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Sample records for bilateral subdural hematoma

  1. Bilateral chronic subdural hematoma

    DEFF Research Database (Denmark)

    Andersen-Ranberg, Nina Christine; Poulsen, Frantz Rom; Bergholt, Bo;

    2016-01-01

    ) surgery. The overall retreatment rate was 21.6% (57 of 264 patients). Cases treated with unilateral surgery had twice the risk of retreatment compared with cases undergoing bilateral surgery (28.7% vs 14.1%, respectively, p = 0.002). In accordance with previous studies, the data also showed that a...

  2. Bilateral Biconvex Frontal Chronic Subdural Hematoma Mimicking Extradural Hematoma

    OpenAIRE

    Agrawal, Amit

    2010-01-01

    Chronic subdural hematoma (CSDH) is one of the most common clinical entities encountered in daily neurosurgical practice. The advent of computed tomography (CT) has made a major impact on the radiological diagnosis of CSDH. Although unilateral chronic isodense subdural hematomas as a result of indirect signs of a space-occupying lesion are easily recognizable on CT, bilateral CSDH may cause considerable difficulty, particularly when it is biconvex in shape as discussed in the present case. A ...

  3. Bilateral subdural hematoma secondary to accidental dural puncture

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    Sofía Ramírez

    2015-08-01

    Full Text Available We report the case of a 25-year-old woman, who received epidural analgesia for labor pain and subsequently presented post-dural puncture headache. Conservative treatment was applied and epidural blood patch was performed. In the absence of clinical improvement and due to changes in the postural component of the headache, a brain imaging test was performed showing a bilateral subdural hematoma. The post-dural puncture headache is relatively common, but the lack of response to established medical treatment as well as the change in its characteristics and the presence of neurological deficit, should raise the suspicion of a subdural hematoma, which although is rare, can be lethal if not diagnosed and treated at the right time.

  4. Decompression hyperostosis: cranial hyperostosis mimicking bilateral subdural hematoma on brain scintigraphy

    International Nuclear Information System (INIS)

    Scintigraphic findings suggestive of bilateral subdural hematoma developed after successful decompression of communicating hydrocephalus. These findings were secondary to cranial hyperostosis. The similarity of brain scintigraphic findings in the two disorders is pointed out, and the necessity of correlating brain scintigraphs with skull radiographs is stressed. (U.S.)

  5. Clinical study of cerebral blood flow in bilateral chronic subdural hematoma measured by 99mTc-HMPAO SPECT

    International Nuclear Information System (INIS)

    Cerebral blood flow (CBF) in 34 patients with bilateral chronic subdural hematoma was measured by 99mTc-HMPAO SPECT before operation. The regional CBF was measured in 26 regions of the 10 cortical regions, putamen, thalamus and cerebellar hemisphere on both sides. According to the thickness of subdural hematoma, the thicker hematoma side was measured and examined as the thick hematoma side, and the other side as the thin hematoma side. Thirty four cases with bilateral chronic subdural hematoma were classified into four groups on the basis of clinical symptoms :13 cases with headache (headache group), 10 cases with hemiparesis (hemiparesis group), 5 cases with tetraparesis (tetraparesis group) and 6 cases with consciousness disturbance or dementia (consciousness disturbance group), and into two groups according to the degree of midline brain shift on MRI: 14 cases of non-shifted group and 20 cases of shifted group. The average CBF of 34 patients in each region indicated a regional CBF reduction in the frontal, parietal and occipital cortices on the thin hematoma side, and in the putamen on the thick hematoma side. In the headache group, the regional CBF reduction on the thin hematoma side was found in the frontal, parietal and occipital cortices compared with the corresponding regions on the thick hematoma side, and in thalamus on the thick hematoma side. In the hemiparesis and tetraparesis groups, there was no statistically significant CBF reduction between the thick and thin hematoma sides. In the consciousness disturbance group, the CBF reduction in whole brain was remarkably significant. By the degree of the midline brain shift, the CBF reductions between the thick and thin hematoma sides were observed. Namely, in the shifted group, the CBF reductions were noted in the frontal, parietal and occipital cortices in the thin hematoma side, and in the putamen in the thick hematoma side. We concluded that the CBF reduction of bilateral chronic subdural hematoma was

  6. [Chronic subdural hematoma presenting visual disturbance: a case report].

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    Hasegawa, S; Manabe, H; Shimizu, T; Itoh, C; Suzuki, S

    2001-03-01

    The authors reported a rare case of chronic subdural hematoma presenting bilateral visual impairment caused by papilledema. A 49-year-old man was admitted to our department due to left blurred vision. On admission, ophthalmological examination revealed visual acuity disturbance on the left eye, bilateral nasal visual field defect and papilledema. CT scan and MRI demonstrated bilateral subdural hematoma. No remarkable findings were detected on cerebral angiography. After evacuation of bilateral subdural hematomas, his visual symptoms recovered. In this report, we discuss the mechanism of visual impairment caused by chronic subdural hematoma. PMID:11296405

  7. Spontaneous development of bilateral subdural hematomas in an infant with benign infantile hydrocephalus: color Doppler assessment of vessels traversing extra-axial spaces

    International Nuclear Information System (INIS)

    We present an infant with macrocrania, who initially demonstrated prominent extra-axial fluid collections on sonography of the brain, compatible with benign infantile hydrocephalus (BIH). Because of increasing macrocrania, a follow-up sonogram of the brain was performed; it revealed progressive enlargement of the extra-axial spaces, which now had echogenic debris. Color Doppler US showed bridging veins traversing these extra-axial spaces, so it was initially thought that these spaces were subarachnoid in nature (positive cortical vein sign). However, an arachnoid membrane was identified superior to the cortex, and there was compression of true cortical vessels beneath this dural membrane. An MRI of the brain showed the extra-axial spaces to represent bilateral subdural hematomas. The pathogenesis of spontaneous development of the subdural hematomas, in the setting of BIH, is discussed. We also emphasize that visualizing traversing bridging veins through extra-axial spaces does not necessarily imply that these spaces are subarachnoid in origin. (orig.)

  8. Traumatic lumbar spinal subdural hematoma

    OpenAIRE

    Gordon, William E.; Brent Y. Kimball; Arthur, Adam S

    2014-01-01

    Spinal subdural hematoma (SDH) is a rare and potentially life-threatening condition associated with trauma, lumbar puncture, hemorrhagic disorder, anticoagulant therapy, spinal surgery, tumor, vascular malformations, and spinal or epidural anesthesia. Traumatic SDH is even more uncommon than other forms of SDH with only 10 reported cases in the literature. Following a punch to the head and loss of consciousness, a 35-year-old man reported headaches, right-sided tinnitus, and dull ache behi...

  9. Temporal fossa arachnoid cyst presenting with bilateral subdural hematoma following trauma: two case reports

    OpenAIRE

    Pillai Promod; Menon Sajesh K; Manjooran Raju P; Kariyattil Rajiv; Pillai Ashok B; Panikar Dilip

    2009-01-01

    Abstract Introduction Intracranial arachnoid cysts are considered to be congenital malformations with a predilection for the temporal fossa. They are often asymptomatic but can sometimes be symptomatic due to enlargement or hemorrhage. There are multiple case reports of arachnoid cysts becoming symptomatic with hemorrhagic complications following head trauma. In such cases, the bleeding is often confined to the side ipsilateral to the arachnoid cyst. Occurrence of contralateral subdural hemat...

  10. 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)

  11. Parkinsonsim due to a Chronic Subdural Hematoma

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    Bosuk Park

    2009-05-01

    Full Text Available Subdural hematoma is a rare cause of parkinsonism. We present the case of a 78-year-old man with right-side dominant parkinsonism about 3 months after a minor head injury. MRI reveals a chronic subdural hematoma on the left side with mildly displaced midline structures. The parkinsonian features were almost completely disappeared after neurosurgical evacuation of the hematoma without any anti-parkinson drug.

  12. A case of interhemispheric subdural hematoma.

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    Koumtchev, Y; Petkov, S; Gozmanov, G

    1994-01-01

    The interhemispheric subdural hematoma is a rare condition. We present a case of interhemispheric subdural hematoma in a patient aged 65 years. A day prior to admission he was struck with a water-pipe on the head. He went to sleep the same evening complaining of a slight headache. At about two o'clock in the morning the headache increased in intensity. By the morning he lost consciousness. On examination by a neurosurgeon the patient was found to be comatose. The physical examination revealed blue eyelids of the left eye, paraplegia of the right leg, paresis of the left leg and arms. Bilateral Babinski's reflex was present, the abdominal reflexes were absent, the tendon and periosteal reflexes were hyperactive. The pupils were equal in size and slowly reactive to light. The patient exhibited symptoms of meningoradicular irritation. An emergency CT scan revealed high-density area in the interhemispheric sulcus extending frontally to parietally. The patients was operated on in an emergency. At operation, extensive rupture of the sagittal sinus was identified. Later the patient died. The presented case was interesting with the extensive rupture of the sagittal sinus and the relatively long lucid interval until clear manifestation of the clinical picture becomes evident. PMID:7867995

  13. History of Chronic Subdural Hematoma.

    Science.gov (United States)

    Lee, Kyeong-Seok

    2015-10-01

    Trephination or trepanation is an intentional surgical procedure performed from the Stone Age. It looks like escaping a black evil from the head. This technique is still used for treatment of chronic subdural hematoma (SDH). Now, we know the origin, pathogenesis and natural history of this lesion. The author try to explore the history of trephination and modern discovery of chronic SDH. The author performed a detailed electronic search of PubMed. By the key word of chronic SDH, 2,593 articles were found without language restriction in May 2015. The author reviewed the fact and way, discovering the present knowledge on the chronic SDH. The first authentic report of chronic SDH was that of Wepfer in 1657. Chronic SDH was regarded as a stroke in 17th century. It was changed as an inflammatory disease in 19th century by Virchow, and became a traumatic lesion in 20th century. However, trauma is not necessary in many cases of chronic SDHs. The more important prerequisite is sufficient potential subdural space, degeneration of the brain. Modifying Virchow's description, chronic SDH is sometimes traumatic, but most often caused by severe degeneration of the brain. From Wepfer's first description, nearly 350 years passed to explore the origin, pathogenesis, and fate of chronic SDH. The nature of the black evil in the head of the Stone Age is uncovering by many authors riding the giant's shoulder. Chronic SDH should be categorized as a degenerative lesion instead of a traumatic lesion. PMID:27169062

  14. The outcome of the acute subdural hematoma

    International Nuclear Information System (INIS)

    Thirty-five cases of acute subdural hematoma (ASDH) were reviewed and divided into two groups of A and B according to the outcome. The findings of computed tomography (CT) and the time interval between head trauma and surgical intervention were investigated to know the factors that influence the prognosis in ASDH. Group A, 18 patients, had a poor outcome. Fifteen patients out of 18 had the removal of hematoma and decompression craniectomy with 10 deaths, 4 vegetative states and 1 severe disability. Three patients died without surgery. Group B, 17 patients, were treated surgically in the same way as in group A and all patients had a good recovery with 14 making a full recovery and 3 with a moderate disability. Surgical mortality was 31.3% and overall mortality was 37.1%. The features of the CT findings in 18 patients of group A were as follows. Eleven patients had midline shift of more than 15 mm, 9 had subdural high density area of more than 15 mm and 12 patients had bilateral collapse of the lateral ventricles. The charactaristic finding of CT recognized in all patients of group A was disappearance of the ambient cistern. On the contrary, in 17 patients of group B the displacement of the intracranial structure was not so severe as in group A. The midline shift of 14 patients was less than 7.5 mm, the width of subdural high density area of 15 patients was less than 7.5 mm and the ambient cistern was recognized in 12 patients. For 11 patients out of 15 in group A, the operation was performed within 6 hours following the onset of head trauma, however, 9 patients died, one in a vegetative state and one had severe disability postoperatively. Thirteen patients out of 17 in group B were operated on later than 6 hours after the onset of the head trauma, and yet took a good outcome. (J.P.N.)

  15. Chronic subdural hematoma following electro convulsive therapy

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    Debasish Saha

    2012-01-01

    Full Text Available 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.

  16. Age determination of subdural hematomas: survey among radiologists.

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

    2014-08-01

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

  17. Spontaneous acute subdural hematoma in a patient with multiple myeloma

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    Abrar Ahad Wani

    2012-01-01

    Full Text Available Acute spontaneous subdural hematoma in a patient of multiple myeloma receiving chemotherapy is an unknown event, needing an urgent neurosurgical management. We report this patient who presented with progressive neurological deterioration and a low platelet count. She was successfully managed by craniotomy and evacuation of subdural hematoma with intraoperative transfusion of platelets. The acute spontaneous subdural hematoma in her was probably related to the bleeding diathesis due to thrombocytopenia associated with chemotherapy.

  18. Hematoma subdural crónico

    OpenAIRE

    Martínez Rozo, Jairo

    2011-01-01

    Se estudiaron 169 pacientes con diagnóstico de Hematoma Subdural Crónico (H.S.C.) admitidos en el Servicio Neurocirugía del Hospital San Juan de Dios desde 1959 a 1980. Los datos clínicos y paraclínicos fueron recopilados en un formato precodificado y luego perforados en tarjetas de computador. Usando el Computador 360/40 disponible en el Centro de Cálculo de la Universidad Nacional y el Computador Intel de el DANE y utilizando el programa SPSS se clasificó, ordenó y depuró.la información. Se...

  19. Bilateral Symmetrical Parietal Extradural Hematoma

    OpenAIRE

    Agrawal, Amit

    2011-01-01

    The occurrence of bilateral extradural hematomas (EDH) is an uncommon consequence of craniocerebral trauma, and acute symmetrical bilateral epidural hematomas are extremely rare. We discuss the technique adopted by us for the management of this rare entity. A 55-year-old patient presented with history of fall of branch of tree on her head. She had loss of consciousness since then and had multiple episodes of vomiting. Examination of the scalp was suggestive of diffuse subgaleal hematoma. Her ...

  20. Acute Spontaneous Posterior Fossa Subdural Hematoma

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    Osama Shukir Muhammed Amin

    2014-02-01

    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.

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

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    Sridhar Krishnamurthy

    2010-01-01

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

  2. Experience in Endovascular Treatment of Recurrent Chronic Subdural Hematoma

    OpenAIRE

    Ishihara, H.; Ishihara, S.; Kohyama, S.; Yamane, F.; Ogawa, M.; A. Sato; Matsutani, M.

    2007-01-01

    Most cases with chronic subdural hematoma (CSDH) are treated by simple irrigation and drainage, then more than eighty percent of them result in good recovery. But we sometimes encounter intractable cases with hematoma re-collection, which is considered of repeated bleeding from macrocapillary in the hematoma capsule. Embolization of the middle meningeal artery (MMA) is considered to be useful to eliminate the blood supply to this structure. The authors experienced seven cases of intractable C...

  3. Simultaneous Spinal and Intracranial Chronic Subdural Hematoma Cured by Craniotomy and Laminectomy: A Video Case Report

    Science.gov (United States)

    Kanamaru, Hideki; Kanamaru, Kenji; Araki, Tomohiro; Hamada, Kazuhide

    2016-01-01

    Simultaneous spinal and intracranial chronic subdural hematoma (CSDH) is a rare entity. A 67-year-old man visited our hospital due to headache after diving into a river 2 weeks before. Non-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) revealed bilateral intracranial CSDH. The bilateral CSDH was evacuated and his symptoms improved. Three days after craniotomy, he complained of sensory disturbance on his buttocks. Lumbar MRI showed a space-occupying lesion behind the thecal sac at L5. CT with myelography showed a subdural mass lesion; there was no communication with the subarachnoid space. Fourteen days after craniotomy, L5 laminectomy was performed and the dura mater was incised carefully. The video shows that a liquid hematoma similar to the intracranial CSDH flowed out, followed by cerebrospinal fluid. His symptoms improved after the operation and the hematoma did not recur. This is a rare condition of spinal CSDH demonstrated by neuroimaging and intraoperative video. PMID:27194987

  4. 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 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)

  5. 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 20x104μl 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 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.)

  6. Chronic Subdural Hematoma after Eccentric Exercise Using a Vibrating Belt Machine

    OpenAIRE

    Park, Hey-Ran; Lee, Kyeong-Seok; Bae, Hack-Gun

    2013-01-01

    We report a case of bilateral chronic subdural hematoma (CSDH) in a 75-year-old man after exercise using a vibrating belt machine on the head. He suffered from headache and intermittent left side numbness for ten days. He denied any head injuries except eccentric exercise using a vibrating belt on his own head for 20 days. An MRI revealed bilateral CSDH. The hematoma was isodense on the CT scan. We made burr-holes on the both sides under local anesthesia. We identified the neomembrane and dar...

  7. Analysis of infantile subdural hematoma caused by abuse

    International Nuclear Information System (INIS)

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

  8. Acute subdural hematoma: morbidity, mortality, and operative timing.

    Science.gov (United States)

    Wilberger, J E; Harris, M; Diamond, D L

    1991-02-01

    Traumatic acute subdural hematoma remains one of the most lethal of all head injuries. Since 1981, it has been strongly held that the critical factor in overall outcome from acute subdural hematoma is timing of operative intervention for clot removal; those operated on within 4 hours of injury may have mortality rates as low as 30% with functional survival rates as high as 65%. Data were reviewed for 1150 severely head-injured patients (Glasgow Coma Scale (GCS) scores 3 to 7) treated at a Level 1 trauma center between 1982 and 1987; 101 of these patients had acute subdural hematoma. Standard treatment protocol included aggressive prehospital resuscitation measures, rapid operative intervention, and aggressive postoperative control of intracranial pressure (ICP). The overall mortality rate was 66%, and 19% had functional recovery. The following variables statistically correlated (p less than 0.05) with outcome; motorcycle accident as a mechanism of injury, age over 65 years, admission GCS score of 3 or 4, and postoperative ICP greater than 45 mm Hg. The time from injury to operative evacuation of the acute subdural hematoma in regard to outcome morbidity and mortality was not statistically significant even when examined at hourly intervals although there were trends indicating that earlier surgery improved outcome. The findings of this study support the pathophysiological evidence that, in acute subdural hematoma, the extent of primary underlying brain injury is more important than the subdural clot itself in dictating outcome; therefore, the ability to control ICP is more critical to outcome than the absolute timing of subdural blood removal. PMID:1988590

  9. Chronic spinal subdural hematoma; Spinales chronisches subdurales Haematom

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

    2008-10-15

    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.)

  10. Chronic subdural hematoma after eccentric exercise using a vibrating belt machine.

    Science.gov (United States)

    Park, Hey-Ran; Lee, Kyeong-Seok; Bae, Hack-Gun

    2013-09-01

    We report a case of bilateral chronic subdural hematoma (CSDH) in a 75-year-old man after exercise using a vibrating belt machine on the head. He suffered from headache and intermittent left side numbness for ten days. He denied any head injuries except eccentric exercise using a vibrating belt on his own head for 20 days. An MRI revealed bilateral CSDH. The hematoma was isodense on the CT scan. We made burr-holes on the both sides under local anesthesia. We identified the neomembrane and dark red subdural fluid on both sides. In the postoperative CT scan, we found an arachnoid cyst on the left temporal pole. Although the arachnoid cyst itself is asymptomatic, trivial injury such as vibrating the head may cause a CSDH. PMID:24278662

  11. Hypothalamo-Pituitary Dysfunction in Patients With Chronic Subdural Hematoma

    Czech Academy of Sciences Publication Activity Database

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

    2012-01-01

    Roč. 61, č. 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

  12. Apparently Ipsilateral Parkinsonism in a Patient with Chronic Subdural Hematoma

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    Tae Hwan Roh

    2012-05-01

    Full Text Available Symptomatic parkinsonism secondary to ipsilateral lesion is rarely reported. Although the contribution of the contralateral lesions was assumed in some cases, the pathomechanism remains undetermined. Herein we report a patient with a subdural hematoma, who developed parkinsonism in the ipsilateral hemibody. Structural and functional imaging suggests the contralateral dopaminergic dysfunction as the major culprit of apparently ipsilateral parkinsonism.

  13. Prospects for conservative treatment of chronic subdural hematomas

    International Nuclear Information System (INIS)

    111In-DTPA was injected into the hematoma cavity before and after hematoma evacuation and irrigation in 12 cases of chronic subdural hematoma with comparatively mild symptoms. The radioactivity in the head was measure with time using a scintillation counter and the attenuation rate was obtained. The value measured hourly were expressed as ratios of the 1st measured value. Because of the properties of 111In-DTPA, this attenuation rate was considered to be the absorption rate of the liqid components of the hematoma. In 8 of the preoperative cases, the average measured values, were 84.8 +- 12.6% after 3 hours, 77.3 +- 12.1% after six hours, 34.5 +- 13.8% after 24 hours and 13.3 +- 13.5% after 48 hours. In six of the postoperative cases, the values were 70.4 +- 14.3% after 3 hours, 47.8 +- 10.8% after 6 hours, 12.4 +- 6.7% after 24 hours and 3.6 +- 2.0% after 48 hours. In a comparison between the two, the postoperative cases showed clearly advanced absorption with a significant difference at a risk factor of 0.1% or less in each case. This is because the osmotic pressure is the same for the liquid in the hematoma, the blood and the cerebrospinal fluid and an explanation based on this alone is difficult; it is neccessary to consider colloid osmotic pressure. When the radioactivities in the liquid in the hematoma, blood and cerebrospinal fluid were measured, the values for the blood were always higher than those for the cerebrospinal fluid and most of the absorption of the hematoma is considered to originate in the vascular bed in the hematoma cavity (sinusoidal channel layer). Therefore, for the conservative treatment of chronic subdural hematomas, it is necessary to consider methods which promote absorption of the hematoma. (J.P.N.)

  14. MR imaging evaluation of subdural hematomas in child abuse

    International Nuclear Information System (INIS)

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

  15. Chronic subdural hematoma: a comparison of two drainage methods

    OpenAIRE

    Lotfinia; Shakere; Shimia; Mahbobee; Mashrabi

    2008-01-01

    "nBackground: Chronic Subdural Hematoma (CSDH) is one of the most common challenges of neurosurgeons. Most predominant among the elderly, the incidence increases incrementally with age and might lead to permanent severe complications. The aim of this study is to outline the symptoms and signs and to compare the outcomes and complications among two groups of patients who underwent two different surgical procedures."n"nMethods: In a cross-sectional and descriptive-analytical stud...

  16. Fenestration of bone flap during decompressive craniotomy for subdural hematoma

    OpenAIRE

    Ha Son Nguyen; Ninh Doan; Christopher Wolfla; Glen Pollock

    2016-01-01

    Background: Persistent/recurrent extra-axial hemorrhage may occur after decompression of a subdural hematoma (SDH) followed by an immediate replacement of bone flap. A fenestration of the bone flap may encourage extra-axial fluid absorption; however, the literature has not explored this technique. Methods: Forty-four consecutive patients who underwent surgical decompression of SDH with immediate replacement of bone flap were divided into two groups: Fenestration (F), n = 33, and no fenest...

  17. Clinical studies on cerebral blood flow in chronic subdural hematoma

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

    Krupa, Mariusz; Moskała, Marek; Składzień, Tomasz; Grzywna, Ewelina

    2009-01-01

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

  19. 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)

  20. MRI findings in spinal subdural and epidural hematomas

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-10-15

    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.

  1. Post-traumatic epidural and subdural hematomas of the spinal cord in MR imaging

    International Nuclear Information System (INIS)

    Diagnostics of epi- and subdural hematomas of the spinal cord is discussed on the basis of 1992 records of Konstancin Rehabilitation Center. 54 patients with symptoms of partial or complete cord injury were submitted to MR imaging. In 4 cases (7.5%) epi- and subdural hematoma was found to contribute to neurological condition of the patient. MRI determines indications for surgical intervention. (author)

  2. A rare, high cervical traumatic spinal subdural hematoma.

    Science.gov (United States)

    Berhouma, Moncef; Al Dahak, Nouman; Messerer, Rostom; Al Rammah, Mohamed; Vallee, Bernard

    2011-04-01

    Spinal subdural hematomas (SSDH) are rare lesions occurring in association with a wide variety of conditions, including anticoagulation, coagulation disorders, spinal anesthesia, lumbar puncture, spinal tumors and vascular malformations. SSDH resulting from trauma are the exception. We present a 62-year-old woman with a rare post-traumatic focal SSDH at C1 with bulbomedullary compression, treated successfully with surgery. A review of the literature revealed 26 patients with traumatic SSDH. The aim of this report is to describe the clinical presentation, imaging characteristics and management of traumatic SSDH. The controversial pathogenesis is also discussed. PMID:21277780

  3. Traumatic Acute Subdural Hematoma Extending from the Posterior Cranial Fossa to the Cerebellopontine Angle

    OpenAIRE

    Gulsen, Salih; Sonmez, Erkin; Yilmaz, Cem; Altinors, Nur

    2009-01-01

    Posterior cranial fossa subdural hematomas and extension of the subdural hematoma to the cerebellopontine angle is rarely seen and the concurrent development of acute peripheral facial palsy and the management strategy have not previously been reported in this pathology because of its rarity. We present this case to emphasize that minor head trauma may lead to a posterior cranial fossa hematoma extending to the cerebellopontine angle and cause peripheral facial palsy in patients using aspirin...

  4. Chronic subdural hematoma: a comparison of two drainage methods

    Directory of Open Access Journals (Sweden)

    Lotfinia

    2008-08-01

    Full Text Available "nBackground: Chronic Subdural Hematoma (CSDH is one of the most common challenges of neurosurgeons. Most predominant among the elderly, the incidence increases incrementally with age and might lead to permanent severe complications. The aim of this study is to outline the symptoms and signs and to compare the outcomes and complications among two groups of patients who underwent two different surgical procedures."n"nMethods: In a cross-sectional and descriptive-analytical study performed on 125 patients with CSDH from 2000 to 2005. Computed tomography scan was used for diagnostic imaging in all cases and magnetic resonance imaging was also obtained for six patients. In one center, group 1, which included 82 patients, underwent surgery with a single burr hole and closed drainage, and, at another center, group 2, which included 43 patients, was treated with a method using two burr holes and close drainage."n"nResults: Of the 125 patients, 102 were male and 23 were female. The mean age of patients was 65.79±16.41 years. The most common symptoms were weakness in extremities (78.4%, headache (72.8% and decreased level of consciousness (24%, respectively. At presentation, 88 (70.4% of the patients had several symptoms and 37 (29.6% had only one symptom. A history of mild head trauma, such as falling, was observed in 83 (68% of the patients. The interval between head trauma and the onset of symptoms ranged from 10 to 120 days (mean: 46 days. Hematoma recurred in five cases from group 1, whereas two cases from group 2 had recurrence of hematoma. Postoperative epidural hematoma developed in one case from group 2 and tension pneumocephalus also occurred in one group 2 patients."n"nConclusion: As a treatment for CSDH, the single burr hole method was significantly better than the two burr hole method.

  5. Subdural hematoma cases identified through a Danish patient register

    DEFF Research Database (Denmark)

    Poulsen, Frantz Rom; Halle, Bo; Pottegård, Anton;

    2016-01-01

    PURPOSE: This study aimed to assess the usefulness of Danish patient registers for epidemiological studies of subdural hematoma (SDH) and to describe clinical characteristics of validated cases. METHODS: Using a patient register covering a geographically defined area in Denmark, we retrieved...... hospital contacts recorded under SDH International Classification of Diseases version 10 codes S065 and I620 in 2000-2012. Neurosurgeons reviewed medical records of all potential cases. Based on brain scan results, verified cases were classified by SDH type (chronic SDH (cSDH) or acute SDH (aSDH)). Thirty...... (OR), 95% confidence interval (95%CI)). RESULTS: We verified the diagnosis in 936 of 1185 identified patients. The positive predictive value was highest for hospital contacts with principal discharge diagnosis code S065 (96%) but was low for other contact types under code S065 (25-54%), and only...

  6. Psychiatric manifestation of chronic subdural hematoma: The unfolding of mystery in a homeless patient

    Directory of Open Access Journals (Sweden)

    Sujita Kumar Kar

    2015-01-01

    Full Text Available The clinical manifestation of chronic subdural hematoma is not limited to neurological deficits or cognitive impairment. It may present with behavioral abnormalities. When the behavioral abnormalities present without obvious neurological deficits and in the absence of trauma, it leads to misdiagnosis. A trivial trauma may cause intracranial bleed that is either missed or ignored in the clinical history. This case report highlights the clinical picture of a homeless patient who presented with withdrawn and disorganized behavior, apathy and poverty of speech in the absence of any neurological deficit. His clinical presentation led to a possibility of psychosis and he was started on antipsychotics. He had developed extrapyramidal side effects in low dose of antipsychotic without any clinical benefit in his clinical picture. Neuroimaging done to rule out any possible organicity-revealed bilateral subdural hematoma, which was later evacuated by neurosurgical intervention in multiple settings and the patient had improved. This case report unfolds the mystery behind the psychotic presentation in a homeless adult.

  7. Neuroendoscopic Removal of Acute Subdural Hematoma with Contusion: Advantages for Elderly Patients

    Directory of Open Access Journals (Sweden)

    Ryota Tamura

    2016-01-01

    Full Text Available Background. Large craniotomy for acute subdural hematoma is sometimes too invasive. We report good outcomes for two cases of neuroendoscopic evacuation of hematoma and contusion by 1 burr hole surgery. Case Presentation. Both patients arrived by ambulance at our hospital with disturbed consciousness after falling. Case 1 was an 81-year-old man who took antiplatelet drugs for brain infarction. Case 2 was a 73-year-old alcoholic woman. CT scanning showed acute subdural hematoma and frontal contusion in both cases. In the acute stage, glycerol was administered to reduce edema; CTs after 48 and 72 hours showed an increase of subdural hematoma and massive contusion of the frontal lobe. Disturbed consciousness steadily deteriorated. The subdural hematoma and contusion were removed as soon as possible by neuroendoscopy under local anesthesia, because neither patient was a good candidate for large craniotomy considering age and past history. 40%~70% of the hematoma was removed, and the consciousness level improved. Conclusion. Neuroendoscopic removal of acute subdural hematoma and contusion has advantages and disadvantages. For patients with underlying medical issues or other risk factors, it is likely to be effective.

  8. A Motion Simulator Ride Associated With Headache and Subdural Hematoma: First Case Report.

    Science.gov (United States)

    Scranton, Robert A; Evans, Randolph W; Baskin, David S

    2016-02-01

    We report the first case report of symptomatic bilateral subdural hematomas (SDH) associated with riding a centrifugal motion simulator ride. A previously healthy 55-year-old male developed new onset daily headaches 1 week after going on the ride that were due to symptomatic bilateral SDH requiring operative intervention with a full recovery. There was no history of other trauma or other systemic or intracranial abnormality to account for the development of the SDH. We review the headaches and other clinical features associated with chronic SDH. Twelve cases of roller coaster headaches due to SDH associated with riding roller coasters have been reported. The pathophysiology is reviewed, which we believe is the same mechanism that may be responsible in this case. Although it is possible that this neurovascular injury is truly rare, it is also possible that this injury is underreported as patients and physicians may not make the association or physicians have not reported additional cases. The risk of this injury likely increases with age, as the size of the subdural space increases, and may support the maxim that "roller coasters and simulators are for kids." PMID:26581189

  9. 'Subarachnoid cyst' after evacuation of chronic subdural hematoma: Case report of an unusual postoperative morbidity.

    Science.gov (United States)

    Sharon, Low Y Y; Wai Hoe, N G

    2016-01-01

    Burr-hole drainage of chronic subdural hematomas are routine operative procedures done by neurosurgical residents. Common postoperative complications include acute epidural and/or subdural bleeding, tension pneumocephalus, intracranial hematomas and ischemic cerebral infarction. We report an interesting post-operative complication of a 'subarachnoid cyst' after burr-hole evacuation of a chronic subdural hematoma. The authors hypothesize that the 'cyst' is likely secondary to the splitting of the adjacent neomembrane within its arachnoid-brain interface by iatrogenic irrigation of the subdural space. Over time, this 'cyst' develops into an area of gliosis which eventually causes long-term scar epilepsy in the patient. As far as we are aware, this is the first complication of such a 'subarachnoid cyst' post burr-hole drainage reported in the literature. PMID:27366276

  10. Subdural Hematoma: An Adverse Event of Electroconvulsive Therapy—Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Ranganath R. Kulkarni

    2012-01-01

    Full Text Available Electroconvulsive therapy (ECT is commonly used in the management of medication nonresponsive depressive disorder, with proven efficacy in psychiatric practice since many decades. A rare complication of intracranial bleed following this therapeutic procedure has been reported in sporadic case reports in the English literature. We report a case of such a complication in a 42-year-old male, a known case of nonorganic medication nonresponsive depressive disorder for the last two years who required ECT application. Presenting symptoms included altered mental state, urinary incontinence, and repeated episodes of vomiting; following ECT procedure with magnetic resonance imaging (MRI of the brain suggestive of bilateral acute subdural hematoma. Despite the view that it may be used in neurological conditions without raised intracranial tension, it will be worthwhile to be vigilant during post-ECT recovery for any emergent complications.

  11. A case of diffuse hemispheric gyral high density on CT scan following acute subdural hematoma in children

    International Nuclear Information System (INIS)

    A case of diffuse hemispheric gyral high density area following acute subdural hematoma was reported. A 2 - 10/12 year-old male was admitted to our hospital in comatous state after head injury by fall. Neurological examination revealed deep coma with anisocoria (R < L), absence of light reflex and positive bilateral Babinski reflex. CT scan disclosed left acute subdural hematoma with remarkable midline shift and tentorial herniation sign. Emergency decompressive craniectomy was performed. Posttraumatic hydrocephalus appeared after 10 days. So, ventriculoperitoneal shunt was done. The patient became gradually improved, but was in appalic state. 23 days after craniectomy, suddenly diffuse hemispheric gyral high density appeared on plain CT scan. In spite of this change, no clinical change was found. This high density spontaneously disappeared 10 days after appearance. Cerebral infarction-like phenomenon on postoperative CT scan of acute subdural hematoma in infants was sometimes reported. This phenomenon was sometimes accompanied with hemorrhagic infarction-like high density on CT scan. Diffuse hemispheric gyral high density was probably a kind of those hemorrhagic infarction-like phenomenon. Possible mechanism of this peculiar high density is discussed on the basis of characteristics of child's cerebral artery and pathophysiology of cerebral infarction. (author)

  12. Spontaneous subdural hematoma of the thoracolumbar region with massive recurrent bleed

    Directory of Open Access Journals (Sweden)

    Cincu Rafael

    2009-01-01

    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.

  13. Differential diagnosis of frontal lobe atrophy from chronic subdural hematoma or subdural hygroma on CT in aged patients. Usefulness of CT cisternogram

    International Nuclear Information System (INIS)

    Metrizamide CT cisternograms (CTC) were performed in order to examine the CSF passage to subarachnoid space, cerebral sulci and Sylvian fissure. The old aged 20 patients (from 63 to 88 years old) with the layer of low density area around bilateral frontal lobe (bi-frontal LDA) in plain CT finding were selected from 2000 aged patients hospitalized in Hanwa-Senboku Hospital. In these 20 patients, it was difficult to differentiate frontal lobe atrophy from the chronic subdural hematoma and subdural hygroma. Conservative therapy was applied in 19 patients for their old age or their complicated diseases. Only 1 patient was operated for subdural hygroma. The 20 patients were investigated in EEGs, severity of dementia, disturbance of consciousness, activity of daily life, their clinical course and prognosis. Only 2 of the 11 patients with type 1 CTC findings (cerebral sulci, Sylvian fissure and bi-frontal LDA were simultaneously enhanced by metrizamide) showed disturbance of consciousness and/or delirium for their serious somatic disorders. All of 6 patients with type 3 CTC findings (only bi-frontal LDA was not enhanced by metrizamide) showed disturbance of consciousness. Three patients with type 2 CTC findings (atypical findings) were reported independently. Subdural disorder elevating intracranial pressure were clarified in the cases with type 3 CTC findings. (author)

  14. Differential diagnosis of frontal lobe atrophy from chronic subdural hematoma or subdural hygroma on CT in aged patients. Usefulness of CT cisternogram

    Energy Technology Data Exchange (ETDEWEB)

    Hayashi, Hideaki [Osaka Univ. (Japan). Faculty of Medicine

    1995-02-01

    Metrizamide CT cisternograms (CTC) were performed in order to examine the CSF passage to subarachnoid space, cerebral sulci and Sylvian fissure. The old aged 20 patients (from 63 to 88 years old) with the layer of low density area around bilateral frontal lobe (bi-frontal LDA) in plain CT finding were selected from 2000 aged patients hospitalized in Hanwa-Senboku Hospital. In these 20 patients, it was difficult to differentiate frontal lobe atrophy from the chronic subdural hematoma and subdural hygroma. Conservative therapy was applied in 19 patients for their old age or their complicated diseases. Only 1 patient was operated for subdural hygroma. The 20 patients were investigated in EEGs, severity of dementia, disturbance of consciousness, activity of daily life, their clinical course and prognosis. Only 2 of the 11 patients with type 1 CTC findings (cerebral sulci, Sylvian fissure and bi-frontal LDA were simultaneously enhanced by metrizamide) showed disturbance of consciousness and/or delirium for their serious somatic disorders. All of 6 patients with type 3 CTC findings (only bi-frontal LDA was not enhanced by metrizamide) showed disturbance of consciousness. Three patients with type 2 CTC findings (atypical findings) were reported independently. Subdural disorder elevating intracranial pressure were clarified in the cases with type 3 CTC findings. (author).

  15. Acute subdural hematoma in a high school football player.

    Science.gov (United States)

    Litt, D W

    1995-03-01

    A 16-year-old football player developed a headache following a collision during a game. When his headache persisted for 1 week, he underwent a computerized tomographic (CT) scan to determine the cause. Findings were normal and a concussion was diagnosed. Seventeen days after the injury, the athlete reported disappearance of his symptoms. Provocative testing failed to recreate symptoms. The athlete continued to deny any symptoms and was cleared for unlimited participation 30 days after the initial injury. In the next game, the athlete collided with an opposing player, ran to the sidelines, and deteriorated on the sidelines after complaining of dizziness. Local Emergency Medical Squad personnel intubated him and transported him to a local hospital emergency room. Attending neurosurgeons diagnosed a right subdural hematoma by CT scan. A burr hole craniotomy evacuated the lesion. The operative report noted a second area of chronic membrane formation consistent with past head trauma. This lesion had escaped detection on two CT scans. In an interview 4 months postoperatively, the athlete admitted having experienced constant symptoms between the first and second injuries. PMID:16558315

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

    Energy Technology Data Exchange (ETDEWEB)

    Sho, Atsuko; Asaeda, Masahiro; Ohtake, Minoru [Tottori Univ., Yonago (Japan). Inst. of Neurological Sciences] [and others

    2002-09-01

    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)

  17. Mechanism of subdural effusion evolves into chronic subdural hematoma: IL-8 inducing neutrophil oxidative burst.

    Science.gov (United States)

    Tao, Zhiqiang; Lin, Yingying; Hu, Maotong; Ding, Shenghong; Li, Jianwei; Qiu, Yongming

    2016-01-01

    Chronic subdural hematoma (CSDH) is still a mysterious disease. Though great success has been has achieved by neuro-surgery treatment, the origin and development of CSDH remains unknown. Tremendous clinical observations have found the correlation of subdural effusion (SDE) and CSDH. However, systematic elucidation of CSDH's origin and progression is lacking while almost all the current hypothesis only explained partial phenomenon. This hypothesis proposes Interleukin (IL)-8 inducing neutrophil respiratory burst is the crucial impact when SDE evolves into CSDH. IL-8 initially secreted by dural border layer cells, accumulates and the concentration of IL-8 rises in the SDE cavity. Accompanied by the formation of neo-membrane under the dura meninges, IL-8 firstly prompts to establish the neo-vasculature in it, and then attracts lymphocytes aggregation in the neo-membrane. Both the newly recruited lymphocytes and endothelial cells assist the further elevation of local IL-8 concentration. When the IL-8 concentration elevated to a particular level, it attracts neutrophils to the inner wall of neo-vessels and primes them to oxidative burst. Lysosomes and superoxide released by these neutrophils make the fragile neo-capillary became leaky, and subsequently the plasma and blood cells run into SDE. However, as long as the erythrocytes come into the cavity, they shall bind large quantity of IL-8 and decrease IL-8 concentration to a lower level relatively that reduce the neutrophils recruit. When this negative feedback is stagnancy, for example, the SDE space is so large in elder man who is experiencing brain atrophy, the neo-vessels have to release more erythrocytes to bind IL-8, the liquid cavity will expand and the high intracranial pressure symptoms appeared. Our hypothesis holds potential for the proper therapeutic intervention of CSDH. IL-8 antagonist and other anti-inflammation drugs like macrolides antibiotics, glucocorticoid and atorvastatin might be optional to resist

  18. Acute subdural hematoma secondary to cerebral venous sinus thrombosis: Case report and review of literature

    Science.gov (United States)

    Bansal, Hanish; Chaudhary, Ashwani; Mahajan, Anuj; Paul, Birinder

    2016-01-01

    Cerebral venous sinus thrombosis is a rare type of stroke primarily affecting young women. Diagnosis is generally delayed or overlooked due to a wide spectrum of clinical symptoms. Subdural hematoma secondary to cerebral venous sinus thrombosis is very rare. We report a case of 40-year-old female with cerebral venous sinus thrombosis who presented to us with an acute subdural hematoma and subarachnoid hemorrhage besides venous infarct. Management of such patients is complicated due to the rarity of the condition and contraindication for the use of anticoagulation. We conducted a thorough literature search through PubMed and could find only nine cases of spontaneous subdural hematoma secondary to cerebral venous sinus thrombosis. PMID:27057237

  19. Indirect computerized tomography sign of chronic subdural hematoma demonstrated in the posterior fossa

    Energy Technology Data Exchange (ETDEWEB)

    Machi, Takao; Fukui, Masashi; Maeyama, Ryutaro; Takaki, Tosuke; Yoshiura, Shogo; Kamoi, Itsuma

    1985-03-01

    In cases of chronic subdural hematoma (CSH), brain computerized tomography (CT) scans frequently disclose a low density band in the posterior fossa (LDBP) between the lateral margin of the cerebellum and the adjacent petrous bone/tentorium cerebelli. Out of 121 cases of CSH, 56 (46%) showed the LDBP. The LDBP was mostly ipsilateral to the side of the CSH or bilateral. The frequency of the LDBP had no correlation with the severity of the cerebral midline shift or the thickness of the hematoma. As normal controls, CT scans of 257 cases in which no organic lesions were detected were used. Also 30 cases with dementing diseases, 2 cases with spinocerebellar degeneration and 428 cases of other neurological diseases such as head trauma other than CSH, brain tumor, cerebrovascular disease etc. were studied as disease controls. The incidence of the LDBP in both controls was significantly lower than in CSH. Therefore, the LDBP in cases of CSH was considered to be a significant associated finding of CT scans. The mechanism of the LDBP is discussed.

  20. A prospective randomized study of use of drain versus no drain after burr-hole evacuation of chronic subdural hematoma

    OpenAIRE

    Amit Kumar Singh; Bhaskar Suryanarayanan; Ajay Choudhary; Akhila Prasad; Sachin Singh; Laxmi Narayan Gupta

    2014-01-01

    Objective: Chronic subdural hematoma (CSDH) recurs after surgical evacuation in 5-30% of patients. Inserting subdural drain might reduce the recurrence rate, but is not commonly practiced. There are few prospective studies to evaluate the effect of subdural drains. Materials and Methods: A prospective randomized study to investigate the effect of subdural drains in the on recurrence rates and clinical outcome following burr-hole drainage (BHD) of CSDH was undertaken. During the study period, ...

  1. Spinal subdural hematoma revealing hemophilia A in a child: A case report

    OpenAIRE

    Bakhtiari Abbas; Ketabchi Ebrahim; Ghodsi Mohammad; Eftekhar Behzad; Mostajabi Pardis

    2003-01-01

    Abstract Background Intraspinal bleeding especially in the form of subdural hematoma is rare in hemophiliacs. In the present case, we report a neglected hemophilic A child with such a problem and discuss its management options. Case Presentation A 9-year old hemophilic A boy presented with quadriparesis, confusion and meningismus after a fall 4 days previously. There was no sign of direct trauma to his back. His CT Scan and MRI showed spinal extramedullary hematoma extended from C5 to L2. We...

  2. Recovery of corticospinal tract injury following subdural hematoma removal A diffusion tensor imaging study

    Institute of Scientific and Technical Information of China (English)

    Ji Heon Hong; Sung Ho Jang

    2010-01-01

    Subdural hematoma can cause compression or damage to the neural tracts in the brain;however,very little is known about this injury.We report on a patient with subdural hematoma who was evaluated by diffusion tensor imaging prior to and after trephination and drainage of subdural hematoma.A 58-year-old male patient and ten age-matched normal control subjects were evaluated.The patient showed mild hemiparesis for 3 weeks prior to surgery.His hemiparesis recovered to a nearly normal state at 5 weeks post-surgery when the follow up diffusion tensor image was acquired.Two diffusion tensor image parameters,fractional anisotropy and apparent diffusion coefficient,were measured along the corticospinal tract.Pre-operative diffusion tensor image showed that the corticospinal tract of the affected hemisphere seemed to be injured or compressed.However,the follow up diffusion tensor image showed recovery of this corticospinal tract to a normal state.It would appear that diffusion tensor images are a useful tool for evaluation of the effects of subdural hematomas on neural tracts.

  3. Spinal subdural hematoma revealing hemophilia A in a child: A case report

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    Bakhtiari Abbas

    2003-08-01

    Full Text Available Abstract Background Intraspinal bleeding especially in the form of subdural hematoma is rare in hemophiliacs. In the present case, we report a neglected hemophilic A child with such a problem and discuss its management options. Case Presentation A 9-year old hemophilic A boy presented with quadriparesis, confusion and meningismus after a fall 4 days previously. There was no sign of direct trauma to his back. His CT Scan and MRI showed spinal extramedullary hematoma extended from C5 to L2. We corrected the factor VIII level, but two days later, the patient's lower limbs weakened to 1/5 proximally as well as distally. We performed a laminectomy from T11 to L2, according to the level of the maximal neurological deficit and recent deterioration course. The subdural hematoma was evacuated. The hematoma in other spinal levels was managed conservatively. In the week following the operation, the patient's neurological status approached normal. Conclusion This case calls attention to the clinical manifestation, radiological features and management options of the rarely reported intraspinal hematoma in hemophilic children. Although this case has been managed operatively for its hematoma in the thoracolumbar region, at the same time it can be considered a successful case of conservative management of intraspinal hematoma in the cervicothoracic region. Both conservative and surgical management could be an option in managing these patients considering their neurological course.

  4. Spinal subdural hematoma revealing hemophilia A in a child: A case report.

    Science.gov (United States)

    Eftekhar, Behzad; Ghodsi, Mohammad; Ketabchi, Ebrahim; Bakhtiari, Abbas; Mostajabi, Pardis

    2003-08-01

    BACKGROUND: Intraspinal bleeding especially in the form of subdural hematoma is rare in hemophiliacs. In the present case, we report a neglected hemophilic A child with such a problem and discuss its management options. CASE PRESENTATION: A 9-year old hemophilic A boy presented with quadriparesis, confusion and meningismus after a fall 4 days previously. There was no sign of direct trauma to his back. His CT Scan and MRI showed spinal extramedullary hematoma extended from C5 to L2. We corrected the factor VIII level, but two days later, the patient's lower limbs weakened to 1/5 proximally as well as distally. We performed a laminectomy from T11 to L2, according to the level of the maximal neurological deficit and recent deterioration course. The subdural hematoma was evacuated. The hematoma in other spinal levels was managed conservatively. In the week following the operation, the patient's neurological status approached normal. CONCLUSION: This case calls attention to the clinical manifestation, radiological features and management options of the rarely reported intraspinal hematoma in hemophilic children. Although this case has been managed operatively for its hematoma in the thoracolumbar region, at the same time it can be considered a successful case of conservative management of intraspinal hematoma in the cervicothoracic region. Both conservative and surgical management could be an option in managing these patients considering their neurological course. PMID:12904268

  5. Correlation between CT and MRI findings of chronic subdural hematomas, and total hemoglobin, oxyhemoglobin and methemoglobin concentrations in hematomas

    International Nuclear Information System (INIS)

    The authors investigated the correlation between the neuroradiological findings (computerized tomography (CT) scan and magnetic resonance (MR) image) of chronic subdural hematomas (CSDH) and the fractions in those hematomas (hemoglobin (Hb), oxyhemoglobin (oxy-Hb), and methemoglobin (met-Hb)). Thirty-three patients with a total of forty lesions were chosenas subjects, all with CSDH showing almost homogenous findings in CT scans and MR images. The density in the patients' CT scans was divided into high density, iso-density and low density. The intensity in their MR images was also divided into high intensity, isointensity and low intensity, and the correlation of these to the Hb, oxy-Hb and met-Hb concentrations calculated from the absorption spectrum of the hematoma sampled during the operation was examined. The CT findings were highly correlated to the Hb and oxy-Hb, concentrations and the CT scans of the hematomas with an Hb concentration above 9.4 g/dl all showed high density. The T1-weighted MR image and met-Hb concentration also showed a high correlation, and the images of the hematomas with a met-Hb concentration above 0.4 g/dl all showed high intensity. These results indicated that the fraction in the content of CSDH was predictable from the image findings. To obtain prior knowledge of the content of a hematoma seemed extremely useful for the clucidation of the pathogenesis of CSDH and for deciding its therapeutic policy. (author)

  6. Neurological and functional outcomes of subdural hematoma evacuation in patients over 70 years of age

    Directory of Open Access Journals (Sweden)

    Patrick Mulligan

    2013-01-01

    Full Text Available Background: Subdural hematoma (SDH is a common disease entity treated by neurosurgical intervention. Although the incidence increases in the elderly population, there is a paucity of studies examining their surgical outcomes. Objectives: To determine the neurological and functional outcomes of patients over 70 years of age undergoing surgical decompression for subdural hematoma. Materials and Methods: We retrospectively reviewed data on 45 patients above 70 years who underwent craniotomy or burr holes for acute, chronic or mixed subdural hematomas. We analyzed both neurological and functional status before and after surgery. Results: Forty-five patients 70 years of age or older were treated in our department during the study period. There was a significant improvement in the neurological status of patients from admission to follow up as assessed using the Markwalder grading scale (1.98 vs. 1.39; P =0.005, yet no improvement in functional outcome was observed as assessed by Glasgow Outcome Score. Forty-one patients were admitted from home, however only 20 patients (44% were discharged home, 16 (36% discharged to nursing home or rehab, 6 (13% to hospice and 3 (7% died in the postoperative period. Neurological function improved in patients who were older, had a worse pre-operative neurological status, were on anticoagulation and had chronic or mixed acute and chronic hematoma. However, no improvement in functional status was observed. Conclusion: Surgical management of SDH in patients over 70 years of age provides significant improvement in neurological status, but does not change functional status.

