were performed. After 2.5 months of rehabilitation, he regained almost all motor function and sensation. Late after epidural anesthesia, attention should be paid to possible SEH even though appropriate anticoagulant therapy had been initiated after epidural catheter removal. PMID:24492175

Kobayashi, Yoshihisa; Nakada, Junya; Kuroda, Hiroaki; Sakakura, Noriaki; Usami, Noriyasu; Sakao, Yukinori

2014-02-01

320

Unoperated subdural hematomas. Long-term follow-up study by brain scan and electroencephalography  

International Nuclear Information System (INIS)

The authors report nine patients selected from over 100 patients with subdural hematomas successfully treated without surgery. These patients were followed for as long as 5 years. All had angiographically demonstrated subdural hematomas. Electroencephalograms (EEG) documented well the clinical improvement of the patient, but were poor guides to the true size of the hematoma, since EEG returns to normal early in the patient's course. Static scans are a better guide to the presence of a subdural hematoma, but they lag behind clinical improvement and usually remain abnormal for considerable periods of time after a major portion of the hematoma has been reabsorbed, and the patient is asymptomatic

321

Chronic spinal epidural hematoma in hemophilia A in a child  

International Nuclear Information System (INIS)

A case of chronic spinal epidural hematoma in a thirteen-year-old male, subsequently found to have hemophilia A is reported. Following myelography, surgery was undertaken with clotting factor replacement with relief of cord compression. The patient made an uneventful recovery. (orig.)

322

Multiple remote epidural hematomas following pineal gland tumor resection  

OpenAIRE

In cases of pineal tumor combined with obstructive hydrocephalus, preoperative ventriculostomy or ventriculoperitoneal shunting is typically required prior to tumor resection. The objectives of preoperative ventriculostomy are gradual reduction of intracranial pressure and consequent preoperative brain protection. Here we report a case of pineal tumor resection with preoperative ventriculostomy that was complicated by multiple epidural hematomas. While postoperative intracranial hemorrhage ma...

Lim Jeong-Wook; Yang Seung-Hwan; Lee Jong-Soo; Song Shi-Hun

2010-01-01

323

Evaluation of subdural space after evacuation of chronic subdural hematoma  

International Nuclear Information System (INIS)

Subdural low density lesions of two cases were reexplored after evacuation of chronic subdural hematoma and thickening of the outer membrane was found in both cases. 1st case was a 88 year-old male, who had shown at least 7 months history of chronic subdural fluid accumulation. Reexploration of residual subdural low density space on CT after 14 days following the evacuation disclosed thickening of the outer membrane and none of fluid. 2nd case was a 71 year-old male who had a history of head injury 2 months before. Reexploration of residual low density lesion 14 days later disclosed a similar thickening of the outer membrane without fluid accumulation. The postoperative low density area in both cases was suspected to be a residual hematoma before reexploratin, but only thickening of the outer membrane of the hematoma was found. The outer membrane of 2nd case was histologically composed of layers of matured granulation, contiguous to the dura and a layer of immature granulation with microhemorrhage, facing the cavity. Thickening of the outer membrane seems to play an important role not only to develope, but to resolve the chronic subdural hematoma. It is neccessary to evaluate other factors than low density space per se to eliminate a needless reexploration. (author)

324

Traumatic bilateral basal ganglia hematoma: A report of two cases  

OpenAIRE

Traumatic Basal ganglia hemorrhage is relatively uncommon. Bilateral basal ganglia hematoma after trauma is extremely rare and is limited to case reports. We report two cases of traumatic bilateral basal ganglia hemorrhage, and review the literature in brief. Both cases were managed conservatively.

Bhargava, Pranshu; Grewal, Sarvpreet Singh; Gupta, Bharat; Jain, Vikas; Sobti, Harman

2012-01-01

325

Traumatic Hematoma in a Palmoplantar wart Mimicking Acral Lentiginous Melanoma  

OpenAIRE

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

326

Fatal spontaneous rectus sheath hematoma in a patient with cirrhosis  

OpenAIRE

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; Bellam Shashi

2010-01-01

327

Fatal spontaneous rectus sheath hematoma in a patient with cirrhosis  

Directory of Open Access Journals (Sweden)

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

328

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. PMID:24808360

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

2014-01-01

329

Hematoma de músculo iliopsoas na vigência de tratamento com varfarina Hematoma de músculo iliopsoas en la vigencia de tratamiento con warfarina Iliopsoas muscle hematoma during treatment with warfarin  

Directory of Open Access Journals (Sweden)

Full Text Available A varfarina é droga amplamente utilizada na prevenção de fenômenos tromboembólicos e o conhecimento de seus efeitos adversos faz-se necessário para o acompanhamento dos pacientes. Embora o desenvolvimento de discrasias sanguíneas seja complicação potencial nesses pacientes, a ocorrência de sangramento retroperitoneal é rara. Este artigo discute o caso de um paciente que evoluiu com hematoma do músculo iliopsoas durante tratamento com a referida droga, pós-implante de prótese aórtica metálica, com quadro clínico envolvendo importantes diagnósticos diferenciais.La warfarina es un fármaco ampliamente utilizado en la prevención de fenómenos tromboembólicos, y el conocimiento de sus efectos adversos se hace necesario para el seguimiento de los pacientes. Aunque el desarrollo de discrasias sanguíneas es la complicación potencial en estos pacientes, la ocurrencia de sangrado retroperitoneal es rara. Este artículo discute el caso de un paciente que evolucionó con hematoma del músculo ileopsoas durante tratamiento con el referido fármaco en el postimplante de prótesis mitral metálica, con cuadro clínico implicando importantes diagnósticos diferenciales.Warfarin is a widely used drug for the prevention of thromboembolic events. Knowledge of its adverse effects is necessary for patient follow-up. Although the development of blood dyscrasias is a potential complication in these patients, retroperitoneal bleeding is rare. This article reports the case of a patient who developed iliopsoas muscle hematoma during treatment with warfarin after implantation of a metallic prosthetic aortic valve. The clinical manifestations involved important differential diagnoses.

Gabriel Zago

2010-01-01

330

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

OpenAIRE

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.

Cavalcanti, C. E.; Jansen, E.

1985-01-01

331

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

Directory of Open Access Journals (Sweden)

