WorldWideScience
1

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

Science.gov (United States)

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 delayed angiography if the initial studies fail to reveal the cause. PMID:8492902

Willinsky, R A; Fitzgerald, M; TerBrugge, K; Montanera, W; Wallace, M

1993-01-01

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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 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.)

4

Delayed post-operative contralateral epidural hematoma in a patient with right-sided acute subdural hematoma: a case report  

OpenAIRE

Head injury is one of the leading causes of death and disability in traumatic accidents. Post-operative contralateral epidural hematomas after surgery for acute subdural hematoma seem to be rare. In this case, expansion and spontaneous resolution of a fractural epidural hematoma contralateral to the side of acute subdural hematoma is presented. The importance of immediate post-operative computed tomography is also highlighted to detect delayed traumatic mass lesions.

Saberi, Hooshang; Meybodi, Ali Tayebi; Meybodi, Keyvan Tayebi; Habibi, Zohreh; Mirsadeghi, Sayed Mohammad Haji

2009-01-01

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Intracranial aneurysms causing spontaneous acute subdural hematoma  

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Full Text Available Acute subdural hematoma is an uncommon presentation of the rupture of an intracranial aneurysm. We report two cases of intracranial aneurysms causing spontaneous acute subdural hematoma.

Shenoy S

2003-07-01

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Delayed extradural hematoma : a case report.  

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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 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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Fatal deterioration of delayed acute subdural hematoma after mild traumatic brain injury: two cases with brief review.  

Science.gov (United States)

Both delayed posttraumatic intracerebral hemorrhage and epidural hematoma have been well described in the neurosurgical literatures. However, delayed posttraumatic acute subdural hematoma which happens more than a week with a rapid progress after mild traumatic brain injury and causes death of patient is rarely reported. We show two such cases and briefly review the literature and discuss the probable pathogenesis of their rapid progress. PMID:24698583

Chen, Shiwen; Xu, Chen; Yuan, Lutao; Tian, Hengli; Cao, Heli; Guo, Yan

2014-04-01

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A case of rectus sheath hematoma caused by yoga exercise.  

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Rectus sheath hematoma is a relatively rare condition but a significant cause of acute abdominal pain. The acute abdominal pain associated with rectus sheath hematoma can mimic several conditions, such as appendicitis, intestinal problems (obstruction, perforation, hernia, malignancy), and gynecologic disease (ovarian cyst, torsion, tubo-ovarian abscess, ectopic pregnancy). Correct diagnosis and subsequent treatment depends on careful history taking and appropriate use of diagnostic tools to avoid unnecessary laparotomy. We report a case of rectus sheath hematoma due to noncontact strenuous exercise, yoga, that mimicked gynecologic diseases. PMID:19683130

Choi, Yoonhee; Lee, Donghoon

2009-09-01

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

OpenAIRE

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 ...

Jkb, Parthiban Chandra; Majeed Shiju A

2008-01-01

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Acute subdural hematoma caused by clopidrogel  

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Full Text Available Clopidogrel, is a potent oral antiplatelet agent often used in the treatment of coronary artery disease, peripheral vascular disease, and cerebrovascular disease. Clopidrogel a thienopyridine deritivate, selectively inhibits the binding to adenosine diphosphate, thereby inhibiting platelet aggregation. It thus reduces the formation of arterial and venous thrombi. Reported side effects of clopidrogel include gastrointestinal symptoms of nausea, stomach ache, diarrhea, and constipation. Serious side effects consist of an increased risk of bleeding, intracranial hemorrhage, and severe neutropenia. A 75-year-old man with syncope was admitted to cardiology clinic. The patient had undergone two vessel angioplasty 15 years earlier. Furthermore, the patient had undergone placement of coronary artery stent 3 months earlier. His daily prescription contained clopidrogel 75 mg for the past 3 years. Fourteen hours after admittance to the cardiology clinic, the patient experienced a blackout. A computed tomography of the brain revealed acute subdural hematoma of the right frontoparietal region with 1.5 cm midline shift. The patient subsequently underwent right frontoparietal craniotomy with drainage of the subdural hematoma. Unfortunately, the patient died on the postoperative eleventh day.

Kaan ALTINKAYA

2010-01-01

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Subdural hematoma caused by epithelioid angiosarcoma originating from the skull.  

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Cancers metastatic to the skull or dura may cause subdural hematoma (SDH). However, the frequency is low, and the presence of underlying cancers has almost always been known in such situations. We report a case of skull angiosarcoma manifesting as SDH, posing a diagnostic challenge to physicians. A 75-year-old man visited our clinic with sensorimotor disturbance of gradual onset approximately 1 month after a minor head trauma. He was diagnosed with SDH after imaging studies, and underwent surgery to evacuate the hematoma. Because the hematoma was organized, surgery was switched from burr-hole drainage to craniotomy. The bone flap as well as the dura over the hematoma had grossly normal appearance, and only the hematoma itself was submitted for histological examination. Although postoperative recovery was uneventful, the patient experienced recurrence of the SDH 2 months after surgery. At the second surgery, the bone flap and dura were intermingled with tumor tissue, and histological examination revealed that an epithelioid angiosarcoma originating from the skull was responsible for the SDH. Timely diagnosis of angiosarcoma manifesting as SDH is difficult because of its rarity. In retrospect, however, the diagnosis might have been established earlier if the bone flap and/or the dura had been biopsied at the time of the first surgery. The present case gives us a lesson that SDH may be an unusual manifestation of malignant tumors of skull or dural origin, and histological examination of not only hematoma capsule but also of the surrounding tissues may provide important diagnostic clues. PMID:22843419

Yamada, Yasuhiro; Inamasu, Joji; Moriya, Shigeta; Oguri, Daikichi; Hasegawa, Mitsuhiro; Abe, Masato; Hirose, Yuichi

2013-06-01

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Importance of serial CT scanning in the diagnosis and treatment of delayed traumatic intracerebral hematoma  

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Between January, 1980, and December, 1982, 99 cases of traumatic intracranial hemorrhage were admitted to our hospital. Of these cases, we analyzed 25 cases which had been submitted to initial CT scanning within 4 hours after head trauma. We found 17 cases which had no hematoma on the initial CT scan but which were found to have formed intracerebral hematoma on a repeated CT scan. We found that we could classify the delayed traumatic intracerebral hematoma into two types: Type I hematoma, which had a relatively bad outcome, and Type II hematoma which had a relatively good outcome. The neurological sign comes to deteriorate in accordance with the hematoma formation in Type I, while the neurological sign remains unchanged or takes an uphill course in accordance with hematoma formation in Type II. We recognized some differences between the two types both in the time from trauma to hematoma formation and in the serial CT findings. However, we could not differentiate the two types of hematoma on the basis only of the initial CT findings, probably because of a dynamic change in the damaged brain tissue. There seems to be no means to predict the course of delayed traumatic intracerebral hematoma; therefore, we stress the importance of strict observation both of the clinical course and of the serial CT findings in order to diagnose and to choose an appropriate course of therapy, medical or surgical.

Ikeda, Hidetoshi; Kuwayama, Naoya; Kagawa, Shigeki; Sonobe, Makoto; Takahashi, Shinichiro (Mito National Hospital, Mito (Japan))

1984-02-01

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

OpenAIRE

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 p...

Shimodaira Masanori; Kitano Tomohiro; Kibata Minoru; Shirahata Kumiko

2013-01-01

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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 had a fractured first cervical v...

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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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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MRI of intracerebral hematoma: value of vasogenic edema ratio for predicting the cause  

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We evaluated a method for quantifying vasogenic edema (VE) on MRI to identify brain hematomas caused by neoplasms. We performed a blinded review of 68 acute and subacute hematomas caused by neoplasms (22), hypertension or presumed amyloid angiopathy (27), or vascular malformations (19). The extent of vasogenic edema was quantified on an axial T2-weighted image using the VE ratio: the maximum width of high signal surrounding a hematoma and the mean diameter of the hematoma. Hematomas caused by neoplasm were associated with more vasogenic edema (mean VE ratio 104%{+-}15%; mean VE width 2.4{+-}0.7 cm) than non-neoplastic hematomas (mean VE ratio 37%{+-}5%; P =0.001). When the width of VE was equal to or more half the diameter the hematoma (VE ratio 50%), the positive predictive value for tumor was 66%; when it was equal to or more than the diameter, the positive predictive value was 71%. All six hematomas with VE ratios {>=}150% were caused by neoplasm. (orig.)

Tung, G.A.; Julius, B.D.; Rogg, J.M. [Department of Diagnostic Imaging, Brown Medical School and Rhode Island Hospital, 593 Eddy Street, 02903, Providence, RI (United States)

2003-06-01

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MRI of intracerebral hematoma: value of vasogenic edema ratio for predicting the cause  

International Nuclear Information System (INIS)

We evaluated a method for quantifying vasogenic edema (VE) on MRI to identify brain hematomas caused by neoplasms. We performed a blinded review of 68 acute and subacute hematomas caused by neoplasms (22), hypertension or presumed amyloid angiopathy (27), or vascular malformations (19). The extent of vasogenic edema was quantified on an axial T2-weighted image using the VE ratio: the maximum width of high signal surrounding a hematoma and the mean diameter of the hematoma. Hematomas caused by neoplasm were associated with more vasogenic edema (mean VE ratio 104%±15%; mean VE width 2.4±0.7 cm) than non-neoplastic hematomas (mean VE ratio 37%±5%; P =0.001). When the width of VE was equal to or more half the diameter the hematoma (VE ratio 50%), the positive predictive value for tumor was 66%; when it was equal to or more than the diameter, the positive predictive value was 71%. All six hematomas with VE ratios ?150% were caused by neoplasm. (orig.)

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Small supratentorial, extraaxial primitive neuroectodermal tumor causing large intracerebral hematoma  

OpenAIRE

A 16-year-old boy presented with an unusual case of a supratentorial, extraaxial small round blue cell tumor of the central nervous system, which was most likely a primitive neuroectodermal tumor (PNET). Preoperative computed tomography and magnetic resonance imaging showed a large multistage hematoma in the left central region. Intraoperatively, a small, superficial tumorous lesion was found between the sagittal sinus and a large cortical vein hidden by the hematoma. The histological diagnos...

Burkhardt, J. K.; Kockro, R. A.; Dohmen-scheufler, H.; Woernle, C. M.; Bellut, D.; Kollias, S. S.; Bertalanffy, H.

2011-01-01

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

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

Yajima Hiroshi

2008-03-01

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[Hypovolemic shock during surgery caused by a rectus sheath hematoma].  

Science.gov (United States)

Prophylactic treatment with low molecular weight heparins (LMWH) is currently widely used to prevent thromboembolic events. However, such treatment is not free of risk. Among the possible complications described is rectus sheath hematoma. We report the case of a patient undergoing surgery for a hypophysial adenoma approached by the transsphenoidal route. He received LMWH prophylaxis for thromboembolism and showed a tendency to hypotension during surgery. The patient's condition deteriorated to hypovolemic shock accompanied by episodes of atrial fibrillation with rapid ventricular response. With the transfusion of medications, blood products and plasma volume expanders, the patient was stabilized and surgery was completed. A computed tomography scan then revealed a hematoma occupying the greater part of the left anterior rectus muscle. With conservative wait-and-see treatment the abdominal symptoms disappeared and the hematoma gradually receded until fully resolved. Spontaneous rectus sheath hematoma is a rare condition. Presentation is quite nonspecific and computed tomography is needed for reaching a firm diagnosis. When a hematoma is large, the initial clinical picture may include hypovolemic shock, which may develop during surgery if the hematoma is not diagnosed early. Intraoperative management will be much more difficult than it would have been if diagnosis and treatment had taken place before the operation. PMID:16281745

Vidal, M A; López-Escobar, M; Medina, C; García, R; Torres, L M

2005-10-01

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

Scientific Electronic Library Online (English)

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

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

26

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)

27

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

Science.gov (United States)

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

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

2007-05-01

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Myelopathy Caused by Chronic Epidural Hematoma Associated with L1 Osteoporotic Vertebral Collapse: A Case Report and Review of the Literature  

OpenAIRE

Epidural hematoma associated with osteoporotic vertebral collapse has not been reported yet in the literature. We report a case of myelopathy caused by chronic epidural hematoma associated with L1 osteoporotic vertebral collapse and review the relevant literature.

Oda, Itaru; Fujiya, Masanori; Hasegawa, Kyoichi; Terae, Satoshi

2008-01-01

29

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

30

Rectus sheath hematoma caused by non-contact strenuous exercise mimicking acute appendicitis.  

Science.gov (United States)

A healthy 26-year-old man visited the Emergency Department due to right lower quadrant pain of 2 days' duration that developed after wakeboarding. There was no history of direct trauma to the abdomen. Physical examination revealed tenderness and rebound tenderness on the right lower quadrant area. There was no palpable abdominal mass. Computed tomography (CT) of the abdomen was undertaken to discern the causes of acute abdomen, including acute appendicitis. CT revealed a small-size rectus sheath hematoma beneath the lower end of the right rectus muscle. The patient was admitted for supportive care including pain control and was discharged with improvement after 5 days. Rectus sheath hematoma can be caused by not only a direct blow but also non-contact strenuous exercise, for example, wakeboarding in this case. Although the majority of rectus sheath hematomas are self-limiting, some can cause peritoneal irritation signs, mimicking acute abdomen, and eventually lead to unnecessary laparotomy without clinical suspicion and ancillary tests including CT scan and ultrasonography. PMID:18722739

Oh, Je Hyeok; Kim, Tae Han; Cha, Sung Jae; Kim, Seung Ho

2010-09-01

31

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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Abdominal chronic expanding hematoma causing iron-deficiency anemia in a dog.  

Science.gov (United States)

A 2 yr old spayed female mixed-breed Irish wolfhound was referred for assessment of anemia and slowly progressing abdominal distention. At the time of admission, the dog had marked anemia and thrombocytosis, a decreased serum iron concentration, and a normal coagulation profile. An ultrasound examination showed a massive fluid-filled cavitated structure in the abdominal cavity. Paracentesis of that structure yielded a large amount of hemorrhagic fluid with an iron concentration >24 times greater than the serum iron concentration, consistent with chronic sequestration of iron, leading to iron-deficiency anemia. Blood transfusions and incomplete surgical removal of the structure allowed short-term stabilization of the patient, but the dog was euthanized 17 days postsurgery for lethargy and continued abdominal distention. Histopathological evaluation of the structure was consistent with a chronic expanding hematoma. To the authors' knowledge, this is the first reported case of intra-abdominal chronic expanding hematoma in a dog. It is also unique given its features of iron-deficiency anemia caused by internal blood loss. PMID:25028435

Sebbag, Lionel; Harkin, Kenneth R; Habekost, Allison; Gumber, Sanjeev; Lee, Tiffany

2014-01-01

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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

34

Subungual Hematoma  

Science.gov (United States)

... Name: Category: Share: Yes No, Keep Private Subungual Hematoma Share | A subungual hematoma is a transient condition where blood and fluid ... area works best. Compression can further reduce the bleeding underneath the nail. Regardless of treatment the hematoma ...

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Hematoma espinal / Spinal hematoma  

Scientific Electronic Library Online (English)

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

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

2013-04-01

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Intracranial subdural hematoma as a cause of postoperative delirium and headache in cervical laminoplasty: A case report and review of the literature  

Science.gov (United States)

Objectives To describe a rare case of acute intracranial subdural hematoma as a cause of postoperative delirium and headache following cervical spine surgery. Summary of Background Data Headache is uncommon following spinal surgery, but can be observed in cases of accidental tearing of the dura during surgery. The causes of headache after surgery are thought to include dural tear and CSF leakage. On the other hand, intracranial subdural hematoma can be a cause of headache and cognitive dysfunction. However, only 4 cases as a postoperative complication of spinal surgery have been reported in the literature. Methods A 55-year-old man underwent re-explorative surgery due to postoperative hematoma causing hemiplegia following cervical laminoplasty. During this operation, accidental dural tear occurred and induced CSF leakage. On the following day, headache and delirium were noted. CSF leakage continued despite intraoperative repair of the dural laceration. Cranial CT at that time clearly demonstrated subdural hematoma. Results We reexplored the surgical site and attempted to stop the CSF leakage with meticulous suturing of the dural sac under microscopic observation. The intracranial subdural hematoma was carefully observed under consultation with a specialist neurosurgeon. Following this reexploration, the headache and delirium gradually improved, with spontaneous resolution of intracranial hematoma over a two-month period of observation. Conclusions We have reported a rare case of acute intracranial subdural hematoma caused by CSF leakage following cervical spine surgery. This report demonstrates the possibility of intracranial hematoma as a cause of postoperative cognitive dysfunction or headache, especially when accidental tearing of the dura has occurred in spinal surgery.

Habunaga, Hiroshi; Nakamura, Hiroaki

2011-01-01

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Suprarrenal hematoma Hematoma suprarrenal  

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

Concepción Guardo B.

1996-04-01

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Nasal septal hematoma  

Science.gov (United States)

A nasal septal hematoma is collection of blood within the septum of the nose. The septum is the part of the nose between ... A septal hematoma can be caused by: A broken nose Injury to the soft tissue of the area Surgery The problem ...

39

Iliacus hematoma syndrome.  

Science.gov (United States)

In a patient receiving warfarin and heparin in the treatment of pulmonary embolism, a hematoma developed in the iliacus muscle, compressing the overlying femoral nerve. Femoral nerve paralysis ensued, causing inability to walk, pain and loss of sensation in the sensory distribution of the nerve. Surgical intervention and removal of the hematoma relieved the nerve compression and the condition gradually improved. PMID:1122461

Kounis, N. G.; Macauley, M. B.; Ghorbal, M. S.

1975-01-01

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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.)

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Complete motor recovery after acute paraparesis caused by spontaneous spinal epidural hematoma: case report  

OpenAIRE

Abstract Background Spontaneous spinal epidural hematoma is a relatively rare but potentially disabling disease. Prompt timely surgical management may promote recovery even in severe cases. Case presentation We report a 34-year-old man with a 2-hour history of sudden severe back pain, followed by weakness and numbness over the bilateral lower limbs, progressing to intense paraparesis and anesthesia. A spinal magnetic resonance imaging scan was performed and revealed an anterior epidural hemat...

Qt, Gomes Marcos; Brock Roger S; Ed, Lu?cio Jose?; Pahl Felix H; Taniguchi Leandro U; Adoni Tarso; Cc, Fiorini Victor; Carvalho Rodrigo C; Evaristo Eli F; Mutarelli Eduardo G.; Schettino Guilherme

2011-01-01

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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

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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 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

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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

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Hematoma traumático del psoas  

Scientific Electronic Library Online (English)

Full Text Available 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

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Spontaneous vertex extradural hematoma: considerations about causes. Case report and review of the literature.  

Science.gov (United States)

A 36-year-old woman with an uneventful medical history was admitted to the emergency department following an initial generalized seizure. Neuroimaging workup disclosed a homogeneous mass at the vertex, which first was diagnosed as vertex meningioma. Anticonvulsant drug therapy was administered and the patient was discharged. Two months later the patient was examined in our neurosurgery department for additional therapeutic recommendations. A repeated neuroimaging examination showed considerable regression of the lesion. The findings on magnetic resonance imaging were consistent with those of a regressing extradural hematoma (EDH). A complete blood-coagulation study displayed no evidence of abnormality. Thorough questioning of the patient revealed no history of pericranial infection or head trauma occurring within the last 2 years. The final diagnosis was spontaneously occurring vertex EDH. In this report the authors describe the clinical and neuroimaging features of the case as well as the management strategy, and discuss etiological aspects within the context of a careful review of the literature. PMID:11302666

Dufour, H; Métellus, P; Manera, L; Fuentes, S; Do, L; Grisoli, F

2001-04-01

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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.

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PATOBIOLOGÍA DEL HEMATOMA SUBDURAL CRÓNICO.  

OpenAIRE

Treatment of subdural cronic hematoma in all ages is a therapeutic challenge. Chronic subdural hematoma is a disease that can be fatal without surgical treatment. A variety of treatment options like subdural tapping, endoscopic washout, shunting and craniotomy have been discussed. In chronic subdural hematoma, spontaneous resolution with conservative treatment is not an common therapeutic method because it has causes high mortality, requires long periods of time, and finally, many patients ne...

Rubén Sabogal Barrios; Luís Rafael Moscote Salazar

2008-01-01

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PATOBIOLOGÍA DEL HEMATOMA SUBDURAL CRÓNICO.  

Directory of Open Access Journals (Sweden)

Full Text Available Treatment of subdural cronic hematoma in all ages is a therapeutic challenge. Chronic subdural hematoma is a disease that can be fatal without surgical treatment. A variety of treatment options like subdural tapping, endoscopic washout, shunting and craniotomy have been discussed. In chronic subdural hematoma, spontaneous resolution with conservative treatment is not an common therapeutic method because it has causes high mortality, requires long periods of time, and finally, many patients need surgical treatment. The etiology, physiopathology and surgical alternatives in the treatment of subdural chronic hematoma is discussed.

Rubén Sabogal Barrios

2008-01-01

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[Post-traumatic intramural duodenal hematoma as a cause of high ileus in a child].  

Science.gov (United States)

The authors describe the case of an intramural duodenal haematoma caused a high ileus after a seven-day post-traumatic interval. The authors recommend surgical revision, in particular in children because the mechanism of injury is the same in intramural haematoma and in duodenal perforation. Only thus it is possible to prevena a fatal course, while the operation is easy and healing after drainage of the haematoma is rapid. PMID:2749389

Soudek, K; Husek, J; Randa, V; Dan?k, J

1989-04-01

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The CT examination of changes in intracranial hematoma density  

International Nuclear Information System (INIS)

The study was undertaken to assess the changes in the size and densities of intracranial hematoma by analyzing the sequential CT examination of 23 patients at Soonchunhyang College Hospital from Jul. 1980 to Aug. 1981. The results were as follows; 1. The right densities of hematoma were reduced slowly in size and density. 2. The factors influence the rate of changes were the cause of hematoma, hematoma location, age and sex of patient, and initial hematoma size. 3. The CT findings that indicate complete absorption of hematomas were normalization of mass effect, not disappearance of hematoma densities. 4. In intracerebral hematoma, the high density of hematoma reduced it's density and mass effect about 4-6 weeks duration. 5. In subdural hematoma, about 7 weeks after head trauma, the CT findings were normalized

52

Retropharyngeal hematoma.  

OpenAIRE

ABSTRACT Retropharyngeal hematomas (RPH) are relatively rare. They are clinically important because of the close proximity to the upper airway, which can be life threatening and requires immediate intervention. We report one patient who presented with RPH due to anticoagulation that resulted in airway obstruction and subsequent intubations. We outline the normal anatomy of the retropharyngeal space, the pathogenesis and treatment of RPH, with related literature review.

Alherabi, Ameen Z.

2008-01-01

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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.

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

Nuclear power plant delays: probable causes and resolutions  

International Nuclear Information System (INIS)

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

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Acute subdural hematoma without subarachnoid hemorrhage caused by ruptured A1-A2 junction aneurysm. Case report.  

Science.gov (United States)

A 54-year-old man was admitted to our hospital with complaint of sudden headache. The patient had suffered two episodes of transient headache before admission. Computed tomography (CT) revealed acute subdural hematoma (ASDH) on the right side of the cerebral convexity with bilateral extension along the tentorium cerebelli without signs of subarachnoid hemorrhage (SAH) or intracerebral hemorrhage (ICH). Three-dimensional CT angiography and conventional cerebral angiography revealed a left A1-A2 junction aneurysm. Neck clipping of the aneurysm was performed. The aneurysm extended inferiorly, with the dome embedded in the chiasmatic cistern and tightly adhered to the arachnoid membrane. There was no evidence of hematoma in the subarachnoid space. The patient was discharged without neurological deficit. Ruptured aneurysms resulting in ASDH without SAH or ICH are very rare. Radiological investigation such as three-dimensional CT angiography should be performed to find the causative aneurysm in a patient with ASDH with a history of repeated headaches and without traumatic signs or episodes, and the appropriate treatment should be planned with expediency. PMID:22729076

Takada, Tomoya; Yamamoto, Tetsuya; Ishikawa, Eiichi; Zaboronok, Alexander; Kujiraoka, Yuji; Akutsu, Hiroyoshi; Ihara, Satoshi; Nakai, Kei; Matsumura, Akira

2012-01-01

57

Optoacoustic detection of intra- and extracranial hematomas in rats after blast injury  

OpenAIRE

Surgical drainage of intracranial hematomas is often required within the first four hours after traumatic brain injury (TBI) to avoid death or severe disability. Although CT and MRI permit hematoma diagnosis, they can be used only at a major health-care facility. This delays hematoma diagnosis and therapy. We proposed to use an optoacoustic technique for rapid, noninvasive diagnosis of hematomas. In this study we developed a near-infrared OPO-based optoacoustic system for hematoma diagnosis a...

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

2014-01-01

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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.)

59

Two faces of orbital hematoma in intranasal (endoscopic) sinus surgery.  

Science.gov (United States)

Orbital hematoma and blindness can occur during or after sinus surgery. All orbital hematomas in 3500 endoscopic sinus ethmoidectomies were identified and evaluated for type, treatment, and sequelae. Fifteen orbital hematomas were identified, with 1 case of temporary blindness and no cases of permanent blindness. Two types of orbital hematoma were identified-slow (venous) and fast (arterial)-which differ in management. The venous type results from penetration of the lamina papyracea and disruption of veins. The arterial hematoma is caused by anterior or posterior ethmoid artery injury. The treatment approach to each is different, with blindness more likely occurring from a fast (arterial) hematoma. Of the 2 types of orbital hematoma that can occur during sinus surgery, surgical decompression and hemorrhage control are more likely with the fast arterial hematoma, which has not been the subject of any prior presentation. Cause and management of each will be discussed. PMID:10352437

Stankiewicz, J A; Chow, J M

1999-06-01

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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.)

61

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

62

Cervical spine fracture in a patient with ankylosing spondylitis causing a C2-T9 spinal epidural hematoma- Treatment resulted in a rapid and complete recovery from tetraplegia: Case report and literature review.  

Science.gov (United States)

Full recovery from tetraplegia is uncommon in cervical spine injury. This has not being reported for cervical spine fracture in a patient with ankylosing spondylitis causing spinal epidural hematoma. We report on a case of cervical spine fracture in a patient with ankylosing spondylitis who came with tetraplegia. He underwent a two stage fixation and fusion. He had a complete recovery. Two hours after the operation he regained full strength in all the limbs while in the Intensive Care Unit. He went back to full employment. There are only two other reports in the literature where patients with ankylosing spondylitis and extradural hematoma who underwent treatment within 12 h and recovered completely from tetraparesis and paraplegia respectively. Patient with ankylosing spondylitis has a higher incidence of spinal fracture and extradural hematoma. Good outcome can be achieved by early diagnosis and treatment. This can ensure not only a stable spine, but also a rapid and complete recovery in a tetraplegic patient. PMID:25767586

Wong, Albert Sii Hieng; Yu, Denis Hee Youg

2015-01-01

63

Cervical spine fracture in a patient with ankylosing spondylitis causing a C2-T9 spinal epidural hematoma- Treatment resulted in a rapid and complete recovery from tetraplegia: Case report and literature review  

Science.gov (United States)

Full recovery from tetraplegia is uncommon in cervical spine injury. This has not being reported for cervical spine fracture in a patient with ankylosing spondylitis causing spinal epidural hematoma. We report on a case of cervical spine fracture in a patient with ankylosing spondylitis who came with tetraplegia. He underwent a two stage fixation and fusion. He had a complete recovery. Two hours after the operation he regained full strength in all the limbs while in the Intensive Care Unit. He went back to full employment. There are only two other reports in the literature where patients with ankylosing spondylitis and extradural hematoma who underwent treatment within 12 h and recovered completely from tetraparesis and paraplegia respectively. Patient with ankylosing spondylitis has a higher incidence of spinal fracture and extradural hematoma. Good outcome can be achieved by early diagnosis and treatment. This can ensure not only a stable spine, but also a rapid and complete recovery in a tetraplegic patient.

Wong, Albert Sii Hieng; Yu, Denis Hee youg

2015-01-01

64

Spinal subdural hematoma associated with traumatic intracranial interhemispheric subdural hematoma.  

Science.gov (United States)

A 78-year-old female fell and hit the back of her head on the floor. Head computed tomography (CT) showed right acute interhemispheric subdural hematoma (ISDH). Her left hemiparesis worsened, so partial removal of ISDH was performed. The hemiparesis was improved, but leg monoparesis persisted. Lumbar magnetic resonance imaging showed spinal subdural hematoma (SSDH) at the S1-2 level. Nerve conduction velocity measurements at the knee joint to lower limb showed disappearance of the left peroneal nerve conduction wave, indicating that one of the causes of drop foot was common peroneal nerve palsy. With conservative therapy, her drop foot was gradually improved, then she recovered to walk with a stick and moved to a rehabilitation hospital. Lumbar MR imaging should be performed to rule out SSDH in a patient with posterior fossa subdural hematoma on initial head CT who develops leg palsy. PMID:23006875

Wajima, Daisuke; Yokota, Hiroshi; Ida, Yuki; Nakase, Hiroyuki

2012-01-01

65

Chronic subdural hematoma  

Science.gov (United States)

Subdural hemorrhage - chronic; Subdural hematoma - chronic; Subdural hygroma ... A subdural hematoma develops when the tiny veins that run between the dura and surface of the brain (bridging veins) tear ...