  7. Evaluation of awake burr hole drainage for chronic subdural hematoma in geriatric patients: a retrospective analysis of 3 years

    OpenAIRE

    Serdal Albayrak; ibrahim Burak Atci; Necati Ucler; Hakan Yilmaz; Metin Kaplan

    2016-01-01

    Purpose: The goal of this research was to evaluate the effectiveness of burr hole drainage under local anesthesia in geriatric patients with chronic subdural hematoma. Material and Methods: This retrospective study involved 21 geriatric patients with chronic subdural hematoma who applied to the department of neurosurgery in an education and research hospital between 2011 and 2014. Sedoanalgesia was performed on 21 patients, then awake burr hole drainage was performed after scalp and perios...

  8. HEMATOMA SUBDURAL EN PACIENTE CON LEUCEMIA MIELODE CRONICA: REPORTE DE CASO

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    Carlos Fernando Lozano-Tangua

    2009-01-01

    Full Text Available El hematoma subdural cronico se define como una colección sanguíneo fibrinoide en el espacio existente entre las meninges duramadre y aracnoides, debido a traumas, infecciones (empiema y meningitis, coagulopatías u otras causas. En este se puede precisar durante la intervención quirúrgica la presencia de cápsula o membranas. Entre las diversas causas de hematoma subdural crónico se encuentra la leucemia mieloide crónica que es un síndrome mieloproliferativo, donde se ve una acentuada proliferación de glóbulos blancos de la serie granulocítica, que infiltran la sangre, médula ósea, cerebro entre otros tejidos. Presentamos brevemente un caso de esta interesante y no infrecuente asociación.

  9. Spontaneous acute subdural hematoma as an initial presentation of choriocarcinoma: A case report

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    Rocque Brandon G

    2008-06-01

    Full Text Available Abstract Introduction Diverse sequelae of central nervous system metastasis of choriocarcinoma have been reported, including infarction, intra or extra axial hemorrhages, aneurysm formation and carotid-cavernous fistula. Here we report a case of subdural hematoma as the first presentation of choriocarcinoma. Case presentation The patient is a 34-year-old woman whose initial presentation of widely metastatic choriocarcinoma was an acute subdural hematoma, requiring decompressive craniectomy. Histopathologic examination of the tissue showed no evidence of choriocarcinoma, but the patient was found to have diffuse metastatic disease and cerebrospinal fluid indices highly suggestive of intracranial metastasis. Conclusion Choriocarcinoma frequently metastasizes intracranially. We review the diverse possible manifestations of this process. In addition, the cerebrospinal fluid:serum beta-human chorionic gonadotropin ratio is an important factor in diagnosing these cases. Finally, the role of the neurosurgeon is discussed.

  10. Spontaneous Resolution of Non-traumatic Cervical Spinal Subdural Hematoma Presenting Acute Hemiparesis: A Case Report

    OpenAIRE

    Park, Yong Jin; Kim, Seok Won; Ju, Chang Il; Wang, Hui Sun

    2012-01-01

    Spontaneous cervical SDH with no underlying pathology is a very unusual condition. To the best of the authors' knowledge, only two cases have been previously reported. A 48-year-old female patient was admitted to our emergency room due to severe neck pain following standing up position with rapid onset of hemiparesis. MRI revealed a dorsolateral subdural hematoma from C3-C5 with cord compression. An emergency laminectomy was planned, but motor weakness gradually improved during surgical prepa...

  11. Acute Subdural Hematoma Following Spinal Cerebrospinal Fluid Drainage in a Patient with Freezing of Gait

    OpenAIRE

    Kim, Han-Joon; Cho, Yong-Jin; Cho, Joong-Yang; Lee, Dong-Ha; Hong, Keun-Sik

    2009-01-01

    Background Headache is a common complication of lumbar puncture (LP). Although in most cases post-LP headaches are not severe and have a benign course, they can also be a manifestation of a potentially life-threatening complication such as subdural hematoma (SDH). Case Report We describe a patient in whom a massive SDH developed after LP and cerebrospinal fluid (CSF) drainage, which were performed during the diagnostic evaluation of freezing of gait. Conclusions SDH should not be excluded fro...

  12. Fatal cerebritis and brain abscesses following a nontraumatic subdural hematoma in a chronic hemodialyzed patient.

    Science.gov (United States)

    Mesquita, Maria; Damry, Nasroolla; Gazagnes, Marie D

    2008-10-01

    Staphylococcus aureus is the leading cause of bacteremia in hemodialysis-dependent patients that can lead to metastatic abscesses with poor outcome. We report a case of a 65-year-old chronic hemodialyzed male patient who developed cerebritis and brain abscesses complicating a spontaneous subdural hematoma, following Staphylococcus aureus bacteremia related to infected arteriovenous fistula. In spite of adequate antibiotherapy and several surgical brain drainages, our patient did not survive. Prevention of S. aureus is highly important in hemodialysis patients. PMID:19090864

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

    OpenAIRE

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

    2012-01-01

    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 (...

  14. The level of circulating endothelial progenitor cells may be associated with the occurrence and recurrence of chronic subdural hematoma

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    Yan Song

    2013-01-01

    Full Text Available OBJECTIVES: The onset of chronic subdural hematoma may be associated with direct or indirect minor injuries to the head or a poorly repaired vascular injury. Endothelial progenitor cells happen to be one of the key factors involved in hemostasis and vascular repair. This study was designed to observe the levels of endothelial progenitor cells, white blood cells, platelets, and other indicators in the peripheral blood of patients diagnosed with chronic subdural hematoma to determine the possible relationship between the endothelial progenitor cells and the occurrence, development, and outcomes of chronic subdural hematoma. METHOD: We enrolled 30 patients with diagnosed chronic subdural hematoma by computer tomography scanning and operating procedure at Tianjin Medical University General Hospital from July 2009 to July 2011. Meanwhile, we collected 30 cases of peripheral blood samples from healthy volunteers over the age of 50. Approximately 2 ml of blood was taken from veins of the elbow to test the peripheral blood routine and coagulation function. The content of endothelial progenitor cells in peripheral blood mononuclear cells was determined by flow cytometry. RESULTS: The level of endothelial progenitor cells in peripheral blood was significantly lower in preoperational patients with chronic subdural hematomas than in controls. There were no significant differences between the two groups regarding the blood routine and coagulation function. However, the levels of circulating endothelial progenitor cells were significantly different between the recurrent group and the non-recurrent group. CONCLUSIONS: The level of circulating endothelial progenitor cells in chronic subdural hematoma patients was significantly lower than the level in healthy controls. Meanwhile, the level of endothelial progenitor cells in recurrent patients was significantly lower than the level in patients without recurrence. Endothelial progenitor cells may be related to the

  15. Spontaneous Resolution of Non-traumatic Cervical Spinal Subdural Hematoma Presenting Acute Hemiparesis: A Case Report.

    Science.gov (United States)

    Park, Yong Jin; Kim, Seok Won; Ju, Chang Il; Wang, Hui Sun

    2012-09-01

    Spontaneous cervical SDH with no underlying pathology is a very unusual condition. To the best of the authors' knowledge, only two cases have been previously reported. A 48-year-old female patient was admitted to our emergency room due to severe neck pain following standing up position with rapid onset of hemiparesis. MRI revealed a dorsolateral subdural hematoma from C3-C5 with cord compression. An emergency laminectomy was planned, but motor weakness gradually improved during surgical preparation. The patient showed substantial clinical improvement and complete recovery was confirmed after 7 days of conservative management without surgical treatment. To determine a differential diagnosis distinct from other conditions such as cervical epidural hematoma, a lumbar spinal puncture was performed. Follow-up MRI performed 10 days after admission revealed complete resolution of the hematoma. We report an extremely rare case of spontaneous cervical spinal subdural hematoma (SDH), present a review of relevant literature, and discuss the etiology, pathogenesis, and prognosis of this case. PMID:25983826

  16. Comparing twist-drill drainage with burr hole drainage for chronic subdural hematoma

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    LIN Xin

    2011-06-01

    Full Text Available 【Abstract】Objective: The surgical management of chronic subdural hematoma (CSDH is still a controver- sial issue, and a standard therapy has not been established because of the unclear pathogenic mechanisms in CSDH. The intention of this paper is to find a simple and efficient surgical procedure for CSDH. Methods: A retrospective study of 448 patients with CSDH by surgical treatment during 2005 to 2009 was con- ducted in order to compare the efficiency between two dif- ferent primary surgical methods, i.e. twist-drill drainage with- out irrigation in Group A (n=178 and one burr-hole with irrigation in Group B (n=270. The results were statistically analyzed. Results: The reoperation rates in Group A and Group B were 7.9% and 11.9% respectively. The good outcome rate was 88.8% and 75.5%, the complication was 7.9% and 20.7% in Group A and Group B, respectively. Conclusions: The burr-hole drainage with irrigation of the hematoma cavity is not beneficial to the outcome and prognosis. Irrigation is not important in the surgical treat- ment for CSDH. Thus in initial treatment, twist-drill drainage without irrigation of the hematoma cavity is recommended because it is relatively safe, time-saving and cost-effective. Key words: Hematoma, subdural; Brain injury, chronic; Drainage

  17. Chronic subdural hematomas as evaluated by measns of SPECT, CT and EEG topography

    International Nuclear Information System (INIS)

    Nineteen patients with chronic subdural hematomas were reviewed, and, in an attempt to delineate the pathophysiology of this condition, evaluations were made by means of single-photon-emission tomography (SPECT), computed tomography (CT), and electroencephalographic (EEG) topography. Choronic subdural hematomas were classified into three types on the basis of their SPECT appearances: Type I: normal cerebral blood flow (CBF) in the basal ganglionic region, with or without a decreased mean cerebral hemispheric CBF on the affected side; Type II: decreased basal ganglionic as well as mean cerebral hemispheric CBF on the affected side; Type III: Diffuse, marked reduction of CBF on both sides. In 11 patients with headaches, the SPECT images were often classified as Type I, in which there was a normal regional CBF in the basal ganglia. In the majority, CT scans revealed either hypo- or iso-density in the lesions, with a minimal midline shift. No evidence of focal slow waves was seen on the EEG topograms. On the other hand, 6 patients with hemiparesis demonstrated, on their SPECT images, a relative reduction of both hemispheric and basal ganglionic CBF, as designated as Type II. CT showed high- or mixed-density, and focal slow waves were found on the EEG topograms. Subsequent measurements of the CBF after the evacuation of the hematomas in 13 patients disclosed a 10-20% increase in both hemispheric and basal ganglionic CBF, particularly in patients younger than 65. The present clinical studies suggest a critical role of CBF, especially basal ganglionic CBF, in the pathophysiology of chronic subdural hematomas. (author)

  18. Hematoma subdural de medula espinhal associada ao uso de anticoagulante oral Hematoma subdural de la médula espinal asociado al uso de anticoagulante oral Spine subdural hematoma: a rare complication associated with vitamin K antagonist (VKA

    Directory of Open Access Journals (Sweden)

    Uri Adrian Prync Flato

    2009-01-01

    Full Text Available O hematoma subdural de medula espinhal (HSDME é uma complicação rara decorrente do uso de antagonistas de vitamina K (AVK e de diagnostico difícil. Este artigo apresenta um caso com complicação ameaçadora à vida: um paciente octogenário portador de fibrilação atrial de início recente em uso de AVK. A história e o exame físico inicialmente se apresentavam normais, associados com a elevação dos valores de coagulograma supraterapêuticos (INR > 10. Após 24 horas da admissão hospitalar, o paciente apresentou tetraparesia progressiva, evidenciando na ressonância nuclear magnética (RNM de medula espinhal um HSDME (Figura 1. Após reversão completa da hipocoagulação e intervenção neurocirúrgica o paciente obteve melhora do quadro neurológico.El hematoma subdural espinal (HSE es una complicación rara proveniente del uso de antagonistas de vitamina K (AVK y de diagnostico difícil. Este artículo presenta un caso con complicación amenazadora para la vida: un paciente octogenario portador de fibrilación auricular de inicio reciente, en uso de AVK. Inicialmente, la historia y el examen físico se presentaban normales, asociados a la elevación de los valores de coagulograma supra terapéuticos (INR > 10. Tras 24 horas del ingreso hospitalario, el paciente presentó tetraparesia progresiva. Al realizarse una resonancia nuclear magnética (RNM de médula espinal, se evidenció un HSE (Figura 1. Tras reversión completa de la hipocoagulación e intervención neuroquirúrgica el paciente obtuvo mejora del cuadro neurológico.Spinal subdural hematoma (SSDH is a rare condition, which is difficult to diagnose, related to Vitamin K Antagonist. This a case report of a life-threatening situation in a octogenarian patient with a history of recent atrial fibrillation that received K-Vitamin Antagonist (KVA therapy. The history and the clinical assessment were normal at the admission, associated with increase in the coagulation parameters

  19. MR imaging of shaken baby syndrome manifested as chronic subdural hematoma

    International Nuclear Information System (INIS)

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

  20. Etizolam, an anti-anxiety agent, attenuates recurrence of chronic subdural hematoma--evaluation by computed tomography.

    Science.gov (United States)

    Hirashima, Yutaka; Kuwayama, Naoya; Hamada, Hideo; Hayashi, Nakamasa; Endo, Shunro

    2002-02-01

    Etizolam, an anti-anxiety agent which is an antagonist of platelet-activating factor receptors, was administered to patients with chronic subdural hematoma (CSH) after hematoma removal to assess the effectiveness for preventing recurrence compared with control patients not given the drug after surgery. The remaining volumes of subdural hematomas on brain computed tomography were measured approximately 1 month after removal. Volume in the etizolam group (15 patients) was significantly smaller than in the control group (24 patients). Hematoma recurrence was not detected in the etizolam group 3 months after surgery, but occurred in the control group. The difference was significant. Etizolam administration may be useful for the prevention of recurrence of CSH. PMID:11944589

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

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    Gabaeff, Steven C

    2011-05-01

    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.

  2. Evaluation of awake burr hole drainage for chronic subdural hematoma in geriatric patients: a retrospective analysis of 3 years

    Directory of Open Access Journals (Sweden)

    Serdal Albayrak

    2016-03-01

    Conclusion: Surgical interventions under local anesthesia in geriatric patients with chronic subdural hematoma can provide short operation time, early mobilization, early oral intake, avoidance of possible general anesthesia complications. Herewith, this intervention decrease mortality and morbidity in this age group. [Cukurova Med J 2016; 41(1.000: 69-73

  3. Subdural hematoma

    Science.gov (United States)

    ... falls Repeated head injury Very young or very old age Symptoms Confused speech Difficulty with balance or walking ... help arrives. Prevention Always use safety equipment at work and play to reduce your risk of a ...

  4. Post-traumatic epidural and subdural hematomas of the spinal cord in MR imaging; Pourazowe nadoponowe i podoponowe krwiaki rdzenia kregowego w obrazie MR

    Energy Technology Data Exchange (ETDEWEB)

    Bronarski, J.; Wozniak, E.; Kiwerski, J. [Stoleczne Centrum Rehabilitacji, Konstancin (Poland)]|[Inst. Psychiatrii i Neurologii, Warsaw (Poland)

    1993-12-31

    Diagnostics of epi- and subdural hematomas of the spinal cord is discussed on the basis of 1992 records of Konstancin Rehabilitation Center. 54 patients with symptoms of partial or complete cord injury were submitted to MR imaging. In 4 cases (7.5%) epi- and subdural hematoma was found to contribute to neurological condition of the patient. MRI determines indications for surgical intervention. (author). 6 refs, 6 figs.

  5. A case of complete clearance of chronic subdural hematoma accompanied by recurrent glioblastoma multiforme after administration of bevacizumab.

    Science.gov (United States)

    Suzuki, Keiko; Kawataki, Tomoyuki; Kanemaru, Kazuya; Mitsuka, Kentaro; Ogiwara, Masakazu; Sato, Hiroki; Kinouchi, Hiroyuki

    2016-07-01

    The efficacy of bevacizumab, a humanized monoclonal antibody against vascular endothelial growth factor (VEGF), as an adjuvant therapy against various malignant tumors was recently established. Its pharmacological effects in malignant tumors, including gliomas, were speculated to involve neovascularization inhibition and vascular permeability. Recently, it has been reported that the outer membrane of chronic subdural hematoma (CSDH) contains high levels of VEGF, which were implicated in neovascularization of the outer membrane. Furthermore, studies suggested that VEGF has the etiology in CSDH development, although its involvement is not fully understood. Here, we report the first case of chronic subdural hematoma that was improved by bevacizumab administration for recurrent glioblastoma. The present case could contribute to the hypothesis that VEGF may be associated with CSDH. We also discuss the pathogenesis and mechanism of CSDH recurrence from the viewpoint of VEGF function. PMID:26919835

  6. Hematoma subdural intracraniano: uma rara complicação após raquianestesia: relato de caso

    OpenAIRE

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

    2012-01-01

    JUSTIFICATIVA E OBJETIVOS: O hematoma subdural intracraniano é uma complicação rara após raquianestesia. O diagnóstico é muitas vezes difícil porque os sintomas iniciais são os mesmos da cefaleia pós-punção da dura-máter. O objetivo é relatar o caso de um hematoma subdural diag nosticado precocemente, após uma raquianestesia realizada com agulha de calibre fino e punção única. RELATO DO CASO: Paciente de 48 anos, ASA I, submetida a raquianestesia para cirurgia de correção de incontinência uri...

  7. Hematoma subdural intracraniano: uma rara complicação após raquianestesia: relato de caso

    Directory of Open Access Journals (Sweden)

    Flora Margarida Barra Bisinotto

    2012-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O hematoma subdural intracraniano é uma complicação rara após raquianestesia. O diagnóstico é muitas vezes difícil porque os sintomas iniciais são os mesmos da cefaleia pós-punção da dura-máter. O objetivo é relatar o caso de um hematoma subdural diag nosticado precocemente, após uma raquianestesia realizada com agulha de calibre fino e punção única. RELATO DO CASO: Paciente de 48 anos, ASA I, submetida a raquianestesia para cirurgia de correção de incontinência urinária. Foi realizada a raquianestesia com agulha 27G Quincke e punção única. A cirurgia foi sem intercorrências, e a paciente recebeu alta hospitalar. Após 48 horas da punção raquidiana, a paciente relatou cefaleia de início súbito, de forte intensidade, acometendo principalmente a região orbitária, mas também a região temporal, com melhora importante no decúbito dorsal e acompanhada de dois episódios de vômitos. Foi solicitada tomografia de crânio que revelou a presença de um hematoma subdural agudo frontotemporoparietal esquerdo. Foi indicado tratamento conservador com analgésicos, dexametasoma e hidantoína. Após 17 dias, apresentou quadro de cefaleia intensa, acompanhada de dormência e paresia do membro superior direito, e distúrbio da fala e comportamento. O hematoma foi drenado cirurgicamente. A paciente evoluiu bem sem sequelas. CONCLUSÕES: A cefaleia é a complicação mais frequente após raquianestesia e é considerada de evolução benigna. Faz com que diagnósticos potencialmente fatais, como o hematoma subdural, não sejam feitos em muitos casos, ou sejam tardios. Este caso descreve uma ocorrência rara, um hematoma subdural agudo após uma raquianestesia com agulha fina em uma paciente sem fatores de risco para sangramento

  8. Chronic subdural hematoma of the posterior fossa associated with cerebellar hemorrhage: report of rare disease with MRI findings Hematoma subdural crônico de fossa posterior associado a hemorragia cerebelar espontânea: relato de doença rara com achados de RNM

    Directory of Open Access Journals (Sweden)

    Leodante B. Costa Jr

    2004-03-01

    Full Text Available Chronic subdural hematoma of the posterior fossa is an uncommon entity, and spontaneous lesions are very rarely described, occurring mostly during anticoagulation therapy. The association of the posterior fossa chronic subdural hematoma with spontaneous parenchymal hemorrhage without anticoagulation therapy was never related in the literature, to our knowledge. We describe a case of a 64 year-old woman who suffered a spontaneous cerebellar hemorrhage, treated conservatively, and presented 1 month later with a chronic subdural posterior fossa hematoma.Hematomas subdurais da fossa posterior são lesões raras, mais comumente relacionadas com traumas graves. A ocorrência de hematomas subdurais crônicos na fossa posterior é muito rara, sendo descritos 15 casos até o momento, boa parte relacionada ao uso de anticoagulantes. Em nossa revisão da literatura, não pudemos encontrar nenhum relato da associação entre hematoma subdural crônico da fossa posterior e hemorragia cerebelar espontânea. Relatamos o caso de paciente de 64 anos com hematoma intraparenquimatoso cerebelar tratado conservadoramente e hematoma subdural crônico, tratado cirurgicamente, cerca de 1 mês após o acidente vascular cerebelar.

  9. Age determination of subdural hematomas with CT and MRI: A systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Sieswerda-Hoogendoorn, Tessa, E-mail: t.sieswerda@amc.nl [Section of Forensic Pediatrics, Department of Forensic Medicine, Netherlands Forensic Institute, PO Box 24044, 2490 AA The Hague (Netherlands); Department of Radiology, Academic Medical Center/Emma Children' s Hospital, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Postema, Floor A.M., E-mail: f.a.postema@amc.nl [Faculty of Medicine, University of Amsterdam, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Verbaan, Dagmar, E-mail: d.verbaan@amc.nl [Department of Neurosurgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Majoie, Charles B., E-mail: c.b.majoie@amc.nl [Department of Radiology, Academic Medical Center/Emma Children' s Hospital, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Rijn, Rick R. van, E-mail: r.r.vanrijn@amc.nl [Section of Forensic Pediatrics, Department of Forensic Medicine, Netherlands Forensic Institute, PO Box 24044, 2490 AA The Hague (Netherlands); Department of Radiology, Academic Medical Center/Emma Children' s Hospital, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands)

    2014-07-15

    Objectives: To systematically review the literature on dating subdural hematomas (SDHs) on CT and MRI scans. Methods: We performed a systematic review in MEDLINE, EMBASE and Cochrane to search for articles that described the appearance of SDHs on CT or MRI in relation to time between trauma and scanning. Two researchers independently screened the articles, assessed methodological quality and performed data extraction. Medians with interquartile ranges were calculated. Differences were tested with a Mann–Whitney U or Kruskal–Wallis H test. Results: We included 22 studies describing 973 SDHs on CT and 4 studies describing 83 SDHs on MRI. Data from 17 studies (413 SDHs) could be pooled. There were significant differences between time intervals for the different densities on CT (p < 0.001). Time interval differed significantly between children and adults for iso- and hypodensity (p = 0.000) and hyperdensity (p = 0.046). Time interval did not differ significantly between abused and non-abused children. On MRI, time intervals for different signal intensities on T1 and T2 did not differ significantly (p = 0.108 and p = 0.194, respectively). Conclusions: Most time intervals of the different appearances of SDHs on CT and MRI are broad and overlapping. Therefore CT or MRI findings cannot be used to accurately date SDHs.

  10. A calvarial acute subdural hematoma migrating into the spinal canal in a young male.

    Science.gov (United States)

    Köksal, Vaner; Özdemir, Bülent

    2015-10-01

    It is not common for an acute subdural hematoma (SDH) in the supratentorial region to show rapid resolution or migration during the clinical course. In this report, we present a rare case where the SDH in the supratentorial region was observed to rapidly migrate into the lumbar spinal canal, leading to severe radiculopathy. A 20-year-old male patient was admitted to the emergency department with severe headache after head trauma. The patient's overall condition was good, whereas his Glasgow Coma Scale score was 15 and blood pressure was normal. He had vomited 3 times after the onset of pain. No stiff neck was found, and the computed tomography showed an ASDH over the outer layer of the right hemisphere, causing a 7- to 8-mm shift. During the follow-up, the headache regressed and eventually resolved after 12 hours; however, another severe pain occurred in the lumbar region and in both legs. The pain worsened over time, progressing to sciatica in both legs. Acute SDH associated with a minor head trauma may migrate from the supratentorial compartment into the spinal canal by the help of elastic cerebral tissues in young adults and children. PMID:26314217

  11. Computed tomography findings examined on an event which would originate chronic subdural hematoma

    International Nuclear Information System (INIS)

    Computed tomography (CT) findings examined on an event which would originate chronic subdural hematoma (CSDH) in the future are rare. We studied the original events causing CSDH and the following mechanism by which CSDH was originated on the basis of our CT findings examined on the event originating CSDH. Nine patients with traumatic CSDH were reviewed. The patients ranged in age from 48 to 89 years (mean 69.1 years). CT findings examined on the event originating CSDH were analyzed about both extracranial and intracranial lesions. All patients were divided into two groups; non-advanced age (under 70 years, n=5) and advanced age (over 70 years, n=4). All five patients in the non-advanced age group had abnormal findings at least in the extracranial area on CT examined on the event originating CSDH. On the other hand, only one patient had abnormal findings on CT examined on the event originating CSDH in the advanced age group. It is fact that slight head injuries cause CSDH in the advanced age, but it is probably that not slight head injuries such as to reveal abnormal findings at least in the extracranial area on CT cause CSDH in the non-advanced age. (author)

  12. Acute Subdural Hematoma in Infants with Abusive Head Trauma: A Literature Review.

    Science.gov (United States)

    Karibe, Hiroshi; Kameyama, Motonobu; Hayashi, Toshiaki; Narisawa, Ayumi; Tominaga, Teiji

    2016-05-15

    The number of cases with child abuse is increasing in Japan, and abusive head trauma (AHT) is a major cause of death in abused children. Child abuse has been recognized by the late 19th century, and widely accepted as battered child syndrome in the middle of the 20th century. As terms, there had been considerable mechanistic controversies between shaken-baby and -impact syndrome until the beginning of the 21st century. In recent years, AHT has been utilized as a less mechanistic term. Most of the characteristics of AHT in Japan have been similar to those in the United States as follows: infant is the most common victim, acute subdural hematoma (SDH) is the most common intracranial lesion, and retinal hemorrhage is often complicated. On the other hand, several characteristics have been different as follows: mother is the most common perpetrators, impact is a more common mechanism of trauma than shaking, and external trauma is more common reflecting the existence of impact. Since AHT as well as child abuse is a social pathological phenomenon influenced by victims, perpetrators, socioeconomic circumstances, and so on, various aspects of AHT as well as child abuse can be changed with times. Actually, a recent paper suggests such changes in infants with acute SDH due to AHT. In this review article, AHT, abusive infantile acute SDH in particular, are reviewed from the aspect of neurosurgical perspectives, including its mechanisms of trauma, biomechanics, clinical features, management, and prognosis, to update the trend in Japan. PMID:26960448

  13. Age determination of subdural hematomas with CT and MRI: A systematic review

    International Nuclear Information System (INIS)

    Objectives: To systematically review the literature on dating subdural hematomas (SDHs) on CT and MRI scans. Methods: We performed a systematic review in MEDLINE, EMBASE and Cochrane to search for articles that described the appearance of SDHs on CT or MRI in relation to time between trauma and scanning. Two researchers independently screened the articles, assessed methodological quality and performed data extraction. Medians with interquartile ranges were calculated. Differences were tested with a Mann–Whitney U or Kruskal–Wallis H test. Results: We included 22 studies describing 973 SDHs on CT and 4 studies describing 83 SDHs on MRI. Data from 17 studies (413 SDHs) could be pooled. There were significant differences between time intervals for the different densities on CT (p < 0.001). Time interval differed significantly between children and adults for iso- and hypodensity (p = 0.000) and hyperdensity (p = 0.046). Time interval did not differ significantly between abused and non-abused children. On MRI, time intervals for different signal intensities on T1 and T2 did not differ significantly (p = 0.108 and p = 0.194, respectively). Conclusions: Most time intervals of the different appearances of SDHs on CT and MRI are broad and overlapping. Therefore CT or MRI findings cannot be used to accurately date SDHs

  14. Motor vehicle crash-related subdural hematoma from real-world head impact data.

    Science.gov (United States)

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

    2012-12-10

    Abstract 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 (CT) scans were selected from the Crash Injury Research Engineering Network (CIREN) with Abbreviated Injury Scale (AIS) level 3+ SDH. Semi-automated methods were used to isolate the intracranial volume. SDH and additional occupant intracranial injuries were segmented across axial CT images, providing a total SDH injury volume. SDH volume was correlated to crash parameters and occupant characteristics. Results show a positive correlation between SDH volume and crash severity in near-side and frontal crashes. Additionally, the location of the resulting hemorrhage varied by crash type. Those with greater SDH volumes had significantly lower Glasgow Coma Scale (GCS) scores at the crash site in near-side crashes. Age and fracture type were found to be significant contributors to SDH volume. This study is a volumetric analysis of real world brain injuries and known MVC impacts. The results of this study demonstrate a relationship among SDH volume, crash mechanics, and occupant characteristics that provide a better understanding of the injury mechanisms of MVC-associated TBI. PMID:22928543

  15. Relations among traumatic subdural lesions.

    OpenAIRE

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

    1996-01-01

    Acute subdural hematoma (ASDH), chronic subdural hematoma (CSDH) and subdural hygroma (SDG) occur in the subdural space, usually after trauma. We tried to find a certain relationship among these three traumatic subdural lesions in 436 consecutive patients. We included all subdural lesions regardless of whether they were main or not. We evaluated the distribution, age incidence and interval from injury to diagnosis of these lesions, and the frequency of new subdural lesions in each lesion. ASD...

  16. Chronic subdural hematoma associated with sylvian arachnoid cyst in juvenile athletes: report of two cases and literature review

    Institute of Scientific and Technical Information of China (English)

    ZENG Tao; SHI Song-sheng; LIN Yu-feng

    2011-01-01

    The association of chronic subdural hematoma (CSDH) and arachnoid cyst (AC) is uncommon.We reported 2 juvenile athletes with CSDH associated with AC which occurred in their daily sports activities and reviewed the literature. Both of them were treated surgically, with satisfactory outcome. AC is a common predisposing factor in young patients with CSDH. The complication of intracranial bleeding is an indication for surgical management. Though there are still controversies in the treatment of asymptomatic AC, it is the consensus that the patients with AC should avoid violent sports so as to reduce the incidence of intracranial hemorrhage resulted from head injuries.

  17. CYP2C9*3 polymorphism presenting as lethal subdural hematoma with low-dose warfarin.

    Science.gov (United States)

    Karnik, Niteen D; Sridharan, Kannan; Tiwari, D; Gupta, V

    2014-01-01

    Warfarin is the most common and cheap oral anticoagulant currently used in clinical practice. A high inter-individual variation is seen in the response to warfarin. Recently, pharmacogenetics has gained importance in managing patients on warfarin, both in predicting the optimum required dose as well as in decreasing the risk of bleeding. This case report is a description of a 49-year-old patient who had a lethal subdural hematoma with low-dose warfarin. He was subsequently found to have CYP2C9 gene polymorphism (*1/*3). This case report stresses the importance of pre-prescription assessment of genetic analysis for those initiated on warfarin. PMID:25298588

  18. CYP2C9*3 polymorphism presenting as lethal subdural hematoma with low-dose warfarin

    OpenAIRE

    Karnik, Niteen D.; Sridharan, Kannan; Tiwari, D.; Gupta, V.

    2014-01-01

    Warfarin is the most common and cheap oral anticoagulant currently used in clinical practice. A high inter-individual variation is seen in the response to warfarin. Recently, pharmacogenetics has gained importance in managing patients on warfarin, both in predicting the optimum required dose as well as in decreasing the risk of bleeding. This case report is a description of a 49-year-old patient who had a lethal subdural hematoma with low-dose warfarin. He was subsequently found to have CYP2C...

  19. Extra-Axial Hematoma and Trimethoprim-Sulfamethoxazole Induced Aplastic Anemia: The Role of Hematological Diseases in Subdural and Epidural Hemorrhage

    OpenAIRE

    Menger, Richard P.; Dossani, Rimal H.; Jai Deep Thakur; Frank Farokhi; Kevin Morrow; Bharat Guthikonda

    2015-01-01

    Objective and Importance. To illustrate the development of spontaneous subdural hematoma secondary to aplastic anemia resulting from the administration of trimethoprim-sulfamethoxazole. This is the first report of trimethoprim-sulfamethoxazole potentiating coagulopathy leading to any form of intracranial hematoma. Clinical Presentation. A 62-year-old female developed a bone marrow biopsy confirmed diagnosis of aplastic anemia secondary to administration of trimethoprim-sulfamethoxazole follow...

  20. Rapid resolution of an acute subdural hematoma by increasing the shunt valve pressure in a 63-year-old man with normal-pressure hydrocephalus with a ventriculoperitoneal shunt: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Hayes Jackson

    2012-11-01

    Full Text Available Abstract Introduction Symptomatic subdural hematoma development is a constant concern for patients who have undergone cerebrospinal fluid shunting procedures to relieve symptoms related to normal-pressure hydrocephalus. Acute subdural hematomas are of particular concern in these patients as even minor head trauma may result in subdural hematoma formation. The presence of a ventricular shunt facilitates further expansion of the subdural hematoma and often necessitates surgical treatment, including subdural hematoma evacuation and shunt ligation. Case presentation We present the case of a 63-year-old North American Caucasian man with normal-pressure hydrocephalus with an adjustable valve ventriculoperitoneal shunt who developed an acute subdural hematoma after sustaining head trauma. Conservative treatment was favored over operative evacuation because our patient was neurologically intact, but simple observation was considered to be too high risk in the setting of a low-pressure ventriculoperitoneal shunt. Thus, the valve setting on the ventriculoperitoneal shunt was increased to its maximum pressure setting in order to reduce flow through the shunt and to mildly increase intracranial pressure in an attempt to tamponade any active bleeding and limit hematoma expansion. A repeat computed tomography scan of the head six days after the valve adjustment revealed complete resolution of the acute subdural hematoma. At this time, the valve pressure was reduced to its original setting to treat symptoms of normal-pressure hydrocephalus. Conclusions Programmable shunt valves afford the option for non-operative management of acute subdural hematoma in patients with ventricular shunts for normal-pressure hydrocephalus. As illustrated in this case report, increasing the shunt valve pressure may result in rapid resolution of the acute subdural hematoma in some patients.

  1. Concurrent Intracranial and Spinal Subdural Hematoma in a Teenage Athlete: A Case Report of This Rare Entity

    Directory of Open Access Journals (Sweden)

    Daniel S. Treister

    2014-01-01

    Full Text Available A 15-year-old male high school football player presented with episodes of headache and complete body stiffness, especially in the arms, lower back, and thighs, immediately following a football game. This was accompanied by severe nausea and vomiting for several days. Viral meningitis was suspected by the primary clinician, and treatment with corticosteroids was initiated. Over the next several weeks, there was gradual symptom improvement and the patient returned to his baseline clinical status. The patient experienced a severe recurrence of the previous myriad of symptoms following a subsequent football game, without an obvious isolated traumatic episode. In addition, he experienced a new left sided headache, fatigue, and difficulty ambulating. He was admitted and an extensive workup was performed. CT and MRI of the head revealed concurrent intracranial and spinal subdural hematomas (SDH. Clinical workup did not reveal any evidence of coagulopathy or predisposing vascular lesions. Spinal SDH is an uncommon condition whose concurrence with intracranial SDH is an even greater clinical rarity. We suggest that our case represents an acute on chronic intracranial SDH with rebleeding, membrane rupture, and symptomatic redistribution of hematoma to the spinal subdural space.

  2. Concurrent intracranial and spinal subdural hematoma in a teenage athlete: a case report of this rare entity.

    Science.gov (United States)

    Treister, Daniel S; Kingston, Sara E; Zada, Gabriel; Singh, Manu; Jones, Jesse G A; Mills, Jena N; Lerner, Alexander; Boyko, Orest B; Law, Meng; Rajamohan, Anandh; Shiroishi, Mark S

    2014-01-01

    A 15-year-old male high school football player presented with episodes of headache and complete body stiffness, especially in the arms, lower back, and thighs, immediately following a football game. This was accompanied by severe nausea and vomiting for several days. Viral meningitis was suspected by the primary clinician, and treatment with corticosteroids was initiated. Over the next several weeks, there was gradual symptom improvement and the patient returned to his baseline clinical status. The patient experienced a severe recurrence of the previous myriad of symptoms following a subsequent football game, without an obvious isolated traumatic episode. In addition, he experienced a new left sided headache, fatigue, and difficulty ambulating. He was admitted and an extensive workup was performed. CT and MRI of the head revealed concurrent intracranial and spinal subdural hematomas (SDH). Clinical workup did not reveal any evidence of coagulopathy or predisposing vascular lesions. Spinal SDH is an uncommon condition whose concurrence with intracranial SDH is an even greater clinical rarity. We suggest that our case represents an acute on chronic intracranial SDH with rebleeding, membrane rupture, and symptomatic redistribution of hematoma to the spinal subdural space. PMID:25349764

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

    Directory of Open Access Journals (Sweden)

    Enny Harliany Alwi

    2009-09-01

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

  4. Preoperative angiotensin converting enzyme inhibitor usage in patients with chronic subdural hematoma: Associations with initial presentation and clinical outcome.

    Science.gov (United States)

    Neidert, Marian C; Schmidt, Tobias; Mitova, Tatyana; Fierstra, Jorn; Bellut, David; Regli, Luca; Burkhardt, Jan-Karl; Bozinov, Oliver

    2016-06-01

    The aim of this study is to analyze the association of preoperative usage of angiotensin converting enzyme (ACE) inhibitors with the initial presentation and clinical outcome of patients with chronic subdural hematoma (cSDH). Patients treated for cSDH between 2009 and 2013 at our institution were included in this retrospective case-control study. Medical charts were reviewed retrospectively and data were analyzed using descriptive and inferential statistics. Out of 203 patients (58 females, mean age 73.2years), 53 (26%) patients were on ACE inhibitors before their presentation with cSDH. Median initial hematoma volume in individuals with ACE inhibitors (179.2±standard error of the mean [SEM] 13.0ml) was significantly higher compared to patients without ACE inhibitors (140.4±SEM 6.2ml; p=0.007). There was an increased probability of surgical reintervention in the ACE inhibitor group (12/53, 23% versus 19/153, 12%; p=0.079), especially in patients older than 80years (6/23, 26% versus 3/45, 7%; p=0.026). ACE inhibitors are associated with higher hematoma volume in patients with cSDH and with a higher frequency of recurrences requiring surgery (especially in the very old). We hypothesize that these effects are due to ACE inhibitor induced bradykinin elevation causing increased vascular permeability of the highly vascularized neomembranes in cSDH. PMID:26898577

  5. CYP2C9FNx013 polymorphism presenting as lethal subdural hematoma with low-dose warfarin

    Directory of Open Access Journals (Sweden)

    Niteen D Karnik

    2014-01-01

    Full Text Available Warfarin is the most common and cheap oral anticoagulant currently used in clinical practice. A high inter-individual variation is seen in the response to warfarin. Recently, pharmacogenetics has gained importance in managing patients on warfarin, both in predicting the optimum required dose as well as in decreasing the risk of bleeding. This case report is a description of a 49-year-old patient who had a lethal subdural hematoma with low-dose warfarin. He was subsequently found to have CYP2C9 gene polymorphism (FNx011/FNx013. This case report stresses the importance of pre-prescription assessment of genetic analysis for those initiated on warfarin.

  6. Clinical features, treatment and outcome of the acute subdural hematoma in JNTDB. Comparison between Project 1998 and Project 2004

    International Nuclear Information System (INIS)

    The purpose of this study was clarify the clinical features, a change of the therapy and the effect, connection with the outcome of acute subdural hematoma registered on the Japan Neurotrauma Data Bank (JNTDB) presented in 1998 and 2004. Among those, 421 cases in P1998 and 380 cases in P2004 aged more than 6 years who presented with Glasgow Coma Scale (GCS) 8 or less on admission and with acute subdural hematoma (ASDH) on CT findings were retrospectively analyzed. As for the age distribution, two peaks were seen in young aged 16-20 years and old aged 61-65 years. The ratio of the ASDH case in young cases (45 years) decreased compared with P1998. A ratio of traffic accidents decreased, and a ratio of the injury by the fall increased. Surgical treatment was performed to 63.2% (P2004), 65.1% (P1998), and was performed both projects most together by a 46-65 year-old case. Hematoma evacuation group increased to 21.1% from 14.5%, and a burr hole opening decreased to 17.1% (P2004) from 22.3% (P1998). The temperature management was performed to 41.2% (P2004), 20.5% (P1998), especially the younger cases (45 years) in P2004, the temperature management was performed to 56.2%. The overall mortality is 67.7% (P1998), and 54.5% (P2004). The mortality of the temperature management cases was decreased, but the favorable outcome group does not increase. In younger cases (45 years), the favorable outcome group improved to 47.1% (P2004) from 33.3% (P1998) in the hypothermia group, and improved to 45.5% (P2004) from 30.0% (P1998) in the normothermia group. Temperature management after surgical treatment was more common, used to 57.5% (P2004) and 29.2% (P1998). The rate of favorable outcome group tends to increase in the hypothermia and normothermia group with craniotomy, but the mortality was not seen in the difference with the no temperature management group. For the case that used temperature management with a burr hole opening, the effect was not clear. An outcome tends to be good

  7. 儿童外伤性硬膜下血肿临床特点%The clinical features of traumatic subdural hematomas in children

    Institute of Scientific and Technical Information of China (English)

    冀园琦; 谢坚; 佟献增

    2008-01-01

    Objective To discuss the clinical features of traumatic subdural hematomas in children. Methods One hundred and sixty-six children with traumatic subdural hematomas managed in the previous six years were retrospectively reviewed. Results Children with traumatic subdural hematomas took the proportion of 15% of all head injury and 31.6% of intracranial hematomas in children in the same period. About 42.2% patients were neonates or infants. The primary causes of head injury were in the order of birth injury, accidental falls, road accident and violence. Most hematomas were located at the supra tentoriurn of cerebellum, with the symptoms of headache, vomiting, conscious disturbance, epilepsy and local symptom in nervous system. Patients with surgical indications took 24.7% among all cases. The operations included craniotomy and burr hole drainage. Conclusions Conservative treatment can be used for most cases of traumatic subdural hematomas in children. Surgical indications are conscious disturbance, defection of nervous system, and large hematomas found on CT scan. Most patients completely recovered with timely treatment.%目的 探讨儿童外伤性硬脑膜下血肿的临床特点.方法 回顾性分析了6年间收治的儿童硬脑膜下血肿166例的临床特点.结果 儿童硬脑膜下血肿占同期儿童颅脑外伤的15.1%、颅内血肿的31.6%.新生儿、婴幼儿在本组中占42.2%.随着年龄的增长,造成出血的主要原因依次为产伤、坠落伤以及车祸和暴力伤害.血肿主要位于小脑幕上,主要症状为:头痛、呕吐、意识障碍、癫痫和神经系统局灶症状.需要手术治疗者仅为所收治患儿的24.7%,手术方法包括钻孔血肿引流术和开颅血肿清除术.结论 儿童硬膜下血肿多数可以保守治疗,手术治疗的指征是:有意识障碍及神经功能缺陷,CT显示血肿较大,占位效应明显.多数经及时治疗后预后较好.

  8. Comparison of Two Algorithms for Analysis of Perfusion Computed Tomography Data for Evaluation of Cerebral Microcirculation in Chronic Subdural Hematoma.

    Science.gov (United States)

    Trofimov, Alexey O; Kalentiev, George; Voennov, Oleg; Yuriev, Michail; Agarkova, Darya; Trofimova, Svetlana; Bragin, Denis E

    2016-01-01

    The aim of this work was comparison of two algorithms of perfusion computed tomography (PCT) data analysis for evaluation of cerebral microcirculation in the perifocal zone of chronic subdural hematoma (CSDH). Twenty patients with CSDH after polytrauma were included in the study. The same PCT data were assessed quantitatively in cortical brain region beneath the CSDH (zone 1), and in the corresponding contralateral brain hemisphere (zone 2) without and with the use of perfusion calculation mode excluding vascular pixel 'Remote Vessels' (RV); 1st and 2nd analysis method, respectively. Comparison with normal values for perfusion indices in the zone 1 in the 1st analysis method showed a significant (p < 0.01) increase in CBV and CBF, and no significant increase in MTT and TTP. Use of the RV mode (2nd analysis method) showed no statistically reliable change of perfusion parameters in the microcirculatory blood flow of the 2nd zone. Maintenance of microcirculatory blood flow perfusion reflects the preservation of cerebral blood flow autoregulation in patients with CSDH. PMID:27526170

  9. Relationship between intracranial hypertension and cerebral blood flow after craniotomy in cases with traumatic acute subdural hematoma

    International Nuclear Information System (INIS)

    The purpose of this study is to investigate relationship between the duration of initial intracranial hypertension and postoperative cerebral blood flow (CBF) changes in cases with traumatic acute subdural hematoma (ASDH). Intracerebral pressure (ICP) was monitored using ICP catheter in 17 cases with unilateral traumatic ASDH. ICP monitoring was started before craniotomy, and was continued for 7 days. CBF was quantitatively measured at 7 days after craniotomy with 123I-infetamine (IMP) single photon emission computed tomography (SPECT). Clinical outcome was evaluated using Glasgow Outcome Scale (GOS) at the time of discharge. Patients were divided into 2 groups by the duration of intracranial hypertension: patients who presented with intracranial hypertension (>25 mmHg) and received surgical decompression within 6 hours after deterioration (group A, n=9), and patients who presented with intracranial hypertension and received surgical decompression more than 6 hours after deterioration (group B, n=6). In group A, 7 of 9 patients demonstrated ipsilateral hemispheric hyperperfusion, and the clinical outcome was relatively favorable: Good Recovery (GR) 4 cases, Moderately Disabled (MD) 4 cases, and Severely Disabled (SD) 1 case. In group B, 5 of 6 patients demonstrated ipsilateral hemispheric hypoperfusion, and the clinical outcome was unfavorable: SD 4 cases, and Dead 2 cases. These results suggest that the duration of intracranial hypertension affects on postoperative CBF changes. Duration of intracranial hypertension may also affect on clinical outcome directly, or secondary by altering postoperative CBF changes in patients with traumatic ASDH. (author)

  10. Bilateral hematoma of sternocleidomastoid muscles. A case presentation.

    Directory of Open Access Journals (Sweden)

    Zoe Quintero Delgado

    2005-08-01

    Full Text Available Presentation of the case of an infant with bilateral congenital torticollis which development was followed by ultrasound. Homeopathy and physiotherapy were used for its treatment. This is an infrequent disease scarcely reported in medical literature.

  11. Core Outcomes and Common Data Elements in Chronic Subdural Hematoma: A Systematic Review of the Literature Focusing on Reported Outcomes.

    Science.gov (United States)

    Chari, Aswin; Hocking, Katie C; Broughton, Ellie; Turner, Carole; Santarius, Thomas; Hutchinson, Peter J; Kolias, Angelos G

    2016-07-01

    The plethora of studies in chronic subdural hematoma (CSDH) has not resulted in the development of an evidence-based treatment strategy, largely due to heterogeneous outcome measures that preclude cross-study comparisons and guideline development. This study aimed to identify and quantify the heterogeneity of outcome measures reported in the CSDH literature and to build a case for the development of a consensus-based core outcome set. This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was registered with the PROSPERO international prospective register of systematic reviews (CRD42014007266). All full-text English language studies with >10 patients (prospective) or >100 patients (retrospective) published after 1990 examining clinical outcomes in CSDH were eligible for inclusion. One hundred two eligible studies were found. There were 14 (13.7%) randomized controlled trials, one single arm trial (1.0%), 25 (24.5%) cohort comparison studies, and 62 (60.8%) prospective or retrospective cohort studies. Outcome domains reported by the studies included mortality (63.8% of included studies), recurrence (94.1%), complications (48.0%), functional outcomes (40.2%), and radiological (38.2%) outcomes. There was significant heterogeneity in the definitions of the outcome measures, as evidenced by the seven different definitions of the term "recurrence," with no definition given in 19 studies. The time-points of assessment for all the outcome domains varied greatly from inpatient/hospital discharge to 18 months. This study establishes and quantifies the heterogeneity of outcome measure reporting in CSDH and builds the case for the development of a robust consensus-based core outcome set for future studies to adhere to as part of the Core Outcomes and Common Data Elements in CSDH (CODE-CSDH) project. PMID:26295586

  12. Subacute subdural hematoma in a 45-year-old woman with no significant past medical history after a roller coaster ride.