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

332

Hematoma após anestesia peridural: tratamento conservador. Relato de caso / Hematoma after epidural anesthesia: conservative treatment. Case report / Hematoma posterior a la anestesia peridural: tratamiento conservador. Relato de caso  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese JUSTIFICATIVA E OBJETIVOS: O hematoma associado à compressão espinhal após anestesia peridural é uma complicação neurológica grave, apesar da pequena incidência relatada (1:150.000). É um episódio agudo, e o tratamento tradicionalmente aplicado é a descompressão cirúrgica de urgência. Mais recenteme [...] nte, em casos específicos, o tratamento com corticosteróide tem sido aplicado como alternativa, com boa recuperação neurológica. O objetivo deste relato foi expor um caso de hematoma peridural com tratamento conservador e recuperação neurológica completa. RELATO DO CASO: Paciente do sexo feminino, 34 anos, estado físico ASA I, sem qualquer histórico de coagulopatia ou terapia anticoagulante, submetida à anestesia peridural com punção única, em L2-L3, para tratamento cirúrgico de varizes nos membros inferiores. Oito horas após a anestesia regional, ela ainda apresentava bloqueio motor completo (escala de Bromage), redução das sensibilidades térmica e dolorosa abaixo do nível L3, hiperalgesia na região plantar esquerda, preservação dos reflexos tendinosos e ausência de dor lombar. A tomografia computadorizada revelou hematoma peridural em L2 com compressão do saco dural. Dez horas após a punção peridural não havia progressão dos sinais e sintomas neurológicos. Optou-se, então, pelo tratamento com metilprednisolona em infusão venosa contínua (5,3 mg.kg-1 na primeira hora e 1,4 mg.kg-1.h-1 nas 23 horas subseqüentes). Oito horas após o início do tratamento, a paciente recuperou as sensibilidades térmica e dolorosa, e houve regressão total do bloqueio motor. Na 12ª hora, deambulava e referia dor na ferida operatória. O hematoma peridural não foi visualizado em nova tomografia computadorizada na 14ª hora após o início do tratamento. A paciente recebeu alta hospitalar 86 horas depois do início do tratamento conservador, sem comprometimento neurológico. Uma tomografia computadorizada de controle, após sete meses, mostrou o canal vertebral completamente normal. CONCLUSÕES: A eficiência da abordagem conservadora mostrou-se uma alternativa importante à intervenção cirúrgica em casos específicos. A avaliação da progressão ou a estabilização do comprometimento neurológico, sobretudo após a oitava hora após a punção peridural, é essencial para a escolha do tratamento. Abstract in spanish JUSTIFICATIVA Y OBJETIVOS: O hematoma asociado a la compresión espinal después de la anestesia peridural es una complicación neurológica grave, a pesar de la pequeña incidencia relatada (1:150.000). Es un episodio agudo y el tratamiento tradicionalmente aplicado es la descompresión quirúrgica de urg [...] encia. Recientemente, en casos específicos, el tratamiento con corticosteroide ha sido aplicado como alternativa y con una buena recuperación neurológica. El objetivo de este relato fue exponer un caso de hematoma peridural con tratamiento conservador y recuperación neurológica completa. RELATO DEL CASO: Paciente del sexo femenino, 34 años, estado físico ASA I, sin ningún historial de coagulopatía o terapia anticoagulante, sometida a la anestesia peridural con punción única, en L2-L3, para tratamiento quirúrgico de várices en los miembros inferiores. Ocho horas después de la anestesia regional, todavía presentaba bloqueo motor completo (escala de Bromage), reducción de las sensibilidades térmica y dolorosa por debajo del nivel L3, hiperalgesia en la región plantar izquierda, preservación de los reflejos tendinosos y ausencia de dolor lumbar. La tomografía computadorizada reveló hematoma peridural en L2 con compresión del saco dural. Diez horas después de la punción peridural no había progresión de las señales y síntomas neurológicos. Se optó entonces por el tratamiento con metilprednisolona en infusión venosa continua (5,3 mg.kg-1 en la primera hora y 1,4 mg.kg-1.h-1 en las 23 horas siguientes). Ocho horas después del inicio del tratamiento, la paciente r

Edno, Magalhães; Cátia Sousa, Govêia; Luís Cláudio de Araújo, Ladeira; Laura Elisa Sócio de, Queiroz.

2007-04-01

333

Hematoma intrahepático y subcapsular posterior a colangiopancreatografía retrógrada endoscópica (CPRE) reporte de un caso y revisión  

Scientific Electronic Library Online (English)

Full Text Available SciELO Venezuela | Language: Spanish Abstract in spanish Las complicaciones de la colangiopancreatografía retrógrada endoscópica (CPRE) terapéutica más frecuentes son: pancreatitis, hemorragia y colangitis. La hemorragia extraluminal, así como las complicaciones que son asociadas con el uso de guía metálica son raras, afortunadamente, pero pueden ser más [...] frecuentes de lo reportado. Nosotros describimos el caso de una paciente de 28 años de edad, con ictericia obstructiva por coledocolitiasis, quien fue sometida a CPRE electiva para extracción de litiasis biliar. Posteriormente se presentó como complicación hematomas hepáticos intraparenquimatoso y subcapsular, probablemente por lesión producida por la guía metálica utilizada durante dicho procedimiento. Esta complicación fue tratada con medidas conservadoras no quirúrgicas con buenos resultados. El diagnóstico y tratamiento precoz de esta complicación pueden evitar la cirugía. Abstract in english The most frequent complications of endoscopic retrograde cholangiopancreatography (ERCP) are pancreatitis, bleeding and cholangitis. A number of less common adverse events have also been described including intraperitoneal bleeding reported in only a small number of patients or as individual case re [...] ports. A case of a 28-year-old female patient with choledocholithiasis is presented. Elective ERCP was performed with stone extraction. Intraparenchymal and subcapsular hepatic hematoma was reported following ERCP as a short term complication probably caused by the guide wire. This complication was treated with conservative measures. Early diagnosis and treatment of this complication can avoid surgery.

Miguel, Del Rossi; Yolette, Martínez; César, Louis; Miguel, Garassini Ch.

2007-09-01

334

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.

335

CT of blunt renal injury; correlation of renal injury and retroperitoneal hematoma  

International Nuclear Information System (INIS)

The this study was performed to evaluate whether the extent and location of retroperitoneal hematoma correlate with the severity of renal injury. We evaluated the CT findings of 27 patients with renal trauma. The retroperitoneal hematoma were subdivided into perirenal hematoma(PRH), anterior pararenal hematoma(APH), posterior parareneal hematoma(PPH) and interfascial hematoma(IFH). The perirenal hematoma(PRH) was classified as grade I, II and III according to the amount of hematoma. PRH was present in all 27, PPH in 8, IFH in 3 patients and APH was not observed. Grade I PRH was present in 7 (70%) of 10 minor injury (contusion, intrarenal hematoma), grade III PRH in2(20%) of 10 minor injury and in 7 (41.2%) of 17 major and catastrophic injury (laceration, fracture, shattered kidney and renal pedicle injury). Eight PPH were present only in the major and catastrophic injury and 3 IFH in each of intrarenal hematoma, laceraton and pedicle injury. The location and extent of PRH and PPH correlated somewhat with the severity of renal injury, while the presence of IFH and APH did not correlate with severity of the renal injury

336

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  

Scientific Electronic Library Online (English)

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.

2013-06-01

337

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  

Energy Technology Data Exchange (ETDEWEB)

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

338

Diplopia from subacute bilateral subdural hematoma after spinal anesthesia.  

Science.gov (United States)

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. PMID:22461938

Hassen, Getaw Worku; Kalantari, Hossein

2012-02-01

339

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

340

Postpartum spontaneous subcapsular hepatic hematoma related to preeclampsia.  

Science.gov (United States)

Subcapsular hematoma of the liver represents an unusual clinical phenomenon in the pregnancy and postpartum period with serious complications in terms of fetal and maternal mortality. Here we report a case of a 32-year-old primiparous female at 36 weeks of gestation, admitted to a maternity ward of a private clinic for preeclampsia. The woman underwent an emergency caesarean section with the extraction of an alive foetus. A few hours after delivery, she was transferred to the emergency department of our institution complaining of severe epigastric pain. Diagnostic work-up was suggestive of a subcapsular right lob hepatic hematoma which was successfully managed conservatively. Timely diagnosis is necessary for the prevention of life-threatening events in mother and fetus. For this reason acute care physicians have to be vigilant of the condition and consider this in the differential diagnosis of epigastric pain during pregnancy and postpartum. PMID:25202460

Anyfantakis, Dimitrios; Kastanakis, Miltiades; Fragiadakis, Georgios; Karona, Paraskevi; Katsougris, Nikolaos; Bobolakis, Emmanouil

2014-01-01

341

A case of chronic expanding hematoma resulting in fatal hemoptysis  

OpenAIRE

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...

Hata, Yoshinobu; Sakamoto, Susumu; Shiraga, Nobuyuki; Sato, Keita; Sato, Fumitomo; Otsuka, Hajime; Goto, Hidenori; Takagi, Keigo; Watanabe, Yoshinori

2012-01-01

342

Idiopathic Hypertrophic Cranial Pachymeningitis Misdiagnosed as Acute Subtentorial Hematoma  

OpenAIRE

A case of idiopathic hypertrophic cranial pachymeningitis (IHCP) misdiagnosed as an acute subdural hematoma is reported. A 37-year-old male patient presented with headache following head trauma 2 weeks earlier. Computerized tomography showed a diffuse high-density lesion along the left tentorium and falx cerebri. Initial chest X-rays revealed a small mass in the right upper lobe with right lower pleural thickening, which suggested lung cancer, such as an adenoma or mediastinal metastasis. Dur...

Park, Ik-seong; Kim, Hoon; Chung, Eun Yong; Cho, Kwang Wook

2010-01-01

343

Iliopsoas hematoma due to muscular rupture following defibrillation.  