66

Spontaneous Spinal Epidural Hematoma  

OpenAIRE

Spontaneous spinal epidural hematoma (SSEH) is a relatively rare but significant spinal condition. Urgent surgical evacuation of a hematoma is generally indicated to prevent serious permanent neurological deficits. We encountered three cases of spontaneous spinal epidural hematomas associated with motor weakness that were treated successfully by surgical intervention.

Baek, Byung Suck; Hur, Jin Woo; Kwon, Ki Young; Lee, Hyun Koo

2008-01-01

67

Rectus Sheath Hematoma Mimicking Acute Abdominal Pain  

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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

68

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

OpenAIRE

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 ...

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

2012-01-01

69

Epidural hematomas of posterior fossa  

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Full Text Available Background. Posterior fossa epidural hematomas represent 7-14% of all traumatic intracranial epidural hematomas. They are most frequently encountered posttraumatic mass lesions in the posterior fossa. The aim of this study was to identify clinical features that could lead to the early diagnosis of posterior fossa epidural hematoma. Methods. Between 1980 and 2002, 28 patients with epidural hematoma of the posterior fossa were operated on at the Institute for Neurosurgery, Belgrade. Clinical course neuroradiological investigations, and the results of surgical treatment of the patients with posterior fossa epidural hematomas were analyzed retrospectively. Results. Almost two thirds of patients were younger than 16 years of age. In 20 cases injury was caused by a fall, in 6 cases by a traffic accident, and in 2 by the assault. Clinical course was subacute or chronic in two thirds of the patients. On the admission Glasgow Coma Scale was 7 or less in 9 injured, 8-14 in 14 injured, and 15 in 5 injured patients. Linear fracture of the occipital bone was radiographically evident in 19 patients, but was intraoperatively encountered in all the patients except for a 4-year old child. In 25 patients the diagnosis was established by computer assisted tomography (CAT and in 3 by vertebral angiography. All the patients were operated on via suboccipital craniotomy. Four injured patients who were preoperatively comatose were with lethal outcome. Postoperatively, 24 patients were with sufficient neurologic recovery. Conclusion. Posterior fossa epidural hematoma should be suspected in cases of occipital injury, consciousness disturbances, and occipital bone fracture. In such cases urgent CAT-scan is recommended. Early recognition early diagnosis, and prompt treatment are crucial for good neurological recovery after surgery.

Radulovi? Danilo

2004-01-01

70

Spinal epidural hematomas examined on MRI  

International Nuclear Information System (INIS)

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

71

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

72

Spinal epidural hematoma  

International Nuclear Information System (INIS)

Spinal epidural hematoma is an accumulation of blood in the potential space between the dura and bone. On unenhanced computed tomography epidural hemorrhage appears as a high-density spinal canal mass with variable cord compression. Magnetic resonance imaging is the modality of choice for evaluating spinal epidural hematoma and can demonstrate the extent of the hematoma and degree of cord compression. When treated surgically the outcome depends on the extent of preoperative neurological deficits and on the operative timing interval. (orig.)

73

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 presenting with a mass in the ...

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

2008-01-01

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Acute bilateral extradural hematomas.  

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

Ramzan A

2002-04-01

75

Omeprazole causes delay in gastric emptying of digestible meals.  

Science.gov (United States)

We have studied gastric emptying of a solid, realistic meal (800 cal, 15% protein, 45% fat, 40% carbohydrate) in 21 healthy subjects twice, with and without a four-day pretreatment with 40 mg omeprazole. The last dose of the drug was taken 24 hr before the test, to avoid hypothetical nonsecretory side effects of the drug . Gastric emptying was measured by ultrasound of antral diameters. The results show that basal and maximal postprandial antral cross-sectional areas were the same during the two tests. A greater residual distention of the antrum was present throughout the study after the omeprazole treatment, the difference being significant at time 120 and 240. Omeprazole induced a highly significant delay in gastric emptying [control 199.6 (12.6) vs omeprazole 230.9 (12.7) min, mean (1 SEM); P<0.003]. The delay was not due to a prolonged lag phase, but rather to an effect on the slope of the emptying curve. This study shows that in normal subjects omeprazole delays gastric emptying of a digestible solid meal. PMID:8617117

Benini, L; Castellani, G; Bardelli, E; Sembenini, C; Brentegani, M T; Caliari, S; Vantini, I

1996-03-01

76

Posterior fossa epidural hematoma  

International Nuclear Information System (INIS)

CT demonstrated posterior fossa epidural hematoma in three patients with head trauma in whom this diagnosis was not clinically apparent. No patient was in stupor or coma and no patient experienced a lucid interval. Only one patient had signs referable to the posterior fossa. Two patients had occipital skull fracture disclosed by plain radiographs. CT revealed a unilateral biconvex hematoma in two cases, and a bilateral hematoma with supratentorial extension in the third. All patients underwent suboccipital craniectomy and recovered. Therapeutic success in these cases was facilitated by early CT and the rapid disclosure of the unsuspected posterior fossa lesions. CT showing contiguous hematoma below and above the tentorium cerebelli after posterior head trauma is highly suggestive of epidural hematoma arising from the posterior fossa. (orig.)

77

Calcified subdural hematoma associated with hypertensive intracerebral hemorrhage  

International Nuclear Information System (INIS)

A case of calcified subdural hematoma associated with hypertensive intracerebral hemorrhage is reported. A left frontal subdural hematoma with left putaminal hemorrhage was incidentally found when a CT scan was performed to evaluate right hemiparesis and aphasia in a 55-year-old man. The putaminal hemorrhage was not very extensive, but his clinical symptoms were rather serious. Not only the putaminal hemorrhage, but also the presence of the calcified subdural hematoma was considered to have caused his clinical deterioration. The subtotal removal of the calcified subdural hematoma brought about a good result. (author)

78

CT finding of right retroperitoneal space : analysis of extension of right perirenal hematoma  

International Nuclear Information System (INIS)

To understand the structure and character of the right retroperitoneal space by analysis of the extension of retroperitoneal hematoma in patients with traumatic right renal injuries. We retrospectively reviewed CT scans of 13 patients with right retroperitoneal hematomas caused by right renal injury. At te renal level, we analyzed the relation of a hematoma contacting psoas muscle with other retroperitoneal compartmental hematomas. At the suprarenal level, a perirenal hematoma and a hematoma contacting the diaphragm were analyzed according to their relation with intrahepatic IVC and pericaval hematoma. Below renal hilar level, all hematomas contacting psoas muscle, observed in eight cases, were connected with retrorenal extension of anterior pararenal hematoma. At the suprarenal level, intrahepatic pericaval hematomas were not, in all 13 cases, connected with a hematoma contacting the diaphragm, but with a perirenal hematoma. At the upper suprarenal level, the only pericaval hematomas containing a medial component of perirenal hematoma extended superiorly to the upper one third of the tenth thoracic vertebral body. The anterior renal fascia envelops perirenal space except in its medial aspect. In the upper suprarenal region, the anterior and posterior planes of the anterior renal fascia unite to fuse with diaphragmatic fascia, but along the medial aspect they fuse with intrahepatic pericaval connective tissue and posteromedial diaphragm, respectively diaphragm, respectively

79

Postoperative epidural hematoma. Five cases of epidural hematomas developed after supratentorial craniotomy on the contralateral side  

Energy Technology Data Exchange (ETDEWEB)

Postoperative epidural hematomas developed far from the operative field are generally recognized as a complication of ventriculo-peritoneal shunt, ventricular drainage or suboccipital craniotomy. It is very rare but may occur after supratentorial craniotomy on the contralateral side. Five such cases are presented with a review of the relevant literature. The mechanism of this complication is not clearly understood. In hydrocephalus, these massive epidural hematomas are probably caused by dura-skull detachment when the brain volume is strikingly reduced by a decompressive procedure. On rare occasions, pins of head rest may detach the dura and cause epidural hematomas. When sudden brain swelling during craniotomy is encountered, attention should be directed not only to intracerebral hemorrhage but also epidural hematoma developed on the contralateral side.

Sato, M. (Shiga Univ. of Medical Science, Ohtsu (Japan)); Mori, K.; Handa, H.

1981-10-01

80

Spontaneous acute subdural hematoma and chronic epidural hematoma in a child with F XIII deficiency.  

Science.gov (United States)

Factor XIII (F XIII) deficiency is a rare autosomal recessive congenital disorder that can cause spontaneous subdural or epidural hematomas. Due to its low incidence, F XIII deficiency may well be under-diagnosed. A 7-year-old girl with no history of medical problems presented with progressive headache of 3 days. Cerebral computed tomography (CT) scans revealed a large right acute parietooccipital subdural hematoma with a significant midline shift. After an emergent parietooccipital craniotomy and evacuation of the subdural hematoma, a screening test for factor XIII was performed. The results of the test were abnormal. She had full recovery and was discharged with a follow-up treatment of monthly transfusion of fresh frozen plasma as the replacement and prophylactic therapy. Ten months later, she was referred to our center with headache after a minor head trauma. Her medical history revealed that she had not received fresh frozen plasma for the last 2 months. CT scan showed a chronic right parietal epidural hematoma beneath the craniotomy flap. The present case indicates that although its incidence is very rare, F XIII deficiency can cause acute or chronic subdural and epidural hematomas. Therefore, in acute or chronic subdural and epidural hematomas with no underlying cause, the presence of a potential F XIII deficiency should be suspected as a cause of hemorrhagic diathesis. PMID:18514462

Vural, Murat; Yarar, Coskun; Durmaz, Ramazan; Atasoy, Metin Ant

2010-01-01

81

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)

82

Simultaneous appearance of cerebral venous thrombosis and subdural hematomas as rare cause of headache in puerperium following epidural analgesia: a case report  

OpenAIRE

The aim of this study is to report the first case of simultaneous appearance of cerebral venous thrombosis (CVT) and bilateral subdural hematomas (SDHs) following epidural analgesia for labor and delivery and to point out the difficulty of establishing such a diagnosis in the presence of postpartum headache. A 26-year old primigravida with a history of epilepsy received epidural analgesia for delivery. Three days after the uneventful spontaneous vaginal delivery she complained about the heada...

Z?upan, Z?eljko; Sotos?ek Tokmadz?ic?, Vlatka; Matanic?-manestar, Marinka; S?ustic?, Alan; Antonc?ic?, Igor; Dunatov, Sinis?a; Pavlovic?, Ivan; Antulov, Ronald

2012-01-01

83

Impact of early surgical evacuation of sylvian hematoma on clinical course and outcome after subarachnoid hemorrhage  

International Nuclear Information System (INIS)

The present study aimed to evaluate the impact of early surgical evacuation of sylvian hematoma caused by ruptured middle cerebral artery (MCA) aneurysm on clinical outcome after subarachnoid hemorrhage. Hospital records and computed tomography scans for 26 patients with MCA aneurysm who underwent surgical clipping between June 2001 and January 2008 were retrospectively reviewed. All patients presented with sylvian hematoma associated with subarachnoid hemorrhage and received surgery at 7.9±3.6 (mean±standard deviation) hours of ictus. They were divided postoperatively into two groups, achievement (n=16) and non-achievement (n=10) of extensive hematoma evacuation, and their clinical course and functional outcomes were compared. The frequencies of delayed ischemic neurological deficit and vasospasm-related cerebral infarction were significantly less (p<0.05) in the achievement group. Better functional outcomes were obtained in patients with successful evacuation (p<0.05), as assessed by improvement of hemiparesis on manual muscle testing scale at postoperative 1-month follow up and by the modified Rankin scale at postoperative 3 and 6 months. Clinical outcomes were also better in the achievement group. These results suggest that better clinical course and outcome can be expected in patients who undergo early successful hematoma evacuation with surgical clipping of a ruptured MCA aneurysm. (author)

84

SPONTANEOUS MESENTERIC HEMATOMA  

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Full Text Available Spontaneous small bowel mesentery or retroperitoneal hematomas are rare pathology occurring in absence of any trauma, anticoagulant therapy, vessel’s anomaly or systemic inflammatory disease. We present a case of a 23-year old male patient diagnosed with small bowel mesentery hematoma that corresponds to the „spontaneous” definition, who was admitted three days after onset accusing pain and a tumorous mass in the mesogastric region. Abdominal US and CT revealed a high density tumorous mass with well defined borders and nonhomogenous content, localized anterior to the left kidney, being in intimate contact with the small bowel loops and the transverse colon. Surgery was performed and the mesenteric hematoma was completely removed. Histological examination revealed characteristic changes for encapsulated hematoma. Postoperative period was uneventful, the patient being disease free during 24 months follow-up.

Gh. Ghidirim

2009-08-01

85

Handheld Hematoma Detector  

Science.gov (United States)

This new device will allow a doctor or EMT to diagnose hematomas in patients with a traumatic brain injury at the scene of an accident or in other situations where full medical facilities are not available.

86

SPONTANEOUS MESENTERIC HEMATOMA  

OpenAIRE

Spontaneous small bowel mesentery or retroperitoneal hematomas are rare pathology occurring in absence of any trauma, anticoagulant therapy, vessel’s anomaly or systemic inflammatory disease. We present a case of a 23-year old male patient diagnosed with small bowel mesentery hematoma that corresponds to the „spontaneous” definition, who was admitted three days after onset accusing pain and a tumorous mass in the mesogastric region. Abdominal US and CT revealed a high density tumorous m...

Gh. Ghidirim; Mis?in, I.; Gh.Zastavni?chi; Condrat?chi, E.

2009-01-01

87

Cavernosal hematoma mimicking priapism.  

Science.gov (United States)

We present a case of corpus cavernosum hematoma mimicking priapism. A 42-year-old man presented to the emergency room with penile pain and partial erection. Examination revealed partial erection and palpable space-occupying lesion of the corpus cavernosum without lymphadenopathy. Malignant workup was negative. Imaging assisted in diagnosis of unilateral hematoma of the corpus cavernosum. The lesion spontaneously resolved without the need for intervention. PMID:25817127

Phillips, Elizabeth A; Menchini Fabris, Filippo; Mendoza, Pierre; Munarriz, Ricardo

2015-04-01

88

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

89

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

90

Optoacoustic detection of intra- and extracranial hematomas in rats after blast injury.  

Science.gov (United States)

Surgical drainage of intracranial hematomas is often required within the first four hours after traumatic brain injury (TBI) to avoid death or severe disability. Although CT and MRI permit hematoma diagnosis, they can be used only at a major health-care facility. This delays hematoma diagnosis and therapy. We proposed to use an optoacoustic technique for rapid, noninvasive diagnosis of hematomas. In this study we developed a near-infrared OPO-based optoacoustic system for hematoma diagnosis and cerebral venous blood oxygenation monitoring in rats. A specially-designed blast device was used to inflict TBI in anesthetized rats. Optoacoustic signals were recorded from the superior sagittal sinus and hematomas that allowed for measurements of their oxygenations. These results indicate that the optoacoustic technique may be used for early diagnosis of hematomas and may provide important information for improving outcomes in patients with TBI. PMID:25302157

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

2014-06-01

91

Postraumatic delayed loss of vision  

International Nuclear Information System (INIS)

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

92

Ultrasonographic findings of intrahepatic hematoma  

International Nuclear Information System (INIS)

Sequential ultrasonography was performed in 22 cases of intrahepatic hematomas diagnosed by operation, laboratory data, and clinical manifestation. We analyzed the shape, location, size of hematoma, and change in size and echogenicity by age of hematoma. The results were as follows: 1. The most common shape of intrahepatic hematoma was round. 2. The most common site of intrahepatic hematoma was the posterior segment of the right lobe of the liver. 3. Size of hematoma was decreased from 3rd day, and most hematomas were nearly or completely absorbed from 2nd week to 4th week. 4. Echogenecities of intrahepatic hematoma in immediate ultrasonography after injury showed mainly echogenic or mixed form, and then the echogenecities were decreased and nearly or completely not seen from 2nd week to 4th week

93

[Infected subdural hematoma having a surgery of chronic subdural hematoma 1 year ago:a case report].  

Science.gov (United States)

We report a case of an infected subdural hematoma that occurred 1 year after burr-hole irrigation for chronic subdural hematoma. A 78-year-old woman who had developed left hemiparesis was admitted to our hospital. A computed tomography(CT)scan revealed the presence of a chronic subdural hematoma in the right hemisphere. Her clinical symptoms improved immediately after emergency burr-hole irrigation, which allowed her discharge from the hospital. One year after the initial surgery, she developed an infection of the urinary tract infection, which led to severe pyelonephritis and septic shock. Treatment of the urological symptoms eliminated the systemic inflammation. One month after the urinary infection, the patient was readmitted to the hospital in a comatose state. A CT scan showed regrowth of a residual subdural hematoma surrounded by a thick capsule, causing a midline shift in the brain. An emergency operation for removal of the subdural hematoma by burr-hole irrigation was performed, and pus was drained from the subdural mass. Microbiological cultures of the abscess revealed the presence of Proteus mirabilis. After surgery, the patient was administered an antibiotic treatment for three weeks and she was discharged with no neurological deficits. Cultures of blood from the septic shock as well as from the abscess both revealed the presence of Proteus mirabilis. Therefore, a diagnosis of infected subdural hematoma, which was caused by hematogenous infection, was made. We conclude that attention should be paid to the risk of infection of the hematoma capsule in subdural hematomas. PMID:25672558

Nagao, Takaaki; Miyazaki, Chikao; Ando, Shunpei; Haga, Daisuke; Kuroki, Takao; Sugo, Nobuo; Nagao, Takeki

2015-02-01

94

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

95

Spontaneous ligamentum flavum hematoma in the lumbar spine  

International Nuclear Information System (INIS)

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

96

Spontaneous ligamentum flavum hematoma in the lumbar spine  

Energy Technology Data Exchange (ETDEWEB)

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

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

2006-09-15

97

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)

98

Hematoma epidural lumbar crónico espontáneo / Chronic spontaneous lumbar epidural hematoma  

Scientific Electronic Library Online (English)

Full Text Available 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

99

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

100

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

101

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

102

Chronic subdural hematoma  

International Nuclear Information System (INIS)

Recently much attention has been paid once again to etiology of chronic subdural hematoma since the appearance of computed tomography (CT). Authors examined 1824 head injury cases by CT from January 1977 to September 1979. Among them, there are 40 cases (they were all over 16 years old) whose CT showed frontal extracerebral low density area. The low density area which is considered to be so-called fluid collection could be classified into four types (type I to IV). In two cases of those 40 cases (5%), the low density area changed into high density area which seemed to be hemorrhage. The 2 cases were diagnosed to be chronic subdural hematoma and proved surgery. The change of density on CT developed only from type I (the brain surface looks smooth and sulci are not recognized beneath the low density area). The change of density, occurred in 2 cases among 24 cases of type I (8.3%), was recognized about 2 months after the head injury. This fact is compatible with the report by Yamada et al. (1979). Thus, when CT after the head injury shows frontal extracerebral low density area of type I, the case may develop to chronic subdural hematoma about 2 months after the head injury. Therefore, careful observation should be needed especially during this period after the head injury. (author)

103

Microwave hematoma detector  

Science.gov (United States)

The Microwave Hematoma Detector is a non-invasive device designed to detect and localize blood pooling and clots near the outer surface of the body. While being geared towards finding sub-dural and epi-dural hematomas, the device can be used to detect blood pooling anywhere near the surface of the body. Modified versions of the device can also detect pneumothorax, organ hemorrhage, atherosclerotic plaque in the carotid arteries, evaluate perfusion (blood flow) at or near the body surface, body tissue damage at or near the surface (especially for burn assessment) and be used in a number of NDE applications. The device is based on low power pulsed microwave technology combined with a specialized antenna, signal processing/recognition algorithms and a disposable cap worn by the patient which will facilitate accurate mapping of the brain and proper function of the instrument. The invention may be used for rapid, non-invasive detection of sub-dural or epi-dural hematoma in human or animal patients, detection of hemorrhage within approximately 5 cm of the outer surface anywhere on a patient's body.

Haddad, Waleed S. (Dublin, CA); Trebes, James E. (Livermore, CA); Matthews, Dennis L. (Moss Beach, CA)

2001-01-01

104

Delayed neurotoxicity - do trichlorphon and/or dichlorvos cause delayed neuropathy in man or in test animals?  

Science.gov (United States)

Many, but not all, reports of delayed neuropathy associated with acute poisoning by trichlorphon refer to cases in U.S.S.R. Adulteration of technical trichlorphon with the ethyl analogue would greatly increase the neurotoxic hazard but analysis of a few samples has not revealed such impurities. Simultaneous ingestion of alcohol does not appear to increase neuropathic hazard. In hens double doses of trichlorphon each exceeding unprotected LD50 can produce moderate neuropathy associated with appropriately high inhibitions of neurotoxic esterase. Similar results are obtained with 2 doses of 10 x LD50 of dichlorvos. In vitro the inhibitory power of dichlorvos against neurotoxic esterase of hen brain is 0.02 x the power against acetylcholinesterase. This ratio correlates reasonably with the ratio of LD50/neuropathic dose. The factor for human brain enzymes is 0.06 suggesting that man is more susceptible to neuropathic effects of near-lethal doses of circulating dichlorvos. It is concluded that the only neuropathic hazard to man from good quality trichlorphon arises from rapid ingestion of massive doses. To obtain critical levels of inhibition of neurotoxic esterase and to cause neuropathy in man by repeated doses would require each dose to be severely toxic. Dichlorvos ingested in large doses is likely to kill rather than to cause neuropathy. PMID:7344417

Johnson, M K

1981-01-01

105

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

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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

106

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

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

P. P. Lema

2012-01-01

107

Ethmoidal hematoma in nine horses.  

Science.gov (United States)

Ethmoidal hematoma was diagnosed in 9 horses by results of physical examination, endoscopy, radiography, and histologic examination of tissues. The horses had stertorous breathing (n = 4) or intermittently sanguineous nasal discharge (n = 7). All horses underwent sinusotomy and extirpation of the lesion. At reexamination 15 to 104 months after surgery (mean, 61 months), 3 horses had recurrence of ethmoidal hematoma, and 1 horse had ethmoidal hematoma involving the contralateral ethmoturbinates. One of the horses with recurrence of ethmoidal hematoma also developed a contralateral lesion; both lesions recurred and additional surgeries were performed. PMID:2211311

Specht, T E; Colahan, P T; Nixon, A J; Brown, M P; Turner, T A; Peyton, L C; Schneider, R K

1990-09-01

108

Acute aortic intramural hematoma  

International Nuclear Information System (INIS)

To evaluate the radiologic findings of acute intramural hematoma of the aorta, and the clinical follow up thereof. Among 34 cases confirmed clinically and radiologically as aortic dissection, and analysis was carried out based on 15 cases in which intramural hematoma without false lumen was demonstrated, on initial CT, 12 cases of in which follow up CT was used and five cases involving an aortogram. Elements such as the shape of the thickened aortic wall, ulcer-like intimal defects, and intimal calcification were examined. Changes in these elements were also examined on follow-up CT. DeBackey types 1 and 3 accounted for one and 14 cases, respectively. Initial precontrast CT demonstrated continuous, crescentic high attenuation areas along the wall of the descending aorta. In postcontrast scans, the crescentic areas were of relatively lower-attenuation and appeared along the aorta wall. Displaced intimal calcifications were seen in nine of fifteen patients. There was no intimal flap on all five aortogram, while aortic wall thickening and atherosclerotic change were demonstrated in four cases and in one case, respectively. Focal ulcers were seen in three cases. Ulcer-like intimal defects were demonstrated in a total of eleven cases (eight on CT, two on aortogram, and one on both). In ten of the twelve cases seen on follow up CT, the thickness of the intramural hematoma was seen to be reduced. Among the 15 cases, the operation was performed in two cases, and the remaining performed in two cases, and the remaining 13 received conservative treatment. In ten cases observed for more than twelve months, a recurrence of symptoms did not occur. Eccentric aortic wall thickening in patients who complain of acute chest pain is the result of acute aortic dissection with intramural hematoma, or a penetrating atherosclerotic ulcer of the aorta. The later may be differentiated from the former by the presence of on ulcer-like intimal defect. When both diseases are limited to the descending aorta, conservative treatment may be effective, unless patients experience persistent or recurrent chest pain, or unless intramural hematoma progresses further

109

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

OpenAIRE

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

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

2012-01-01

110

Thyroid Gland Hematoma After Blunt Neck Trauma  

OpenAIRE

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...

Saylam, Baris; Comcali, Bulent; Ozer, Mehmet Vasfi; Coskun, Faruk

2009-01-01

111

Spontaneous epidural hematoma at lumbar facet joint: a case report  

International Nuclear Information System (INIS)

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

112

Spontaneous ignition delays as a diagnostic of the propensity of alkanes to cause engine knock  

Energy Technology Data Exchange (ETDEWEB)

The spontaneous ignition of a range of alkanes (C{sub 4}-C{sub 8}) and of the primary reference fuels (PRF), n-heptane + i-octane (2,2,4 trimethylpentane), have been investigated. Autoignition (or spontaneous ignition) delays were measured over a wide range of compressed gas temperatures (T{sub c}) at gas densities of 131 mol/m{sup 3} in a rapid compression machine. In the first instance, a reference temperature, which is typical of that reached in the end gas of spark ignition engines under violent knocking conditions (T{sub c} = 900 K), was used as a basis of comparison of ignition delay of the single fuels with the comparable PRF mixtures with respect to the research octane number (RON). A broad qualitative agreement was found to exist between the ignition delay of single-component fuels and the PRF mixtures of corresponding RON, but the quantitative agreement became increasingly less satisfactory for some fuels at high RON, especially above 85. A major contributing factor appears to be that, whereas for the binary PRF mixtures quite considerable extents of reaction can occur during the course of compression, which leads to a sensitization of the mixture in the postcompression period at higher temperature, not all of the single-component alkanes are similarly reactive. These features are tied to the relative activities of the fuels and to the characteristics of the negative temperature dependence of reaction rate in the temperature range 750--850 K. However, even throughout a wide range of compressed gas temperatures, ignition delay does not appear to offer a quantitative basis for assessing the relative sensitivity of fuels to cause engine knock. It is suggested that the minimum temperature at which autoignition occurs in a given system may give a closer correlation than ignition delay for the relationship between reactivity and octane number.

Griffiths, J.F.; Halford-Maw, P.A.; Mohamed, C. [Univ. of Leeds (United Kingdom). School of Chemistry

1997-12-01

113

Spontaneous subdural hematoma of the thoracolumbar region with massive recurrent bleed  

OpenAIRE

Spinal subdural hematoma is a rare disorder and can be caused by abnormalities of coagulation, blood dyscrasias, lumbar puncture, trauma, underlying neoplasm, and arteriovenous malformation. We discuss an unusual case of an elderly woman who presented with spontaneous spinal subdural hematoma and developed massive rebleeding on the third day following initial evacuation of hematoma. This case illustrates that a patient with routine normal coagulation profile and adequate hemostasis can still ...

Cincu Rafael; Lorente Francisco de Asis; Rivero David; Eiras Jose; Ara Jose

2009-01-01

114

Spinal epidural hematomas  

DEFF Research Database (Denmark)

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

Laursen, J; Fode, K

1987-01-01

115

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

116

MRI evaluation of postoperative epidural hematoma after lumbar spine surgery  

International Nuclear Information System (INIS)

Pain or numbness in the lower extremities often persists after lumbar spine surgery and it is not rare for such symptoms to occur anew. We performed a retrospective comparative study in 66 cases to determine whether there were differences in post-operative symptoms based on the presence of an epidural hematoma diagnosed by postoperative MRI. An epidural hematoma was identified in 30 of the cases, but not in the other 36 cases. The incidence of buttocks pain was 40.0% in the epidural hematoma group (EH group), as opposed to 16.7% among those without an epidural hematoma (non-EH group), and the difference between the two groups was significant (P=0.034). The incidence of pain in the lower extremities was 40.0% in the EH group, as opposed to 16.7% in the non-EH group, and the difference between the two groups was significant (P=0.034). However, there were no difference between the groups in low back pain, lower extremity numbness, presence of muscular weakness, or rate of improvement in Japanese Orthopedic Association (JOA) score. All of the postoperative hematomas resolved spontaneously. The result of the study showed that some epidural hematomas cause postoperative symptoms to persist and make the short-term outcome unsatisfactory even through the long-term results are ultimately satisfactory. (author)

117

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

118

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

119

Two rare cases of intrahepatic subcapsular hematoma after laparoscopic cholecystectomy.  

Science.gov (United States)

The appearance of subcapsular liver hematoma after a laparoscopic cholecystectomy (LC) is an infrequent complication and seldom studied. Some cases have been connected to ketorolac given during surgery and after surgery. Other described causes are : hemangiomas or small iatrogenic lesions that could be aggravated by administration of ketorolac. Coagulation dysfunction like circulating heparin as seen in hemathological diseases is cause of bleeding after aggressive procedures. We describe two cases of subcapsular liver hematoma after LC, both of them have been given intravenous ketorolac and one of them had multiple myeloma. We discuss the causes and treatment of it. PMID:22131659

Minaya Bravo, Ana María; González González, Enrique; Ortíz Aguilar, Manuel; Larrañaga Barrera, Eduardo

2010-12-01

120

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

121

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 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

122

Large Intraluminal Ileal Hematoma Presenting as Small Bowel Obstruction in a Child  

Science.gov (United States)

Intraluminal small bowel hematoma has been rarely reported in children, as a rare cause of small bowel obstruction. We present a case of an intraluminal ileal hematoma presenting as small bowel obstruction in a child. Computed Tomography (CT) indicated a large intraluminal hyperdense lesion in the distal ileum as the cause of small bowel obstruction. Abdominal ultrasonography (US) showed an echogenic mass-like lesion with multiple septa in the distal ileum. Small bowel obstruction due to a complicated cystic mass was provisionally diagnosed. Histopathologic examination of the resected mass suggested a submucosal ileal hematoma. Although intraluminal small bowel hematoma is rare in children, it can present as an intraluminal cystic mass and should be considered as a rare cause of small bowel obstruction. The US and CT findings of submucosal ileal hematoma could be useful for the diagnosis of such cases in the future.