    Science.gov (United States)

    Williams, Kim A; Kouloumberis, Pelagia; Engelhard, Herbert H

    2009-05-01

    Amusement park ride injuries have been newsworthy events for many years. The multitude and severity of these injuries has been reported many times over the past 20 years and includes spinal cord and vertebral injuries, subarachnoid hemorrhage, internal and vertebral artery dissections, and even a few cases of subdural hematoma (SDH). There has also been as many theories to explain these injuries as there have been injuries themselves including how G forces and rotational acceleration can cause both neuroparenchymal and neurovascular injury. PMID:19555640

  13. Gestational trophoblastic disease and bilateral renal subcapsular hematoma, an unusual form of clinical presentation

    International Nuclear Information System (INIS)

    Full text: Introduction: Gestational trophoblastic disease (GTD)includes a heterogeneous group of rare diseases which originate in the trophoblastic epithelial proliferation placental βHCG elevation. Recognizes clinico pathological mainly 4 ways: hydatidiform mole (partial and complete), invasive mole, placental site tumor coriocarcioma, latter being highly aggressive to spread through the blood. The most common sites of metastasis are lung, liver and CN S. The presentation with renal and bilateral subcapsular hematoma is a rarity with few reports in the literature. It is a potentially curable disease chemotherapy, even in advanced stages. Case report: A 28 years with complete hydatidiform mole A P in 2006. Login low back pain in May/2011. Urinary tract ultrasonography and CT pelvis tx- ab d- subcapsular hematomas showed bilateral bulky, up to 6 cm. nodule right lung. R M ab d- pelvic supports multiple hepatic hematomas secundarismo renal subcapsular. The study cancer and brain CT were normal and βHCG of 256,000 mIU / ml. The FIGO prognostic score was higher than 7 constituting high-risk disease. Urological behavior was watchful waiting. Q T received 3 cycles of PE B type, followed by EMA- CO, obtaining βHCG normalization after the 3rd. this protocol cycle, completing two additional cycles of consolidation to November/2011. Complete remission was obtained and frank imagenological reduction hematomas. In February/2012 βHCG rise is observed. Cranial CT and MRI confirmed single lesion right parietal being operated on. The A- P confirms metastases choriocarcinoma support. Get Q T Type E P for 4 cycles with normalization of βHCG maintaining the time of this communication. Discussion and Conclusions: The choriocarcinoma is an unusual entity being chemosensitive clinical presentation with a renal subcapsular hematomas. presents For a patient who responded completely to the cisplatin -based Q T that evolution has a single brain metastasis treated with surgery and Q T

  14. Effect of platelet-activating factor receptor antagonist, etizolam, on resolution of chronic subdural hematoma. A prospective study to investigate use as conservative therapy

    International Nuclear Information System (INIS)

    Inflammatory reaction is very important for formation of the neomembrane of chronic subdural hematoma (CSDH). The present study evaluated medical treatment with the platelet-activating factor receptor antagonist, etizolam, for the resolution of CSDH, and the factors indicating surgery or conservative therapy. Alternate patients were assigned to the etizolam group or control group without medical treatment. Patients in the etizolam group received 3.0 mg etizolam per day for 14 days. A total of 53 patients were followed up for at least 6 months. Univariate analysis of differences in demographic characteristics, clinical findings, and initial computed tomography (CT) findings, and multiple logistic regression analysis of the relationship between etizolam treatment and requirement for surgery using age, sex, low density of hematoma on CT, and paresis as confounders were performed. Etizolam treatment (adjusted odds ratio [OR] 0.156, 95% confidence interval [CI] 0.024-0.999, p=0.049) was negatively correlated with requirement for surgery. Low density of hematoma (adjusted OR 0.125, 95% CI 0.019-0.846, p=0.033) was found to be an independent negative predictor, and paresis as an initial symptom (adjusted OR 6.35, 95% CI 1.04-38.7, p=0.045) was an independent positive predictor of requirement for surgery. Etizolam administration can promote the resolution of CSDH, especially at the stage of hygroma appearing as low density on CT. Surgery is recommended if the patient presents with paresis. (author)

  15. Effect of platelet-activating factor receptor antagonist, etizolam, on resolution of chronic subdural hematoma--a prospective study to investigate use as conservative therapy.

    Science.gov (United States)

    Hirashima, Yutaka; Kurimoto, Masanori; Nagai, Shoichi; Hori, Emiko; Origasa, Hideki; Endo, Shunro

    2005-12-01

    Inflammatory reaction is very important for formation of the neomembrane of chronic subdural hematoma (CSDH). The present study evaluated medical treatment with the platelet-activating factor receptor antagonist, etizolam, for the resolution of CSDH, and the factors indicating surgery or conservative therapy. Alternate patients were assigned to the etizolam group or control group without medical treatment. Patients in the etizolam group received 3.0 mg etizolam per day for 14 days. A total of 53 patients were followed up for at least 6 months. Univariate analysis of differences in demographic characteristics, clinical findings, and initial computed tomography (CT) findings, and multiple logistic regression analysis of the relationship between etizolam treatment and requirement for surgery using age, sex, low density of hematoma on CT, and paresis as confounders were performed. Etizolam treatment (adjusted odds ratio [OR] 0.156, 95% confidence interval [CI] 0.024-0.999, p = 0.049) was negatively correlated with requirement for surgery. Low density of hematoma (adjusted OR 0.125, 95% CI 0.019-0.846, p = 0.033) was found to be an independent negative predictor, and paresis as an initial symptom (adjusted OR 6.35, 95% CI 1.04-38.7, p = 0.045) was an independent positive predictor of requirement for surgery. Etizolam administration can promote the resolution of CSDH, especially at the stage of hygroma appearing as low density on CT. Surgery is recommended if the patient presents with paresis. PMID:16377949

  16. BILATERAL SUPERFICIAL CERVICAL BLOCKS AS THE PRIMARY ANESTHETIC FOR THE PATIENT UNDERGOING AN EVACUATION OF NECK HEMATOMA AFTER PARATHYROID SURGERY.

    Science.gov (United States)

    Heller, Benjamin; Levine, Adam

    2015-10-01

    This is the case of an 80-year-old female who presented for evacuation of a neck hematoma on POD#3 after a parathyroidectomy. Her medical history included coronary artery disease with a drug-eluding stent, off aspirin for 2 weeks. She had a significant hematoma from the hyoid bone extending down to below the suprasternal notch. She reported hoarseness. The anesthesiology team provided regional anesthesia with bilateral superficial cervical blocks, supplemented with minimal sedation for patient compliance. The surgical team used no adjuvant local anesthetic. A deep exploration was performed and significant clot was evacuated. The patient went home safely from the PACU. PMID:26860031

  17. Midbrain hematoma presenting with isolated bilateral palsy of the third cranial nerve in a Moroccan man: a case report

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    El Ouali Ouarda

    2012-07-01

    Full Text Available Abstract Introduction Bilateral third nerve palsy secondary to a hemorrhagic stroke is exceptional. To the best of our knowledge, no similar case has been reported in the literature. Case presentation We describe the case of a 69-year-old Moroccan man who presented with isolated sudden bilateral third nerve palsy. Computed tomography (CT of the brain revealed a midbrain hematoma. The oculomotor function gradually and completely improved over eight months of follow-up. Conclusion Stroke should be included in the differential diagnosis of sudden isolated oculomotor paralysis even when it is bilateral because of the severity of the underlying disease and the importance of its therapeutic implications.

  18. "Rabbit Ear" scalp deformity caused by massive subdural effusion in infant following bilateral burr-hole drainage

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    Guru Dutta Satyarthee

    2013-01-01

    Full Text Available Subdural effusion (SDE in an infant is a rare clinical scenario, which may be secondary to a variety of etiologies. Massive SDE is an extremely rare complication of head injury. It usually runs a self-limiting course. Though neurosurgical intervention is occasionally needed, different methods of surgical procedure for management includes burr-hole alone, burr-holes with subdural drain placement, twist drill craniotomy with drain and even craniotomy. The authors report a rare case of progressive massive SDE, which despite bilateral burr-hole placement and drainage failed and presented with visual deterioration and massive bulge of scalp at burr-hole sites producing rabbit ear sign in a 10 month old infant. Ultimately cystoperitoneal shunt was carried out in a desperate attempt to prevent impending rupture of scalp sutures at sites of previous burr-hole placement. Astonishingly not only complete resolution of hygroma, but visual recovery also took place. Patient is doing well at 6 months following shunt with regaining normal vision and appropriate developmental milestones. A magnetic resonance imaging scan of brain at last follow-up revealed mild ventriculomegaly with subduro-peritoneal shunt in situ and rest of brain was unremarkable. Such cases have not been reported in literature until date.

  19. The dangerous gamble of heparinization within two weeks of nonoperative traumatic acute subdural hematoma in patients with increased stroke risk: A case series

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    S McClelland

    2014-01-01

    Full Text Available Background: In traumatic acute subdural hematoma (aSDH management, systemic anticoagulation is contraindicated, particularly during the first 2 weeks. We present two cases of patients with nonoperative aSDH whose stroke risk led to heparinization within 2 weeks of the initial hemorrhage and examine their outcomes to illustrate the risks and benefits associated with systemic anticoagulation. Materials and Methods: Two elderly males, on warfarin at baseline who developed traumatic nonoperative aSDH were heparinized within 2 weeks of aSDH onset. Results: One patient showed a decreased SDH volume on Day 19. The second patient developed sudden onset headache with fixed/dilated pupils on Day 5. In this patient, a CT scan of the brain revealed marked enlargement of the aSDH from 0.9 to 2.4 cm with midline shift of 1.5 cm, and uncal herniation that was incompatible with life. Conclusion: Heparinization within two weeks of aSDH may cause SDH enlargement resulting in rapidly fatal neurologic deterioration. Further study is needed to more definitively address this issue.

  20. [Subdural hemorrhage of aneurysmal origin].

    Science.gov (United States)

    Sánchez, R; Alfaro, A; Perla, C; Blasco, R; Cortés, F; Solís, P

    1994-02-01

    Although most subdural hematomas are considered to be venous in origin, they may also be of arterial origin. When subdural bleeding is due to the rupture of an intracranial aneurysm, most commonly at the middle cerebral or internal carotid arteries, the amount of subdural blood is usually small and of no clinical importance. We describe two patients with subdural hematomas secondary to rupture of an intracranial aneurysm, who needed prompt surgical treatment. The first patient had a left internal carotid artery aneurysm at the origin of the ophthalmic artery. In the second patient the aneurysm was at the anterior communicating artery and rebled into the subdural space directly through a right intraparenchymatous frontobasal hematoma. The most probable mechanism of subdural bleeding in our two patients was the existence of adhesions between the aneurysm and the arachnoid due to previous minor hemorrhages. The indication of cerebral angiography in a patient with subdural hematoma is based mainly upon the existence of meningeal signs, the presence of blood in more than one intracranial compartment or the rapid progression of bleeding. PMID:8204251

  1. Surgical treatment of 137 cases with chronic subdural hematoma at the university clinical center of Kosovo during the period 2008-2012

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    Agon Y Mekaj

    2015-01-01

    Full Text Available Background: Chronic subdural hematoma (CSDH is frequent pathology in neurosurgical practice. The aim of this study is to present the first series of patients with CSDH, who got surgically treated in Clinic of Neurosurgery, University Clinical Center of Kosovo. Materials and Methods: This is a retrospective study that included 137 patients with CSDH who had been treated during the period 2008-2012. The data were collected and analyzed from the archives and protocols of the University Clinical Center of Kosovo. Patients were analyzed in many aspects such as age, gender, etiological factors, clinical features, localization, diagnoses, methods of surgical interventions, recurrences and mortality of patients. Results: From 137 patients with CSDH, 106 (77.3% were males and 31 (22.7% females. Average age of patients was 62.85 years. Analyzed according to the decades, the highest number of causes with CSDH was between 70 and 79 years (46%. The head trauma has been responsible for CSDH in 88 patients (64.3%, while the main symptom was headache (92 patients or 67.1%. One burr-hole trepanation with closed drainage system has been used in majority of cases (in 101 patients or 73.7%. The recurrence of CSDH was 6.5%, whereas mortality 2.9%. Conclusion: CSDH is more common in elderly patients. The male-female ratio is 3.4:1. Like other authors we also think that treatment with one burr-hole and drainage is a method of choice, because of its simplicity and safety.

  2. Surgical treatment of 137 cases with chronic subdural hematoma at the university clinical center of Kosovo during the period 2008–2012

    Science.gov (United States)

    Mekaj, Agon Y.; Morina, Arsim A.; Mekaj, Ymer H.; Manxhuka-Kerliu, Suzana; Miftari, Ermira I.; Duci, Shkelzen B.; Hamza, Astrit R.; Gashi, Musli M.; Xhelaj, Mentor R.; Kelmendi, Fatos M.; Morina, Qamile Sh.

    2015-01-01

    Background: Chronic subdural hematoma (CSDH) is frequent pathology in neurosurgical practice. The aim of this study is to present the first series of patients with CSDH, who got surgically treated in Clinic of Neurosurgery, University Clinical Center of Kosovo. Materials and Methods: This is a retrospective study that included 137 patients with CSDH who had been treated during the period 2008–2012. The data were collected and analyzed from the archives and protocols of the University Clinical Center of Kosovo. Patients were analyzed in many aspects such as age, gender, etiological factors, clinical features, localization, diagnoses, methods of surgical interventions, recurrences and mortality of patients. Results: From 137 patients with CSDH, 106 (77.3%) were males and 31 (22.7%) females. Average age of patients was 62.85 years. Analyzed according to the decades, the highest number of causes with CSDH was between 70 and 79 years (46%). The head trauma has been responsible for CSDH in 88 patients (64.3%), while the main symptom was headache (92 patients or 67.1%). One burr-hole trepanation with closed drainage system has been used in majority of cases (in 101 patients or 73.7%). The recurrence of CSDH was 6.5%, whereas mortality 2.9%. Conclusion: CSDH is more common in elderly patients. The male-female ratio is 3.4:1. Like other authors we also think that treatment with one burr-hole and drainage is a method of choice, because of its simplicity and safety. PMID:25883478

  3. Acute subdural hematoma and diffuse axonal injury in fatal road traffic accident victims: a clinico-pathological study of 15 patients Hematoma subdural agudo e lesão axonal difusa em vítimas fatais de acidente de trânsito: estudo clínico-patológico de 15 pacientes

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    Sebastião Nataniel Silva Gusmão

    2003-09-01

    Full Text Available OBJECTIVE: Although acute subdural hematoma (ASDH and diffuse axonal injury (DAI are commonly associated in victims of head injury due to road traffic accidents, there are only two clinico-pathological studies of this association. We report a clinical and pathological study of 15 patients with ASDH associated with DAI. METHOD: The patients were victims of road traffic accidents and were randomly chosen. The state of consciousness on hospital admission was evaluated by the Glasgow coma scale. For the identification of axons the histological sections of the brain were stained with anti-neurofilament proteins. RESULTS: Twelve of the 15 patients were admitted to hospital in a state of coma; in three patients, the level of consciousness was not evaluated, as they died before hospital admission. CONCLUSION: The poorer prognosis in patients with ASDH who lapse into coma immediately after sustaining a head injury, as described by several authors, can be explained by the almost constant association between ASDH and DAI in victims of fatal road traffic accidents.OBJETIVO: Embora o hematoma subdural agudo (HSDA e a lesão axonal difusa (LAD estejam frequentemente associados em vítimas de trauma crânio-encefálico causado por acidentes de trânsito, há somente dois estudos clínico-patológicos sobre esta associação. Relatamos o estudo clínico-patológico de 15 pacientes com HSDA associado com LAD. MÉTODO: Os pacientes, vítimas de acidentes de trânsito, foram selecionados aleatoriamente. O estado de consciência à admissão hospitalar foi avaliado pela escala de coma de Glasgow. Para a identificação dos axônios, os cortes histológicos do cérebro foram corados com antisoro anti-proteínas do neurofilamento. RESULTADOS: Doze dos 15 pacientes foram admitidos no hospital em estado de coma; em três pacientes, o nível de consciência não foi avaliado, pois eles faleceram antes da admissão hospitalar. CONCLUSÃO: O pior prognóstico em pacientes

  4. Bilateral hematoma of sternocleidomastoid muscles. A case presentation. Hematoma bilateral de los músculos esternocleidomastoideos. Presentación de un caso.

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    José Julio Requeiro Molina

    2005-11-01

    Full Text Available Presentation of the case of an infant with bilateral congenital torticollis which development was followed by ultrasound. Homeopathy and physiotherapy were used for its treatment. This is an infrequent disease scarcely reported in medical literature. Se reporta el caso de un lactante con una tortícolis congénita bilateral, que fue seguida evolutivamente por ultrasonido y para el tratamiento se utilizó homeopatía y fisioterapia. Esta es una afección poco común, y reportada con poca frecuencia en la literatura.

  5. A rare complication of spinal anesthesia: Intracranial subdural hemorrhage

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    Cengiz Kaplan

    2015-02-01

    Full Text Available Spinal (subarachnoid anesthesia (SA is a widely used general-purpose anesthesia. Postdural Puncture Headaches (PDPHs represent one of the principal complications of spinal anesthesia. A 21-year-old man underwent inguinal herniorrhaphy and orchiectomy using spinal anesthesia. Postoperatively, our patient started to have a headache with nausea. The patient received symptomatic therapy, but the severe headache persisted even in the supine position, with his vital signs and neurological examination being normal. Cranial MRI showed a bilateral subdural hematoma from his frontal to temporal region. A postdural puncture headache is a frequent complication after spinal anesthesia. However, serious complications, such as an intracranial subdural hemorrhage, can rarely occur. [Arch Clin Exp Surg 2015; 4(1.000: 54-56

  6. Traumatic lumbar spinal subdural hematoma

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    William E. Gordon

    2014-12-01

    Our case illustrates rapid resolution of a posttraumatic spinal SDH after treatment with oral corticosteroids. Recognition of blood products on MRI is vital to diagnosis and expedient treatment. There is agreement that prompt laminectomy with evacuation of SDH should be performed before permanent damage to the spinal cord occurs. Including our patient, 4 of 11 reported cases of thoracic or lumbar SDH resolved with conservative treatment.

  7. Neuroprotective effect of preoperatively induced mild hypothermia as determined by biomarkers and histopathological estimation in a rat subdural hematoma decompression model

    Science.gov (United States)

    Yokobori, Shoji; Gajavelli, Shyam; Mondello, Stefania; Mo-Seaney, Jixiang; Hayes, Ronald L; Bramlett, Helen M.; Dietrich, W. Dalton; Bullock, M. Ross

    2016-01-01

    Object In traumatic brain injury (TBI) patients, hypothermia therapy has not shown efficacy in multicenter clinical trials. With the post-hoc data from the latest clinical trial (NABIS:H II), we hypothesized that hypothermia may be beneficial in the rat acute subdural hematoma (ASDH) model by blunting the effects of ischemic/ reperfusional (I/R) injury. The major aim of our study was to test the efficacy of temperature management in reducing brain damage after ASDH. Methods Rats were induced with ASDH and placed into (1) Normothermia group (37°C) (2) Early hypothermia group; head and body temperature reduced to 33°C at 30 minutes prior to craniotomy (3) Late hypothermia group; temperature was lowered to 33°C at 30 minutes after decompression (4) Sham group; no ASDH and underwent only craniotomy with normothermia. To assess of neuronal and glial cell damage, we analyzed microdialysate (MD ; using 100kD probe) concentrations of: glial fibrillary acidic protein (GFAP) and ubiquitin carboxyl-terminal hydrolase-L1 (UCH-L1). Fluoro-Jade B (FJB) positive neurons and injury volume with 2,3,5-triphenyltetrazolium chloride (TTC) staining were also measured. Results In the early phase of reperfusion (30min- 2.5 hrs after decompression), extracellular UCH-L1 in the early hypothermia group was significantly lower than in the normothermia. (Early; 4.9±1.0 ng/dl, Late; 35.2±12.1 ng/dl, Normo; 50.20± 28.3 ng/dl, Sham; 3.1±1.3 ng/dl, Early vs Normo; p 2.5hrs after decompression), extracellular GFAP in the early hypothermia group was also lower than in the normothermia and late hypothermia groups (Early; 5.5±2.9 ng/dl, Late; 7.4±3.4 ng/dl, Normo; 15.3±8.4 ng/dl, Sham; 3.3±1.0 ng/dl, Normo vs Sham; p group was significantly smaller than in normothermia group (Normo vs Early: 774,588 ± 162,173 vs 180,903 ± 42,212, pgroup in which hypothermia was induced before craniotomy and cerebral reperfusion (115.2±15.4 mm3 in early hypothermia group, 344.7±29.1 mm3 in late

  8. 10 Levels thoracic no-intrumented laminectomy for huge spontaneous spinal subdural hematoma removal. Report of the first case and literature review

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    Visocchi Massimiliano

    2015-01-01

    Conclusion: To our knowledge, the present case is the most extensive laminectomy for a SSDH removal never described before. No postoperative instability occurs in 10 levels thoracic laminectomy in case the articular processes are spared. When major neurological deficits are documented, early decompressive laminectomy with evacuation of hematoma should be considered the best treatment for SSDH.

  9. Results of surgery in patients with bilateral independent temporal lobe spiking (BITLS with normal MRI or bilateral mesial temporal sclerosis (MTS investigated with bilateral subdural grids Resultados cirúrgicos em pacientes com descargas bilaterais independentes do lobo temporal (DBILT e ressonância magnética normal ou com esclerose mesial bilateral investigados com implante bilateral de grades subdurais

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    ARTHUR CUKIERT

    2000-12-01

    Full Text Available PURPOSE: The introduction of new technologies in the clinical practice have greatly decreased the number of patients submitted to invasive recordings. On the other hand, some patients with refractory temporal lobe epilepsy have normal MR scans or bilateral potentially epileptogenic lesions. This paper reports the results of invasive neurophysiology and surgical outcome in such patients. METHOD: Sixteen patients were studied. Eleven had normal MRI (Group I and five had bilateral mesial temporal sclerosis (Group II. All patients had BITLS and non-localizatory seizures on video-EEG monitoring. All patients were implanted bilaterally with 32-contacts subdural grids. They were submitted to a cortico-amygdalo-total hippocampectomy at the side defined by chronic electrocorticography (ECoG. RESULTS: In Group I, seizures came from a single side in nine patients. In nine patients, seizures started at one side, spread to the ipsolateral contacts and contralaterally afterwards. On the other hand, in two Group I patients seizures started in one mesial region and spread to the contralateral parahippocampus and neocortex before spreading to ipsolateral contacts. All patients in Group II had seizures starting unilaterally with focal EcoG onset in the mesial regions. Eight Group I patients are seizure-free and three are in Engel's class II. Eighty percent of Group II patients are seizure-free after surgery and one patient is in Engel's class II. CONCLUSION: Good surgical results can be obtained in patients with BITLS. Patients with normal MRI seem to have a worse prognosis when compared to patients with unilateral or even bilateral MTS. Extensive subdural coverage is essential in patients with normal MRI.INTRODUÇÃO: A introdução de novas tecnologias na prática clínica tem diminuído em muito a necessidade do estudo com eletrodos invasivos em pacientes epilépticos refratários. Por outro lado, alguns pacientes com epilepsia do lobo temporal ainda possuem

  10. Suprarrenal hematoma Hematoma suprarrenal

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    Concepción Guardo B.

    1996-04-01

    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.

  11. Delayed-onset bilateral abducens paresis after head trauma

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    Pravin Salunke

    2012-01-01

    Full Text Available Bilateral sixth nerve paresis following closed head injury, though rare, is a known entity. However, delayed-onset post-traumatic bilateral abducens paresis is extremely rare. We present two cases. The first patient had onset of bilateral abducens paresis 2 weeks after closed head injury and the second patient after 3 days. The cause in the former was detected to be chronic subdural hematoma and in the latter is speculated to be edema/ischemia due to injury to soft tissue structures housing these nerves. The delayed onset of bilateral abducens paresis following head injury may vary according to the cause. There may be another mechanism of injury apart from direct trauma. Though rare, it needs to be evaluated and may have a treatable cause like elevated intracranial pressure.

  12. Subdural haemorrhage following endoscopic third ventriculostomy. A rare complication.

    LENUS (Irish Health Repository)

    Kamel, M H

    2012-02-03

    Subdural collections or hematomas are frequently observed after shunt placement [7-9, 13], but rarely after ETV [6]. A review of literature revealed 7 cases [1, 5, 6, 10, 12], of which only 1 was symptomatic [5]. We will discuss the causes, management, and methods of prevention of this complication and we will present a case of symptomatic subdural haematoma, following endoscopic third ventriculostomy for illustration.

  13. Subdural abscess in infant and child

    International Nuclear Information System (INIS)

    Two cases of subdural abscess in infant and child treated with irrigation via burr holes were reported. The first case was a 1.4-year-old boy with right hemiparesis and mental retardation since severe head trauma at 9 months old. The patient with manifested with an acute onset of high fever followed by disturbance of consciousness and convulsive seizures 2.5 months prior to admission to our department. During admission in the other hospital, the diagnosis of septicemia caused by E. coli was made by blood cultures when CT scan demonstrated a huge lentiform low density area over the right hemisphere and contralateral crescent low density area. The low density area on the right side was well circumscribed by high density rim which was enhanced by contrast medium. Under the diagnosis of bilateral subdural abscess secondary to septicemia caused by E. coli, irrigation of the purulent cavity was carried out. The contralateral low density area was found to be chronic subdural effusion. The second case of 3-month-old infant who complained of high fever, neck stiffness, unconsciousness and right hemiconvulsions 8 days prior to admission. CT scan showed bilateral crescent low density areas indicating subdural effusion. Subdural punctures performed via the fontanelle revealed pus in the left subdural space and xanthocromic fluid in the right side. The low density area on CT scan was changed to the lentiform high density area circumscribed smooth high density rim during the course of the patient. The subdural abscess was treated with irrigation via burr holes. In this report, the etiology of the subdural abscess and route of infection in addition to follow up study of CT findings were presented with the literature. (author)

  14. Spinal subdural metastasis

    International Nuclear Information System (INIS)

    A case of metastasis to the thoracic spinal subdural space is reported. Metrizamide myelography showed narrowing of the upper thoracic subarachnoid space. A tumor in the spinal subdural space is unusual; only a few cases have been reported. The myelographic appearance is not specific; and epidural metastasis can produce the same myelographic picture. (orig.)

  15. HEMATOMA AURIKULA

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    Sari Indah

    2014-12-01

    Full Text Available Hematoma aurikula merupakan sekuele yang terjadi akibat trauma langsung pada daun telingayang menyebabkan penimbunan darah dalam ruang antara perikondrium dan kartilago yang biasanyaditemukan pada pegulat atau petinju. Keterlambatan diagnosis serta penanganan dapat menimbulkankomplikasi dimana salah satunya adalah telinga kembang kol atau cauliflower ear. Penatalaksanaanhematoma aurikula cukup bervariasi, namun tujuan utama pengobatan tersebut adalah mengevakuasidarah subperikondrial, mencegah kekambuhan, dan mencegah terjadinya infeksi. Dilaporkan satukasus hematoma aurikula pada seorang laki-laki dewasa berusia 68 tahun di Rumah Sakit UmumPusat ( RSUP  Sanglah-Denpasar yang telah dilakukan penanganan aspirasi serta bebat tekanmenggunakan teknik bolster yang memberikan hasil yang baik.

  16. Recurrence of Subdural Haematoma in a Population-Based Cohort - Risks and Predictive Factors.

    Directory of Open Access Journals (Sweden)

    Linnea Schmidt

    Full Text Available To estimate the risks of and identify predictors for recurrent subdural haematoma in surgically and conservatively treated patients.The cohort comprised all individuals diagnosed with a first-time subdural hematoma in Denmark 1996-2011. Information on potential predictors was retrieved from the Danish health registers. Cumulative recurrence risks were estimated using the Aalen-Johansen estimator. Rate ratios (RR were estimated using Poisson regression.Among 10,158 individuals with a subdural hematoma, 1,555 had a recurrent event. The cumulative risk of recurrent subdural hematoma was 9% at 4 weeks after the primary bleeding, increasing to and stabilising at 14% after one year. Predictors associated with recurrence were: Male sex (RR 1.60, 95% CI:1.43-1.80, older age (>70 years compared to 20-49 years; RR 1.41, 95% CI: 1.21-1.65, alcohol addiction (RR 1.20, 95% CI:1.04-1.37, surgical treatment (RR 1.76, 95% CI:1.58-1.96, trauma diagnoses (RR 1.14, 95% CI:1.03-1.27, and diabetes mellitus (RR 1.40, 95% CI:1.11-1.74. Out of a selected combination of risk factors, the highest cumulative 1-year recurrence risks for subdural hematoma of 25% (compared to 14% for all patients was found in surgically treated males with diabetes mellitus.The recurrence risk of subdural hematoma is largely limited to the first year. Patient characteristics including co-morbidities greatly influence the recurrence risk of SDH, suggesting that individualized prognostic guidance and follow-up is needed.

  17. Macrocephaly in infancy: benign enlargement of the subarachnoid spaces and subdural collections.

    Science.gov (United States)

    Tucker, Jacqueline; Choudhary, Arabinda Kumar; Piatt, Joseph

    2016-07-01

    OBJECTIVE Benign enlargement of the subarachnoid spaces (BESS) is a common finding on imaging studies indicated by macrocephaly in infancy. This finding has been associated with the presence of subdural fluid collections that are sometimes construed as suggestive of abusive head injury. The prevalence of BESS among infants with macrocephaly and the prevalence of subdural collections among infants with BESS are both poorly defined. The goal of this study was to determine the relative frequencies of BESS, hydrocephalus, and subdural collections in a large consecutive series of imaging studies performed for macrocephaly and to determine the prevalence of subdural fluid collections among patients with BESS. METHODS A text search of radiology requisitions identified studies performed for macrocephaly in patients ≤ 2 years of age. Studies of patients with hydrocephalus or acute trauma were excluded. Studies that demonstrated hydrocephalus or chronic subdural hematoma not previously recognized but responsible for macrocephaly were noted but not investigated further. The remaining studies were reviewed for the presence of incidental subdural collections and for measurement of the depth of the subarachnoid space. A 3-point scale was used to grade BESS: Grade 0, race, sex, or insurance status with subdural collections. Patients with BESS had larger head circumference Z-scores, but there was no association of head circumference or age with subdural collections. Interrater reliability in the diagnosis and grading of BESS was only fair. CONCLUSIONS The current study confirms the association of BESS with incidental subdural collections and suggests that greater depth of the subarachnoid space is associated with increased prevalence of such collections. These observations support the theory that infants with BESS have a predisposition to subdural collections on an anatomical basis. Incidental subdural collections in the setting of BESS are not necessarily indicative of abusive

  18. Subdural effusion following purulent meningitis

    International Nuclear Information System (INIS)

    The authors experienced 6 cases of subdural effusion following purulent meningitis. All patients were less than one year old. Subdural puncture revealed subdural effusion in all cases. CT scan was performed in 4 cases at an acute stage and showed a low density area in the anterior parietal region. In 3 of them, although neurological symptoms disappeared after subdural puncture, CT findings did not improve. Follow-up CT scan revealed ventricular dilatation and cerebral atrophy. CT is considered to be useful for diagnosis of subdural effusion after meningitis and follow-up the effect of treatment. (Ueda, J.)

  19. 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.)

  20. Webino syndrome presented with pontine hematoma

    OpenAIRE

    Ayşin Kısabay; Eda Çakıroğlu; Deniz Selçuki

    2012-01-01

    Webino syndrome is considered a special form of bilateral internuclear ophthalmoplegia.It is characterized by bilateral absence of adduction, nystagmic abduction of both eyes, convergence deficiency and mostly with exotropia. Ischemic, demyelinating and infectious etiologies have been described. A 57 years old male patient is found worthy for presentation since there are eye findings compatible with very rarely encountered Webino syndrome secondary to pontine hematoma.

  1. Webino syndrome presented with pontine hematoma

    Directory of Open Access Journals (Sweden)

    Ayşin Kısabay

    2012-12-01

    Full Text Available Webino syndrome is considered a special form of bilateral internuclear ophthalmoplegia.It is characterized by bilateral absence of adduction, nystagmic abduction of both eyes, convergence deficiency and mostly with exotropia. Ischemic, demyelinating and infectious etiologies have been described. A 57 years old male patient is found worthy for presentation since there are eye findings compatible with very rarely encountered Webino syndrome secondary to pontine hematoma.

  2. Infantile benign subdural effusion

    International Nuclear Information System (INIS)

    Twenty cases of infants with low density area over the frontal lobes on CT scans mimicking cortical atrophy were reported. Almost all cases showed increased intracranial pressure of slight degree associated with delayed milestones. Marginal low density over the frontal lobes disappeared and the infants developed almost normally without operations in many cases. The lesion might be called ''Infantile benign subdural effusion'' and should be treated conservatively. (author)

  3. Acute Subdural Hematoma in a High School Football Player

    OpenAIRE

    Litt, David W.

    1995-01-01

    A 16-year-old football player developed a headache following a collision during a game. When his headache persisted for 1 week, he underwent a computerized tomographic (CT) scan to determine the cause. Findings were normal and a concussion was diagnosed. Seventeen days after the injury, the athlete reported disappearance of his symptoms. Provocative testing failed to recreate symptoms. The athlete continued to deny any symptoms and was cleared for unlimited participation 30 days after the ini...

  4. Spontaneous Arachnoid Cyst Rupture with Subdural Hygroma in a Child.

    Science.gov (United States)

    Khilji, Muhammad Faisal; Jeswani, Niranjan Lal; Hamid, Rana Shoaib; Al Azri, Faisal

    2016-01-01

    Arachnoid cyst of the brain is common in children but its association with spontaneous subdural hygroma is rare. A case of a nine-year-old boy, without any preceding history of trauma, is presented here who came to the emergency department of a tertiary care hospital with complaints of headache, nausea, and vomiting for the last two weeks but more for the last two days. Examination showed a young, fully conscious oriented boy with positive Cushing's reflex and papilledema of left eye. MRI (magnetic resonance imaging) of the brain showed left temporal extra-axial cystic lesion of 5.40 × 4.10 cm in size, representing arachnoid cyst, with bilateral frontoparietal subdural hygromas. Cyst was partially drained through left temporal craniectomy and subdural hygromas were drained through bilateral frontal burr holes. Postoperatively the child recovered uneventfully and was discharged on the seventh postoperative day. Histopathology proves it to be arachnoid cyst of the brain with subdural CSF (cerebrospinal fluid) collection or hygroma. PMID:26989525

  5. Acute onset of intracranial subdural hemorrhage five days after spinal anesthesia for knee arthroscopic surgery: a case report

    Directory of Open Access Journals (Sweden)

    Hagino Tetsuo

    2012-03-01

    Full Text Available Abstract Introduction Spinal anesthesia is a widely used general purpose anesthesia. However, serious complications, such as intracranial subdural hemorrhage, can rarely occur. Case presentation We report the case of a 73-year-old Japanese woman who had acute onset of intracranial subdural hemorrhage five days after spinal anesthesia for knee arthroscopic surgery. Conclusion This case highlights the need to pay attention to acute intracranial subdural hemorrhage as a complication after spinal anesthesia. If the headache persists even in a supine position or nausea occurs abruptly, computed tomography or magnetic resonance imaging of the brain should be conducted. An intracranial subdural hematoma may have a serious outcome and is an important differential diagnosis for headache after spinal anesthesia.

  6. Recurrence of Subdural Haematoma in a Population-Based Cohort - Risks and Predictive Factors

    DEFF Research Database (Denmark)

    Schmidt, Linnea; Gørtz, Sanne; Wohlfahrt, Jan; Melbye, Mads; Munch, Tina Noergaard

    2015-01-01

    subdural hematoma was 9% at 4 weeks after the primary bleeding, increasing to and stabilising at 14% after one year. Predictors associated with recurrence were: Male sex (RR 1.60, 95% CI:1.43-1.80), older age (>70 years compared to 20-49 years; RR 1.41, 95% CI: 1.21-1.65), alcohol addiction (RR 1.20, 95......% CI:1.04-1.37), surgical treatment (RR 1.76, 95% CI:1.58-1.96), trauma diagnoses (RR 1.14, 95% CI:1.03-1.27), and diabetes mellitus (RR 1.40, 95% CI:1.11-1.74). Out of a selected combination of risk factors, the highest cumulative 1-year recurrence risks for subdural hematoma of 25% (compared to 14...

  7. Polymicrobial subdural empyema

    DEFF Research Database (Denmark)

    Greve, Thomas; Clemmensen, Dorte; Ridderberg, Winnie; Pedersen, Lisbeth N; Møller, Jens K

    2011-01-01

    The authors report a case of a subdural empyema (SDE) caused by a coinfection with Streptococcus intermedius and Streptococcus pneumoniae, initially considered a S. intermedius infection only. An otherwise healthy 11-year-old female was admitted to the hospital after 5 days of illness. Symptoms....... The empyema was evacuated twice, day 8 and 18, with good results. Primary samples showed growth of S. intermedius only. The severity of the clinical picture elicited supplementary samples, which were additionally positive for S. pneumoniae by an in-house specific lytA PCR and/or a commercial antigen...

  8. Acute subdural empyema

    International Nuclear Information System (INIS)

    The patient, a 19-year-old male, began suffering from severe headache, vomiting, and high fever. Two days later the patient was admitted in a semicomatose state and with left hemiplegia. Nuchal rigidity and choked disc were not noticed. WBC count was 12,500/mm3. CT scan disclosed marked swelling of the right cerebral hemisphere with midline shift. Except for a small lucent space in the parafalcial region, no extracerebral collection was noted in either pre- or post-contrast scans. Plain craniograms showed clouding of the left frontal, ethmoidal, and sphenoidal sinuses. Carotid angiography revealed prolongation of the circulation time and stenosis of the supraclinoidal portion of the right carotid artery. Right fronto-parietal decompressive craniectomy was performed. Subdural empyema was found and evacuated. Curettage and drainage of the empyema in the paranasal sinuses were also done. A bone defect 4 mm in diameter was detected on the medial-upper wall of the left frontal sinus. The causative organism was confirmed as α-Streptococcus. Both systemic and local antibiotics were administered and the patient recovered well and was discharged without any neurological deficit. The authors emphasized that cerebral angiography is necessary for its accurate diagnosis of subdural empyema in its acute stage and that emergency intracranial and rhino-otological operations should be concomitantly performed. (author)

  9. Subdural hydatid cyst presenting as recurrent subdural hygroma.

    Science.gov (United States)

    Wani, Abrar A; Ramzan, Altaf U; Nizami, Furqan A; Malik, Nayil K; Dar, Bashir; Kumar, Ashish

    2016-01-01

    Intracranial hydatid disease is an uncommon entity that usually is parenchymal in location. Presence of hydatid cyst in subdural location is being reported for the first time in the literature. A 13-year-old female child with the diagnosis of hydatid disease of brain was operated. She was advised to take albendazole which she did not take. In postoperative period she developed recurrent subdural hygroma for which multiple surgical interventions were done and finally cause of recurrent subdural hygroma was found to be hydatid cyst in the subdural space. The patient had initially undergone craniotomy for the excision of hydatid cyst. Later on she developed subdural hygroma for which the burr hole drainage was done twice. At time of third recurrence subduro-peritoneal (SDP) shunt was done. When she had recurrence again along with hydrocephalus, than VP shunt and revision of the SDP shunt was planned. While doing revision of SDP shunt, hydatid cyst was seen emerging from the burr hole site. A craniotomy was done to remove the hydatid cyst from the subdural space. Since then there has been no recurrent collection. Complete surgical excision is the best treatment modality to treat hydatid cyst of brain. Accidental spillage of the contents can have lead to recurrence, so every effort must be taken to prevent spillage of contents. Postoperatively all the patients must be put on antihelminthics. PMID:27366285

  10. Unilateral proptosis and extradural hematoma in a child with scurvy

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.)

  11. Cerebral atrophy and subdural haemorrhage after cerebellar and cerebral infarcts in an 8-month-old child after having been stung by a scorpion

    Science.gov (United States)

    Sığırcı, Ahmet; Öztürk, Mehmet; Yakıncı, Cengiz

    2014-01-01

    A scorpion sting causing cerebellar and cerebral infarctions with corpus callosum involvement and bilateral cerebral atrophy with subdural haemorrhage in an 8-month-old girl, has not been previously described to the best of our knowledge. PMID:24962491

  12. Subdural effusions in children under two years

    International Nuclear Information System (INIS)

    We investigated 161 children under 24 months of age by CT of the skull and reviewed the anamnestic and clinical history. 87 children showed subdural effusions, and 74 did not. There were 33 patients with other pathological findings in CT, and 41 had normal scans. Age and sex distribution as well as localization of the subdural effusions were consistent with the literature. The 87 children with subdural effusions represented 1,7% in a sample of about 5.000 CT scans. CT was the most reliable method for diagnosis of subdural effusions, compared to other techniques. There was a preponderance of small subdural effusions from 1 to 7 mm thickness (51%). Other CT abnormalities accompanying subdural effusions were found. Most frequently the interhemispheric sulcus was dilated and an internal hydrocephalus was present. Also in our group there were 7 anamnestical and 6 clinical symptoms highly diagnostic of subdural effusions. (orig.)

  13. Gerıatrıc Traumatıc Acute Subdural Haematomas: A Retrospectıve Study

    OpenAIRE

    KOCABIÇAK, Ersoy; Yarar, Ercan; Çokluk, Cengiz; AYDIN, Keramettin

    2010-01-01

    Objective:Acute subdural hematomas (ASDH) are severe traumatic brain injuries. Older patients have a higher mortality rate.We retrospectively reviewed 19 geriatric patients with ASDH to demonstrate the outcome of the management of ASDH and to find out which parameters are significant in predicting the outcome. Methods:Computer records and patient files of 19 geriatric patients with traumatic ASDH who underwent surgical intervention in OndokuzMayıs University School of Medicine at Depar...

  14. Idiopathic Hypertrophic Cranial Pachymeningitis Misdiagnosed as Acute Subtentorial Hematoma

    Science.gov (United States)

    Park, Ik-Seong; Kim, Hoon; Chung, Eun Yong

    2010-01-01

    A case of idiopathic hypertrophic cranial pachymeningitis (IHCP) misdiagnosed as an acute subdural hematoma is reported. A 37-year-old male patient presented with headache following head trauma 2 weeks earlier. Computerized tomography showed a diffuse high-density lesion along the left tentorium and falx cerebri. Initial chest X-rays revealed a small mass in the right upper lobe with right lower pleural thickening, which suggested lung cancer, such as an adenoma or mediastinal metastasis. During conservative treatment under the diagnosis of a subdural hematoma, left cranial nerve palsies were developed (3rd and 6th), followed by scleritis and uveitis involving both eyes. Magnetic resonance imaging (MRI) revealed an unusual tentorium-falx enhancement on gadolinium-enhanced T1-weighted images. Non-specific chronic inflammation of the pachymeninges was noticed on histopathologic examination following an open biopsy. Systemic steroid treatment was initiated, resulting in dramatic improvement of symptoms. A follow-up brain MRI showed total resolution of the lesion 2 months after steroid treatment. IHCP should be included in the differential diagnosis of subtentorial-enhancing lesions. PMID:20856672

  15. Subdural effusions and lack of early pontocerebellar hypoplasia in siblings with RARS2 mutations.

    Science.gov (United States)

    Kastrissianakis, Katherina; Anand, Geetha; Quaghebeur, Gerardine; Price, Sue; Prabhakar, Prab; Marinova, Jasmina; Brown, Garry; McShane, Tony

    2013-12-01

    Mutations in the recently described RARS2 gene encoding for mitochondrial arginyl-transfer RNA synthetase give rise to a disorder characterised by early onset seizures, progressive microcephaly and developmental delay. The disorder was named pontocerebellar hypoplasia type 6 (PCH6) based on the corresponding radiological findings observed in the original cases. We report two siblings with the RARS2 mutation who displayed typical clinical features of PCH6, but who had distinct neuroimaging features. Early scans showed marked supratentorial, rather than infratentorial, atrophy, and the pons remained preserved throughout. One sibling also had bilateral subdural effusions at presentation. The deceleration in head growth pointed to an evolving genetic/metabolic process giving rise to cerebral atrophy and secondary subdural effusions. RARS2 mutations should be considered in infants presenting with seizures, subdural effusions, decelerating head growth and evidence of cerebral atrophy even in the absence of pontocerebellar hypoplasia on imaging. PMID:24047924

  16. Subchorionic hematoma: a review.

    Science.gov (United States)

    Pearlstone, M; Baxi, L

    1993-02-01

    A review of the English literature on subchorionic hematoma (SCH) is presented. Fourteen studies are reviewed. The incidence of SCH varied greatly among studies from 4 to 48 per cent. Small SCH tend to be more common in the first trimester and appear to pose no added risk to the ongoing pregnancy. Conversely, SCH in the second trimester often are larger and may be associated with an increased risk of preterm delivery. The etiology of these hematomas remains unclear. Pathological changes that might contribute to their formation are reviewed. Larger studies with controls, including data on the incidence of SCH in a population of normal obstetric patients are needed. PMID:8437776

  17. Intra-bleb hematoma and hyphema following digital ocular compression

    Directory of Open Access Journals (Sweden)

    Sagar Bhargava

    2014-01-01

    Full Text Available We report successful outcome of a huge post- trabeculectomy intra-bleb hematoma and hyphema that occurred following digital ocular compression. The patient was a 64-year-old lady suffering from bilateral primary angle closure glaucoma and cataract. She was on anti-platelet therapy. She underwent single-site phacoemulsification, intra-ocular lens implantation and trabeculectomy with mitomycin C in the right eye. The trabeculectomy was under-filtering. She was asked to perform digital ocular compression thrice daily. On 15 th post-operative day, she presented with a huge intra-bleb hematoma and hyphema. The hematoma did not respond to conservative measures and was drained to prevent bleb failure. We recommend caution in the consideration of digital ocular compression in patients on prophylactic anti-coagulation.

  18. Acute aortic intramural hematoma

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Oh Keun; Choi, Yo Won; Kim, Kwon Hyung; Jeon, Seok Chol; Park, Choong Kee; Seo, Heung Suk; Hahm, Chang Kok [Hanyang Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-02-01

    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 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

  19. 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 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

  20. Acute subdural effusion in vasculitis

    Directory of Open Access Journals (Sweden)

    Raghavendra Seetharam

    2008-01-01

    Full Text Available We report a 29-year-old man with a unique presentation of vasculitis as acute unilateral subdural effusion and meningoencephalitis. Magnetic resonance imaging showed a brainstem lesion that spread to the thalamus over time. There were no systemic features of vasculitis other than a positive pathergy test. Histopathological examination from the pathergy site showed neutrophilic infiltrate and leucocytoclastic vasculitis. The condition was steroid responsive and he remained in remission at two years′ follow-up. The anatomy of the brainstem lesion, absence of other inflammatory and infective conditions on evaluation suggests a vasculitic pathology either as primary central nervous system angiitis or as neurological presentation of systemic vasculitis like Behηet′s disease although the international diagnostic criteria for Behηet′s were not fulfilled.

  1. Differential diagnosis of isolated calf muscle vein thrombosis and gastrocnemius hematoma by high-frequency ultrasound

    Institute of Scientific and Technical Information of China (English)

    SU Li-ya; GUO Fa-jin; XU Guang; HAN Xiu-jie; SUN Chang-kun; ZHANG Zheng; JING Qing-hong

    2013-01-01

    Background Differential diagnosis of isolated calf muscle vein thrombosis (ICMVT) and gastrocnemius hematoma is essential for early identification of deep vein thrombosis (DVT).This study aimed to investigate the diagnostic value of high-frequency color Doppler ultrasound for differential diagnosis of ICMVT and gastrocnemius hematoma.Methods A retrospective case series of 35 ICMVT (M∶F,21∶14; mean age (64.5±10.6) years) and 23 gastrocnemius hematoma (M∶F,16∶7; mean age (75.4±11.8) years) patients with bilateral/unilateral lower limb pain was conducted between January 2006 and September 2012.Characteristics and the morphology of high-frequency color Doppler ultrasonography of the lower limb deep vein,great saphenous vein,calf muscles,skin,and soft tissue were examined.Results ICMVT hypoechoic signals were characterized by long,tube-like masses on longitudinal sections and oval masses on transverse sections,with apparent muscle thrombosis boundaries,distal and proximal venous connections,and,often,lower limb DVT.Gastrocnemius hematoma hypoechoic signals were characterized by large volumes,enhanced posterior hematoma echo,hyperechoic muscle boundaries,no hematoma blood flow,and no DVT,and clear differences in trauma/exercise-and oral anticoagulant-induced hematomas were readily apparent.According to the measurement,the ratio of long diameter/transverse diameter (D/T) in ICMVT patients was about less than 2.0,whereas in gastrocnemius hematoma patients the ratio was more than 2.0.Early stage isoechoic and hypoechoic signals were detected with gradually increasing ovular anechoic areas.Partial muscle fibers in the hematoma due to muscle fractures were apparent.Conclusion High-frequency color Doppler ultrasound was found to be a sensitive and reliable method for differential diagnosis of ICMVT and gastrocnemius hematoma due to trauma and exercise or prolonged oral anticoagulant use.

  2. Cerebral cysticercus granuloma associated with a subdural effusion.

    Directory of Open Access Journals (Sweden)

    Rajshekhar V

    2001-04-01

    Full Text Available The association of a solitary cerebral cysticercus granuloma with a subdural effusion is being reported. The granuloma and the effusion resolved following albendazole therapy. We speculate that the spread of the inflammatory changes around the granuloma to the subdural space could have led to the development of the subdural effusion.

  3. Prevention of Hematomas and Seromas

    OpenAIRE

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

    2006-01-01

    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 ...

