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Sample records for hypertensive putaminal hemorrhage

  1. Relationship between CT findings and consciousness in patients with hypertensive putaminal hemorrhage

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    Yamane, Kanji; Mikami, Takashi; Takahashi, Masaru; Shibata, Kenji (Matsue Red Cross Hospital (Japan)); Kuwabara, Satoshi; Uemura, Yoshihiko

    1984-10-01

    The authors studied 66 patients with hypertensive putaminal hemorrhage and noted a close relationship between the CT classfication according to the shape of the suprasellar cistern (S) and the third ventricle (III), and the state of altered consciousness: when S is not deformed and III is identified in CT images, the patient may be in a clear or confusional state; if S is not deformed but III is not identified or is packed with hematoma, consciousness may be somnolent or stuporous; if S is deformed and III is not identified or is packed with hematoma, the patient may be in a semicomatose or comatose state. However, within several hours after onset there are exceptional cases in which the states of consciousness do not correlate with the CT findings. In these cases, however, with conservative therapy the state of consciousness corresponded well with the CT findings. From the neurosurgical points of view, immediate removal of the hematoma is required when the patient's consciousness is relatively good despite of large hematoma. If at the acute stage the state of consciouness, which corresponded well with the CT findings at initial examination, has deteriorated, rebleeding or enlargement of hematoma must be suspected.

  2. Treatment of huge hypertensive putaminal hemorrhage by surgery and cerebrospinal fluid drainage.

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    Zhang, Hong-Tian; Xue, Sha; Li, Pei-Jian; Fu, Yan-Bin; Xu, Ru-Xiang

    2013-09-01

    There is limited information available regarding the treatment of huge hypertensive putaminal hemorrhage (HPH). This study aimed to evaluate our experience of 33 patients with huge HPH who were treated by open surgery (decompressive craniectomy and hematoma evacuation) and external cerebrospinal fluid (CSF) drainage. We reviewed the records of 33 consecutive patients admitted to our hospital with huge HPH (≥ 60 cm(3)). All patients were treated by decompressive craniectomy, hematoma evacuation, and CSF drainage. Data collected included age, gender, blood pressure at admission, Glasgow Coma Scale (GCS) score, intracranial hemorrhage (ICH) location, ICH volume, degree of midline shift, presence/absence of basal cistern obliteration at admission and before surgery, and presence/absence of intraventricular hemorrhage (IVH). Outcome was assessed by the Glasgow Outcome Scale score at 30 days after surgery. The median GCS score was 5.0 at admission, and improved to 8.0 at 1 week after surgery. The median ICH volume was 95 cm(3) before surgery and 4 cm(3) after surgery. IVH was observed in 93.9% of patients. The overall survival rate to discharge was 75.6% (25/33), including 15.1% (4/33) with good function, 36.4% (12/33) with disability, and 24.3% (8/33) in a vegetative state. The mortality rate was 24.3% (8/33). Patients with right-sided ICH had better outcomes than those with left-sided ICH. No patients with GCS score ≤ 6 and ICH volume ≥ 90cm(3) at admission achieved good postoperative function. Operative time was significantly shorter with hematoma evacuation via the transcortical approach than via the transsylvian approach (3.41 ± 0.75 h vs. 4.14 ± 0.59 h, Phuge HPH by decompressive craniectomy, hematoma evacuation, and CSF drainage is life-saving. Patients with GCS score 7-8, ICH volume 60-90 cm(3), and right-sided ICH may achieve good recovery. The transcortical approach appears to be more effective than the transsylvian approach for rapid decompression of

  3. Evaluation of cerebro-circulatory metabolic conditions and prognosis in hypertensive putaminal hemorrhage by {sup 31}P-MRS

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    Deguchi, Itaru [Tokyo Medical Coll. (Japan)

    2000-07-01

    Phosphorus-31 nuclear magnetic resonance spectroscopy ({sup 31}P-MRS) provides a non-invasive means to obtain metabolic information. We studied cerebro-circulatory metabolic conditions in the subacute phase of hypertensive putaminal hemorrhage with {sup 31}P-MRS and N-isopropyl-I-(123)-p-Iodoamphetamine single photon emission computed tomography ({sup 123}I-IMP SPECT). The subjects consisted of 33 cases of hypertensive putaminal hemorrhage. Upon evaluation of cerebral blood flow (CBF) around the ipsilateral frontal lobe cortex and examination by {sup 123}I-IMP SPECT, they would broadly divided into the following three groups: (A) a group with high uptake on both the early image and delayed image, (B) a group with low uptake on the early image but with good redistribution, and (C) a group with low uptake on both images. In these groups {sup 31}P-MRS in the ipsilateral frontal lobe cortex was measured for comparative analysis. In group A, the PCr/Pi ratio was 3.12{+-}0.14 as opposed to 2.87{+-}0.13 in group B, and the ratio was extremely depressed in group C, 1.96{+-}0.16. These observations implied that a high level circulatory metabolic disorder was present in group C and that local viability or metabolic activity was relatively well maintained despite the low perfusion in group B with a satisfactory prognosis being expected due to their high functional level. (author)

  4. Auditory agnosia associated with bilateral putaminal hemorrhage: A case report of clinical course of recovery.

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    Tokida, Haruki; Kanaya, Yuhei; Shimoe, Yutaka; Imagawa, Madoka; Fukunaga, Shinya; Kuriyama, Masaru

    2017-08-31

    A 45-year-old right-handed man with a past history (10 years) of putaminal hemorrage presented with auditory agnosia associated with left putaminal hemorrhage. It was suspected that the auditory agnosia was due to bilateral damage in the acoustic radiations. Generalized auditory agnosia, verbal and non-verbal (music and environmental), was diagnosed by neuropsychological examinations. It improved 4 months after the onset. However, the clinical assessment of attention remained poor. The cognition for speech sounds improved slowly, but once it started to improve, the progress of improvement was rapid. Subsequently, the cognition for music sounds also improved, while the recovery of the cognition for environmental sounds remained delayed. There was a dissociation in recovery between these cognitions. He was able to return to work a year after the onset. We also reviewed the literature for cases with auditory agnosia and discuss their course of recovery in this report.