Science.gov (United States)

We describe a 62 year old patient who presented with acute anterior ischemia and subsequently developed an iliopsoas hematoma. The patient was treated surgically due to rapid progression and femoral neuropathy, and the iliopsoas muscle rupture was diagnosed intraoperatively. The rupture was related to the external electrical defibrillation the patient had on admission. This was a rare case, and we hope the report would help to raise physicians' awareness regarding this complication and treatment. PMID:24347218

Jahollari, Artan; Cavolli, Raif; Tavlasoglu, Murat; Sallahu, Ferat; Muriqi, Shkelzen

2013-11-01

344

Retrobulbar Hematoma in Blow-Out Fracture after Open Reduction  

OpenAIRE

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...

Ji Seon Cheon; Bin Na Seo; Jeong Yeol Yang; Kyung Min Son

2013-01-01

345

Hematoma of Rectus Sheath Following Subcutaneous Enoxaparin Injection  

OpenAIRE

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...

Shahram Firoozbakhsh; Reza Parsaei; Reyhaneh Jafarshad

2013-01-01

346

Hematoma of Rectus Sheath Following Subcutaneous Enoxaparin Injection  

Directory of Open Access Journals (Sweden)

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

347

Rectus Sheath Hematoma: A Simplified Emergency Surgical Approach  

OpenAIRE

Rectus sheath hematoma (RSH) is an uncommon clinical event usually associated with trauma or coagulation disorders. It can also occur spontaneously. RSH usually runs a benign course but it can present with hypovolemic shock. When conservative management fails, surgical exploration becomes mandatory. We propose a technique of emergency ligation of the inferior epigastric artery. This is a simple approach as this artery originates at the posterior rectus sheath above the inguinal ligament. This...

Mantelas, Michael; Katsiki, Niki; Antonitsis, Polychronis; Kyurdzhieva, Ellada; Mikhailidis, Dimitri P.; Hatzitolios, Apostolos

2011-01-01

348

Postpartum Spontaneous Subcapsular Hepatic Hematoma Related to Preeclampsia  

OpenAIRE

Subcapsular hematoma of the liver represents an unusual clinical phenomenon in the pregnancy and postpartum period with serious complications in terms of fetal and maternal mortality. Here we report a case of a 32-year-old primiparous female at 36 weeks of gestation, admitted to a maternity ward of a private clinic for preeclampsia. The woman underwent an emergency caesarean section with the extraction of an alive foetus. A few hours after delivery, she was transferred to the emergency depart...

Dimitrios Anyfantakis; Miltiades Kastanakis; Georgios Fragiadakis; Paraskevi Karona; Nikolaos Katsougris; Emmanouil Bobolakis

2014-01-01

349

[Influence of anticoagulants on the appearance of chronic subdural hematoma].  

Science.gov (United States)

In recent years in the Department of Neurotraumatology in Cracow it has been noticed the frequent connection between appearance of chronic subdural hematoma (CSDH) and treatment by anticoagulant medications. The aim of this study is to draw attention to the problem of insufficient control of anticoagulants consumption, especially by patients treated for cardiovascular system diseases that increases the risk of bleeding and CSDH development. The paper is based on data from questionnaires that was sent to patients with CSDH, cured in the Department of Neurotraumatology form 2004 to 2005. Analyzed was the group of 51 patients with chronic subdural hematoma; 37 individuals (72.5%) confirmed taking acetylsalicylic acid in the period of 3 months before admission to the Department, 9 (17.6%) patients answered that they were taking low-molecular weight heparin. One patient (1.9%) was taking chronically derivative of cumarin. The authors would inform that anticoagulant treatment might favour increase of chronic subdural hematoma incidence. It's especially important, because the average life expectancy has been prolonged in Poland and there are more people taking acetylsalicylic acid. This can be an epidemiological problem in future. PMID:20043584

Krupa, Mariusz; Moska?a, Marek; Sk?adzie?, Tomasz; Grzywna, Ewelina

2009-01-01

350

Operative results of hypertensive intracerebral hematomas treated by stereotactic aspiration  

Energy Technology Data Exchange (ETDEWEB)

Stereotactic aspiration for hypertensive intracerebral hematomas was performed in 23 patients, 10 cases of putaminal hemorrhage, 11 of thalamic hemorrhage, 1 of cerebellar hemorrhage, and 1 of hemorrhage in the caudate nucleus. Slight disturbance of consciousness was observed in 16 cases, and moderate or severe motor disturbance was noted in all cases. Intervals from the onset of disease to the operation ranged from 1 to 23 days (mean 7 days). Seventy-seven percent of the hematoma were aspirated (86 % for putaminal hemorrhage, 57 % for thalamic hemorrhage, 93 % for cerebellar hemorrhage, 100 % for hemorrhage in the caudate nucleus). Improvement of neurological deficits was seen within 1 week (mean 3.8 days) after operation in 17 patients, and good outcome (ADL I, II, III) was noted in 15 patients. There was postoperative improvement on CT scan in 8 of 23 cases, on SEP in 2 of 10 cases, on EEG in 1 of 1 case, and on /sup 123/I-IMP SPECT in 4 of 5 cases. Rebleeding occurred in only 1 patient, in whom hematoma was reaspirated successfully 7 days after the first operation.

Kumon, Yoshiaki; Chaki, Takahiro; Sakaki, Saburo; Matsuoka, Kenzo.

1987-12-01

351

Non-Traumatic Subcapsular Spleen Hematoma in a Patient with Brucellosis  

OpenAIRE

Brucellosis is a zoonotic disease. A characteristic clinical findings are fever, headache, arthralgia and splenomegali. Brucellosis occurs after direct contact with an infected animal or consumption of products of an infected animal. Subcapsular hematoma in the spleen is very rare complication of brucella infection. We report here, an 11 year old patient with brucellosis who admitted to our clinic with subcapsular non-traumatic spleen hematoma. Hematoma and clinical findings were resolved wit...

Murat Söker; Alpay Çakmak; Orhan Ayy?ld?z; Abdurrahman I??kdo?an

2005-01-01

352

Giant unusual shaped chronic subdural hematoma in a patient with untreated congenital hydrocephalus.  

Science.gov (United States)

Subdural hematoma is a well known complication of ventriculoperitoneal shunt insertion for hydrocephalus and usually spreads out over the cerebral convexity, and appears as a crescent shaped lesion on imaging. Chronic subdural hematoma in a case of untreated compensated congenital hydrocephalus has not been reported in English literature. We report the rare case of an adult with congenital hydrocephalus with a huge unusual shaped hemispheric subdural hematoma. PMID:22347339

Mishra, Arvind; Ojha, Bal K; Chandra, Anil; Srivastava, Chhitij; Singh, Sunil Kumar

2011-07-01

353

Giant unusual shaped chronic subdural hematoma in a patient with untreated congenital hydrocephalus  

OpenAIRE

Subdural hematoma is a well known complication of ventriculoperitoneal shunt insertion for hydrocephalus and usually spreads out over the cerebral convexity, and appears as a crescent shaped lesion on imaging. Chronic subdural hematoma in a case of untreated compensated congenital hydrocephalus has not been reported in English literature. We report the rare case of an adult with congenital hydrocephalus with a huge unusual shaped hemispheric subdural hematoma.

Mishra, Arvind; Ojha, Bal K.; Chandra, Anil; Srivastava, Chhitij; Singh, Sunil Kumar

2011-01-01

354

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Os autores apresentam caso de hematoma subdural agudo, evacuado na presença de coagulopatia, e fazem considerações necessárias para a compreensão da etiopatogenia da enfermidade. [...] Abstract in english 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; E., Jansen.

1985-09-01

355

Non-Traumatic Subcapsular Spleen Hematoma in a Patient with Brucellosis  

Directory of Open Access Journals (Sweden)

Full Text Available Brucellosis is a zoonotic disease. A characteristic clinical findings are fever, headache, arthralgia and splenomegali. Brucellosis occurs after direct contact with an infected animal or consumption of products of an infected animal. Subcapsular hematoma in the spleen is very rare complication of brucella infection. We report here, an 11 year old patient with brucellosis who admitted to our clinic with subcapsular non-traumatic spleen hematoma. Hematoma and clinical findings were resolved with doxicyclin and streptomycin combination. We emphasised that brucella infection should be keept in mind when non-traumatic subcapsular spleen hematoma occur.

Murat Söker

2005-01-01

356

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

357

[Pure motor hemiparesis secondary to chronic subdural hematoma with total recovery through medical treatment].  