  4. Retroperitoneal hematoma following rofecoxib and enoxaparin coadministration in a patient with atrial fibrillation

    International Nuclear Information System (INIS)

    There are very few published reports implicating enoxaparin as a factor in retroperitoneal hematoma. We report a patient who developed a retroperitoneal hematoma after using enoxaparin for paroxysmal atrial fibrillation. A 72 year old man was admitted with a history of low back pain, radiating beyond the back to the buttocks. His medical history was positive for bilateral knee osteoarthritis. On his physical examination his vital signs were: temperature 36.8, blood pressure 100/70 mm Hg, pulse 72/min, respiratory rate 16/min. X-ray of both the knees showed bilateral osteoarthritic changes. Computerized tomography scan of the spine showed lumbar spinal stenosis and he was referred to a Neurosurgeon, who finds the patient not fit surgical intervention. ECG showed atrial fibrillation. He was given enoxaparin one mg/kg every 12 hour and digoxin. Abdominal computed tomography revealed a right retroperitoneal hematoma and no aortic aneurysm was noted and enoxaparin and rofecoxib were discontinued. His general condition improved. The factors that increase the risk of bleeding in patients receiving enoxaparin are use of high doses of enxaparin, advanced stage, renal impairment, and the concomitant use of drugs affecting hemostasis. Retroperotoneal hematoma should be considered in the different diagnosis in patients receiving enoxaparin and experiencing unexplained decreases in hemoglobin and hematocrit. In the order of precedence of radiologic diagnostic procedures for fast diagnosis of a retroperitoneal hematoma, abdominal CT-scan is the preferred method

  5. Acute Subdural Hematoma in Infants with Abusive Head Trauma: A Literature Review

    OpenAIRE

    KARIBE, Hiroshi; KAMEYAMA, Motonobu; Hayashi, Toshiaki; NARISAWA, Ayumi; Tominaga, Teiji

    2016-01-01

    The number of cases with child abuse is increasing in Japan, and abusive head trauma (AHT) is a major cause of death in abused children. Child abuse has been recognized by the late 19th century, and widely accepted as battered child syndrome in the middle of the 20th century. As terms, there had been considerable mechanistic controversies between shaken-baby and -impact syndrome until the beginning of the 21st century. In recent years, AHT has been utilized as a less mechanistic term. Most of...

  6. Comparison Between Cerebral Tissue Oxygen Tension and Energy Metabolism in Experimental Subdural Hematoma

    DEFF Research Database (Denmark)

    Nielsen, Troels Halfeld; Engell, Susanne I; Johnsen, Rikke Aagaard;

    2011-01-01

    . Intracranial pressure (ICP) was monitored in the "good-side." RESULTS: ICP, cerebral perfusion pressure (CPP), PbtO(2), glucose, lactate, pyruvate, lactate-pyruvate ratio (LP ratio), glutamate, and glycerol were recorded at baseline (60 min) and post trauma (360 min). After the creation of the ASDH, PbtO(2...

  7. Perindopril and residual chronic subdural hematoma volumes six weeks after burr hole surgery

    DEFF Research Database (Denmark)

    Poulsen, Frantz Rom; Munthe, Sune; Søe, Morten;

    2014-01-01

    perindopril 5mg or placebo treatment daily for three months prior to surgery. Cerebral CT scans were performed after six weeks, and clinical follow-ups were performed three months after surgery. Additionally, a retrospective analysis of the data and CT scans from all nonrandomized patients from the same time...... surgery revealed no difference between the placebo and perindopril-treated groups. In the retrospective group (245 patients), there was no correlation between the risk of recurrence and ACE inhibitor treatment. CONCLUSION: Our data suggest that perindopril does not diminish the size of residual CSHs six...

  8. Postpartum spinal subdural hematoma: irrelevant epidural blood patch: a case report.

    Science.gov (United States)

    Choe, Won Joo; Kim, Ji Yeon; Yeo, Hyeok Jae; Kim, Jun Hyun; Lee, Sang-Il; Kim, Kyung-Tae; Park, Jang Su; Kim, Jung Won

    2016-04-01

    We report a healthy patient with postpartum headache and neck stiffness which were diagnosed as symptoms of pseudoaneurysm of vertebral artery. She had received a Cesarean section under the spinal anesthesia, and complaint of headache and neck stiffness. Epidural blood patches were done twice, but symptoms persisted. Eight days later, she experienced sensory disturbance and emergent laminectomy was done. When persistent postpartum headache occurs after epidural blood patch, more precise differential diagnosis should be made and considering other possible pathologies. PMID:27066211

  9. Expanding traumatic intracerebral contusion/hematoma

    Directory of Open Access Journals (Sweden)

    Yadav Yad

    2006-01-01

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

  10. Is human fracture hematoma inherently angiogenic?

    LENUS (Irish Health Repository)

    Street, J

    2012-02-03

    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.

  11. Microwave Hematoma Detector for the Rapid Assessment of Head Injuries

    Energy Technology Data Exchange (ETDEWEB)

    Hadded, W.; Chang, J.; Rosenbury, T.; Dallum, G.; Welsch, P.; Scott, D.; Duarte, D.; Acevedo-Bolton, V.

    2000-02-11

    A non-invasive microwave device for the detection of epi/subdural hemorrhaging (hematoma) is under current development. The final device will be highly portable and allow real time assessment of head injuries, thereby satisfying early detection needs of the field technician as well as providing a tool for repetitious monitoring of high-risk individuals. The device will adopt the advanced technology of micropower impulse radar (MIR) which is a state of the art low cost ultra wide band (UWB) microwave radar developed here at LLNL. It will consist of a MIR transmitting and receiving module, a computer based signal processing module, and a device-to-patient signal coupling module--the UWB antenna. The prototype design is being guided by the needs of the patient and the practitioner along with the prerequisites of the technology including issues such as the specificity of the device, efficacy of diagnosis, accuracy, robustness, and patient comfort. The prototype development follows a concurrent approach which .includes experiments designed to evaluate requirements of the radar and antenna design, phantom development to facilitate laboratory investigations, and investigation into the limits of adapting pre-existing non-medical MIR devices to medical applications. This report will present the accomplishments and project highlights to date in the fiscal year 1999. Future project projections will also be discussed.

  12. Subperiosteal hematoma of the iliac bone: imaging features of acute and chronic stages with emphasis on pathophysiology

    International Nuclear Information System (INIS)

    The goal of this work is to describe the radiological appearance and clinical presentation of subperiosteal iliac hematoma and present a review of the literature. We retrospectively reviewed the radiological and clinical files of 19 patients (age range: 12-75; mean: 47) who presented with acute or chronic subperiosteal iliac hematomas. Imaging findings and relevant clinical information were recorded. A thorough literature search was performed to find additional cases of this rare condition. Three young patients presented with acute subperiosteal iliac hematoma following a fall. Clinical presentation was characterized by pain and gait disturbance presumed to result from crural nerve compression. Unilateral or bilateral lenticular hematomas deep in the iliacus muscle were demonstrated by CT for all patients while MRI was also available for two of them. In 16 asymptomatic patients, chronic ossified subperiosteal iliac hematomas were incidentally detected by CT. Progressive ossification of acute hematoma was demonstrated at follow-up in two patients. Subperiosteal iliac hematoma is rare but has typical imaging findings that may present acutely in adolescents or chronically in asymptomatic adults. (orig.)

  13. Interventricular septum hematoma during cineventriculography

    Directory of Open Access Journals (Sweden)

    Melzer Christoph

    2008-01-01

    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.

  14. Late unilateral hematoma after breast augmentation

    OpenAIRE

    Peters, Walter; Fornasier, Victor; Howarth, David

    2014-01-01

    Incidence data regarding late hematoma following breast augmentation do not exist, nor has its etiology been elucidated. Hematomas have been reported to develop months to decades after augmentation with various types of implants, even in the absence of trauma. This study reviewed the occurrence of late hematoma in five patients who received smooth, round silicone gel implants in a single-surgeon practice over a 30-year period. All patients presented with progressive enlargement of the involve...

  15. SUBDURAL HYGROMA PRESENTING AS DEMENTIA WITH KLUVER-BUCY SYMPTOMS

    OpenAIRE

    Duggal, Harpreet S.; Khess, Christoday R.J.; Nizamie, S. Haque

    1999-01-01

    Dementia is not an uncommon presentation in psychiatric practice. Of the various causes of reversible dementia, subdural hygroma is a lesser-known potentially reversible cause. A case of dementia with Kluver-Bucy symptoms secondary to subdural hygroma is described and implications of Kluver-Bucy symptoms in dementia are discussed.

  16. Intra-uterine hematoma in pregnancy

    DEFF Research Database (Denmark)

    Glavind, K; Nøhr, S; Nielsen, P H; Ipsen, L

    1991-01-01

    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......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...

  17. Intra-uterine hematoma in pregnancy.

    Science.gov (United States)

    Glavind, K; Nøhr, S; Nielsen, P H; Ipsen, L

    1991-06-01

    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. PMID:1855608

  18. Subchorionic hematomas and the presence of autoantibodies.

    Science.gov (United States)

    Baxi, L V; Pearlstone, M M

    1991-11-01

    Five cases of subchorionic hematoma detected by ultrasonography in patients with threatened abortion are presented. Three of these subjects had antinuclear antibodies, and the remaining two subjects had anticardiolipin antibodies. We recommend that patients with subchorionic hematomas be tested for autoantibodies regardless of their obstetric history. PMID:1957874

  19. Severe traumatic vulva hematoma in teenage girl

    OpenAIRE

    Ernest, Alex; Knapp, Gregory

    2015-01-01

    Key Clinical Message Nonobstetric hematomas of the vulva are rare and not extensively reported in literature. There are no consensus guidelines and a paucity of literature to guide best practices with regard to management. We present a case of vulva hematoma in a teenage girl. Our experience highlights the importance of prompt surgical intervention to reduce associated morbidity and minimize hospital stay.

  20. Spontaneous extracranial decompression of epidural hematoma

    International Nuclear Information System (INIS)

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

  1. Streptococcal Subdural Empyema as a Complication of Varicella

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2005-01-01

    Full Text Available A 3-month-old male infant who presented with a group A streptococcal subdural empyema on day 5 of a varicella skin rash is reported from the University of British Columbia, Vancouver, BC, Canada.

  2. Occult, massive hematomas following antegrade femoral angioplasty

    International Nuclear Information System (INIS)

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

  3. Current Treatment Options for Auricular Hematomas.

    Science.gov (United States)

    MacPhail, Catriona

    2016-07-01

    Ear disease, such as otitis externa, resulting in aggressive head shaking or ear scratching, is the most common cause of the development of aural hematomas in dogs and cats. An underlying immunologic cause has also been proposed to explain cartilage and blood vessel fragility. Numerous options exist for management of aural hematomas, from medical management alone with corticosteroids, to simple hematoma centesis, to surgical intervention. Because this condition is usually secondary to another disease process, regardless of mode of treatment, likelihood of recurrence is low if the underlying condition is managed properly. PMID:27012935

  4. Epidural hematoma after routine epidural steroid injection

    Science.gov (United States)

    Alkhudari, Azzam M.; Malk, Craig S.; Rahman, Abed; Penmetcha, Taruna; Torres, Maria

    2016-01-01

    Background: There are few reported cases of an epidural spinal hematoma following interventional pain procedures. Case Description: We report a case of a spinal epidural hematoma in a patient with no known risk factors (e.g. coagulopathy), who underwent an epidural steroid injection (ESI) in the same anatomic location as two previously successful ESI procedures. Conclusion: Early detection was the key to our case, and avoiding sedation allowed the patient to recognize the onset of a new neurological deficit, and lead to prompt diagnosis as well as surgical decompression of the resultant hematoma.

  5. Are traumatic bilateral adrenal injuries associated with higher morbidity and mortality?-A prospective observational study

    OpenAIRE

    Panda, Ananya; Kumar, Atin; Gamanagatti, Shivanand; Bhalla, Ashu Seith; Sharma, Raju; Kumar, Subodh; Mishra, Biplab

    2015-01-01

    Background Traumatic bilateral adrenal injuries are uncommon. Adrenal injuries are overall associated with worse outcome than non-adrenal injuries. However, direct comparative evidence between unilateral and bilateral adrenal injuries is unavailable in literature. This study aims to investigate clinical significance of bilateral adrenal hematomas in terms of injury severity, morbidity and mortality. Methods All blunt trauma abdomen patients with adrenal gland involvement on initial CECT scans...

  6. Surgical treatment of hydrocephalus and spinal dysraphism

    Directory of Open Access Journals (Sweden)

    Besnik Elshani

    2014-01-01

    Conclusions: Shant meningitis due to infection or eventual reduction in immune intervention, was warned to 5 patients; Hematoma bilateral subdural due to excessive absorption of the system is evidenced in 1 patient.

  7. Delayed extradural hematoma : a case report.

    Directory of Open Access Journals (Sweden)

    Alappat J

    2002-07-01

    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.

  8. Bilateral dacryoadenitis

    Directory of Open Access Journals (Sweden)

    Charlotte Derr

    2012-01-01

    Full Text Available Acute dacryoadenitis is an uncommon condition that involves inflammation of the lacrimal gland. In rare instances, dacryoadenitis may be bilateral. A delay in proper treatment of an otherwise simple case of dacryoadenitis may lead to significant soft tissue morbidity such as cellulitis, lacrimal gland abscess, or orbital abscess. We report the case of a 24-year-old male who presented to the emergency department with acute bilateral dacryoadenitis. The patient′s symptoms did not respond to oral antibiotics and he subsequently required admission for intravenous antibiotics. During his hospitalization the patient had diagnostic testing to try to determine the etiology for his symptoms. The unique aspects of managing a case of bilateral dacryoadenitis as well as treatment recommendations are discussed in this case report.

  9. Zero drift of intraventricular and subdural intracranial pressure monitoring systems

    Institute of Scientific and Technical Information of China (English)

    CHEN Li; DU Hang-gen; YIN Li-chun; HE Min; ZHANG Guo-jun; TIAN Yong; WANG Cheng

    2013-01-01

    Objective:To assess zero drift of intraventricular and subdural intracranial pressure (ICP) monitoring systems.Methods:A prospective study was conducted in patients who received Codman ICP monitoring in the neurosurgical department from January 2010 to December 2011.According to the location of sensors,the patients were categorized into two groups:intraventricular group and subdural group.Zero drift between the two groups and its association with the duration of ICP monitor were analyzed.Results:Totally,22 patients undergoing intraventricular ICP monitoring and 27 receiving subdural ICP monitoring were enrolled.There was no significant difference in duration of ICP monitoring,zero drift value and its absolute value between intraventricular and subdural groups (5.38 d±2.58 d vs 4.58 d±2.24d,0.77 mmHg±2.18 mm Hg vs 1.03 mmHg±2.06mmHg,1.68 mmHg±155 mmHg vs 1.70mmHg±153 mmHg,respectively; all P>0.05).Absolute value of zero drift in both groups significantly rose with the increased duration of ICP monitoring (P<0.05) while zero drift value did not.Moreover,daily absolute value in the intraventricular group was significantly smaller than that in the subdural group (0.27 mm Hg±0.32 mm Hg vs 0.29 mm Hg±0.18 mm Hg,P<0.05).Conclusion:This study demonstrates that absolute value of zero drift significantly correlates with duration of both intraventricular and subdural ICP monitoring.Due to the smaller daily absolute value,ICP values recorded from intraventricular system may be more reliable than those from subdural system.

  10. Serial computed tomographies in subdural effusions following purulent meningitis

    International Nuclear Information System (INIS)

    The subdral effusion complicating acute purulent meningitis were visualized in seven children by means of cranial computed tomography (CCT). All these children were infants less than two years old; four were male, and three were female. The etiologic organisms could be cultured in three cases: Group B Streptococcus, Diplococcus pneumoniae, and Hemophilus influenza. The others could not be cultured. The subdural effusion could be detected by CCT on the 5th day after the onset in the earliest case and on the 30th day in the latest case. Four cases of them were resolved by chemotherapy and subdural taps, two cases were resolved spontaneously by chemotherapy only, and one case was resolved by means of a subdural-peritoneal shunt operation. The subdural taps through the anterior fontanelle were done in five cases. The fluids obtained by the subdural taps showed a bloody fluid in one case, a blood-tinged fluid in two cases, and a yellowish or brown-coloured fluid not including red cells in two cases. These fluids had a higher protein content than the CSF. These children were followed-up after the discharge. Their psychomotor development was good and they showed no epileptic complications. (author)

  11. Aspiration of coagulated hematoma in the third and fourth ventricles via paracele anterior horn puncture

    Institute of Scientific and Technical Information of China (English)

    Zhi-Qiang Tao; Sheng-Hong Ding

    2016-01-01

    Intraventricular hemorrhage (IVH) is a neurological urgency with a high mortality and unfavorable prognosis.Fast removal of intraventricular blood should be considered as a priority.The current treatments of IVH mainly focus on external ventricular drain and endoscopic aspiration,but neither way can remove the blood in the fourth ventricle easily and relieve the compression of brainstem.Here we report a unique procedure to solve this problem.A 41-year-old male patient who had suffered sudden attack of headache and disturbance of consciousness for 2 h was diagnosed as having high density lesion in thewhole ventricular system by computed tomographic (CT) imaging.An emergent bilateral ventriculopuncture and intraventricular hematoma removal under non-line-of-sight was performed immediately;the catheter was extended to the fourth ventricle to maximally remove the hematoma.Postoperative CT scan demonstrated total removal of IVH and no sign of extra brain damage.

  12. Aspiration of coagulated hematoma in the third and fourth ventricles via paracele anterior horn puncture.

    Science.gov (United States)

    Tao, Zhi-Qiang; Ding, Sheng-Hong

    2016-01-01

    Intraventricular hemorrhage (IVH) is a neurological urgency with a high mortality and unfavorable prognosis. Fast removal of intraventricular blood should be considered as a priority. The current treatments of IVH mainly focus on external ventricular drain and endoscopic aspiration, but neither way can remove the blood in the fourth ventricle easily and relieve the compression of brainstem. Here we report a unique procedure to solve this problem. A 41-year-old male patient who had suffered sudden attack of headache and disturbance of consciousness for 2 h was diagnosed as having high density lesion in the whole ventricular system by computed tomographic (CT) imaging. An emergent bilateral ventriculopuncture and intraventricular hematoma removal under non-line-of-sight was performed immediately; the catheter was extended to the fourth ventricle to maximally remove the hematoma. Postoperative CT scan demonstrated total removal of IVH and no sign of extra brain damage. PMID:27033269

  13. Synchronous intrauterine and tubal pregnancies with subchorionic hematoma.

    Science.gov (United States)

    Gemer, O; Zohav, E; Calman, D; Sassoon, E; Segal, S

    1993-08-01

    A case of a heterotopic pregnancy is presented. Clinical manifestations included vaginal bleeding, and on ultrasonography a subchorionic hematoma was demonstrated. The subchorionic hematoma may be regarded as blood draining from the tubal pregnancy through the uterus. PMID:8394632

  14. Traumatic cervical epidural hematoma in an infant

    Directory of Open Access Journals (Sweden)

    Vithal Rangarajan

    2013-01-01

    Full Text Available An 8-month-old male infant had presented with a history of a fall from the crib a fortnight ago. He had developed progressive weakness of both lower limbs. On examination, the infant had spastic paraplegia. Magnetic resonance (MR imaging of the cervical spine showed an epidural hematoma extending from the fourth cervical (C4 to the first dorsal (D1 vertebral level with cord compression. The patient had no bleeding disorder on investigation. He underwent cervical laminoplasty at C6 and C7 levels. The epidural hematoma was evacuated. The cervical cord started pulsating immediately. Postoperatively, the patient′s paraplegia improved dramatically in 48 hours. According to the author′s literature search, only seven cases of post-traumatic epidural hematoma have been reported in pediatric patients, and our patient is the youngest. The present case report discusses the etiopathology, presentation, and management of this rare case.

  15. Delayed epidural hematoma after mild head injury

    Directory of Open Access Journals (Sweden)

    Radulović Danilo

    2005-01-01

    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.

  16. 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.)

  17. Spontaneous cerebral intraparenchymatous hematoma: computed tomography findings

    International Nuclear Information System (INIS)

    The objective of this study was to identify the most frequent aspects of spontaneous cerebral intraparenchymatous hematoma found at computed tomography examinations. We reviewed, retrospectively, the computed tomography studies of 250 patients with spontaneous intracerebral hemorrhage carried out in three hospitals in Rio de Janeiro, Brazil. The results showed deep intracerebral hematomas showed the highest incidence and were observed in 54.4% of the cases (136 patients) followed by lobar hemorrhage in 34.8% of the cases (87 patients). Cerebellar hemorrhage and brainstem bleeding were more rarely observed, occurring in 8.4% (21 patients) and 2.4% (six patients) of the cases, respectively. Chronic headache was the most frequent symptom whereas hypertension was observed in the majority of the cases. Blood draining into the ventricular system occurred more frequently in patients with deep hematomas. (author)

  18. Spontaneous aortic dissecting hematoma in two dogs.

    Science.gov (United States)

    Boulineau, Theresa Marie; Andrews-Jones, Lydia; Van Alstine, William

    2005-09-01

    This report describes 2 cases of spontaneous aortic dissecting hematoma in young Border Collie and Border Collie crossbred dogs. Histology was performed in one of the cases involving an unusual splitting of the elastin present within the wall of the aorta, consistent with elastin dysplasia as described in Marfan syndrome in humans. The first case involved a young purebred Border Collie that died suddenly and the second case involved a Border Collie crossbred dog that died after a 1-month history of seizures. Gross lesions included pericardial tamponade with dissection of the ascending aorta in the former case and thoracic cavity hemorrhage, mediastinal hematoma, and aortic dissection in the latter. Histologic lesions in the case of the Border Collie crossbred dog included a dissecting hematoma of the ascending aorta with elastin dysplasia and right axillary arterial intimal proliferation. PMID:16312247

  19. CT-guided stereotactic evacuation of hypertensive intracerebral hematomas

    International Nuclear Information System (INIS)

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

  20. Subcorneal hematomas in excessive video game play.

    Science.gov (United States)

    Lennox, Maria; Rizzo, Jason; Lennox, Luke; Rothman, Ilene

    2016-01-01

    We report a case of subcorneal hematomas caused by excessive video game play in a 19-year-old man. The hematomas occurred in a setting of thrombocytopenia secondary to induction chemotherapy for acute myeloid leukemia. It was concluded that thrombocytopenia subsequent to prior friction from heavy use of a video game controller allowed for traumatic subcorneal hemorrhage of the hands. Using our case as a springboard, we summarize other reports with video game associated pathologies in the medical literature. Overall, cognizance of the popularity of video games and related pathologies can be an asset for dermatologists who evaluate pediatric patients. PMID:26919354

  1. Cognitive Performance in Late Adolescence and the Subsequent Risk of Subdural Hematoma: An Observational Study of a Prospective Nationwide Cohort

    OpenAIRE

    Nordström, Anna; Nordström, Peter

    2011-01-01

    Editors' Summary Background Every year, about 10 million people worldwide sustain a traumatic brain injury that needs medical attention or that proves fatal. Such injuries occur when the head is suddenly hit or jolted or when an object such as a bullet pierces the skull and enters the brain. Motor vehicle accidents are responsible for many traumatic brain injuries, but falls, assaults, and military action can also cause these serious injuries. The symptoms of a traumatic brain injury, which m...

  2. A prospective randomised study to compare the utility and outcomes of subdural and subperiosteal drains for the treatment of chronic subdural haematoma.

    LENUS (Irish Health Repository)

    Kaliaperumal, Chandrasekaran

    2012-11-01

    The usage of a drain following evacuation of a chronic subdural haematoma (CSDH) is known to reduce recurrence. In this study we aim to compare the clinical outcomes and recurrence rate of utilising two different types of drains (subperiosteal and subdural drain) following drainage of a CSDH.

  3. CT guided stereotactic evacuation of hypertensive and traumatic intracerebral hematomas

    International Nuclear Information System (INIS)

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

  4. Preoperative cisternoscintigraphy as a guide to therapeutic decision making for cystic subdural hygroma: case report

    International Nuclear Information System (INIS)

    We report a case of a patient with cystic subdural hygroma who underwent pre-operative Tc-99m DTPA cistrenoscintigraphy to determine the course of operation. A 68-year-old female was admitted to the department of neurosurgery because of scute subarachnoid hemorrhage. After emergency ventricular drainage, the hydrocephalus and cystic subdural hygroma in the right fronto-temporal area developed. She underwent Tc-99m DTPA cisternoscintigraphy to evaluate the type of hydrocephalus, which revealed obstructive communicating hydrocephalus and the communication between the subdural hygroma and the subarachnoid space. As a result of these findings, she underwent the ventriculo-peritoneal shunt operation without removal of the subdural hygroma. Post-operative brain CT showed nearly normalized shape and size of the right ventricle and disappearance of subdural hygroma. We recommend the pre-operative cisternoscintigraphy in patients with complex hygroma to evaluate the communication between subdural hygroma and the subarachnoid space.=20

  5. Bilateral agreements

    International Nuclear Information System (INIS)

    Ten bilateral agreements are presented. These are: 1) Co-operation agreement relating to the peaceful uses of nuclear energy between Argentina and EURATOM (1996); 2) Agreement on co-operation in the peaceful uses of nuclear energy between Argentina and Greece (1997); 3) Implementing arrangement for technical exchange and co-operation in the area of peaceful uses of nuclear energy between Argentina and the United States (1997); 4) Agreement concerning co-operation in nuclear science and technology between Australia and Indonesia (1997); 5) Implementation of the 1985 Agreement for co-operation concerning the peaceful uses of nuclear energy between the People's Republic of China and the United States (1998); 6) Protocol of co-operation between France and Lithuania (1997); 7) Agreement on co-operation in energy research, science and technology, and development between Germany and the United States (1998); 8) Agreement on early notification of a nuclear accident and exchange of information on nuclear facilities between Greece and Romania (1997); 9) Agreement on early notification of nuclear accidents and co-operation in the field of nuclear safety between Hungary and the Ukraine (1997); 10) Agreement in the field of radioactive waste management between Switzerland and the United States (1997). (K.A.)

  6. Image Diagnosis: Spontaneous Hematoma from Scurvy

    OpenAIRE

    Apostolakos, Diane; Halvorsen, Lee O

    2014-01-01

    A 58-year-old alcoholic man presents with pain, swelling, and bruising of his right leg, without history of trauma or injury. He had had frequent spontaneous hematomas in his legs. This patient drank a 1.75 liter bottle of vodka daily, smoked cigarettes, and ate mostly precooked hash brown potatoes, pasta, and occasional canned tuna. He did not eat fresh vegetables and rarely ate fruit, leading to Vitamin C deficiency.

  7. Subcapsular hepatic hematoma. Serious complication during pregnancy

    OpenAIRE

    María Teresa Pérez Hernández; Viviana de la Caridad Sáez Cantero

    2010-01-01

    Subcapsular hepatic hematoma is a rare complication during pregnancy, but potentially lethal and usually related to severe pre-eclampsia or HELLP syndrome (hemolysis, elevated liver enzymes and diminished platelets). Maternal and perinatal mortality in these cases is high, hence the importance of early diagnosis and timely and multidisciplinary treatment. This paper is a review on the subject, held in Ebsco, Hinari and Sci databases.

  8. Idiopathic Adrenal Hematoma Masquerading as Neoplasm

    Directory of Open Access Journals (Sweden)

    Kazuki Sasaki

    2012-04-01

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

  9. [Diagnostic and treatment of hypertensive cerebellar hematomas].

    Science.gov (United States)

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

    2009-01-01

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

  10. Spontaneous cerebral intraparenchymatous hematoma: computed tomography findings; Hematoma intraparenquimatoso cerebral espontaneo: aspectos a tomografia computadorizada

    Energy Technology Data Exchange (ETDEWEB)

    Soares, Celso Monteiro [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina. Programa de Pos-graduacao em Radiologia]. E-mail: celsomsoares@ig.com.br; Carvalho, Antonio Carlos Pires [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia

    2001-02-01

    The objective of this study was to identify the most frequent aspects of spontaneous cerebral intraparenchymatous hematoma found at computed tomography examinations. We reviewed, retrospectively, the computed tomography studies of 250 patients with spontaneous intracerebral hemorrhage carried out in three hospitals in Rio de Janeiro, Brazil. The results showed deep intracerebral hematomas showed the highest incidence and were observed in 54.4% of the cases (136 patients) followed by lobar hemorrhage in 34.8% of the cases (87 patients). Cerebellar hemorrhage and brainstem bleeding were more rarely observed, occurring in 8.4% (21 patients) and 2.4% (six patients) of the cases, respectively. Chronic headache was the most frequent symptom whereas hypertension was observed in the majority of the cases. Blood draining into the ventricular system occurred more frequently in patients with deep hematomas. (author)

  11. 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.)

  12. Hematoma shape, hematoma size, Glasgow coma scale score and ICH score: which predicts the 30-day mortality better for intracerebral hematoma?

    Directory of Open Access Journals (Sweden)

    Chih-Wei Wang

    Full Text Available To investigate the performance of hematoma shape, hematoma size, Glasgow coma scale (GCS score, and intracerebral hematoma (ICH score in predicting the 30-day mortality for ICH patients. To examine the influence of the estimation error of hematoma size on the prediction of 30-day mortality.This retrospective study, approved by a local institutional review board with written informed consent waived, recruited 106 patients diagnosed as ICH by non-enhanced computed tomography study. The hemorrhagic shape, hematoma size measured by computer-assisted volumetric analysis (CAVA and estimated by ABC/2 formula, ICH score and GCS score was examined. The predicting performance of 30-day mortality of the aforementioned variables was evaluated. Statistical analysis was performed using Kolmogorov-Smirnov tests, paired t test, nonparametric test, linear regression analysis, and binary logistic regression. The receiver operating characteristics curves were plotted and areas under curve (AUC were calculated for 30-day mortality. A P value less than 0.05 was considered as statistically significant.The overall 30-day mortality rate was 15.1% of ICH patients. The hematoma shape, hematoma size, ICH score, and GCS score all significantly predict the 30-day mortality for ICH patients, with an AUC of 0.692 (P = 0.0018, 0.715 (P = 0.0008 (by ABC/2 to 0.738 (P = 0.0002 (by CAVA, 0.877 (P<0.0001 (by ABC/2 to 0.882 (P<0.0001 (by CAVA, and 0.912 (P<0.0001, respectively.Our study shows that hematoma shape, hematoma size, ICH scores and GCS score all significantly predict the 30-day mortality in an increasing order of AUC. The effect of overestimation of hematoma size by ABC/2 formula in predicting the 30-day mortality could be remedied by using ICH score.

  13. Minimally Invasive Surgical Treatment of Acute Epidural Hematoma: Case Series

    Science.gov (United States)

    2016-01-01

    Background and Objective. Although minimally invasive surgical treatment of acute epidural hematoma attracts increasing attention, no generalized indications for the surgery have been adopted. This study aimed to evaluate the effects of minimally invasive surgery in acute epidural hematoma with various hematoma volumes. Methods. Minimally invasive puncture and aspiration surgery were performed in 59 cases of acute epidural hematoma with various hematoma volumes (13–145 mL); postoperative follow-up was 3 months. Clinical data, including surgical trauma, surgery time, complications, and outcome of hematoma drainage, recovery, and Barthel index scores, were assessed, as well as treatment outcome. Results. Surgical trauma was minimal and surgery time was short (10–20 minutes); no anesthesia accidents or surgical complications occurred. Two patients died. Drainage was completed within 7 days in the remaining 57 cases. Barthel index scores of ADL were ≤40 (n = 1), 41–60 (n = 1), and >60 (n = 55); scores of 100 were obtained in 48 cases, with no dysfunctions. Conclusion. Satisfactory results can be achieved with minimally invasive surgery in treating acute epidural hematoma with hematoma volumes ranging from 13 to 145 mL. For patients with hematoma volume >50 mL and even cerebral herniation, flexible application of minimally invasive surgery would help improve treatment efficacy. PMID:27144170

  14. Hematoma intraparenquimatoso cerebral espontâneo: aspectos à tomografia computadorizada Spontaneous cerebral intraparenchymatous hematoma: computed tomography findings

    OpenAIRE

    Celso Monteiro Soares; Antonio Carlos Pires Carvalho

    2005-01-01

    OBJETIVO: Identificar os aspectos mais freqüentes do hematoma intraparenquimatoso cerebral espontâneo observados na tomografia computadorizada. MATERIAIS E MÉTODOS: Foram analisados, retrospectivamente, os exames de tomografia computadorizada de 250 pacientes com hematoma intraparenquimatoso cerebral espontâneo, provenientes de três diferentes hospitais da cidade do Rio de Janeiro. RESULTADOS: O hematoma intraparenquimatoso cerebral profundo foi o de maior incidência, equivalendo a 54,4% (136...

  15. Subdural electrode recording of generalized photoepileptic responses

    Directory of Open Access Journals (Sweden)

    L. Mukundan

    2015-01-01

    Full Text Available We evaluated the spatiotemporal distribution of photic driving (PDR, photoparoxysmal (PPR, and photoconvulsive (PCR responses recorded by intracranial electrodes (ic-EEG in a patient with generalized photosensitivity and right frontal lobe cortical dysplasia. Intermittent light stimulation (ILS was performed thirteen times in nine days. Cortical responses to ILS recorded by ic-EEG were reviewed and classified as PDRs, PPRs, and PCRs. Photic driving responses were restricted to the occipital lobe at ILS frequencies below 9 Hz, spreading to the parietal and central regions at >9 Hz. Photoparoxysmal responses commonly presented as focal, medial occipital, and parietal interictal epileptic discharges (IEDs, the latter propagating to the sensorimotor cortices. Generalized IEDs were also generated in the setting of PPRs. Photoconvulsive responses, characterized by repetitive bilateral upper extremity myoclonus sustained until the end of the stimulus, were associated with propagation of the medial parieto-occipital discharge to the primary sensorimotor and supplementary area cortices, while generalized myoclonic seizures were associated with a generalized spike-and-wave discharge with an interhemispheric posterior cingulate onset sparing the sensorimotor cortices. Both types of PCR could occur during the same stimulus. Regardless of the pathway, PCRs only occurred when PDRs involved the parietal cortices. While there may be more than one pathway underlying PCRs, parietal lobe association cortices appear to be critical to their generation.

  16. Bilateral anterior shoulder dislocation

    OpenAIRE

    Meena, Sanjay; Saini, Pramod; Singh, Vivek; Kumar, Ramakant; Trikha, Vivek

    2013-01-01

    Shoulder dislocations are the most common major joint dislocations encountered in the emergency departments. Bilateral shoulder dislocations are rare and of these, bilateral posterior shoulder dislocations are more prevalent than bilateral anterior shoulder dislocations. Bilateral anterior shoulder dislocation is very rare. We present a case of 24-year-old male who sustained bilateral anterior shoulder dislocation following minor trauma, with associated greater tuberosity fracture on one side...

  17. Prognostic factors in intraparenchymatous hematoma with ventricular hemorrhage.

    Science.gov (United States)

    Ruscalleda, J; Peiró, A

    1986-01-01

    Intraventricular hemorrhage following intraparenchymatous hematoma is thought to be a frequent and often fatal event. Computerized tomography has proved to be valuable for its 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. PMID:3951686

  18. Prognostic factors in intraparenchymatous hematoma with ventricular hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Ruscalleda, J.; Peiro, A.

    1986-01-01

    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.).

  19. 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.)

  20. Subcapsular hematoma of the liver in a neonate: case report

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-07-15

    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.

  1. Surgical treatment for acute traumatic multiple intracranial hematomas

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Traumatic multiple intracranial hematomas (TMICHs) are intracranial hematomas (ICHs)formed in more than two positions or with more than two types after head injury.1 This article reports 147 cases of TMICHs treated in our hospital between July 1993 and December 1999.

  2. Subchorionic hematoma in threatened abortion: Sonographic evaluation and significance.

    Science.gov (United States)

    Al Nuaim, L; Chowdhury, N; Adelusi, B

    1996-11-01

    In a study of 92 women with subchorionic hematoma evaluated with sonographic scan in King Khalid University Hospital, it was found that the mean ages and live births of patients who carried their pregnancies to viability were higher when compared with the patients who aborted. There was a statistically significant association between the gestational age at diagnosis of subchorionic hematoma and the size of the hematoma. There was, however, no statistically significant association found between the gestational age at diagnosis, size and site of the hematoma and the outcome of pregnancy. It was concluded that subchorionic hematoma which appear either in the second trimester, or are larger, or located in the lower uterine segment, may be associated with higher rates of abortion or preterm deliveries. Nevertheless, there is no statistically significant impact of these on the outcome of pregnancy. PMID:17429250

  3. 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 position of the tip of cannula even at operation, if necessary. (author)

  4. CT guided stereotactic evacuation for hypertensive intracerebral hematoma

    International Nuclear Information System (INIS)

    Sixty-one cases of hypertensive intracerebral hematoma were evacuated by CT guided stereotactic method. The operation was performed in the CT room under general anesthesia using the KOMAI-NAKAJIMA STEREOTACTIC DEVICE. This instrument has a micromanipulater that can be used for various kinds of stereotactic procedures. Three dimensional position of the target point (aspiration point of the hematoma) was determined on the film obtained from CT scanning of the patient in the stereotactic system. If the hematoma was small, the target point was enough to be one point at the center of the hematoma, but in case of the large hematoma, several target points were given according to the shape of hematoma. The probe, ordinarily a steel tube 4 mm in outer diameter, was inserted through brain to the target point and the hematoma was aspirated through a silicon tube connected to a vacuum system. Among 61 cases examined, 30 cases of thalamic hemorrhage were operated upon and 36 cases were not operated. They were classified according to the volume of hematoma into 3 groups as follows: A=less than 10 ml, B=11-25 ml, C=more than 25 ml. The operated cases were compared with the non operated cases on the improvement of consciousness in each group. In the A group, the operated patients in the level I recovered more slowly than the non operated patients, but in the level II patients, this was reversed. In the B group, the operated patients improved more quickly except the level I patients. In the C group, almost all of non operated patients died. Thus, this operation was very useful in improving consciousness of level II or III patients independent of hematoma volume. It accelerated the recovery of motor function in the level I. This non inversive technique is considered effective for the removal of deep intracerebral hematoma. (author)

  5. Longterm surgery of posttraumatic intracranial hematoma

    Directory of Open Access Journals (Sweden)

    Babochkin D.S.

    2012-03-01

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

  6. Coleção subdural na criança: fisiopatologia e tratamento Subdural effusions in children: pathophysiology and treatment

    Directory of Open Access Journals (Sweden)

    Sebastião Gusmão

    1997-06-01

    Full Text Available Nove crianças portadoras de coleção subdural (CSD foram tratadas por meio de derivação subduro-peritoneal. Todas foram submetidas a controle com tomografia computadorizada do encéfalo. O tamanho da coleção subdural foi avaliado por medida de sua área no corte tomográfico por meio de morfologia quantitativa com planímetro. Ocorreu regressão completa ou quase completa da CSD em oito pacientes. Os resultados funcionais foram excelentes em quatro pacientes, bons em três e maus em dois. Foi feita uma revisão da fisiopatologia e do tratamento da CSD na criança.Nine children harboring subdural effusions were treated by subduro peritoneal shunt. These patients were followed-up by CT scans. The area of the subdural effusions was measured by quantitative morphology with a planimeter. With the surgical treatment, the subdural effusion disappeared completely or near completely in 8 patients. The patient's functional state were excellent in 4, good in 3 and bad in 2 in the postoperative follow-up. We aldo reviewed the literature as far as the pathophysiology and the treatment of the subdural effusions are concerned.

  7. Hematoma perirrenal e envolvimento da artéria temporal em paciente com poliarterite nodosa (PAN) Perirenal hematoma and involvement of the temporal artery in a patient with polyarteritis nodosa (PAN)

    OpenAIRE

    Lilian Schade; Daniela Terumi Akish; Salun Coelho Aragão; Gibran Avelino Frandolo; Eduardo dos Santos Paiva

    2009-01-01

    Descrevemos o caso de um paciente masculino, 48 anos, com poliartralgias e mialgias migratórias, associadas a febre e emagrecimento com dois meses de evolução; um episódio de dor testicular bilateral; e cefaleia unilateral pulsátil com espessamento de artéria temporal esquerda sugerindo arterite temporal. Na evolução, o paciente apresentou hematoma perirrenal esquerdo espontâneo, infartos esplênicos e insuficiência renal aguda oligúrica. Foi tratado com prednisona e ciclofosfamida. Foram real...

  8. Spontaneous Arachnoid Cyst Rupture with Subdural Hygroma in a Child

    OpenAIRE

    Muhammad Faisal Khilji; Niranjan Lal Jeswani; Rana Shoaib Hamid; Faisal Al Azri

    2016-01-01

    Arachnoid cyst of the brain is common in children but its association with spontaneous subdural hygroma is rare. A case of a nine-year-old boy, without any preceding history of trauma, is presented here who came to the emergency department of a tertiary care hospital with complaints of headache, nausea, and vomiting for the last two weeks but more for the last two days. Examination showed a young, fully conscious oriented boy with positive Cushing’s reflex and papilledema of left eye. MRI (ma...

  9. Delayed Duodenal Hematoma and Pancreatitis from a Seatbelt Injury

    Directory of Open Access Journals (Sweden)

    DeAmbrosis, Katherine

    2011-02-01

    Full Text Available Traumatic duodenal hematoma is a rare condition that is encountered in the paediatric age group following blunt abdominal trauma. It poses both a diagnostic and therapeutic challenge. The main concern is increased morbidity secondary to delayed diagnosis and associated occult injuries to the adjacent structures. Most of these hematomas resolve spontaneously with conservative management, and the prognosis is good. We present a case of a 15-year-old boy who had a delayed presentation of duodenal hematoma and acute pancreatitis, which was treated conservatively with complete resolution. [West J Emerg Med. 2011;12(1:128-130.

  10. 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.)

  11. Spontaneous ligamentum flavum hematoma in the lumbar spine

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.)

  12. Microsurgical excision of hematoma of the lumbar ligamentum flavum.

    Science.gov (United States)

    Takeno, Kenichi; Kobayashi, Shigeru; Miyazaki, Tsuyoshi; Yayama, Takafumi; Baba, Hisatoshi

    2010-07-01

    Hematoma of the lumbar ligamentum flavum is a very rare cause of sciatica. A 72-year-old man presented with left-sided sciatica and paresthesia of the lateral aspect of his left foot. From CT and MRI findings, he was diagnosed as having a hematoma embedded in the ligamentum flavum, which compressed the dura mater at the L5/S1 disc level. After an adequate surgical field was obtained with a microscope and a Casper retractor, the hematoma of the ligamentum flavum could be excised via a unilateral approach and satisfactory decompression of the cauda equina and nerve roots were obtained. PMID:20537575

  13. First report of hepatic hematoma after presumed Bothrops envenomation

    Directory of Open Access Journals (Sweden)

    Fernanda Cristina Cunha

    2015-10-01

    Full Text Available ABSTRACTIn Latin America, Bothrops envenomation is responsible for the majority of accidents caused by venomous snakes. Patients usually present local edema, bleeding and coagulopathy. Visceral hemorrhage is extremely rare and considered a challenge for diagnosis and management. We report the first case of hepatic hematoma owing to the bothropic envenomation in a 66-year-old man who was bitten in the left leg. He presented local edema, coagulopathy, and acute kidney injury. Radiological findings suggested hepatic hematoma, with a volume of almost 3 liters. The hepatic hematoma was gradually absorbed without the need for surgical intervention with complete resolution in 8 months.

  14. Changes in signal intensity of cerebral hematoma in magnetic resonance

    International Nuclear Information System (INIS)

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

  15. First report of hepatic hematoma after presumed Bothrops envenomation.

    Science.gov (United States)

    Cunha, Fernanda Cristina; Heerdt, Maike; Torrez, Pasesa Pascuala Quispe; França, Francisco Oscar de Siqueira; Molin, Graziela Zibetti Dal; Battisti, Rúbia; Zannin, Marlene

    2015-01-01

    In Latin America, Bothrops envenomation is responsible for the majority of accidents caused by venomous snakes. Patients usually present local edema, bleeding and coagulopathy. Visceral hemorrhage is extremely rare and considered a challenge for diagnosis and management. We report the first case of hepatic hematoma owing to the bothropic envenomation in a 66-year-old man who was bitten in the left leg. He presented local edema, coagulopathy, and acute kidney injury. Radiological findings suggested hepatic hematoma, with a volume of almost 3 liters. The hepatic hematoma was gradually absorbed without the need for surgical intervention with complete resolution in 8 months. PMID:26516980

  16. Intra-Abdominal Hematoma Following Enoxaparin Injection.

    Science.gov (United States)

    Chung, Kin Tong

    2016-01-01

    An elderly patient, who was being treated for therapeutic enoxaparin for a couple of days due to suspected deep vein thrombosis, was admitted to hospital following a collapse and severe abdominal pain. She was in hypovolemic shock and was fluid resuscitated. Ultrasound scan and computed tomography (CT) scan showed a large pelvic hematoma. Radiologists also suspected a possibility of bleeding from inferior epigastric artery following a CT angiogram. The patient was stabilized and transferred to intensive care unit (ICU) for further hemodynamic supports and close monitoring. The patient was then transferred back to the general ward when she was stable. She was managed conservatively as there were no more signs of active bleeding. Unfortunately, she died of recurrent bleeding three days after ICU discharge. PMID:27158226

  17. Computed tomographic investigations on intraventricular hematomas

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1992-01-01

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

  19. Threatened miscarriage and intrauterine hematomas. Sonographic and biochemical studies.

    Science.gov (United States)

    Stabile, I; Campbell, S; Grudzinskas, J G

    1989-06-01

    In a prospective study of 406 women with threatened miscarriage (TMC), 22 (5.4%) had an intrauterine hematoma (less than 16 mL) noted ultrasonically, decreasing in size as the patients experienced repeated episodes of bleeding. Twenty (91%) of the hematomas visualized were subchorionic and two (9%) were retroplacental. None of these women subsequently miscarried. Human chorionic gonadotrophin (hCG), Schwangerschafts protein 1 (SP1), and pregnancy-associated plasma protein A (PAPP-A) levels measured in these patients were not significantly different in women with or without hematomas. We conclude that the presence of small intrauterine hematomas in women with TMC does not increase the risk of miscarriage. PMID:2472492

  20. Idiopathic intraparenchymal hematoma of the liver in a neonate

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-04-01

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

  1. Delayed Duodenal Hematoma and Pancreatitis from a Seatbelt Injury

    OpenAIRE

    DeAmbrosis, Katherine; Subramanya, Manjunath S.; Memon, Breda; Memon, Muhammed A.

    2011-01-01

    Traumatic duodenal hematoma is a rare condition that is encountered in the paediatric age group following blunt abdominal trauma. It poses both a diagnostic and therapeutic challenge. The main concern is increased morbidity secondary to delayed diagnosis and associated occult injuries to the adjacent structures. Most of these hematomas resolve spontaneously with conservative management, and the prognosis is good. We present a case of a 15-year-old boy who had a delayed presentation of duodena...

  2. Spontaneous Intracranial Extradural Hematoma in Sickle Cell Disease

    OpenAIRE

    N'dri Oka, Dominique; Tokpa, André; Bah, Alpha; Derou, Louis

    2015-01-01

    Spontaneous extradural hematoma is rare in patients with sickle cell disease. We report a clinical case of a 19-year-old young man with sickle cell anemia who presented a sickle cell crisis complicated by the development of multiple acute extradural and subgaleal hematomas that had not been treated surgically. We discuss the physiopathology of this event. Although it is rare, clinicians should be aware of this phenomenon as part of a spectrum of neurologic complications in these patients.

  3. Pathomechanism of ring enhancement in intracerebral hematomas on CT

    International Nuclear Information System (INIS)

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

  4. Spontaneously Developed Pulmonary Arterial Intramural Hematoma That Mimicked Thromboembolism

    OpenAIRE

    Kang, Eun-Ju; Lee, Ki-Nam; Kim, In; Chae, Jong-Min; Kim, Gun-Jik; Yang, Dong Heon; Lee, Jongmin

    2012-01-01

    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 bel...

  5. Spontaneous thoracic epidural hematoma: a case report and literature review.

    Science.gov (United States)

    Babayev, Rasim; Ekşi, Murat Şakir

    2016-01-01

    Spinal epidural hematoma is a rare neurosurgical emergency in respect of motor and sensory loss. Identifiable reasons for spontaneous hemorrhage are vascular malformations and hemophilias. We presented a case of spontaneous epidural hematoma in an 18-year-old female patient who had motor and sensory deficits that had been present for 1 day. On MRI, there was spinal epidural hematoma posterior to the T2-T3 spinal cord. The hematoma was evacuated with T2 hemilaminectomy and T3 laminectomy. Patient recovered immediately after the surgery. Literature review depicted 112 pediatric cases (including the presented one) of spinal epidural hematoma. The female/male ratio is 1.1:2. Average age at presentation is 7.09 years. Clinical presentations include loss of strength, sensory disturbance, bowel and bladder disturbances, neck pain, back pain, leg pain, abdominal pain, meningismus, respiratory difficulty, irritability, gait instability, and torticollis. Most common spinal level was cervicothoracic spine. Time interval from symptom onset to clinical diagnosis varied from immediate to 18 months. Spinal epidural hematoma happened spontaneously in 71.8 % of the cases, and hemophilia was the leading disorder (58 %) in the cases with a definable disorder. Partial or complete recovery is possible after surgical interventions and factor supplementations. PMID:26033378

  6. Dating of Acute and Subacute Subdural Haemorrhage: A Histo-Pathological Study

    Science.gov (United States)

    Rao, Murali G; Vashista, Rakesh Kumar; Sharma, Suresh Kumar

    2016-01-01

    Introduction Microscopic study of the organization of the Subdural Haemorrhage (SDH) verified against the time period can help us in the determination of its age which has serious medico-legal implications. Very few studies concerning the dating of SDH are present in the literature. Aim This study was conducted for dating the early subdural haemorrhage by routine histopathological stains. Materials and Methods A prospective analytical study was conducted during July 2009 to December 2010. A total of 100 cases (50 males and 50 females) fulfilling the inclusion and exclusion criteria were included in this study. Routine histopathological staining of the subdural haematoma was done. Results Correlation between the frequency of a given histomorphological phenomenon and the length of the Post-Traumatic Interval (PTI) was evidential. All the histomorphological features, when correlated with PTI groups, were found to be statistically significant, except for Polymorphonuclear Leukocytes (PMN). Conclusion We concluded that routine histopathology was reliable in the dating of early subdural haemorrhages.

  7. Subdural infusion of dexamethasone inhibits leukomyelitis after acute spinal cord injury in a rat model

    Czech Academy of Sciences Publication Activity Database

    Kwiecien, J. M.; Jarocz, B.; Urdzíková, Lucia; Rola, R.; Dabrowski, W.