  5. Chinese writing function in patients with left versus right putaminal hemorrhage.

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    Hua, M S; Chen, S T; Chu, Y C

    2001-06-01

    This study was designed to explore the Chinese writing function of patients with subcortical stroke. Two cohorts of patient subjects with either the left or the right subcortical strokes, mainly putaminal hemorrhagic strokes, and one group of normal controls participated in the study. All participants received a writing test battery including the three aspects of writing function, that is, Spontaneous Writing, Writing to Dictation, and Writing from Copy, as well as a battery of non-writing linguistic tests. Comparing with normal controls revealed that writing function change occurred in both patient groups. The deficits in the patients with the left subcortical stroke essentially included Spontaneous Writing, and Writing to Dictation. These impairments were most likely secondary to aphasic disorders. The writing problem, mainly Writing from Copy, was noted in the patients with the right subcortical stroke. This deficit, however, was independent of the core linguistic impairment. On the basis of the results, we suggest that the lesion involving white matter in the left hemisphere probably interrupts left perisylvian cortical language organization in a manner that produces problems with spontaneous writing and writing to dictation, which are language-related, associated with lesion in the dominant hemisphere. This further suggests that left or right subcortical lesions in the putamen and surrounding white matter are associated with differential effects (language vs. non-language based effects) which are similar to such differences observed with left vs. right cortical lesions.

  6. Semiquantitative regional cerebral blood flow evaluation using sup 123 I-IMP SPECT in a case showing transient ischemic attack caused by putaminal hemorrhage

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    Tsuda, Y.; Ayada, Y.; Takahashi, T.; Toyama, Y.; Matsuo, H. (Second Department of Internal Medicine, Kagawa Medical School (Japan)); Katsuragawa, M.; Tanabe, M. (Department of Radiology, Kagawa Medical School (Japan))

    1991-01-01

    A 69-year-old woman presented a transient cerebral ischemic attack, showing left arm weakness and slurred speech which recovered within 4 h of onset, while computed tomography indicated a putaminal hemorrhage. The regional cerebral blood flow distribution, measured semiquantitatively by use of {sup 123}I amphetamine emission tomography, was disturbed, which persisted more than one month up to a maximum of 4.5 months from the onset of symptoms. the case illustrates a variety of putaminal hemorrhage of good functional and vital prognosis, and provides and example in which the regional cerebral blood flow disturbances might persist for more than one month up to 4.5 months after the occurrence of a transient ischemic attack caused by a putaminal hemorrhage. (author).

  7. Bilateral putaminal hemorrhage related to methanol poisoning: a complication of hemodialysis? Case report Hemorragia putaminal bilateral em intoxicação por metanol: uma complicação de hemodiálise? Relato de caso

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    Miguel Giudicissi Filho; Holanda,Carlos V. M.; Nader,Nelson A.; Sergio R. P. Gomes; Bertolucci, Paulo H.F.

    1995-01-01

    A case of acute methanol intoxication is presented, in which bilateral putaminal hemorrhage developed after hemodialysis. Even though the patient was initially comatose and profoundly acidotic, favorable outcome was achieved, with long-term neurologic impairments essentially restricted to mild crural paraparesis, retrograde amnesia, and marked visual deficit. A comparative literature review is evaluated.Um caso de intoxicação aguda por metanol é relatado, no qual o paciente desenvolveu hemorr...

  8. Evaluation by computed tomography of the destruction of the internal capsule in hypertensive intracerebral hemorrhage

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    Tomita, Yukio; Ohuchi, Tadao; Yukawa, Hideki; Konno, Jyoji; Saiki, Iwao (Iwate Medical Coll., Morioka (Japan). School of Medicine)

    1983-12-01

    Seventy-five patients, 37 with putaminal hemorrhage and 38 with thalamic hemorrhage. were examined by CT immediately after the ictus and while the patients were undergoing conservative treatment. The distance was measured on every CT from the center of the pineal body to the inside edge of the hematoma in the putaminal hemorrhage and to the outside edge in the thalamic hemorrhage, by using a slice 5 cm above the orbitomeatal line on which the pineal body was clearly recognizable. At 6 months after ictus, recuperations from hemiplegia were estimated in all patients and compared with the degree of the measured distance on CT. In the group of patients who had recovered completely from hemiplegia, the degrees were more than 28 mm in the cases of putaminal hemorrhage and less than 32 mm in the cases of thalamic hemorrhage. If the degrees were under 25 mm in the putaminal hemorrhage or over 36 mm in the thalamic hemorrhage, no rehabilitation was effective for their paralytic upper extremities. Measurements of the internal capsule were also performed on three fresh brains without cerebral disease. The normal values of the distance were 34.7+-1.0 mm from the center of the pineal body to the outside edge of the posterior limb of the internal capsule and 25.0+-0.9 mm to its inside edge. Judging from these results, it is thought that the attainable limits of avoiding destruction of the posterior limb of the internal capsule by the hematoma are 28 mm in the case of a putaminal hemorrhage and 32 mm in the case of a thalamic hemorrhage. Therefore, it was considered that the internal capsule can be shifted about 7 mm to the medial or lateral side without any direct or indirect effects from the hematoma.

  9. Correlative research between homocysteine,cystatin C and patients with essential hypertension and hypertensive intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    孙屿

    2014-01-01

    Objective To investigate the correlation between homocysteine(Hcy),cystatin C(Cys C)and patients with essential hypertension and hypertensive intracerebral hemorrhage.Methods Subjects were divided into hypertensive intracerebral hemorrhage group(108 cases),essential hypertension group(100 cases)and control group(100 cases),and their cystatin C,homocysteine and total cholesterol(TC)and triglycerides(TG)were surveyed.Results The patients with hypertensive intracerebral hemorrhage and essential hypertension had higher

  10. Contrast study on CT and BA in cerebral hemorrhage due to hypertension%CONTRAST STUDY ON CT AND BA IN CEREBRAL HEMORRHAGE DUE TO HYPERTENSION

    Institute of Scientific and Technical Information of China (English)

    Mingshun Liu; Guoqiu Wang; Po Ma

    2007-01-01

    Objectives:To explore contrast application on CT and BA in cerebral hemorrhage due to hypertension. Methods: CT and BA were examined in 106 patients with cerebral hemorrhage due to hypertension. Results:The different changes of CT and BA were showed in 106 patients with cerebral hemorrhage due to hypertension. Conclusions: There were separately different advantage and shortcoming in CT and BA in diagnosis of cerebral hemorrhage due to hypertension. The value of clinical application of BA was important in cerebral hemorrhage due to hypertension.