Lim, Yun Jung; Nam, So Hyun; Kim, Seon Jeong

2015-01-01

123

Hepatostomy for central hepatic hematomas  

International Nuclear Information System (INIS)

Two patients with central hepatic hematomas are presented. Hepatostomy tube drainage provided prompt healing of the cavities without complications. The technique is presented as a safe and effective alternative to hepatic resection without compromising the established principles of management

124

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

125

Spontaneous intraorbital hematoma: case report  

OpenAIRE

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 se...

Vinodan Paramanathan; Ardalan Zolnourian

2010-01-01

126

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

127

Whole Spontaneous Spinal Epidural Hematoma  

OpenAIRE

A 26-year-old male who had no underlying disease, including coagulopathy, underwent thoracotomy and bleeding control due to hemothorax. On the fifth postoperative day, paralysis of both lower limbs occurred. Urgent spine magnetic resonance imaging showed a massive anterior spinal epidural hematoma from C2 to L1 level with different signal intensities, which was suspected to be staged hemorrhage. Hematoma evacuation with decompressive laminectomy was performed. The patient's neurologic deterio...

Yoon, Kyeong-wook; Song, Jae Gyok; Ryu, Jae-wook; Kim, Young-jin

2014-01-01

128

HEMATOMA OF THE PROXIMAL NAIL FOLD. REPORT OF 41 CASES  

OpenAIRE

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...

Chang Patricia; Rodas Diaz Cecilia

2011-01-01

129

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)

130

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

131

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

132

Mutations in TRNT1 cause congenital sideroblastic anemia with immunodeficiency, fevers, and developmental delay (SIFD).  

Science.gov (United States)

Mutations in genes encoding proteins that are involved in mitochondrial heme synthesis, iron-sulfur cluster biogenesis, and mitochondrial protein synthesis have previously been implicated in the pathogenesis of the congenital sideroblastic anemias (CSAs). We recently described a syndromic form of CSA associated with B-cell immunodeficiency, periodic fevers, and developmental delay (SIFD). Here we demonstrate that SIFD is caused by biallelic mutations in TRNT1, the gene encoding the CCA-adding enzyme essential for maturation of both nuclear and mitochondrial transfer RNAs. Using budding yeast lacking the TRNT1 homolog, CCA1, we confirm that the patient-associated TRNT1 mutations result in partial loss of function of TRNT1 and lead to metabolic defects in both the mitochondria and cytosol, which can account for the phenotypic pleiotropy. PMID:25193871

Chakraborty, Pranesh K; Schmitz-Abe, Klaus; Kennedy, Erin K; Mamady, Hapsatou; Naas, Turaya; Durie, Danielle; Campagna, Dean R; Lau, Ashley; Sendamarai, Anoop K; Wiseman, Daniel H; May, Alison; Jolles, Stephen; Connor, Philip; Powell, Colin; Heeney, Matthew M; Giardina, Patricia-Jane; Klaassen, Robert J; Kannengiesser, Caroline; Thuret, Isabelle; Thompson, Alexis A; Marques, Laura; Hughes, Stephen; Bonney, Denise K; Bottomley, Sylvia S; Wynn, Robert F; Laxer, Ronald M; Minniti, Caterina P; Moppett, John; Bordon, Victoria; Geraghty, Michael; Joyce, Paul B M; Markianos, Kyriacos; Rudner, Adam D; Holcik, Martin; Fleming, Mark D

2014-10-30

133

Developmental delay and growth failure caused by a peroxisomal disorder, dihydroxyacetonephosphate acyltransferase (DHAP-AT) deficiency.  

Science.gov (United States)

We describe a 6 1/2-year-old-girl presenting with a unique phenotype and dihydroxyacetonephosphate acyltransferase (DHAP-AT) deficiency (1.6% of control activity in cultured fibroblasts), a peroxisomal enzyme deficiency which was reported previously to cause rhizomelic chondroplasia punctata (RCDP). Her phenotype is less severe than that seen in classical RCDP, and is notable for short stature, microcataracts, normal limbs, mild hypotonia, and severe mental retardation. Epiphyseal stippling is present. This patient illustrates the variability of peroxisomal disorders whereby a specific defect in peroxisomal plasmalogen synthesis may lead to several phenotypes. Her case also suggests that children presenting with deficient growth, developmental delay, and epiphyseal stippling should be screened carefully for peroxisomal disorders, with measurement of plasmalogens in addition to very long chain fatty acids. PMID:9843043

Elias, E R; Mobassaleh, M; Hajra, A K; Moser, A B

1998-11-16

134

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

135

Mutations in the human SC4MOL gene encoding a methyl sterol oxidase cause psoriasiform dermatitis, microcephaly, and developmental delay  

OpenAIRE

Defects in cholesterol synthesis result in a wide variety of symptoms, from neonatal lethality to the relatively mild dysmorphic features and developmental delay found in individuals with Smith-Lemli-Opitz syndrome. We report here the identification of mutations in sterol-C4-methyl oxidase–like gene (SC4MOL) as the cause of an autosomal recessive syndrome in a human patient with psoriasiform dermatitis, arthralgias, congenital cataracts, microcephaly, and developmental delay. This gene enco...

He, Miao; Kratz, Lisa E.; Michel, Joshua J.; Vallejo, Abbe N.; Ferris, Laura; Kelley, Richard I.; Hoover, Jacqueline J.; Jukic, Drazen; Gibson, K. Michael; Wolfe, Lynne A.; Ramachandran, Dhanya; Zwick, Michael E.; Vockley, Jerry

2011-01-01

136

Hematoma subdural espinal no traumático / Nontraumatic spinal subdural hematoma  

Scientific Electronic Library Online (English)

Full Text Available Un paciente varón de 88 años, en diálisis por insuficiencia renal crónica, presentó cervicalgia intensa y, progresivamente, déficit sensitivo motor completo dependiente de ventilación mecánica. La tomografía cervicodorsal y la resonancia magnética (RM) inicial sugirieron varios diagnósticos, entre e [...] llos hematoma subdural espinal. El tiempo de protrombina y el INR estaban ligeramente fuera del rango normal y las plaquetas eran normales. La RM contrastada hecha al cuarto día indicaba la probable presencia de un hematoma espinal. Se realizó una punción lumbar, la que confirmó in hematoma subdural espinal en fase crónica. Se evacuó 60 mL, sin obtener mejora clínica neurológica. No fue posible realizar una RM de control, debido a la condición clínica del paciente. El paciente falleció debido a una sepsis de foco respiratorio. Abstract in english A 88yearold male receiving hemodialysis for chronic renal insufficiency, developed cervical pain and progressively motor/sensitive deficit with mechanic ventilation support. Computed tomography and Magnetic resonance imaging (MRI) admission showed a variety of diagnostics, inclunding spinal subdural [...] hematoma. Prothrombin time and international normalized ratio (INR) were slightly out of range, with normal platelets amount. MRI after four days found a spinal subdural hematoma, confirmed with lumbar puncture. Sixty cc was evacuated without neurologic amelioration. A new MRI was impossible to perform. He died due a respiratory sepsis.

Carlos, Casallo-Quiliano; Dennis, Dávila-García; Catherine, Ruiz-Perea; Ronald, Pineda-García.

2014-10-01

137

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.)

138

Computed tomography of traumatic extradural hematoma  

International Nuclear Information System (INIS)

Since the introduction of CT in February, 1977, 64 cases with 67 traumatic extradural hematomas were experienced. These cases were analysed, especially with regard to CT findings of the hematomas, small extradural hematomas, and combined intracerebral hematomas, and the correlation between CT gradings and clinical outcomes. From these analyses, the following results were obtained. In 64 out of 66 hematomas, except for a case of sagittal sinus hematoma, shapes were biconvex on CT scans. The other two were planconvex and crescent. One sagittal sinus hematoma could not be diagnosed by CT alone because the highest parietal slice was not taken. In 60 acute hematomas, densities of 59 were high. The other one was hypo- or iso-dense. In six subacute hematomas, two were hypo- and iso-dense respectively. These two cases showed a marked dural enhancement for contrast material. Initial admission CT scans disclosed 35 large hematomas (> 20 mm in thickness) and 29 small ones (<= 20 mm). The other three were not clear in the initial CT scans. Among 12 small hematomas for which initial CT scans were performed within 6 hours after injury and sequential CT scans were carried out, six were shown to become larger. Three of these were operated on thereafter. Eleven cases with small hematomas on the initial CT scans were operated on. Their bleeding sources were the middle meningeal arteries in three cases, dural vein in one, fracture sites in four, and unclear in three. In 16 combined intr and unclear in three. In 16 combined intradural lesions, ten were traumatic intracerebral hematomas. Four of these intracerebral hematomas were found simultaneously with extradural ones in CT scans. Six were obviously found later than the latter. Two cases with multiple extradural hematomas were reported. After evacuation of one extradural hematoma, additional extradural and intracerebral hematomas developed at other sites in these cases. (author)

139

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

140

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

141

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.)

142

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

143

Spontaneous retropharynegeal hematoma: A case report and literature overview  

Energy Technology Data Exchange (ETDEWEB)

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

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

2014-02-15

144

Spontaneous retropharynegeal hematoma: A case report and literature overview  

International Nuclear Information System (INIS)

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

145

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

146

Medicolegal cases for spinal epidural hematoma and spinal epidural abscess.  

Science.gov (United States)

Spinal epidural hematoma and spinal epidural abscess are rare surgical emergencies resulting in significant neurologic deficits. Making the diagnosis for spinal epidural hematoma and spinal epidural abscess can be challenging; however, a delay in recognition and treatment can be devastating. The objective of this retrospective analysis study was to identify risk factors for an adverse outcome for the provider. The LexisNexis Academic legal search database was used to identify a total of 19 cases of spinal epidural hematoma and spinal epidural abscess filed against medical providers. Outcome data on trial verdicts, age, sex, initial site of injury, time to consultation, time to appropriate imaging studies, time to surgery, and whether a rectal examination was performed or not were recorded. The results demonstrated a significant association between time to surgery more than 48 hours and an unfavorable verdict for the provider. The degree of permanent neurologic impairment did not appear to affect the verdicts. Fifty-eight percent of the cases did not present with an initial deficit, including loss of bowel or bladder control. All medical professionals must maintain a high level of suspicion and act quickly. Physicians who are able to identify early clinical features, appropriately image, and treat within a 48 hour time frame have demonstrated a more favorable medicolegal outcome compared with their counterparts in filed lawsuits for spinal epidural hematoma and spinal epidural abscess cases. PMID:23276337

French, Keisha L; Daniels, Eldra W; Ahn, Uri M; Ahn, Nicholas U

2013-01-01

147

Whole spontaneous spinal epidural hematoma.  

Science.gov (United States)

A 26-year-old male who had no underlying disease, including coagulopathy, underwent thoracotomy and bleeding control due to hemothorax. On the fifth postoperative day, paralysis of both lower limbs occurred. Urgent spine magnetic resonance imaging showed a massive anterior spinal epidural hematoma from C2 to L1 level with different signal intensities, which was suspected to be staged hemorrhage. Hematoma evacuation with decompressive laminectomy was performed. The patient's neurologic deterioration was recovered immediately, and he was discharged without neurological deficits. A drug history of naftazone, which could induce a drug-induced platelet dysfunction, was revealed retrospectively. To our knowledge, this is the first report of whole spontaneous spinal epidural hematoma in a young patient, with a history of hemorrhoid medication. PMID:24967052

Yoon, Kyeong-Wook; Song, Jae Gyok; Ryu, Jae-Wook; Kim, Young-Jin

2014-06-01

148

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

149

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

OpenAIRE

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 suspi...

Balasubramanian Thiagarajan

2014-01-01

150

Postoperative course of chronic subdural hematoma  

International Nuclear Information System (INIS)

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

151

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

152

Renal Artery Embolization of Perirenal Hematoma in Hemorrhagic Fever with Renal Syndrome: A Case Report  

Energy Technology Data Exchange (ETDEWEB)

Hemorrhagic fever with renal syndrome (HFRS) is an acute viral disease characterized by fever, hemorrhage and renal failure. Among the various hemorrhagic complications of HFRS, spontaneous rupture of the kidney and perirenal hematoma are very rare findings. We report here on a case of HFRS complicated by massive perirenal hematoma, and this was treated with transcatheter arterial embolization. Hemorrhagic fever with renal syndrome (HFRS) is an acute infectious disease caused by hantavirus. HFRS is clinically characterized by fever, renal failure and hemorrhage in organs such as lung, kidney, spleen and the pituitary gland. Renal medullary hemorrhage is a well-known complication in the kidney, but spontaneous rupture of the kidney and perirenal hematoma in HFRS is rare, and patients showing continuous bleeding and massive perirenal hematoma have often been surgically treated. We report here on a case of HFRS complicated by massive perirenal hematoma, and the patient was treated with transcatheter arterial embolization. In summary, spontaneous rupture of the kidney and perirenal hematoma is a rare complication of HFRS. We report here on a case of HFRS that caused massive perirenal hematoma, and this was treated with superselective renal artery embolization.

Choi, Hee Seok; Lee, Yong Seok; Lim, Ji Hyon; Kim, Kyung Soo; Yoon, Yup [Dongguk University College of Medicine, Goyang (Korea, Republic of); Hwang, Jae Cheol [Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan (Korea, Republic of)

2007-08-15

153

Renal Artery Embolization of Perirenal Hematoma in Hemorrhagic Fever with Renal Syndrome: A Case Report  

International Nuclear Information System (INIS)

Hemorrhagic fever with renal syndrome (HFRS) is an acute viral disease characterized by fever, hemorrhage and renal failure. Among the various hemorrhagic complications of HFRS, spontaneous rupture of the kidney and perirenal hematoma are very rare findings. We report here on a case of HFRS complicated by massive perirenal hematoma, and this was treated with transcatheter arterial embolization. Hemorrhagic fever with renal syndrome (HFRS) is an acute infectious disease caused by hantavirus. HFRS is clinically characterized by fever, renal failure and hemorrhage in organs such as lung, kidney, spleen and the pituitary gland. Renal medullary hemorrhage is a well-known complication in the kidney, but spontaneous rupture of the kidney and perirenal hematoma in HFRS is rare, and patients showing continuous bleeding and massive perirenal hematoma have often been surgically treated. We report here on a case of HFRS complicated by massive perirenal hematoma, and the patient was treated with transcatheter arterial embolization. In summary, spontaneous rupture of the kidney and perirenal hematoma is a rare complication of HFRS. We report here on a case of HFRS that caused massive perirenal hematoma, and this was treated with superselective renal artery embolization

154

Spontaneous subperiosteal hematoma precipitated by anxiety attack.  

Science.gov (United States)

A 60-year-old woman presented with diplopia and left periorbital edema and pressure, which developed during an anxiety attack the previous day. Examination revealed left inferotemporal globe dystopia, periorbital edema, ecchymosis, and limitation in supraduction. Orbital MRI confirmed the diagnosis of a superior subperiosteal orbital hematoma. The patient's signs and symptoms rapidly resolved with administration of oral corticosteroids. The patient remains asymptomatic with complete resolution of orbital signs at 3-month follow-up. Subperiosteal orbital hematoma (SOH) is a rare condition in which blood accumulates between the bony orbit and separated periosteum, and is often due to blunt head trauma. Non-traumatic SOH (NTSOH) is exceedingly rare and usually associated with known coagulopathies or tendency to bleed. However, few cases of spontaneous NTSOH have been reported without any such predisposition and are thought to be caused by sudden elevations in intrathoracic and intracranial venous pressure such as vomiting, coughing, SCUBA diving, weight lifting and labor. We herein describe the presentation, radiography and outcome of a unique case of spontaneous NTSOH following an anxiety attack. PMID:24063522

Swanenberg, Irene M; Rizzuti, Allison E; Shinder, Roman

2013-12-01

155

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

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

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

2014-01-01

156

Delay in Diagnosis of Adrenal Insufficiency Is a Frequent Cause of Adrenal Crisis  

OpenAIRE

Delay of diagnosis of primary adrenal insufficiency (PAI) leads to adrenal crisis which is potentially lethal complication. The objective of our work was an assessment whether the establishment of diagnosis of adrenocortical insufficiency in Poland is so much delayed as assessed in the past. We have analysed data from 60 patients with diagnosis of PAI established in our department during the past 12 years and who are still under our care. We found that the time to diagnosis of primary adrenal...

Lucyna Papierska; Rabijewski, Micha Amp X.

2013-01-01

157

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-brain barrier, in...

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

2008-01-01

158

Contralateral acute subdural hematoma following traumatic acute subdural hematoma evacuation.  

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Contralateral acute subdural hematoma (ASDH) occurring after removal of traumatic ASDH is a rare, but nearly devastating postoperative complication. We treated a 26-year-old male who developed a contralateral ASDH shortly after craniectomy for evacuation of a traumatic ASDH. Burr-hole craniotomy was performed before decompressive craniectomy, and the bleeding source was a cortex artery within the frontal lobe contusion. Despite supportive therapy with barbiturate and mild hypothermia he expired 3 days later of brain death. Literature review suggests that the old are more susceptible to contralateral ASDH following evacuation of traumatic ASDH. Contralateral ASDH following evacuation of traumatic ASDH is a rare but potentially lethal complication, so neurosurgeons should try to detect such contralateral hematoma formation and prevent clinical deterioration. PMID:23615411

Shen, Jian; Fan, Zuoxu; Ji, Tao; Pan, Jianwei; Zhou, Yongqing; Zhan, Renya

2013-01-01

159

Spontaneous subdural hematoma of the thoracolumbar region with massive recurrent bleed  

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

Cincu Rafael

2009-01-01

160

Is human fracture hematoma inherently angiogenic?  

LENUS (Irish Health Repository)

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

Street, J

2012-02-03

161

Ogura-CMS in Chinese cabbage (Brassica rapa ssp. pekinensis) causes delayed expression of many nuclear genes.  

Science.gov (United States)

We investigated the mechanism regulating cytoplasmic male sterility (CMS) in Brassica rapa ssp. pekinensis using floral bud transcriptome analyses of Ogura-CMS Chinese cabbage and its maintainer line in B. rapa 300-K oligomeric probe (Br300K) microarrays. Ogura-CMS Chinese cabbage produced few and infertile pollen grains on indehiscent anthers. Compared to the maintainer line, CMS plants had shorter filaments and plant growth, and delayed flowering and pollen development. In microarray analysis, 4646 genes showed different expression, depending on floral bud size, between Ogura-CMS and its maintainer line. We found 108 and 62 genes specifically expressed in Ogura-CMS and its maintainer line, respectively. Ogura-CMS line-specific genes included stress-related, redox-related, and B. rapa novel genes. In the maintainer line, genes related to pollen coat and germination were specifically expressed in floral buds longer than 3mm, suggesting insufficient expression of these genes in Ogura-CMS is directly related to dysfunctional pollen. In addition, many nuclear genes associated with auxin response, ATP synthesis, pollen development and stress response had delayed expression in Ogura-CMS plants compared to the maintainer line, which is consistent with the delay in growth and development of Ogura-CMS plants. Delayed expression may reduce pollen grain production and/or cause sterility, implying that mitochondrial, retrograde signaling delays nuclear gene expression. PMID:23265314

Dong, Xiangshu; Kim, Wan Kyu; Lim, Yong-Pyo; Kim, Yeon-Ki; Hur, Yoonkang

2013-02-01

162

Delayed rearterialization unlikely leads to nonanastomotic stricture but causes temporary injury on bile duct after liver transplantation  

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Nonanastomotic strictures (NAS) are common biliary complications after liver transplantation (LT). Delayed rearterialization induces biliary injury in several hours. However, whether this injury can be prolonged remains unknown. The correlation of this injury with NAS occurrence remains obscure. Different delayed rearterialization times were compared using a porcine LT model. Morphological and functional changes in bile canaliculus were evaluated by transmission electron microscopy and real-time PCR. Immunohistochemistry and TUNEL were performed to validate intrahepatic bile duct injury. Three months after LT was performed, biliary duct stricture was determined by cholangiography; the tissue of common bile duct was detected by real-time PCR. Bile canaliculi were impaired in early postoperative stage and then exacerbated as delayed rearterialization time was prolonged. Nevertheless, damaged bile canaliculi could fully recover in subsequent months. TNF-? and TGF-? expressions and apoptosis cell ratio increased in the intrahepatic bile duct only during early postoperative period in a time-dependent manner. No abnormality was observed by cholangiography and common bile duct examination after 3 months. Delayed rearterialization caused temporary injury to bile canaliculi and intrahepatic bile duct in a time-dependent manner. Injury could be fully treated in succeeding months. Solo delayed rearterialization cannot induce NAS after LT. PMID:25406364

Liu, Yang; Wang, Jiazhong; Yang, Peng; Lu, Hongwei; Lu, Le; Wang, Jinlong; Li, Hua; Duan, Yanxia; Wang, Jun; Li, Yiming

2015-01-01

163

Myelination Delay and Allan-Herndon-Dudley Syndrome Caused by a Novel Mutation in the SLC16A2 Gene.  

Science.gov (United States)

Allan-Herndon-Dudley syndrome is an X-linked disease caused by mutations in the solute carrier family 16 member 2 (SLC16A2) gene. As SLC16A2 encodes the monocarboxylate transporter 8 (MCT8), a thyroid hormone transporter, patients with Allan-Herndon-Dudley syndrome present a specific altered thyroid hormone profile. Allan-Herndon-Dudley syndrome has been associated with myelination delay on the brain magnetic resonance imaging (MRI) of affected subjects. We report a patient with Allan-Herndon-Dudley syndrome characterized by developmental delay, hypotonia, and delayed myelination caused by a novel SLC16A2 mutation (p.L291R). The thyroid hormones profile in our patient was atypical for Allan-Herndon-Dudley syndrome. The follow-up examinations showed that the progression of the myelination was not accompanied by a clinical improvement. Our paper suggests that SLC16A2 mutations should be investigated in patients with myelination delay even when the thyroid function is not conclusively altered. PMID:25380603

Piana, Roberta La; Vanasse, Michel; Brais, Bernard; Bernard, Genevieve

2014-11-01

164

MR imaging and clinical findings of spontaneous spinal epidural hematoma  

Energy Technology Data Exchange (ETDEWEB)

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

Kim, Sam Soo [Seoul City Boramae Hospital, Seoul (Korea, Republic of); Han, Moon Hee; Kim, Hyun Beom [College of Medicine, Seoul National University, Seoul (Korea, Republic of)] [and others

2000-01-01

165

MR imaging and clinical findings of spontaneous spinal epidural hematoma  

International Nuclear Information System (INIS)

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

166

Interventricular septum hematoma during cineventriculography  

OpenAIRE

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 th...

Melzer Christoph; Rutsch Wolfgang; Knebel Fabian; Eddicks Stephan; Elgeti Thomas; Grohmann Andrea; Baumann Gert; Borges Adrian C

2008-01-01

167

Ethmoid Hematoma of the Equine  

OpenAIRE

Two cases of ethmoid hematoma of the equine are reported. Clinically both horses had intermittent unilateral epistaxis unassociated with exercise. In one horse, diagnosis was based on the use of an endoscope for visualization and for biopsy of a mass associated with the ethmoid turbinates. In the other horse, exploratory trephination of the posterior maxillary sinus was necessary to obtain a diagnostic biopsy specimen. Radiography was helpful in the diagnosis of one case. Surgical removal of ...

Etherington, W. G.; Vasey, J. R.; Horney, F. D.

1982-01-01

168

Computerized tomography in chronic subdural hematoma  

International Nuclear Information System (INIS)

In this report, the computerized tomography (CT) of chronic subdural hematoma was studied. Our experience was based on 22 patients with chronic subdural hematoma, verified by surgery. The results of the analysis of 16 cases excluded infant cases and post-operative cases. (1) In 8 cases, the locations of the hematoma were bilateral, and in 8 cases, unilateral. (2) The CT findings of the hematomas were classified into 4 types: low density (9 cases), iso-density (2 cases), mixed density (2 cases), and high density (3 cases). (3) Contrast enhancement in the capsule and the content of hematoma was indicated by the Marginal Curve. In infant cases (4), it is difficult to diagnose by the CT scan alone. We concluded, however, that CT was very useful in diagnosing chronic subdural hematoma. (author)

169

The retro placental hematoma and fetal death in utero: About 49 cases and review of the literature  

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Full Text Available The Retro Placental Hematoma (RPH or placental abruption untimely normally inserted paroxysmal is an accident that threatens maternal and fetal prognosis. It is a major emergency obstetric pathology and remains the second leading cause of maternal mortality after postpartum haemorrhage. It is actually very difficult to have an accurate evaluation the frequency of the HRP because it requires a complete table including Pathologists; or simple macroscopic or microscopic findings; or purely clinical diagnosis for some. Its occurrence requires appropriate resuscitation and adapted care to improve the prognosis. We report our study of 49 cases the HRP hospitalized in Obstetrics and Gynecology of Instruction Military Hospital Mohamed V in Rabat, diagnosed on a suggestive clinical picture and the presence of hematoma after examining the issue. This is a descriptive and comparative retrospective study over a period of one year. This study compared two groups: with HRP feotale death in utero and HRP without fetal death in utero. This study aims to evaluate neonatal mortality and maternal morbidity related to RPH and therapeutic modalities. This pathology formerly known pathology multiparous tends to reach more and more heifer. The important blood loss and delay the expulsion worse prognosis causing severe maternal morbidity hence the need to expand the indications for cesarean of retro placental hematoma regardless of the fetal state. Our study aims to contribute to reduce mortality and morbidity Fetomaternal by improving our work is stepping up efforts for a rapid decision-making, and we must educate what especially pregnant women of the risk factors to see from the beginning of symptoms. The pregnancy monitoring, early diagnosis of RPH, an obstetrical treatment adequate, and a resuscitation well driving can improve the prognosis of this disease.

Saida Mezane

2013-06-01

170

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

171

Spontaneous renal hematoma - a case report  

International Nuclear Information System (INIS)

Spontaneous pararenal hematoma is a rare pathology most frequently coexisting with renal tumours, vascular anomalies and inflammatory processes. In some cases one cannot establish its etiology. The paper describes a case of a 58-year-old man with a spontaneous pararenal hematoma and presents a diagnostic algorithm. Ultrasonography and CT play an important role in diagnostics of spontaneous pararenal haemorrhages. These methods enable a precise evaluation of size and location of hematoma and its evolution. (author)

172

Traumatic bilateral intraorbital (subperiosteal) hematoma associated with epidural hematoma: case report Hematoma intraorbitário bilateral traumático associado a hematoma epidural: relato de caso  

OpenAIRE

Extradural hematoma (EDH) is a frequent lesion, with an incidence varying from 0.2 to 6% in patients admitted to hospital due to traumatic head injury. The higher incidence is found in patients with more severe injuries. The association of EDH with subperiosteal intraorbital hematomas is rarely reported, and we were not able to find in the literature any report of traumatic bilateral intraorbital hematomas and EDH. We report this case of a 32 year-old man with bilateral intraorbital (subperio...

Leodante Batista da Costa Jr; Agustinho de Andrade; José Gilberto de Bastos Henriques; Anderson Finotti Cordeiro; Cícero do Juazeiro Job Maciel

2003-01-01

173

Multiple Causes for Delay in Arrival at Hospital in Acute Stroke Patients in Aydin, Turkey  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract This descriptive, hospital-based study, performed in western Turkey, was designed to assess the level of pre-hospital delay and reasons for such delay in acute stroke patients, taking into consideration certain factors such as socioeconomic status, availability of transport options at onset of symptoms. Data were collected from hospital records, and a questionnaire was administered that included questions about socio-demographics, self-reported risk factors and questions related to hospital arrival. The rate of patients arriving at the hospital more than 3 hours after symptom onset was found to be 31.6% for this study. Approximately 1/3 of patients delayed going to the hospital because they were waiting for symptoms to go away while 1/3 of patients were not aware of the importance of seeking immediate medical help. There was a significant relationship between the use of ambulance transportation and length of time before arrival at the hospitals, though there was no statistically significantly relationship between the existence of stroke risk factors and hospital arrival delay. These results will likely be helpful to health care decision makers as they develop a model for stroke health care and community based training.

Evci E Didem

2008-05-01

174

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

OpenAIRE

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...

Patricia Chang; Monica Vanesa Vásquez Acajabón

2014-01-01

175

Massive sublingual hematoma secondary to anticoagulant therapy complicated by a traumatic denture: a case report  

OpenAIRE

Abstract Introduction Sublingual hematoma secondary to excessive anticoagulation is a rare but potentially fatal condition, and few cases have been documented in the literature. Case presentation We report the case of a 73-year-old Caucasian woman who attended our Accident and Emergency department with massive sublingual hematoma causing superior displacement of the tongue. The condition was found to be the result of an elevated international normalized ratio, further complicated by a traumat...