    2015-01-01

    Roč. 53, č. 1 (2015), s. 41-51. ISSN 1641-4640 Institutional support: RVO:68378041 Keywords : spinal cord injury * leukomyelitis * macrophages * subdural infusion * dexamethasone Subject RIV: FH - Neurology Impact factor: 1.568, year: 2014

  8. MRI Changes of the Spinal Subdural Space after Lumbar Spine Surgeries: Report of Two Cases

    OpenAIRE

    Sakai, Toshinori; Sairyo, Koichi; Bhatia, Nitin N.; Miyagi, Ryo; Tamura, Tatsuya; Katoh, Shinsuke; Yasui, Natsuo

    2011-01-01

    Although magnetic resonance imaging (MRI) is frequently used to assess the lumbar spine, there are few reports in the medical literature that have evaluated using MRI immediately following spinal surgery. Furthermore, descriptions of the subdural changes after lumbar spine surgery are also infrequent. In this paper, we present two cases with subdural change seen on MRI immediately after lumbar surgery. Both the patients had mild symptoms that resolved spontaneously, and the follow-up MRI scan...

  9. Baboon Model of Generalized Epilepsy: Continuous Intracranial Video-EEG Monitoring with Subdural Electrodes

    OpenAIRE

    Szabó, C. Ákos; Salinas, Felipe S.; Leland, M Michelle; Caron, Jean-Louis; Hanes, Martha A.; Knape, Koyle D.; Xie, Dongbin; Williams, Jeff T.

    2012-01-01

    The baboon provides a natural non-human primate model for photosensitive, generalized epilepsy. This study describes an implantation procedure for the placement of subdural grid and strip electrodes for continuous video-EEG monitoring in the epileptic baboon to evaluate the generation and propagation of ictal and interictal epileptic discharges. Subdural grid, strip and depth electrodes were implanted in six baboons, targeting brain regions that were activated in functional neuroimaging studi...

  10. Correlations Between Subdural Empyema and Paraclinical as well as Clinical Parameters amongst Urban Malay Paediatric Patients

    OpenAIRE

    Nayan, Saiful Azli Mat; Abdullah, Mohd Shafie; Naing, Nyi Nyi; Haspani, Mohd Saffari Mohd; Md Ralib, Ahmad Razali

    2008-01-01

    Paediatric subdural empyema is frequently seen in developing Asean countries secondary to rinosinusogenic origins. A cross-sectional analysis on the surgical treatment of intracranial subdural empyema in Hospital Kuala Lumpur (HKL), a major referral center, was done in 2004. A total number of 44 children who fulfilled the inclusion criteria were included into this study. The methods of first surgery, volume of empyema on contrasted CT brain, improvement of neurological status, re-surgery, mor...

  11. Bilateral lateral periodontal cyst

    OpenAIRE

    Govil, Somya; Gupta, Vishesh; Misra, Neeta; Misra, Pradyumna

    2013-01-01

    The bilateral lateral periodontal cyst is a rare nasological entity, which despite clinical and radiological presentation is being diagnosed by histological characteristics. It is asymptomatic in nature and is observed in routine radiography. The aim and objective of this article is to present a rare case of bilateral lateral periodontal cyst in a 14-year-old child. The clinical and radiographical findings, along with its management have been discussed. Enucleation of bilateral cyst without e...

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

    OpenAIRE

    Viviana de la Caridad Sáez Cantero; María Teresa Pérez Hernández

    2010-01-01

    Subcapsular hepatic hematoma is a rare complication during pregnancy, but potentially lethal and usually related to severe pre-eclampsia or HELLP syndrome (hemolysis, elevated liver enzymes and diminished platelets). Maternal and perinatal mortality in these cases is high, hence the importance of early diagnosis and timely and multidisciplinary treatment. This paper is a review on the subject, held in Ebsco, Hinari and Sci databases.El hematoma subcapsular hepático es una complicación rara de...

  13. Hematoma intraparenquimatoso cerebral espontâneo: aspectos à tomografia computadorizada Spontaneous cerebral intraparenchymatous hematoma: computed tomography findings

    Directory of Open Access Journals (Sweden)

    Celso Monteiro Soares

    2005-02-01

    Full Text Available OBJETIVO: Identificar os aspectos mais freqüentes do hematoma intraparenquimatoso cerebral espontâneo observados na tomografia computadorizada. MATERIAIS E MÉTODOS: Foram analisados, retrospectivamente, os exames de tomografia computadorizada de 250 pacientes com hematoma intraparenquimatoso cerebral espontâneo, provenientes de três diferentes hospitais da cidade do Rio de Janeiro. RESULTADOS: O hematoma intraparenquimatoso cerebral profundo foi o de maior incidência, equivalendo a 54,4% (136 casos, seguido do lobar com 34,8% (87 casos. Mais raramente, observou-se sangramento cerebelar em 8,4% (21 casos e do tronco cerebral em 2,4% (seis casos dos pacientes. CONCLUSÃO: A cefaléia foi o sintoma mais comum e a hipertensão arterial foi o sinal mais freqüentemente apresentado. A drenagem do hematoma para o sistema ventricular ocorreu mais comumente nos hematoma profundos.OBJECTIVE: To identify the most frequent aspects of spontaneous cerebral intraparenchymatous hematoma found at computed tomography examinations. MATERIALS AND METHODS: We reviewed, retrospectively, the computed tomography studies of 250 patients with spontaneous intracerebral hemorrhage carried out in three hospitals in Rio de Janeiro, Brazil. RESULTS: Deep intracerebral hematomas showed the highest incidence and were observed in 54.4% of the cases (136 patients followed by lobar hemorrhage in 34.8% of the cases (87 patients. Cerebelar hemorrhage and brainstem bleeding were more rarely observed, occurring in 8.4% (21 patients and 2.4% (six patients of the cases, respectively. CONCLUSION: Chronic headache was the most frequent symptom whereas hypertension was observed in the majority of the cases. Blood draining into the ventricular system occurred more frequently in patients with deep hematomas.

  14. Subdural collections associated with pediatric bacterial meningitis MR imaging

    International Nuclear Information System (INIS)

    To evaluate meningitis complications caused by spontaneously resolving sterile subdural (SD) effusions in children, the authors used CT and MR imaging to examine six children (age range, 2 months to 5 years) with bacterial meningitis; two patients also underwent Gadolinium-enhanced MR imaging. Seven SD collections were identified, ranging from nearly isointense (two) to hyperintense (five) relative to cerebrospinal fluid. Both collections evaluated with gadolinium enhanced markedly. Although the presence of hyperintense, enhancing SD collections might suggest that they were empyemas, all patients were clinically stable or improving. This contrasted with the acutely ill adolescents with otorhinologic-related empyemas who required immediate extensive craniotomy. Clinical factors (age, type of bacteria, severity of illness) might be more helpful than MR features to assess clinical status and surgical requirements

  15. Optimal management of hemophilic arthropathy and hematomas

    Directory of Open Access Journals (Sweden)

    Lobet S

    2014-10-01

    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

  16. Spontaneous bacterial seeding of a biceps hematoma.

    Science.gov (United States)

    Frye, Benjamin; Prud'homme, Joseph; Daney, Blake

    2010-11-01

    A 19-year-old male construction worker presented with an injury to his left upper arm after lifting a heavy pipe. He reported an acute onset of sharp pain followed by swelling, warmth, and weakness with elbow flexion. The diagnosis of a distal biceps tendon rupture was made and elective repair was scheduled. Seventy-two hours later, the patient presented with a spontaneous draining wound on his anterior distal humerus. The wound was draining thick purulent material. The patient underwent surgery for irrigation and debridement of his abscess. Nearly 500 cc of hematoma and purulent fluid were evacuated. A large tear of both the biceps and brachialis muscle bellies were found. Cultures were obtained that revealed the infecting organism to be Streptococcus intermedius. Human immunodeficiency virus and hepatitis-C virus testing were negative, and no history, signs, or symptoms of any cause of underlying immunodeficiency were detected. No signs or history of drug use were present. He was discharged home on culture-specific oral antibiotics. At 4-month postoperative follow-up, the patient reported no pain or limitations. He has returned to full duty at his job. Elbow range of motion was measured from 7° to 150° of flexion. Strength of elbow flexion and extension was symmetric to the uninjured side. Pronation and supination of the forearm was symmetric on both sides. He has been released from scheduled follow-up and will be seen again on an as-needed basis. PMID:21053873

  17. 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 suggest, that the most important factor in therapeutic decision-making should be a clinical status of the patient. (author)

  18. Bilateral Congenital Diaphragmatic Hernia

    OpenAIRE

    Dhua, Anjan K; Aggarwal, Satish K; NB Mathur; GR Sethi

    2012-01-01

    Bilateral congenital diaphragmatic hernia (CDH) is a rare birth defect, with a poor prognosis. We describe a case of bilateral CDH discovered while repairing the right sided CDH. Diaphragmatic defect was repaired and a silo was applied on the abdominal wound to avoid abdominal compartment syndrome. The patient however died postoperatively due to severe pulmonary hypertension.

  19. Anestesia subdural após punção peridural: relato de dois casos Anestesia subdural después punción peridural: relato de dos casos Subdural anesthesia after epidural puncture: two case reports

    Directory of Open Access Journals (Sweden)

    Carlos Escobar Vásquez

    2003-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Anestesias condutivas peridurais são realizadas amplamente no nosso meio. A anestesia subdural acidental após punção peridural é uma complicação rara. O objetivo deste relato é descrever dois casos de injeção subdural que coincidentemente ocorreram de forma consecutiva realizadas pelo mesmo anestesiologista. RELATO DOS CASOS: Caso 1: Paciente do sexo masculino, 41 anos, estado físico ASA I, a realizar procedimento cirúrgico de retirada de cálculo renal. Optou-se por anestesia peridural. Após 30 minutos do início da anestesia, o paciente mantinha-se comunicativo mas sonolento com SpO2 de 100%, quando lentamente começou a apresentar diminuição da SpO2 chegando a 80%. Apresentava-se inconsciente com apnéia e anisocoria. A partir deste momento foi levantada hipótese diagnóstica de anestesia subdural acidental. O paciente foi então intubado e mantido em ventilação controlada mecânica. Terminada a cirurgia, foi encaminhado para a sala de recuperação, recebendo alta após 6 horas, sem nenhuma alteração clínico-neurológica. Caso 2: Paciente do sexo feminino, 82 anos, estado físico ASA II, programado para procedimento cirúrgico de fixação de fratura transtrocanteriana. Optou-se por anestesia peridural contínua. Assim como no caso anterior, após 30 minutos, a paciente começou a apresentar diminuição da SpO2 para 90%. Mostrava-se inconsciente e com anisocoria; entretanto, sem apnéia. Optou-se por manter a paciente sob vigilância constante, não sendo necessária intubação. A hipótese diagnóstica aventada também neste caso foi de anestesia subdural acidental. Terminada a cirurgia, a paciente foi encaminhada à sala de recuperação pós-anestésica, tendo alta após 4 horas, sem nenhuma alteração clínico-neurológica. CONCLUSÕES: Anestesia subdural acidental é uma complicação extremamente rara. A hipótese diagnóstica de anestesia subdural acidental, nestes casos, limitou

  20. Analysis on the risk factors of bacterial meningitis complicated with subdural effusion

    Directory of Open Access Journals (Sweden)

    Zhi JIANG

    2015-08-01

    Full Text Available Objective To investigate the risk factors of bacterial meningitis complicated with subdural effusion.  Methods The clinical data of children with bacterial meningitis in our hospital were collected and analyzed retrospectively. Logistic regression analysis was used to investigate the risk factors for subdural effusion.  Results A total of 128 cases were divided into control group (N = 64 and subdural effusion group (N = 64. There was no significant difference on serum erythrocyte sedimentation rate (ESR, C-reactive protein (CRP, and white blood cell (WBC between 2 groups (P > 0.05, for all. Compared with control group, cerebrospinal fluid (CSF WBC (Z = 3.126, P = 0.003, CSF protein (Z = 4.928, P = 0.000 and serum procalcitonin (PCT; Z = 2.823, P = 0.007 in subdural effusion group were significantly higher, while CSF glucose (t = 2.166, P = 0.033 was significantly lower. After treatment, CSF WBC (Z = 2.467, P = 0.012 in subdural effusion group was still significantly higher than that of control group, and CSF glucose (t = 4.938, P = 0.000 was still significantly lower. Logistic regression analysis showed that WBC in CSF (P = 0.027, CSF protein (P = 0.002 and serum PCT (P = 0.014 were independent risk factors for bacterial meningitis complicated with subdural effusion.  Conclusions CSF examination of children with bacterial meningitis reveals significant increase of CSF WBC, CSF protein and serum PCT, suggesting concurrent subdural effusion is easily occurred. DOI: 10.3969/j.issn.1672-6731.2015.08.012

  1. Subdural enhancement on postoperative spinal MRI after resection of posterior cranial fossa tumours

    Energy Technology Data Exchange (ETDEWEB)

    Warmuth-Metz, M.; Solymosi, L. [Abteilung fuer Neuroradiologie, Klinikum der Bayerischen Julius Maximilians Universitaet, Josef-Schneider-Strasse 11, 97080, Wuerzburg (Germany); Kuehl, J. [Paediatric Oncology, Klinikum der Bayerischen Julius Maximilians Universitaet, Josef-Schneider-Strasse 11, 97080, Wuerzburg (Germany); Krauss, J. [Paediatric Neurosurgery, Klinikum der Bayerischen Julius Maximilians Universitaet, Josef-Schneider-Strasse 11, 97080, Wuerzburg (Germany)

    2004-03-01

    In malignant brain tumours which may disseminate staging, usually by cranial and spinal MRI is necessary. If MRI is performed in the postoperative period pitfalls should be considered. Nonspecific subdural contrast enhancement on spinal staging MRI is rarely reported after resection of posterior fossa tumours, which may be mistaken for dissemination of malignancy. We investigated the frequency of spinal subdural enhancement after posterior cranial fossa neurosurgery in children. We reviewed 53 postoperative spinal MRI studies performed for staging of paediatric malignant brain tumours, mainly infratentorial primitive neuroectodermal tumours 2-40 days after surgery. There was contrast enhancement in the spinal subdural space in seven cases. This was not seen in any of eight patients who had been operated upon for a supratentorial tumour. After resection of 45 posterior cranial fossa tumours the frequency of subdural enhancement was 15.5%. MRI showing subdural enhancement was obtained up to 25 days postoperatively. No patient with subdural enhancement had cerebrospinal fluid (CSF) examinations positive for tumour cells or developed dissemination of disease in the CSF. Because the characteristic appearances of subdural contrast enhancement, appropriate interpretation is possible; diagnosis of neoplastic meningitis should rarely be impeded. Because of the striking similarity to that in patients with a low CSF-pressure syndrome and in view of the fact that only resection of tumours of the posterior cranial fossa, usually associated with obstructive hydrocephalus, was followed by this type of enhancement one might suggest that rapid changes in CSF pressure are implicated, rather the effects of blood introduced into the spinal canal at surgery. (orig.)

  2. Pregnancy following bilateral salpingectomy

    DEFF Research Database (Denmark)

    Oturai, Annette Bang

    2008-01-01

    This report presents a rare case of spontaneous pregnancy following bilateral salpingectomy. A woman with a history of bilateral salpingectomy was admitted to hospital because of abdominal pain and positive urine HCG. Surprisingly, ultrasound confirmed a live intrauterine fetus. The pregnancy was...... unwanted, and the woman decided to terminate the pregnancy. She was offered diagnostic examination to localise a potential fistula, but she declined. In a MEDLINE search of English literature this is only the second case of spontaneous pregnancy following bilateral salpingectomy Udgivelsesdato: 2008/4/21...

  3. 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

  4. Intramural Duodenal Hematoma with Acute Pancreatitis in a Patient With an Overt Pancreatic Malignancy

    OpenAIRE

    Khurana, Tanvi; Shah, Apeksha; Ali, Ijlal; Islam, Raafa; Siddiqui, Ali A.

    2014-01-01

    Intramural hematomas have rarely been associated with pancreatitis, and to date there is only 1 case report of an intramural hematoma occurring with pancreatic adenocarcinoma. We describe a patient who presented with gastric outlet obstruction secondary to a spontaneous intramural duodenal hematoma and was found to have a pancreatic adenocarcinoma on endoscopic ultrasound (EUS) after it was not visualized by computed tomography (CT).

  5. Antenatal MRI diagnosis of massive subchorionic hematoma: a case report.

    Science.gov (United States)

    Gupta, Rohini; Sharma, Raju; Jain, Tarun; Vashisht, Sushma

    2007-01-01

    Massive subchorionic hematoma is a large maternal blood clot, which separates the chorionic plate from the villous chorion [Kojima K, et al: Fetal Diagn Ther 2001;16:57-60]. It is an uncommon condition associated with poor perinatal prognosis and intrauterine growth retardation [Tan WH, et al: Fetal Diagn Ther 1997;76:381-383, Nishijima K, et al: Fetal Diagn Ther 2005;20:23-26]. Ultrasound may not be able to differentiate this condition from other placental abnormalities [Kojima K, et al: Fetal Diagn Ther 2001;16:57-60]. We report a case of massive subchorionic hematoma where the antenatal diagnosis was made on MRI. PMID:17652925

  6. Spontaneous Meckel's cave hematoma: A rare cause of trigeminal neuralgia

    Science.gov (United States)

    Alafaci, Concetta; Grasso, Giovanni; Granata, Francesca; Marino, Daniele; Salpietro, Francesco M.; Tomasello, Francesco

    2015-01-01

    Background: The most common etiology of classic trigeminal neuralgia (TN) is vascular compression. However, other causes must be considered. Among these, spontaneous hematoma of the Meckel's cave (MC) causing symptomatic TN is very rare. Case Description: We present the case of a 60-year-old woman with a 2-month history of left TN and diplopia. Neuroradiological examinations revealed a well-defined hematoma in the left MC. The patient underwent surgical decompression with a progressive neurological improvement. Conclusion: Despite the number of lesions potentially affecting the MC, spontaneous hemorrhage is rare but should be taken into account in the differential diagnosis. PMID:26539319

  7. 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.)

  8. Spontaneous epidural hematoma due to cervico-thoracic angiolipoma.

    Science.gov (United States)

    Eap, C; Bannwarth, M; Jazeron, J-F; Kleber, J-C; Theret, É; Duntze, J; Litre, C-F

    2015-12-01

    Epidural angiolipomas are uncommon benign tumors of the spine. Their clinical presentation is usually a progressive spinal cord compression. We report the case of a 22-year-old patient who presented with an acute paraparesis and a spontaneous epidural hematoma, which revealed a epidural angiolipoma which extended from C7 to T3. The patient underwent a C7-T3 laminectomy, in emergency, with evacuation of the hematoma and extradural complete resection of a fibrous epidural tumor bleeding. The postoperative course was favorable with regression of neurological symptoms. Epidural angiolipomas can be revealed by spontaneous intratumoral hemorrhage without traumatism. The standard treatment is total removal by surgery. PMID:26597606

  9. A Lethal Complication of Endoscopic Therapy: Duodenal Intramural Hematoma

    Directory of Open Access Journals (Sweden)

    Turan Calhan

    2015-01-01

    Full Text Available Duodenal intramural hematoma (DIH usually occurs in childhood and young adults following blunt abdominal trauma. It may also develop in the presence of coagulation disorders and may rarely be an iatrogenic outcome of endoscopic procedures. Management of DIH is usually a conservative approach. A case of intramural duodenal hematoma that developed following endoscopic epinephrine sclerotherapy and/or argon plasma coagulation and that was nonresponsive to conservative therapy in a patient with chronic renal failure who died from sepsis is being discussed in this report. Clinicians should be aware of such possible complications after endoscopic hemostasis in patients with coagulation disorders.

  10. Spontaneous retropharynegeal hematoma: A case report and literature overview

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-02-15

    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.

  11. HEMATOMA OF THE PROXIMAL NAIL FOLD. REPORT OF 41 CASES

    OpenAIRE

    Chang Patricia; Rodas Diaz Cecilia

    2011-01-01

    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...

  12. Sickle cell disease with orbital infarction and epidural hematoma

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-04-01

    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.)

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

    Directory of Open Access Journals (Sweden)

    M. Bermejo

    2004-11-01

    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

  14. Bilateral Primary Intraocular Lymphoma

    OpenAIRE

    Mehrdad Karimi; Masoud Soheilian; Mozhgan Rezaei Kanavi

    2011-01-01

    Purpose: To report a case of bilateral primary intraocular lymphoma. Case report: A 33-year-old man presented with bilateral blurred vision since two years ago. Examination revealed large keratic precipitates, anterior chamber reaction, posterior subcapsular cataracts, and vitreous infiltration. After a short trial of topical and periocular steroids, diagnostic 25-gauge pars plana vitrectomy was performed and cytologic evaluation of the aspirate confirmed a diagnosis of intraocular lympho...

  15. Coexistent of paradoxical herniation and subdural hygroma: a case report

    Institute of Scientific and Technical Information of China (English)

    Yi Feng; Yuhai Wang

    2015-01-01

    Background: Coexistent of paradoxical herniation and subdural hygroma (SDG) is very rare, confusing symptoms may mislead the therapies.Case presentation: We report a case of a 33-year-old man underwent decompressive craniectomy (DC),postoperatively, the patient developed progressive neurologic deterioration and midline shift opposite to the DC window, CT scan revealed a SDG beside the DC window, instead of attributing the midline shift to the SDG, we recognized the underlying paradoxical herniation according to the sunken skin flap and history of lumbar cistern drainage.Subsequently we treat him with intravenous fluid expansion therapy instead of draining from the SDG, the patient recovered in one day and no recurrence was found later.Conclusion: For patients underwent DC, we should pay attention to the occurrence of paradoxicalherniation, SDG following DC may be the consequence of paradoxical herniation caused by CSF reduce therapy in post-DC patient, intravenous fluid expansion therapy is recommended and would play a great role for the recovery of the patient rather than surgical management.

  16. Idiopathic Thoracic Spontaneous Spinal Epidural Hematoma

    Science.gov (United States)

    Aycan, Abdurrahman; Ozdemir, Seymen; Gonullu, Edip; Bozkına, Cemal

    2016-01-01

    A 33-year-old male patient experienced temporary sensory loss and weakness in the right lower extremity one month prior to admission. The patient was admitted to a private clinic with a three-day history of acute onset of sensory loss and weakness in both lower extremities and was treated and followed up with a prediagnosis of transverse myelitis and the Guillain-Barre syndrome (GBS). The patient was subsequently transferred to our clinic and the neurologic examination revealed paraplegia in both lower extremities, positive bilateral Babinski signs, and hypesthesia below the T10 dermatome with saddle anesthesia. The patient had urinary incontinence and thoracic magnetic resonance imaging (MRI) showed an image of a mass compressing the medulla. PMID:27088028

  17. Idiopathic Thoracic Spontaneous Spinal Epidural Hematoma

    Directory of Open Access Journals (Sweden)

    Abdurrahman Aycan

    2016-01-01

    Full Text Available A 33-year-old male patient experienced temporary sensory loss and weakness in the right lower extremity one month prior to admission. The patient was admitted to a private clinic with a three-day history of acute onset of sensory loss and weakness in both lower extremities and was treated and followed up with a prediagnosis of transverse myelitis and the Guillain-Barre syndrome (GBS. The patient was subsequently transferred to our clinic and the neurologic examination revealed paraplegia in both lower extremities, positive bilateral Babinski signs, and hypesthesia below the T10 dermatome with saddle anesthesia. The patient had urinary incontinence and thoracic magnetic resonance imaging (MRI showed an image of a mass compressing the medulla.

  18. Idiopathic Thoracic Spontaneous Spinal Epidural Hematoma.

    Science.gov (United States)

    Aycan, Abdurrahman; Ozdemir, Seymen; Arslan, Harun; Gonullu, Edip; Bozkına, Cemal

    2016-01-01

    A 33-year-old male patient experienced temporary sensory loss and weakness in the right lower extremity one month prior to admission. The patient was admitted to a private clinic with a three-day history of acute onset of sensory loss and weakness in both lower extremities and was treated and followed up with a prediagnosis of transverse myelitis and the Guillain-Barre syndrome (GBS). The patient was subsequently transferred to our clinic and the neurologic examination revealed paraplegia in both lower extremities, positive bilateral Babinski signs, and hypesthesia below the T10 dermatome with saddle anesthesia. The patient had urinary incontinence and thoracic magnetic resonance imaging (MRI) showed an image of a mass compressing the medulla. PMID:27088028

  19. Prediction and observation of post-admission hematoma expansion in patients with intracerebral hemorrhage

    DEFF Research Database (Denmark)

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

    2014-01-01

    within the hematoma along with the hematoma-size is reported to be predictive of hematoma expansion and outcome. Because patients tend to arrive earlier to the hospital, a larger fraction of acute ICH-patients must be expected to undergo hematoma expansion. This renders observation and radiological...... follow-up investigations increasingly relevant. Transcranial duplex sonography has in recent years proven to be able to estimate hematoma volume with good precision and could be a valuable tool in bedside serial observation of acute ICH-patients. Future studies will elucidate, if better prediction and...

  20. MR imaging and clinical findings of spontaneous spinal epidural hematoma

    Energy Technology Data Exchange (ETDEWEB)

    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

    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)

  1. HEMATOMA OF THE PROXIMAL NAIL FOLD. REPORT OF 41 CASES

    Directory of Open Access Journals (Sweden)

    Chang Patricia

    2011-04-01

    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.

  2. Epidural hematoma after ventriculoperitoneal shunt surgery: report of two cases

    Directory of Open Access Journals (Sweden)

    PEREIRA CARLOS UMBERTO

    1998-01-01

    Full Text Available Ventriculoperitoneal shunt operations represent the most used choice for treating hydrocephalus, although some related complications have been reported. Due to its rarity, potential dangers, and mortality rate, we present two cases of epidural hematoma following ventriculoperitoneal shunt, discussing its pathophysiology and prophylaxis.

  3. Multiple remote epidural hematomas following pineal gland tumor resection

    OpenAIRE

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

    2010-01-01

    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...

  4. 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)

  5. Giant splenic hematoma can be a hidden condition

    DEFF Research Database (Denmark)

    Jensen, Kristian Kiim; Hangaard, Stine

    2014-01-01

    An otherwise healthy 28-year old male presented to his general practitioner with dyspnoea in the morning and abdominal discomfort through months. Four months earlier, he had experienced a blunt trauma to the left side of his abdomen. Abdominal ultrasonography revealed a splenic hematoma and the p...

  6. [Bilateral caudate head infarcts].

    Science.gov (United States)

    Kuriyama, N; Yamamoto, Y; Akiguchi, I; Oiwa, K; Nakajima, K

    1997-11-01

    We reported a 67-year-old woman with bilateral caudate head infarcts. She developed sudden mutism followed by abulia. She was admitted to our hospital 2 months after ictus for further examination. She showed prominent abulia and was inactive, slow and apathetic. Spontaneous activity and speech, immediate response to queries, spontaneous word recall and attention and persistence to complex programs were disturbed. Apparent motor disturbance, gait disturbance, motor aphasia, apraxia and remote memory disturbance were not identified. She seemed to be depressed but not sad. Brain CT and MRI revealed bilateral caudate head hemorrhagic infarcts including bilateral anterior internal capsules, in which the left lesion was more extensive than right one and involved the part of the left putamen. These infarct locations were thought to be supplied by the area around the medial striate artery including Heubner's arteries and the A1 perforator. Digital subtraction angiography showed asymptomatic right internal carotid artery occlusion. She bad had hypertension, diabetes mellitus and atrial fibrillation and also had a left atrium with a large diameter. The infarcts were thought to be caused by cardioembolic occlusion to the distal portion of the left internal carotid artery. Although some variations of vasculature at the anterior communicating artery might contribute to bilateral medial striate artery infarcts, we could not demonstrate such abnormalities by angiography. Bilateral caudate head infarcts involving the anterior internal capsule may cause prominent abulia. The patient did not improve by drug and rehabilitation therapy and died suddenly a year after discharge. PMID:9503974

  7. Bilateral popliteal arterial dissection.

    Science.gov (United States)

    Chen, Po-Liang; Ko, Shih-Yu; Tan, Ken-Hing

    2012-01-01

    A clinical feature of bilateral popliteal arterial dissection without involving the descending aorta, bilateral iliac, as well as femoral arteries has never been reported in the past literature. We report a 56-year-old man with hypertension and coronary artery disease who presented to our emergency department with complaints of bilateral knee pain after long-distance walking. Physical examination was notable for elevated blood pressure, but there was no palpable pulsation over dorsalis pedis arteries on his feet. Laboratory evaluation revealed a d-dimer level of 35.2 mg/L (FEU) on the day of the test and 1.2 mg/L one and a half months ago (normal level, <0.55). These findings were suggestive of a recent-onset peripheral arterial occlusive disorder. Computed tomography of the aorta showed bilateral popliteal arterial dissection with arterial intimal flap. Abdominal aorta, bilateral iliac, and femoral arteries remained intact with only arteriosclerotic change. Minimally invasive endovascular stent grafting was then performed. The patient had an uneventful recovery. PMID:21106320

  8. Escleritis posterior bilateral Bilateral posterior scleritis

    Directory of Open Access Journals (Sweden)

    A. Zurutuza

    2011-08-01

    Full Text Available La escleritis posterior es un proceso inflamatorio de la parte posterior de la esclera. Su prevalencia es muy baja y el diagnóstico puede resultar complicado por la ausencia de signos oculares externos. Es más frecuente en mujeres. Cuando aparece en pacientes jóvenes no suele tener otras patologías asociadas, pero en mayores de 55 años hasta un tercio de los casos tienen relación con alguna enfermedad sistémica, sobre todo la artritis reumatoide. El diagnóstico de esta patología puede requerir un abordaje multidisciplinar y la colaboración de oftalmólogos con neurólogos, internistas o reumatólogos. En este artículo se describe un caso de escleritis posterior bilateral idiopática.Posterior scleritis is an inflammatory process of the posterior part of the sclera. Its prevalence is very low and its diagnosis can be complicated due to the absence of external ocular signs. It is more frequent in women. In young patients it does not usually have other associated pathologies, but in those over 55 years nearly one-third of the cases have a relation with some systemic disease, above all rheumatoid arthritis. The diagnosis of this pathology can require a multidisciplinary approach and the collaboration of ophthalmologists with neurologists, internists or rheumatologists. This article describes a case of idiopathic bilateral posterior scleritis.

  9. Bilaterally Incarcerated Morgagni Hernia

    Directory of Open Access Journals (Sweden)

    Zuhal Demirhan Yananli

    2013-06-01

    Full Text Available Morgagni hernia is a rare congenital diaphragmatic hernia. It is seen rarely bilaterally. Patients are usually asymptomatic. Therefore, diagnosis may be delayed until adulthood. Significant morbidity can occur in case complications arise and diagnosis is delayed. The patient, a 74 year-old female, presented in this article, was admitted to the emergency department with abdominal pain, vomiting, and shortness of breath. The plain abdominal radiograph of the patient revealed bowel obstruction and suspicious appearence in favor of the diaphragmatic hernia on both sides of the sternum. Computed tomography revealed bilaterally incarcerated Morgagni hernia with strangulated omentum in the right side of the sternum and a part of colon in the left side of sternum. Incarcerated organs were withdrawn to peritoneal cavity and defects of hernia were sutured primarily on laparatomy. Because bilateral incarcerated Morgagni hernia can be seen rarely, this case was reported.

  10. Efficacy of bilateral pallidotomy.

    Science.gov (United States)

    Kim, R; Alterman, R; Kelly, P J; Fazzini, E; Eidelberg, D; Beric, A; Sterio, D

    1997-03-15

    Unilateral pallidotomy is a safe and effective treatment for medically refractory bradykinetic Parkinson's disease, especially in those patients with levodopa-induced dyskinesia and severe on-off fluctuations. The efficacy of bilateral pallidotomy is less certain. The authors completed 11 of 12 attempted bilateral pallidotomies among 150 patients undergoing pallidotomy at New York University. In all but one patient, the pallidotomies were separated by at least 9 months. Patients were selected for bilateral pallidotomy if they exhibited bilateral rigidity, bradykinesia, or levodopa-induced dyskinesia prior to treatment or if they exhibited disease progression contralateral to their previously treated side. The Unified Parkinson's Disease Rating Scale (UPDRS) and timed upper-extremity tasks of the Core Assessment Protocol for Intracerebral Transplantation (CAPIT) were administered to all 12 patients in the "off" state (12 hours without receiving medications) preoperatively and again at 6 and 12 months after each procedure. The median UPDRS and contralateral CAPIT scores improved 60% following the initial procedure (p = 0.008, Wilcoxon rank sums test). The second pallidotomy generated only an additional 10% improvement in the UPDRS and CAPIT scores ipsilateral to the original procedure (p = 0.05). Worsened speech was observed in two cases. In the 12th case, total speech arrest was noted during test stimulation. Speech returned within minutes after stimulation was halted. Lesioning was not performed. These results indicate that bilateral pallidotomy has a narrow therapeutic window. Motor improvement ipsilateral to the first lesion leaves little room for further improvement from the second lesion and the risk of speech deficit is greatly enhanced. Chronic pallidal stimulation contralateral to a previously successful pallidotomy may prove to be a safer alternative for the subset of patients who require bilateral procedures. PMID:15096015

  11. Clinical characteristics and prognosis of traumatic basal ganglia hematomas: A retrospective analysis of 40 cases

    Institute of Scientific and Technical Information of China (English)

    Jialiang Li; Chunjiang Yu

    2006-01-01

    30 minutes to 24 hours after injury in 37 cases, and delayed TBGH was diagnosed by serial CT reexamination at 24 to 48 hours after injury in 3 cases. Apart from the TBGH, signs of diffuse axonal injury (DAI) were observed in 22 cases and the criterion of CT diagnosis was that apart from TBGH, small hemorrhagic foci were found in the deep white matter of the hemisphere, corpus callosum, dorsolateral quadrants of the midbrain and the upper pons, internal capsule, basal ganglia area, intraventricle, and cerebellum, etc., but there was no obvious mass effect (clinically manifested by conscious disturbance immediately after brain injury, and primary coma lasted for longer than 6 hours). Secondary intraventricular hemorrhage occurred in 19 cases, acute subdural hematoma in 3 cases, acute epidural hematoma in 1 case, cerebral contusion in 7 cases, and diffuse cerebral swelling in 3 cases. TBGH located at contralateral to the side of impact in 29 cases. The volume of TBGH was 3-9 mL in 8 cases, 10-19 mL in 10 cases, 20-29 mL in 12 cases, and more than 30 mL in 9 cases. ④Ten patients underwent surgical treatment, including TBGH were evacuated by craniotomy in 7 cases, drained by drilling hole in 2 cases, and hematoma drainage combined with extraventricular drainage in 1 case. 30 patients received conservative treatment, including hyperbaric oxygen treatment in 22 cases. ⑤ At 6 months after injury, good recovery obtained in 10 cases (25%), moderately disabled in 17 cases (42.5%), severely disabled in 2 cases (5%) and dead in 11 cases (27.5%) respectively.CONCLUSION: In our study, the proportion of TBGH in closed brain injury was 3.2%, and it had a higher incidence of disability. Most of the patients were young people and injured in traffic accident, and TBGH mostly occurred at contralateral to the side of impact. The patients suffered from hemiplegia and long-term coma, incidence rate of diffuse axonal injury was higher, but conscious disturbance was milder

  12. Bilateral Primary Intraocular Lymphoma

    Directory of Open Access Journals (Sweden)

    Mehrdad Karimi

    2011-01-01

    Full Text Available Purpose: To report a case of bilateral primary intraocular lymphoma. Case report: A 33-year-old man presented with bilateral blurred vision since two years ago. Examination revealed large keratic precipitates, anterior chamber reaction, posterior subcapsular cataracts, and vitreous infiltration. After a short trial of topical and periocular steroids, diagnostic 25-gauge pars plana vitrectomy was performed and cytologic evaluation of the aspirate confirmed a diagnosis of intraocular lymphoma. The patient was subsequently managed with intravitreal methotrexate in both eyes and responded favorably. Central nervous system workup for lymphoma was negative. Conclusion: Primary intraocular lymphoma should be considered in young adults suffering from chronic recalcitrant panuveitis.

  13. Bilateral neck paragangliomas.

    Science.gov (United States)

    Mumoli, N; Cei, M; Pauletti, M; Ferrito, G; Scazzeri, F

    2009-10-01

    Paragangliomas of the head and neck are rare neoplasms presented as cervical mass, generally bilateral, that arise from chemoreceptors located at the carotid bifurcation (carotid body tumors), along the vagus nerve (vagal paragangliomas), and in the jugular fossa and tympanic cavity (jugulotympanic paragangliomas). They are typically asymptomatic at the beginning, highly vascular, slow-growing and compressing the surrounding anatomic structures. Only radical surgery is the curative treatment for paragangliomas. We present a case of a 62- year-old woman with a diagnosis of bilateral neck paragangliomas where surgical removal was judged burdened by excessive risk because of the size of the tumor. PMID:19622673

  14. BILATERAL IMMATURE OVARIAN TERATOMA

    OpenAIRE

    Vinay; Aditya Pratap; Chetan; Ramesh; Rajlaxmi Jaysing

    2014-01-01

    : Immature teratoma (IMT) is tumor composed of tissues from ectoderm, mesoderm and endoderm and is considered the second most common germ cell tumor. IMT account for 10-20% of all ovarian neoplasias in women less than 20 years of age, with peak incidence between 15 and 19 years old. IMT rarely occurs during menopause. We herein reporting a rare case in a 3 years old girl with bilateral immature ovarian teratoma which is very rare in bilateralism of tumor as well as the fac...

  15. BILATERAL IMMATURE OVARIAN TERATOMA

    Directory of Open Access Journals (Sweden)

    Vinay

    2014-10-01

    Full Text Available : Immature teratoma (IMT is tumor composed of tissues from ectoderm, mesoderm and endoderm and is considered the second most common germ cell tumor. IMT account for 10-20% of all ovarian neoplasias in women less than 20 years of age, with peak incidence between 15 and 19 years old. IMT rarely occurs during menopause. We herein reporting a rare case in a 3 years old girl with bilateral immature ovarian teratoma which is very rare in bilateralism of tumor as well as the fact that the patient age is below the average for the occurrence of these tumors.

  16. Bilateral akillesseneruptur hos nyretransplanterede

    DEFF Research Database (Denmark)

    Skovgaard, D; Feldt-Rasmussen, B F; Nimb, L;

    1996-01-01

    Increased incidence of tendinitis and tendon ruptures is reported in recipients of a kidney transplant. Two cases of bilateral achilles tendon rupture after minimal trauma are described. Tendon ruptures are more frequent in individuals with kidney disease in dialysis or after transplantation comp...

  17. Bilateral endogenous fungal endophthalmitis

    OpenAIRE

    Michal, Wilczynski; Olena, Wilczynska; Wojciech, Omulecki

    2013-01-01

    Endogenous endophthalmitis is a rare and severe intraocular infection which can be vision-threatening. We describe a case of bilateral fungal endogenous endophthalmitis in a 64-year-old male which was successfully treated with systemic administration of fluconazole followed by pars plana vitrectomy with an intravitreous injection of amphotericin B.

  18. Bilateral lunate intraosseous ganglia

    International Nuclear Information System (INIS)

    An intraosseous ganglion is a relatively uncommon, benign, cyst-like lesion that occurs in young and middle-aged adults. Most commonly seen adjacent to the hip, ankle, knee, or wrist, they are histologically identical to their soft tissue counterparts. A review of the literature revealed only two previously reported examples of bilateral symmetrical ganglia of the lunate bones. (orig.)

  19. Bilateral meandering pulmonary veins

    Energy Technology Data Exchange (ETDEWEB)

    Thupili, Chakradhar R.; Udayasankar, Unni [Pediatric Imaging, Imaging Institute Cleveland Clinic, Cleveland, OH (United States); Renapurkar, Rahul [Imaging Institute Cleveland Clinic, Thoracic Imaging, L10, Cleveland, OH (United States)

    2015-06-15

    Meandering pulmonary veins is a rare clinical entity that can be mistaken for more complex congenital syndromes such as hypogenetic lung syndrome. We report imaging findings in a rare incidentally detected case of bilateral meandering pulmonary veins. We briefly discuss the role of imaging in diagnosing this condition, with particular emphasis on contrast-enhanced CT. (orig.)

  20. The importance of serial CT scanning in the diagnosis and treatment of delayed traumatic intracerebral hematoma

    International Nuclear Information System (INIS)

    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. (author)

  1. Spontaneous cervical epidural hematoma: Report of a case managed conservatively

    Directory of Open Access Journals (Sweden)

    Halim Tariq

    2008-01-01

    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.

  2. Complete nonsurgical resolution of a spontaneous spinal epidural hematoma.

    Science.gov (United States)

    Silber, S H

    1996-07-01

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

  3. 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.)

  4. Dengue Fever With Rectus Sheath Hematoma: A Case Report

    OpenAIRE

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

    2014-01-01

    Dengue fever, also known as breakbone fever, is an infectious tropical disease caused by the Dengue virus. It is associated with a number of complications, which are well documented. However, Dengue fever associated with rectus sheath hematoma (RSH) is a very rare complication. Only one case report has been published prior supporting the association of Dengue fever with RSH. We report a case of Dengue fever who presented with RSH and was successfully treated conservatively. RSH is also an unc...

  5. Blunt Facial Trauma Causing Isolated Optic Nerve Hematoma

    Directory of Open Access Journals (Sweden)

    R. Parab

    2013-01-01

    Full Text Available Traumatic optic neuropathy is an uncommon, yet serious, result of facial trauma. The authors present a novel case of a 59-year-old gentleman who presented with an isolated blunt traumatic left optic nerve hematoma causing vision loss. There were no other injuries or fractures to report. This case highlights the importance of early recognition of this rare injury and reviews the current literature and management of traumatic optic neuropathy.

  6. Craniofacial trauma and double epidural hematomas from horse training ☆

    OpenAIRE

    Baugh, Aaron D.; Baugh, Reginald F.; Atallah, Joseph N.; Gaudin, Daniel; Williams, Mallory

    2013-01-01

    INTRODUCTION A case of complex poly-trauma requiring multi-service management of rare, diagnoses is reviewed. PRESENTATION OF CASE A healthy 20 year old female suffered double epidural hematoma, base of, skull fracture, traumatic cranial nerve X palsy, benign positional paroxysmal vertigo and supraorbital, neuralgia following equestrian injury. DISCUSSION Epidemiology, differential diagnosis, and principles of management for each condition, are reviewed. CONCLUSION Coordinated trauma care is ...

  7. Large Subcapsular Liver Hematoma Following Single-Incision Laparoscopic Cholecystectomy

    OpenAIRE

    Hansen, Adam J.; Augenstein, Julie; Ong, Evan S

    2011-01-01

    Background and Objectives: Many laparoscopic surgeons are now transitioning from standard multiple-port laparoscopic cholecystectomy to single-incision laparoscopic surgery (SILS) in an attempt to improve cosmetic outcomes and decrease postoperative morbidity. However, little has been published regarding the potential complications of SILS operations. Methods: We report the case of a patient undergoing SILS cholecystectomy who developed the complication of a large hepatic hematoma, resulting ...

  8. Acute pancreatitis and subdural haematoma in a patient with severe falciparum malaria: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Sathyendra Sowmya

    2008-05-01

    Full Text Available Abstract Plasmodium falciparum infection is known to be associated with a spectrum of systemic complications ranging from mild and self-limiting to life-threatening. This case report illustrates a patient who had a protracted course in hospital due to several rare complications of falciparum malaria. A 21-year old man presented with a five-day history of high-grade fever, jaundice and abdominal pain and a two-day history of altered conscious state. A diagnosis of severe falciparum malaria was made based on the clinical presentation and a positive blood smear with parasitaemia of 45%. Despite adequate anti-malarial therapy with artesunate, the patient had persistent and worsening abdominal pain. Investigations suggested a diagnosis of acute pancreatitis, a rare association with falciparum malaria. However, in spite of supportive therapy for acute pancreatitis and a 10-day course of intravenous artesunate and oral doxycycline at recommended doses, he continued to be febrile with peripheral blood smear showing persistence of ring forms. Antimalarial therapy was, therefore, changed to quinine on the suspicion of possible artesunate resistance. On the 17th day of stay in hospital, the patient developed generalized tonic-clonic seizures. Computerized tomography of the brain showed bilateral fronto-parietal subdural haematomas that were surgically drained. His fever persisted beyond 30-days despite broad-spectrum antibiotics, quinine therapy and negative malarial smears. A possibility of drug fever was considered and all drugs were ceased. He subsequently became afebrile and was discharged on the 38th hospital admission day. Recognition of complications and appropriate management at each stage facilitated successful outcome. This report has been presented to highlight the occurrence of several rare complications of falciparum malaria in the same patient.

  9. A Case of Spontaneous Spinal Epidural Hematoma Mimicking Stroke

    Directory of Open Access Journals (Sweden)

    Emine Rabia Koç

    2014-09-01

    Full Text Available Spontaneous spinal epidural hematoma is an uncommon cause of acute non-traumatic myelopathy and may present with various clinical phenotypes. Focal neurological symptoms can result in overlooking this differential diagnosis in patients presenting with neurological deficits and assuming the diagnosis of a stroke. Therefore, a thorough documentation of patient history is of great importance, since this can reveal symptoms suggestive of a different etiology. Here, we present a case of an 80-year-old female who was admitted with a hemiparesis without cortical or cranial neurological abnormalities. She mentioned of preceding shoulder and neck pain. Diagnosis of epidural hematoma was made by cervical magnetic resonance imaging. Symptoms resolved partially after surgical intervention. Our case illustrates the variation in the clinical presentation of spontaneous spinal epidural hematoma which can be misdiagnosed as stroke. Therefore, in patients with preceding neck, shoulder or interscapular pain and focal neurological deficits, this diagnosis should be included in the differential, particularly when cortical and cranial signs are lacking.

  10. Association of canine splenic hemangiosarcomas and hematomas with nodular lymphoid hyperplasia or siderotic nodules.

    Science.gov (United States)

    Cole, Patricia Ann

    2012-07-01

    Hemorrhagic splenic masses diagnosed as hemangioma or hemangiosarcoma were reviewed. Lymphoid hyperplasia was present in none of the hemangiosarcoma cases and in 27% of the hematoma cases. Siderotic nodules in the capsule or trabeculae were present in 25% of hemangiosarcoma cases and in 36% of hematoma cases. Hemoabdomen was noted in the clinical history of 54% of hemangiosarcoma cases and in 22% of hematoma cases. The average age (10.3 and 9.6 years, respectively), sex ratios (slightly more males), and most common breeds (Labrador Retriever, Golden Retriever, and German Shepherd Dog) were similar for the hemangiosarcoma and hematoma cases. Since lymphoid hyperplasia is much more common in cases of hematoma, the presence of this feature lends support to a diagnosis of hematoma rather than hemangiosarcoma. Signalment, history of hemoabdomen, and presence of siderotic nodules do not point to one diagnosis over the other. PMID:22621950

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

    Directory of Open Access Journals (Sweden)

    Viviana de la Caridad Sáez Cantero

    2010-12-01

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

  12. Radiation-induced bilateral cystic frontal lobe necroses demonstrating a fluid-blood level

    International Nuclear Information System (INIS)

    A 41-year-old male developed radiation-induced bilateral cystic frontal lobe necroses after irradiation for an olfactory neuroblastoma. Computed tomography (CT) and magnetic resonance (MR) imaging revealed the lesions, one containing a fluid-blood level on CT scans and niveau formation on MR images. It was proved to be a coagulated hematoma within the cyst at surgery. Such a fluid-blood level in a radiation-induced cyst has never been reported, although hemorrhage frequently accompanies delayed radiation necrosis. Positron emission tomography with multiple tracers may be useful in differentiating cerebral radiation necrosis from tumor recurrence, because of absence of abnormal tracer accumulation. (author)

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

    OpenAIRE

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

    2007-01-01

    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...

  14. Difficult Airway due to Retropharyngeal Hematoma after Stabbing to the Neck

    Directory of Open Access Journals (Sweden)

    Kouhei Iwashita

    2014-07-01

    Full Text Available Reports of retropharyngeal hematoma have been scarce in the anesthesiology literature. We report a patient whose trachea was difficult to intubate due to retropharyngeal hematoma after stabbing to the neck. A woman with a knife injury to the common carotid artery required emergency carotid arterioplasty. When tracheal intubation was attempted, marked swelling of the posterior pharyngeal wall made the vocal cords impossible to visualize. Preoperative computed tomography showed a retropharyngeal hematoma. The patient required mechanical ventilation for 2 days.

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

    OpenAIRE

    Christopher Caputo; Ziho Lee; Andrew Harbin; Daniel Eun

    2014-01-01

    We describe a case in which a patient with a past medical history of ovarian cancer received a diagnostic renal biopsy for an incidentally discovered renal mass. During left robotic partial nephrectomy (RPN), a perinephric hematoma was encountered. The hematoma was not present on preoperative imaging and was likely a result of the renal biopsy. The renal cell carcinoma (RCC) and the associated hematoma were widely excised with negative surgical margins. On follow-up imaging at five months pos...

  16. Bilateral intraocular dirofilariasis

    Directory of Open Access Journals (Sweden)

    Viney Gupta

    2014-01-01

    Full Text Available Ocular dirofilariasis mostly presents as a subconjunctival or eyelid lesion. [1] Intraocular dirofilarial infestation is rare. [2],[3] We report a case of a young woman who was accidentally detected to have a live motile worm in the anterior segment in one eye and a cystic lesion on the optic disc in the other eye. To our knowledge, bilateral intraocular dirofilariasis has never been reported.

  17. Bilateral ocular osseous choristomas

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Jeung Hee; Yoon, Dae Young; Choi, Chul Soon; Yoon, Eun Joo; Park, Sang Joon; Seo, Young Lan [Hallym University, Department of Radiology, Kangdong Sacred Heart Hospital, Seoul (Korea); Kim, Byoung Jin [Hallym University, Department of Ophthalmology, Kangdong Sacred Heart Hospital, Seoul (Korea)

    2005-11-01

    Choristoma is a benign tumour defined as normal tissue in an ectopic location. Osseous choristoma, one subtype of this entity, occurring within the orbit has rarely been reported in the world literature. We report a 6-year-old girl with bilateral ocular osseous choristomas who presented with palpable nodules protruding from both upper lids. The radiological and clinical findings are described and previous reports are reviewed. (orig.)