  11. Putaminal involvement in Rasmussen encephalitis

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    Rajesh, Bhagavatheeswaran; Ashalatha, Radhakrishnan [Sree Chitra Tirunal Institute for Medical Sciences and Technology, Department of Neurology, Trivandrum, Kerala (India); Kesavadas, Chandrasekharan; Thomas, Bejoy [Sree Chitra Tirunal Institute for Medical Sciences and Technology, Department of Imaging Sciences and Interventional Radiology, Trivandrum, Kerala (India)

    2006-08-15

    Rasmussen encephalitis (RE) is a rare devastating disease of childhood causing progressive neurological deficits and intractable seizures, typically affecting one hemisphere. Characteristic MRI features include progressive unihemispheric focal cortical atrophy and grey- or white-matter high-signal changes and basal ganglion involvement, particularly of the caudate nucleus. To analyse the pattern of involvement of different brain structures in a series of patients with RE and to attempt clinical correlation. We reviewed the medical records and neuroimaging data of 12 patients diagnosed with RE satisfying the European Consensus Statement diagnostic criteria. The disease manifested as seizures in all patients and was refractory; epilepsia partialis continua was a notable feature (nine patients). Hemiparesis of varying grades was noted in all but one patient; none had extrapyramidal signs. Neuroimaging showed cortical involvement in the insular/periinsular regions in 11 patients. Caudate atrophy was noted in ten patients. Putaminal atrophy was seen in nine patients, six of whom had additional hyperintense signal changes. Our study highlights frequent putaminal atrophy and signal changes in RE, which suggests a more extensive basal ganglion involvement than emphasized previously. Recognition of putaminal changes may be a useful additional tool in the radiological diagnosis of RE. (orig.)

  12. The Frequency of Recurrence in Primary Hypertensive Intracerebral Hemorrhage

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    SA Mousavi

    2006-01-01

    Full Text Available Background: Primary intracerebral Hemorrhage (PICH is a devasting illness with high early mortality which causes 10 -12 percent of stroke cases. Survivors of PICH are at risk for recurrence of hemorrhage. We wanted to determine the frequency of recurrence of ICH in patients with PICH at Alzahra and Noor hospital Isfahan, Iran. Methods: A descriptive retrospective study was did on the hospital records of patients with a discharge diagnosis of intracerebral hemorrhage to identify the cases. Data were gathered by means of a check list and were analysed by using SPSS statistical software. Results: A total number of 660 cases were identified by computer search. After abstraction, 400 patients with primary hypertensive intracerebral hemorrhage were identified. Widespread distribution of recurrence of ICH were 65 cases which 33 cases of them were men and 32 cases were women. Conclusion: Totally, 16 .25 percent of patients had recurrence which is greater risk of recurrence in comparison to other studies. Key Words: Intracerebral Hemorrhage, hypertension, recurrence of Intracerebral Hemorrhage

  13. Youth hypertension cerebral hemorrhage in basal ganglia surgery operation analysis

    Institute of Scientific and Technical Information of China (English)

    Qi-Hua Wang; Da-Shuang Lu; Jie Cui; Bo-Lin Qiao; Jing-Chun Wang

    2016-01-01

    Objective:Discuss surgical treatment of youth hypertension cerebral hemorrhage in basal ganglia.Methods:Retrospective analysis from January 2012 to April 2015 were adopted to bone flap craniotomy decompression for removal of hematoma and drainage drilling two kinds of surgical treatment of 46 cases of young patients with hypertension cerebral hemorrhage in basal ganglia.Results:Surgical operation, 28 patients postoperative review head CT, no further hemorrhage cases, residual hematoma volume 2-6 mL. Drilling drainage in the treatment of 18 patients, 1 case was bleeding again given surgical operation to remove the hematoma and the rest of the 17 cases without bleeding again, after 3 d, 17 cases of patients of postoperative hematoma drainage thoroughly. After 6 months, 46 cases of patients with postoperative review, GOS score light disability 9 cases, moderate disability 33 cases, 4 cases were severely disabled, curative effect is satisfied.Conclusions:Two kinds of operative methods each have advantages and disadvantages, young patients with hypertension cerebral hemorrhage in basal ganglia should according to patients' disease progression after speed, on admission patient's state of consciousness and head CT measured on admission hematoma volume, respectively.

  14. Computed tomography in hypertensive cerebellar hemorrhage

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    Nose, T.; Maki, Y.; Ono, Y.; Yoshizawa, T.; Tsuboi, K. (Tsukuba Univ., Sakura, Ibaraki (Japan))

    1981-11-01

    Fourteen cases of cerebellar hemorrhage were analysed from the point of CT-scan, and the following results were obtained. 1. The number of cases of cerebellar hemorrhage forms 4.4% of that of total intracranial hemorrhage. 2. Most of the cerebellar hematomas extend upward. Downward extension is rare. 3. In acute dead cases hematomas are 5 cm or more in diameter and lie over bilateral hemispheres with the extension to third or fourth ventricles in CT-scans. 4. Slowly progressive cases are detriorated by the secondary hydrocephalus. 5. In mild cases hematomas are 3cm or less in diameter on CT-scans and the hematoma evacuation is not indicated for these cases. 6. The shunt operation alone is sufficient for the life saving of the slowly progressive cases, but the hematoma evacuation is indicated in these cases if the functional prognosis is taken into consideration. 7. Immediate hematoma evacuation together with the ventricular drainage is considered to be effective for the life saving of the acute fulminant cases.