Puri Anchal; Nusrath Muzzammil A; Harinathan Deepak; Lyall Jamie

2012-01-01

176

Spontaneous resolution of paraparesis because of acute spontaneous thoracolumbar epidural hematoma  

OpenAIRE

Symptomatic spontaneous spinal epidural hematoma(SSEH) is an uncommon cause of cord compression that commonly is considered as an indication for emergent surgical decompression. We aimed to investigate a patient with a SSEH that completely resolved clinically and radiographically, without surgical treatment. The patient presented three days after the sudden onset of back pain, numbness, and weakness. Magnetic Resonance Imaging (MRI) revealed a posterior thoracolumbar epidural hematoma extendi...

Gundag, M.; Seyithanoglu, M. H.; Dogan, K.; Kitis, S.; Ozkan, N.

2012-01-01

177

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

OpenAIRE

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, ...

Satomi Jyunichiro; Ikeyama Shizuo; Fukunaga Naoto; Satoh Koichi

2009-01-01

178

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

Science.gov (United States)

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

Miller, Jimmy D; Nader, Remi

2014-06-01

179

Contralateral development of chronic subdural hematoma after evacuation of chronic subdural hematoma. A case report.  

Science.gov (United States)

Contralateral acute complications such as acute epi/subdural hematomas can be encountered after evacuation of a chronic subdural hematoma, though they are rare. We found only one case of chronic subdural hematoma following the surgery for contralateral chronic subdural hematoma, have been published in English language literature. A 73-year-old male admitted to our hospital with a right-sided subdural hematoma. The subdural hematoma was evacuated through a burr-hole. A left-sided subdural higroma appeared after operation and turned into classical subdural hematoma in the course of time. After evacuation of contralateral chronic subdural hematoma, the patient recovered completely. All stages of the development of contralateral chronic subdural hematomas were shown by serial computed tomograms. It was suggested that traumatic chronic subdural hematomas develop from mostly subdural higromas. If contralateral subdural higroma is seen after surgical evacuation of a chronic subdural hematoma, the possibility of development of contralateral chronic subdural hematoma must be kept on mind. PMID:17019388

Sucu, H Kamil; Gökmen, M; Bezircioglu, H; Tekta?, S

2006-09-01

180

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

181

Unoperated giant cerebellar hematoma: Case report  

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

Gezen, F.

2005-01-01

182

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.)

183

An Experimental Study on the Effect of Subperiosteal Transplantation of Fracture Site Hematoma: Focus on the Scintigraphic Detection  

International Nuclear Information System (INIS)

It has been reported that hematoma is one of the most crucial factors in fracture healing since callus formation is disturbed by washing out the hematoma near a fracture site. However, it is not clear why the hematoma is important and how it plays a role during the fracture healing. In order to investigate the role of hematoma in the process of fracture healing, the osteogenic potential by subperiosteal transplantation have been studied. Experimental fractures by operation were made at the mid-shaft of the tibia in New Zealand white rabbits. Removal of hematoma at the fracture site was done after 2 and 3 days from experimental fracture, and the removed hematoma was transplanted into the subperiosteal area at the mid-shaft of the ulna of each rabbit. As control groups, we have performed 3 different procedures 1) the hematoma was transplanted into the muscular layers at the thigh and forearm; 2) autologous blood clots were transplanted into the subperiosteal area of the ulna; and 3) sham operation without a transplantation into the subperiosteal area. After transplantation, serial bone scintigraphy and simple radiography were performed at 4 days, 1 week, and 2 weeks to detect an abnormality. The results of bone scintigraphy were positive in 5 of 6 experimental group. However, all in three control groups were negative. Histological observation of the positive bone revealed new bone formation with trabeculation. These results suggest the hematoma in fracture site has osteest the hematoma in fracture site has osteogenic potential in the subperiosteal area which can be demonstrable by bone scintigraphy and histologic findings. Therefore, it is considered that hematoma of the fracture site plays an important role in the process of fracture healing. Further biochemical investigation using various experimental models is mandatory to apply this preliminary result to the treatment of clinical delayed union or nonunion.

184

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

185

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

Directory of Open Access Journals (Sweden)

Full Text Available 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.

Sekmenli T et al.

2010-09-01

186

The causes of delays on government housing construction projects in Botswana  

OpenAIRE

The spate of delays on Botswana government housing construction projects has raised concern – not only to the government but also to the general public. The conditions of contract applicable to the Botswana government building contracts make allowance for extension of construction periods under certain circumstances. Any such circumstances not dealt with by the conditions of contract, do not warrant extension of the construction period and is referred to as a circumstance whi...

Libetwa, Erick Kombuwa

2006-01-01

187

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.)

188

Language recovery after acute intracerebral hematoma in temporoparietal region.  

Science.gov (United States)

Arteriovenous malformations are the most common cause of spontaneous intracerebral hemorrhages in older children. Intracerebral hematoma can cause serious lasting neurologic, cognitive, and language deficits, or even possible death. We present the case of a 16-year-old boy who had language impairments after suffering a large hemorrhagic stroke in the left temporoparietal region. All language components, verbal and nonverbal communication, reading, and writing, were found to be affected. These impairments were expected as they are characteristic of the location of the hematoma. After a year of speech language rehabilitation, there was an almost complete recovery of language skills. Quick diagnosis and adequate therapeutic interventions are important to diminish the influence of intracerebral hemorrhage on cognitive and language functions in children. PMID:24532808

Kolundži?, Zdravko; Klari?, Andrea Šimi?; Krip, Marija; Gotovac, Nikola; Banoži?, Ljerka; Vodanovi?, Dinah

2015-01-01

189

An unusual cause of intestinal obstruction in an adolescent: a case report  

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Full Text Available A 15-year-old boy presented with intestinal obstruction two weeks following a blunt abdominal trauma. He had progressive bilious vomiting without abdominal distension or peritonitis. The contrast computed tomography (CT scan of the abdomen provided the definitive diagnosis: there was an obstructing duodenal hematoma, which might have been slowly progressing or have arisen from secondary hemorrhage after the initial injury. The boy remained stable over a ten-day period of conservative treatment, and his obstructive symptoms and signs were resolved completely. A follow-up CT scan of the abdomen (16 days after admission showed an almost complete resolution of the hematoma. Delayed duodenal hematoma causing intestinal obstruction has been reported rarely in previous literature. Occasionally a significant secondary hemorrhage resulting in intestinal obstruction can become life threatening. Clinical follow-up is paramount after initial recovery. Although conservative treatment suffices in most cases, the surgeon should be wary of the need for definitive surgical intervention if there is evidence of ongoing acute hemorrhage or of the obstructing hematoma failing to resolve. Laparoscopic drainage of the hematoma provides optimistic results for patients failing conservative management.

Wing-Kin Kwok

2009-06-01

190

Antiplatelet antibody may cause delayed transfusion-related acute lung injury  

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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

191

Hematoma da aorta ascendente Intramural hematoma of the ascending aorta  

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Full Text Available É relatado o caso de um paciente do sexo masculino com idade de 71 anos, dando entrada no pronto-atendimento com palidez cutaneomucosa, acompanhada de hipertensão arterial sistêmica e dor torácica. Na investigação diagnóstica não foi evidenciada alteração compatível com isquemia miocárdica aguda. A radiografia de tórax evidenciava alargamento importante do mediastino. Ao ecocardiograma, a aorta ascendente media 47 mm, no nível do tronco pulmonar. Um dia após o eco, o paciente foi submetido a exame de ressonância magnética (RNM, quando se evidenciou aorta ascendente de 62 mm, sem evidenciar fluxo em falsa luz ou "flap" intimal, mas mostrando hematoma intramural da aorta ascendente, estendendo-se da raiz da aorta até um terço proximal do arco aórtico. Procedeu-se a correção cirúrgica, sendo realizada substituição da aorta ascendente e parte do arco aórtico (hemiarco, com preservação da valva aórtica pela suspensão das comissuras. Paciente evolui bem sem intercorrência, recebendo alta no nono dia de pós-operatório. Enfatizamos nesse relato de caso a semelhança do quadro clínico do hematoma intramural da aorta com o quadro de dissecção da aorta, a importância de se estabelecer diagnóstico correto e o melhor tratamento.It is reported the case of a 71 year old male patient admitted to the emergency service pale and with systemic arterial hypertension and thoracic pain. In the diagnostic investigation, there was no evidence of compatible with acute myocardial ischemia. The thorax x-ray showed important enlargement of the mediastinum. In the echocardiogram the ascending aorta measured 47mm, at the level of the pulmonary artery. One day after the echo, submitted to exam of magnetic resonance (RNM, the ascending aorta had a diameter of 62mm, without false lumen flow or intimal "flap", but showing intramural hematoma envolving the ascending aorta and the proximal portion of the aorta. It was submitted to the surgical correction, being accomplished by resection of the ascending aorta and part of the aortic arch (hemiarch, with preservation of the aortic valve with suspension of the comissures. The patient had ununventfull recovery, being discharged in the 9th postoperative day. We emphasized the similarity of the clinical presentation of the intramural hematoma of the aorta with that of aortic dissection, the importance of establishing correct diagnosis and the best treatment.

Noedir Antônio G. Stolf

2006-12-01

192

Hematoma da aorta ascendente / Intramural hematoma of the ascending aorta  

Scientific Electronic Library Online (English)

Full Text Available É relatado o caso de um paciente do sexo masculino com idade de 71 anos, dando entrada no pronto-atendimento com palidez cutaneomucosa, acompanhada de hipertensão arterial sistêmica e dor torácica. Na investigação diagnóstica não foi evidenciada alteração compatível com isquemia miocárdica aguda. A [...] radiografia de tórax evidenciava alargamento importante do mediastino. Ao ecocardiograma, a aorta ascendente media 47 mm, no nível do tronco pulmonar. Um dia após o eco, o paciente foi submetido a exame de ressonância magnética (RNM), quando se evidenciou aorta ascendente de 62 mm, sem evidenciar fluxo em falsa luz ou "flap" intimal, mas mostrando hematoma intramural da aorta ascendente, estendendo-se da raiz da aorta até um terço proximal do arco aórtico. Procedeu-se a correção cirúrgica, sendo realizada substituição da aorta ascendente e parte do arco aórtico (hemiarco), com preservação da valva aórtica pela suspensão das comissuras. Paciente evolui bem sem intercorrência, recebendo alta no nono dia de pós-operatório. Enfatizamos nesse relato de caso a semelhança do quadro clínico do hematoma intramural da aorta com o quadro de dissecção da aorta, a importância de se estabelecer diagnóstico correto e o melhor tratamento. Abstract in english It is reported the case of a 71 year old male patient admitted to the emergency service pale and with systemic arterial hypertension and thoracic pain. In the diagnostic investigation, there was no evidence of compatible with acute myocardial ischemia. The thorax x-ray showed important enlargement o [...] f the mediastinum. In the echocardiogram the ascending aorta measured 47mm, at the level of the pulmonary artery. One day after the echo, submitted to exam of magnetic resonance (RNM), the ascending aorta had a diameter of 62mm, without false lumen flow or intimal "flap", but showing intramural hematoma envolving the ascending aorta and the proximal portion of the aorta. It was submitted to the surgical correction, being accomplished by resection of the ascending aorta and part of the aortic arch (hemiarch), with preservation of the aortic valve with suspension of the comissures. The patient had ununventfull recovery, being discharged in the 9th postoperative day. We emphasized the similarity of the clinical presentation of the intramural hematoma of the aorta with that of aortic dissection, the importance of establishing correct diagnosis and the best treatment.

Noedir Antônio G., Stolf; Anderson, Benício; Gustavo I., Judas; Roberto Rocha Correia Veiga, Giraldez; Wilson, Mathias Júnior.

2006-12-01

193

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

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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

194

Spontaneous spinal epidural hematoma: a case report  

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Full Text Available Spontaneous spinal epidural hematoma is a rare clinical disorder that might result in permanant neurological deficit and death when left untreated. We present a 34 year old male admitted to our emergency department with back pain and paraplegia, and being diagnosed with spontaneous spinal epidural hematoma.

Selami Cagatay ONAL

2010-01-01

195

MRI findings of traumatic spinal subdural hematoma  

International Nuclear Information System (INIS)

To describe the MR imaging findings of traumatic spinal subdural hematoma. We retrospectively reviewed the MR images of six patients, with symptoms of acute spinal cord or cauda equena compression after trauma, together with spinal subdural hematoma. We analyzed the extent, location, configuration and signal intensity of the lesions. In five of sex cases, hematomas were distributed extensively throughout the thoracolumbosacral or lumbosacral spinal levels. In five cases they were located in the dorsal portion of the thecal sac, and in one case, in the ventral portion. On axial images, hematomas showed a concave or convex contour, depending on the amount of loculated hematoma. A lobulated appearance was due to limitation of free extension of the hematoma within the subdural space at the lateral sites (nerve root exist zone) at whole spine levels, and at the posteromedian site under lumbar 4-5 levels. In cases of spinal subdural hematoma, the lobulated appearance of hematoma loculation in the subdural space that bounds the lateral sites at al spinal levels and at the posteromedian site under L4-5 levels is a characteristic finding. (author)

196

Polyarteritis nodosa presenting with spontaneous perirenal hematoma  

OpenAIRE

Spontaneous perirenal hematoma following ruptured microaneurysm is an unusual but serious complication of polyarteritis nodosa. We describe a young male who presented with spontaneous perirenal hematoma and was subsequently diagnosed to have polyarteritis nodosa. He was managed with immunosuppressive medications with no recurrence of symptoms.

Mukhopadhyay, P.; Rathi, M.; Kohli, H. S.; Jha, V.; Gupta, K. L.; Sakhuja, V.

2012-01-01

197

Multiple cerebral hematoma and viral encephalitis  

International Nuclear Information System (INIS)

A patient with the clinical diagnosis of brain abcess presented with a CT brain scan showing an intracerebral hematoma. Subsequently bilateral spontaneous hyperdense lesions appeared. Autopsy showed the typical findings of viral encephalitis probably due to herpes simplex. It is stressed that the differential diagnosis of intracerebral hematoma includes viral encephalitis in the proper clinical setting. (orig.)

198

Multiple cerebral hematoma and viral encephalitis  

Energy Technology Data Exchange (ETDEWEB)

A patient with the clinical diagnosis of brain abcess presented with a CT brain scan showing an intracerebral hematoma. Subsequently bilateral spontaneous hyperdense lesions appeared. Autopsy showed the typical findings of viral encephalitis probably due to herpes simplex. It is stressed that the differential diagnosis of intracerebral hematoma includes viral encephalitis in the proper clinical setting.

Zegers de Beyl, D.; Noterman, J.; Martelart, A.; Baleriaux, D.; Flament-Durand, J.

1980-08-01

199

Multiple cerebral hematoma and viral encephalitis.  

Science.gov (United States)

A patient with the clinical diagnosis of brain abcess presented with a CT brain scan showing an intracerebral hematoma. Subsequently bilateral spontaneous hyperdense lesions appeared. Autopsy showed the typical findings of viral encephalitis probably due to herpes simplex. It is stressed that the differential diagnosis of intracerebral hematoma includes viral encephalitis in the proper clinical setting. PMID:7422119

Zegers de Beyl, D; Noterman, J; Martelart, A; Flament-Durand, J; Baleriaux, D

1980-08-01

200

Traumatic subdural hematoma in the lumbar spine.  

Science.gov (United States)

Traumatic spinal subdural hematoma is rare and its mechanism remains unclear. This intervention describes a patient with mental retardation who was suffering from back pain and progressive weakness of the lower limbs following a traffic accident. Magnetic resonance imaging of the spine revealed a lumbar subdural lesion. Hematoma was identified in the spinal subdural space during an operation. The muscle power of both lower limbs recovered to normal after surgery. The isolated traumatic spinal subdural hematoma was not associated with intracranial subdural hemorrhage. A spinal subdural hematoma should be considered in the differential diagnosis of spinal cord compression, especially for patients who have sustained spinal trauma. Emergency surgical decompression is usually the optimal treatment for a spinal subdural hematoma with acute deterioration and severe neurological deficits. PMID:21943822

Song, Jenn-Yeu; Chen, Yu-Hao; Hung, Kuang-Chen; Chang, Ti-Sheng

2011-10-01

201

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 | Languages: English, Portuguese, Spanish 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

202

Spontaneous cervical epidural hematoma: Report of a case managed conservatively  

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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

203

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

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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

204

Delayed neurotoxicity caused by a single massive dose of dichlorvos to adult hens.  

Science.gov (United States)

A moderate neuropathic response was obtained in hens 2 weeks after being given a single massive s.c. dose of dichlorvos (100 mg/kg of active ingredient in a commercial 50% formulation). 1 day after dosing inhibition of neurotoxic esterase in peripheral nerve was 79-90%, in spinal cord 70-81% and in brain 89-92%. It is unlikely that repeated exposure of man to dichlorvos could cause neuropathy except at doses causing severe cholinergic effects at every exposure. PMID:7302988

Caroldi, S; Lotti, M

1981-10-01

205

Cortical enhancement in chronic subdural hematoma  

International Nuclear Information System (INIS)

In the CT findings of chronic subdural hematoma, brain enhancement adjacent to a subdural hematoma was seen occasionally after the injection of a contrast material. The authors called this finding ''cortical enhancement'', and 35 cases of chronic subdural hematoma were studied concerning cortical enhancement in relation to age, clinical signs and symptoms, hematoma density, and volume of the hematoma. Eight cases out of the 35 were subjected to measurements of the regional cerebral blood flow preoperatively by the method of the carotid injection of Xe-133. Cortical enhancement was apt to be seen in the cases which revealed intracranial hypertension or disturbance of consciousness, in isodensity or mixed-density hematomas, and in huge subdural hematomas. There was no specific correlation with age distribution. The pathogenesis of cortical enhancement seemed to be the result of cerebral compression with an increase in the contrast material per unit of volume and a prolonged venous outflow from the hemisphere, but no characteristic feature was detected in the average regional cerebral blood flow in our cases. (author)

206

Surgical management of traumatic acute subdural hematoma in adults: a review.  

Science.gov (United States)

Traumatic acute subdural hematoma (ASDH) is a major clinical entity in traumatic brain injury (TBI). It acts as a space occupying lesion to increase intracranial pressure, and is often complicated by co-existing lesions, and is modified by cerebral blood flow (CBF) changes, coagulopathy, and delayed hematomas. Because of its complicated pathophysiology, the mortality of ASDH is still remaining high. In this review article, its epidemiology, pathophyiology, surgical treatment, and salvage ability are described. With regard to epidemiology, as the population ages, growing number of elderly patients with ASDH, especially patients with prehospital anticoagulant and antiplatelets, increase. Concerning pathophysiology, in addition to well-known initial intracranial hypertension and subsequent ischemia, delayed hyperemia/hyperperfusion, or delayed hematoma is being recognized frequently in recent years. However, optimal treatments for these delayed phenomenons have not been established yet. With regard to surgical procedures, all of craniotomy, decompressive craniectomy, and initial trephination strategies seem to be effective, but superiority of each procedure have not been established yet. Since Glasgow Coma Scale (GCS) scores, age, papillary reaction, and computed tomographic findings are strongly correlated to outcome, each factor has been investigated as an indicator of salvage ability. None of them, however, has been defined as such one. In future studies, epidemiological changes as population ages, management of delayed pathophysiology, superiority of each surgical procedures, and salvage ability should be addressed. PMID:25367584

Karibe, Hiroshi; Hayashi, Toshiaki; Hirano, Takayuki; Kameyama, Motonobu; Nakagawa, Atsuhiro; Tominaga, Teiji

2014-01-01

207

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

208

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 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

209

Calcification of Cryopreserved Arterial Graft Causing Delayed Obstruction of Portal Vein Flow After Liver Transplant.  

Science.gov (United States)

In patients with biliary atresia, portal vein problems may cause challenges for liver transplant. Interposition grafts have been used for vascular anastomoses in transplant recipients with varied success. A cryopreserved iliac artery graft was used for the reconstruction of the portal vein in a 29-month-old infant with biliary atresia. At 17 months after transplant, she developed upper gastrointestinal bleeding that was caused by portal vein occlusion because of vascular calcifications in the graft. Upper gastrointestinal endoscopy showed esophageal varices with fresh bleeding, and the varices were band ligated. At 3 months after the bleeding episode, the patient was asymptomatic and biochemical tests were normal. In summary, liver transplant with cryopreserved iliac artery graft may be complicated by calcifications and portal vein occlusion, and caution is advised in using this graft material for portal vein anastomoses. PMID:24919040

Cimsit, Bayindir; Yankol, Yucel; Mecit, Nesimi; Kanmaz, Turan; Acarli, Koray; Kalayoglu, Munci

2014-06-01

210

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

Science.gov (United States)

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

Ehrich, M; Correll, L; Veronesi, B

1997-07-01

211

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

212

Mutations in the human SC4MOL gene encoding a methyl sterol oxidase cause psoriasiform dermatitis, microcephaly, and developmental delay.  

Science.gov (United States)

Defects in cholesterol synthesis result in a wide variety of symptoms, from neonatal lethality to the relatively mild dysmorphic features and developmental delay found in individuals with Smith-Lemli-Opitz syndrome. We report here the identification of mutations in sterol-C4-methyl oxidase–like gene (SC4MOL) as the cause of an autosomal recessive syndrome in a human patient with psoriasiform dermatitis, arthralgias, congenital cataracts, microcephaly, and developmental delay. This gene encodes a sterol-C4-methyl oxidase (SMO), which catalyzes demethylation of C4-methylsterols in the cholesterol synthesis pathway. C4-Methylsterols are meiosis-activating sterols (MASs). They exist at high concentrations in the testis and ovary and play roles in meiosis activation. In this study, we found that an accumulation of MASs in the patient led to cell overproliferation in both skin and blood. SMO deficiency also substantially altered immunocyte phenotype and in vitro function. MASs serve as ligands for liver X receptors ? and ?(LXR? and LXR?), which are important in regulating not only lipid transport in the epidermis, but also innate and adaptive immunity. Deficiency of SMO represents a biochemical defect in the cholesterol synthesis pathway, the clinical spectrum of which remains to be defined. PMID:21285510

He, Miao; Kratz, Lisa E; Michel, Joshua J; Vallejo, Abbe N; Ferris, Laura; Kelley, Richard I; Hoover, Jacqueline J; Jukic, Drazen; Gibson, K Michael; Wolfe, Lynne A; Ramachandran, Dhanya; Zwick, Michael E; Vockley, Jerry

2011-03-01

213

Pontine tegmentum hematoma: report of a case with pure hemiplegia / Hematoma do tegmento pontino: relato de caso com hemiplegia pura  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Os autores relatam o caso um paciente de sexo masculino de 50 anos de idade com hipertensão arterial sistêmica que apresentava um hematoma pontino. A única manifestação clínica era caracterizada por síndrome piramidal pura sem outros sinais ou sintomas neurológicos. A ausência de acometimento de out [...] ras estruturas do tronco cerebral neste caso decorre possivelmente de variação da anatomia vascular do segmento pontino do tronco cerebral e constitui evento pouco comum em hematomas dessa região. Abstract in english The authors report the case of a 50 year-old hypertensive male patient with a pontine hematoma. The clinical presentation was characterized by pure pyramidal deficit signs (no other signs or symptoms were present). A pure hemiplegia syndrome, although common in supratentorial lesions, is considered [...] to be a rare event in pontine vascular lesions. The pathophysiologic mechanisms of these neurological findings are unclear. The exclusive involvement of the pyramidal tract in this case is likely due to a variation in the vascular anatomy of the pons but, in some cases, a vascular malformation may be the cause.

ANTONIO CARLOS DE PÁDUA, MILAGRES; FLÁVIO, ALÓE; JOÃO CARLOS PAPATERRA, LIMONGI.

1998-03-01

214

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

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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

215

Acute cervical epidural hematoma: case report / Hematoma epidural cervical agudo: relato de caso  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Paciente de 74 anos acordou à noite sentindo fortes dores na região da nuca acompanhadas de ansiedade e desconforto torácico e respiratório. A internação emergencial em clinica cardiológica não demonstrou problemas cardíacos. Com a progressão do quadro neurológico traduzida por quadriplegia severa f [...] oi realizada uma punção lombar para afastar hipótese de meningite, sendo retirados cerca de 20 ml de liquor. Trinta minutos imediatamente após a punção lombar foi observada completa remissão do déficit neurológico. Transferido para um hospital geral a tomografia computadorizada demonstrou extenso hematoma epidural espinal em nivel C4/C5 com extensão a C7/Th1, bem como hemangioma do sexto corpo vertebral (C6). A ressonância magnética demonstrou as mesmas lesões. Observando-se os parâmetros clínicos e neurológicos, optou-se por tratamento conservador. Dezoito meses após este episódio o paciente se apresenta normal, sem deficit residual. Neste artigo, relatamos um caso de completa recuperação de déficit neurológico devido a hematoma epidural espinal, após forma não usual de descompressão medular. Abstract in english A 74 year-old patient with a nocturnal onset of neck and chest pain was brought to an emergency clinic. Physical examination and cardiac assessment were normal. Three hours after the addmittance, a flaccid paralysis of the four limbs supervened. Suspecting of an unusual onset of central nervous syst [...] em infection, a lumbar puncture was performed, yielding 20 ml of normal cerebrospinal fluid. Thirty oinutes after the puncture, the patient completely regained neurological funcion. He was then referred to a General Hospital where a computed tomography (CT) scan was done showing a large cervical epidural bleeding in the posterolateral region of C4/C5 extending to C7/Th1, along with a C6 vertebral body hemangioma. A magnetic resonance imaging revealed the same CT findings. A normal selective angiography of vertebral arteries, carotid arteries and thyreocervical trunk was carried out. Spontaneous spinal epidural hematoma (ASSEH) is a rare but dramatic cause of neurological impairment. In this article we report a fortunate case of complete recovery after an unusual spine cord decompression. We also review the current literature concerning diagnosis and treatment of ASSEH.

GUILHERME, BORGES; LEONARDO, BONILHA; MARCOS VINICIUS CALFAT, MALDAUM; JOSÉ RIBEIRO, MENEZES; VERÔNICA, ZANARDI.

2000-09-01

216

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.

217

Acute cervical epidural hematoma: case report  

Directory of Open Access Journals (Sweden)

Full Text Available A 74 year-old patient with a nocturnal onset of neck and chest pain was brought to an emergency clinic. Physical examination and cardiac assessment were normal. Three hours after the addmittance, a flaccid paralysis of the four limbs supervened. Suspecting of an unusual onset of central nervous system infection, a lumbar puncture was performed, yielding 20 ml of normal cerebrospinal fluid. Thirty oinutes after the puncture, the patient completely regained neurological funcion. He was then referred to a General Hospital where a computed tomography (CT scan was done showing a large cervical epidural bleeding in the posterolateral region of C4/C5 extending to C7/Th1, along with a C6 vertebral body hemangioma. A magnetic resonance imaging revealed the same CT findings. A normal selective angiography of vertebral arteries, carotid arteries and thyreocervical trunk was carried out. Spontaneous spinal epidural hematoma (ASSEH is a rare but dramatic cause of neurological impairment. In this article we report a fortunate case of complete recovery after an unusual spine cord decompression. We also review the current literature concerning diagnosis and treatment of ASSEH.

BORGES GUILHERME

2000-01-01

218

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

OpenAIRE

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

Brach Del Prever, Elena Maria

2012-01-01

219

Clinical study of treatment of cerebral hemorrhage: remove the intracranial hematoma with a minimal invasive procedure  

International Nuclear Information System (INIS)

Objective: To study the feasibility and factors of minimal invasive intracranial hematoma removing procedure as a treatment of cerebral hemorrhage. Methods: From May, 2000 to September, 2003, 33 patients with intracerebral hemorrhage underwent minimal invasive intracranial hematoma removing procedure and from May, 1997 to September, 2000, 27 patients with cerebral hemorrhage received conservative treatments. Two groups were compared and analyzed. The quantity of hemorrhage and the indication of procedure were also studied. Results: State of an illness has no significant difference between the two groups (P<0.05). The rate of recovery were higher in the group undergoing the procedure (57.6%) than in the control group (14.8%) (P<0.05). The rate of handicap were lower in the procedure group (24.0%) than in the control group (60.0%) (P<0.05). The mortality were also lower in the procedure group (24.2%) than in the control group (63.0%) (P<0.01). In the control group no patient with a hematoma larger than 70 ml survived. In the procedure group patients with hematoma larger than 70 ml had less chance of survival than the other patients (P<0.01). The mortality rate were respectively 50%, 5.6%, 33.3% when the procedure was done in super early, early, delayed stage. The mortality rate was higher in the super early stage than in early stage (P<0.05). Conclusion: The minimal invasive intracranial hematoma removing procedure has a better clinical outcome than the conservative treclinical outcome than the conservative treatment. The procedure reduces obviously mortality rate and increase the quality of survival. Multiple puncturing and draining or craniotomy are recommended to remove huge hematoma. The earlier treatment brings better clinical effects. This technique is simple, less invasive and provides good clinical outcome, which is worth recommendation

220

[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

221

Nasolacrimal sac hematoma masquerading as an orbital mass.  