  18. Bilateral Integrative Medicine, Obviously

    OpenAIRE

    Shapiro, Simon J.; Stumpf, Steven H.

    2006-01-01

    Unstated and unacknowledged bias has a profound impact on the nature and implementation of integrative education models. Integrative education is the process of training conventional biomedical and traditional Chinese medicine practitioners in each tradition such that patient care may be effectively coordinated. A bilateral education model ensures that students in each tradition are cross-taught by experts from the ‘other’ tradition, imparting knowledge and values in unison. Acculturation is ...

  19. Bilateral lunate intraosseous ganglia

    Energy Technology Data Exchange (ETDEWEB)

    Pablos, J.M. [Department of Radiology, Hospital San Juan de Dios, Seville (Spain); Valdes, J.C. [Department of Radiology, Cemedi, Seville (Spain); Gavilan, F. [Department of Pathology, Hospital Universitario Virgen del Rocio, Seville (Spain)

    1998-12-01

    An intraosseous ganglion is a relatively uncommon, benign, cyst-like lesion that occurs in young and middle-aged adults. Most commonly seen adjacent to the hip, ankle, knee, or wrist, they are histologically identical to their soft tissue counterparts. A review of the literature revealed only two previously reported examples of bilateral symmetrical ganglia of the lunate bones. (orig.) With 3 figs., 10 refs.

  20. Compressive Bilateral Filtering.

    Science.gov (United States)

    Sugimoto, Kenjiro; Kamata, Sei-Ichiro

    2015-11-01

    This paper presents an efficient constant-time bilateral filter that produces a near-optimal performance tradeoff between approximate accuracy and computational complexity without any complicated parameter adjustment, called a compressive bilateral filter (CBLF). The constant-time means that the computational complexity is independent of its filter window size. Although many existing constant-time bilateral filters have been proposed step-by-step to pursue a more efficient performance tradeoff, they have less focused on the optimal tradeoff for their own frameworks. It is important to discuss this question, because it can reveal whether or not a constant-time algorithm still has plenty room for improvements of performance tradeoff. This paper tackles the question from a viewpoint of compressibility and highlights the fact that state-of-the-art algorithms have not yet touched the optimal tradeoff. The CBLF achieves a near-optimal performance tradeoff by two key ideas: 1) an approximate Gaussian range kernel through Fourier analysis and 2) a period length optimization. Experiments demonstrate that the CBLF significantly outperforms state-of-the-art algorithms in terms of approximate accuracy, computational complexity, and usability. PMID:26068315

  1. Hypertensive thalamic hematoma treated by CT stereotactic evacuation (with two cases reports)

    International Nuclear Information System (INIS)

    Objective: To investigate new surgical method to treat hypertensive thalamic hematoma. Methods: Two medial-degree coma patients with hypertensive thalamic hematoma were treated by CT stereotactic evacuation. Results: One week after operation the two patients regained consciousness. The function of paraplegic appendage restored partly, and one patient could take care of himself. Conclusion: CT stereotactic evacuation to treat hypertensive thalamic hematoma has the advantages of small trauma, little complication and good clinical results. The authors suggest that it be selected firstly in treating hypertensive thalamic hematoma

  2. Subchorionic hematomas in early pregnancy: clinical outcome and blood flow patterns.

    Science.gov (United States)

    Kurjak, A; Schulman, H; Zudenigo, D; Kupesic, S; Kos, M; Goldenberg, M

    1996-01-01

    A case control study of 59 women with subchorionic hematomas compared to 135 normally pregnant. Transvaginal ultrasound was used to image the pregnancy, and identify the site and size of the hematomas. Color flow Doppler was used to calculate velocity indices of the spiral arteries. More spontaneous abortions occurred in women with subchorionic hematomas (SCH). There was general correlation between gestational age, velocity indices, and hematoma size. There were 10 spontaneous abortions in the study group (17%) versus 9 (6.5%) in the controls (P = 0.02). Hematoma size did not affect outcome, but site did. Most hematomas associated with abortion were found in the corpus or fundus of the uterus, not in the supracervical area (P = 0.03). The presence of a hematoma did not affect the frequency of preterm delivery. In conclusion, subchorionic hematomas in early pregnancy are associated with an increased risk of spontaneous abortion. Flow disturbances are seen in the spiral arteries, but these are probably secondary effects. The critical factor is site of hematoma, not volume. PMID:8796766

  3. Non-Traumatic Subcapsular Spleen Hematoma in a Patient with Brucellosis

    Directory of Open Access Journals (Sweden)

    Murat Söker

    2005-01-01

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

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

    Science.gov (United States)

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

    2014-03-01

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

  5. Bilateral Testicular Epidermoid Cysts

    OpenAIRE

    Norman Loberant; Shweta Bhatt; Edward Messing; Dogra, Vikram S.

    2011-01-01

    Testicular epidermoid cysts are the most common benign tumors of the testes, but account for only 1-2% of all testicular tumors. In a young man presenting with a testicular mass, a high index of suspicion must be maintained for the malignant testicular germ cell tumor, which is 50-times more common than testicular epidermoid cyst. Bilateral testicular epidermoid cysts are a very rare condition, with only a few reports in the literature. It is extremely important in this condition to make a co...

  6. Computed tomography in epidural abscess, subdural empyema, meningitis, and brain abscess

    International Nuclear Information System (INIS)

    Computerised tomography cannot be of great help in diagnosing meningitis. Examination of the cerebrospinal fluid remains essential. After the inflammation of the meninges has progressed to some stage of encephalitis, the formation of an abscess can be located via computed tomography. It is characterised by the ring-type abscess capsule. Computed tomography for diagnostic purposes is superior to cerebral scanning, which demonstrates enhanced activity, but does not show the formation of a membrane, so essential for differential diagnosis. Furthermore, computed tomography shows the adjacent anatomical structures and answers the questions of displacements and threatening invasion of the ventricle system. Epidural and subdural abscesses can also be located by computed tomography. Therapy can begin directly after computerised tomography, whereas in scintigraphy only a non-specific enhanced activity is present, which often does not allow differentiation between epidural and subdural location. (orig.)

  7. Anatomy and development of the meninges: implications for subdural collections and CSF circulation

    Energy Technology Data Exchange (ETDEWEB)

    Mack, Julie [Penn State Hershey Medical Center, Department of Radiology, Hershey, PA (United States); Squier, Waney [John Radcliffe Hospital, Department of Neuropathology, Oxford (United Kingdom); Eastman, James T. [Lancaster General Hospital, Department of Pathology and Laboratory Medicine, Lancaster, PA (United States)

    2009-03-15

    The dura is traditionally viewed as a supportive fibrous covering of the brain containing the dural venous sinuses but otherwise devoid of vessels and lacking any specific function. However, review of the embryology and anatomy reveals the dura to be a complex, vascularized and innervated structure, not a simple fibrous covering. The dura contains an inner vascular plexus that is larger in the infant than in the adult, and this plexus likely plays a role in CSF absorption. This role could be particularly important in the infant whose arachnoid granulations are not completely developed. Although subdural hemorrhage is frequently traumatic, there are nontraumatic conditions associated with subdural hemorrhage, and the inner dural plexus is a likely source of bleeding in these nontraumatic circumstances. This review outlines the development and age-specific vascularity of the dura and offers an alternative perspective on the role of the dura in homeostasis of the central nervous system. (orig.)

  8. [Subdural empyema due to gemella morbillorum as a complication of acute sinusitis].

    Science.gov (United States)

    Boto, Leonor Reis; Calado, Cláudia; Vieira, Marisa; Camilo, Cristina; Abecasis, Francisco; Campos, Alexandre R; Correia, Manuela

    2011-01-01

    Subdural empyema is a life-threatening infection that may complicate acute sinusitis. The authors report the case of a previously healthy 10 year-old girl who presented with subdural empyema due to Gemella morbillorum after an untreated maxillary, ethmoidal and esphenoidal sinusitis. Despite immediate drainage of the empyema and underlying primary infection and treatment with broad spectrum antibiotics, she later developed frontal cerebritis and refractory intracranial hypertension, needing urgent decompressive craniectomy. She recovered gradually, maintaining to date slight right hemyparesis and aphasia. Even though it is considered a low virulence organism, G. morbillorum has been increasingly described in central nervous system infection. In this case, the prompt institution of broad spectrum antibiotics and surgical drainage, as well as the agressive treatment of complications, including decompressive craniectomy, were crucial to the patient's recovery. PMID:22015038

  9. Escherichia coli positive infratentorial subdural empyema secondary to mastoiditis and underlying cholesteatoma

    OpenAIRE

    Mirza, Omar; Varadarajan, Vinay; Youshani, Amir Saam; Willatt, David J

    2014-01-01

    Infratentorial subdural empyema is a neurosurgical emergency that is associated with an alarmingly high morbidity and mortality if appropriate management is delayed. It is an important differential to consider when confronted with a patient with a reduced Glasgow Coma Scale, focal neurology and symptoms of raised intracranial pressure in the presence of a head and neck infection. It is also important that the primary team managing these patients is aware of the many pathogens that may be invo...

  10. Dipole Source Analyses of Early Median Nerve SEP Components Obtained From Subdural Grid Recordings

    OpenAIRE

    Baumgärtner, Ulf; Vogel, Hagen; Ohara, Shinji; Treede, Rolf-Detlef; Lenz, Fred A.

    2010-01-01

    The median nerve N20 and P22 SEP components constitute the initial response of the primary somatosensory cortex to somatosensory stimulation of the upper extremity. Knowledge of the underlying generators is important both for basic understanding of the initial sequence of cortical activation and to identify landmarks for eloquent areas to spare in resection planning of cortex in epilepsy surgery. We now set out to localize the N20 and P22 using subdural grid recording with special emphasis on...

  11. Interhemispheric subdural empyema diagnosed by CT and cured by antibiotic therapy

    International Nuclear Information System (INIS)

    A case of interhemispheric subdural empyema cured by high doses of antibiotics was reported. A 23-year-old man was admitted with complaints of headache, fever and motor weakness of the left lower leg of 2 days' duration. The neurological examination revealed neck stiffness, motor weakness and sensory disturbance of left lower leg. The WBS count was 26,000/cumm, and ESR was 74 mm/hour. The CSF showed a pressure of 230 mm H2O and contained 1001/3 cells (63% polymorphonuclears, 37% lymphocytes) in association with slight elevation of protein but with normal sugar content. The CSF culture was negative. Administration of high doses of antibiotics was started on the first hospital day. On the fourth hospital day, Jacksonian seizures occurred in the left lower extremity, and were controlled by anticonvulsants. CT scans with contrast enhancement revealed an area of low density in the right interhemispheric space with irregular marginal enhancement. Right carotid arteriography demonstrated a small oval avascular space along the interhemispheric cistern. The abnormalities on CT scan disappeared after one month, when the patient was discharged without neurological deficit. Unlike the previously reported cases with interhemispheric subdural empyema commonly associated with a collection of pus over the cerebral convexities, a localized interhemispheric subdural empyema as was found in the present case appears to be a very rare condition. The interhemispheric subdural empyema has been thought to be exclusively surgical indication and, to the best of our knowlage, there is no report in the literature of a case with successful medical treatment. However, successful treatment by antibiotics alone may become more practical if the diagnoses could be made in the early stage with the aid of CT scan. (author)

  12. The Risk Factors for Hydrocephalus and Subdural Hygroma after Decompressive Craniectomy in Head Injured Patients

    OpenAIRE

    Ki, Hee Jong; Lee, Hyung-Jin; Lee, Hong-Jae; Yi, Jin-Seok; Yang, Ji-Ho; Lee, Il-Woo

    2015-01-01

    Objective The present study aims to investigate 1) the risk factors for hydrocephalus and subdural hygroma (SDG) occurring after decompressive craniectomy (DC), and 2) the association between the type of SDG and hydrocephalus. Methods We retrospectively reviewed the clinical and radiological features of 92 patients who underwent DC procedures after severe head injuries. The risk factors for developing post-traumatic hydrocephalus (PTH) and SDG were analyzed. Types of SDGs were classified acco...

  13. The fate of traumatic subdural hygroma in serial computed tomographic scans.

    OpenAIRE

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

    2000-01-01

    We reviewed serial computed tomographic (CT) scans of 58 patients with traumatic subdural hygroma (SDG) to investigate its natural history. All were re-evaluated with a special reference to the size and density of SDG. Thirty-four patients (58.6%) were managed conservatively and 24 patients (41.4%) underwent surgery. The lesion was described as remained, reduced, resolved, enlarged and changed. Means of interval from injury to diagnosis and any changes in CT were calculated. SDGs were resolve...

  14. Age related outcome in acute subdural haematoma following traumatic head injury.

    LENUS (Irish Health Repository)

    Hanif, S

    2009-09-01

    Acute subdural haematoma (ASDH) is one of the conditions most strongly associated with severe brain injury. Reports prior to 1980 describe overall mortality rates for acute subdural haematomas (SDH\\'s) ranging from 40% to 90% with poor outcomes observed in all age groups. Recently, improved results have been reported with rapid diagnosis and surgical treatment. The elderly are predisposed to bleeding due to normal cerebral atrophy related to aging, stretching the bridging veins from the dura. Prognosis in ASDH is associated with age, time from injury to treatment, presence of pupillary abnormalities, Glasgow Coma Score (GCS) or motor score on admission, immediate coma or lucid interval, computerized tomography findings (haematoma volume, degree of midline shift, associated intradural lesion, compression of basal cisterns), post-operative intracranial pressure and type of surgery. Advancing age is known to be a determinant of outcome in head injury. We present the results of a retrospective study carried out in Beaumont Hospital, Dublin, Ireland\\'s national neurosurgical centre. The aim of our study was to examine the impact of age on outcome in patients with ASDH following severe head injury. Only cases with acute subdural haematoma requiring surgical evacuation were recruited. Mortality was significantly higher in older patients (50% above 70 years, 25.6% between 40 and 70 years and 26% below 40 years). Overall poor outcome (defined as Glasgow outcome scores 3-5) was also higher in older patients; 74.1% above 70 years, 48% between 40 and 70 years and 30% below 40 years. Poor outcome in traumatic acute subdural haematoma is higher in elderly patients even after surgical intervention.

  15. Bilateral matrix-exponential distributions

    DEFF Research Database (Denmark)

    Bladt, Mogens; Esparza, Luz Judith R; Nielsen, Bo Friis

    2012-01-01

    In this article we define the classes of bilateral and multivariate bilateral matrix-exponential distributions. These distributions have support on the entire real space and have rational moment-generating functions. These distributions extend the class of bilateral phasetype distributions of [1......] and the class of multivariate matrix-exponential distributions of [9]. We prove a characterization theorem stating that a random variable has a bilateral multivariate distribution if and only if all linear combinations of the coordinates have a univariate bilateral matrix-exponential distribution. As...... an application we demonstrate that certain multivariate disions, which are governed by the underlying Markov jump process generating a phasetype distribution, have a bilateral matrix-exponential distribution at the time of absorption, see also [4]....

  16. Pregnancy Outcomes in Pregnant Women with Subchorionic Hematoma

    OpenAIRE

    Victoria V. Barinova; Anna V. Kovaleva; Maria P. Dmitrieva

    2015-01-01

    Background: The role of subchorionic hematoma (SCH) in the first trimester of pregnancy remains open for discussion. Some authors claim that SCH does not affect the pregnancy; others have found that it is a serious risk factor for adverse pregnancy outcome. The objective of the present study was to explore the outcomes of pregnancy in patients with SCH diagnosed in the first trimester. Methods and Results: The study involved 194 pregnant women who were in terms of 6 to12 weeks: 115 women w...

  17. Extensive spinal epidural hematoma: a rare complication of aortic coarctation

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-07-01

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

  18. Unusual Case of Overt Aortic Dissection Mimicking Aortic Intramural Hematoma.

    Science.gov (United States)

    Disha, Kushtrim; Kuntze, Thomas; Girdauskas, Evaldas

    2016-04-01

    We report an interesting case in which overt aortic dissection mimicked two episodes of aortic intramural hematoma (IMH) (Stanford A, DeBakey I). This took place over the course of four days and had a major influence on the surgical treatment strategy. The first episode of IMH regressed completely within 15 hours after it was clinically diagnosed and verified using imaging techniques. The recurrence of IMH was detected three days thereafter, resulting in an urgent surgical intervention. Overt aortic dissection with evidence of an intimal tear was diagnosed intraoperatively. PMID:27066437

  19. Pontine tegmentum hematoma: report of a case with pure hemiplegia

    Directory of Open Access Journals (Sweden)

    MILAGRES ANTONIO CARLOS DE PÁDUA

    1998-01-01

    Full Text Available 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.

  20. [Post-traumatic subdural hygroma: diagnostic conditions and therapeutic attitude in Gabon].

    Science.gov (United States)

    Loembe, P M; Ndong-Launay, M

    1989-01-01

    An excessive collection of cerebrospinal fluid in the subdural space is known as subdural hygroma, or hydroma. By far, the most common cause is severe cranial trauma. The diagnosis can be made by angiography or computer tomography and, with certainly, only by trephine or burr hole evacuation. 11 cases of post-traumatic subdural hygromas, mainly diagnosed during operative interventions, from April 1981 to September 1988, are reported. Most patients had acute forms of hygroma requiring acute surgical intervention. The acuteness could broken down as: coma (medium Glasgow coma scale: 6), lateralizing neurologic signs (4 cases) and temporal lobe herniation signs (7 cases). There were difficulties in obtaining angiographic studies. 10 patients underwent burr hole evacuation. Craniectomy was performed in one case. Time between cranial trauma and surgical intervention varied from 24 hours (6 cases) to 34 days. It appears that the prognosis is related to the extent of primary brain damage and not to the pressure exerted by the (usually) small mass lesion. The authors propose a clinical management of this lesion and hope for improvement in the diagnostic technics available. PMID:2808559

  1. Spinal Subdural Staphylococcus Aureus Abscess: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Fligou Fotini

    2009-08-01

    Full Text Available Abstract Background Only 65 cases (including our case of spinal subdural abscesses have been reported to the literature, mostly to the lumbar spine. Staphylococcus aureus is the most common bacterial. The symptoms are not caracteristic and contrast – enhanced magnetic resonance imaging scan (MRI is the imaging method of choice. The early diagnosis is crucial for the prognosis of the patient. Case presentation We present a patient 75 years old who had a history of diabetes and suffered acute low back pain in the region of the lumbar spine for the last 4 days before his admission to the hospital. He also experienced lower leg weakness, fever and neck stiffness. After having a brain CT scan and a lumbar puncture the patient hospitalized with the diagnosis of meningitis. Five days after his admission the diagnosis of subdural abscess secured with contrast – enhanced MRI but meanwhile the condition of the patient impaired with respiratory failure and quadriplegia and he was admitted to the ICU. A laminectomy was performed eight days after his admission into the hospital but unfortunately the patient died. Conclusion Early diagnosis and treatment are very important for the good outcome in patients with subdural abscess. Although morbidity and mortality are very high, surgical and antibiotic treatment should be established as soon as possible after the diagnosis has secured.

  2. CT findings and clinical analysis of subcortical hematomas in elderly patients

    International Nuclear Information System (INIS)

    Ten elderly patients (73-87 years, 78.4 years on the average) with subcortical hematomas were divided into two groups according to the shape of the hematoma on a CT scan: a lobulated group (6 patients) and a global group (4 patients). The lobulated group had a history of hypertension in one patient. The hematomas extended widely around the parietal lobe and were accompanied by perifocal edema, brain shifts and subarachnoid hemorrhages, deep consciousness disturbances, and poor prognosis of life and function. Amyloid depositions in the arteries around the hematomas were confirmed histologically in one patient. The global group had a history of hypertension in two patients. The hematomas were localized in the parietal, temporal, or occipital lobe without perifocal edema, brain shift and subarachnoid hemorrhages, and accompanied by mild consciousness disturbances. The life prognosis was good, but the functional prognosis was poor, with a subsequent development of dementia. A lobulated subcortical hematoma is thought to be due to amyloid angiopathy, while a global subcortical hematoma is thought to be due to hypertension. A surgical evacuation is seldom indicated for either type of subcortical hematoma in elderly patients. (author)

  3. Sonographic and radiological presentation of a hematoma of the duodenum: a case report

    International Nuclear Information System (INIS)

    Sonographic and radiological presentation of a hematoma of the duodenum: a case report. The authors reported a case of intramural hematoma of the third and fourth portions of the duodenum, investigated by ultrasonography and upper gastro-intestinal study. The diagnosis was suspected by ultrasonography and confirmed by the radiological examination. (author)

  4. CT scan and US evaluation of the traumatic duodenal intramural hematoma in childhood

    International Nuclear Information System (INIS)

    CT scan and ultrasonography were very effective in evaluating and following-up the traumatic duodenal intramural hematoma in a child (5-year-old boy). These two methods were demonstrated very useful not only for ditection of associated trauma but also for diagnosis and follow-up of the duodenal intramural hematoma. (author)

  5. Achondroplasia Associated with Bilateral Keratoconus

    OpenAIRE

    Samar A. Al-Swailem; Al Bin Ali, Ghada Y.; Al Katan, Hind M.; Al Mahmood, Ammar M.

    2012-01-01

    We report a rare case of bilateral keratoconus in association with achondroplasia. A 26-year-old male, with a known case of achondroplasia, complained of bilateral gradual deterioration in vision for the past few years. Slit lamp biomicroscopy showed bilateral central corneal protrusion and stromal thinning at the apex consistent with keratoconus. a trial of hard contact lens fitting failed to improve VA in the left eye (LE). Right eye (RE) improved to 20/25. The patient underwent penetrating...

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

    OpenAIRE

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

    2009-01-01

    CONTEXT: Although endoscopic esophageal variceal sclerotherapy has been largely supplanted by variceal band ligation, it is still performed routinely in many institutions, especially in developing countries. Intramural esophageal hematoma has been described as a rare complication of sclerotherapy. Risk factors have not been completely established. OBJECTIVE: To demonstrate the incidence of post-sclerotherapy intramural esophageal hematoma in our hospital and discuss the possible factors invol...

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

    International Nuclear Information System (INIS)

    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

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

    Directory of Open Access Journals (Sweden)

    John Baliah

    2015-01-01

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

  9. Head trauma and CT with reference to epidural hematoma

    International Nuclear Information System (INIS)

    Computed tomography (CT) is useful to detect lesions in patients with mild head trauma in its acute stage which may be followed by a lucid interval of hours to several days before exact diagnosis is made, or in serious patients with impairment in state of consciousness. Non-enhanced scan can determine the location of the lesion in 94% of patients with brain tumor, and enhanced scan can do in more than 98%. CT can reveal many anatomical changes due to trauma. Of these pathological changes, epidural hematoma is often caused by the damage of the middle meningeal artery or its branch. Therefore, CT should be performed if a bone-fracture line runs across the meningeal artery. CT is also applicable for the patients with some brain symptoms such as those who had not immediate post-traumatic unconsciousness but have developed impairment in state of consciousness after a lucid interval, or those who have persistent headache even if they have no impairment in stage of consciousness. In CT findings, the margin of hematoma and normal cerebral tissues is usually clear in acute causes but unclear in subacute cases. (Ueda, J.)

  10. Evaluation of Risk Factors for Rectus Sheath Hematoma.

    Science.gov (United States)

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

    2016-04-01

    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

  11. [Non-lethal brain stem hematomas in hypertensive patients].

    Science.gov (United States)

    Morel-Maroger, A; Metzger, J; Bories, J; Gardeur, D; Verger, J B; Noël, M C

    1982-01-01

    Brain stem hemorrhages (peduncular, pontine, medullary) were demonstrated by CT scan in hypertensive patients, the outcome being favorable without surgical intervention. Such lesions are considered as being usually massive and fatal. A review of the literature show that hemorrhages in the brain stem represent 5 to 9 p. cent of intraparenchymatous hemorrhages, and are usually located in the pons. A favorable course was known to occur before the use of computed tomography: the rare cases described were often related to subacute hematomas in young normotensive subjects which could be treated by surgery with or without ventricular shunting. Clinical diagnosis is based on the rapid progressive course of the disorder and the location of the lesion. Computed tomography provides an immediate correlation between anatomical and clinical findings, and allows a better evaluation of semiological and prognostic features that were previously considered well established. A major element appears to be the degree to which the hematoma is tolerated. As far as possible neurosurgical procedures should be avoided in hypertensive patients. PMID:7146726

  12. Bilateral Antepartum Mastitis

    Directory of Open Access Journals (Sweden)

    Peyman Alibeigi

    2010-12-01

    Full Text Available Antepartum mastitis is a rare condition, whereas postpartum orlactation mastitis is a common problem. This report introducesa case of complicated bilateral antepartum mastitis, which wastreated successfully by drain insertion and antibiotic therapy.The patient was a 23-year-old woman in the 23rd week of herfirst pregnancy. Her chief complaint was progressive swelling,redness and radicular pain in both breasts, which had beenstarted gradually from the 18th week of pregnancy. The patientwas admitted to hospital, and received oral and intravenous antibioticsempirically, which was not effective. The patient wastreated by drainage and oral antibiotic therapy. Based on theapproaches employed and the outcomes achieved it is suggestedthat early surgical insertion in the presence of fluid collection inantepartum mastitis will shorten hospitalization and course ofintravenous antibiotic therapy.Iran J Med Sci 2010; 35(4: 327-330.

  13. Idiopathic Bilateral Bloody Tearing

    Directory of Open Access Journals (Sweden)

    Emrullah Beyazyıldız

    2015-01-01

    Full Text Available Bloody tear is a rare and distinct clinic phenomenon. We report a case presenting with the complaint of recurrent episodes of bilateral bloody tearing. A 16-year-old girl presented to our clinic with complaint of bloody tearing in both eyes for 3 months. Bloody tearing was not associated with her menses. A blood-stained discharge from the punctum was not observed during the compression of both nasolacrimal ducts. Nasolacrimal passage was not obstructed. Imaging studies such as dacryocystography and gradient-echo magnetic resonance imaging (MRI of nasolacrimal canal were normal. Intranasal endoscopic evaluation was normal. We collected samples from bloody tears two times and pathological examination was performed. Pathological analysis showed lots of squamous cells and no endometrial cells; dysplastic cells were found. Further evaluations for underlying causes were unremarkable. No abnormalities were found in ophthalmologic, radiologic, and pathologic investigations. This condition is likely a rare abnormality and the least recognized aetiology for the idiopathic phenomenon.

  14. Isolated bilateral ectopic microspherophakia

    Directory of Open Access Journals (Sweden)

    André Omgbwa Eballe

    2010-02-01

    Full Text Available André Omgbwa Eballe1, Godefroy Koki2, Emilienne Epée2, Didier Owono2, Lucienne Bella Asumpta2, Côme Ebana Mvogo21Faculty of Medicine and Pharmaceuticals Sciences, University of Douala Cameroon; 2Faculty of Medicine and Biomedical Sciences, University of Yaoundé CameroonSummary: An eight-year-old school girl presented to us with a bilateral ectopic microspherophakia. She was surgically managed in the ophthalmology unit of the Gynaeco-Obstetric and Pediatric Hospital of Yaoundé in Cameroon. The postoperative follow up was uneventful, and the patient returned to school with a best corrected visual acuity of 4/10 in both eyes to the great satisfaction of her parents.Keywords: ectopic, microspherophakia, surgery

  15. Silicosis with bilateral spontaneous pneumothorax

    OpenAIRE

    Fotedar Sanjay; Chaudhary Dhruva; Singhla Vikas; Narang Rajat

    2010-01-01

    Presentation with simultaneous bilateral pneumothorax is uncommon and usually in the context of secondary spontaneous pneumothorax. The association of pneumothorax and silicosis is infrequent and most cases are unilateral. Bilateral pneumothorax in silicosis is very rare with just a few reports in medical literature.

  16. Silicosis with bilateral spontaneous pneumothorax

    Directory of Open Access Journals (Sweden)

    Fotedar Sanjay

    2010-01-01

    Full Text Available Presentation with simultaneous bilateral pneumothorax is uncommon and usually in the context of secondary spontaneous pneumothorax.The association of pneumothorax and silicosis is infrequent and most cases are unilateral. Bilateral pneumothorax in silicosis is very rare with just a few reports in medical literature.

  17. Bilateral, independent juvenile nasopharyngeal angiofibroma

    DEFF Research Database (Denmark)

    Mørkenborg, Marie-Louise; Frendø, M; Stavngaard, T;

    2015-01-01

    BACKGROUND: Juvenile nasopharyngeal angiofibroma is a benign, vascular tumour that primarily occurs in adolescent males. Despite its benign nature, aggressive growth patterns can cause potential life-threatening complications. Juvenile nasopharyngeal angiofibroma is normally unilateral, originati...... with bilateral symptoms. Our management, including successful pre-operative planning, enabled one-step total removal of both tumours and rapid patient recovery....... from the sphenopalatine artery, but bilateral symptoms can occur if a large tumour extends to the contralateral side of the nasopharynx. This paper presents the first reported case of true bilateral extensive juvenile nasopharyngeal angiofibroma involving clinically challenging pre-surgical planning...... bilateral embolisation. Radical removal performed as one-step, computer-assisted functional endoscopic sinus surgery was performed. The follow-up period was uncomplicated. CONCLUSION: This case illustrates the importance of suspecting bilateral juvenile nasopharyngeal angiofibroma in patients presenting...

  18. Traumatic hematomas in deep middle portion of the cerebrum case report

    International Nuclear Information System (INIS)

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

  19. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.

  1. [First manic episode in the elderly--consider a subdural haematoma due to head trauma as cause].

    Science.gov (United States)

    Marijnissen, Radboud M; Bakker, Miranda; Stek, Max L

    2010-01-01

    A manic episode in old age presents a diagnostic challenge to the clinician due to the different symptomatology often difficult to distinguish from delirium, dementia, agitated depression and psychosis. To complicate matters further, a first episode of mania in later life is very often based on underlying physical and cerebral pathology ('secondary mania'). Many causes of 'secondary mania', including neurological, systemic or endocrine diseases, infections, intoxications, apnoea, post-thoracic surgery and vitamin B12 deficiency have been described to date, but there have been no reports on subdural haematomas in this context. However, the elderly are more prone to subdural haematomas following head trauma than younger patients. We present two case reports of older patients with a first manic episode in later life probably caused by subdural haematomas. A first episode of mania in later life always requires thorough assessment of the patient to determine physical and cerebral pathology. PMID:20456795

  2. On the differential diagnosis of the abdominal aorta aneurysm and retroperitoneal paraaortal hematoma

    International Nuclear Information System (INIS)

    Chronic retroperitoneal paraaortal hematoma appeared to be a rare disease. Paraaortal hematoma should be differentiated from abdomen aorta aneurysm and retroperitoneal tumor, for it requires no surgical intervention. Computerized tomography CT was shown to be the most sensitive method in differential diagnosis. CT with intravenous contrast intensification displayed complete information on aorta size, its aneurysms, extention of the disease, degree of dissemination into adjacent blood vessels and tissues. Retention of contrast media in the vessels occurred with 5 min delay and the blood was shown to free from the contrast substance up to that moment. The phenomenon permitted to distinguish thrombosed aneurysm from paraaortal tumor or hematoma

  3. Elevated maternal serum alpha-fetoprotein levels in patients with subchorionic hematoma.

    Science.gov (United States)

    Kumbak, Banu; Sahin, Levent

    2010-07-01

    Subchorionic hematoma might be associated with poor pregnancy outcome. Two intra cytoplasmic sperm injection pregnancies complicated with subchorionic hematoma were found to have elevated mid-trimester maternal serum alpha-fetoprotein levels. One of them had miscarriage at 16 weeks' gestation and the other delivered a healthy baby by cesarean section. The valid interpretation of triple test result might be complicated by subchorionic hematoma. Therefore, it is better not to order triple test in such cases to avoid unnecessarily provoking the anxiety of the couple. PMID:19883262

  4. Massive subchorionic hematoma: peculiar prenatal images and review of the literature.

    Science.gov (United States)

    Nishijima, Koji; Shukunami, Ken-Ichi; Tsuyoshi, Hideaki; Orisaka, Makoto; Tajima, Kimihisa; Kurokawa, Tetsuji; Yoshida, Yoshio; Kotsuji, Fumikazu

    2005-01-01

    Massive subchorionic hematoma is a localized collection of blood or hematoma in the placenta, and can result in serious obstetrical complications. The condition can be diagnosed antenatally by ultrasound. However, no reports have previously described the same condition featuring an intraplacental fluid-fluid level on imaging studies. We report a case of massive subchorionic hematoma diagnosed prenatally, and propose an additional peculiar finding detectable on both the ultrasound and magnetic resonance images: the intraplacental fluid-fluid level. We also review previously reported cases that were detected by ultrasonography. PMID:15608455

  5. Neonatal adrenal hematoma with urinary tract infection: Risk factor or a chance association?

    Directory of Open Access Journals (Sweden)

    Abdelhadi M Habeb

    2014-01-01

    Full Text Available Neonatal adrenal hematoma is a rare finding that can be discovered incidentally or presents with various symptoms. However, urinary tract infection (UTI has not been reported in association with this condition. We report on a 4-week old child with massive unilateral adrenal hematoma discovered incidentally during a routine abdominal ultrasound scan for UTI. The mass resolved spontaneously after several months with no complications. The diagnosis and ma-nagement of infantile suprarenal mass and the possible link between this child′s UTI and the adrenal hematoma are discussed.

  6. Obturator Compartment Syndrome Secondary to Pelvic Hematoma After Robot-Assisted Laparoscopic Radical Prostatectomy

    Science.gov (United States)

    Song, Jun H.; Abbott, Daniel; Gewirtz, Eric; Hauck, Ellen; Eun, Daniel D.

    2016-01-01

    Abstract Obturator nerve injury is a known injury after robot-assisted laparoscopic radical prostatectomy (RALP) and patients often present with motor and sensory deficits in the immediate postoperative period. We describe a 65-year-old male who presented with motor deficits, indicative of obturator neurapraxia after RALP upon waking from anesthesia. Work-up revealed an expansile hematoma possibly compressing the obturator nerve. After evacuation of the hematoma, the patient had immediate improvement of his neurologic deficits. Our patient's clinical vignette illustrates the importance of considering postsurgical hematoma in the differential diagnosis when patients present with signs and symptoms of obturator neurapraxia after RALP.

  7. Langerhans' cell histiocytosis presenting with an intracranial epidural hematoma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, K.-W. [Department of Pediatrics, Loma Linda Children' s Hospital and University Medical Center, Loma Linda, CA (United States); McLeary, M.S. [Div. of Pediatric Radiology, Loma Linda Children' s Hospital and University Medical Center, Loma Linda, CA (United States); Zuppan, C.W. [Dept. of Pathology, Loma Linda Children' s Hospital and University Medical Center, Loma Linda, CA (United States); Won, D.J. [Div. of Pediatric Neurosurgery, Loma Linda University Children' s Hospital, Loma Linda, CA (United States)

    2000-05-01

    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.)

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Fujiwara, H.; Oki, K.; Momoshima, S.; Kuribayashi, S. [Keio Univ. School of Medicine (Japan). Dept. of Diagnostic Radiology and Dept. of Neurology

    2005-08-01

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

  10. Obturator Compartment Syndrome Secondary to Pelvic Hematoma After Robot-Assisted Laparoscopic Radical Prostatectomy.

    Science.gov (United States)

    Song, Jun H; Kaplan, Joshua R; Abbott, Daniel; Gewirtz, Eric; Hauck, Ellen; Eun, Daniel D

    2016-01-01

    Obturator nerve injury is a known injury after robot-assisted laparoscopic radical prostatectomy (RALP) and patients often present with motor and sensory deficits in the immediate postoperative period. We describe a 65-year-old male who presented with motor deficits, indicative of obturator neurapraxia after RALP upon waking from anesthesia. Work-up revealed an expansile hematoma possibly compressing the obturator nerve. After evacuation of the hematoma, the patient had immediate improvement of his neurologic deficits. Our patient's clinical vignette illustrates the importance of considering postsurgical hematoma in the differential diagnosis when patients present with signs and symptoms of obturator neurapraxia after RALP. PMID:27579444

  11. Endoscopy-assisted cerebral falx incision via unilateral approach for treatment of dissymmetric bilateral frontal contusion

    Institute of Scientific and Technical Information of China (English)

    DONG Ji-rong; HU Xu; XU Qin-yi; CAI Xue-jian; WANG Biao; WANG Yu-hai; SHI Zhong-hua; LIU Bing; CAI Sang; HE Jian-qing

    2012-01-01

    Objective: To investigate the clinical features and treatment strategy of dissymmetric bilateral frontal contusion,and to summarize our experience in treating these patients by minimally invasive surgery.Methods: Over the past 3 years,we have treated a total of 31 patients with dissymmetric bilateral frontal contusion using endoscopy-assisted unilateral cerebral falx incision.Other 30 patients treated by routine bilateral approaches within the same period were taken as control.Results: Seventeen cases (54.8%) in the unilateral operation group survived and were in good condition,8 (25.8%) had moderate disability,4 (12.9%) had severe disability,1 (3.2%) was in vegetative state,and 1 (3.2%) died.Compared with the control group,the Glasgow Outcome Scale score was not significantly different in the unilateral operation group,but the operation time,blood transfusion volume,the length of hospital stay,the incidences of mental disorder and olfactory nerve injury were greatly reduced in the unilateral operation group.Conclusions: Endoscopy-assisted unilateral cerebral falx incision can shorten the operation time,reduce surgical trauma and complications in treatment of patients with dissymmetric bilateral frontal contusion.It can obviously diminish the chance of delayed intracerebral hematoma and subsequently minimize the incidences of subfalcial and centrencephalic herniation.

  12. Massive subchorionic hematoma (Breus' mole) complicated by intrauterine growth retardation.

    Science.gov (United States)

    Nishida, N; Suzuki, S; Hamamura, Y; Igarashi, K; Hayashi, Z; Sawa, R; Yoneyama, Y; Asakura, H; Kawabata, K; Shima, Y; Shin, S; Araki, T

    2001-02-01

    We present here a case of massive subchorionic hematoma complicated by intrauterine growth retardation and oligohydramnios diagnosed at 22 weeks' gestation. The patient was managed with the following medications: (1) tocolysis with ritodrine infusion, (2) 10%maltose infusion therapy (1500mL/day), (3) antibiotic infusion (cefotaxim sodium, 2 g/dayx7) and (4) kampo therapy with Sairei-to until delivery. At 33 weeks and 0 days' gestation, a female baby weighing 1,342 g was delivered without complication by caesarean section. During surgery, an escape of about 500~600 g of dark brown blood with no clots was noted from the subchorionic space of the placenta. Examination of the placenta showed a large fibrosis with well-defined margins on the fetal surface. PMID:11180702

  13. Subchorionic hematoma associated with thrombophilia: report of three cases.

    Science.gov (United States)

    Heller, Debra S; Rush, Demaretta; Baergen, Rebecca N

    2003-01-01

    Subchorionic hematomas (SCHs) are associated with poor reproductive outcome including spontaneous abortions and stillbirth. Although many associations with maternal and prenatal factors have been reported, an underlying etiology has not been elucidated. We report three cases of SCHs associated with thrombophilias in the mother. One patient suffered a fetal demise at 30 wk gestational age, and two patients had second trimester losses. The mother of the 30-wk fetus was homozygous for mutations on the methylene-tetrahydrofolate reductase gene C677T. The other two patients had Protein S deficiency. SCHs may be associated with abnormal coagulative states suggesting that the underlying etiology of SCH may be related to hypercoagulability in the maternal circulation. The presence of a SCH may be the first indicator of an underlying thrombophilia and, thus, it is suggested that women who have placentas showing SCH should undergo a thrombophilia workup. PMID:12658542

  14. Hematoma extradural da fossa posterior: relato de sete casos

    Directory of Open Access Journals (Sweden)

    Mauro A. Oliveira

    1993-06-01

    Full Text Available Hematomas da fossa posterior são complicação incomum de traumatismo cra-nioencefálico. Quase invariavelmente eles ocorrem após traumatismo da região occipital e estão associados com fraturas de crânio. O diagnóstico e tratamento dessa patologia tem sido grandemente favorecido pela tomografia computadorizada. Na presente série, a maioria dos pacientes teve evolução aguda, indicando o risco potencial de um tratamento conservador. Nossos resultados (29% de mortalidade são similares àqueles previamente relatados para outras séries dessas lesões.

  15. Imaging management of spontaneous giant esophageal intramural hematoma

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-04-15

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

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

    Directory of Open Access Journals (Sweden)

    Wagner Pasqualini

    2012-09-01

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

  17. Acute silicosis with bilateral pneumothorax.

    Science.gov (United States)

    Srivastava, G N; Prasad, Rajniti; Meena, Manoj; Hussain, Moosa

    2014-01-01

    We present a case of acute silicosis with bilateral pneumothorax of a 28-year-old man working at a stone crusher factory for 1 year. He presented to the emergency department with cough, respiratory distress and diffuse chest pain. The patient was managed with bilateral intercostal tube drainage under water seal, oxygen inhalation and conservative therapy. On follow-up he showed improvement of resting dyspnoea and was doing well. This case is being reported because of the rare complications of acute silicosis as bilateral pneumothorax. PMID:24862410

  18. MR imaging of epidural hematoma in the lumbar spine

    International Nuclear Information System (INIS)

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

  19. MR imaging of epidural hematoma in the lumbar spine

    Energy Technology Data Exchange (ETDEWEB)

    Dorsay, Theodore A.; Helms, Clyde A. [Duke University Medical Center, Department of Radiology, Erwin Road, Room 1504, Durham, NC 27710 (United States)

    2002-12-01

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

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

    OpenAIRE

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

    2007-01-01

    JUSTIFICATIVA E OBJETIVOS: O hematoma associado à compressão espinhal após anestesia peridural é uma complicação neurológica grave, apesar da pequena incidência relatada (1:150.000). É um episódio agudo, e o tratamento tradicionalmente aplicado é a descompressão cirúrgica de urgência. Mais recentemente, em casos específicos, o tratamento com corticosteróide tem sido aplicado como alternativa, com boa recuperação neurológica. O objetivo deste relato foi expor um caso de hematoma peridural com ...

  1. Hyperacute spinal subdural haematoma as a complication of lumbar spinal anaesthesia: MRI

    International Nuclear Information System (INIS)

    We report two cases of hyperacute spinal subdural haematoma secondary to lumbar spinal anaesthesia, identified with MRI. Prompt diagnosis of this infrequent, potentially serious complication of spinal anaesthesia is essential, as early surgical evacuation may be needed. Suggestive MRI findings in this early phase include diffuse occupation filling of the spinal canal with poor delineation of the spinal cord on T1-weighted images, and a poorly-defined high-signal lesion with a low-signal rim on T2-weighted images. (orig.)

  2. Bilateral support programmes

    International Nuclear Information System (INIS)

    In the Russian Federation, serious consideration is being given to the safety of nuclear facilities and to security of nuclear material. One important factor in ensuring security of nuclear material and facilities is physical protection. The Ministry of Atomic Energy of the Russian Federation is making great efforts to improve physical protection of nuclear facilities. Some of the measures which are being implemented to improve physical protection are being carried out in the framework of international co-operation in this field. To date, the Russian Federation has established bilateral co-operation with the United States of America, Germany, Belgium, France and Finland, and has studied and taken account of the experience of foreign countries in the field of physical protection and nuclear material accounting and control. At present, over 20 enterprises of the Ministry of Atomic Energy of the Russian Federation representing all the main branches of the nuclear activities of the Ministry are involved in international co-operation on physical protection and nuclear material accounting and control. The main branches of this co-operation are as follows: Scientific and technical co-operation; production of a conceptual design to improve physical protection systems directly at nuclear risk facilities; swift improvement of physical protection (without developing design documentation for the nuclear risk facility as a whole); reinforcement of physical protection during the transport of nuclear material; and training of staff at nuclear risk facilities. During this work, many facilities were equipped with modern physical protection and with nuclear material accounting and control equipment. The Ministry of Atomic Energy of the Russian Federation is pleased with the results of this international co-operation and feels that it should continue. (author)

  3. Bilateral internal laryngoceles mimicking asthma.

    Science.gov (United States)

    Aksoy, Elif A; Elsürer, Cağdaş; Serin, Gediz M; Unal, O Faruk

    2013-05-01

    Laryngocele is an air-filled, abnormal dilation of the laryngeal saccule that extends upward within the false vocal fold, in communication with the laryngeal lumen. A case of 43-year-old male with bilateral internal laryngoceles, who has been treated as asthma for 4 years, is presented. The patient had dyspnea, cough, and excessive phlegm for a month and a late onset stridor. Flexible nasopharyngolaryngoscopy showed bilateral cystic enlargements of the false vocal folds and true vocal folds could not be visualized. Laryngeal CT without contrast enhancement showed bilateral internal laryngoceles. Submucosal total excision of bilateral cystic masses including parts of false vocal folds was performed. The symptoms resolved immediately after surgery. Although the incidence of internal laryngocele is rare, it should be remembered in the differential diagnosis of upper airway problems and diagnostic flexible nasopharnygolaryngoscopy is routinely indicated for airway evaluation in at-risk patients. PMID:24174956

  4. Bilateral internal laryngoceles mimicking asthma

    Directory of Open Access Journals (Sweden)

    Elif A Aksoy

    2013-01-01

    Full Text Available Laryngocele is an air-filled, abnormal dilation of the laryngeal saccule that extends upward within the false vocal fold, in communication with the laryngeal lumen. A case of 43-year-old male with bilateral internal laryngoceles, who has been treated as asthma for 4 years, is presented. The patient had dyspnea, cough, and excessive phlegm for a month and a late onset stridor. Flexible nasopharyngolaryngoscopy showed bilateral cystic enlargements of the false vocal folds and true vocal folds could not be visualized. Laryngeal CT without contrast enhancement showed bilateral internal laryngoceles. Submucosal total excision of bilateral cystic masses including parts of false vocal folds was performed. The symptoms resolved immediately after surgery. Although the incidence of internal laryngocele is rare, it should be remembered in the differential diagnosis of upper airway problems and diagnostic flexible nasopharnygolaryngoscopy is routinely indicated for airway evaluation in at-risk patients.

  5. Bilateral Polydactyly in a foal

    OpenAIRE

    Carstanjen, Bianca; Abitbol, Marie; Desbois, Christophe

    2007-01-01

    The following case report describes the diagnosis and surgery of bilateral polydactyly of unknown origin in a colt. A 7-month-old Berber colt was referred for cosmetic and curative excision of supernumerary digits. Radiographic examination revealed bilateral polydactyly and well-developed first carpal bones. Surgery consisted of an osteotomy of both second metacarpal bones combined with an amputation of the supernumerary digits. The follow-up at 18 months after surgery revealed a sound horse ...

  6. Bilateral cleft lip nasal deformity

    OpenAIRE

    Singh Arun; Nandini R.

    2009-01-01

    Bilateral cleft lip nose deformity is a multi-factorial and complex deformity which tends to aggravate with growth of the child, if not attended surgically. The goals of primary bilateral cleft lip nose surgery are, closure of the nasal floor and sill, lengthening of the columella, repositioning of the alar base, achieving nasal tip projection, repositioning of the lower lateral cartilages, and reorienting the nares from horizontal to oblique position. The multiplicity of procedures in the li...

  7. Safety of sonographically guided aspiration of intramuscular, bursal, articular and subcutaneous hematomas

    International Nuclear Information System (INIS)

    Objective: To evaluate the safety and efficacy of sonographically guided aspiration of intramuscular, bursal and subcutaneous hematomas. Materials and methods: One hundred eleven interventions were performed in 75 patients at a single institution from January 2005 to December 2009. In all cases the target of interest was identified with ultrasonography. Results: Ninety-six procedures (87.3%) were successful, 14 procedures (12.7%) were unsuccessful due to excessive density and/or viscosity of the content. No significant complications were encountered during or immediately after any procedure. Clinical follow-up records were available for 73 (75%) procedures in 45 (66%) patients, 30 patients did not return for follow-up after hematoma evacuation. No septic or hemorrhagic complications or cases of neurovascular compromise were recorded. Conclusions: Sonographically guided hematoma evacuation is a safe procedure. However, the proportion of unsuccessful evacuations and hematoma recurrence is substantial.

  8. Long-term prognosis of pregnancies in women with intrauterine hematomas.

    Science.gov (United States)

    Børlum, K G; Thomsen, A; Clausen, I; Eriksen, G

    1989-08-01

    To evaluate the long-term significance of intrauterine hematomas in patients with threatened abortion, 380 women with a living fetus of more than 8 weeks were studied. On ultrasound, intrauterine hematomas, defined as an echo-poor subchorionic collection, were found in 86 women. Two hundred ninety-four patients without hematomas served as controls. The rate of miscarriage was significantly increased in the study group (22.1 versus 8.2%; P less than .05). Patients discharged from the initial hospitalization without aborting still had a higher abortion risk than controls (16.3 versus 5.6%; P less than .05). Second-trimester debut of symptoms was followed more often by preterm delivery. Thus, patients with intrauterine hematomas continue to be a high-risk group for the remainder of their pregnancies. PMID:2664611

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

    Directory of Open Access Journals (Sweden)

    Ciceri David P

    2007-03-01

    Full Text Available 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 vertebra and was diagnosed with a left brachial plexopathy. The patient underwent emergent awake fiberoptic endotracheal intubation to provide a definitive airway. Conclusion Retropharyngeal hematoma with life-threatening airway compromise can develop hours or days after a precipitating injury. Clinicians should be alert to the potential for this delayed airway collapse, and should also be prepared to rapidly secure the airway in this patient population likely to have concomitant cervical spinal or head injuries.

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  12. Spontaneous ventral spinal epidural hematoma in a child: A case report and review of literature.