  15. A study on correlation of obstructive sleep apnea-hypopnea syndrome and perihematoma edema of hypertensive cerebral hemorrhage

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    高晓刚

    2013-01-01

    Objective To analyse the correlation of obstructive sleep apnea-hypopnea syndrome (OSAHS) and perihematoma edema of hypertensive cerebral hemorrhage.Methods One hundred and forty-four patients with hypertensive cerebral hemorrhage were collected and 78 of

  16. Changes of vasoactive polypeptides during postoperative hypertensive crisis in patients with hypertensive intracerebral hemorrhage

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    WANG Zhi; WANG Xue-feng; WANG Chao; LUAN Wen-zhong

    2007-01-01

    Background Hypertensive crisis could be found after operation in patients with hypertensive intracerebral hemorrhage (HICH).The aim of this study was to explore the changes and the roles of some vasoactive polypeptides during postoperative hypertensive crisis in patients with HICH.Methods A total of 31 patients,who were admitted for craniotomy,were enrolled into this study.After the operation,the patients were divided into three groups.Group Ⅰ consisted of 9 patients with postoperative hypertensive crisis,and group Ⅱ was composed of 13 patients without postoperative hypertensive crisis.Nine patients,who denied history of hypertension or HICH,were set as group Ⅲ.The levels of some vasoactivators in the three groups were measured before and after the operation.The differences in the results among the groups were analyzed using the ANOVA.The data collected before and after the operation in the group Ⅰ was compared by Wilcoxon test.Results The concentration of endothelin in group Ⅰ was significantly higher than that in group Ⅲ (P0.05).Conclusions Postoperative hypertensive crisis may be due to the increased thromboxane A2 and relatively inadequate prostacyclin,especially 6-keto-PGF1α.The increased level of endothelin and intraoperative stimulation also play a certain role in the development of postoperative hypertensive crisis.

  17. Effects of hypertension on hemodynamic response and serum nitrite concentration during graded hemorrhagic shock in rats

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    Babak Barmaki; Ali Nasimi; Majid Khazaei

    2011-01-01

    Background: Hypertensive patients have higher morbidity and mortality from hemorrhage. In this study, we investigated hemodynamic responses and serum nitrite concentrations during graded hemorrhagic shock and resuscitation in hypertensive (HT) and normotensive (NT) rats. Methods: Thirteen male rats were divided into two groups, namely HT (n = 6) and NT (n = 7). Hypertension was induced by deoxycorticosterone acetate (DOCA)-salt method in uninephrectomized rats. After 8 weeks, graded hemor...

  18. Changes of TXA2 and PGI2 during postoperative hypertensive crisis in patients with hypertensive intracerebral hemorrhage.

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    Wang, Zhi; Wang, Chao; Zhang, Weiguang; Wang, Laizang; Lei, Ting

    2008-02-01

    In order to explore the changes and the roles of TXA2 and PGI2 during postoperative hypertensive crisis in patients with hypertensive intracerebral hemorrhage, 31 cases subject to craniotomy were divided into three groups: group A, 9 patients with postoperative hypertensive crisis; group B, 13 patients without postoperative hypertensive crisis; and group C, 9 patients without history of hypertension and hypertensive intracerebral hemorrhage. TXA2, TXB2, 6-keto-PGF1 alpha and PGI2 were measured after operation in the three groups respectively. The postoperative blood pressure in group A, including SBP and DBP, was elevated more obviously than that in the other two groups. TXA2 and PGI2 in group A were significantly higher than those in other two groups (Phypertensive crisis. And the increased value of TXB2 to 6-keto-PGF1 alpha could provide the basis for diagnosis of postoperative hypertensive crisis.

  19. An Unusual Complication of Hypertensive Hemorrhage – Delayed Oculomotor Palsy: Case Report and Literature Review

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    C. Dardis

    2011-09-01

    Full Text Available We present a case of oculomotor palsy due to hypertensive hemorrhage in the caudate nucleus, with intraventricular extension. To our knowledge, this is the only instance of this complication occurring due to hypertensive hemorrhage. Our patient initially developed headache at the time of her hemorrhage; 8 days later, she developed complete third nerve palsy, which showed improvement at follow-up 4 months later. This was due to tracking of blood into the perimesencephalic cistern. The presence of hemorrhage in the basal cisterns was not visible on the initial CT scans and highlights the role of MRI in evaluating the brainstem for the presence of blood products.

  20. Effect of intracranial hypertension on cerebral hemorrhage induced autonomic nerve imbalance

    Institute of Scientific and Technical Information of China (English)

    Xuelong Jin; Wenli Jing; Fengxia Yan; Zhaoqiang Zhang; Fengjun Lü; Shuiqing Jing; Na Sun; Kazushige Mizoguchi

    2007-01-01

    BACKGROUND: Cerebral hemorrhage can cause the imbalance of nerve function, whereas its mechanism and main impact factors are still not quite clear.OBJECTIVE: To explore the rules about the changes of intracranial pressure in brainstem hemorrhage and internal capsule hemorrhage, and analyze the role of intracranial hypertension in the changes of nerve function caused by cerebral hemorrhage.DESIGN: A self-controlled trial.SETTING: Department of Physiology, Tianjin Medical University.MATERIALS: Sixty-five healthy male Japanese white rabbits with long ears (1.5-1.8 kg) were supplied and fed by the Department of Animal Experiment of Tianjin Medical University. The RM6240B biological signal collecting and processing system was used.METHODS: The experiments were conducted in the Department of Physiology, Tianjin Medical University from August 2001 to May 2006. ① The rabbits were anesthetized, then fixed onto the brain stereotaxic apparatus, and afterwards fenestration on skull and intubation to lateral ventricle were performed. The dynamic changes of intracranial pressure were monitored continuously. Rabbits were infused with autologous arterial blood (0.3 mL) into midbrain corpora quadrigemina inferior colliculus to induce model of acute brainstem hemorrhage; models of internal capsule hemorrhage were established by infusing autologous arterial blood into internal capsule. ② The dynamic intracranial pressures under the above conditions were recorded continuously with the RM6240B biological signal collecting and processing system. ③ An animal model of persistent intracranial hypertension was established by infusion of physiologic saline into lateral ventricle. ④ The changes of the intensity of autonomic nerve discharge were analyzed, using the biological signal collecting and processing system before and after hemorrhage and under persistent intracranial hypertension. ⑤ Ten animal models of internal capsule hemorrhage and 10 of brainstem hemorrhage were selected