Science.gov (United States)

A distended or infiltrated nasolacrimal sac can present as a mass in the medial orbit. We present a case of aspergillus sinusitis complicated by intractable epistaxis after debridement of the nasal septum, which caused pain and rapid distension of the nasolacrimal sac. The clinical and radiographic appearance of the distended nasolacrimal sac mimicked the appearance of an orbital mass and orbital extension of aspergillosis. After embolization of the maxillary artery to control the epistaxis, the nasolacrimal sac hematoma spontaneously resolved, and the patient proceeded with his medical treatment without the need for orbital surgery. PMID:15083090

Yen, Michael T; Hipps, W Michael

2004-03-01

222

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

223

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

International Nuclear Information System (INIS)

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

224

A case of acoustic neurinoma associated with chronic subdural hematoma after gamma knife radiosurgery  

International Nuclear Information System (INIS)

A 72-year-old female presented with a unique case of acoustic neurinoma with a cystic component followed by the chronic subdural hematoma manifesting as trigeminal neuralgia, facial palsy and trunchal ataxia 7 months after gamma knife radiosurgery. Magnetic resonance imaging demonstrated a loss of central contrast enhancement at the postoperative residual tumor mass and a large cyst associated with a hematoma in the subdural space. A right suboccipital craniectomy was performed. A biopsy of the mass and the membrane was performed following aspiration of the brown-reddish fluid collection. The histological diagnosis was acoustic neurinoma with a hemorrhagic necrosis. The membranous tissue mimicked an outer membrane obtained from chronic subdural hematoma. The postoperative course was satisfactory and preoperative symptom have been alleviated. In this case, the chronic subdural hematoma occurred at posterior fossa during the development of cysts caused by the radiosurgery, because the subdural space had been connected with the subarachnoid space after the first operation. The development of cysts or hematoma should be taken into consideration as possible complications following treatment with gamma knife radiosurgery for acoustic neurinomas. (author)

225

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

International Nuclear Information System (INIS)

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

226

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2010-03-15

227

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

Directory of Open Access Journals (Sweden)

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

José Gilberto de Brito Henriques

2007-12-01

228

Facial and neck hematoma after carotid artery stenting: an uncommon misadventure in endovascular carotid revascularization.  

Science.gov (United States)

The complication rates of carotid artery stenting (CAS) vary from 3.0% to 4.4%, and most commonly include ischemic stroke, intracranial hemorrhage, or groin complications. We present the rare complication of a patient who underwent CAS for a symptomatic 90% left internal carotid artery stenosis and developed an expanding cervical hematoma after the procedure with imminent respiratory compromise. After intubation, an arteriogram revealed perforation of the external carotid artery trunk, proximal to the origin of the internal maxillary artery. The artery was subsequently embolized and the hematoma resolved without further intervention. We present a potential catastrophic complication and suggest potential causes and treatment options available. PMID:24071715

Grandhi, Ramesh; Gande, Abhiram; Zwagerman, Nathan Thomas; Jankowitz, Brian Thomas

2014-09-01

229

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

230

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

231

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

232

A case of acute traumatic subdural hematoma in a child with previous bilateral encephaloduroarteriosynangiosis.  

Science.gov (United States)

The authors report the case of a 5-year-old female with right-sided hemiparesis and aphasia secondary to moyamoya disease, who had previously undergone staged bilateral encephaloduroarteriosynangiosis procedures. A subsequent ground-level fall caused an acute traumatic subdural hematoma with mass effect and neurological decline. She underwent emergency hematoma evacuation and decompressive craniectomy, which required interruption of the superficial temporal artery that had been used for indirect bypass, followed later by autologous cranioplasty. There were no acute or long-term ischemic events related to the occurrence or treatment of the traumatic hematoma. Follow-up angiography revealed extensive spontaneous vascular collateralization in the field of the decompressive craniectomy and cranioplasty. The patient returned to her pre-injury neurological baseline. PMID:24081710

Curry, Merlin; Whitney, Nathaniel; Roundy, Neil; Selden, Nathan R

2014-04-01

233

Bilateral asynchronous acute epidural hematoma : a case report  

OpenAIRE

Abstract Background Bilateral extradural hematomas have only rarely been reported in the literature. Even rarer are cases where the hematomas develop sequentially, one after removal of the other. Among 187 cases of operated epidural hematomas during past 4 years in our hospital, we found one case of sequentially developed bilateral epidural hematoma. Case Presentation An 18-year-old conscious male worker was admitted to our hospital after a fall. After deterioration of his consciousness, an e...

Ghodsi Mohammad; Ketabchi Ebrahim; Eftekhar Behzad; Esmaeeli Babak

2003-01-01

234

Atrial Septal Hematoma after Minimally Invasive Aortic Valve Replacement  

OpenAIRE

Interatrial septal hematoma is a very rare complication after mitral valve surgery. Unusually, it is the result of aortic valve disease, including aortic dissection. We report a case wherein interatrial septal hematoma followed minimally invasive aortic valve replacement in a 68-year-old woman. The hematoma was recognized upon intraoperative transesophageal echocardiography, but there was no evidence of accompanying aortic dissection. The interatrial septal hematoma was at first drained by ne...

Biniwale, Reshma M.

2010-01-01

235

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

International Nuclear Information System (INIS)

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

236

Spinal epidural hematoma; Spinales epidurales Haematom  

Energy Technology Data Exchange (ETDEWEB)

Spinal epidural hematoma is an accumulation of blood in the potential space between the dura and bone. On unenhanced computed tomography epidural hemorrhage appears as a high-density spinal canal mass with variable cord compression. Magnetic resonance imaging is the modality of choice for evaluating spinal epidural hematoma and can demonstrate the extent of the hematoma and degree of cord compression. When treated surgically the outcome depends on the extent of preoperative neurological deficits and on the operative timing interval. (orig.) [German] Das spinale epidurale Haematom ist eine Blutansammlung zwischen Dura und Knochen. Die klinische Praesentation ist aehnlich dem akuten Bandscheibenvorfall, die Symptomatik ist allerdings in der Regel progredient. In der CT stellt sich ein frisches Haematom hyperdens dar. Die MRT ist die Methode der Wahl zur Diagnose spinaler epiduraler Haematome und kann die Ausdehnung sowie auch das Ausmass der Kompression darstellen. Die wichtigste Differenzialdiagnose vom epiduralen Haematom ist das epidurale Empyem. (orig.)

Papanagiotou, P. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany)

2012-05-15

237

Computer tomography of intracranial tumours and hematomas  

International Nuclear Information System (INIS)

The value of computed tomography (CT) for the diagnosis of intracranial tumors and hematomas was investigated in a retrospective study comprising 220 patients. All C.T.scans are reviewed and described in detail. To assess the diagnostic accuracy, the original interpretation of the C.T.scans was compared with that of conventional neuroradiological and neurophysiological examinations. The aspect on C.T. of the various types of tumors and hematomas proved to vary widely and specific features were seldom seen. This holds particularly for the malignant tumors. Benign tumors such as meningeomas, adenomas and neurilemmomas showed a rather easily identifiable and almost identical picture of the C.T.scan, and diagnosis had to be based mainly on differences in localization. The hematomas, with the exception of the older intracerebral ones, showed the most characteristic C.T.abnormalities. (Auth.)

238

Simultaneous Intracranial and Spinal Subdural Hematoma: Two Case Reports  

Energy Technology Data Exchange (ETDEWEB)

Spinal subdural hematoma is a rare disease. Simultaneous intracranial and spinal subdural hematoma is extremely rare and only 14 such cases have been reported. We report here on two cases of simultaneous intracranial and spinal subdural hematoma that occurred following a fall-down head injury and intracranial surgery, and we discuss the pathogenesis of the disease.

Yoon, Chung Dae; Song, Chang Joon; Lee, Jeong Eun; Choi, Seung Won [Chungnam National University, Daejeon (Korea, Republic of)

2009-02-15

239

Percutaneous catheter drainage of complicated traumatic perirenal hematoma: case report  

International Nuclear Information System (INIS)

A perirenal hematoma very commonly occurs after trauma. Treatment differs according to the degree of renal injury, though many cases are managed conservatively and complications are rare. We report tow cases in which successful treatment of a perirenal hematoma involved percutaneous catheter drainage; in one there was bowel obstruction, and in the other the hematoma was infected

240

The repeat CT-findings of the contusional hematoma  

International Nuclear Information System (INIS)

Twenty-seven cases of traumatic intracerebral hematoma were treated from 1977 to 1979. The intracerebral hematomas are classified into three groups: central type, hematoma within contusional area and contusional hematoma, according to the CT findings and the clinical course. Fourteen of these cases are diagnosed as contusional hematoma which show a normal CT scan, subarachnoidal hemorrhage, subdural hematoma and epidural hematoma without any kind of intracerebral high density in the initial CT scan performed within 6 hours after injury. Ten of the cases were found during conservative treatment; in 2 cases, hematomas were revealed within 24 hours; in 2 more cases within 48 hours, and in 6 cases, within 3 - 5 days following injury. In the other 4 cases, hematoma occurred 1 - 2 days following the emergency evacuation of a subdural hematoma and decompressive craniectomy. Based on the clinical experience outlined above, it is our current practice in diagnosing patients with contusional hematoma to perform repeat CT scanning within 5 - 6 days after injury whenever isodensity or subarachnoidal hemorrhage with a shift in the midline structure is observed in an initial CT scan within 6 hours or whenever an evacuation of the subdural hematoma with decompressive craniectomy is performed. (author)

241

Spontaneous intramural esophageal hematoma: Case report and review  

OpenAIRE

Intramural esophageal hematoma is a rare form of esophageal injury. The presenting symptoms are nonspecific. Esophagogastroscopy and computed tomography scan are usually needed to establish the diagnosis of intramural esophageal hematoma. Presented here is a patient with spontaneous intramural esophageal hematoma who was successfully treated with conservative measures.

Cheung, Justin; Mu?ller, Nestor; Weiss, Alan

2006-01-01

242

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)

243

Chronic Subdural Hematoma Following Electro Convulsive Therapy  

Science.gov (United States)

Subdural hematoma is a rare but serious complication following electroconvulsive therapy (ECT), a frequently used treatment modality in the management of various psychiatric morbidities including bipolar affective disorder (BAD). There are very few reports of intracranial bleeding following ECT in the literature. A 38-year-old female, known case of BAD for last fifteen years receiving ECT, presented with the symptoms of dysphasia, headache, left sided paresis, and sudden deterioration of sensorium. Computed tomography (CT) scan of the brain was suggestive of left-sided fronto parietal chronic subdural hematoma with midline shift that was drained successfully. PMID:23162198

Saha, Debasish; Bisui, Bikash; Thakurta, Rajarshi Guha; Ghoshmaulik, Sumanta; Singh, Om Prakash

2012-01-01

244

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

245

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

OpenAIRE

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

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

2005-01-01

246

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

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

Jian-Jie Qin

2012-01-01

247

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

248

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

OpenAIRE

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

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

2012-01-01

249

Computed tomographic findings of intramural hematoma  

International Nuclear Information System (INIS)

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

250

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

251

Spontaneous rectus sheath hematoma during rivaroxaban therapy  

OpenAIRE

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.

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

2014-01-01

252

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

253

Endoscopic surgery for traumatic acute subdural hematoma.  

Science.gov (United States)

Traumatic acute subdural hematoma (ASDH) is generally addressed by craniotomy under general anesthesia. We report a patient whose traumatic ASDH was treated under local anesthesia by one-burr-hole endoscopic surgery. This 87-year-old woman had undergone coil embolization for a ruptured right middle-cerebral artery aneurysm and placement of a ventriculoperitoneal shunt for normal pressure hydrocephalus 5 years earlier. Upon admission, she manifested consciousness disturbance after suffering head trauma and right hemiplegia. Her Glasgow Coma Scale score was 8 (E2V2M4). Computed tomography (CT) demonstrated a thick, left-frontotemporal ASDH. Due to her advanced age and poor condition, we performed endoscopic surgery rather than craniotomy to evacuate the ASDH. Under local anesthesia, we made a burr hole in her left forehead and increased its size to 15 mm in diameter. After introducing a transparent sheath into the hematoma cavity with a rigid endoscope, the clot was evacuated with a suction tube. The arterial bleeding point was electrically coagulated. A postoperative CT scan confirmed the reduction of the hematoma. There was neither brain compression nor brain swelling. Her consciousness disturbance and right hemiplegia improved immediately. Endoscopic surgery may represent a viable method to address traumatic intracranial hematomas in some patients. PMID:24659965

Kon, Hiroyuki; Saito, Atsushi; Uchida, Hiroki; Inoue, Mizuho; Sasaki, Tatsuya; Nishijima, Michiharu

2013-09-01

254

Study of near infrared technology for intracranial hematoma detection  

Science.gov (United States)

Although intracranial hematoma detection only requires the continuous wave technique of near infrared spectroscopy (NIRS), previous studies have shown that there are still some problems in obtaining very accurate, reliable hematoma detection. Several of the most important limitations of NIR technology for hematoma detection such as the dynamic range of detection, hair absorption, optical contact, layered structure of the head, and depth of detection are reported in this article. A pulsed light source of variable intensity was designed and studied in order to overcome hair absorption and to increase the dynamic range and depth of detection. An adaptive elastic optical probe was made to improve the optical contact and decrease contact noise. A new microcontroller operated portable hematoma detector was developed. Due to the layered structure of the human head, simulation on a layered medium was analyzed experimentally. Model inhomogeneity tests and animal hematoma tests showed the effectiveness of the improved hematoma detector for intracranial hematoma detection.

Zhang, Quan; Ma, Hong Y.; Nioka, Shoko; Chance, Britton

2000-04-01

255

A case of acute spinal epidural hematoma after abdominal aortic aneurysm operation.  

Science.gov (United States)

A 76-year-old man who had an abdominal aortic aneurysm underwent vascular replacement, and an acute spinal epidural hematoma developed postoperatively despite the absence of abnormal preoperative laboratory data other than hypertension. General anesthesia was induced using nitrous oxide, oxygen, and sevoflurane (GOS), and epidural anesthesia was also performed at the intervertebral space between Th10 and Th11. At 5 days after operation, an emergency operation was carried out to remove the epidural hematoma, which was noted at the Th5-Th9 vertebral level. The patient's clinical course was relatively favorable, and he was eventually able to walk with a stick. The cause of this acute hematoma remains unclear, but the following important factors might have been involved in its development: a transient bleeding tendency caused by intraoperative use of heparin as well as adverse effects to the epidural blood vessels due to an increased venous pressure following the surgical procedures. Our patient, fortunately, had no significant sequelae. However, when performing epidural anesthesia, it is necessary to keep in mind that epidural hematoma, though observed very rarely, may develop, particularly in patients with a tendency for bleeding. PMID:21302220

Kaneda, Toru; Suzuki, Toshiyasu; Takeda, Junzou

2006-04-01

256

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

257

Biomechanical analysis of acute subdural hematoma resulting from judo.  

Science.gov (United States)

This study investigated biomechanical mechanisms of acute subdural hematoma caused by judo and sought preventive measures to reduce injury. A Japanese judo expert repeatedly threw an anthropometric test device using two throwing techniques, Osoto-gari and Ouchi-gari. Linear and angular accelerations of the head were measured. Both throwing techniques resulted in the dummy falling backwards, with the occipital area of the head contacting the mat, and peak linear and angular accelerations being observed when the head contacted the mat. For linear acceleration, the posterior-anterior direction showed the greatest force (41.0 ± 2.6 G using Osoto-gari, and 86.5 ±4.3 G using Ouchi-gari). For angular acceleration, values for sagittal plane rotation were greatest among the three directions measured (3315 ± 168 rad/s(2) using Osoto-gari, and 1328 ± 201 rad/s(2) using Ouchi-gari). We concluded that occipital head contact produced the most forceful longitudinal linear and sagittal plane angular accelerations; subsequent stretches and ruptures of parasagittal bridging veins resulting in acute subdural hematoma. As severe head injuries can result if a person's head comes into contact with the mat, offensive throwing techniques should be restricted to participants able to sufficiently demonstrate the Ukemi technique. PMID:25355441

Hitosugi, Masahito; Murayama, Haruo; Motozawa, Yasuki; Ishii, Kanto; Ogino, Masahiro; Koyama, Katsuhiro

2014-01-01

258

Chronic lumbar epidural hematoma in a patient suffering with spondylolytic spondylolisthesis at the L4-5 level: a case report  

International Nuclear Information System (INIS)

Nontraumatic spinal epidural hematoma (SEH) is a rare condition and the exact cause of the hemorrhage in SEH had never been established. However, there have been a few recent reports on some types of the epidural hematoma with a detectable origin of hemorrhage. We encountered a case of chronic SEH in a patient who had spondylolytic spondylolisthesis, which is also a rare condition to be associated with SEH. We report here on the radiologic findings of a case of chronic epidural hematoma in a patient who had spondylolytic spondylolisthesis at the L4-5 level, and we include a review of the related literatures

259

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

260

An ultrasonographic study of experimental hematoma in rabbit  

International Nuclear Information System (INIS)

Sequenctial ultrasonography was performed after induction of vitreous hematoma in 24 rabbits eyeball to analyze the characteristic sonographic findings of resorbing hematoma. Ultrasonography was done at immediate after inducing hematoma and were followed up at 2nd day, 1st week, 2nd week and 4th week. The result were as follows; 1. In immediate scan after inducing hematoma, multiple sheet-like or linear shaped hematoma was more common than round or diffuse shaped. 2. Size of hematoma was decreased from 2nd day, much more at l1st week, and nearly or completely absorbed at 4th week. 3. Margin of hematoma was blurred from 2nd day and rapidly changed afterward. 4. Even though echogenecity of hematoma in immediate B-mode scan after inducing hematoma showed largely less echogenic than that of retro-orbital fat, hyperechoic and isoechoic cases were also seen. 5. Reflectivity of hematoma, till 2nd day, showed largely over 50% of that of retro-orbital fat, but decreased to the level of below 50%at 1st week, and nearly or completely absorbed at 4th week

261

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)

262

Hematomas espontáneos de la pared abdominal Spontaneous Hematomas of the abdominal wall  

Directory of Open Access Journals (Sweden)

Full Text Available Introducción: El hematoma espontáneo de la pared abdominal (HEPA es una entidad de aparición infrecuente y de difícil diagnóstico debido a la similitud clínica con otros procesos agudos. Suele aparecer en pacientes que siguen tratamiento anticoagulante y se caracteriza por su forma de presentación brusca como dolor abdominal agudo. La cirugía puede evitarse en la mayoría de los casos si se diagnostica correctamente mediante pruebas de imagen. Observaciones clínicas: Presentamos 12 casos de HEPA tratados en nuestro Servicio entre los años 1999 y 2005, y realizamos una revisión de esta entidad en cuanto a etiología, factores desencadenantes, diagnóstico y tratamiento. Conclusión: El tratamiento del HEPA debe ser conservador, reservando la cirugía para aquellos casos que presenten deterioro hemodinámico por sangrado activoIntroduction: Spontaneous hematoma of the abdominal wall is infrequent and difficult to diagnose due to its clinical similarity with other acute processes. It is usually associated with patients undergoing anticoagulant therapy and is characterized for its form of abrupt presentation like acute abdominal pain. Surgery can be avoided in most patients if hematoma is correctly diagnosed by imaging tests. Clinical observations: We present 12 cases of spontaneous hematoma of the abdominal wall from 1999 through 2005 and we review the etiology, precipitating factors, diagnosis and treatment of this clinical entity. Conclusion: Treatment of spontaneous hematoma of abdominal wall must be preservative, reserving the surgery for those cases that present hemodynamic compromise by persistent hemorrhage

Rafael Cerdán P

2007-02-01

263

Hematomas espontáneos de la pared abdominal / Spontaneous Hematomas of the abdominal wall  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish Introducción: El hematoma espontáneo de la pared abdominal (HEPA) es una entidad de aparición infrecuente y de difícil diagnóstico debido a la similitud clínica con otros procesos agudos. Suele aparecer en pacientes que siguen tratamiento anticoagulante y se caracteriza por su forma de presentación [...] brusca como dolor abdominal agudo. La cirugía puede evitarse en la mayoría de los casos si se diagnostica correctamente mediante pruebas de imagen. Observaciones clínicas: Presentamos 12 casos de HEPA tratados en nuestro Servicio entre los años 1999 y 2005, y realizamos una revisión de esta entidad en cuanto a etiología, factores desencadenantes, diagnóstico y tratamiento. Conclusión: El tratamiento del HEPA debe ser conservador, reservando la cirugía para aquellos casos que presenten deterioro hemodinámico por sangrado activo Abstract in english Introduction: Spontaneous hematoma of the abdominal wall is infrequent and difficult to diagnose due to its clinical similarity with other acute processes. It is usually associated with patients undergoing anticoagulant therapy and is characterized for its form of abrupt presentation like acute abdo [...] minal pain. Surgery can be avoided in most patients if hematoma is correctly diagnosed by imaging tests. Clinical observations: We present 12 cases of spontaneous hematoma of the abdominal wall from 1999 through 2005 and we review the etiology, precipitating factors, diagnosis and treatment of this clinical entity. Conclusion: Treatment of spontaneous hematoma of abdominal wall must be preservative, reserving the surgery for those cases that present hemodynamic compromise by persistent hemorrhage

Rafael, Cerdán P; Sandra, Paterna L; María Eugenia, Guillén S; Sonia, Cantín B; Joaquín, Bernal J; Jesús María, Esarte M.

2007-02-01

264

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

International Nuclear Information System (INIS)

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

265

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

266

Chronic expanding hematoma extending over multiple gluteal muscles associated with piriformis syndrome.  

Science.gov (United States)

We report on a patient with an unusual, slowly enlarging hematoma of the left buttock. A 62-year-old man presented with a 6-year history of an enlarging mass of the left buttock. He had first noted the mass 6 years earlier and had had sciatica of the left lower limb for the last 2 months. He denied any history of antecedent trauma. The lesion extended over 3 gluteal muscles (the gluteus medius, gluteus minimus, and piriformis). On microscopic examination, the lesion showed typical signs of chronic expanding hematoma. The sciatica was relieved after surgical removal of the lesion. The lesion had not recurred at the last follow-up 4 years after the operation. The present case suggested that chronic expanding hematoma can extend into multiple muscles due, perhaps, to long-term growth and the anatomical and functional conditions of the affected muscles. Our case also suggests that chronic expanding hematoma can be a cause of piriformis syndrome. PMID:23291848

Kitagawa, Yasuyuki; Yokoyama, Munehiro; Tamai, Kensuke; Takai, Shinro

2012-01-01

267

Spontaneous intraneural hematoma of the sural nerve.  

Science.gov (United States)

Symptomatic intraneural hemorrhage occurs rarely. It presents with pain and/or weakness in the distribution following the anatomic innervation pattern of the involved nerve. When a purely sensory nerve is affected, the symptoms can be subtle. We present a previously healthy 36-year-old female who developed an atraumatic, spontaneous intraneural hematoma of her sural nerve. Sural dysfunction was elicited from the patient's history and physical examination. The diagnosis was confirmed with magnetic resonance imaging, and surgical decompression provided successful resolution of her preoperative symptoms. To our knowledge, this entity has not been reported previously. Our case highlights the importance of having a high index of suspicion for nerve injury or compression in patients whose complaints follow a typical peripheral nerve distribution. Prior studies have shown that the formation of intraneural hematoma and associated compression of nerve fibers result in axonal degeneration, and surgical decompression decreases axonal degeneration and aids functional recovery. PMID:25311865

Richardson, Shawn S; McLawhorn, Alexander S; Mintz, Douglas N; DiCarlo, Edward F; Weiland, Andrew J

2015-04-01

268

Ultrasonographic findings of psoas abscess and hematoma  

International Nuclear Information System (INIS)

A retrospective analysis of the ultrasonographic findings of 9 cases tuberculous abscess, 5 cases of pyogenic abscess and 2 cases of hematoma of psoas and adjacent muscles was made. Fluid collection with or without internal echoes was seen in 12 cases out of total 16 cases. Other findings were 2 cases of only muscle swelling, 1 cases of highly echogenic mass-like appearance and 1 case of fluid collection with septae. Ultrasonography is considered an accurate method in identifying early pathologic changes of the psoas muscle and determining its extent, and in differentiating tumor from fluid collection of the psoas muscle. Authors dare to say that ultrasound examination is a procedure of choice in the diagnosis of psoas abscess and hematoma

269

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

270

A new treatment for hypertensive intracerebral hematoma  

International Nuclear Information System (INIS)

Durining the last 2 years, 46 cases of hypertensive intracerebral hemorrhage in the basal ganglia were treated by CT guided stereotactic aspiration and their outcome was evaluated in terms of the rate of hematoma removal, the change of consciousness level and the recovery of motor and sensory functions. They are aged from 45 to 79 years old, the average 56, and aspirated 1 to 24 days after the onset, two third of them being within 1 week. The whole procedure was done in the CT room under direct CT guidance and by one trial. In putaminal type hemorrhage, the removed hematoma volumes ranged from 9 to 48 ml, average being 23.7 ml, in thalamic type from 5 to 29 ml, average being 15.5 ml. The average rate of removal was 81.1 % in 30 cases within 1 week. In most cases, preoperative consciousness was not severely disturbed, in putaminal type, 19 were alert or confused, 4 somnolent, 5 stuperous and in thalamic type, 6, 6, 3 respectively and 2 were semicomatous, one of them had herniation sign. In putaminal type all but 2 cases recovered to alert or confused state, the first one had postoperative bleeding and the other was already apallic preoperatively. In thalamic type, we lost 3 cases, 2 by gastrointestinal bleeding and 1 DIC, by rehemorrhage 2 months after the operation. All but one who was semicomatous preoperatively recovered to alertness. In motor function, some cases of the putaminal bleeding with intact internal capsule remained hemiplegic. On the other hand, most of the cases with partial destruction of the internal capsule on CT recovered well in both types of hematoma. Especially in thalamic type, only 2 had inability to walk durinig the follow-up period. In sensory function, two thirds of the cases recovered to almost normal level. CT guided stereotactic aspiration, therefore, can be evaluated as less invasive and more definitive treatment for intracerebral hematoma in the basal ganglia. (author)

271

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

272

Endoscopic Surgery for Traumatic Acute Subdural Hematoma  

OpenAIRE

Traumatic acute subdural hematoma (ASDH) is generally addressed by craniotomy under general anesthesia. We report a patient whose traumatic ASDH was treated under local anesthesia by one-burr-hole endoscopic surgery. This 87-year-old woman had undergone coil embolization for a ruptured right middle-cerebral artery aneurysm and placement of a ventriculoperitoneal shunt for normal pressure hydrocephalus 5 years earlier. Upon admission, she manifested consciousness disturbance after suffering he...

Kon, Hiroyuki; Saito, Atsushi; Uchida, Hiroki; Inoue, Mizuho; Sasaki, Tatsuya; Nishijima, Michiharu

2014-01-01

273

Acute Spontaneous Subdural Hematoma of Arterial Origin  

OpenAIRE

Acute spontaneous subdural hematoma (SDH) of arterial origin is very rare. We report a case of acute spontaneous SDH that showed contrast media extravasation from cortical artery on angiograms. A 58-year-old male patient developed sudden onset headache and right hemiparesis. Brain CT scan demonstrated acute SDH at left convexity. The patient was drowsy mentality on admission. He had no history of head trauma. Cerebral angiography was performed and revealed a localized extravasation of the con...

Sung, Soon Ki; Kim, Sung Hoon; Son, Dong Wuk; Lee, Sang Weon

2012-01-01

274

CORRELACIÓN CLÍNICO-TOMOGRÁFICA DEL HEMATOMA INTRAPARENQUIMATOSO  

Directory of Open Access Journals (Sweden)

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

275

An obscure case of hepatic subcapsular hematoma.  

Science.gov (United States)

Spontaneous liver bleeding is often reported in preeclampsia. It is otherwise rare and has been linked to gross anatomical lesions and coagulopathy. We report a case of subcapsular hematoma of the liver without any apparent lesion and in the absence of coagulopathy. A 41-year-old male, paraplegic for 16 years, presented to the emergency department 3 days after sudden onset of right upper quadrant and shoulder pain. He had been on vitamins and 5,000 units subcutaneous heparin 12-hourly at the nursing home for the last month. He was in no distress, afebrile, with stable vitals. Physical examination showed a diverting colostomy, tender hepatomegaly and sacral decubiti. A fecal occult blood test was negative. There was spastic paraplegia below the level of T12. Two days after admission, the patient was afebrile and hemodynamically stable. PTT, PT, liver profile, BUN and creatinine were all normal, however his hemoglobin had dropped from 11.3 to 7.6 g/dl. An abdominal CT scan revealed an isolated 9.0 × 1.8 cm subcapsular hematoma. The patient received blood transfusion in the intensive care unit and was discharged 7 days later. In conclusion, spontaneous liver hemorrhage occurs in the nonobstetrical population in the setting of gross anatomical lesions or coagulopathy. This is the first report of an isolated subcapsular liver hematoma. PMID:21552450

Ndzengue, Albert; Hammoudeh, Fadi; Brutus, Pierre; Ajah, Ofem; Purcell, Roland; Leadon, Joseph; Rafal, Richard B; Balmir, Simon; Enriquez, Danilo A; Posner, Gerald L; Jaffe, Eric A; Chandra, Pradeep

2011-01-01

276

Langerhans' cell histiocytosis presenting with an intracranial epidural hematoma  

International Nuclear Information System (INIS)

An 8-year-old boy developed vomiting and severe headache following minor head trauma. A CT scan of the head demonstrated a lytic lesion of the skull and adjacent epidural hematoma. Surgical evacuation and removal of the skull lesion and hematoma were carried out, and pathologic evaluation resulted in a diagnosis of Langerhans' cell histiocytosis (LCH). Epidural involvement of Langerhans' cell histiocytosis is very rare, and we report the first case of LCH presenting as an intracranial epidural hematoma. (orig.)