Science.gov (United States)

We discuss in this paper the cases of two patients with pure motor hemiparesis which were secondary to chronic subdural hematoma who evolved satisfactorily only with medical treatment. Of 1,000 consecutive patients with cerebro-vascular pathology admitted in our Neurology Department in the last 5 years, said two patients were the only ones (0.2%) in whom the lacunar syndrome "pure motor hemiparesis" was secondary to a chronic subdural hematoma. Such cases show that a subdural hematoma can manifest itself as a lacunar syndrome and that in selected cases the medical treatment of chronic subdural hematoma can yield goods results. PMID:8516509

Arboix, A; Massons, J; Oliveres, M; Titus, F

1993-05-01

358

Various magnetic resonance imaging patterns of chronic subdural hematomas. indicators of the pathogenesis?  

International Nuclear Information System (INIS)

Magnetic resonance (MR) imaging can detect various patterns in chronic subdural hematomas. These patterns were compared to the computed tomography (CT) appearances and chemical analysis of the content in 60 hematomas from 44 patients. The hematomas could be classified into five types on both T1- and T2-weighted images: low, high, and mixed intensity, isointensity, and layered. Combining the T1- and T2-weighted images of all 60 hematomas revealed a total of 14 different imaging patterns. Combining the CT and MR imaging findings of 55 hematomas identified 25 different patterns. Analysis of the hematoma contents showed that hemolysis-related parameters, such as potassium, glutamate oxaloacetate transaminase, bilirubin, lactate dehydrogenase, and protein concentration, were markedly higher than in the peripheral blood, and there were significant correlations between these parameters. Mixed intensity hematomas were significantly thicker than the other types, and showed markedly higher values of hemolysis-related parameters. Factors affecting the CT and MR imaging findings, such as fresh bleeding, hemolysis, and hemoglobin changes, coexist in a hematoma to varying degrees, and these factors may interact with the age of the hematoma to produce the different patterns that are observed. (author)

359

An Unusual Complication of EVAR, Spontaneous Rectus Sheath Hematoma: A Case Report  

OpenAIRE

Objective: To report a successful conservative management in a case of spontaneous rectus sheath hematoma (SRSH) after Endovascular Aneurysmal Repair (EVAR) of infrarenal Abdominal Aortic Aneurysm (AAA).

Laohapensang, Kamphol; Sirivanichai, Chusak

2009-01-01

360

Frequency of Hematoma Formation Subsequent to Injection of Dental Local Anesthetics In Children  

OpenAIRE

This study investigated the frequency of hematoma formation subsequent to injection of dental local anesthetics in 4,134 children, 3 to 13 years of age. Hematoma formation occurred following 0.1% of the injections, all being buccal infiltrations of maxillary molars. This represents a 0.4% incidence of hematoma formation subsequent to this injection. There was no age specificity in hematoma formation, occurring in one 5 year old, one 7 year old, one 8 year old, one 10 year old, and one 11 year...

Kuster, Curtis G.; Udin, Richard D.

1984-01-01

361

Hematoma epidurale in patients with delirium tremens  

Directory of Open Access Journals (Sweden)

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

362

[Spontaneous hematoma of the rectus muscle].  

Science.gov (United States)

The possibility of heart surgery and vascular surgery and the increased number of dialyzed patients receiving dicourmarin and heparin treatment raises the question of the probable rupture of the abdominal muscles, in particular the rectus muscles, following the onset of lancing abdominal pain. The authors report a clinical case referred to them in emergency conditions. They examine the possible etiopathogenetic causes and underline the symptoms of acute abdomen in patients being treated with anti-coagulating drugs. PMID:8121595

Vadalà, G; Cardì, F; Fisicaro, E; De Luca, A; Mangiameli, A

1993-10-31

363

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.

1955-12-01

364

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.

365

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

Energy Technology Data Exchange (ETDEWEB)

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

366

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

OpenAIRE

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 precocemente, 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 d...

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

2012-01-01

367

Hematoma de fosa posterior no traumático: consideraciones clínicas y terapéuticas / Non-traumatic Posterior Fossa Hematomas: Clinical and Therapeutical issues  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish Se analizan 52 pacientes portadores de hematoma de fosa posterior no traumático. Correspondieron a 28 hombres y 24 mujeres, con una media de edad de 60 años. Diez (19,2%) fueron secundarios a malformación arteriovenosa (5), cavernomas (3), angioma venoso (1) y hemangioblastoma (1). Cuarenta y dos (8 [...] 0,7%) fueron catalogados como primarios, encontrándose el antecedente de hipertensión arterial en 31, trastornos de coagulación en 5 y en 6 no se demostró un factor predisponente. Hipertensión intracraneana fue el cuadro clínico de presentación en la mayoría (84%). La Tomografía Computarizada demostró el hematoma en todos los casos. Cuatro de ellos medían menos de 2 cm., 24 entre 2 y 3 cm. y 24 eran mayores de 3 cm. Hidrocefalia estuvo presente en 22 casos (42,3%). Angiografía digital se realizó en 12 pacientes, siendo positiva en 7 (5 malformaciones arteriovenosas, 1 angioma venoso y 1 hemangioblastoma). Resonancia Magnética fue practicada en 2 enfermos, demostrando en uno angioma cavernoso. Treinta y un pacientes fueron operados realizándose vaciamiento del hematoma en 24, 14 de ellos con drenaje de LCR. En los restantes solo se trató la hidrocefalia. Se observó buenos resultados en el 67,3% y la mortalidad global fue de 9,6%. La mortalidad quirúrgica fue de 12,5%. Incide en los resultados el estado de conciencia inicial y el tamaño. Las cisternas troncales no fueron evaluadas en nuestra casuística. Sin embargo, creemos que el tratamiento debiera ser evaluado en cada caso en particular, ya que ningún factor influyen en forma absoluta en la evolución Abstract in english Fifty two patients (28 male and 24 female) with non-traumatic posterior fossa hematomas were analyzed. Average age of the patients was 60 years old. In ten cases (19.2%), the hematomas were secondary to arteriovenous malformations (5), cavernomas (3), venous angiomas (1) and hemangioblastoma (1). Fo [...] rty two (80.7%) were considered primary, with a history of high blood pressure in 31 patients and coagulation disorders in 5. Six cases had no predisposing factors. Most subjects also had intercraneal hypertension (84%). Computerized tomography showed hematomas in all cases, of which four were under 2 cm in size, 24 were between 2 and 3 cm, and 24 were larger than 3 cm. Hydrocephalus was present in 22 cases (42.3%). Twelve patients underwent digital angiography, with favorable results in seven (5 arteriovenous malformations, 1 venous angioma and 1 hemangioblastoma). Magnetic resonance imaging was done with two patients, and showed one cavernous angioma. Thirty-one patients underwent surgery; the hematoma was drained in 24 cases, 14 of which involved LCR draining. The remaining cases were treated for hydrocephalus only. Favorable results were seen in 67.3% of the cases, and the overall mortality rate was 9.6%. Surgical mortality was 12.5%. The initial state of consciousness and size had a bearing on results. We believe that treatment must be evaluated on a case-by-case basis, since no single factor has an absolute effect on a patient's outcome

Patricio, Tagle; Luis Carlos, Vintimilla; Sergio, Del Villar; Gonzalo, Torrealba; Pablo, Villanueva; Jorge, Méndez; Sergio, Rey.

2002-04-01

368

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

369

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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 dir [...] etamente 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. Abstract in spanish 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. Abstract in english 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 o [...] f epidural hematoma in the early postoperative period of surgical decompression of the lumbar spinal canal, in a patient with leukemia.

Wagner, Pasqualini; Marcos Antonio, Tebet; Mareio Oliveira Penna de, Carvalho.

2012-09-01

370

Delayed pubertal development by hypothalamic suppression causes an increase in periosteal modeling but a reduction in bone strength in growing female rats  

OpenAIRE

The timing of the pubertal growth is a critical event in skeletal development. A delay in the onset of puberty has been correlated with increased stress fracture incidence in young women and as a result, suboptimal skeletal development may affect long-term bone strength. Gonadotropin releasing hormone antagonist (GnRH-a) injections were used to delay the onset of puberty in growing female rats. Twenty-three-day-old female rats were injected with a GnRH-antagonist at 2 dosage levels (n =15/gro...