  1. Hypertensive thalamic hemorrhage. Clinical symptoms and outcomes in 40 cases

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    Munaka, Masahiro; Nishikawa, Michio; Hirai, Osamu; Kaneko, Takaaki; Watanabe, Syu; Fukuma, Jun; Handa, Hajime

    1988-12-01

    In the past six years, we have had experience with 40 patients with hypertensive thalamic hemorrhages, as verified by CT scan at our hospital within 24 hours. These patients were classified into the following three groups according to the location of the bleeding point and the size of the hematoma: (1) anteromedial (4 cases), (2) posterolateral (16 cases), and (3) massive (20 cases). The (1) and (2) hematomas were small (less than 3 cm in diameter), while those in (3) were large (more than 3 cm in diameter). Twenty cases (50% of all the thalamic hematomas) were small hematomas. The characteristic clinical symptoms of the anteromedial type were a mild disturbance of consciousness and thalamic dementia, while those of the posterolateral type were motor and sensory disturbance, and thalamic aphasia, respectively. Twenty cases (50%) were large hematomas. The clinical symptoms of these cases were mainly consciousness disturbance; 7 of them expired. Based on this experience, it may be considered that the patients whose hematoma size was larger than 3 cm had a poor prognosis and that the patients with the posterolateral type had a poor functional diagnosis.

  2. Cllnical analysis on 80 cases with hypertensive cerebral hemorrhage compllcating upper digestive tract hemorrhage

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    Yang Y1chao; Wang Jian; Ye Bin; Li Honghong

    2000-01-01

    Objective: To irrvestigate the treatment and prognosis of the hypertensive cerebral hemorrhage (HCH)With upper dgest tract hemorrhage (UDDIH). Scence:I a surey of 760 cases randomely with HCH in nerve department betweem Jaruarry 1995 and October 1999, including 80 cases wuth UDTH (9.5%). Of the 80 cases 55 were males and25 were fenales, mean age of 60.2 years andrange of 45 to 80 years. Methods:To analyze the clinical materials of 80 cases with HCH complicating UDTH and HCH without UDTH for the same time. Results: Of the 80 cases 52 were cled during the treatment, death rate was 65%, but the death rate of cases without UDTH was 30.2% at the sane time. The death rate of HCH complicating UDTH was significantly ligher than that without UDTH Discussion The nosogeny of HCH complicating UDTH was more likely related to thalanic and brain-stem Lew is thought that thalemric and brain-stem were stimulated to secret CRF and made pituitany gland release ACTH, futhet secret advencortirn These factors gave rise to UDTH by incriesed to secretion of gastic acid Therefore, original ciseases wre Primarily be predcted and treated Patients with intracranial lypenrtension should be inmediately treated by using manniol or glyceric co, and antiacid, anticholinergic drugs. If all kinds of methods shouldn′t control UDTH, thrombin and noradrenaline bitarlrate with cold Natrii Chlori de would be giwn by nostril There have bettertherapeutic efficiency. Conclusion: HCH with UDTH belongs to severe cases, death rates are higher, original diseases and complication should be actively treated

  3. Hemodynamic responses and serum nitrite concentration during uncontrolled hemorrhagic shock in normotensive and hypertensive rats.

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    Khazaei, Majid; Barmaki, Babak; Nasimi, Ali

    2012-09-01

    We evaluated the effect of hypertension on hemodynamic responses and serum nitrite concentrations in normotensive (NT) and deoxycorticosteron acetate (DOCA)-Salt hypertensive (HT) rats. Uncontrolled hemorrhagic shock was induced in NT and HT rats (n=7 each) by preliminary bleed of 25 ml/kg followed by a 75% tail amputation. The mean arterial pressure (MAP), heart rate and serum nitrite were measured pre-hemorrhage and during hemorrhage. Changes in time-averaged MAP after hemorrhage were significantly greater in HT group than NT. After resuscitation, the HT rats failed to restore MAP to baseline level. Serum nitrite level in both groups was significantly increased during shock period. Survival rate of HT animals was lower than NT group, although it was not statistically significant. Marked reduction of MAP and less improvement after resuscitation suggested the less adaptation of cardiovascular system in HT animals which may interfere with management of these subjects during uncontrolled hemorrhagic shock.

  4. Study on Compound Salvia Pellet in Treating Hypertensive Cerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    徐雄鹰; 陈霄峰

    2004-01-01

    Objective: To assess the efficacy and safety of compound Salvia pellet (CSP) in treating hypertensive cerebral hemorrhage (HCH). Methods: Control group (n= 116) was given HCH conventional therapy, and the treated group (n=118) given the same conventional therapy plus CSP 10 pills through sublingual sucking/6 hrs, the efficacy was compared. Results= (1) The 3rd day after admission CT monitoring showed both the volume of hematoma and hematoma plus edema in the treated group were smaller than those in the control group, the difference was significant (P<0.05); comparison between 14th day and 28th day after admission showed that the difference was significant (P<0.01). (2) The 14th day, 28th day and 3months after admission, regarding the Chinese stroke scale (CSS), activity of daily living (ADL) andmodified Barthol index (BI), the treated group was better than that of control group, the difference was significant (P<0.01). (3) The incidence of brain-heart syndrome reduced as time went by in both groups, but that of the treated group lowered more than that of control group, the difference being.significant (P<0.05, or P<0.01). Conclusion= CSP in treating HCH patients could cease the expansion of cerebral hematoma in the early phase, and accelerate the absorption of cerebral hematoma, improve the cerebral blood flow, alleviate cerebral edema, lower the disability, and elevate the quality of life. Besides, CSP also could prevent and treat brain-heart syndrome. CSP is cheap, convenient in administration, effective and safe.