277

Spontaneous Rapid Resolution of Acute Epidural Hematoma in Childhood  

OpenAIRE

Acute epidural hematoma is a critical emergency all around the world, and its aggressive diagnosis and treatment are of vital importance. Emergent surgical evacuation of the hematoma is known as standard management; however, conservative procedures are also used for small ones. Spontaneous rapid resolution of these hematomas has also been reported in eight pediatric cases. Various theories have been proposed to explain the underlying pathophysiology of this resolution. Herein, we are reportin...

En, Ismail G. Xfc L. X. F.; Hakan Ak; Xfc Nc Xfc, Enver S. Xf S.; Alpaslan Yavuz; Nejmi Kiymaz

2013-01-01

278

CT findings in a case of neonatal acute subdural hematoma  

International Nuclear Information System (INIS)

The CT findings in a case of neonatal accute subdural hematoma are presented. CT demonstrated a crescentic high density area in the subdural space over the left cerebral hemisphere and an oval high density area in the left occipital region. The latter was suspected of being an intracerebral hematoma. Emergency craniotomy revealed that the high density area was due to a subdural hematoma between the occipital lobe and the tentorium cerebelli. (orig.)

279

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

280

Differentiated surgical treatment of patients with hypertensive intracerebral hematomas  

OpenAIRE

Hypertensive intracerebral hematoma is one of the most severe forms of cerebrovascular pathology, characterized by high lethality and disability. One of the objectives in providing assistance remains the development of new minimally invasive methods for the removal of hematomas. We have analyzed the results of surgical treatment of 176 patients with intracerebral hematoma. Patients from the 1st group were done open craniotomy. Patients from the 2nd group were performed the external ventricula...

Natalia Ivanova; Valery Bersnev; Istam Agzamov; Mansur Agzamov

2011-01-01

281

Rapid Spontaneous Reduction of a Huge Intracerebral Hematoma  

OpenAIRE

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

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

2012-01-01

282

Bilateral Rectus Sheath Hematoma in Kidney Transplant Patient: Case Study and Literature Review  

OpenAIRE

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.

Feizzadeh Kerigh, Behzad; Maddah, Ghodratolah

2013-01-01

283

77 FR 16925 - Medical Devices; Neurological Devices; Classification of the Near Infrared Brain Hematoma Detector  

Science.gov (United States)

...Classification of the Near Infrared Brain Hematoma Detector AGENCY: Food and Drug Administration...Near Infrared (NIR) Brain Hematoma Detector into class II (special controls...Near Infrared (NIR) Brain Hematoma Detector, and it is identified as a...

2012-03-23

284

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 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

285

Sonographic diagnosis of intramural hematoma of gastrointestinal tract  

International Nuclear Information System (INIS)

Sonographic findings of nine cases of intramural hematoma of the gastrointestinal tract are presented. The duodenum was the most common site, followed by the ascending colon and the stomach. Intramural hematomas present as centrally or eccentrically located bowel mass of variable echogenicity: heter-ogeneously echogenic in six cases; hypoechoic in two case; anechoic in one case. In five cases of duodenal hematoma, the stomach and/or duodenal bulb were distended and filled with fluid. It is concluded that ultrasonography is a simple and useful tool in the diagnosis of intramural hematoma of the intestine

286

The study of hematomas in 500 consecutive face lifts.  

Science.gov (United States)

Our incidence of hematoma in 500 consecutive face lifts was 2.6 percent, of which 1.6 percent were severe enough to need evacuation. This incidence of hematoma correlated well with the blood pressures of patients on admission; when the pressure was above 150/100 mm Hg on admission, hematoma occurred 2.6 times more frequently than in normotensive patients. Our premedication regime and hypotensive therapy was effective in reducing preoperative hypertension to normotensive levels in most, but not all, patients. However, this reduction of the postoperative blood pressure to normal levels did not prevent hematoma formation entirely. PMID:850705

Straith, R E; Raju, D R; Hipps, C J

1977-05-01

287

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

288

Secondary mania in a patient with delayed anoxic encephalopathy after carbon monoxide intoxication caused by a suicide attempt.  

Science.gov (United States)

We report herein a female patient presenting with delayed anoxic encephalopathy after carbon monoxide (CO) intoxication. Five months after she attempted suicide in her car using burning charcoal, she showed manic symptoms including aggressive behaviors, irritability, decreased total sleep time, increased energy and sexual interest, and hyperactivity, as well as illusions and visual hallucinations related to bugs, certain animals, monsters and her ex-husband. Fluid-attenuated inversion recovery and T2-weighted images in brain magnetic resonance imaging showed white-matter hyperintensity in the frontal lobe and periventricular area. Her manic symptoms and psychotic features improved following daily administration of valproate (600 mg) and olanzapine (10 mg). These observations indicate that clinicians should monitor for delayed neuropsychiatric symptoms in patients with CO intoxication. PMID:23932665

Park, Young-Min; Kim, Yo Sup

2014-01-01

289

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

290

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

OpenAIRE

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

Woods, Amanda M.; Bouton, Mark E.

2008-01-01

291

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

OpenAIRE

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. ...

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

2011-01-01

292

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

293

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

294

CT-guided stereotaxic evacuation of cerebellar hematoma  

International Nuclear Information System (INIS)

Stereotaxic lateral approach for cerebellar hematoma is presented using Leksell's CT-stereotaxic system. All of the procedures are performed in the CT room. Patient's head is turned to contralateral side of the hematoma 30 to 400 with slight flexion of the neck. Stereotaxic apparatus is secured to the head under local anesthesia. Hematoma is confirmed by computerized tomograms. Three dimensional coordinates of the target point (center of the hematoma) are measured from the vertical and diagonal rods of Leksell's system. Linear skin incision 4 cm in length is made on retromastoid area. Burr-hole is put on just lateral position of the target point, usually 5 to 6 cm posterior and 1 cm above from the external auditory meatus. Transverse or sigmoid sinus does not appeared through the burr-hole by this approach. Specially made Dandy's cannula (3.0 mm in diameter, 220 mm in length) is inserted into the target point, and manual evacuation of the hematoma is performed carefully using a syringe. Then Dandy's cannula is replaced by silastic drainage tube (3.5 mm in diameter), and 6,000 Units of Urokinase solved in 2 ml of saline is administered to the hematoma cavity. Dissolved hematoma is aspirated every 24 hours until the most of the hematoma is evacuated. We operated three cases of cerebellar hematoma by this method with favorable results. Advantages of this method are as follows: Operative invasion is minimal; The surgeon can cbeck the residual hematoma and posit can cbeck the residual hematoma and position of the tip of cannula even at operation, if necessary. (author)

295

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

296

Thickening of the pulmonary artery wall in acute intramural hematoma of the ascending aorta  

OpenAIRE

Abstract Background The occurrence of pulmonary artery obstruction in the course of acute aortic dissection is an unusual complication. The mechanism implicated is the rupture of the outer layer of the aorta and the subsequent hemorrhage into the adventitia of the pulmonary artery that causes its wall thickening and, at times, produces extrinsic obstruction of the vessel. There are no reports of this complication in acute intramural hematoma. Case presentation An 87-year-old woman was admitte...

Lardani Héctor; Spernanzoni Fernando; Redondo Juan; Sanchez Gustavo; Lombardero Martín; Goerner María S; Munín Martín; Torres Víctor

2007-01-01

297

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

OpenAIRE

Abstract Introduction Iliopsoas hemorrhage is a serious complication of bleeding disorders that occurs most commonly in patients with hemophilia and less commonly in patients with von Willebrand disease. It causes severe pain, muscle dysfunction and occasionally femoral nerve palsy. We describe the case of a patient with von Willebrand disease type 3 with a large iliopsoas hematoma who was treated with a von Willebrand factor concentrate (Humate-P). Case presentation A 20-year-old Iranian man...

Soltani Shirazi Ahmad; Keikhaei Bijan

2011-01-01

298

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

299

Misdiagnosed spontaneous intracranial hypotension complicated by subdural hematoma following lumbar puncture  

OpenAIRE

Nissrine Louhab,1 Nawal Adali,1 Mehdi Laghmari,2 Wafae El Hymer,2 Said Ait Ben Ali,2 Najib Kissani11Neurology Department, 2Neurosurgery Department, University Hospital of Mohammed the VIth, Cadi Ayyad University, Marrakech, MoroccoIntroduction: Spontaneous intracranial hypotension is an infrequent cause of secondary headache due to cerebrospinal fluid (CSF) hypovolemia.Objective: To describe a case of headache revealing spontaneous intracranial hypotension complicated by subdural hematoma fol...

Louhab N; Adali N; Laghmari M; El Hymer W; Ait Ben Ali S; Kissani N

2014-01-01

300

Motor Vehicle Crash-Related Subdural Hematoma from Real-World Head Impact Data  

OpenAIRE

Approximately 1,700,000 people sustain a traumatic brain injury (TBI) each year and motor vehicle crashes (MVCs) are a leading cause of hospitalization from TBI. Acute subdural hematoma (SDH) is a common intracranial injury that occurs in MVCs associated with high mortality and morbidity rates. In this study, SDH volume and midline shift have been analyzed in order to better understand occupant injury by correlating them to crash and occupant parameters. Fifty-seven head computed tomography (...

Urban, Jillian E.; Whitlow, Christopher T.; Edgerton, Colston A.; Powers, Alexander K.; Maldjian, Joseph A.; Stitzel, Joel D.

2012-01-01

301

De novo missense mutations in the NAA10 gene cause severe non-syndromic developmental delay in males and females.  

Science.gov (United States)

Recent studies revealed the power of whole-exome sequencing to identify mutations in sporadic cases with non-syndromic intellectual disability. We now identified de novo missense variants in NAA10 in two unrelated individuals, a boy and a girl, with severe global developmental delay but without any major dysmorphism by trio whole-exome sequencing. Both de novo variants were predicted to be deleterious, and we excluded other variants in this gene. This X-linked gene encodes N-alpha-acetyltransferase 10, the catalytic subunit of the NatA complex involved in multiple cellular processes. A single hypomorphic missense variant p.(Ser37Pro) was previously associated with Ogden syndrome in eight affected males from two different families. This rare disorder is characterized by a highly recognizable phenotype, global developmental delay and results in death during infancy. In an attempt to explain the discrepant phenotype, we used in vitro N-terminal acetylation assays which suggested that the severity of the phenotype correlates with the remaining catalytic activity. The variant in the Ogden syndrome patients exhibited a lower activity than the one seen in the boy with intellectual disability, while the variant in the girl was the most severe exhibiting only residual activity in the acetylation assays used. We propose that N-terminal acetyltransferase deficiency is clinically heterogeneous with the overall catalytic activity determining the phenotypic severity. PMID:25099252

Popp, Bernt; Støve, Svein I; Endele, Sabine; Myklebust, Line M; Hoyer, Juliane; Sticht, Heinrich; Azzarello-Burri, Silvia; Rauch, Anita; Arnesen, Thomas; Reis, André

2015-05-01

302

Vertex epidural hematoma neuroradiological findings and management. A case report  

International Nuclear Information System (INIS)

Epidural hematomas occurring at the vertex are uncommon, and they can be difficult to diagnose by axial CT. We report a case of acute traumatic vertex epidural hematoma, which resolved spontaneously with time. We stress the importance of MR investigations in this diagnostic challenge

303

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.)

304

Cocaine-Induced Intramural Hematoma of the Ascending Aorta  

OpenAIRE

We report the case of a 35-year-old man who presented at our institution with intramural aortic hematoma shortly after inhaling cocaine and smoking crack cocaine. To our knowledge, such a case has not previously been reported in the English medical literature. Problems of diagnosis and the mechanisms of intramural hematoma and aortic dissection are discussed.

Neri, Eugenio; Toscano, Thomas; Massetti, Massimo; Capannini, Gianni; Frati, Giacomo; Sassi, Carlo

2001-01-01

305

Subcapsular hematoma of the liver in a neonate: case report  

Energy Technology Data Exchange (ETDEWEB)

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

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

2005-07-15

306

Prognostic factors in intraparenchymatous hematoma with ventricular hemorrhage  

International Nuclear Information System (INIS)

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

307

Prognostic factors in intraparenchymatous hematoma with ventricular hemorrhage  

Energy Technology Data Exchange (ETDEWEB)

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

Ruscalleda, J.; Peiro, A.

1986-01-01

308

Spontaneous subdural hematoma in a young adult with hemophilia  

Directory of Open Access Journals (Sweden)

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

Agrawal D

2003-01-01

309

Ectrodactyly-ectodermal dysplasia-cleft syndrome (EEC syndrome) with a developmental delay caused by R304W mutation in the tp63 gene.  

Science.gov (United States)

Ectrodactyly-ectodermal dysplasia-cleft syndrome (EEC) results from a simultaneous developmental abnor-caused by mutations of the tp63 gene. Five mutations: 204, 227, 279, 280, and 304 account for most cases of this syndrome. A case with R304W mutation, characterized by the presence of all major (ectrodactyly, ectodermal dysplasia, cleft lip and palate) and two minor (lacrimal duct obstruction, developmental delay) clinical symptoms of the syndrome is presented. This severe case improves the existing knowledge concerning the genotype-phenotype correlations in EEC syndrome. PMID:24734328

Gawrych, Elzbieta; Bi?czak-Kuleta, Agnieszka; Janiszewska-Olszowska, Joanna; Ciechanowicz, Andrzej

2013-01-01

310

Delayed Puberty  

Directory of Open Access Journals (Sweden)

Full Text Available Puberty is a quite important phase in the physical and psychosocical development of the adolescent. The timing of puberty is variable and is dependent on several factors including ethnic group, nutrition and genetic factors. It may commence from 8 years of age in girls and 9 years in boys and is usually complete after 3,5 years in female and 2,5 years in males. Delayed puberty is defined as the lack of secondary sexual characteristics from the age of 13 years in females and 14 years in males. The most common cause is constitutional delay in growth and puberty. It is more common in boys and most cases are familial, usually occurring in the same-sex parent. This typically occurs in healthy children who have delayed puberty with short stature for their chronological age, but this delay is appropriate for the bone age. Pubertal delay can be classified according to circulating levels of luteinizing hormone and follicle stimulating hormone. Central nervous system abnormalities result in hypogonadotrophic hypogonadism and gonadal failure causes hypergonadotrophic hypogonadism. A detailed history is the first step in the diagnostic evaluation of a constitutional delay and abnormal puberty. Further evaluation includes laboratory testing (estradiol, testosterone, the results of a GnRH test, karyotip analysis and imaging studies (X-ray of the left hand and wrist, USG of the gonads, MRI . Treatment is directed at both the acute and long-term consequences of delayed or absent pubertal development. Delayed puberty and other pubertal disorders should be recognized early, correctly diagnosed by a pediatric endocrinologist, and appropriately treated. (Turk Arch Ped 2011; 46 Suppl: 88-91

Zehra

2011-03-01

311

De Novo Nonsense Mutations in KAT6A, a Lysine Acetyl-Transferase Gene, Cause a Syndrome Including Microcephaly and Global Developmental Delay.  

Science.gov (United States)

Chromatin remodeling through histone acetyltransferase (HAT) and histone deactylase (HDAC) enzymes affects fundamental cellular processes including the cell-cycle, cell differentiation, metabolism, and apoptosis. Nonsense mutations in genes that are involved in histone acetylation and deacetylation result in multiple congenital anomalies with most individuals displaying significant developmental delay, microcephaly and dysmorphism. Here, we report a syndrome caused by de novo heterozygous nonsense mutations in KAT6A (a.k.a., MOZ, MYST3) identified by clinical exome sequencing (CES) in four independent families. The same de novo nonsense mutation (c.3385C>T [p.Arg1129(?)]) was observed in three individuals, and the fourth individual had a nearby de novo nonsense mutation (c.3070C>T [p.Arg1024(?)]). Neither of these variants was present in 1,815 in-house exomes or in public databases. Common features among all four probands include primary microcephaly, global developmental delay including profound speech delay, and craniofacial dysmorphism, as well as more varied features such as feeding difficulties, cardiac defects, and ocular anomalies. We further demonstrate that KAT6A mutations result in dysregulation of H3K9 and H3K18 acetylation and altered P53 signaling. Through histone and non-histone acetylation, KAT6A affects multiple cellular processes and illustrates the complex role of acetylation in regulating development and disease. PMID:25728775

Arboleda, Valerie A; Lee, Hane; Dorrani, Naghmeh; Zadeh, Neda; Willis, Mary; Macmurdo, Colleen Forsyth; Manning, Melanie A; Kwan, Andrea; Hudgins, Louanne; Barthelemy, Florian; Miceli, M Carrie; Quintero-Rivera, Fabiola; Kantarci, Sibel; Strom, Samuel P; Deignan, Joshua L; Grody, Wayne W; Vilain, Eric; Nelson, Stanley F

2015-03-01

312

Hemorrhagic lumbar facet cysts accompanying a spinal subdural hematoma at the same level.  

Science.gov (United States)

Context We present a rare and interesting case of hemorrhagic lumbar facet cysts accompanying a spinal subdural hematoma at the same level suggesting a possible mechanism by which spinal subdural hematomas can arise. Findings A 71-year-old man presented with persistent sciatic pain and intermittent claudication. Magnetic resonance imaging demonstrated a multilocular mass lesion that showed high signal intensity in both T1- and T2-weighted images, and was located both inside and outside of the spinal canal. Computed tomographic myelography showed a cap-shaped block of the dural tube at L5 and computed tomography with L5-S facet arthrography demonstrated cystic masses. The patient was diagnosed with lumbar radiculopathy caused by hemorrhagic facet cysts, and then progressed to surgical treatment. Surgery revealed that the cysts contained blood clots, and intraoperative findings that the inside of the dural tube appeared blackish and that the dural tube was tensely ballooned after removal of the cysts led us to explorative durotomy. The durotomy demonstrated concentrated old blood pooling both in the dorsal and ventral subdural space, and these spaces were subsequently drained. After surgery, his sciatic pain and intermittent claudication resolved. There was no evidence of cyst mass recurrence at 2 years of follow-up. Conclusion We propose a newly described mechanism for the formation of spinal subdural hematomas. We recommend surgeons be alert to epidural lesions causing repeated acute compression of the dural tube, which can cause spinal subdural hematoma, and consider the possible coexistence of these lesions in diagnosis and strategic surgical decisions. PMID:24976137

Ikeda, Osamu; Minami, Norihiko; Yamazaki, Masashi; Koda, Masao; Morinaga, Tatsuo

2015-03-01

313

Posttraumatic arteriovenous fistula of the distal posterior tibial artery as cause of delayed wound healing in an unrecognized arterial injury.  

Science.gov (United States)

Background?Cases of posttraumatic arteriovenous (AV) fistula of the distal lower limb are rarely reported. Time from trauma to diagnosis varies from hours to years. Case Description?This case report of a 51-year-old male patient shows very impressively the extensive consequences of an unrecognized traumatic AV fistula. The fistula developed here after a car accident led to a massive healing delay in a pilon fracture of the tibia and a wound, resulting in almost 1?year immobilization, 20 operations, and extensive pain drug therapy. After surgical revision of the fistula, bone and wound healing improved quickly. Conclusions?The possibility of an AV fistula should be considered in case of persistent swelling after high-energy trauma of an extremity. The therapy of choice is surgery and the long-term result of successful fistula ligature is excellent. PMID:25798368

Roth, Peter; Heiss, Christian; Koshty, Ahmed; Niemann, Bernd; Boening, Andreas

2014-12-01

314

Contrast of artificial subcutaneous hematomas in MRI over time.  

Science.gov (United States)

In clinical forensic medicine, hematomas and other externally visible injuries build the basis for the reconstruction of events. However, dating of subcutaneous hematomas based on their external aspect is difficult. Magnetic resonance imaging (MRI) has proven its use in dating intracranial hemorrhage. Thus, the aim was to investigate if MRI can also be used for dating subcutaneous hematomas and to analyze an eventual influence of the hematoma shape. In 20 healthy volunteers (11 females, 9 males, aged 26.9?±?3.8 years), 4 ml of autologous blood were injected subcutaneously in the thigh. The hematoma was scanned immediately after the injection, after 3 and 24 h and 3, 7, and 14 days using three sequences with different contrast. Data was analyzed by measuring signal intensities of the hematoma, the muscle, and the subcutaneous tissue over time, and the Michelson contrast coefficients between the tissues were calculated. In the analysis, hematoma shape was considered. Signal intensity of blood in the proton density-weighted sequence reached its maximum 3 h after the injection with a subsequent decrease, whereas the signal intensities of muscle and fatty tissue remained constant. The time course of the Michelson coefficient of blood versus muscle decreased exponentially with a change from hyperintensity to hypointensity at 116.9 h, depending on hematoma shape. In the other sequences, either variability was large or contrast coefficients stayed constant over time. The observed change of contrast of blood versus muscle permits a quick estimate of a hematoma's age. The consideration of the hematoma shape is expected to further enhance dating using MRI. PMID:25416961

Hassler, Eva Maria; Ogris, Kathrin; Petrovic, Andreas; Neumayer, Bernhard; Widek, Thomas; Yen, Kathrin; Scheurer, Eva

2015-03-01

315

Hematoma intraventricular como complicação de meningite purulenta: relato de caso Intraventricular hematoma as a meningitis complication: case report  

OpenAIRE

Relato de caso de rara complicação de meningite purulenta, ou seja, hematoma intraventricular não associado a malformação vascular ou septação ventricular que justificassem a não difusão do sangue.Report of a case of intraventricular hematoma as purulent meningitis complication in a child of 6 months old, without vascular malformation. The evolution was sactisfatory after the surgical treatment.

Pedro Garcia Lopes; Wanderley, Eliana C. F. O.; Lamartine Correa de Moraes Junior; Wander Tamburus

1985-01-01

316

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

Directory of Open Access Journals (Sweden)

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

Ivan Hack

1984-03-01

317

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

Scientific Electronic Library Online (English)

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

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

1984-03-01

318

Acute Spontaneous Posterior Fossa Subdural Hematoma  

Directory of Open Access Journals (Sweden)

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

319

Severe complication after administration of formalin for treatment of progressive ethmoidal hematoma in a horse.  

Science.gov (United States)

Formalin was injected into an ethmoidal hematoma in an 18-year-old Arabian gelding. Abnormal neurologic signs were observed within minutes of the injection. The horse did not respond favorably to medical treatment of the neurologic signs and was euthanatized. Postmortem examination revealed erosion and necrosis of the ventral cribriform plate, which appeared to have allowed the injected formalin to reach the rostral portion of the frontal lobe of the brain. Endoscopy and radiography had been performed prior to euthanasia, but neither delineated the cribriform lesion. Before treating large progressive ethmoidal hematomas with formalin, it may be beneficial to perform computed tomography to assess the extent of damage caused by the lesion. PMID:11601791

Frees, K E; Gaughan, E M; Lillich, J D; Cox, J; Gorondy, D; Nietfeld, J C; Kennedy, G A; Cash, W

2001-10-01

320

Intramural duodenal hematoma after submucosal injection of epinephrine for a bleeding ulcer: case report and review  

Science.gov (United States)

We present a case of intramural duodenal hematoma as a complication of endoscopic therapy for a bleeding duodenal ulcer in an adult patient with no evidence of other pathologies. A 18-year-old man was admitted in emergency room with gastrointestinal bleeding manifested by melena. Previous medical history revealed that he had endoscopic sclerotherapy for bleeding duodenal ulcer 5 months before. Endoscopy revealed a Forrest 2a ulcer in the duodenal bulb and sclerotherapy was performed by injecting 10 ml of 0.2% epinephrine and 20 ml of NaCl 0.9% solution. Upper occlusion’s signs appeared 36 hours after the procedure. The hematoma, that was identified by endoscopy and confirmed by MRI and CT scan of the abdomen, caused transient duodenal obstruction. Combined conservative management with nasogastric tube and total parenteral nutrition resulted in reduction of obstructive symptoms within 4 weeks. PMID:25827667

DIBRA, A.; KËLLIÇI, S.; ÇELIKU, E.; DRAÇINI, Xh.; MATURO, A.; ÇELIKU, E.

2015-01-01

321

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

Directory of Open Access Journals (Sweden)

Full Text Available 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 dural repair is required to treat this severe complication when conservative treatments fail. We present a case report of severe persistent CSF leak after intrathecal pump revision that resulted in a subdural hematoma and postdural puncture headache. In this case, an epidural blood patch was performed using epidural catheter under fluoroscopic guidance to target the site of CSF leak and to avoid damaging the intrathecal catheter. This patient’s headache was resolved and intrathecal catheter remained intact after this blood patch.

Andrew Ng

2014-09-01

322

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

323

Nonaneurysmal subarachnoid hemorrhage in intramural hematoma of the basilar artery - a case report and literature review  

International Nuclear Information System (INIS)

Pretruncal (perimesencephalic) nonaneurysmal subarachnoid hemorrhage (SAH) is a benign variant of SAH. Although angiography fails to show a source of the hemorrhage, mild basilar artery narrowing may be observed. The cause of pretruncal nonaneurysmal SAH has not been established. Recent imaging studies have demonstrated that the center of this type of SAH is not around the mesencephalon but is in the prepontine or interpeduncular cistern with the hemorrhage closely associated with the basilar artery. We review the possible sources of hemorrhage in these cisterns and hypothesize that pretruncal nonaneurysmal SAH is caused by a primary intramural hematoma of the basilar artery. Such an intramural hematoma would explain bleeding under low pressure, the location of the hemorrhage anterior to the brainstem, and the typical findings of hemorrhage adjacent to the basilar artery lumen on magnetic resonance imaging and mild basilar artery narrowing on angiography. Hemorrhage in such location is easily found in native computed tomography (CT) images. Crescent, hyperdense thickening of the basilar artery wall is also observed. We have presented this unusual case to highlight the possible mechanism of hematoma formation and underline the importance of MDCT examination in the diagnosis confirmation and also excluding other potentially serious underlying condition that could also lead to non traumatic SAH. (authors)

324

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

325

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

Scientific Electronic Library Online (English)

Full Text Available 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

326

Thrombospondin-1 deficiency causes a shift from fibroproliferative to inflammatory kidney disease and delays onset of renal failure.  

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Thrombospondin-1 (TSP1) is a multifunctional matricellular protein known to promote progression of chronic kidney disease. To gain insight into the underlying mechanisms through which TSP1 accelerates chronic kidney disease, we compared disease progression in Col4a3 knockout (KO) mice, which develop spontaneous kidney failure, with that of Col4a3;Tsp1 double-knockout (DKO) mice. Decline of excretory renal function was significantly delayed in the absence of TSP1. Although Col4a3;Tsp1 DKO mice did progress toward end-stage renal failure, their kidneys exhibited distinct histopathological lesions, compared with creatinine level-matched Col4a3 KO mice. Although kidneys of both Col4a3 KO and Col4a3;Tsp1 DKO mice exhibited a widened tubulointerstitium, predominant lesions in Col4a3 KO kidneys were collagen deposition and fibroblast accumulation, whereas in Col4a3;Tsp1 DKO kidney inflammation was predominant, with less collagen deposition. Altered disease progression correlated with impaired activation of transforming growth factor-?1 (TGF-?1) in vivo and in vitro in the absence of TSP1. In summary, our findings suggest that TSP1 contributes to progression of chronic kidney disease by catalyzing activation of latent TGF-?1, resulting in promotion of a fibroproliferative response over an inflammatory response. Furthermore, the findings suggest that fibroproliferative and inflammatory lesions are independent entities, both of which contribute to decline of renal function. PMID:25111226

Zeisberg, Michael; Tampe, Björn; LeBleu, Valerie; Tampe, Desiree; Zeisberg, Elisabeth M; Kalluri, Raghu

2014-10-01

327

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

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

Séraphin Nguefack

2013-08-01

328

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

329

Epidural hematoma confirmed by contrast enhancement in computed tomography  

International Nuclear Information System (INIS)

Four cases of chronic epidural hematomas confirmed only by contrast enhancement are presented. In two cases, hematomas were found in the posterior fossa, in one, in both supra- and infratentorial regions, and in the remaining one, in the supratentorial region. Noncontrast CT failed to show the biconvex high-density area typical of an acute epidural hematoma. One supratentorial and two posterior fossa hematomas were definitely diagnosed only after an injection of the contrast medium. In the remaining one with combined supra- and infratentorial hematomas, a hematoma in the right occipital region was diagnosed on plain CT alone, but the left supratentorial lesion was confirmed only after the injection of an iodinated contrast medium. The mechanisms responsible for the enhancement of the margin of the chronic epidural hematoma are discussed. The dura mater in close contract with the inner table of the skull is usually not seen on the enhanced CT. The falx and tentorium are ordinarily well enhanced, however, and in patients who have undergone bone-flap removal, the dura mater without any juxtaposed skull is enhanced. It may be supposed that the enhanced margin as seen in chronic epidural hematoma represents either the enhanced dura mater displaced from the inner table of the skull, with or without overlying granulation tissue, or the compressed and congested brain underneath the hematoma, or both. An extravasation of the iodine from the immature neovasculature of the granum the immature neovasculature of the granulation tissue may prove to play an important role. The importance of the contrast enhancement in CT scanning of selected patients in chronic stage after the head injury is stressed. (author)

330

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

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

J. P. Rial

1988-03-01

331

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

OpenAIRE

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 defic...