Yingling, Vanessa R.; Taylor, Garvin

2008-01-01

371

Intra-abdominal hypertension due to heparin - induced retroperitoneal hematoma in patients with ventricle assist devices: report of four cases and review of the literature  

OpenAIRE

Abstract Introduction Elevated intra-abdominal pressure (IAP) has been identified as a cascade of pathophysiologic changes leading in end-organ failure due to decreasing compliance of the abdomen and the development of abdomen compartment syndrome (ACS). Spontaneous retroperitoneal hematoma (SRH) is a rare clinical entity seen almost exclusively in association with anticoagulation states, coagulopathies and hemodialysis; that may cause ACS among patients in the intensive care...

Spiliopoulos Sotirios; Klimatsidas Michael N; Schaedel Manja; Daliakopoulos Stavros I; Koerfer Reiner; Tenderich Gero

2010-01-01

372

An alarming but self-limited case of isolated large spontaneous liver hematoma in pregnancy  

OpenAIRE

Spontaneous subcapsular liver hematoma is rare but potentially life-threatening complication of pregnancy usually associated with severe preeclampsia and HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets). We present here a case of such a large spontaneous liver hematoma presenting in pregnancy, but without other known associated abnormalities, which has not been described before and it resolved on itself without any intervention.

Shakya, Vikal Chandra; Regmi, Mohan Chandra; Sah, Pannalal; Khaniya, Sudeep; Adhikary, Shailesh

2013-01-01

373

Positron emission tomography in the evaluation of subdural hematomas  

International Nuclear Information System (INIS)

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 68Ga-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

374

The computed tomographic attenuation and the age of subdural hematomas.  

OpenAIRE

The sequential change in density (attenuation coefficient) of subdural hematomas (SDHs) in computed tomography (CT) is important in understanding the pathogenesis and evolution of SDHs. We retrospectively investigated the age of SDHs by CT in 446 cases. We included 30 cases of chronic SDHs, in whom the density was directly measured in the CT. The density of acute (within 7 days) SDH was hyperdense in 98.6%, isodense in 1.1%, and hypodense in 0.3% of the cases. In subacute (8-22 days) SDHs, it...

Lee, K. S.; Bae, W. K.; Bae, H. G.; Doh, J. W.; Yun, I. G.

1997-01-01

375

Spontaneous Rapid Reduction of a Large Acute Subdural Hematoma  

OpenAIRE

The majority of acute post-traumatic subdural hematomas (ASDH) require urgent surgical evacuation. Spontaneous resolution of ASDH has been reported in some cases. We report here on a case of a patient with a large amount of ASDH that was rapidly reduced. A 61-yr-old man was found unconscious following a high speed motor vehicle accident. On initial examination, his Glasgow Coma Score scale was 4/15. His pupils were fully dilated and non-reactive to bright light. Brain computed tomography (CT)...

Lee, Chul-hee; Kang, Dong Ho; Hwang, Soo Hyun; Park, In Sung; Jung, Jin-myung; Han, Jong Woo

2009-01-01

376

LEIOMYOSARCOMA PRESENTING AS A RECURRENT HEMATOMA OF THE DELTOID REGION  

OpenAIRE

Leiomyosarcoma is a rare cancer of smooth muscle. The prognosis depends on the patient's age and the size, histologic grade and stage of the tumor.CASE REPORT: The case of a 63year-old man diagnosed with a leiomyosarcoma of the deltoid region is reported. The patient was previously admitted twice in our surgical unit with a largerecurrent posttraumatic hematoma of the right deltoid region which was incised and drained. One month later the patient was readmitted under the suspicion of malignan...

Lidia Ionescu; Camelia Tama?; Da?nila?, R.; Dana Clement ,; Anca Munteanu; Ferariu, D.; Delia Ciobanu

2012-01-01

377

Iliopsoas Muscle Hematoma Secondary to Alcoholic Liver Cirrhosis  

OpenAIRE

Iliopsoas muscle hematoma in a patient with alcoholic liver cirrhosis is rarely seen, however it has a high mortality. Thus we should cautiously make a diagnosis and treatment. This is the case of a 60-year-old male. He had a 15-year history of alcoholic liver disease and emphysema. He presented with low back pain after a fall that had happened 2 months before. Due to persistent back pain, he went to see a local physician who, after detailed examination, suspected rupture of bilateral common ...

Yamashita, Suguru; Tanaka, Nobutaka; Nomura, Yukihiro; Miyahara, Takuya; Furuya, Takatoshi

2012-01-01

378

Cervical Spinal Epidural Hematoma Following Cervical Posterior Laminoforaminotomy  

OpenAIRE

A 65-year-old man who had lateral cervical disc herniation underwent cervical posterior laminoforaminotomy at C5-6 and C6-7 level right side. During the operation, there was no serious surgical bleeding event. After operation, he complained persistent right shoulder pain and neck pain. Repeated magnetic resonance image (MRI) showed diffuse cervical epidural hematoma (EDH) extending from C5 to T1 level right side and spinal cord compression at C5-6-7 level. He underwent exploration. There was ...

Choi, Jeong Hoon; Kim, Jin-sung; Lee, Sang-ho

2013-01-01

379

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.

2010-09-01

380

Sharp tooth induced sublingual hematoma in a patient with elevated international normalized ratio  

Science.gov (United States)

Sublingual hematoma secondary to anticoagulation is a rare fatal condition. Hemorrhagic complications of warfarin are well-known. This particular case is unique because the patient was on warfarin for the past 2 years but did not develop the sublingual hematoma. However, a trauma by an attrited sharp cusp triggered the episode of the sublingual hematoma in this patient. Being a medical emergency, patient was promptly hospitalized in cardiac care unit and managed by medical team. The patient was transfused with 2 units of fresh frozen plasma and warfarin was temporarily stopped for 4 days. Alternate day regimen of warfarin was started after 4 days, and international normalized ratio dropped to 3. In dental management, enameloplasty of the mandibular first molar tooth was done to prevent trauma and ulcer development in the floor of the mouth. The hematoma resolved, and no new hematoma formation was observed for a period of 6 months.

Baliah, John; Kayalvizhi; Rangdhol, Vishwanath; Livingstone, David

2015-01-01

381

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

Directory of Open Access Journals (Sweden)

Full Text Available 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 precocemente, 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 sangramentoJUSTIFICATIVA 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 sangramientoBACKGROUND 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 objective was to report a case of early diagnosed subdural hematoma after spinal anesthesia performed with a fine-gauge ne

Flora Margarida Barra Bisinotto

2012-02-01

382

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish 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 tratamiento Abstract in english Most 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; NICOLÁS, JARUFE C; FERNANDO, VULETIN S; JORGE, MARTÍNEZ C.

2006-10-01

383

Investigating the possibility and probability of perinatal subdural hematoma progressing to chronic subdural hematoma, with and without complications, in neonates, and its potential relationship to the misdiagnosis of abusive head trauma.  