  5. Changes of TXA2 and PGI2 during Postoperative Hypertensive Crisis in Patients with Hypertensive Intracerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Zhi WANG; Chao WANG; Weiguang ZHANG; Laizang WANG; Ting LEI

    2008-01-01

    In order to explore the changes and the roles of TXA2 and PGI2 during postoperative hypertensive crisis in patients with hypertensive intracerebral hemorrhage, 31 cases subject to crani- otomy were divided into three groups: group A, 9 patients with postoperative hypertensive crisis; group B, 13 patients without postoperative hypertensive crisis; and group C, 9 patients without his- tory of hypertension and hypertensive intracerebral hemorrhage. TXA2>, TXB2>, 6-keto-PGF1α and PGI2> were measured after operation in the three groups respectively. The postoperative blood pres- sure in group A, including SBP and DBP, was elevated more obviously than that in the other two groups. TXA2> and PGI2> in group A were significantly higher than those in other two groups (P<0.01). Moreover, the ratio of TXB2> to 6-keto-PGF1α in group A was significantly higher than that in other two groups (P<0.05). The increase of TXA2> and the relative inadequacy of prostacyclin, especially 6-keto-PGF1α, may play roles in the postoperative hypertensive crisis. And the increased value of TXB2> to 6-keto-PGF1α could provide the basis for diagnosis of postoperative hypertensive crisis.

  6. Combined effects of socioeconomic position, smoking, and hypertension on risk of ischemic and hemorrhagic stroke

    DEFF Research Database (Denmark)

    Nordahl, Helene; Osler, Merete; Frederiksen, Birgitte Lidegaard

    2014-01-01

    between socioeconomic position (ie, education), smoking, and hypertension on ischemic and hemorrhagic stroke incidence by the use of the additive hazards model. RESULTS: During 14 years of follow-up, 3613 ischemic strokes and 776 hemorrhagic strokes were observed. Current smoking and hypertension were......, particularly among men: 134 (95% confidence interval, 49-219) extra cases per 100 000 person-years because of interaction, adjusted for age, cohort study, and birth cohort. There was no clear evidence of interaction between low education and hypertension. The combined effect of current smoking and hypertension......, and birth cohort. CONCLUSIONS: Reducing smoking in those with low socioeconomic position and in those with hypertension could potentially reduce social inequality stroke incidence....

  7. Previous hypertensive hemorrhage increases the risk for bleeding and ischemia for PCI patients on dual antiplatelet therapy.

    Science.gov (United States)

    Qiao, Manli; Bi, Qi; Fu, Paul; Wang, Yixin; Song, Zhe; Guo, Fang

    2017-06-01

    The use of antiplatelet therapy after intracerebral hemorrhage remains controversial, while the use of dual antiplatelet therapy (DAPT) is required after cardiac stenting. In this study, we examine the risk of bleeding and ischemic events for PCI patients with a history of hypertensive hemorrhage on DAPT. A total of 128 cases and 153 controls were selected from Chinese patients with cardiac stenting on dual anti-platelet therapy for a single-center retrospective case-control study. Patients with a history of hypertensive hemorrhage were selected for the case group, while patients with a history of hypertension were chosen as control. All patients were on aspirin 100 mg and clopidogrel 75 mg after cardiac stenting, and were followed for a duration of 12-48 months. The primary outcomes were intracerebral hemorrhage, major bleeding, and major adverse cardiovascular and cerebrovascular events. A history of previous hypertensive hemorrhage was not found to be a risk factor for intracerebral hemorrhage and major bleeding while on dual anti-platelet therapy. However, a history of either hypertensive hemorrhage or coronary artery disease was independently found to be risk factors for major adverse cardiovascular and cerebrovascular events. On sub-group analysis, patients with a history of hypertensive hemorrhage within 12 months were found to be at higher risk for bleeding on dual anti-platelet therapy, while patients with history of hypertensive hemorrhage outside of 12 months on dual anti-platelet therapy did not have the same increased risk. A history of hypertensive hemorrhage and coronary heart disease were two independent risk factors for major adverse cardiovascular and cerebrovascular events in PCI patients taking DAPT. A history of hypertensive hemorrhage less than 12 months had an increased risk for recurrent intracerebral hemorrhage and major bleeding in PCI patients taking DAPT.

  8. Endovascular interventions for traumatic portal venous hemorrhage complicated by portal hypertension

    Institute of Scientific and Technical Information of China (English)

    Dinesh; Kumar; Sundarakumar; Crysela; Mirta; Smith; Jorge; Enrique; Lopera; Matthew; Kogut; Rajeev; Suri

    2013-01-01

    Life-threatening hemorrhage rarely occurs from the portal vein following blunt hepatic trauma.Traditionally,severe portal bleeding in this setting has been controlled by surgical techniques such as packing,ligation,and venorrhaphy.The presence of portal hypertension could potentially increase the amount of hemorrhage in the setting of blunt portal vein trauma making it more difficult to control.This case series describes the use of indirect carbon dioxide portography to identify portal hemorrhage.Furthermore,these cases illustrate attempted endovascular treatment utilizing a transjugular intrahepatic portosystemic shunt in one scenario and transmesocaval shunt coiling of a jejunal varix in the other.

  9. Protective Role of Selective Nitric Oxide Synthase Inhibitor for Treatment of Decompensated Hemorrhagic Shock in Normotensive and Hypertensive Rats

    OpenAIRE

    Majid Khazaei; Babak Barmaki; Ali Nasimi

    2012-01-01

    Introduction: Different vasoactive factors can modulate cardiovascular adaptation to hemorrhagic shock including Nitric Oxide (NO). In this study we investigated the effect of the NO synthase inhibitor for treatment of decompensated hemorrhagic shock in normotensive and hypertensive rats. Methods: Twenty-four male Wistar rats were divided into two groups: The normotensive and hypertensive groups. Hypertension was induced by the DOCA-Salt method for eight weeks. Then, the animals were give...

  10. Effects of hypertension on hemodynamic response and serum nitrite concentration during graded hemorrhagic shock in rats

    Directory of Open Access Journals (Sweden)

    Babak Barmaki

    2011-01-01

    Conclusions: More reduction of MAP after hemorrhagic shock, less improvement of MAP and HR after resuscitation and low survival rate in HT animals suggested the impairment of cardiovascular system adaptation of HT animals during blood loss and it should be considered in management of hypertensive subjects.

  11. Effects of hypertension on hemodynamic response and serum nitrite concentration during graded hemorrhagic shock in rats.