Fang, Huang; Chen, Jing; Lin, Sen; Wang, Pengfei; Wang, Yanchun; Xiong, Xiaoyi; Yang, Qingwu

2014-01-01

332

Baker's Cyst Filled with Hematoma at the Lower Calf.  

Science.gov (United States)

Baker's cyst is a distension of the gastrocnemius-semimembranosus bursa of the knee, which communicates with the posterior portion of the joint capsule. Baker's cyst is commonly located in the inferomedial or superficial layers of the knee joint and rarely extends laterally or proximally. Complications of Baker's cysts are dissection, rupture, pseudothrombophlebitis, leg ischemia, nerve entrapment, and compartment syndrome. However, hematomas in the Baker's cyst have not been reported in Korea. We report a rare case of hematoma in the Baker's cyst with subfascial extension into the calf. The hematoma was demonstrated by magnetic resonance imaging and removed by mass excision. PMID:25505709

Yoo, Moon-Jib; Yoo, Jae-Sung; Jang, Ho-Seong; Hwang, Chang-Hwan

2014-12-01

333

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

334

Giant Chest Wall Hematoma Mimicking Elastofibroma Dorsi: A Case Report  

International Nuclear Information System (INIS)

Hematoma on the thoracic wall is very rare. We describe here a 63-year-old man with a huge chest wall hematoma and the man had no history of trauma. The patient was found to have a large mass located subjacent to the inferior angle of the right scapula area and the CT and MRI findings were similar to those of an elastofibroma dorsi. We describe the CT and MRI findings of this hematoma and how to make the differential diagnosis from elastofibroma dorsi

335

Spontaneously Developed Pulmonary Arterial Intramural Hematoma That Mimicked Thromboembolism  

Energy Technology Data Exchange (ETDEWEB)

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

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

2012-07-15

336

MRI of spinal hematoma as a result of lumbar puncture  

International Nuclear Information System (INIS)

A 59-year-old woman was suspected of having meningitis. A lumbar puncture was performed for CSF analysis; however, a traumatic tap induced hemorrhage in the subarachnoid space and formed a hematoma from the L3 to the S1 level. This resulted in a paraparesis. Myelography showed a band-like filling defect and a subsequent computed tomography (CT) myelogram showed a soft tissue mass in the intradural space. T1 weighted magnetic resonance imaging revealed a lesion with moderate hyperintensity within the dural sac, hinting that the lesion was a hematoma. Laminectomy was performed, and the hematoma was entirely removed. (orig.)

337

Spontaneous resolution of nontraumatic acute spinal subdural hematoma.  

Science.gov (United States)

Spinal subdural hematoma (SSDH) is an extremely uncommon condition. Causative factors include trauma, anticoagulant drug administration, hemostatic disorders, and vascular disorders such as arteriovenous malformations and lumbar punctures. Of SSDH cases, those that do not have any traumatic event can be considered cases of nontraumatic acute spinal subdural hematoma, which is known to have diverse clinical progress. Treatment typically consists of surgical decompression and cases in which the condition is relieved with conservative treatment are rarely reported. We report two nontraumatic acute spinal subdural hematoma patients who were successfully treated without surgery. PMID:22102963

Yang, Na-Rae; Kim, Sang Jin; Cho, Yong Jae; Cho, Do Sang

2011-09-01

338

Giant Chest Wall Hematoma Mimicking Elastofibroma Dorsi: A Case Report  

Energy Technology Data Exchange (ETDEWEB)

Hematoma on the thoracic wall is very rare. We describe here a 63-year-old man with a huge chest wall hematoma and the man had no history of trauma. The patient was found to have a large mass located subjacent to the inferior angle of the right scapula area and the CT and MRI findings were similar to those of an elastofibroma dorsi. We describe the CT and MRI findings of this hematoma and how to make the differential diagnosis from elastofibroma dorsi

Lee, Yeon Soo; Park, Kuhn; Kim, Jong Ok; Choi, Eun Seok; Kang, Si Won [Daejeon St. Mary' s Hospital, The Catholic University of Korea, Daejeon (Korea, Republic of)

2011-02-15

339

Outcome of burr hole surgery in the emergency room for severe acute subdural hematoma  

International Nuclear Information System (INIS)

We have performed burr hole surgery in the emergency room for severe acute subdural hematoma from April 2007 in twenty five patients. All patients were deep comatose and showed cerebral herniation sign with bilateral pupillary abnormalities. Burr hole surgeries were performed as soon as possible after CT evaluation. Continually decomporresive craiectomies were followed if clinical improvements were achieved and mild baribiturate-moderate hypothermia combined (MB-MH) therapy was induced postoperatively in some cases. The mean average was 65.6 years (range 16-93). The causes of head injuries were traffic accident in 9, fall down in 13 and unknown in 3. The mean Glasgow coma scale (GCS) on admission was 4.4 (range 3-9). The mean time interval from arrival to burr hole surgery was 33.5 minutes (range 21-50 minutes). Decompressive craniectomy was indicated in 14 cases and MB-MH therapy was induced in 13 cases. The overall clinical outcome consisted of good recovery in 3, moderate disability in 2, severe disability in 3, persistent vegetative state in 3 and death in 14. Favorable results can be expected even in patients with serious acute subdural hematoma. Emergent burr hole surgery was effective to decrease intracranial pressure rapidly and to save time. So active burr hole surgery in the emergency room is strongly recommended to all cases of severe acute subdural hematoma. (author)

340

Spontaneous intramural duodenal hematoma in type 2B von Willebrand disease  

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Full Text Available Intramural duodenal hematoma is a rare cause of a proximal gastrointestinal tract obstruction. Presentation of intramural duodenal hematoma most often occurs following blunt abdominal trauma in children, but spontaneous non-traumatic cases have been linked to anticoagulant therapy, pancreatitis, malignancy, vasculitis and endoscopy. We report an unusual case of spontaneous intramural duodenal hematoma presenting as an intestinal obstruction associated with acute pancreatitis in a patient with established von Willebrand disease, type 2B. The patient presented with abrupt onset of abdominal pain, nausea, and vomiting. Computed tomography imaging identified an intramural duodenal mass consistent with blood measuring 4.7 cm × 8.7 cm in the second portion of the duodenum abutting on the head of the pancreas. Serum lipase was 3828 units/L. Patient was managed conservatively with bowel rest, continuous nasogastric decompression, total parenteral nutrition, recombinant factor VIII (humateP and transfusion. Symptoms resolved over the course of the hospitalization. This case highlights an important complication of an inherited coagulopathy.

Derrick D Eichele

2013-01-01

341

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).

342

Delayed Symptom Development in ein2-1, an Arabidopsis Ethylene-Insensitive Mutant, in Response to Bacterial Wilt Caused by Ralstonia solanacearum.  

Science.gov (United States)

ABSTRACT Wilt disease caused by the phytopathogenic bacterium Ralstonia solanacearum is poorly understood at the molecular level. The possible roles of salicylic acid, jasmonic acid, and ethylene, compounds commonly associated with the plant response to pathogens, in wilt symptom development were investigated using various Arabidopsis thaliana mutants in a Col-0 background, an ecotype that develops wilt symptoms in response to the virulent GMI1000 strain. Following root inoculation, wilt symptoms were delayed in ein2-1, an ethylene-insensitive mutant, in response to several virulent strains of the pathogen. In ein2-1, bacteria invade the plant and multiply, reaching concentrations slightly lower than those detected in susceptible plants but 1 to 2 logs higher than in Nd-1, an A. thaliana ecotype resistant to strain GMI1000. This delay in disease symptom development of ein2-1 plants suggests that ethylene signaling plays a critical role in wilt disease development. Furthermore, a strong accumulation of transcripts corresponding to PR-3 and PR-4, two ethylene-responsive genes, was observed in susceptible Col-0 plants, but not in ein2-1 and Nd-1 plants, providing additional evidence for a role of ethylene in wilt symptom production. However, this hormone is probably not involved in the establishment of resistance to R. solanacearum, because homozygous ein2-1 plants in a resistant background remain fully resistant to strain GMI1000. PMID:18944225

Hirsch, Judith; Deslandes, Laurent; Feng, Dong Xin; Balagué, Claudine; Marco, Yves

2002-10-01

343

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

344

Analysis of chronic subdural hematoma based on CT, (2)  

International Nuclear Information System (INIS)

Twenty-three cases of chronic subdural hematoma were observed soon after head injury for the relationship between its CT findings and clinical symptoms. It has been found that the chronic subdural hematoma is a slowly growing and expanding intracranial disease that starts in an early period of head injury. Chronic subdural hematoma did not present any signs or symptoms initially, except for the gradual occurrence of headache, but finally it presented signs of intracranial hypertension and focal signs. Chronic subdural hematoma in the hygroma-like period did not show any signs and symptoms. In the capsulated period, when changes in CT density suggested intracapsular hemorrhage, a heavy sensation of the head was noted. It was recognized as an abnormal feeling or a full sensation of the head. When the bleeding continued in the cavity, headache became continuous and focal signs gradually appeared. (author)

345

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

346

Differentiated surgical treatment of patients with hypertensive intracerebral hematomas  

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

Natalia Ivanova

2011-04-01

347

Mutations in NALCN cause an autosomal-recessive syndrome with severe hypotonia, speech impairment, and cognitive delay.  

Science.gov (United States)

Sodium leak channel, nonselective (NALCN) is a voltage-independent and cation-nonselective channel that is mainly responsible for the leaky sodium transport across neuronal membranes and controls neuronal excitability. Although NALCN variants have been conflictingly reported to be in linkage disequilibrium with schizophrenia and bipolar disorder, to our knowledge, no mutations have been reported to date for any inherited disorders. Using linkage, SNP-based homozygosity mapping, targeted sequencing, and confirmatory exome sequencing, we identified two mutations, one missense and one nonsense, in NALCN in two unrelated families. The mutations cause an autosomal-recessive syndrome characterized by subtle facial dysmorphism, variable degrees of hypotonia, speech impairment, chronic constipation, and intellectual disability. Furthermore, one of the families pursued preimplantation genetic diagnosis on the basis of the results from this study, and the mother recently delivered healthy twins, a boy and a girl, with no symptoms of hypotonia, which was present in all the affected children at birth. Hence, the two families we describe here represent instances of loss of function in human NALCN. PMID:24075186

Al-Sayed, Moeenaldeen D; Al-Zaidan, Hamad; Albakheet, Albandary; Hakami, Hana; Kenana, Rosan; Al-Yafee, Yusra; Al-Dosary, Mazhor; Qari, Alya; Al-Sheddi, Tarfa; Al-Muheiza, Muhammed; Al-Qubbaj, Wafa; Lakmache, Yamina; Al-Hindi, Hindi; Ghaziuddin, Muhammad; Colak, Dilek; Kaya, Namik

2013-10-01

348

Calf hematoma - computed tomographic and magnetic resonance findings  

International Nuclear Information System (INIS)

Four patients with hematomas of the calf are presented. The diagnosis was made by computed tomography (CT) in three cases and CT/magnetic resonance imaging (MRI) in one case. In all cases, CT or MRI clarified a confusing clinical picture. CT and MRI can help differentiate the types of calf mass (i.e., hematoma, tumor, Baker cyst, thrombophlebitis) and assist proper clinical management in a rapid, noninvasive fashion. (orig.)

349

Unilateral proptosis and extradural hematoma in a child with scurvy  

International Nuclear Information System (INIS)

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

350

Subdural Hematoma in Grave’s Disease Induced Thrombocytopenia.  

OpenAIRE

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,; Sanjay Diwan; Shailee Chandek; Pratik Nitey; Anand Kakani

2013-01-01

351

A life threatening problem in infants: supratentorial epidural hematoma  

OpenAIRE

Traumatic epidural hematoma (EDH) represents a rare head injury complication in infants.Its diagnosis can be quite challenging because its clinical presentation is usually subtle and nonspecific.Authors present a study on 30 infants with epidural hematoma (EDH) admitted in the Pediatric Department of Neurosurgery of the ‘Bagdasar–Arseni’ Clinical Hospital in the period of 1990–2007 (17 years).The most common symptom was irritability, which occurred in 16 cases (53.3%), of ...

Ciurea, Av; Tascu, A.; Brehar, Fm; Nuteanu, L.; Rizea, R.

2009-01-01

352

Chronic subdural hematoma fluid and its computerized tomographic density  

International Nuclear Information System (INIS)

Laboratory and in vivo CT analysis were performed on 19 chronic subdural hematomas and five subdural hygromas. In these 25 hematoma samples, red blood cells (RBC), hematocrit, and hemoglobin (Hgb) varied greatly, though, these values correlated well with the CT densities. Plasma protein content was fairly constant with an average of 7.1+-0.8g/dl. There were four hematoma samples with RBC of less than 20x104?l or Hgb of less than 2.0g/dl. Their CT values ranged between 18 and 23 H.U., which were considered close to the in vivo serum level CT density. Five hygroma fluid showed no RBC and very little protein content of less than 0.4g/dl. CT density ranged between -2 and 13 H.U. The edge effect of the skull was experimentally studied using a phantom skull filled with water. This revealed a remarkable overshoot of the CT values within ten pixels from the inner wall of the skull. Visual observation of the original CT pictures revealed four low density hematomas and seven mixed density ones. When compared to the density of the ventricular cavity, all of the low density hematomas and the supernatant part of the mixed density ones were clearly higher in density. All five hygromas appeared CSF dense or lower. In conclusion, because of the edge effect by the skull, thin subdural fluids could not be diagnosed by CT alone. Thick subdural fluids could be differentiated as either hematoma or hygroma by their CT densities. Subdural hematomas had in vivo CT densities of at hematomas had in vivo CT densities of at least serum level or approximately 20 H.U., while subdural hygromas had densities close to CSF. These characteristics were best appreciated by visual observation of the CT scan films. (J.P.N.)

353

Unilateral proptosis and extradural hematoma in a child with scurvy  

Energy Technology Data Exchange (ETDEWEB)

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

Verma, Sumit; Sivanandan, Sindhu; Seth, Rachna; Kabra, Shushil [All India Institute of Medical Sciences (AIIMS), Department of Pediatrics, New Delhi (India); Aneesh, Mangalasseril K.; Gupta, Vaibhav [All India Institute of Medical Sciences (AIIMS), Department of Radiodiagnosis, New Delhi (India)

2007-09-15

354

Intracranial Subdural Hematoma after Spinal Anesthesia for Cesarean Section  

OpenAIRE

Intracranial subdural hematoma following spinal anesthesia is an infrequent occurrence in the obstetric population. Nevertheless, it is a potentially life-threatening complication. In the majority of the cases, the first clinical symptom associated with intracranial subdural bleeding is severe headache, but the clinical course may have different presentations. In this report, we describe the case of a 38-year-old woman with an acute intracranial subdural hematoma shortly after spinal anesthes...

Vittorio Schweiger; Giovanni Zanconato; Gisella Lonati; Silvia Baggio; Leonardo Gottin; Enrico Polati

2013-01-01

355

Spontaneous Resolution of Nontraumatic Acute Spinal Subdural Hematoma  

OpenAIRE

Spinal subdural hematoma (SSDH) is an extremely uncommon condition. Causative factors include trauma, anticoagulant drug administration, hemostatic disorders, and vascular disorders such as arteriovenous malformations and lumbar punctures. Of SSDH cases, those that do not have any traumatic event can be considered cases of nontraumatic acute spinal subdural hematoma, which is known to have diverse clinical progress. Treatment typically consists of surgical decompression and cases in which the...

Yang, Na-rae; Kim, Sang Jin; Cho, Yong Jae; Cho, Do Sang

2011-01-01

356

Acute Cervical Spinal Subdural Hematoma Not Related to Head Injury  

OpenAIRE

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

Kim, Hee Yul; Ju, Chang Il; Kim, Seok Won

2010-01-01

357

Acute Spontaneous Spinal Subdural Hematoma with Vague Symptoms  

OpenAIRE

Spinal subdural hematoma is a rarely reported disease and spontaneous spinal subdural hematomas (SSDH) without underlying pathological changes are even rarer. The patients usually show typical symtoms such as back pain, quadriplegia, paraplegia or sensory change. But rarely, patients may show atypical symptoms such as hemiparesis and misdiagnosed to cerebrovascular accident. We recently experienced a case of SSDH, where the patient initially showed vague symptoms, such as the sudden onset of ...

Chung, Jaehwan; Park, In Sung; Hwang, Soo-hyun; Han, Jong-woo

2014-01-01

358

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

359

[Chronic expanding hematoma of the soleus: a case report].  

Science.gov (United States)

Trauma-induced hematomas of the limbs usually resorb without sequelae. In certain circumstances which are not fully understood, the hematoma may expand progressively, eventually leading to the development of a tumor-like mass in the soft tissues. We report the case of a chronic expanding hematoma observed in the right soleus muscle of a 75-year-old man. The mass grew +9 cm compared with the other side over a period of two to three years with no notion of recent trauma. Surgical biopsy disclosed a thick capsule containing "chocolate pus". Pathology and cytology examination led to the diagnosis of pseudo-tumor calcinosis subsequent to a hematoma which the patient had developed 34 years earlier when as a mountain guide he had experienced a tear of the soleus muscle. Local care required complete resection of the soleus muscle. The patient was able to resume activities without pain. Well described in the literature, encapsulated hematoma of the limbs is not well known in France. This case illustrated the potentially long latency period (34 years in our patient). Pathologically similar to tumor calcinosis, chronic expanding hematoma should be entertained as a possible diagnosis in a patient with a longstanding mass and a history of past trauma. The differential diagnosis with sarcoma is established by magnetic resonance imaging which reveals a peripheral low intensity signal on T1 and T2 sequences. PMID:17124458

Pichon, H; Pittet Barbier, L; Pasquier, B; Cartier, J; Saragaglia, D

2006-11-01

360

Chronic subdural hematoma infected by propionibacterium acnes: a case report.  

Science.gov (United States)

We present a very rare case of a patient with an infected subdural hematoma due to Propionibacterium acnes. A 63-year-old male complained of dizziness and was admitted to our hospital. He had a history of left chronic subdural hematoma due to a traffic accident, which had been conservatively treated. Physical, neurological and laboratory examinations revealed no definite abnormality. Plain CT scan demonstrated a hypodense crescentic fluid collection over the surface of the left cerebral hemisphere. The patient was diagnosed with chronic subdural hematoma and underwent burr hole surgery three times and selective embolization of the middle meningeal artery, but the lesion easily recurred. Repeated culture examinations of white sedimentation detected P. acnes. Therefore, he underwent craniotomy surgery followed by intravenous administration of antibiotics. The infected subdural hematoma was covered with a thick, yellowish outer membrane, and the large volume of pus and hematoma was removed. However, the lesion recurred again and a low-density area developed in the left frontal lobe. Craniotomy surgery was performed a second time, and two Penrose drainages were put in both the epidural and subdural spaces. Subsequently, the lesions completely resolved and he was discharged without any neurological deficits. Infected subdural hematoma may be refractory to burr hole surgery or craniotomy alone, in which case aggressive treatment with craniotomy and continuous drainage should be indicated before the brain parenchyma suffers irreversible damage. PMID:25759659

Yamamoto, Shusuke; Asahi, Takashi; Akioka, Naoki; Kashiwazaki, Daina; Kuwayama, Naoya; Kuroda, Satoshi

2015-01-01

361

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

362

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

363

Bilateral chronic subdural hematomas resulting in unilateral oculomotor nerve paresis and brain stem symptoms after operation--case report.  

Science.gov (United States)

An 85-year-old male presented with bilateral chronic subdural hematomas (CSDHs) resulting in unilateral oculomotor nerve paresis and brainstem symptoms immediately after removal of both hematomas in a single operation. Initial computed tomography on admission demonstrated marked thick bilateral hematomas buckling the brain parenchyma with a minimal midline shift. Almost simultaneous removal of the hematomas was performed with the left side was decompressed first with a time difference of at most 2 minutes. However, the patient developed right oculomotor nerve paresis, left hemiparesis, and consciousness disturbance after the operation. The relatively marked increase in pressure on the right side may have caused transient unilateral brain stem compression and herniation of unilateral medial temporal lobe during the short time between the right and left procedures. Another factor was the vulnerability of the oculomotor nerve resulting from posterior replacement of the brain stem and stretching of the oculomotor nerves as seen on sagittal magnetic resonance (MR) images. Axial MR images obtained at the same time demonstrated medial deflection of the distal oculomotor nerve after crossing the posterior cerebral artery, which indicates previous transient compression of the nerve and the brain stem. Gradual and symmetrical decompression without time lag is recommended for the treatment of huge bilateral CSDHs. PMID:10481440

Okuchi, K; Fujioka, M; Maeda, Y; Kagoshima, T; Sakaki, T

1999-05-01

364

Warfarin Induced Iliopsoas Hematoma Detected by Bedside Emergency Ultrasonography  

Directory of Open Access Journals (Sweden)

Full Text Available Warfarin is frequently used as an oral anticoagulant in a variety of clinical settings, e.g. atrial fibrillation or following valvular heart disease. The most serious and common complication associated with anticoagulation using warfarin is bleeding. Hemorrhage into the iliopsoas muscle causing femoral neuropathy is an infrequent complication of anticoagulant therapy. Two women, 53 and 70 year-old, each with a history of mitral valve replacement surgery, presented at the emergency department with right hip pain. They had been taking warfarin 5 mg once a day since their operations. Physical examinations were normal except for the right hip pain,on movement and femoral nerve palsy in the second patient. Prothrombin, activated prothrombin time and international normalized ratio were prolonged. In order to make the differential diagnosis, we decided to perform bedside emergency ultrasound examination. Ultrasound examination of the patients showed an anechoic lesion in the area of the right iliopsoas muscle. They were admitted to hospital for observation and treatment. Fresh frozen plasma and vitamin K were given for treatment. The possibility of iliopsoas hematoma should be considered in any patient with hip pain undergoing anticoagulant treatment.

F?rat Bekta?

2012-01-01

365

Clinical appraisal of stereotactic hematoma aspiration surgery for hypertensive thalamic hemorrhage; With respect to volume of the hematoma  

Energy Technology Data Exchange (ETDEWEB)

Three hundred and four patients with hypertensive thalamic hemorrhage were managed by medical treatment, ventricular drainage, or CT-controlled stereotactic aspiration surgery (AS). The therapeutic results of the 6-month outcome were analyzed and correlated with the volume of the hematoma. A hematoma volume of 20 ml was thought to be the critical size in determining whether the outcome would be favorable or unfavorable. Indications for AS are suggested as follows. In patients with a small-sized hematoma having a volume of less than 10 ml use of AS should be restricted to patients with severe paralysis or other neurological complications and the elderly (aged 70 years or older). For patients with a medium-sized hematoma having a volume between 10 ml and 20 ml, AS is indicated for patients having severe paralysis and disturbances of consciousness. For patients with a large-sized hematoma having a volume of 20 ml or more, AS increases not only the survival rate of patients but also reduces the number of bedridden patients. We conclude that AS opens up a new avenue of surgical treatment for hypertensive thalamic hemorrhage, which has been no indication for hematoma evacuation by conventional craniotomy. (author).

Sasaki, Koji; Matsumoto, Keizo (Tokushima Univ. (Japan). School of Medicine)

1992-06-01

366

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

Scientific Electronic Library Online (English)

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

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

1988-03-01

367

De Novo Mutations in NALCN Cause a Syndrome Characterized by Congenital Contractures of the Limbs and Face, Hypotonia, and Developmental Delay.  

Science.gov (United States)

Freeman-Sheldon syndrome, or distal arthrogryposis type 2A (DA2A), is an autosomal-dominant condition caused by mutations in MYH3 and characterized by multiple congenital contractures of the face and limbs and normal cognitive development. We identified a subset of five individuals who had been putatively diagnosed with "DA2A with severe neurological abnormalities" and for whom congenital contractures of the limbs and face, hypotonia, and global developmental delay had resulted in early death in three cases; this is a unique condition that we now refer to as CLIFAHDD syndrome. Exome sequencing identified missense mutations in the sodium leak channel, non-selective (NALCN) in four families affected by CLIFAHDD syndrome. We used molecular-inversion probes to screen for NALCN in a cohort of 202 distal arthrogryposis (DA)-affected individuals as well as concurrent exome sequencing of six other DA-affected individuals, thus revealing NALCN mutations in ten additional families with "atypical" forms of DA. All 14 mutations were missense variants predicted to alter amino acid residues in or near the S5 and S6 pore-forming segments of NALCN, highlighting the functional importance of these segments. In vitro functional studies demonstrated that NALCN alterations nearly abolished the expression of wild-type NALCN, suggesting that alterations that cause CLIFAHDD syndrome have a dominant-negative effect. In contrast, homozygosity for mutations in other regions of NALCN has been reported in three families affected by an autosomal-recessive condition characterized mainly by hypotonia and severe intellectual disability. Accordingly, mutations in NALCN can cause either a recessive or dominant condition characterized by varied though overlapping phenotypic features, perhaps based on the type of mutation and affected protein domain(s). PMID:25683120

Chong, Jessica X; McMillin, Margaret J; Shively, Kathryn M; Beck, Anita E; Marvin, Colby T; Armenteros, Jose R; Buckingham, Kati J; Nkinsi, Naomi T; Boyle, Evan A; Berry, Margaret N; Bocian, Maureen; Foulds, Nicola; Uzielli, Maria Luisa Giovannucci; Haldeman-Englert, Chad; Hennekam, Raoul C M; Kaplan, Paige; Kline, Antonie D; Mercer, Catherine L; Nowaczyk, Malgorzata J M; Klein Wassink-Ruiter, Jolien S; McPherson, Elizabeth W; Moreno, Regina A; Scheuerle, Angela E; Shashi, Vandana; Stevens, Cathy A; Carey, John C; Monteil, Arnaud; Lory, Philippe; Tabor, Holly K; Smith, Joshua D; Shendure, Jay; Nickerson, Deborah A; Bamshad, Michael J

2015-03-01

368

Evaluation of intracerebral hematoma resorption dynamics with computed tomography  

International Nuclear Information System (INIS)

High mortality and severe grade of disability observed in patients after intracerebral hemorrhage provide efforts to improve diagnostics and therapy of the hemorrhagic cerebral stroke. An aim of this paper was an evaluation of blood resorption dynamics in patients with intracerebral hematoma, performed with computed tomography of the head and an analysis of clinical significance of this process. An examined group included 133 patients with intracerebral hematoma proven by a CT exam. In 97 patients resorption of the hematoma was measured, based on control scans taken on 15th and 30th day on average. Volume of the hemorrhagic foci was measured as well as the width of ventricles and the displacement of medial structures. The mean hematoma volume reached 11,59 ml after 15 days, and 3,16 m after 30 days (average decrease of the volume 0,67 ml/day). There was a significant difference in the rate of resorption between the first (0-15 days) and the second (15-30 days) observation period - 0,78 and 0,62 ml/day respectively. The dynamics of the process was dependent on volume and localization of the hematoma and independent of the grade of displacement and compression of the ventricles. The calculated mean rate of the hematomas resorption enables to schedule control examinations precisely. The significant differences of the dynamics of blood resorption depending on hematomas size and the independence of compression and displacement of ventricular system su and displacement of ventricular system suggest, that the most important factor in therapeutic decision-making should be a clinical status of the patient. (author)

369

Challenging the Pathophysiologic Connection between Subdural Hematoma, Retinal Hemorrhage and Shaken Baby Syndrome  

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Full Text Available Child abuse experts use diagnostic findings of subdural hematoma and retinal hemorrhages as near-pathognomonic findings to diagnose shaken baby syndrome. This article reviews the origin of this link and casts serious doubt on the specificity of the pathophysiologic connection. The forces required to cause brain injury were derived from an experiment of high velocity impacts on monkeys, that generated forces far above those which might occur with a shaking mechanism. These forces, if present, would invariably cause neck trauma, which is conspicuously absent in most babies allegedly injured by shaking. Subdural hematoma may also be the result of common birth trauma, complicated by prenatal vitamin D deficiency, which also contributes to the appearance of long bone fractures commonly associated with child abuse. Retinal hemorrhage is a non-specific finding that occurs with many causes of increased intracranial pressure, including infection and hypoxic brain injury. The evidence challenging these connections should prompt emergency physicians and others who care for children to consider a broad differential diagnosis before settling on occult shaking as the de-facto cause. While childhood non-accidental trauma is certainly a serious problem, the wide exposure of this information may have the potential to exonerate some innocent care-givers who have been convicted, or may be accused, of child abuse. [West J Emerg Med. 2011;12(2:144-158.

Gabaeff, Steven C

2011-05-01

370

Optimal management of hemophilic arthropathy and hematomas  

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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

371

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

372

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

373

Spontaneous peri-nephric hematoma in a patient with acute kidney injury following Russell's viper envenomation.  