Science.gov (United States)

The high incidence of subdural hematoma (SDH) from birthing was first identified with MRI by Looney in 2007 and was then more accurately determined by Rooks in 2008. Rooks screened 101 "normal" deliveries and demonstrated that 46% of the babies in her series and by inference, approximately 46% of the 4 million born normally in the US have SDH that formed in the perinatal (birthing) period during labor. Both metabolic strain and physical forces exerted on the head damage the capillaries within the dura (the intradural capillary bed), which is the source of the blood in the SDH that results from labor and delivery or at times from labor alone. While child abuse pediatricians relying on Rooks, maintain that no permanent complications result, her study was limited to 101 subjects and the sole criteria for resolution was the resolution of the SDH as seen on follow-up MRI. In fact, Rooks did have one patient (1%) who had complications that lead to symptoms and findings often associated with abuse. The purpose of this article is to explore if there is a complication rate for perinatal (PSDH) that supports that 1% of complications that are definable by different criteria. Next, if there are complications, how many of the roughly 2,000,000 cases of perinatal acute subdural hematoma every year in the United States will suffer them? Then, what are the clinical manifestations of the complications if they occur? Lastly, do the complications cause or mimic some or all of the findings that are offered by board certified child abuse pediatricians as evidence of child abuse? The article argues that a small percentage, but significant number of neonates, suffer birth related complications and findings secondary to the development of chronic subdural hematoma CSDH) that are often misdiagnosed as abusive head trauma. PMID:23434514

Gabaeff, Steven C

2013-07-01

384

Hematoma subdural agudo traumático: estudo de 110 pacientes Acute traumatic subdural haematomas: study of 110 cases  

Directory of Open Access Journals (Sweden)

Full Text Available Apresentamos uma série consecutiva de 110 pacientes com hematoma subdural agudo traumático (HSDA admitidos no serviço de emergência do HBDF no período de 1°-janeiro a 1°-dezembro-1994. Todos os pacientes foram atendidos de acordo com o mesmo protocolo. Houve predominância do sexo masculino (79%, com idade variando entre 14 e 70 anos, sendo os atropelamentos (34% e os acidentes automobilísticos (20% as causas mais comuns. A maioria dos pacientes (85,7% foi admitida muito grave, com 8 pontos ou menos na Escala de Coma Glasgow (ECG, o que influenciou diretamente na mortalidade. A tomografia computadorizada de crânio foi o exame diagnóstico de escolha que mostrou serem as contusões e o inchaço cerebral ("swelling" as lesões intracranianas associadas mais freqüentes. A cirurgia foi realizada em 45,1% dos pacientes, e, em sua maioria, através de craniotomia fronto-têmporo-parietal ampla, com drenagem do hematoma, seguida de plástica da dura-mater. Em 54,9% as condições clínicas não permitiram a realização da cirurgia; neste grupo, cerca de 69,6% estavam em coma profundo à admissão, com 3 pontos na ECG. A letalidade cirúrgica foi de 61,2% e esteve diretamente relacionada à condição clínica inicial e à idade do paciente. A letalidade, incluindo todos os pacientes cirúrgicos e não cirúrgicos com HSDA, mesmo aqueles admitidos já com sinais de falência de tronco cerebral, foi de 79,5%. Além destes pacientes que faleceram, cerca de 7% evoluíram sem seqüelas ou com seqüelas mínimas; outros 11,4% com seqüelas de moderadas a paves e 2,1 % permaneceram em estado vegetativo persistente. Nossos dados estão de acordo com os da literatura no que se refere a elevada taxa de morbidade e mortalidade dos pacientes com HSDA.We report a series of 110 patients with acute traumatic subdural hematoma (ASDH admitted at HBDF emergency within 1994 (January Is1 to December PJ.All patients were treated according to the same protocol. There was a predominance of males (79%, with ages ranging from 14 to 70, being car accidents (20% and car-pedestrian accidents (34% the most frequent causes The majority of patients (85.7% was admitted in very serious condition, with a score of 8 points on the Glasgow Coma Scale (GCS or lesser, which directly influenced the mortality rates. CT scan was the diagnostic procedure of choice, and it showed contusion and brain swelling to be the most frequent associated intracranial lesions. Surgery was carried out in 45.1% of cases and, in most instances, through an ample fronto-temporo-parietal craniotomy, with hematoma drainage and dural reconstitution. In 54.9% of cases, clinical conditions did not allow surgery and in this group, 69.6%

Nicandro de Figueiredo Neto

1996-06-01

385

Process of evolution to chronic subdural hematoma, (1)  

International Nuclear Information System (INIS)

The process of evolution to chronic subdural hematoma (CSH) was discussed on the basis of MRI and CT findings. The materials were 22 sides of 15 cases in which CSH had been diagnosed by means of MRI, CT, and/or surgery. These cases were followed by CT with/without MRI after the initial head injury. Various findings were shown in the subdural space, such as subdural hygroma (40%), acute subdural hematoma (25%), normal state (20%), and traumatic subarachnoid hemorrhage (15%). Regardless of the conditions of the subdural space after the head injury, however, CSH was finally present in all cases after the formation of subdural hygroma and its enlargement. The duration of the formation of hygroma after head injury ranged from 0 to 12 days (mean: 2.7 days), and its final confirmation ranged from 11 to 61 days (mean: 33.4 days). The period from the final confirmation of hygroma to the first recognition of CSH was between 8 and 36 days (mean: 17.7 days), while the period from head injury to the formation of CSH was between 27 and 75 days (mean: 51.1 days). The process of evolution to CSH may be thought to be as follows: A normal subdural space changes into a subdural hygroma by the tearing of the arachnoid membrane due to head injury. Capsule formation follows the process lasting for more than three weeks. CSH develops in consequence of bleeding from the outer membrane. (author)

386

Chronic Subdural Hematoma a Review of 58 Cases  

Directory of Open Access Journals (Sweden)

Full Text Available From this short review, immerges a syndrome of the chronic subdural hematoma. The patient is usually an elderly male', with a hisory of moderate or severe trauma to the head incurred about 2 months prionjto admission, with or witout immediate headache which subsides, then recurs lllb6ut two to three weeks prior to admission. The headache becomes severer and the patient may develop a hemiparesis most frequently contralaterally, would become drowsy and may enter coma if not diagnosed and treated early. On examination, he would show dulled mental capacities and possibly papilloedema, with or without a hemiparesis and in one fifth of the cases a peculiar type of disturbance of gait. If there has been waxing and waning of the symptomatology in the past few days. this adds to the completeness of the picture. Although there is a syndrome that caracteriscs cases of subdural hematomas, the picture can be very varied and there is no doubt that the final diagnosis rests with angiography, which shows a typical appearance of an avascular lens shaped area just under tho parietal bone on the AP films or in some cases under the frontal bone in oblique film

Fuad S. Haddad

1964-01-01

387

[Periorbital hematoma as a complication of posterior peribulbar anesthesia].  

Science.gov (United States)

We report a case of a large periorbital hematoma which furtherly extended to the ipsilateral orbit and appeared after posterior peribulbar blockade in a 70-year-old woman undergoing cataract extraction and intraocular implant. Peribulbar blockade was carried out with a 23-gauge blunt bevel Atkinson's needle introduced at the level of nasal or internal angle of the upper lid without loosing contact with the ceiling of the orbit. Anesthetic solution was bupicavaine at 0.75% with 10 U/ml of hyaluronidase, 3 ml. Usual blockade of lower lid was not carried out as with the first blockade, an almost complete paresis of extraocular muscles together with discrete conjunctival ecchymosis occurred. Ocular compression was conducted with Homan's balloon at 30 mmHg gor 30 minutes. Then, the eyeball was decompressed and a progressive increase of edema with conjunctival hemorrhage becoming bilateral was observed. Coagulation tests were normal. The incidence of conjunctival ecchymosis and palpebral hematoma with such technique ranges from 2% to 9%; it does not represent any intraoperative problem but may difficult surgery. PMID:2098862

Ortiz Soler, M; García Guasch, R; Preciado Mora, M J; Blanco Vargas, D; González Tadeo, M; Vidal López, F

1990-01-01

388

Delay of cell differentiation in Anabaena aequalis caused by UV-B radiation and the role of photoreactivation and excision repair.  