    Science.gov (United States)

    Barmaki, Babak; Nasimi, Ali; Khazaei, Majid

    2011-09-01

    Hypertensive patients have higher morbidity and mortality from hemorrhage. In this study, we investigated hemodynamic responses and serum nitrite concentrations during graded hemorrhagic shock and resuscitation in hypertensive (HT) and normotensive (NT) rats. Thirteen male rats were divided into two groups, namely HT (n = 6) and NT (n = 7). Hypertension was induced by deoxycorticosterone acetate (DOCA)-salt method in uninephrectomized rats. After 8 weeks, graded hemorrhagic shock was induced during 34 minutes in four steps separated by 8-minute intervals (totally 16 ml/kg). The animals were kept in this condition for 120 minutes (shock period). Then, they were resuscitated with blood withdrawal. Mean arterial pressure (MAP) and heart rate (HR) were measured throughout the experiment. Blood samples were taken before and after shock induction and at the end of the shock period. HT rats experienced more MAP and HR reduction during the shock period and less improvement of hemodynamic response after resuscitation compared with the NT group (p 0.05). More reduction of MAP after hemorrhagic shock, less improvement of MAP and HR after resuscitation and low survival rate in HT animals suggested the impairment of cardiovascular system adaptation of HT animals during blood loss and it should be considered in management of hypertensive subjects.

  12. Prediction of postpartum hemorrhage in women with gestational hypertension or mild preeclampsia at term

    NARCIS (Netherlands)

    Koopmans, Corine M.; Van der Tuuk, Karin; Groen, Henk; Doornbos, Johannes P. R.; De Graaf, Irene M.; Van der Salm, Pauline C. M.; Porath, Martina M.; Kuppens, Simone M. I.; Wijnen, Ella J.; Aardenburg, Robert; Van Loon, Aren J.; Akerboom, Bettina M. C.; Van der Lans, Peggy J. A.; Mol, Ben W. J.; Van Pampus, Maria G.

    2014-01-01

    OBJECTIVE: To assess whether postpartum hemorrhage can be predicted in women with gestational hypertension or mild preeclampsia at term. DESIGN: A cohort study in which we used data from our multicentre randomized controlled trial (HYPITAT trial). SETTING: The study was conducted in 38 hospitals in

  13. The role of hypertension in bromocriptine-related puerperal intracranial hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Kirsch, C. [Dept. of Radiology, University Hospital, Newark, NJ (United States); Iffy, L. [Dept. of Obstetrics, Gynecology and Womens Health, University Hospital, Newark, NJ (United States); Zito, G.E. [Dept. of Neurology, University Hospital, Newark, NJ (United States); McArdle, J.J. [Dept. of Pharmacology, University Hospital, Newark, NJ (United States)

    2001-04-01

    The spate of medicolegal inquiries following the disqualification of Parlodel (bromocriptine mesylate) by the Food and Drug Administration for postpartum ablactation, uncovered previously unreported side effects associated with its postpartum administration. In 1994, bromocriptine mesylate was withdrawn from the market as a milk suppressant. Since this time, over a dozen cases of postpartum intracranial hemorrhages associated with its use have been reported. We describe three additional cases of postpartum intracranial hemorrhage related to bromocriptine usage. One patient, previously normotensive, developed hypertension and a headache; initial CT was normal, but CT 24 h later demonstrated intracranial hemorrhage. This suggests that the blood-pressure elevation was drug-induced and was the cause, rather than the consequence, of bromocriptine-related intracranial hemorrhage. (orig.)

  14. [Postpartum hemorrhage and pregnancy induced hypertension during emergency lower segment cesarean section: dexmedetomidine to our rescue].

    Science.gov (United States)

    Hariharan, Uma

    Dexmedetomidine is a highly selective α-2 agonist which has recently revolutionized our anesthesia and intensive care practice. An obstetric patient presented for emergency cesarean delivery under general anesthesia, with pre-eclampsia and postpartum hemorrhage. In carefully selected cases with refractory hypertension and postpartum hemorrhage, dexmedetomidine can be used for improving overall patient outcome. It was beneficial in controlling both the blood pressure and uterine bleeding during cesarean section in our patient. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  15. Combined effects of socioeconomic position, smoking, and hypertension on risk of ischemic and hemorrhagic stroke.

    Science.gov (United States)

    Nordahl, Helene; Osler, Merete; Frederiksen, Birgitte Lidegaard; Andersen, Ingelise; Prescott, Eva; Overvad, Kim; Diderichsen, Finn; Rod, Naja Hulvej

    2014-09-01

    Combined effects of socioeconomic position and well-established risk factors on stroke incidence have not been formally investigated. In a pooled cohort study of 68 643 men and women aged 30 to 70 years in Denmark, we examined the combined effect and interaction between socioeconomic position (ie, education), smoking, and hypertension on ischemic and hemorrhagic stroke incidence by the use of the additive hazards model. During 14 years of follow-up, 3613 ischemic strokes and 776 hemorrhagic strokes were observed. Current smoking and hypertension were more prevalent among those with low education. Low versus high education was associated with greater ischemic, but not hemorrhagic, stroke incidence. The combined effect of low education and current smoking was more than expected by the sum of their separate effects on ischemic stroke incidence, particularly among men: 134 (95% confidence interval, 49-219) extra cases per 100 000 person-years because of interaction, adjusted for age, cohort study, and birth cohort. There was no clear evidence of interaction between low education and hypertension. The combined effect of current smoking and hypertension was more than expected by the sum of their separate effects on ischemic and hemorrhagic stroke incidence. This effect was most pronounced for ischemic stroke among women: 178 (95% confidence interval, 103-253) extra cases per 100 000 person-years because of interaction, adjusted for age, cohort study, and birth cohort. Reducing smoking in those with low socioeconomic position and in those with hypertension could potentially reduce social inequality stroke incidence. © 2014 American Heart Association, Inc.

  16. Thalamic hemorrhage in a 4-year-old child induced by nephro-vascular hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Bianchi, E.; Savasta, S.; Torcetta, F.; Solmi, M.; Beluffi, G.; Gajno, T.M.

    1989-08-01

    A child affected by cardiomyopathy from the age of 12 months suddenly manifested right hemiparesis and dysarthria at the age of 48/12 years. Emergency brain CT showed a hemorrhage in progress in the left thalamic area. A serve from of hypertension was concomitant and resisted all pharmacological treatment. Retrograde transfemural aortography pointed out an atrophy of the right renal artery. This finding, together with the high renin and aldosterone values, indicated a nephrogenic hypertension causing both the cardiomyopathy found at 12 months of age and the endocranial hermorrhage. Right nephrectomy led to the normalization of blood pressure. (orig.).