    Science.gov (United States)

    Ratre, Shailendra; Yadav, Yadram; Choudhary, Sushma; Parihar, Vijay

    2016-01-01

    Spontaneous spinal epidural hematoma is very uncommon cause of spinal cord compression. It is extremely rare in children and is mostly located in dorsal epidural space. Ventral spontaneous spinal epidural hematoma (SSEH) is even rarer, with only four previous reports in childrens. We are reporting fifth such case in a 14 year old male child. He presented with history of sudden onset weakness and sensory loss in both lower limbs with bladder bowel involvment since 15 days. There was no history of trauma or bleeding diasthesis. On clinical examination he had spastic paraplegia. Magnetic resonance imaging (MRI) of dorsal spine was suggestive of ventral spinal epidural hematoma extending from first to sixth dorsal vertebrae. Laminectomy of fourth and fifth dorsal vertebrae and complete evacuation of hematoma was done on the same day of admission. Postoperatively the neurological status was same. PMID:27114667

  13. Simultaneous Bilateral Ophthalmic Artery Chemosurgery for Bilateral Retinoblastoma (Tandem Therapy)

    Science.gov (United States)

    Abramson, David H.; Marr, Brian P.; Francis, Jasmine H.; Dunkel, Ira J.; Fabius, Armida W. M.; Brodie, Scott E.; Mondesire-Crump, Ijah; Gobin, Y. Pierre

    2016-01-01

    Objective Report on the 7-year experience with bilateral ophthalmic artery chemosurgery (OAC-Tandem therapy) for bilateral retinoblastoma. Design Retrospective, single institution study. Subjects 120 eyes of 60 children with bilateral retinoblastoma treated since March 2008. Methods Retrospective review of all children treated at Memorial Sloan Kettering with bilateral ophthalmic artery chemosurgery (Melphalan, Carboplatin, Topotecan, Methotrexate) delivered in the same initial session to both naïve and previously treated eyes. Main Outcome Measures Ocular survival, metastatic disease, patient survival from metastases, second cancers, systemic adverse effects, need for transfusion of blood products, electroretinogram before and after treatment. Results 116 eyes were salvaged (4 eyes were enucleated: 3 because of progressive disease, 1 family choice). Kaplan Meier ocular survival was 99.2% at one year, 96.9% at 2 and 3 years and 94.9% for years 4 through 7. There were no cases of metastatic disease or metastatic deaths with a mean follow-up of 3.01 years. Two children developed second cancers (both pineoblastoma) and one of them died. Transfusion of blood products was required in 3 cases (4 transfusions), 1.9%. Two children developed fever/neutropenia requiring hospitalization (0.95%). ERGs were improved in 21.6% and unchanged after treatment in 52.5% of cases (increase or decrease of less than 25μV). Conclusions Bilateral ophthalmic artery chemosurgery is a safe and effective technique for managing bilateral retinoblastoma-even when eyes are advanced bilaterally, and if both eyes have progressed after systemic chemotherapy. Ocular survival was excellent (94.9% at 8 years), there were no cases of of metastatic disease and no deaths from metastatic disease, but children remain at risk for second cancers. In 21.6% of cases ERG function improved. Despite using chemotherapy in both eyes in the same session, systemic toxicity was low. PMID:27258771

  14. Symptoms of an Intrauterine Hematoma Associated with Pregnancy Complications: A Systematic Review

    OpenAIRE

    Xiang, Lan; Wei, Zhaolian; Cao, Yunxia

    2014-01-01

    Objective To evaluate the predictive value of the symptoms of an intrauterine hematoma (IUH) for adverse pregnancy outcomes. Methods A literature review was performed with the search terms, including intrauterine/subchorionic/retroplacental/subplacental hematoma/hemorrhage/bleeding/collection/fluid, covering the period from January, 1981 to January, 2014. We just focused on the pregnancy outcomes associated with different symptoms of an IUH. Results It is generally agreed that a retroplacenta...

  15. Preterm delivery risk among pregnancies with history of first trimester vaginal bleeding and intrauterin hematoma

    OpenAIRE

    ULUĞ, Ulun; Jozwiak, Esra Aksoy; TOSUN, Süleyman; BAHÇECİ, Mustafa

    2006-01-01

    Aim:Vaginal bleeding during the first trimester is considered as threatened abortion. Vaginal bleeding can be associated by sonographic demonstration of subchorionic hematoma. This study evaluates the risk of preterm delivery among pregnancies with a history of intrauterin hematoma with vaginal bleeding during the first trimester. Materials and Methods: The files of singleton pregnancies followed up at our center between 2001 and 2003 were retrospectively evaluated. Gestations with vaginal bl...

  16. Chronic pure radiculopathy in patient with organizing epidural hematoma around C8 nerve root

    OpenAIRE

    Kim, Sang-Hyuk; Jeon, Sang-ho; Cho, Jae-lim; Chong, Hung-tae; Kim, Dong-Jun; Kim, Moon-Chan; Eun, Jong-Pil

    2012-01-01

    Spontaneously occurring spinal epidural hematomas are uncommon clinical findings, and the chronic form is the rarest and its most frequent location is the lumbar spine. Pure radicular involvement is far less frequent than myelopathy. We report a case of progressive radiculopathy in a 52-year-old man with spontaneously occurring cervical epidural hematoma (SCEH). The patient had left hand weakness and numbness for 4 months. MRI scan showed small space-occupying lesion around left 8th cervical ...

  17. Rectus sheath hematoma with low molecular weight heparin administration: a case series

    OpenAIRE

    Sullivan, Laura E J; Wortham, Dale C.; Litton, Kayleigh M

    2014-01-01

    Background Rectus sheath hematoma is an uncommon but potentially serious bleeding complication that can occur spontaneously or as a result of anticoagulation administration. Case presentation Case number one: A 62 year old chronically ill Caucasian female develops a rectus sheath hematoma seven days after hospital discharge. The previous hospitalization included low molecular weight heparin administration for deep vein thrombosis prophylaxis. The patient ultimately chooses comfort care and ex...

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

    OpenAIRE

    Patricia Chang; Monica Vanesa Vásquez Acajabón

    2014-01-01

    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...

  19. Hypertensive intracranial hematomas: endoscopic-assisted keyhole evacuation and application of patent viewing dissector

    Institute of Scientific and Technical Information of China (English)

    邱永明; 林毅兴; 田鑫; 罗其中

    2003-01-01

    Objective To study the effect of endoscopic-assisted keyhole operation (EAKO) on treating hypertensive intracranial hematomas and the value of our patent dissector appli ed during the operation.Methods A total of 25 patients with hypertensive intracranial hematomas underwent endos copic-assisted keyhole evacuation, during which, the viewing dissector, which h ad recently achieved national patent, was connected to the tip of endoscope and used to help dissect hematomas. The outcome of this procedure were compared wit h those of 22 comparable cases undergone conventional surgical treatment (large or smaller craniotomy). The items for comparison included the volum e of remaining hematoma, the duration of operation, postsurgical Glasgow Coma Sc ale (GCS) and Glasgow Outcome Scale (GOS).Results Remaining hematoma was ascertained 48 h after operation with the use of computerized tomography (CT) scans. In the case of EAKO, nearly complete evacuation (>84%) was achieved in 21 cases; GCS was evaluated at 7 d postsurgery result ing in GCS >12 in 9 patients, GCS 9-12 in 12 patients and GCS <9 in 4 patients. The follow-up period ranged from 6 to 21 mon. GOS was estimated at half a year and good recovery rate as defined by GOS was assigned to 76% of the EAKO pa tients. There are significant differences in the volumes of remaining hematomas and the duration of operation between the EAKO and craniotomy group (P<0.0 5). In addition, better clinical outcomes were obtained in EAKO. Conclusion EAKO has the advantage of being minimally invasive, improving surgical results and the prognosis of hypertensive intracranial hematoma patients. We conclude th at keyhole operation is a safe, effective alternative for removal of hypertensiv e intracranial hematoma, particularly during acute stages.

  20. Spontaneous Ventral Spinal Epidural Hematoma in an Infant: An Unusual Presentation

    OpenAIRE

    Abbas, Asad; AFZAL, Kamran; Athar A. MUJEEB; Tabassum SHAHAB; Khalid, Mohd.

    2013-01-01

    How to Cite This Article: Abbad A, Afzal K, Mujeeb AA, Shahab T, Khalid M. Spontaneous Ventral Spinal Epidural Hematoma in an Infant: An Unusual Presentation. Iran J Child Neurol. 2013  Spring;7(2):47-50.Abstract Spontaneous ventral spinal epidural hematomas are extremely rare in children and clinically recognized by the appearance of acute asymmetric focal motor and sensory involvement. In infants, the initial presenting symptoms are very non-specific and irritability is often the only initi...

  1. The effect of topical applications performed after subcutaneous heparin injection on development of bruise and hematoma

    OpenAIRE

    Mehtap Dursun; Reva Balci Akpinar

    2014-01-01

    Objective: Bruising and hematoma, which appear after the subcutaneous heparin injection, are local side effects of heparin. The purpose of this study was to investigate the effect of Vitamin K, adrenaline, and aluminum-potassium-sulphate, which are topically administered on injection area, on development of the bruising and the hematoma caused by the subcutaneous heparin injection. Material and Method: The study was conducted as single group post-test experimental model with control group....

  2. Time Course of Early Postadmission Hematoma Expansion in Spontaneous Intracerebral Hemorrhage

    DEFF Research Database (Denmark)

    Ovesen, Christian; Christensen, Anders Fogh; Krieger, Derk W;

    2014-01-01

    BACKGROUND AND PURPOSE: Early hematoma expansion (EHE) in patients with intracerebral hematoma is a promising treatment target. To date, the time course of EHE has remained poorly described. We prospectively investigated the time course of EHE. METHODS: We included consecutive patients presenting...... occurred within the first 7 to 8 hours after symptom onset. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT01472224....

  3. Conservative treatment of type B aortic intramural hematoma with no calcification

    International Nuclear Information System (INIS)

    Objective: To investigate the effect of conservative treatment for type B aortic intramural hematoma with no calcification, and to discuss the medium-term follow-up results. Methods: During the period from March 2009 to March 2012, a total of 21 patients with type B aortic intramural hematoma without calcification on the aortic wall were admitted to authors' hospital. The diagnosis was confirmed by CT angiography in all patients. Drug therapy was carried out in all the 21 patients, and all the patients were followed up for one year. At 3, 6 and 12 months after the treatment, CT angiography of the aorta was performed to check the results. Results: Of the 21 patients, one received TEVAR therapy one week after the start of drug therapy and the remaining 20 accomplished the whole medication course. At the time of discharge, all the patients were asymptomatic. All the patients were alive up to the end of the following-up period and no recurrence was observed. Three months after the treatment, complete disappearance of the left pleural effusion was obtained in 11 patients, and complete absorption of the intramural hematoma was seen in 3 patients. Six months after the treatment, complete absorption of the intramural hematoma was found in 13 cases. One year after the treatment, complete absorption of the intramural hematoma was confirmed in 19 patients, and in the remaining two patients both the thickness and extent of the intramural hematoma were markedly improved. Conclusion: It is easy to determine whether there is calcification or not in aortic wall of the diseased segment in patients with Stanford type B aortic intramural hematoma. Strict conservative treatment has satisfactory medium-term therapeutic results for type B aortic intramural hematoma with no calcification on the aortic wall. (authors)

  4. Treatment Outcomes of Auricular Hematoma Using Corrugated Rubber Drains: A Pilot Study

    OpenAIRE

    Okolugbo, NE

    2013-01-01

    Background: Hematoma of the auricle which is a collection of blood beneath the perichondrial layer of the pinna usually poses a challenge to the otolaryngologist due to its high rate of recurrence after treatment and lack of appropriate material for use as stitch dressing especially, in the developing world. This is a Pilot study in which corrugated rubber drain was used as a stitch dressing after routine incision and drainage (I and D) in patients who presented with auricular hematoma. Aim: ...

  5. Spontaneous ventral spinal epidural hematoma in a child: A case report and review of literature

    OpenAIRE

    Shailendra Ratre; Yadram Yadav; Sushma Choudhary; Vijay Parihar

    2016-01-01

    Spontaneous spinal epidural hematoma is very uncommon cause of spinal cord compression. It is extremely rare in children and is mostly located in dorsal epidural space. Ventral spontaneous spinal epidural hematoma (SSEH) is even rarer, with only four previous reports in childrens. We are reporting fifth such case in a 14 year old male child. He presented with history of sudden onset weakness and sensory loss in both lower limbs with bladder bowel involvment since 15 days. There was no history...

  6. Nasalseptal hematoma/abscess: management and outcome in a tertiary hospital of a developing country

    Directory of Open Access Journals (Sweden)

    Nwosu JN

    2015-07-01

    Full Text Available Jones N Nwosu, Peter C NnadedeDepartment of Otolaryngology, University of Nigeria Teaching Hospital, Enugu, NigeriaBackground: Nasal hematoma/abscess is an uncommon entity, but capable of leading to serious consequences if not handled meticulously, and with urgency.Objective: To present the management, and outcome of nasal septal hematoma/abscess in a Nigerian tertiary institution.Method: Consecutive patients diagnosed with nasal septal hematoma/abscess over a 10-year period, treated at the University of Nigeria Teaching Hospital, Enugu, Nigeria, were prospectively studied. The processes leading to diagnosis, treatment, and outcome were sequentially evaluated.Results: Fifty-three patients (37 males and 16 females, age 5–65 years (with mean age of 23.10 years, were included. Surgical drainage of the hematoma/abscess, intranasal packing with insertion of drain was performed with total resolution of problem in all the cases.Conclusion: Incision and drainage, and intranasal packing with insertion of drain was effective in treating nasal septal hematoma/abscess.Keywords: septal hematoma, abscess, facial deformity

  7. Psychological barriers in long term non-operative treatment of retroperitoneal hematoma

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    Bogdan Socea

    2015-04-01

    Full Text Available The retroperitoneal hematoma can have, mainly, a traumatic etiology - blunt abdominal trauma (falls from height, road accidents, aggression of any kind, etc., or open (incised wounds, puncture, penetration or gunshot wounds. Ruptured arterial aneurysms can cause hemorrhage in the retroperitoneal space. There is also spontaneous retroperitoneal trauma in patients with chronic treatment with anticoagulant or antiaggregant drugs (1. Hemorrhage in the retroperitoneal space can be iatrogenic, after surgical, open or laparoscopic, interventions (2, 3. A particular type of retroperitoneal hematoma is the psoas muscle hematoma in patients with chronic oral anticoagulant treatment (Acenocumarol, Warfarin. The management of the retroperitoneal hematoma, whatever the cause may be, is, for most of the time, difficult. In case of traumatic etiology, the retroperitoneal hematoma is not the only lesion, being frequently associated with severe hollow or parenchymal organs injury or vascular lesions, which highlights the importance of a complete and precise clinical inventory of the lesions. The decision between an aggressive, surgical or interventional attitude and a conservative one, with monitoring, is often taken under pressure. Especially difficult are the cases in which the imaging results of the lesions is uncertain, when the patient presents hemodynamic instability, when other lesions can not be excluded, or when the parietal peritoneum is ruptured and the retroperitoneal hematoma gets into the peritoneal cavity, the patient presenting haemoperitoneum. For most of the time, these cases have indication for exploratory laparotomy, for a diagnostic, not therapeutic, goal.

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

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    Shimodaira Masanori

    2013-01-01

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

  9. Clinical appraisal of stereotactic hematoma aspiration surgery for hypertensive thalamic hemorrhage

    International Nuclear Information System (INIS)

    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)

  10. Subdural empyema following lumbar facet joint injection: An exceeding rare complication.

    Science.gov (United States)

    Fayeye, Oluwafikayo; Silva, Adikarige Haritha Dulanka; Chavda, Swarupsinh; Furtado, Navin Raoul

    2016-01-01

    Chronic low back pain is extremely common with a life time prevalence estimated at greater than 70% [1]. Facet joint arthrosis is thought to be the causative aetiological substrate in approximately 25% of chronic low back pain cases [2]. Facet joint injection is a routine intervention in the armamentarium for both the diagnostic and therapeutic management of chronic low back pain. In fact, a study by Carrino et al. reported in excess of 94,000 facet joint injection procedures were carried out in the US in 1999 [3]. Although generally considered safe, the procedure is not entirely without risk. Complications including bleeding, infection, exacerbation of pain, dural puncture headache, and pneumothorax have been described. We report a rare case of a 47-year-old female patient who developed a left L4/5 facet septic arthrosis with an associated subdural empyema and meningitis following facet joint injection. This case is unique, as to the best of our knowledge no other case of subdural empyema following facet joint injection has been reported in the literature. Furthermore this case serves to highlight the potential serious adverse sequelae of a routine and apparently innocuous intervention. The need for medical practitioners to be alert to and respond rapidly to the infective complications of facet joint injection cannot be understated. PMID:27154449

  11. Evolution and Prospects for Intracranial Pharmacotherapy for Refractory Epilepsies: The Subdural Hybrid Neuroprosthesis

    Directory of Open Access Journals (Sweden)

    Nandor Ludvig

    2010-01-01

    Full Text Available Intracranial pharmacotherapy is a novel strategy to treat drug refractory, localization-related epilepsies not amenable to resective surgery. The common feature of the method is the use of some type of antiepileptic drug (AED delivery device placed inside the cranium to prevent or stop focal seizures. This distinguishes it from other nonconventional methods, such as intrathecal pharmacotherapy, electrical neurostimulation, gene therapy, cell transplantation, and local cooling. AED-delivery systems comprise drug releasing polymers and neuroprosthetic devices that can deliver AEDs into the brain via intraparenchymal, ventricular, or transmeningeal routes. One such device is the subdural Hybrid Neuroprosthesis (HNP, designed to deliver AEDs, such as muscimol, into the subdural/subarachnoid space overlaying neocortical epileptogenic zones, with electrophysiological feedback from the treated tissue. The idea of intracranial pharmacotherapy and HNP treatment for epilepsy originated from multiple sources, including the advent of implanted medical devices, safety data for intracranial electrodes and catheters, evidence for the seizure-controlling efficacy of intracerebral AEDs, and further understanding of the pathophysiology of focal epilepsy. Successful introduction of intracranial pharmacotherapy into clinical practice depends on how the intertwined scientific, engineering, clinical, neurosurgical and regulatory challenges will be met to produce an effective and commercially viable device.

  12. Dipole source analyses of early median nerve SEP components obtained from subdural grid recordings.

    Science.gov (United States)

    Baumgärtner, Ulf; Vogel, Hagen; Ohara, Shinji; Treede, Rolf-Detlef; Lenz, Fred A

    2010-12-01

    The median nerve N20 and P22 SEP components constitute the initial response of the primary somatosensory cortex to somatosensory stimulation of the upper extremity. Knowledge of the underlying generators is important both for basic understanding of the initial sequence of cortical activation and to identify landmarks for eloquent areas to spare in resection planning of cortex in epilepsy surgery. We now set out to localize the N20 and P22 using subdural grid recording with special emphasis on the question of the origin of P22: Brodmann area 4 versus area 1. Electroencephalographic dipole source analysis of the N20 and P22 responses obtained from subdural grids over the primary somatosensory cortex after median nerve stimulation was performed in four patients undergoing epilepsy surgery. Based on anatomical landmarks, equivalent current dipoles of N20 and P22 were localized posterior to (n = 2) or on the central sulcus (n = 2). In three patients, the P22 dipole was located posterior to the N20 dipole, whereas in one patient, the P22 dipole was located on the same coordinate in anterior-posterior direction. On average, P22 sources were found to be 6.6 mm posterior [and 1 mm more superficial] compared with the N20 sources. These data strongly suggest a postcentral origin of the P22 SEP component in Brodmann area 1 and render a major precentral contribution to the earliest stages of processing from the primary motor cortex less likely. PMID:20861430

  13. Spontaneous Ventral Spinal Epidural Hematoma in an Infant: An Unusual Presentation

    Directory of Open Access Journals (Sweden)

    Asad ABBAS

    2013-06-01

    Full Text Available How to Cite This Article: Abbad A, Afzal K, Mujeeb AA, Shahab T, Khalid M. Spontaneous Ventral Spinal Epidural Hematoma in an Infant: An Unusual Presentation. Iran J Child Neurol. 2013  Spring;7(2:47-50.Abstract Spontaneous ventral spinal epidural hematomas are extremely rare in children and clinically recognized by the appearance of acute asymmetric focal motor and sensory involvement. In infants, the initial presenting symptoms are very non-specific and irritability is often the only initial manifestation. Appearance of other neurological signs may be delayed up to hours or even days later. In the absence of significant precipitating factors such as severe trauma or previously known coagulopathies,the diagnosis is usually delayed until the full picture of severe cord compression is developed. The diagnosis is finally made by performing magnetic resonance imaging. We report a 5-month-old infant with spinal epidural hematoma who presented with symmetrical upper limb weakness and diaphragmatic involvement to highlight the importance of recognizing the atypical manifestations for early diagnosis andintervention. References:1. Phillips TW, Kling TF Jr, McGillicuddy JE. Spontaneous ventral spinal epidural hematoma with anterior cordsyndrome: report of a case. Neurosurgery 1981;9:440-3.2. Patel H, Boaz JC, Phillips JP, Garg BP. Spontaneous spinal epidural hematoma in children. Pediatr Neurol1998;19:302-7. Review.3. Penar PL, Fischer DK, Goodrich I, Bloomgarden GM, Robinson F. Spontaneous spinal epidural hematoma. IntSurg 1987;72:218-21.4. Noth I, Hutter JJ, Meltzer PS, Damiano ML, Carter LP. Spinal epidural hematoma in a hemophilic infant. Am JPediatr Hematol Oncol 1993;15:131-4. Review.5. Beatty RM, Winston KR. Spontaneous cervical epidural hematoma. A consideration of etiology. J Neurosurg1984;61:143-8.6. Alva NS. Traumatic spinal epidural hematoma of a 10-month-old male: a clinical note. Pediatr Neurol2000;23:88-9. Review.7. Aminoff MJ: Vascular

  14. Tuberculous brain abscess and subdural empyema in an immunocompetent child: Significance of AFB staining in aspirated pus

    Directory of Open Access Journals (Sweden)

    B Vijayakumar

    2012-01-01

    Full Text Available Tuberculous brain abscess and subdural empyema are extremely rare manifestations of central nervous system tuberculosis. Here, we report a case of an 11-year-old immunocompetent child who developed temporal lobe abscess and subdural empyema following chronic otitis media. A right temporal craniotomy was performed and the abscess was excised. The Ziehl Nielsen staining of the aspirated pus from the temporal lobe abscess yielded acid fast bacilli. Prompt administration of antituberculous treatment resulted in complete recovery of the child. Even though the subdural abscess was not drained, we presume that to be of tubercular aetiology. Ours is probably the first case of brain abscess and subdural empyema due to Mycobacterium tuberculosis reported in the same child. This case is being reported because of its rarity and to stress the importance of routine staining for tubercle bacilli in all cases of brain abscess, especially in endemic areas, as it is difficult to differentiate tuberculous from pyogenic abscess clinically as well as histopathologically.

  15. Paralisia facial bilateral Bilateral facial paralysis: a case report

    Directory of Open Access Journals (Sweden)

    J. Fortes-Rego

    1976-03-01

    Full Text Available É apresentado um caso de diplegia facial surgida após meningite meningocócica e infecção por herpes simples. Depois de discutir as diversas condições que o fenômeno pode apresentar-se, o autor inclina-se por uma etiologia herpética.A case of bilateral facial paralysis following meningococcal meningitis and herpes simplex infection is reported. The author discusses the differential diagnosis of bilateral facial nerve paralysis which includes several diseases and syndromes and concludes by herpetic aetiology.

  16. Bilateral spontaneous hemotympanum: Case report

    Directory of Open Access Journals (Sweden)

    Economou Nicolas C

    2006-10-01

    Full Text Available Abstract Background The most common causes of hemotympanum are therapeutic nasal packing, epistaxis, blood disorders and blunt trauma to the head. Hemotympanum is characterized as idiopathic, when it is detected in the presence of chronic otitis media. A rare case of spontaneous bilateral hemotympanum in a patient treated with anticoagulants is presented herein. Case presentation A 72-year-old male presented with acute deterioration of hearing. In the patient's medical history aortic valve replacement 1 year before presentation was reported. Since then he had been administered regularly coumarinic anticoagulants, with INR levels maintained between 3.4 and 4.0. Otoscopy revealed the presence of bilateral hemotympanum. The audiogram showed symmetrical moderately severe mixed hearing loss bilaterally, with the conductive component predominating. Tympanograms were flat bilaterally with absent acoustic reflexes. A computerized tomography scan showed the presence of fluid in the mastoid and middle ear bilaterally. Treatment was conservative and consisted of a 10-day course of antibiotics, anticongestants and temporary interruption of the anticoagulant therapy. After 3 weeks, normal tympanic membranes were found and hearing had returned to previous levels. Conclusion Anticoagulant intake should be included in the differential diagnosis of hemotympanum, because its detection and appropriate treatment may lead to resolution of the disorder.

  17. Pregnancy Outcomes in Pregnant Women with Subchorionic Hematoma

    Directory of Open Access Journals (Sweden)

    Victoria V. Barinova

    2015-09-01

    Full Text Available Background: The role of subchorionic hematoma (SCH in the first trimester of pregnancy remains open for discussion. Some authors claim that SCH does not affect the pregnancy; others have found that it is a serious risk factor for adverse pregnancy outcome. The objective of the present study was to explore the outcomes of pregnancy in patients with SCH diagnosed in the first trimester. Methods and Results: The study involved 194 pregnant women who were in terms of 6 to12 weeks: 115 women with SCH (Group 1 and 79 apparently healthy pregnant women (Group 2. A missed miscarriage was observed in 27/23% women of Group 1 and in 4/5% of Group 2 (P<0.05, recurrent threat of miscarriage in 27/23% and in 4/5%, recurrent bleeding in 14/12% and 2/3%, and the short cervix syndrome in 22/19% and 5/6% women, respectively. Conclusion: The results of our study show that the presence of SCH adversely affects the first half of pregnancy, leading to recurrent threatened abortion, recurrent threat of miscarriage, missed miscarriage until 12 weeks of gestation, and the short cervix syndrome.

  18. Concomitant bilateral testicular epidermoid cysts

    International Nuclear Information System (INIS)

    Epidermoid cyst of the testis is a rare benign germ tumor, comprising 1-2% of all resected benign testicular masses. Approximately 300 cases have been reported to date. Unilateral involvement has often been reported in the English literature. However, bilateral occurrence is very rare and to the best of our knowledge, there only 3 previous reports of bilateral testicular epidermoid cysts. The fact that they are completely benign makes them amenable to treatment by local excision, thereby saving patient from orchidectomy. Recognition of their characteristic ulatrsonographic features is very important to avoid unnecessary intervention. We present here, a case of bilateral epidermoid cyst in which characteristic ultrasound (US) findings allowed testis-sparing enucleation instead of radical orchiectomy. (author)

  19. 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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    Fernando Campos Gomes Pinto

    2003-12-01

    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.

  20. Non-contact hematoma damage and healing assessment using reflectance photoplethysmographic imaging

    Science.gov (United States)

    Amelard, Robert; Pfisterer, Kaylen J.; Clausi, David A.; Wong, Alexander

    2016-03-01

    Impact trauma may cause a hematoma, which is the leakage of venous blood into surrounding tissues. Large hematomas can be dangerous as they may inhibit local blood ow. Hematomas are often diagnosed visually, which may be problematic if the hematoma leaks deeper than the visible penetration depth. Furthermore, vascular wound healing is often monitored at home without the aid of a clinician. We therefore investigated the use of near infrared (NIR) re ectance photoplethysmographic imaging (PPGI) to assess vascular damage resulting from a hematoma, and monitor the healing process. In this case study, the participant experienced internal vascular damage in the form of a hematoma. Using a PPGI system with dual-mode temporally coded illumination for ambient-agnostic data acquisition and mounted optical elements, the tissue was illuminated with a spatially uniform irradiance pattern of 850 nm wavelength light for increased tissue penetration and high oxy-to-deoxyhemoglobin absorption ratio. Initial and follow-up PPGI data collection was performed to assess vascular damage and healing. The tissue PPGI sequences were spectrally analyzed, producing spectral maps of the tissue area. Experimental results show that spatial differences in spectral information can be observed around the damaged area. In particular, the damaged site exhibited lower pulsatility than the surrounding healthy tissue. This pulsatility was largely restored in the follow-up data, suggesting that the tissue had undergone vascular healing. These results indicate that hematomas can be assessed and monitored in a non-contact visual manner, and suggests that PPGI can be used for tissue health assessment, with potential extensions to peripheral vascular disease.

  1. Sequential bilateral retinal artery occlusion

    OpenAIRE

    Padrón-Pérez N; Aronés JR; Muñoz S; Arias-Barquet L; Arruga J

    2014-01-01

    Noel Padrón-Pérez,1 Janny Rosario Aronés,2 Silvia Muñoz,1 Luis Arias-Barquet,1 Jorge Arruga1,31Department of Ophthalmology, Hospital Universitari de Bellvitge, 2Hospital de l'Esperança – Parc de Salut Mar, 3Institut Català de Retina, Barcelona, SpainAbstract: An 86 year old woman experienced a sequential bilateral loss of vision over a period of less than 24 hours. Clinical findings and complementary studies suggested a bilateral atherogenic...

  2. Acute silicosis with bilateral pneumothorax

    OpenAIRE

    Srivastava, G. N.; Prasad, Rajniti; Meena, Manoj; Hussain, Moosa

    2014-01-01

    We present a case of acute silicosis with bilateral pneumothorax of a 28-year-old man working at a stone crusher factory for 1 year. He presented to the emergency department with cough, respiratory distress and diffuse chest pain. The patient was managed with bilateral intercostal tube drainage under water seal, oxygen inhalation and conservative therapy. On follow-up he showed improvement of resting dyspnoea and was doing well. This case is being reported because of the rare complications of...

  3. Post meningitis subdural hygroma: anatomical and functional evaluation with 99mTc-ethylene cysteine dimer single photon emission tomography/computed tomography

    International Nuclear Information System (INIS)

    Subdural hygroma is the collection of cerebrospinal fluid in the subdural space. Most often these resolve spontaneously. However, in cases with neurological complications surgical drainage may be needed. We here, present the case of an 8-year-old boy with post meningitis subdural hygroma. 99mTc-ethylene cysteine dimer (99mTc-ECD) hybrid single photon emission tomography/computed tomography (SPECT/CT) carried out in this patient, demonstrated the subdural hygroma as well as the associated cerebral hypoperfusion. If 99mTc-ECD SPECT/CT is integrated into management of these patients, it can help in decision making with respect to conservative versus surgical management. (author)

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

    Directory of Open Access Journals (Sweden)

    Hannah Pitanga Lukashok

    2009-12-01

    Full Text Available CONTEXT: Although endoscopic esophageal variceal sclerotherapy has been largely supplanted by variceal band ligation, it is still performed routinely in many institutions, especially in developing countries. Intramural esophageal hematoma has been described as a rare complication of sclerotherapy. Risk factors have not been completely established. OBJECTIVE: To demonstrate the incidence of post-sclerotherapy intramural esophageal hematoma in our hospital and discuss the possible factors involved. Methods - This is a retrospective observational study made at the "Hospital Universitário Clementino Fraga Filho", Rio de Janeiro, RJ, Brazil, reviewing the medical records of all esophageal variceal sclerotherapy procedures performed from April 2000 to November 2005. The evaluation of the clinical, laboratorial and endoscopic features in our patients and those reported in the literature was also done. Review of literature was performed through MEDLINE search. RESULTS: A total of 1,433 esophageal variceal sclerotherapy procedures were performed in 397 patients, with an intramural esophageal hematoma incidence of 4 cases (0.28%. Three of our patients developed additional complications, and one death was a direct consequence of a rupture of the hematoma. Nineteen well described cases were reported in the literature. Intramural esophageal hematoma occurred mostly after the forth esophageal variceal sclerotherapy session. Coagulation disturbances were present in the majority of cases. CONCLUSION: Intramural esophageal hematoma is a rare complication of esophageal variceal sclerotherapy and its incidence in our institution was similar to those observed in the literature. Our study suggests that this complication occurs as a result of a fragile esophageal mucosa after previous esophageal variceal sclerotherapy sessions. Impaired coagulation, although not essential, could contribute to hematoma formation and extension through esophageal submucosa

  5. Bilateral posterior cerebral artery infarction

    OpenAIRE

    Ryan, Davinia; Murphy, Sinead M; Hennessey, Michael J

    2010-01-01

    We report the case of a 70-year-old man who presented with short-term memory impairment and a homonymous left inferior quadrantanopia secondary to simultaneous bilateral posterior cerebral artery (PCA) territory infarction. As in more than a quarter of cases of PCA

  6. Primary synchronous bilateral breast cancer

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    R Krishnappa

    2014-01-01

    Full Text Available Background: Primary synchronous bilateral breast cancer (PSBBC is a rare clinical entity. The reported incidence ranges between 0.3% and 12%. There are several controversial issues regarding PSBBC pertaining to the diagnostic criteria, nomenclature, and management policies. Materials and Methods: Fourteen cases of PSBBC treated between 2001 to 2010 at our institute were retrospectively analysed in regards to demographic data, management and follow up. Results: PSBBC constituted 0.19% of total breast cancer patients at our institute. Age ranged from 28 to 78 years. PSBBC were detected by clinical examination in eight cases and by mammography in six cases. Twelve patients underwent bilateral modified radical mastectomy, one had unilateral mastectomy on one side and breast conservation on the other side and one patient has bilateral breast conservation. Majority of patients belonged to stage 2 and stage 3. All patients were found to have invasive ductal carcinoma. Five cases were ER/PR positive and 8 patients were triple hormone receptor negative. Eight patients received unilateral and six received bilateral adjuvant radiotherapy. Nine patients received adjuvant chemotherapy. 5 patients received adjuvant hormonal therapy. Median follow up of patients was 15.4 months. Conclusion: PSBBC is a rare event warranting awareness and screening of the contralateral breast in patients with unilateral breast cancer. These patients require individualized treatment planning based on the tumor factors of the index lesion. Further multi institutional prospective studies are needed for adequate understanding of management of PSBBC.

  7. Amniotic fluid 'sludge' detected in patients with subchorionic hematoma: a report of two cases.

    Science.gov (United States)

    Tskitishvili, E; Tomimatsu, T; Kanagawa, T; Sawada, K; Kinugasa, Y; Mimura, K; Kimura, T

    2009-04-01

    Amniotic fluid 'sludge' is defined as the presence of dense aggregates of particulate matter in close proximity to the internal cervical os. It is of clinical significance in asymptomatic patients at high risk for spontaneous delivery, and in patients with preterm labor and intact membranes. Subchorionic hematoma is another ultrasound finding that is associated with a higher incidence of threatened miscarriage and preterm delivery. We report two cases of occurrence of amniotic fluid sludge in patients with previously detected large subchorionic hematoma. In the first case subchorionic hematoma and amniotic fluid sludge were detected by ultrasonography at 13 + 1 and 18 + 6 weeks' gestation, respectively, followed by preterm premature rupture of membranes, placental abruption and emergency Cesarean section. In the second case subchorionic hematoma and amniotic fluid sludge were detected by ultrasound at 11 + 3 and 15 + 5 weeks' gestation, respectively, followed by miscarriage with histological chorioamnionitis. The coincidence of subchorionic hematoma and amniotic fluid sludge in these cases points to a possible connection between these two significant ultrasound findings. PMID:19308930

  8. Development and clinical usefulness of stereotactic endoneurosurgical system for intracerebral hematoma

    International Nuclear Information System (INIS)

    Since computed tomography (CT)-guided stereotactic surgery is essentially blind surgery, it always involves the risk of injuring viable brain tissue and vessels. Thus, we have developed a new endoneurosurgical system for stereotactic brain surgery. This system consists of a neuroendoscope made of a Selfoc long rod-shaped deflective distribution lens 1.0 mm in diameter, a special ultrasonic aspirator for fragmentation and aspiration of hard blood clots, a micromanipulator and a specially designed stereotactic attachment device, so that they can be accurately inserted into the optimun position from any direction. We have applied this stereotactic endoneurosurgical system to 30 cases of intracerebral hematoma comprising 12 putaminal, 11 thalamic, 4 subcortical, 2 brain stem, 1 cerebellar hemorrhage. The mean age was 65 years old, 79% of patients were over 60 years old, mean hematoma volume was 22 ml, mean rate of removal was 85%, and there was no intraoperative or postoperative hemorrhage. During removal of an intracerebral hematoma, intraoperative bleeding was prevented by the direct observation of microvessels in the wall of the hematoma cavity. This system was developed to allow application of stereotactic techniques to endoscopic surgery. The stereotactic endoneurosurgery is considered to be less invasive, safer, and more accurate, as it can be applied to removal of intracerebral hematoma. (author)

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

    Directory of Open Access Journals (Sweden)

    Satomi Jyunichiro

    2009-11-01

    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.

  10. Combined spinal subdural tuberculous empyema and intramedullary tuberculoma in an HIV-positive patient

    International Nuclear Information System (INIS)

    Tuberculous involvement of the spinal subdural and intramedullary compartments is extremely uncommon. Simultaneous involvement of both compartments has never been reported, to our knowledge. We present an HIV-positive patient with such kind of combined involvement. Diagnosis was made on the basis of a prior history of pulmonary tuberculous infection and a positive therapeutic response to antituberculous chemotherapy. Magnetic resonance imaging is the diagnostic procedure of choice in order to determine the exact level, site, and size of the disease. Tuberculosis of the spine should always be considered in the differential diagnosis of spinal cord compression if the patient lives in or comes from a region where tuberculosis is endemic or if the patient is immunocompromised. (orig.)

  11. Challenging pyogenic cerebral abscess complicated by subdural empyema. A case report.

    Science.gov (United States)

    Valencia, M P; Moon, A

    2012-12-20

    Brain abscesses develop in response to a parenchymal infection with pyogenic bacteria, beginning as a localized area of cerebritis and evolving into a suppurative lesion surrounded by a well-vascularized fibrotic capsule. The leading etiologic agents of brain abscess are the streptococcal strains and S. aureus. Abscesses may also be secondary to fungal or parasitic organisms. Brain abscess represents a significant medical problem, accounting for one in every 10,000 hospital admissions in the United States, and remains a serious situation despite recent advances made in detection and therapy. These lesions often produce complex clinical and radiologic findings and require prompt recognition and treatment to avoid a fatal neurologic outcome. Subdural empyema represents an important type of intracranial suppurative infectious-inflammatory disorder. Clinically, these patients initially have signs and symptoms of meningitis, but this course might be complicated later by the development of seizures and focal neurologic signs. PMID:24029180

  12. Analysis of Epileptic Discharges from Implanted Subdural Electrodes in Patients with Sturge-Weber Syndrome

    Science.gov (United States)

    2016-01-01

    Objective Almost two-thirds of patients with Sturge-Weber syndrome (SWS) have epilepsy, and half of them require surgery for it. However, it is well known that scalp electroencephalography (EEG) does not demonstrate unequivocal epileptic discharges in patients with SWS. Therefore, we analyzed interictal and ictal discharges from intracranial subdural EEG recordings in patients treated surgically for SWS to elucidate epileptogenicity in this disorder. Methods Five intractable epileptic patients with SWS who were implanted with subdural electrodes for presurgical evaluation were enrolled in this study. We examined the following seizure parameters: seizure onset zone (SOZ), propagation speed of seizure discharges, and seizure duration by visual inspection. Additionally, power spectrogram analysis on some frequency bands at SOZ was performed from 60 s before the visually detected seizure onset using the EEG Complex Demodulation Method (CDM). Results We obtained 21 seizures from five patients for evaluation, and all seizures initiated from the cortex under the leptomeningeal angioma. Most of the patients presented with motionless staring and respiratory distress as seizure symptoms. The average seizure propagation speed and duration were 3.1 ± 3.6 cm/min and 19.4 ± 33.6 min, respectively. Significant power spectrogram changes at the SOZ were detected at 10–30 Hz from 15 s before seizure onset, and at 30–80 Hz from 5 s before seizure onset. Significance In patients with SWS, seizures initiate from the cortex under the leptomeningeal angioma, and seizure propagation is slow and persists for a longer period. CDM indicated beta to low gamma-ranged seizure discharges starting from shortly before the visually detected seizure onset. Our ECoG findings indicate that ischemia is a principal mechanism underlying ictogenesis and epileptogenesis in SWS. PMID:27054715

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

    OpenAIRE

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

    2012-01-01

    A ocorrência de hematoma epidural como complicação pós-cirúrgica é relativamente baixa. O reconhecimento dessa patologia no diagnóstico diferencial nas paraplegias pós-cirúrgicas imediatas e o tratamento precoce por meio de intervenção cirúrgica com a descompressão do canal são fatores que estão diretamente relacionados à melhora do quadro neurológico. Este relato de caso é de um hematoma epidural no pós-operatório imediato de descompressão por estenose do canal vertebral lombar em paciente c...

  14. Ligamentum flavum hematoma: a case report and literature review Hematoma del ligamento amarillo: caso clínico y revisión de la literatura Hematoma de ligamento amarelo: relato de caso e revisão da literatura

    OpenAIRE

    Ericson Sfreddo; Marcelo Teodoro Ezequiel Guerra

    2012-01-01

    The aim is to present a rare case of ligamentum flavum hematoma in the lumbar region, discuss its physiopathology and treatment and review the literature. A woman aged 68 presented with neurogenic claudication due to degenerative lumbar spondylolisthesis that evolved into a sudden worsening with cauda equina syndrome. The magnetic resonance imagining (MRI) showed signs of degeneration of the lumbar spine, with a narrow spinal canal from L2 to S1, anterolisthesis L4 L5 and an expansive lesion ...

  15. Infectious mononucleosis presenting as bilateral acute dacryocystitis.

    OpenAIRE

    Atkinson, P L; Ansons, A M; Patterson, A.

    1990-01-01

    A case of infectious mononucleosis presenting as bilateral acute dacryocystitis in a 7-year-old girl is reported. Acute dacryocystitis is uncommon in this age group, and an underlying systemic illness should be suspected particularly when it is bilateral.

  16. Self-Inflicted Intraoral Hematoma in a Cardiac Patient Receiving Oral Anticoagulant Therapy- A Case Report

    Directory of Open Access Journals (Sweden)

    Shantala Arunkumar

    2015-01-01

    Full Text Available Intraoral hematoma secondary to systemic anticoagulant therapy is rare, but it is a potentially fatal condition requiring immediate medical management. Case report: Here we report a case of self-inflicted hematoma in the anterior maxillary gingival region in a 65year old female cardiac patient who was on systemic anticoagulant therapy with a poor periodontal condition, manifesting as a periodontal swelling for a period of one week. Oral anticoagulant therapy is considerably imperative to prevent thromboembolic complications in various medical conditions, in such patients there are chances for spontaneous bleeding or hematoma by means of minor trauma due to sharp teeth or dental prosthesis in the mouth leading to life threatening complications such as partial or complete airway blockage. Therefore,directives about possible bleeding complications secondary to anticoagulant drugs in the oral cavity and the importance of maintaining oral health hygiene are necessary for the patient.

  17. Solid Right Ventricular Compression by Intraventricular Septum-Hematoma Induced after Percutaneous Coronary Intervention

    Directory of Open Access Journals (Sweden)

    Ibrahim El-Battrawy

    2016-01-01

    Full Text Available Intraventricular septum-hematoma is a rare complication following percutaneous coronary intervention (PCI. This complication may represent a challenge for accurate diagnosis and treatment. This case report is about a 60-year-old male patient being admitted with an acute coronary syndrome. Despite successful PCI with drug eluting stent implantation into the right coronary artery (RCA the patient complained about recurrent angina pectoris according to Canadian Cardiovascular Society (CCS class IV. Cardiac magnetic resonance imaging and transthoracic echocardiography revealed a massive 4.9×9.2 cm sized end-diastolic septum-hematoma, which compromised right ventricular cavity. Emergent recoronary angiography ruled out further contrast extravasation from the RCA. Conservative treatment was intended after discussion in the “heart-team.” The patient completely recovered with nearly complete resolution of the hematoma after 6 months.

  18. Hematoma epidural espinal espontâneo durante a gravidez: registro de um caso

    Directory of Open Access Journals (Sweden)

    Ivan Hack

    1984-03-01

    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.

  19. Imaging of subepithelial hematoma of renal pelvis (Antopol-Goldman lesion) simulating tumor: a case report

    International Nuclear Information System (INIS)

    We report a rare case of subepithelial hematoma of the renal pelvis (Antopol-Goldman Lesion). A 55-year-old women visited our hospital because of gross hematuria. Ultrasonogram showed a 4 cm well-defined solid mass of the left renal pelvis. Intravenous pyelography revealed compression of the left upper pelvicocalyceal system by the mass with contrast filling within the mass. CT scan revealed lobulated well defined mass in the left renal pelvis extending into renal parenchyme. A transitional cell carcinoma or renal cell carcinoma was suspected radiologically, and the patient underwent left total nephrectomy. In pathology, the lesion turned out to be a subepithelial hematoma. In the differential diagnosis of renal malignancy, a subepithelial hematoma of the renal pelvis may be included

  20. Imaging of subepithelial hematoma of renal pelvis (Antopol-Goldman lesion) simulating tumor: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Doo Kyoung; Lee, Eun Ju; Kim, Se Joong; Park, Kwang Hwa; Ji, Hoon; Suh, Jung Ho [College of Medicine, Ajou University, Suwon (Korea, Republic of)

    1995-10-15

    We report a rare case of subepithelial hematoma of the renal pelvis (Antopol-Goldman Lesion). A 55-year-old women visited our hospital because of gross hematuria. Ultrasonogram showed a 4 cm well-defined solid mass of the left renal pelvis. Intravenous pyelography revealed compression of the left upper pelvicocalyceal system by the mass with contrast filling within the mass. CT scan revealed lobulated well defined mass in the left renal pelvis extending into renal parenchyme. A transitional cell carcinoma or renal cell carcinoma was suspected radiologically, and the patient underwent left total nephrectomy. In pathology, the lesion turned out to be a subepithelial hematoma. In the differential diagnosis of renal malignancy, a subepithelial hematoma of the renal pelvis may be included.

  1. Bilateral ovarian tumour in a young girl

    OpenAIRE

    2013-01-01

    Bilateral ovarian tumour in a girl presents the dilemma of conservative versus aggressive approach towards these tumours. When faced with suspicious tumour and complete replacement of the ovaries bilaterally, bilateral oophorectomy is a viable option, though the certain possibility of infertility and lifelong hormonal supplementation is unavoidable. We report a case of bilateral ovarian masses in a young girl, which on histopathological examination showed mature teratoma with aggregates of pr...

  2. Laparoscopic Adrenalectomy for Bilateral Metachronous Aldosteronomas

    OpenAIRE

    Rizek, Philippe; Gorecki, Piotr; Lindenmayer, Aristid; Moktan, Sabita

    2011-01-01

    Introduction: Primary aldosteronism affects 5% to 13% of patients with hypertension. Idiopathic bilateral hyperplasia (IHA) and unilateral aldosterone-producing adenoma (APA) are the most common types of primary aldosteronism. Bilateral APA is a very rare entity with only a few reports in the literature. We present the case of a patient with metachronous bilateral APA treated with metachronous bilateral total and near total adrenalectomy. Case Report: A 66-year-old female was evaluated for hy...

  3. Tratamiento conservador en pacientes con retinoblastoma bilateral

    OpenAIRE

    Juan C. Suárez; Mabel C. Ospina; Sandra A. Arias; González, María E

    2008-01-01

    OBJETIVO: comparar el tratamiento convencional del retinoblastoma bilateral, usado hasta hace algunos años, consistente en radioterapia o enucleación bilateral, con el tratamiento conservador actual que incluye termoterapia transpupilar (TTT) o TTT/quimioterapia al menos en un ojo, en niños con diagnóstico de retinoblastoma bilateral. DISEÑO: estudio retrospectivo descriptivo. MUESTRA: 20 pacientes con diagnóstico de retinoblastoma bilateral que consultaron al Hospital Universitario San Vicen...

  4. Scrotal hematoma resulting from extracorporeal shock wave lithotripsy for a renal calculus: a sign of retroperitoneal hemorrhage

    OpenAIRE

    Devanathan, Raja; Katz, Darren J.; Dodds, Lachlan J.

    2011-01-01

    We report a rare case of a patient presenting with scrotal hematoma associated with retroperitoneal hemorrhage after extracorporeal shock wave lithotripsy (ESWL). We propose a mechanism for the formation of scrotal hematoma and its importance as a sign of retroperitoneal hemorrhage.

  5. Simultaneous and staged bilateral total hip arthroplasty

    DEFF Research Database (Denmark)

    Lindberg-Larsen, Martin; Joergensen, Christoffer Calov; Husted, Henrik;

    2013-01-01

    Bilateral total hip arthroplasty (BTHA) and bilateral simultaneous total hip arthroplasty (BSTHA) are done increasingly. Previous studies evaluating outcomes after bilateral procedures have found different results. The aim of this study was to investigate length of hospital stay (LOS), 30 days...