Science.gov (United States)

The effect of ultraviolet light on cell differentiation was studied in the cyanobacterium Anabaena aequalis. Exposure of cells to UV-B wavelengths (280-320 nm) significantly delayed the differentiation of vegetative cells into heterocysts and akinetes at doses up to 56 kJ m-2. Heterocyst differentiation was essentially stopped at all exposure levels when photoreactivation was prevented, even when excision repair was available to the cells. Photoreactivated samples produced heterocysts at doses through 28 kJ m-2, after which differentiation dropped steeply to near zero levels. Some recovery of differentiation was evident at higher doses but at levels much below that of controls. Akinete differentiation was only slightly delayed by the exposures when cells were photoreactivated. Samples then showed rapid differentiation with the numbers of akinetes significantly greater than controls. Cells that did not receive photoreactivating light showed a greater initial delay in differentiation but 2 weeks after the exposures had recovered to control levels. Caffeine had more effect on the differentiation of akinetes than heterocysts. Inhibition of excision repair greatly reduced differentiation in photoreactivated samples and essentially eliminated differentiation in the nonphotoreactivated samples. PMID:8165241

Blakefield, M K; Harris, D O

1994-02-01

389

A missed injury leading to delayed diagnosis and postoperative infection of an unstable thoracic spine fracture - case report of a potentially preventable complication  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Patients suffering from polytrauma often present with altered mental status and have varying levels of examinability. This makes evaluation difficult. Physicians are often required to rely on advanced imaging techniques to make prompt and accurate diagnoses. Occasionally, injury detection on advanced imaging studies can be challenging given the subtle findings associated with certain conditions, such as diffuse idiopathic skeletal hyperostosis (DISH. Delayed or missed diagnoses in the setting of spinal fracture can lead to catastrophic neurological injury. Case presentation A man struck by a motor vehicle suffered multiple traumatic injuries including numerous rib fractures, a mechanically unstable pelvic fracture, and also had suspicion for an aortic injury. Unfortunately, the upper thoracic segment (T1-5 was only visualized with axial images based on the electronic data. Several days later, a contrast CT scan obtained to check the status of suspected aortic injury revealed T3-T4 subluxation indicative of an unstable extension-type fracture in the setting of DISH. Due to the missed injury and delay in diagnosis, surgery was not performed until eight days after the injury. At surgery, the patient was found to have left T3-T4 facet joint infection as well as infected hematoma surrounding a left T4 transverse process fracture and a traumatic T4 costo-transverse joint fracture-subluxation. Despite presence of infection, an instrumented posterior spinal fusion from T1-T6 was performed and the patient recovered well after antibiotic treatment. Conclusion A T3-T4 unstable DISH extension-type fracture was initially missed in a polytrauma patient due to inadequate imaging acquisition, which caused a delay in treatment and bacterial seeding of fracture hematoma. Complete imaging is especially needed in obtunded patients that cannot be thoroughly examined.

Stahel Philip F

2011-10-01

390

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.

2012-02-01

391

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

392

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

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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.

2013-03-01

393

Use of laterally placed vacuum drains for management of aural hematomas in five dogs.  

Science.gov (United States)

Case Description-5 dogs (a Newfoundland, Golden Retriever, Shiba Inu, Staffordshire Terrier, and Vizsla) were referred for evaluation and treatment of unilateral aural hematomas within a week after their formation. Clinical Findings-Aural hematomas involved the left (3) or right (2) ears. Treatment and Outcome-With patients under anesthesia, the aural hematomas were approached surgically from the convex, or lateral, pinnal surface. Two small incisions were used to position a vacuum drain into the incised hematoma cavity. The drain exited at the base of the pinna and adjacent cervical skin. The free end of the drain was attached to a vacuum reservoir for 18 to 21 days. Drains and skin sutures were removed at this time along with the protective Elizabethan collar. All hematomas resolved and surgical sites healed during the minimum 6-month follow-up period. Cosmetic results were considered excellent in 4 of 5 patients. Slight wrinkling of the pinna in 1 patient resulted from asymmetric enlargement of the cartilaginous walls of the hematoma, where vacuum application resulted in a slight folding of the redundant lateral cartilage wall. Clinical Relevance-The described treatment was efficient, economical, and minimally invasive and required no bandaging or wound care. Placement of the drain tubing on the convex (lateral) aspect sheltered the system from displacement by patients with an Elizabethan collar in place. Overall cosmetic results were excellent; asymmetric enlargement of the cartilaginous walls of the hematoma with slight folding of the pinna was seen in 1 patient. PMID:25517333

Pavletic, Michael M

2015-01-01

394

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 me 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)

395

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  

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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 G1, S, or G2 + 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 t50 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

396

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.  

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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

397

PROPELLER Diffusion-Weighted Magnetic Resonance Imaging of Acute Spinal Epidural Hematoma  

International Nuclear Information System (INIS)

We present the case of an 86-year-old female with spontaneous spinal epidural hematoma. Although T1- and T2-weighted images showed the dilated posterior epidural space at the cervical spine, this finding was non-specific on conventional magnetic resonance imaging obtained 15 h after the onset of symptoms. Diffusion-weighted imaging with the use of periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER), which clearly revealed the high intensity hematoma, was useful for detection and diagnosis of acute spinal epidural hematoma

398

Successful treatment of acute promyelocytic leukemia accompanied by serious subdural hematoma.  

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We present a 56-year-old woman with acute promyelocytic leukemia (APL) complicated with serious chronic subdural hematoma at presentation. She was treated with urgent hematoma evacuation and subsequent prompt chemotherapy, with administration of platelets and fresh frozen plasma. After six weeks, she achieved hematological complete remission. Thereafter she received three courses of conventional consolidation chemotherapy and achieved molecular remission. Even under conditions of severe coagulatory disturbance, aggressive therapeutic intervention including surgical procedures can save the life of a patient suffering from simultaneous APL and fatal subdural hematoma at presentation. PMID:22892505

Ichikawa, Satoshi; Suzuki, Takuma; Kimura, Jun; Harigae, Hideo

2012-01-01

399

Meningioma associated with acute subdural hematoma: A review of the literature  

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Background: Classically meningiomas present with a gradual onset of symptoms and their acute presentation with hemorrhagic events seems to be a rare event. A review of the literature shows only 18 cases of meningioma associated with acute subdural hematoma. The possible mechanisms of hemorrhage are not yet fully understood. Case Description: We report a case of sphenoid wing meningioma associated with acute subdural hematoma, without history of trauma. The presence of meningioma was discovered during the surgery. The tumor and hematoma were removed without postoperative complications. Conclusions: The authors have discussed the etiology of an acute subdural hemorrhage and reviewed the pertinent literature. PMID:25422791

Hambra, Di Vitantonio; Danilo, De Paulis; Alessandro, Ricci; Sara, Marzi; Juan, Galzio Renato

2014-01-01

400

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

OpenAIRE

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

401

Frontal and orbital bone infarctions causing periorbital swelling in patients with sickle cell anemia  

International Nuclear Information System (INIS)

Two cases of unilateral and bilateral periorbital hematomas occurred in patients with sickle cell anemia. The cause of periorbital swelling in these cases was found to be orbital and frontal bone infarctions, respectively, diagnosed by technetium Tc 99m medronate bone scintigraphy. To our knowledge, periorbital bone infarction, as a part of the differential diagnosis of periorbital hematoma and as part of the possible ocular manifestations in patients with sickle cell anemia, has not previously been described

402

Imaging management of spontaneous giant esophageal intramural hematoma  

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A woman, aged 84 years, presented to our emergency department with posteriorly radiating chest pain that began following dinner. She reported no change in bowel habits, hematochezia, or melena. She had previous peptic ulcer disease and a long-standing history of gastroesophageal reflux disease. Her medications included acetylsalicylic acid and rabeprazole. Electrocardiogram and troponin analyses were negative for ischemic heart disease. The emergency physician suspected an aortic dissection, and computed tomography (CT) chest and abdomen scans were performed with and without IV and oral contrast. The aorta was normal and the noncontrast images demonstrated a hyperdense mass (not shown) that did not enhance consistent with a large intramural hematoma extending from the upper esophagus (level of T2 vertebral body) to the fundus of the stomach (Figures 1A and B). (author)

Hagel, J. [Univ. of British Columbia, Dept. of Radiology, Vancouver, British Columbia (Canada); Bicknell, S.G.; Haniak, W. [Lions Gate Hospital, Dept. of Radiology, Vancouver, British Columbia (Canada)]. E-mail: sbicknel@interchg.ubc.ca

2007-04-15

403

Imaging management of spontaneous giant esophageal intramural hematoma  

International Nuclear Information System (INIS)

A woman, aged 84 years, presented to our emergency department with posteriorly radiating chest pain that began following dinner. She reported no change in bowel habits, hematochezia, or melena. She had previous peptic ulcer disease and a long-standing history of gastroesophageal reflux disease. Her medications included acetylsalicylic acid and rabeprazole. Electrocardiogram and troponin analyses were negative for ischemic heart disease. The emergency physician suspected an aortic dissection, and computed tomography (CT) chest and abdomen scans were performed with and without IV and oral contrast. The aorta was normal and the noncontrast images demonstrated a hyperdense mass (not shown) that did not enhance consistent with a large intramural hematoma extending from the upper esophagus (level of T2 vertebral body) to the fundus of the stomach (Figures 1A and B). (author)

404

Unusual Presentation of Pulmonary Hematoma after Blunt Chest Wall Trauma  

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Full Text Available A 25-year-old man was admitted in hospital due to right side hemopneumothorax secondary to car accident. A chest tube was inserted. During the hospitalization days, chest CT scan revealed a 3cmx3 cm oval-shaped density located in the right upper lobe. Since he was in a good general condition, he was discharged from hospital after removal of chest tube and a follow-up chest CT-scan was recommended. In the chest CT scan that was performed 3 months later (Figure 1, the oval-shaped density was increased in size. There was no endobronchial lesion in bronchoscopic evaluation. Surgery was recommended He was underwent thoracotomy and the lesion was resected (Figure 2. It was post-traumatic pulmonary hematoma (Figure 3.