Science.gov (United States)

Snake bite envenomation is a common cause of acute kidney injury (AKI) in the tropics and severe coagulopathy with bleeding manifestations is usually seen, especially with viperine bites. We present a case of a 34-year-old male who had developed AKI following Russell's viper envenomation along with disseminated intravascular coagulation. The patient was seemingly improving during the course of his treatment but subsequently developed a spontaneous unilateral peri-nephric hematoma and finally succumbed to this complication. This is a rare presentation that can be clinically innoccuous in a disease where there are multiple bleeding manifestations and, carries a very poor outcome. PMID:25758885

Golay, Vishal; Roychowdhary, Arpita; Pandey, Rajendra

2015-01-01

374

Delayed presentation of traumatic intraperitoneal bladder rupture  

International Nuclear Information System (INIS)

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

375

Epidural Hematoma Presenting with Severe Neck Pain without Neurological Deficit - A Late Complication of Posterior Cervical Spine Surgery: Presentation of Three Unusual Cases  

OpenAIRE

Postoperative epidural hematoma (EDH) usually present with neurological deficit. Massive EDH presenting with only severe pain without neurological deficit are rare. Atypical presentations of postoperative EDHs may lead to delayed diagnosis and treatment. We present three such cases after posterior cervical spine surgery. Three patients presented with severe neck pain and spasms without motor deficits several days after posterior cervical decompressive procedures. Imaging studies identified co...

Khan, Mustafa H.; Lee, Joon Y.; Donaldson, William F.; Kang, James D.

2007-01-01

376

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

377

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

378

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

Scientific Electronic Library Online (English)

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

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

2004-11-01

379

Chronic subdural hematoma secondary to traumatic subdural hygroma  

International Nuclear Information System (INIS)

Sometimes chronic subdural hematoma can be developed following posttraumatic subdural hygroma. The purpose of this study is to investigate its incidence, the duration required for their conversion, and characteristic CT and MR findings of subdural hygroma and chronic subdural hamatoma. We studied 8 patients with persistent posttraumatic subdural hygroma which consequently developed chronic subdural hamatoma. The patients were examined with CT initially and followed-up with CT in 3 and MR in 5. We analyzed the location of the lesion, the change of the density or signal intensity, the change of the size, and the degree of enhancement and mass effect. The duration required for the formation of hematoma was 48-166 days (mean, 76 days). The characteristic CT findings of subdural hygroma were a crescentric lesion with CSF density along the inner table with-out contrast enhancement. The mass effect was minimal. The CT findings of chronic subdural hematoma were higher density than that of hygroma in all cases, increase in thickness and size in 3 cases, and contrast enhancement along the inner membrane of the hematoma in 5 cases. The signal intensities of the subdural hygroma were identical to those of CSF on both T1 and T2 weighted images, whereas, those of chronic subdural hamatoma were higher. The increased signal intensity on T1 weighted MR images and increased attenuation or contrast enhancement of the lesion on CT may suggest the conversion of subdural hygroma into chron conversion of subdural hygroma into chronic subdural hematoma

380

Recovery of cerebral blood flow in unilateral chronic subdural hematoma. The correlation with cerebral re-expansion in elders  

International Nuclear Information System (INIS)

CT and SPECT were used to investigate the relationship between cerebral re-expansion and changes in cerebral blood flow underneath hematoma in elderly patients after surgery for chronic unilateral subdural hematoma. I studied 22 patients with mild hematoma, aged 43 to 82 years (mean 67 years). The patients were placed in either Group A (under 70 years) or Group B (70 years or over) to observe postoperative changes. CT and SPECT examinations were conducted before surgery and 1, 7 and 30 days after surgery, 4 times in total. Cerebral re-expansion was represented by the re-expansion rate (PER) comparing the pre- and postoperative thickness of the maximal hematoma in CT images. The rate of cerebral re-expansion was slowed in Group B (p<0.01). Cerebral re-expansion was characterized by biphasic, rapid or gradual re-expansion on postoperative day 1 with a significant difference between groups (p<0.01). Before surgery, cerebral blood flow on the affected side correlated with age (p<0.01), thougn blood flow was diminished in both groups. After surgery, cerebral blood flow on the affected side exceeded that on the unaffected side in Group A and transiently increased on postoperative day 1. Cerebral blood flow improved after surgery in both groups, with a significant difference in those changes over time (p<0.01). In both groups, cerebral re-expansion on postoperative days 7 and 30 correlated with cerebral blood flow on the affected side (p<0.05). The present results suggest the (p<0.05). The present results suggest that improvement in cerebral blood flow on the affected side is delayed in elderly patients, due to slower postoperative cerebral re-expansion. (author)

381

Epidural hematoma after thoracic epidural analgesia in a patient treated with ketorolac, mefenamic acid, and naftazone: a case report  

OpenAIRE

A 26-year-old male undergoing thoracotomy and bleeding control received a preoperative thoracic epidural for postoperative analgesia. On the fifth postoperative day, paralysis of both lower limbs occurred and urgent magnetic resonance imaging showed massive anterior epidural hematoma. During laminectomy and decompression, platelet dysfunction was diagnosed and preoperative non-steroidal anti-inflammatory drugs medications were supposed to the cause of platelet dysfunction. After infusion of t...

Jeon, Dae Geun; Song, Jae Gyok; Kim, Seok-kon; Kim, Juri

2014-01-01

382

The retro placental hematoma and fetal death in utero: About 49 cases and review of the literature  

OpenAIRE

The Retro Placental Hematoma (RPH) or placental abruption untimely normally inserted paroxysmal is an accident that threatens maternal and fetal prognosis. It is a major emergency obstetric pathology and remains the second leading cause of maternal mortality after postpartum haemorrhage. It is actually very difficult to have an accurate evaluation the frequency of the HRP because it requires a complete table including Pathologists; or simple macroscopic or microscopic findings; or purely clin...

Saida Mezane; Achnani, M.; Ziyadi, M.; Babahabib, A.; Hafidi, R.; Moussaoui, D.; Dehayni, M.

2013-01-01

383

Acute spinal subdural hematoma in a patient with active systemic lupus erythematosus: a case report and literature review.  

Science.gov (United States)

We herein describe a case of acute spinal subdural hematoma (SSDH) during the administration of high-dose corticosteroids and intravenous heparin for the treatment of active lupus nephritis. After SSDH was promptly diagnosed using magnetic resonance imaging (MRI), the patient recovered well with conservative treatment involving the discontinuation of heparin sodium. Although SSDH is a rare complication, it should be considered as a cause of neurological manifestations in patients with active systemic lupus erythematosus. PMID:24739612

Akita, Koji; Wada, Taishi; Horii, Shunpei; Matsumoto, Mitsuyo; Adachi, Takeshi; Kimura, Fumihiko; Itoh, Kenji

2014-01-01

384

Spontaneous Remission of Ruptured Intramyocardial Hematoma Detected upon Serial Multidetector Computed Tomography  

OpenAIRE

Intramyocardial hematoma is a rare sequela of percutaneous coronary intervention after acute myocardial infarction. Clinical outcomes of intramyocardial hematoma vary from asymptomatic remission to cardiac death. Close follow-up is imperative.

Hsieh, Yu-cheng; Tsai, I-chen; Tsao, Chen-rong; Lin, Tung-chao; Ting, Chih-tai; Wu, Tsu-juey

2010-01-01

385

Chronic calcified subdural hematoma: Case report and review of the literature  

OpenAIRE

Background: Calcified chronic subdural hematoma is a rare but known entity, estimated to represent 0.3-2.7% of chronic subdural hematomas. Although surgical treatment is unanimous for chronic subdural hematomas, therein lies some doubt on it being applied to calcified chronic subdural hematomas. Case Description: We report a case of a 73?year?old male, presenting with deterioration of motor function in his right limbs since 18 months, with computed tomography (CT) scans and...

Pappamikail, L.; Rato, R.; Novais, G.; Bernardo, E.

2013-01-01

386

Prediction and Observation of Post-Admission Hematoma Expansion in Patients with Intracerebral Hemorrhage  

OpenAIRE

Post-admission hematoma expansion in patients with intracerebral hemorrhage (ICH) comprises a simultaneous major clinical problem and a possible target for medical intervention. In any case, the ability to predict and observe hematoma expansion is of great clinical importance. We review radiological concepts in predicting and observing post-admission hematoma expansion. Hematoma expansion can be observed within the first 24?h after symptom onset, but predominantly occurs in the early hours....

Ovesen, Christian; Havsteen, Inger; Rosenbaum, Sverre; Christensen, Hanne

2014-01-01

387

Hematoma subdural crónico calcificado. Reporte de un caso  

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Full Text Available El hematoma subdural crónico constituye una enfermedad frecuente en la práctica neuroquirúrgica cotidiana. Su diagnóstico se realiza actualmente de forma temprana en la mayoría de los pacientes, a partir de la introducción de las modernas técnicas de imagenología. Se presenta el caso de un enfermo de 84 años de edad con historia de cefalea, mutismo acinético y cuadriparesia, cuyo examen tomográfico mostró una colección extraxial supratentorial hemisférica derecha con calcificación masiva; se practicó la exéresis mediante una craneotomía y el estudio histopatológico confirmó el diagnóstico de hematoma subdural crónico. Se concluye que, al constituir la calcificación masiva del hematoma subdural crónico una rara forma de presentación imagenológica en la actualidad, deben contemplarse otras entidades en el diagnóstico diferencial como neoplasias y malformaciones vasculares intracraneales; por otro lado, aumenta la complejidad quirúrgica ya que es imprescindible la práctica de una craneotomía para la evacuación de la lesión.

Ariel Varela Hern\\u00E1ndez

2008-01-01

388

Spinal subdural hematoma as a complication of spinal surgery: can it happen without dural tear?  

OpenAIRE

Post spinal surgery subdural hematoma is a rare entity. This is a report of a case of acute post-operative spinal subdural hematoma, without any dural injury. The case was managed expectantly and went on to complete resolution of the hematoma and full clinical recovery.

Gakhar, Harinder; Bommireddy, Rajendranath; Klezl, Zdenek; Calthorpe, Denis

2012-01-01

389

Jejunal Intramural Hematoma with Bowel Obstruction in a 5-year-old Boy: A Case Report  

Energy Technology Data Exchange (ETDEWEB)

Intramural hematoma of the jejunum is rare and can be classified as trauma-related or occurring spontaneously. Spontaneous intramural hematoma commonly occurs in patients treated with warfarin. We report a case of intramural hematoma of the jejunum with intestinal obstruction in a 5-year-old boy who had neither a definite history of trauma nor the tendency to bleed.

Kim, Seung Soo; Kim, Young Tong [Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of)

2009-12-15

390

Jejunal Intramural Hematoma with Bowel Obstruction in a 5-year-old Boy: A Case Report  

International Nuclear Information System (INIS)

Intramural hematoma of the jejunum is rare and can be classified as trauma-related or occurring spontaneously. Spontaneous intramural hematoma commonly occurs in patients treated with warfarin. We report a case of intramural hematoma of the jejunum with intestinal obstruction in a 5-year-old boy who had neither a definite history of trauma nor the tendency to bleed

391

Retrobulbar Hematoma in Blow-Out Fracture after Open Reduction  

Directory of Open Access Journals (Sweden)

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

392

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

393

Idea on Prevention from Postoperative Intraorbital Hematoma in Orbital Surgery  

OpenAIRE

The retrobulbar hematoma is a rare complication after orbital surgery. Despite of its rareness, the retrobulbar hematoma may be disastrous to the patient’s vision (Chen et al. in J Craniofac Surg 20:963--967, 2009). Since 2007, I have applied the combined use of a scalp vein set and a vacuumed blood sampling bottle in all of the orbital surgeries. In my study, I achieved a good result, and I will introduce this simple method as one of alternatives for the prevention from the postoperative i...

Lee, D. G.

2012-01-01

394

Multiple remote epidural hematomas following pineal gland tumor resection  

Directory of Open Access Journals (Sweden)

Full Text Available 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 may occur at any site, it is rare in those areas remote from the operative field. In the present case, multiple remote sequential epidural hematomas developed following resection of a pineal gland tumor. We also discuss the pathophysiologic mechanisms and provide a literature review.

Lim Jeong-Wook

2010-01-01

395

Cervicothoracic Spinal Epidural Hematoma after Anterior Cervical Spinal Surgery  

OpenAIRE

The purpose of this case report is to describe a rare case of a cervicothoracic spinal epidural hematoma (SEH) after anterior cervical spine surgery. A 60-year-old man complained of severe neck and arm pain 4 hours after anterior cervical discectomy and fusion at the C5-6 level. Magnetic resonance imaging revealed a postoperative SEH extending from C1 to T4. Direct hemostasis and drainage of loculated hematoma at the C5-6 level completely improved the patient's condition. When a patient compl...

Lee, Dong Yeob; Lee, Sang-ho

2010-01-01

396

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

397

Spontaneous rectus sheath hematoma pregnancy: case report and review of the literature.  

Science.gov (United States)

Rectus sheath hematoma (RSH) is a rare, but important potential cause of acute upper abdominal pain in pregnancy. We report a patient with history of hemolysis, elevated liver enzymes, low platelets syndrome who presented with upper abdominal pain, hypotension, elevated hepatic transaminase levels, and a visibly enlarging right costal margin mass at 33 weeks' gestation. She underwent emergent cesarean delivery and upper abdominal exploration with findings of a large hematoma involving the entire right rectus sheath. The current case illustrates that the diagnosis of an RSH in pregnancy can be difficult as its presentation can mimic many common causes of abdominal pain seen outside of pregnancy, as well as many specific to pregnancy. Review of the published cases from the past 20 years shows that correct diagnosis remains difficult in pregnancy despite advances in diagnostic imaging. Although management of an RSH outside of pregnancy is frequently conservative, it is very often treated surgically in pregnant patients and often leads to preterm delivery. PMID:20955630

Tolcher, Mary C; Nitsche, Joshua F; Arendt, Katherine W; Rose, Carl H

2010-08-01

398

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

399

Spontaneous Cervico-Thoracic Spinal Epidural Hematoma in an Elderly Patient: A Rare Presentation  

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Full Text Available Spontaneous spinal epidural hematoma (SSEH is a rare entity.SSEH is an accumulation of blood in the vertebral epidural space in the absence of trauma or iatrogenic procedure like lumbar puncture.The incidence of SSEH has been estimated at 0.1 patients per 100,000 individuals and represents less than 1% of spinal space-occupying lesions .Here we are presenting case of a 65year old female hypertensive on treatment with controlled blood pressure, who presented with sudden onset paraplegia and weakness of muscles of hand, associated with urinary and bowel incontinence that started 6 hours before presenting to Emergency Room .Patient was subjected to MRI spine that revealed a collection in spinal epidural space ,hypointense in T1W images and hyperintense in T2W images, extending from C6-C7 to T1-T2 suggestive of acute / subacute epidural hematoma (fig 1.In our case all possible causes of an epidural haematoma were ruled out by relevant investigations.Patient was subjected to surgical evacuation of hematoma after 48 hours of presentation.Perioperative and Postoperative period was uneventfull . Sensations over involved areas improved. Motor weakness also improved from Grade III to Grade IV+ in bilateral lower limbs and from Grade II to Grade IV in small muscles of hand and triceps, however Patient persisited with urinary incontinence.CONCLUSION: When a patient receiving anticoagulant therapy complains of sudden and unexplained neck or back pain, we should suspect the possibility of SSEH. For early diagnosis, immediate MRI is essential .In addition, we should consider SSEH as one of the important differential diagnoses in elderly patients who have developed acute myelopathy. [Natl J Med Res 2013; 3(4.000: 424-427

Reyaz Ahmed Para,Muzamil Latief,Huma Noor

2013-08-01

400

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.)

401

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

402

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

403

Subintimal hematoma of the aorta after deceleration injury.  

OpenAIRE

Deceleration injuries of the aorta may occur without aortic disruption. We describe the case of a patient with a subintimal hematoma of the aorta that resolved within 48 hours. Serial arteriography confirmed the diagnosis and excluded aortic rupture. Thoracic exploration was not performed.

Baciewicz, F. A.

1995-01-01

404

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

405

Hypothalamo-Pituitary Dysfunction in Patients With Chronic Subdural Hematoma.  

Czech Academy of Sciences Publication Activity Database

Ro?. 61, ?. 2 (2012), s. 161-167. ISSN 0862-8408 Grant ostatní: GA MZd(CZ) NS9794 Institutional research plan: CEZ:AV0Z10300504 Keywords : hypopituitarism * subdural hematoma * brain injury * growth hormone deficiency Subject RIV: ED - Physiology Impact factor: 1.531, year: 2012

Hána, V.; Kosák, M.; Masopust, V.; Netuka, D.; Lacinová, Z.; Kršek, M.; Marek, J.; Pecen, Ladislav

2012-01-01

406

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

Scientific Electronic Library Online (English)

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 sangramen [...] to 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. Abstract in spanish 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 ocurrenc [...] ia 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. Abstract in english 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; Marcelo Campos, Appel-da-Silva; Luiz Claudio, Danzmann.

2010-01-01

407

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

408

Intracerebral low-density areas following acute epidural hematomas  

International Nuclear Information System (INIS)

The author studied secondary lesion after head injury; they could be distinguished from the primary lesions by computerized tomography (CT). Subjects were limited to patients with unilateral supratentorial epidural hematomas, all of whom had been operated on in the Ashikaga Red Cross Hospital. These patients were classified into two groups based on the intermittent serial CT findings; with (13 cases, Group I) and without (17 cases, Group II) intracerebral low-density areas. In the preoperative stage, Group I was severer on the level of conciousness and showed a greater volume of the epidural hematoma on CT than did Group II. The patient's age or sex, or the preoperative administration of mannitol and glycerol did not significantly affect the appearance of the intracerebral low-density areas on CT. In both groups, intradural findings were variable during the operation, but these findings could not be distinguished well between groups. As compared with Group II, Group I had worse outcomes. Neurological deficits, such as hemiparesis, mental disorders, visual disturbance, and epileptic seizures, remained for years. The low-density areas appeared in the cerebrum just below the hematomas (9 cases) in the territory of the posterior cerebral artery (4 cases), and in the boundary zone between anterior, middle and/or posterior cerebral arteries (3 cases). The low-density areas appeared mostly within 24 hours after head injury, while the findings of an abnormal contrast enhancem findings of an abnormal contrast enhancement in the low-density areas were often demonstrated during one to six weeks after injury. These findings resembled those of the cerebral ischemic lesions or infarction, not those of the cerebral contusion on CT. The conclusion of the study is that the appearance of the intracerebral low-density areas on CT following the evacuation of acute epidural hematomas marks a cerebral ischemic secondary lesion occurring as a result of the compression of the hematomas. (author)

409

Follow up study and interested cases in subdural hematoma  

International Nuclear Information System (INIS)

1. Out of 67 patients ranging from 16 to 82 years old, 20 were followed up by CT scan after operation. 2. Five patients presented hematoma on the both sides after operation, though they had suffered from the lesion of one side before operation. In four patients, hematoma was observed on the both sides before and after operation. Neither preoperative involved side changed nor hematoma appeared on the opposite side after operation in 11 patients. Follow-up examinations lasted up almost three months. 3. The maximum width of the subdural space was divided by the maximum intracranial width. These two factors were measured on horizontal CT scan. The calculated value was expressed in percentage and then, the result was regarded as Subdural Space (SDS) Index. Dividing a difference between the largest SDS Index (before operation) and the smallest by the number of days between the two points gave us a reduction rate of SDS Index. As a result, a reduction rate of 0.4 or less was obtained in all the patients less than 65 years old. There were three patients within the range from 0.7 to 1.0 of the rate. 76-year-old patients showed 2.6 and 5.7. Except the 76-old patients, mean duration of 35.5 days was calculated in Group I and SDS Index was 0, while Group II showed mean duration of 52.4 days, resulting in SDS Index of 0. 4. Specific progresses are shown below: 1) Hemorrhage of the caudate nucleus after operation 2) Subdural effusion of the both sides 3) Appearance of abscess 4) Su both sides 3) Appearance of abscess 4) Subtentrial hemorrhage after operation 5) Postoperative epidural hematoma 6) Traumatic intracerebral hemorrhage, resulting in chronic subdural hematoma six months afterward (author)

410

Presentación clínica del hematoma subdural crónico en adultos: el gran simulador Clínica del Hematoma Subdural Crónico  

Scientific Electronic Library Online (English)

Full Text Available Resumo Introdução: o hematoma subdural crônico (HSDC) é uma doença relativamente comum em adultos com mais de 60 anos. Sua apresentação clínica clássica é uma síndrome neurológica focal progressiva com sinais e sintomas de hipertensão endocraniana, em pacientes que de maneira geral tem antecedentes [...] de traumatismo craniano (TEC) nas duas ou três semanas anteriores à consulta. No entanto, o HSDC pode se apresentar sob diferentes formas o que dificulta seu diagnóstico. Material e métodos: são analisados os aspectos clínicos de 63 pacientes portadores de HSDC que consultaram no Hospital de Tacuarembó em um período de 59 meses. Resultados: os pacientes tinham entre 30 e 88 anos sendo 73% do sexo masculino; 67% tinham antecedentes de TEC. A apresentação mais freqüente foi um quadro progressivo de déficit focal ou hipertensão endocraniana. Em dois casos o déficit foi brusco, simulando um ataque cerebrovascular. Em três pacientes não havia registro de antecedente traumático e clinicamente se propôs um processo tumoral expansivo. Em 11 casos os sintomas iniciais foram da esfera neuropsíquica, simulando uma "demência". Em 18 casos houve depressão de vigília, sendo brusca em cinco, levando a proposição de um ataque cerebrovascular hemorrágico ou isquêmico. Em seis pacientes o sintoma mais destacado era cefaléia permanente sem outros sinais ou sintomas. Conclusões: a HSDC pode se apresentar com distintas "máscaras clínicas", simulando processos expansivos tumorais, ataques cerebrovasculares hemorrágicos ou isquêmicos, ataques isquêmicos transitórios ou demências. Em pessoas com mais de 60 anos com um quadro progressivo e de instalação insidiosa, mesmo com ausência de traumatismo craniano, deve-se suspeitar desta patologia. Abstract in spanish Introducción: el hematoma subdural crónico (HSDC) es una enfermedad relativamente común en mayores de 60 años. Su presentación clínica clásica es un síndrome neurológico focal progresivo con síntomas y signos de hipertensión endocraneana, en un paciente que generalmente tiene antecedentes de traumat [...] ismo craneano (TEC) al menos dos o tres semanas previas a la consulta. Sin embargo, el HSDC puede presentarse bajo diferentes formas clínicas que dificultan su diagnóstico. Material y método: se analizan los aspectos clínicos de 63 pacientes portadores de HSDC que consultaron en el Hospital de Tacuarembó en un período de 59 meses. Resultados: los pacientes tenían entre 30 y 88 años, 73% eran hombres. En 67% de los pacientes había antecedente de TEC. La forma de presentación más frecuente fue un cuadro progresivo de déficit focal o hipertensión endocraneana. En dos casos el déficit fue brusco, simulando un ataque cerebrovascular. En tres pacientes el antecedente traumático no fue recogido y se planteó clínicamente un proceso expansivo tumoral. En 11 casos los síntomas iniciales fueron de la esfera neuropsíquica, simulando una "demencia". En 18 casos hubo depresión de vigilia, siendo brusca en cinco de ellos, lo que llevó al planteo de ataque cerebrovascular hemorrágico o isquémico. En seis pacientes el síntoma cardinal era la cefalea permanente sin otros síntomas o signos. Conclusiones: el HSDC puede presentarse con distintas "máscaras clínicas", simulando procesos expansivos tumorales, ataques cerebrovasculares hemorrágicos o isquémicos, ataques isquémicos transitorios o demencias. Se debe entonces tener un alto índice de sospecha de esta enfermedad frente a individuos mayores de 60 años con un cuadro progresivo y de instalación insidiosa aun en ausencia de traumatismo de cráneo Abstract in english Summary Background: chronic subdural hematoma (CSDH-HSDC) is a relatively common disease in adults older than 60 years. The classic clinical presentation is a progressive focal neurologic syndrome with signs and symptoms of endocranial hypertension in patients that usually offer history of cranial t [...] raumatism (CT-TEC) of at least two or three weeks prior to consulting. Howe

Fernando, Martínez.

2007-06-01

411

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 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

412

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

413

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

414

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

Directory of Open Access Journals (Sweden)

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

Soltani Shirazi Ahmad

2011-07-01

415

Misdiagnosed spontaneous intracranial hypotension complicated by subdural hematoma following lumbar puncture  

Directory of Open Access Journals (Sweden)

Full Text Available Nissrine Louhab,1 Nawal Adali,1 Mehdi Laghmari,2 Wafae El Hymer,2 Said Ait Ben Ali,2 Najib Kissani11Neurology Department, 2Neurosurgery Department, University Hospital of Mohammed the VIth, Cadi Ayyad University, Marrakech, MoroccoIntroduction: Spontaneous intracranial hypotension is an infrequent cause of secondary headache due to cerebrospinal fluid (CSF hypovolemia.Objective: To describe a case of headache revealing spontaneous intracranial hypotension complicated by subdural hematoma following lumbar puncture.Observation: A 34-year-old man presented with acute postural headache. The first cerebral computed tomography scan was normal. Lumbar puncture showed hyperproteinorachy at 2 g/L with six lymphocytic cells. The headache became very intense. At admission, clinical examination was normal. Ophthalmological examination did not show any abnormalities. Encephalic magnetic resonance imaging (MRI showed bilateral subdural hematoma with tonsillar descent simulating Chiari type I malformation. After surgical drainage and symptomatic treatment, the patient was discharged with no recurrence.Conclusion: Spontaneous intracranial hypotension is associated with simple clinical presentation, orthostatic headache, and characteristic MRI findings. Misdiagnosed, it leads to unnecessary procedures.Keywords: intracranial hypotension, headache, magnetic resonance imaging

Louhab N

2014-01-01

416

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

Science.gov (United States)

Background. The event-free survival for pediatric leukemia in low-income Countries is much lower than in high-income countries. Late diagnosis, which is regarded as a contributing factor, may be due to “parental” or “medical” delay. Procedures. The present study analyses determinants of lag time from first symptoms to diagnosis of leukemia, comparing pediatric (0–16 years old) patients in two referral centers, one in Nicaragua and one in Italy. An observational retrospective study was conducted to assess factors influencing the time to diagnosis. Results. 81 charts of children diagnosed with acute myeloid leukemia or lymphoblastic leukemia were analyzed from each centre. Median lag time to diagnosis was higher in Nicaragua than in Italy (29 versus 14 days, P < 0.001) and it was mainly due to “physician delay” (16.5 versus 7 days, P < 0.001), whereas “patient delay” from symptoms to first medical assessment was similar in the two centers (7 versus 5 days, P = 0.27). Moreover, median lag time from symptoms to diagnosis was decreased in Nicaraguan districts were a specific training program upon childhood oncological diseases was carried out (20.5 versus 40 days, P = 0.0019). Conclusions. Our study shows that delay in diagnosis of childhood leukemia is mainly associated with “physician delay” and it may be overcome by programs of continuous medical education. PMID:22518173

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

2012-01-01

417

The experience in nicaragua: childhood leukemia in low income countries-the main cause of late diagnosis may be "medical delay".  

Science.gov (United States)

Background. The event-free survival for pediatric leukemia in low-income Countries is much lower than in high-income countries. Late diagnosis, which is regarded as a contributing factor, may be due to "parental" or "medical" delay. Procedures. The present study analyses determinants of lag time from first symptoms to diagnosis of leukemia, comparing pediatric (0-16 years old) patients in two referral centers, one in Nicaragua and one in Italy. An observational retrospective study was conducted to assess factors influencing the time to diagnosis. Results. 81 charts of children diagnosed with acute myeloid leukemia or lymphoblastic leukemia were analyzed from each centre. Median lag time to diagnosis was higher in Nicaragua than in Italy (29 versus 14 days, P < 0.001) and it was mainly due to "physician delay" (16.5 versus 7 days, P < 0.001), whereas "patient delay" from symptoms to first medical assessment was similar in the two centers (7 versus 5 days, P = 0.27). Moreover, median lag time from symptoms to diagnosis was decreased in Nicaraguan districts were a specific training program upon childhood oncological diseases was carried out (20.5 versus 40 days, P = 0.0019). Conclusions. Our study shows that delay in diagnosis of childhood leukemia is mainly associated with "physician delay" and it may be overcome by programs of continuous medical education. PMID:22518173

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

2012-01-01

418

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2011-05-15

419

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.

420

Delayed Perilesional Ischemic Stroke after Gamma-knife Radiosurgery for Unruptured Deep Arteriovenous Malformation: Two Case Reports of Radiation-induced Small Artery Injury as Possible Cause  

Science.gov (United States)

Radiation-induced vasculopathy is a rare occurrence, however, it is one of the most serious complications that can occur after gamma-knife radiosurgery (GKRS). The authors present two cases of incidentally found deep cerebral arteriovenous malformation (AVM), which were treated by GKRS, where subsequently there occurred delayed-onset cerebral infarction (11 and 17 months after GKRS) at an area adjacent to the AVM. In both cases, perforators of the M1 segment of the middle cerebral artery were included in the radiation field and delayed injury to these is suggested to be the mechanism of the ischemic event. PMID:25874184

Kang, Dong-Hun; Park, Jaechan; Hwang, Jeong-Hyun; Park, Seong-Hyun; Son, Won-Soo

2015-01-01