  6. Serial MR Imaging of Intramuscular Hematoma: Experimental Study in a Rat Model with the Pathologic Correlation

    International Nuclear Information System (INIS)

    We wanted to demonstrate the temporal changes of the magnetic resonance imaging (MRI) findings in experimentally-induced intramuscular hematomas in rats and to correlate these data with the concurrent pathologic observations. Intramuscular hematoma was induced in 30 rats. The MR images were obtained at 1, 4, 7 and 10 days and at 2, 3, 4, 6 and 8 weeks after muscle injury. The characteristic serial MRI findings were evaluated and the relative signal intensities were calculated. Pathologic specimens were obtained at each time point. On the T1-weighted imaging (T1WI), the intramuscular hematomas exhibited isointensity compared to that of muscle or the development of a high signal intensity (SI) rim on day one after injury. The high SI persisted until eight weeks after injury. On the T2-weighted imaging (T2WI), the hematomas showed high SI or centrally low SI on day one after injury, and mainly high SI after four days. A dark signal rim was apparent after seven days, which was indicative of hemosiderin on the pathology. The gradient echo (GRE) imaging yielded dark signal intensities at all stages. Unlike brain hematomas, experimentally-induced intramuscular hematomas show increased SI on both the T1WI and T2WI from the acute stage onward, and this is pathologically correlated with a rich blood supply and rapid healing response to injury in the muscle. On the T2WI and GRE imaging, high SI with a peripheral dark signal rim is apparent from seven days to the chronic stage

  7. Serial MR Imaging of Intramuscular Hematoma: Experimental Study in a Rat Model with the Pathologic Correlation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yeon Soo; Kim, Jong Ok; Choi, Eun Seok [Daejeon St. Mary' s Hospital, The Catholic University of Korea, Daejeon (Korea, Republic of); Kwon, Soon Tae [Chungnam National University, School of Medicine, Daejeon (Korea, Republic of)

    2011-02-15

    We wanted to demonstrate the temporal changes of the magnetic resonance imaging (MRI) findings in experimentally-induced intramuscular hematomas in rats and to correlate these data with the concurrent pathologic observations. Intramuscular hematoma was induced in 30 rats. The MR images were obtained at 1, 4, 7 and 10 days and at 2, 3, 4, 6 and 8 weeks after muscle injury. The characteristic serial MRI findings were evaluated and the relative signal intensities were calculated. Pathologic specimens were obtained at each time point. On the T1-weighted imaging (T1WI), the intramuscular hematomas exhibited isointensity compared to that of muscle or the development of a high signal intensity (SI) rim on day one after injury. The high SI persisted until eight weeks after injury. On the T2-weighted imaging (T2WI), the hematomas showed high SI or centrally low SI on day one after injury, and mainly high SI after four days. A dark signal rim was apparent after seven days, which was indicative of hemosiderin on the pathology. The gradient echo (GRE) imaging yielded dark signal intensities at all stages. Unlike brain hematomas, experimentally-induced intramuscular hematomas show increased SI on both the T1WI and T2WI from the acute stage onward, and this is pathologically correlated with a rich blood supply and rapid healing response to injury in the muscle. On the T2WI and GRE imaging, high SI with a peripheral dark signal rim is apparent from seven days to the chronic stage

  8. A Case of Recurrent Hemorrhages due to a Chronic Expanding Encapsulated Intracranial Hematoma

    Directory of Open Access Journals (Sweden)

    Akiko Marutani

    2015-09-01

    Full Text Available Few case reports of encapsulated intracranial hematoma (EIH exist, and the mechanisms underlying the onset and enlargement of EIH remain unclear. Here, we report on a 39-year-old woman with an EIH that repeatedly hemorrhaged and swelled and was ultimately surgically removed. In June 2012, the patient visited her local doctor, complaining of headaches. A magnetic resonance imaging (MRI scan identified a small hemorrhage of approximately 7 mm in her right basal ganglia, and a wait-and-see approach was adopted. Six months later, her headaches recurred. She was admitted to our department after MRI showed tumor lesions accompanying the intermittent hemorrhaging in the right basal ganglia. After admission, hemorrhaging was again observed, with symptoms progressing to left-sided hemiplegia and fluctuating consciousness; thus, a craniotomy was performed. No obvious abnormal blood vessels were observed on the preoperative cerebral angiography. We accessed the lesion using a transcortical approach via a right frontotemporal craniotomy and removed the subacute hematoma by extracting the encapsulated tumor as a single mass. Subsequent pathological examinations showed that the hematoma exhibited abnormal internal vascularization and was covered with a capsule formed from growing capillaries and accumulating collagen fibers, suggesting that it was an EIH. No lingering neurological symptoms were noted upon postoperative follow-up. This type of hematoma expands slowly and is asymptomatic, with reported cases consisting of patients that already have neurological deficits due to progressive hematoma growth. Our report is one of a few to provide a clinical picture of the initial stages that occur prior to hematoma encapsulation.

  9. Spontaneous hematoma in the setting of dual anti-platelet therapy with ticagrelor: A case report

    Science.gov (United States)

    FENG, CHUNGUANG; WANG, LINGUANG; WANG, LULU

    2016-01-01

    A 69-year-old male patient was admitted to hospital because a lump was discovered, accompanied with pain lasting 5 h under his right scapula. Two months earlier, he had undergone a double-stent insertion operation due to lesions on the end of the left main coronary artery, the opening of left circumflex artery, and the opening of the anterior descending branch. After the operation, he was administered with dual anti-platelet therapy (DAPT) with aspirin and ticagrelor and was diagnosed with hematoma under his right scapula through ultrasonic inspection. It was established that no other factor, except DAPT, was responsible for his spontaneous hematoma. PMID:27347115

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

    Directory of Open Access Journals (Sweden)

    Patricia Chang

    2014-01-01

    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.

  11. Hematoma intramural de duodeno. Informe de un caso y revisión de la literatura

    Directory of Open Access Journals (Sweden)

    Harold Pradilla R.

    2014-11-01

    Full Text Available Se presenta el caso de un paciente adolescente tratado en el Hospital Universitario del Valle, Cali, Colombia, con diagnóstico de hematoma intramural de duodeno, manejado médicamente por espacio de 7 días, con remisión total del cuadro. El hematoma intramural de duodeno es una entidad rara de la cual existen escasos informes en la literatura. Se revisa esta entidad, cuyo diagnóstico se debe tener siempre en cuenta, en pacientes con trauma abdominal cerrado.

  12. Abdominal Wall Hematoma as a Rare Complication following Percutaneous Coronary Intervention

    Science.gov (United States)

    Moon, In Tae; Sohn, Young Seok; Lee, Ji Young; Park, Hwan Cheol; Choi, Sung Il; Kim, Soon Gil; Oh, Ji Young

    2016-01-01

    Abdominal wall hematoma is a rare but potentially serious vascular complication that may develop after coronary angiographic procedures. In particular, an oblique muscle hematoma caused by an injury of the circumflex iliac artery is very rare, yet can be managed by conservative treatment including hydration and transfusion. However, when active bleeding continues, angiographic embolization or surgery might be needed. In this study, we report an uncommon case of injury to the circumflex iliac artery by an inappropriate introduction of the hydrophilic guidewire during the performance of a percutaneous coronary intervention.

  13. Traumatic spinal epidural hematoma in a 1-year-old boy.

    Science.gov (United States)

    Tarbé de Saint Hardouin, A-L; Grévent, D; Sainte-Rose, C; Angoulvant, F; Chéron, G

    2016-07-01

    Traumatic spinal epidural hematoma is uncommon in children, making rapid diagnosis difficult. In this report, we present a case of traumatic cervical epidural hematoma in a 1-year-old boy, diagnosed with computed tomography scanning and magnetic resonance imaging (MRI). Management was conservative and the lesion regressed spontaneously. The presentation in childhood is often nonspecific. MRI is the imaging modality of choice for diagnosing these lesions. Conservative treatment has to be considered in cases with a benign clinical course and provided that the patient is followed up neurologically with repeated MRI. PMID:27266638

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

    Directory of Open Access Journals (Sweden)

    Birkholz Torsten

    2010-01-01

    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.

  15. Bilateral posterior cerebral artery infarction.

    Science.gov (United States)

    Ryan, Davinia; Murphy, Sinead M; Hennessey, Michael J

    2010-01-01

    We report the case of a 70-year-old man who presented with short-term memory impairment and a homonymous left inferior quadrantanopia secondary to simultaneous bilateral posterior cerebral artery (PCA) territory infarction. As in more than a quarter of cases of PCA infarction, no aetiological cause was identified. Unlike the transient nature of symptoms in some cases following unilateral infarction, his deficits persisted on 2-month follow-up. PMID:22798298

  16. China's Bilateral Currency Swap Lines

    OpenAIRE

    Zhitao, Lin; Wenjie, Zhan; Cheung, Yin-Wong

    2016-01-01

    We study the determinants of China’s bilateral local currency swap lines that were established since the recent global finance crisis. It is found that economic factors, political considerations, and institutional characteristics including trade intensity, economic size, strategic partnership, free trade agreement, corruption, and stability affect the decision of signing a swap line agreement. Once a swap line agreement decision is made, the size of the swap line is then mainly affected by tr...

  17. Bilateral monopolies and location choice

    OpenAIRE

    Brekke, Kurt R.; Straume, Odd Rune

    2002-01-01

    We analyse how equilibrium locations in location-price games à la Hotelling are affected when firms acquire inputs through bilateral monopoly relations with suppliers. Assuming a duopoly downstream market, we consider the case of two independent input suppliers bargaining with both downstream firms. We find that the presence of input suppliers changes the locational incentives of downstream firms in several ways, compared with the case of exogenous production costs. Bargaining induces downstr...

  18. Bilateral Molariform Mandibular Second Premolars

    OpenAIRE

    Sonu Acharya; Pradip Kumar Mandal; Chiranjit Ghosh

    2015-01-01

    Macrodontia is a rare dental anomaly that refers to teeth that appear larger than normal. Generalised macrodontia can be associated with certain medical conditions and syndromes. This case report presents clinical and radiographic findings of isolated bilateral macrodontia in a 14-year-old child. The patient was referred to the clinic with local crowding of maxillary and mandibular teeth. Radiographic findings revealed the presence of impacted macrodont mandibular second premolar on one side ...

  19. The potential contributing effect of ketorolac and fluoxetine to a spinal epidural hematoma following a cervical interlaminar epidural steroid injection: a case report and narrative review.

    Science.gov (United States)

    Chien, George C Chang; McCormick, Zack; Araujo, Marco; Candido, Kenneth D

    2014-01-01

    Cervical interlaminar epidural steroid injections (ESIs) are commonly performed as one part of a multi-modal analgesic regimen in the management of upper extremity radicular pain. Spinal epidural hematoma (SEH) is a rare complication with a reported incidence ranging from 1.38 in 10,000 to 1 in 190,000 epidurals. Current American Society of Regional Anesthesia (ASRA), American Society of Interventional Pain Physicians (ASIPP), and the International Spine Intervention Society (ISIS) recommendations are that non-steroidal anti-inflammatory drugs (NSAIDs) do not need to be withheld prior to epidural anesthesia. We report a case wherein intramuscular ketorolac and oral fluoxetine contributed to a SEH and tetraplegia following a cervical interlaminar (ESI). A 66 year-old woman with chronic renal insufficiency and neck pain radiating into her right upper extremity presented for evaluation and was deemed an appropriate CESI candidate. Cervical magnetic resonance imaging (MRI) revealed multi-level neuroforaminal stenosis and degenerative intervertebral discs. Utilizing a loss of resistance to saline technique, an 18-gauge Tuohy-type needle entered the epidural space at C6-7. After negative aspiration, 4 mL of saline with 80 mg of methyl-prednisolone was injected. Immediately thereafter, the patient reported significant spasmodic-type localized neck pain with no neurologic status changes. A decision was made to administer 30 mg intramuscular ketorolac as treatment for the spasmodic-type pain. En route home, she developed a sudden onset of acute tetraplegia. She was brought to the emergency department for evaluation including platelet and coagulation studies which were normal. MRI demonstrated an epidural hematoma extending from C5 to T7. She underwent a bilateral C5-T6 laminectomy with epidural hematoma evacuation and was discharged to an acute inpatient rehabilitation hospital. Chronic renal insufficiency, spinal stenosis, female gender, and increasing age have been

  20. Micro-Field Evoked Potentials Recorded from the Porcine Sub-Dural Cortical Surface Utilizing a Microelectrode Array

    OpenAIRE

    Kitzmiller, Joseph P.; Hansford, Derek J.; Fortin, Linda D.; Obrietan, Karl H.; Bergdall, Valerie K.; Beversdorf, David Q.

    2007-01-01

    A sub-dural surface microelectrode array designed to detect microfield evoked potentials has been developed. The device is comprised of an array of 350-micron square gold contacts, with bi-directional spacing of 150 microns, contained within a polyimide Kapton material. Cytotoxicity testing suggests that the device is suitable for use with animal and human patients. Implementation of the device in animal studies revealed that reliable evoked potentials could be acquired. Further work will be ...

  1. CT and MR imaging findings of subdural dermoid cyst extending into right foramen ovale: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, You Cheol; Park, Cheol Min; Lee, Si Kyeong [Seoul Medical Center, Seoul (Korea, Republic of)

    2006-12-15

    Intracranial dermoid cyst is a rare congenital benign disease, representing less than 0.5% of primary brain tumors. Nevertheless, if ruptured spontaneously or during surgery, it has a poor prognosis due to chemical meningitis. Therefore, it is essential to perform accurate diagnosis and proper treatment. We report an intracranial subdural dermoid cyst that may be misdiagnosed as extracranial or epidural lesion because of extension into the right foramen ovale, and describe the CT and MR imaging findings.

  2. Spinal Subdural Abscess Following Laminectomy for Symptomatic Stenosis: A Report of 2 Cases and Review of the Literature

    Science.gov (United States)

    Ramos, Alexander D.; Rolston, John D.; Gauger, Grant E.; Larson, Paul S.

    2016-01-01

    Case series Patient: Male, 87 • Male, 62 Final Diagnosis: Spinal subdural abscess Symptoms: Fever • pain • weakness Medication: — Clinical Procedure: Laminectomy • durotomy • drainage • debridement Specialty: Neurosurgery Objective: Rare disease Background: Spinal subdural abscesses, also known as empyemas, are rare infectious lesions, the exact incidence of which is unknown. Presentation is typically dramatic, with back pain, fever, motor, and sensory deficits. Rapid identification and surgical intervention with laminectomy, durotomy, and washout provides the best outcomes. While hematogenous spread of an extra-spinal infection is the most common cause of this condition, a significant number of cases result from iatrogenic mechanisms, including lumbar punctures, epidural injections, and surgery. Case Report: Here we present 2 cases: 1) an 87-year-old man with type 2 diabetes, schizophrenia, mild cognitive impairment, and symptomatic lumbar spinal stenosis and 2) a 62-year-old man with a prior L3–4 spinal fusion with symptomatic lumbar spinal stenosis. In both cases, patients underwent laminectomy for spinal stenosis and developed epidural abscess. Following successful drainage of the epidural abscess, they continued to be symptomatic, and repeat imaging revealed the presence of a subdural abscess that was subsequently evacuated. Case 1 had significant improvement with residual lower-extremity weakness, while Case 2 made a complete neurological recovery. Conclusions: These cases illustrate patients at increased risk for developing this rare spinal infection, and demonstrate that rapid recognition and surgical treatment is key to cure and recovery. Review of the literature highlights pertinent risk factors and demonstrates nearly one-third of reported cases have an iatrogenic etiology. The cases presented here demonstrate that a subdural process should be suspected in any patient with intractable pain following treatment of an epidural abscess. PMID

  3. CT and SPECT in bilateral hypertensive intracerebral hemorrhages of simultaneous onset

    International Nuclear Information System (INIS)

    A 59-year-old woman was admitted to the hospital on November 6, 1983, after she suddenly lost consciousness. She was semicomatous, and the level of consciousness was evaluated as 100 according to the Japan Coma Scale. There were left hemiparesis and conjugate deviation to the right. CT scans obtained one hour after onset demonstrated bilateral intracerebral hemorrhages involving the right basal ganglia and the left posterior temporal region. Carotid angiograms failed to demonstrate the presence of either cerebral aneurysms or arteriovenous malformations which might be responsible for the intracerebral hemorrhages. A right fronto-temporal craniotomy was performed, and about 50 ml of intracerebral blood clots were evacuated by the transcortical approach. The patient was discharged with left hemiparesis, disorientation, and pseudobulbar palsy. A 57-year-old man was transferred to the hospital on February 22, 1986, with an episode of cerebral stroke. On admission he was free of symptoms except for mild hemiparesis on the right side. CT scan was performed nine days after onset, revealing bilateral intracerebral hemorrhages involving the right putamen and the left thalamus. Bilateral carotid angiograms showed an avascular mass lesion medial to the left insula, displacing both the left lenticulostriate arteries and the insular segment of the left middle cerebral artery laterally. No abnormal vascular lesions, such as cerebral aneurysms and arteriovenous malformations, were demonstrated. SPECT was performed using the continuous inhalation of Xe-133, and a prolonged decrease in the cerebral blood flow was demonstrated in the vicinity of the bilateral intracerebral hematomas, in contrast to the gradual alleviations shown on CT images. (J.P.N.)

  4. Intramural hematoma or aortic dissection – a diagnostic and therapeutic problem. A case report

    Science.gov (United States)

    Suder, Bogdan; Wasilewski, Grzegorz; Sadowski, Jerzy; Kapelak, Bogusław

    2015-01-01

    The authors present a case report of a 60-year-old patient with an ascending aortic aneurysm along with the associated diagnostic and therapeutic problems. The choice of therapy in patients with aortic intramural hematoma is difficult and should be based on comprehensive evaluation of the patient's status as well as on the experience of the radiologist and surgeon. PMID:26702280

  5. Spinal Epidural Hematoma Following Cupping Glass Treatment in an Infant With Hemophilia A.

    Science.gov (United States)

    Fruchtman, Yariv; Dardik, Rima; Barg, Assaf Arie; Livnat, Tami; Feldman, Zeev; Rubinstein, Marina; Grinberg, Gahl; Rosenberg, Nurit; Kenet, Gili

    2016-06-01

    A 6 months old infant, diagnosed with a rare mutation causing severe hemophilia A, presented with spinal epidural hematoma. Parents later admitted the infant had glass cupping therapy performed within 2 weeks of the onset of symptoms. The rare mutation, rare bleeding complication, and the eventual course of therapy applied in this case will be discussed in our case report. PMID:26844816

  6. Duodenal hematoma following blunt abdominal injury. A case in a young child

    International Nuclear Information System (INIS)

    We report a case of traumatic duodenal hematoma. The patient's age (2.5 y.) and the absence of evidence of trauma when the symptoms began led to perform plain films of the abdomen, upper GI series, US, CT and MR. This excess of imaging modalities emphasize the diagnostic value of plain X Rays of the abdomen and opacification of the duodenum. (authors)

  7. Bilateral ECT induces bilateral increases in regional cortical thickness.

    Science.gov (United States)

    van Eijndhoven, P; Mulders, P; Kwekkeboom, L; van Oostrom, I; van Beek, M; Janzing, J; Schene, A; Tendolkar, I

    2016-01-01

    Electroconvulsive therapy (ECT) is the most effective treatment for patients suffering from severe or treatment-resistant major depressive disorder (MDD). Unfortunately its underlying neurobiological mechanisms are still unclear. One line of evidence indicates that the seizures produced by ECT induce or stimulate neuroplasticity effects. Although these seizures also affect the cortex, the effect of ECT on cortical thickness is not investigated until now. We acquired structural magnetic resonance imaging data in 19 treatment-resistant MDD patients before and after a bilateral ECT course, and 16 healthy controls at 2 time points, and compared changes in cortical thickness between the groups. Our results reveal that ECT induces significant, bilateral increases in cortical thickness, including the temporal pole, inferior and middle temporal cortex and the insula. The pattern of increased cortical thickness was predominant in regions that are associated with seizure onset in ECT. Post hoc analyses showed that the increase in thickness of the insular cortex was larger in responders than in non-responders, which may point to a specific relationship of this region with treatment effects of ECT. PMID:27552587

  8. The extent of the perihemorrhagic perfusion zone correlates with hematoma volume in patients with lobar intracerebral hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Beseoglu, Kerim; Etminan, Nima; Steiger, Hans-Jakob; Haenggi, Daniel [Heinrich-Heine-Universitaet Duesseldorf, Department of Neurosurgery, Medical Faculty, Duesseldorf (Germany); Turowski, Bernd [Heinrich-Heine-Universitaet Duesseldorf, Department of Diagnostic and Interventional Radiology, Medical Faculty, Duesseldorf (Germany)

    2014-07-15

    Existing data on perfusion imaging assumes the perihemorrhagic zone (PHZ) in patients with intracerebral hemorrhage (ICH) to be size steady. This study investigates the size of the perihemorrhagic zone (PHZ) in patients with lobar ICH in relation to hematoma volume during the course of treatment using perfusion CT (PCT). The present analysis is based on a previously reported cohort of 20 patients undergoing surgical evacuation for lobar SICH, with pre- and early postoperative PCT scanning. Time to peak of the residue function (T{sub max}) was measured based on the 360 cortical banding method and singular value decomposition. The size of PHZ was determined before and after treatment and correlated with hematoma volume. Preoperative mean hematoma volume constituted 63.0 ml (interquartile ranges (IQR) 39.7-99.4 ml), which correlated significantly (r = 0.563, p = 0.010) with mean PHZ size (5.67 cm, IQR 5.44-8.17 cm). Following a surgical hematoma evacuation, mean hematoma volume was reduced to 2.5 ml IQR 0.0-9.5 ml, which also resulted in a significant reduction of PHZ size to 0.45 cm(IQR 0.0-1.36 cm; p < 0.001). There was no association between postoperative hematoma volume and size of the PHZ. Our findings illustrate that the extent of the PHZ cannot be generally assumed to be constant in size and that this differs significantly following hematoma reduction in patients with space occupying lobar SICH. (orig.)

  9. Bilateral cleft lip nasal deformity

    Directory of Open Access Journals (Sweden)

    Singh Arun

    2009-01-01

    Full Text Available Bilateral cleft lip nose deformity is a multi-factorial and complex deformity which tends to aggravate with growth of the child, if not attended surgically. The goals of primary bilateral cleft lip nose surgery are, closure of the nasal floor and sill, lengthening of the columella, repositioning of the alar base, achieving nasal tip projection, repositioning of the lower lateral cartilages, and reorienting the nares from horizontal to oblique position. The multiplicity of procedures in the literature for correction of this deformity alludes to the fact that no single procedure is entirely effective. The timing for surgical intervention and its extent varies considerably. Early surgery on cartilage may adversely affect growth and development; at the same time, allowing the cartilage to grow in an abnormal position and contributing to aggravation of deformity. Some surgeons advocate correction of deformity at an early age. However, others like the cartilages to grow and mature before going in for surgery. With peer pressure also becoming an important consideration during the teens, the current trend is towards early intervention. There is no unanimity in the extent of nasal dissection to be done at the time of primary lip repair. While many perform limited nasal dissection for the fear of growth retardation, others opt for full cartilage correction at the time of primary surgery itself. The value of naso-alveolar moulding (NAM too is not universally accepted and has now more opponents than proponents. Also most centres in the developing world have neither the personnel nor the facilities for the same. The secondary cleft nasal deformity is variable and is affected by the extent of the original abnormality, any prior surgeries performed and alteration due to nasal growth. This article reviews the currently popular methods for correction of nasal deformity associated with bilateral cleft lip, it′s management both at the time of cleft lip repair

  10. BILATERAL OVARIAN MASS COMPLICATING PREGNANCY

    OpenAIRE

    Arjumand; Triveni

    2015-01-01

    A 22 years old patient with 9 months of Amenorrhoea with a abdominal swelling was admitted to our institution with an Ultrasonography report of Bilateral ovarian mass (14.3x5.9cm in left ovary) and (9.5x7cm in right ovary) with internal vascularity with septations along with single live intrauterine fetus. She delivered by elective caesarean section in V/O breech presenta tion. Left side ovarian cystectomy done Right side ovarian puncture done. Histopathology showed left sid...

  11. Immediate Sequential Bilateral Cataract Surgery

    DEFF Research Database (Denmark)

    Kessel, Line; Andresen, Jens; Erngaard, Ditte; Flesner, Per; Tendal, Britta; Hjortdal, Jesper

    2015-01-01

    performed using the Cochrane Review Manager software. The quality of the evidence was assessed using the GRADE method (Grading of Recommendation, Assessment, Development, and Evaluation). We did not find any difference in the risk of complications or visual outcome in patients randomized to ISBCS or surgery......-based national Danish guidelines for cataract surgery. A systematic literature review in PubMed, Embase, and Cochrane central databases identified three randomized controlled trials that compared outcome in patients randomized to ISBCS or bilateral cataract surgery on two different dates. Meta-analyses were...

  12. Bilateral molariform mandibular second premolars.

    Science.gov (United States)

    Acharya, Sonu; Kumar Mandal, Pradip; Ghosh, Chiranjit

    2015-01-01

    Macrodontia is a rare dental anomaly that refers to teeth that appear larger than normal. Generalised macrodontia can be associated with certain medical conditions and syndromes. This case report presents clinical and radiographic findings of isolated bilateral macrodontia in a 14-year-old child. The patient was referred to the clinic with local crowding of maxillary and mandibular teeth. Radiographic findings revealed the presence of impacted macrodont mandibular second premolar on one side and erupted macrodontic premolar on the other side and their distinct morphological appearance, characterized by large, multitubercular, and molariform crowns and tapering, single roots. PMID:25685564

  13. 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)

    Gabriel Zago

    2010-01-01

    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.

  14. Novel Clinical Scale for Evaluating Pre-Operative Risk of Cerebral Herniation from Traumatic Epidural Hematoma.

    Science.gov (United States)

    Lin, Hong; Wang, Wen-Hao; Hu, Lian-Shui; Li, Jun; Luo, Fei; Lin, Jun-Ming; Huang, Wei; Zhang, Ming-Sheng; Zhang, Yuan; Hu, Kang; Zheng, Jian-Xian

    2016-06-01

    Secondary massive cerebral infarction (MCI) is the predominant prognostic factor for cerebral herniation from epidural hematoma (EDH) and determines the need for decompressive craniectomy. In this study, we tested the clinical feasibility and reliability of a novel pre-operative risk scoring system, the EDH-MCI scale, to guide surgical decision making. It is comprised of six risk factors, including hematoma location and volume, duration and extent of cerebral herniation, Glasgow Coma Scale score, and presence of preoperative shock, with a total score ranging from 0 to 18 points. Application of the EDH-MCI scale to guide surgical modalities for initial hematoma evacuation surgery for 65 patients (prospective cohort, 2012.02-2014.01) showed a significant improvement in the accuracy of the selected modality (95.38% vs. 77.95%; p = 0.002) relative to the results for an independent set of 126 patients (retrospective cohort, 2007.01-2012.01) for whom surgical modalities were decided empirically. Results suggested that simple hematoma evacuation craniotomy was sufficient for patients with low risk scores (≤9 points), whereas decompressive craniectomy in combination with duraplasty were necessary only for those with high risk scores (≥13 points). In patients with borderline risk scores (10-12 points), those having unstable vital signs, coexistence of severe secondary brainstem injury, and unresponsive dilated pupils after emergent burr hole hematoma drainage had a significantly increased incidence of post-traumatic MCI and necessity of radical surgical treatments. In conclusion, the novel pre-operative risk EDH-MCI evaluation scale has a satisfactory predictive and discriminative performance for patients who are at risk for the development of secondary MCI and therefore require decompressive craniectomy. PMID:25393339

  15. The role of CT in pelvic fracture. CT finding of retro-peritoneal hematoma and indication of transcatheter arterial embolization

    International Nuclear Information System (INIS)

    Although retro-peritoneal hematoma accompanying a pelvic fracture has been treated by arterial ligation formerly, it is associated with a high mortality rate and a transcatheter arterial embolization has now become the first choice of treatment. Meanwhile, the usefulness of computed tomography (CT) in traumatized patient has been reported frequently. Our hospital also employs CT positively as an examination following plain radiography in the cases with pelvic fracture. However, while indication of angiography is seen in several reports, the amount of retro-peritoneal hematoma as an index has not been reported. In the present study, we examined 112 patients given CT at the time of examination at the emergency center of our hospital between April 1, 1988, and June 30, 1997, and classified the amount of retro-peritoneal hematoma on CT into 5 groups to discuss indication of angiography. In the cases with moderate or massive amount of retro-peritoneal hematomas, cases with shock state exceeded 60% and the amount of hematoma was considered to reflect the circulation profile to a certain extent. As the amount of retro-peritoneal hematoma increased, the number of cases given embolization also increased; embolization was performed in 29 cases (61.7%) among those which had moderate or massive amount of hematoma. From the above findings, it was predicted that the amount of retro-peritoneal hematoma could be one of the deciding factors for indication of angiography. However, as there are cases falling into a shock state due to gradual increase of hematoma or associated with injuries in other organs, careful observation is needed for the cases judged out of indication. (author)

  16. 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 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.

  17. Ligamentum flavum hematoma: a case report and literature review Hematoma del ligamento amarillo: caso clínico y revisión de la literatura Hematoma de ligamento amarelo: relato de caso e revisão da literatura

    Directory of Open Access Journals (Sweden)

    Ericson Sfreddo

    2012-01-01

    Full Text Available The aim is to present a rare case of ligamentum flavum hematoma in the lumbar region, discuss its physiopathology and treatment and review the literature. A woman aged 68 presented with neurogenic claudication due to degenerative lumbar spondylolisthesis that evolved into a sudden worsening with cauda equina syndrome. The magnetic resonance imagining (MRI showed signs of degeneration of the lumbar spine, with a narrow spinal canal from L2 to S1, anterolisthesis L4 L5 and an expansive lesion hyperintense on T1-weighted and hypointense on T2-weighted images considered compatible with hematoma in the topography of the yellow ligament in L1-L2. The patient underwent laminectomy and lumbar fixation. Her evolution was good in the postoperative period and at 18 months of follow-up hse walked alone, despite the pain that is controlled with simple medications. Even though rare, it seems that ligamentum flavum hematoma has a relationship with the degeneration and rupture of small vessels associated with micro trauma to the spine. Its physiopathology is not well defined and treatment is similar to other spine compression processes.El objetivo es presentar un caso raro de un hematoma ligamento flavum en la región lumbar, discutir su fisiopatología y el tratamiento y revisión de la literatura. Una mujer de 68 años presentó claudicación neurogénica debido a la espondilolistesis lumbar degenerativa y que se convirtió en un repentino empeoramiento con el síndrome de cauda equina. Una imagen de resonancia magnética (RM mostró signos de degeneración de la columna lumbar, con canal espinal estrecho de L2 a S1, anterolistesis L4 L5 y en la L1-L2, un proceso expansivo redondeado e hiperintenso en T1 y hipointenso en los bordes en T2, compatible con hematoma en la topografía del ligamento amarillo. La paciente fue sometida a laminectomía y fijación lumbar. Su evolución fue buena en el postoperatorio y, a los 18 meses de seguimiento caminaba sola, a

  18. Computational Study of Subdural Cortical Stimulation: Effects of Simulating Anisotropic Conductivity on Activation of Cortical Neurons.

    Directory of Open Access Journals (Sweden)

    Hyeon Seo

    Full Text Available Subdural cortical stimulation (SuCS is an appealing method in the treatment of neurological disorders, and computational modeling studies of SuCS have been applied to determine the optimal design for electrotherapy. To achieve a better understanding of computational modeling on the stimulation effects of SuCS, the influence of anisotropic white matter conductivity on the activation of cortical neurons was investigated in a realistic head model. In this paper, we constructed pyramidal neuronal models (layers 3 and 5 that showed primary excitation of the corticospinal tract, and an anatomically realistic head model reflecting complex brain geometry. The anisotropic information was acquired from diffusion tensor magnetic resonance imaging (DT-MRI and then applied to the white matter at various ratios of anisotropic conductivity. First, we compared the isotropic and anisotropic models; compared to the isotropic model, the anisotropic model showed that neurons were activated in the deeper bank during cathodal stimulation and in the wider crown during anodal stimulation. Second, several popular anisotropic principles were adapted to investigate the effects of variations in anisotropic information. We observed that excitation thresholds varied with anisotropic principles, especially with anodal stimulation. Overall, incorporating anisotropic conductivity into the anatomically realistic head model is critical for accurate estimation of neuronal responses; however, caution should be used in the selection of anisotropic information.

  19. Giant frontal mucocele complicated by subdural empyema: treatment of a rare association.

    Science.gov (United States)

    Visocchi, Massimiliano; Esposito, Giuseppe; Della Pepa, Giuseppe Maria; Doglietto, Francesco; Nucci, Carlotta Ginevra; Fontanella, Marco Maria; Montano, Nicola

    2012-03-01

    Giant frontal mucocele (GFM) is an extremely rare cause of frontal lobe syndrome. Subdural empyema (SDE) is an uncommon complication of paranasal sinisutis, for which craniotomy and decompressive craniotomy are the most effective surgical procedures. A 54-year-old man was brought unconscious to the emergency room where recurrent generalized seizures occurred. Heroine abuse, HCV-related hepatitis, prolonged antibiotic therapy for treatment of purulent rhinorrhea, along with recent personality changes were reported. High white blood cell count, pansinusitis, GFM, SDE and cerebritis were documented. The patient underwent bifrontal craniotomy in emergency, extensive drilling of the inner aspect of the frontal bone, surgical toilet of the enlarged frontal sinus and its "cranialization". Prevotella intermedia and Fusobacterium nucleatum were isolated and antibiotic therapy was started intravenously and then continued orally for 3 months. 2 years later the patient has recovered, though minor signs of frontal lobe syndrome persist. To the authors knowledge, this is the first case of GFM with SDE reported in the literature. Although decompressive craniectomy is advocated in extreme conditions, as in this case, "internal decompressive craniectomy", obtained with craniotomy and cranialization of the frontal sinuses, is strongly advocated in cases of SDE associated with megasinuses. PMID:22427297

  20. BILATERAL OVARIAN MASS COMPLICATING PREGNANCY

    Directory of Open Access Journals (Sweden)

    Arjumand

    2015-06-01

    Full Text Available A 22 years old patient with 9 months of Amenorrhoea with a abdominal swelling was admitted to our institution with an Ultrasonography report of Bilateral ovarian mass (14.3x5.9cm in left ovary and (9.5x7cm in right ovary with internal vascularity with septations along with single live intrauterine fetus. She delivered by elective caesarean section in V/O breech presenta tion. Left side ovarian cystectomy done Right side ovarian puncture done. Histopathology showed left side – Mucinous cystadenoma. Right Side – Follicular cyst. Mucinous cystadenomas are benign epithelial ovarian tumors which tend to be unilateral, bilateral a nd multilocular with smooth surface and contain mucinous fluid, 75% of all mucinous tumors are benign, while 10% are borderline and 15% are invasive carcinomas. Benign mucinous tumors are most common in the third to fifth decades of life and may be 20 - 30 c ms in size. The incidence of ovarian cysts during pregnancy is less than 5% and most of them are benign in nature. G i ant cysts found in less than 1% of the cases of ovarian cysts with pregnancy.

  1. [Simultaneous bilateral pneumothorax. Case report].

    Science.gov (United States)

    Paolini, A; Caminiti, F; Tosato, F; Ruggieri, M; Paolini, G; Carnevale, L; Corsini, F; Marano, S; Monsellato, I

    2001-04-01

    A case report of a 44 year-old white man admitted to the surgical unit for a bilateral simultaneous pneumothorax is presented. The pneumothorax occurred on day one after a surgical operation for discal hernia; in the past the patient already presented a right spontaneous pneumothorax at 32 years of age and a left pneumothorax at 37 years of age, both treated with a pleural drainage. A thoracic drain was bilaterally positioned with a good result only in the right side. The persistence of the left pneumothorax induced the authors to perform a postero-lateral thoracotomy bullae excision and pleurectomy with a good postoperative course. After a few months a new right pneumothorax occurred and the patient was treated with a right postero-lateral thoracotomy, bullae resection and pleurectomy. On the basis of the case reported, the authors consider the different opportunities in the treatment of spontaneous pneumothorax in relation to the present knowledges and technologies. Surgical procedure is to be preferred in case of persistence of pneumothorax despite a pleural drain and in case of pneumothorax in high risk subjects. Even if thoracoscopy seems to give better results regarding postoperative pain, it is not always possible with such a method to perform a careful pleurectomy neither to obtain it in all cases (above all in secondary pneumothorax). Every case must then be carefully studied to choose the best treatment at present available. PMID:11353349

  2. Multiresolution Bilateral Filtering for Image Denoising

    OpenAIRE

    Zhang, Ming; Gunturk, Bahadir K.

    2008-01-01

    The bilateral filter is a nonlinear filter that does spatial averaging without smoothing edges; it has shown to be an effective image denoising technique. An important issue with the application of the bilateral filter is the selection of the filter parameters, which affect the results significantly. There are two main contributions of this paper. The first contribution is an empirical study of the optimal bilateral filter parameter selection in image denoising applications. The second contri...

  3. Bilateral ovarian tumour in a young girl

    Directory of Open Access Journals (Sweden)

    Krishna Kumar Govindarajan

    2013-01-01

    Full Text Available Bilateral ovarian tumour in a girl presents the dilemma of conservative versus aggressive approach towards these tumours. When faced with suspicious tumour and complete replacement of the ovaries bilaterally, bilateral oophorectomy is a viable option, though the certain possibility of infertility and lifelong hormonal supplementation is unavoidable. We report a case of bilateral ovarian masses in a young girl, which on histopathological examination showed mature teratoma with aggregates of proliferating capillary and cavernous sized vessels in the tumour wall. Such associations are rare and must be differentiated from a vascular neoplasm.

  4. Bilateral Clavicle Fracture in two Newborn Infants

    Directory of Open Access Journals (Sweden)

    Ali Kanik

    2011-12-01

    Full Text Available Background: The fracture of clavicle is the most frequently observed bone fracture as birth trauma and it is usually unilateral. It is seen following shoulder dystocia deliveries or breech presentation of macrosomic newborns.Case Presentation: We report two macrosomic newborns with bilateral clavicle fracture and brachial plexus palsy due to birth trauma. Chest X-rays confirmed bilateral fracture of clavicles. Both patients were recovered without any sequel.Conclusion: Bilateral clavicular fracture should be considered in any neonate with bilateral absent Moro reflexes.

  5. Bilateral Clavicle Fracture in Two Newborn Infants

    Directory of Open Access Journals (Sweden)

    Esra Arun Ozer

    2011-12-01

    Full Text Available Background: The fracture of clavicle is the most frequently observed bone fracture as birth trauma and it is usually unilateral. It is seen following shoulder dystocia deliveries or breech presentation of macrosomic newborns.Case Presentation: We report two macrosomic newborns with bilateral clavicle fracture and brachial plexus palsy due to birth trauma. Chest X-rays confirmed bilateral fracture of clavicles. Both patients were recovered without any sequel.Conclusion: Bilateral clavicular fracture should be considered in any neonate with bilateral absent Moro reflexes.

  6. Traumatic Subdural Hydroma in Children-A Report of 7 Cases%小儿外伤性硬膜下水瘤(附7例报告)

    Institute of Scientific and Technical Information of China (English)

    章翔; 易声禹

    1985-01-01

    @@ 外伤性硬膜下水瘤(Traumatic Subdural Hygroma,TSH)系指头部外伤后数小时、数月乃至数年内,在硬脑膜下腔形成一种清亮或黄色液体积蓄.%7 cases of traumatic subdural hydroma in children treated between 1958 and 1984 are presented.4 were boys and 3 girls,aged between 7 months and 13 years with an average age of 5.3 years.All the patients presented themselves with a history of head injury,and most of them showed marked increasing intracranial pressure with focal neurologic functional deficit.The authors recommend craniotomy or subdural tapping drainage as choice treatment according to the nature of the hydroma.The results in this series were satisfactory.

  7. A Case Report of Bilateral Mirror Clubfeet and Bilateral Hand Polydactyly

    OpenAIRE

    Nguyen, Mai P; Lawler, Ericka A.; Morcuende, Jose A.

    2014-01-01

    We report a rare case of a patient with bilateral mirror clubfeet and bilateral hand polydactyly. The patient presented to our orthopaedic clinic with bilateral mirror clubfeet, each with eight toes, and bilateral hands with six fingers and a hypoplastic thumb. The pattern does not fit any described syndrome such as Martin or Laurin-Sandrow syndrome. Treatments by an orthopaedic pediatric surgeon and an orthopaedic pediatric hand surgeon are described. The patient achieved excellent functiona...

  8. Bilateral microvascular second toe transfer for bilateral post-traumatic thumb amputation

    OpenAIRE

    Rajendra Nehete; Anita Nehete; Sandeep Singla; Harshad Adhav

    2012-01-01

    In bilateral thumb amputations, the functional impairment is serious and every attempt should be made to reconstruct the thumb. We report a case of bilateral post traumatic thumb amputation, reconstructed with bilateral second toe transfer. Only two such cases have been reported in literature so far. Though there are various modalities for the reconstruction of thumb, microvascular toe transfer has its own merits. The convalescent period is minimal with excellent function. It is bilaterally s...

  9. Bilateral metachronous breast cancer with bilateral recurrences: A case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Park, So Hyun; Sohn, Yu Mee [Dept. of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Kim, Eun Kyung [Dept. of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-05-15

    The incidence of bilateral breast cancer has been reported to range from 0.4% to 14%, and it increases gradually as a result of improved early detection capabilities and longer survival times. We report a rare case where the bilateral breast cancers occurred as a metachronous bilateral breast cancer with bilateral recurrences, detected by mammography, and the rapid growth of tumor that manifested as microcalcification and skin thickening within 3 months.

  10. Diagnosis of epidural hematoma by brain scan and perfusion study: case report. [/sup 99m/Tc tracer techniques

    Energy Technology Data Exchange (ETDEWEB)

    Buozas, D.J.; Barrett, I.R.; Mishkin, F.S.

    1976-11-01

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

  11. Outcome and prognostic factors for dogs with a histological diagnosis of splenic hematoma following splenectomy: 35 cases (2001-2013).

    Science.gov (United States)

    Patten, Steve G; Boston, Sarah E; Monteith, Gabrielle J

    2016-08-01

    Canine splenic hematoma can be indistinguishable from hemangiosarcoma on clinical presentation and grossly at the time of surgery. However, hemangiosarcoma represents an aggressive malignancy and a misdiagnosis of hematoma would forgo indications for chemotherapy. This study describes a long-term follow-up of cases with a histologic diagnosis of splenic hematoma following splenectomy to determine if the clinical course of the disease corroborated the diagnosis. Thirty-five dogs were evaluated to determine survival and prognostic associations with signalment and clinical data. Overall median survival time was 647 days (range: 0 to 3287 days). Statistically significant variables included a palpable abdominal mass during physical examination, sub-clinical coagulopathy, and metastasis. Four cases (11%) had reported evidence of metastasis at the time of euthanasia; 1 case was histologically confirmed. Overall prognosis for splenic hematoma appears excellent, as expected, but a small proportion of cases may have an undiagnosed malignant component. PMID:27493283

  12. Bilateral Auricular Milia en Plaque

    Directory of Open Access Journals (Sweden)

    Savaş

    2011-12-01

    Full Text Available Milia en plaque (MEP is an extremely rare form of milia that is characterized by a number of milia-like cysts on an erythematous base and histologically exhibits features of keratin cysts. The etiology is not exactly known. MEP is generally seen among middle-aged women and especially on the head and neck region. Many of the diagnosed cases are localized in the retroauricular region, eyelids and the nose region. To date, no case of MEP in the auricula has been reported in the literature. In this article, we present the case of a 71-year-old female patient clinically and histologically diagnosed with bilateral auricular milia en plaque (in the external ear canal in the light of current literature. (Turk­derm 2011; 45: 216-8

  13. Sequential bilateral retinal artery occlusion

    Directory of Open Access Journals (Sweden)

    Padrón-Pérez N

    2014-04-01

    Full Text Available Noel Padrón-Pérez,1 Janny Rosario Aronés,2 Silvia Muñoz,1 Luis Arias-Barquet,1 Jorge Arruga1,31Department of Ophthalmology, Hospital Universitari de Bellvitge, 2Hospital de l'Esperança – Parc de Salut Mar, 3Institut Català de Retina, Barcelona, SpainAbstract: An 86 year old woman experienced a sequential bilateral loss of vision over a period of less than 24 hours. Clinical findings and complementary studies suggested a bilateral atherogenic embolic event. Initially, she presented a superior branch retinal artery occlusion in her right eye followed by a central retinal artery occlusion with cilioretinal artery sparing in her left eye. Some conservative maneuvers performed did not improve visual acuity in the left eye. Supra-aortic Doppler ultrasonography revealed mild right internal carotid artery stenosis and moderate left internal carotid artery stenosis with a small, smooth, and homogeneous plaque. The transthoracic echocardiography showed a severe calcification of the mitral valve with a mild-moderate rim of stenosis. Central retinal artery occlusion and branch retinal artery occlusion are characterized by painless monocular loss of vision. Clinical approach and management attempt to treat the acute event, find the source of the vascular occlusion, and prevent further vascular events from occurring. Giant cell arteritis is a potentially treatable cause of central retinal artery occlusion and should be excluded in every single patient over 50 years old.Keywords: loss of vision, branch retinal artery occlusion, central retinal artery occlusion, Hollenhorst plaque

  14. Lack of evidence for a causal relationship between hypoxic-ischemic encephalopathy and subdural hemorrhage in fetal life, infancy, and early childhood

    DEFF Research Database (Denmark)

    Byard, Roger W; Blumbergs, Peter; Rutty, Guy;

    2013-01-01

    It has been asserted that hypoxic-ischemic encephalopathy (HIE) with cerebral swelling in the absence of marked trauma may be responsible for subural hemorrhage in the young. As this may have considerable implications in determining both the mechanism of death and the degree of force required to...... determined in 4 instances. In no case was there macroscopic evidence of subdural hemorrhage. In this study no support could be given to the hypothesis that HIE in the young in the absence of trauma causes subdural hemorrhage....

  15. Spinal Subdural Abscess Following Laminectomy for Symptomatic Stenosis: A Report of 2 Cases and Review of the Literature.

    Science.gov (United States)

    Ramos, Alexander D; Rolston, John D; Gauger, Grant E; Larson, Paul S

    2016-01-01

    BACKGROUND Spinal subdural abscesses, also known as empyemas, are rare infectious lesions, the exact incidence of which is unknown. Presentation is typically dramatic, with back pain, fever, motor, and sensory deficits. Rapid identification and surgical intervention with laminectomy, durotomy, and washout provides the best outcomes. While hematogenous spread of an extra-spinal infection is the most common cause of this condition, a significant number of cases result from iatrogenic mechanisms, including lumbar punctures, epidural injections, and surgery. CASE REPORT Here we present 2 cases: 1) an 87-year-old man with type 2 diabetes, schizophrenia, mild cognitive impairment, and symptomatic lumbar spinal stenosis and 2) a 62-year-old man with a prior L3-4 spinal fusion with symptomatic lumbar spinal stenosis. In both cases, patients underwent laminectomy for spinal stenosis and developed epidural abscess. Following successful drainage of the epidural abscess, they continued to be symptomatic, and repeat imaging revealed the presence of a subdural abscess that was subsequently evacuated. Case 1 had significant improvement with residual lower-extremity weakness, while Case 2 made a complete neurological recovery. CONCLUSIONS These cases illustrate patients at increased risk for developing this rare spinal infection, and demonstrate that rapid recognition and surgical treatment is key to cure and recovery. Review of the literature highlights pertinent risk factors and demonstrates nearly one-third of reported cases have an iatrogenic etiology. The cases presented here demonstrate that a subdural process should be suspected in any patient with intractable pain following treatment of an epidural abscess. PMID:27402228

  16. Progression of cerebellar chronic encapsulated expanding hematoma during late pregnancy after gamma knife radiosurgery for arteriovenous malformation

    OpenAIRE

    Takashi Watanabe; Hideki Nagamine; Shogo Ishiuchi

    2014-01-01

    Background: The etiology and appropriate management strategy of chronic encapsulated expanding hematoma during pregnancy after gamma knife radiosurgery for arteriovenous malformation (AVM) remain unclear. Case Description: A 34-year-old female developed chronic encapsulated expanding hematoma during late pregnancy, after angiographic disappearance of cerebellar AVM following two courses of gamma knife radiosurgery. The present case implicates pregnancy as a potential promoter of growth an...

  17. Natural history of spontaneous aortic intramural hematoma progression: Six years follow-up with cardiovascular magnetic resonance

    OpenAIRE

    Zhao Lei; Fan Zhanming; Zhang Zhaoqi; Ma Xiaohai; Yu Jing

    2010-01-01

    Abstract We described a 6 years follow-up of a spontaneous aortic intramural hematoma (IMH) with cardiovascular magnetic resonance (CMR) examination. Since multiple factors may play roles in the natural history of IMH, the patient experienced the course of progression, which included hematoma absorption, ulcer-like lesion, aneurysm and limited dissection. The initial and follow-up CMR examination included 3D CE MRA and non-enhanced "bright blood" pulse sequence. The inherent advantage of outs...

  18. Warfarin-induced sublingual hematoma mimicking Ludwig angina: Conservative management of a potentially life-threatening condition.

    LENUS (Irish Health Repository)

    Cashman, Emma

    2011-02-01

    Sublingual hematoma secondary to excessive anticoagulation is a rare, life-threatening condition. Reports in the literature have emphasized the importance of a prompt reversal of the causative coagulopathy by intravenous administration of vitamin K and fresh frozen plasma. In the event of an unstable airway, surgical intervention via tracheostomy or cricothyroidectomy is advocated. We report a case of sublingual hematoma that was treated conservatively, and we discuss the presentation and management of this entity.

  19. Warfarin-induced sublingual hematoma mimicking Ludwig angina: Conservative management of a potentially life-threatening condition.

    LENUS (Irish Health Repository)

    Cashman, Emma

    2012-02-01

    Sublingual hematoma secondary to excessive anticoagulation is a rare, life-threatening condition. Reports in the literature have emphasized the importance of a prompt reversal of the causative coagulopathy by intravenous administration of vitamin K and fresh frozen plasma. In the event of an unstable airway, surgical intervention via tracheostomy or cricothyroidectomy is advocated. We report a case of sublingual hematoma that was treated conservatively, and we discuss the presentation and management of this entity.

  20. Bilateral failure of adduction following orbital decompression.

    OpenAIRE

    Kinsella, F; Kyle, P.; Stansfield, A

    1990-01-01

    We report a case of bilateral complete failure of adduction following bilateral translid antralethmoidal orbital decompression. We believe the probable mechanism is neuropraxia (temporary dysfunction) of the third cranial nerves' supply to the medial recti, owing to these nerves' occupying an anatomically abnormal position. Partial recovery of adduction occurred over the ensuing six months.