Reza Bagheri

2014-02-01

405

Delayed fission  

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Delayed fission is a nuclear decay process that couples {beta} decay and fission. In the delayed fission process, a parent nucleus undergoes {beta} decay and thereby populates excited states in the daughter. If these states are of energies comparable to or greater than the fission barrier of the daughter, then fission may compete with other decay modes of the excited states in the daughter. In this paper, mechanism and some experiments of the delayed fission will be discussed. (author)

Hatsukawa, Yuichi [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

1997-07-01

406

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 wh 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.)

407

Hematoma subdural crónico: Resultados quirúrgicos en 2 años de trabajo  

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Full Text Available Disminuir al máximo la mortalidad por hematoma subdural crónico (HSDC, es un reto que se debe alcanzar en todo centro neuroquirúrgico, en el que pueden influir el diagnóstico precoz y la adecuada selección del proceder quirúrgico. Se presentan 20 pacientes, 16 masculinos (80 % y 4 femeninos (20 %, con una edad promedio para el grupo de 66,55 años, tratados quirúrgicamente por medio de la trepanación múltiple con lavado de la cavidad y drenaje cerrado al exterior. La angiografía carotídea constituyó el examen más utilizado para el diagnóstico 14 (70 %, seguida por la tomografía axial computadorizada (TAC 8 (40 %. La escala de Bender se empleó para clasificar a los enfermos según el estado neurológico al ingreso, y se halló que el 80 % estaba en los grados I y II. Los resultados se evaluaron según la escala de resultados de Glasgow, y presentaron 17 (85 %, una buena recuperaciónTo reduce as much as possible mortality from chronic subdural hematoma (CSDH is a goal that should be attained by every neurosurgical center. An early diagnosis and an adequate selection of the surgical procedure may influence on it. 20 patients, 16 males (80 % and 4 females (20 % with an average age by group of 66.55 years of age were surgically treated by multiple trephining with lavage of the cavity and closed drainage. The carotid angiography was the most used test for the diagnosis with 14 (70 %, followed by computerized axial tomography (CAT with 8 (40 %. Bender´s scale was utilized to classify the patients according to the neurological state at the time of admission . 80 % of them corresponded to degrees I and II. The results were evaluated by using the Glasgow´s scale. 17 (85 % had a good recovery

Ángel Jesús Lacerda Gallardo

1999-04-01

408

Pola Kejadian Hematoma Subdural Pada Bayi Yang dirawat di Ruang Rawat Intensif Anak Rumah Sakit Dr. Hasan Sadikin  

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Full Text Available Subdural hematoma (SDH is a common condition in infancy and young children with a poor prognostic. The more studies related SDH with nonaccidental injury. With the aim to identify the characteristics of SDH in infants below 1 year, a retrospective study of infants below 1 year diagnosed as subdural hematoma who were admitted to PICU Hasan Sadikin General Hospital from Januari 2000 to Desember 2003 has been conducted. Infants less than 1 month and SDH developed after neurosurgery intervention were excluded. Fourteen infants met the inclusion criteria's, consisted of 5 (36% girls and 9 (64% boys, most of them were on 1 month of age (57%. Anemia was found on all cases, thrombocyte normal except in 1 case thrombocytopenia (53,000/mm3. PT prolonged in 9 (100% cases and PTT in 5 (56% from 9 cases. Bilirubin total/direct elevated in 4 (80% from 5 cases, SGOT/SGPT elevated in 5 (83% from 6 cases. From 11 cases, 9 (82% cases were IgG anti-CMV positive and 6 (55% cases were IgM anti CMV positive. Conclusions, SDH can be caused by various etiologies, thus a comprehensive examinations to exclude child abuse are needed. The role of CMV infection should be considered as one of SDH etiology.

Enny Harliany Alwi

2009-09-01

409

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.)

410

[An infant with acute subdural hematoma after a minor head injury associated with arachnoid cyst].  

Science.gov (United States)

A ten-month-old male infant fell onto the floor from a chair of 50 cm in height and hit his head on the day before hospitalization. He was admitted due to acute subdural hematoma, which was associated with arachnoid cyst. Head CT conducted on the 4th day confirmed that the hematoma had not enlarged. After discharge, enlargement of the hematoma was detected on MR imaging conducted on the 65th day after injury, followed by the diminution without surgical treatment. MR images were obtained on the 192nd day. In the case of head injury associated with arachnoid cyst, the risk of subdural hematoma as well as its ensuing enlargement in subacute or chronic phase needs to be considered. PMID:24620428

Kuniyoshi, Yasutaka; Kamura, Azusa; Yasuda, Sumie

2014-01-01

411

Case report: treatment of subdural hematoma in the emergency department utilizing the subdural evacuating port system.  

Science.gov (United States)

Patients with acute or chronic subdural hematomas may present with rapidly deteriorating neurological function and are at risk for irreversible brainstem injury. In such cases, rapid surgical intervention is required to evacuate the hematoma and reverse critically elevated intracranial pressure. A variety of surgical drainage methods are in existence, none of which are clearly superior to the others. This report presents the case of a 74-year-old woman who suffered an acute-on-chronic subdural hematoma which was evacuated in the emergency department utilizing the subdural evacuating port system (SEPS). The SEPS provides for a minimally invasive technique to drain subdural hematomas and is advantageous in that it can be performed at the bedside. The SEPS is relatively simple to use and may be especially useful to emergency department staff in outlying areas where there is a shortage of neurosurgical coverage. PMID:24175497

Asfora, Wilson T; Klapper, Hendrik B

2013-08-01

412

Spontaneous acute subdural hematoma as the initial manifestation of chronic myeloid leukemia.  

Science.gov (United States)

Spontaneous acute subdural hematoma is rare and limited to sporadic case reports, associated with neoplasm, aneurysm, arteriovenous malformation and cocaine use. Subdural hematoma has also been reported in association with leukemic malignancies, either during therapy or after diagnosis. However, there are no reports of spontaneous acute subdural hematoma as the primary initial presenting manifestation of a chronic myeloid leukemia. Here we describe one case of a 53-year-old male that presented with severe right-sided headache and intermittent left-sided paresthesias. CT scan showed non-traumatic right-sided acute subdural hematoma. Further evaluation revealed that the patient had chronic myeloid leukemia. His peripheral white blood count normalized after Gleevec and hydroxyurea chemotherapy. Furthermore, he had no neurological deficits after his subdural collection was adequately evacuated. PMID:20582615

Abdulhamid, Mohamed M; Li, Yan Michael; Hall, Walter A

2011-02-01

413

Posttraumatic retroclival acute subdural hematoma: Report of two cases and review of literature  

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Full Text Available Traumatic retroclival hematomas are uncommon lesions usually associated with significant trauma. Majority of the reported hematomas are epidural; and in the pediatric population. Retroclival acute subdural hematomas (RSDH are very rare, with only two previous cases reported in English literature. An 18-year-old man presented with headache and no deficits following an accident. Computer tomography (CT scan and magnetic resonance imaging (MRI showed an acute RSDH extending into the spinal subdural space. He developed bilateral sixth nerve palsies, with symptoms of raised intracranial pressure within the next 24 hours. He underwent evacuation of hematoma with a good outcome. Another 19-year-old man presented with neck pain following a fall from a moving bus. He had no neurological deficits. CT scan showed a RSDH extending across the craniovertebral junction. He was managed conservatively with good outcome.