  17. Arterial spin-labeling MR imaging of cerebral hemorrhages

    Energy Technology Data Exchange (ETDEWEB)

    Noguchi, Tomoyuki [Department of Radiology, National Center for Global Health and Medicine, Tokyo (Japan); Saga University, Department of Radiology, Faculty of Medicine and Graduate School of Medicine, Saga (Japan); Nishihara, Masashi; Egashira, Yoshiaki; Azama, Shinya; Hirai, Tetsuyoshi; Kitano, Isao; Irie, Hiroyuki [Saga University, Department of Radiology, Faculty of Medicine and Graduate School of Medicine, Saga (Japan); Yakushiji, Yusuke [Saga University, Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Saga (Japan); Kawashima, Masatou [Saga University, Department of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Saga (Japan)

    2015-11-15

    The purpose of this study is to identify the characteristics of brain perfusion measured by arterial spin-labeling magnetic resonance imaging (ASL-MRI) in cerebral hemorrhages. Brain blood flow values (CBF-ASL values) for cerebral and cerebellar hemispheres and segmented cerebral regions were measured by ASL-MRI in 19 putaminal hemorrhage patients and 20 thalamic hemorrhage patients in acute or subacute stages. We assessed the lateralities of CBF-ASL values and the relationships between CBF-ASL values and other imaging findings and clinical manifestations. Both the 19 putaminal hemorrhage patients and the 20 thalamic hemorrhage patients had significantly low CBF-ASL values of the contralateral cerebellum in subacute stage, suggesting that ASL-MRI might delineate crossed cerebellar diaschisis (CCD). Ipsilateral low CBF-ASL values were observed in frontal lobes and thalami with a putaminal hemorrhage and lentiform nuclei, temporal lobes, and parietal lobes with a thalamic hemorrhage, suggesting that ASL-MRI showed the ipsilateral cerebral diaschisis (ICD). In the putaminal hemorrhage patients, the hematoma volume negatively affected both the bilateral cerebellar and cerebral hemispheric CBF-ASL values. In the thalamic hemorrhage patients, a concomitant intraventricular hemorrhage caused low cerebral hemispheric CBF-ASL values. The use of ASL-MRI is sensitive to the perfusion abnormalities and could thus be helpful to estimate functional abnormalities in cerebral hemorrhage patients. (orig.)

  18. Early treatment of hypertension in acute ischemic and intracerebral hemorrhagic stroke: progress achieved, challenges, and perspectives.

    Science.gov (United States)

    Feldstein, Carlos A

    2014-03-01

    Hypertension is the leading risk factor for ischemic and intracerebral hemorrhagic subtypes of stroke. Additionally, high blood pressure (BP) in the acute cerebrovascular event is associated with poor outcome, and a high percentage of stroke survivors have inadequate control of hypertension. The present is a systematic review of prospective, randomized, and controlled trials carried out on safety and efficacy of antihypertensive treatment of both subtypes of acute stroke. Six trials involving 7512 patients were included, which revealed controversies on the speed and the goals of treatment. These controversies could be due at least in part, from the fact that some studies analyzed the results of antihypertensive treatment in ischemic and intracerebral hemorrhagic subtypes of acute stroke together, and from a different prevalence of past-stroke in the randomized groups. Further research is necessary to establish whether standard antihypertensive treatment provides greater benefit than simple observation in patients with ischemic acute stroke and Stage 2 hypertension of JNC 7, albeit they were not candidates for acute reperfusion. In that case, the target reduction in BP could be 10% to 15% within 24 hours. The recently published INTERACT 2 has provided evidence that patients with hemorrhagic stroke may receive intensive antihypertensive treatment safely with the goal of reducing systolic BP to levels no lower than 130 mm Hg. It is important to take into account that marked BP lowering in acute stroke increases the risk of poor outcome by worsening cerebral ischemia from deterioration of cerebral blood flow autoregulation. Copyright © 2014 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  19. Influence of different hematoma clearance rates on patients with hypertensive intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Cheng Zhong; Jing-Zhu Shi; Yu Liu; Tao Ou; Guo-Jing Liu; Bin Wang

    2016-01-01

    Objective:To evaluate the influence of different hematoma clearance rates patients with hypertensive intracerebral hemorrhage.Methods: A total of 94 cases with hypertensive intracerebral hemorrhage treated with operation from June 2012 to June 2015 were selected. According to theirhematoma clearance rates, they were divided into groups A (50%-70%, 28 cases), B (70%-90%,48 cases) and C (90%, 18 cases). The recovery and perioperative levels of serum neuron-specific enolase (NSE) and soluble S-100 protein of the three groups were compared.Results: The perioperative mortality and the rates of postoperative rebleeding, intracranial infection and other complications of the three groups showed no statistical significant difference (P>0.05). With the increase of the hematoma clearance rate, the drainage tube removal time and hematoma complete absorption time reduced significantly (P<0.05). In the groups B and C, the grade levels of ADL in postoperative 3 months were significantly superior to those in the group A (P<0.05). The levels of serum NSE and S-100 in the three groups increased in the initial stage and then declined after surgery. In the group B and C, the serum levels of NSE and S-100 were significantly higher than those in the group A on the 7th day after surgery (P<0.05). With the increase of the hematoma clearance rate, the serum levels of NSE and S-100 were significantly reduced on the 14th day after surgery (P<0.05). Conclusions:High level of hematoma clearance rate can help to increase the operation efficacy and prognosis of patients with hypertensive intracerebral hemorrhage.

  20. [Effectiveness of cerebrolysin in hypertensive supratentorial intracranial hemorrhages: results of a randomized triple blind placebo-controled study].

    Science.gov (United States)

    Maksimova, M Iu; Briukhov, V V; Timerbaeva, S L; Kistenev, B A; Rebrova, O Iu; Suslina, Z A

    2009-01-01

    Cerebrolysin was administered to 38 patients with small hypertensive supratentorial intracranial hemorrhages. Cerebrolysin was used intravenous in drops in dosage of 30 ml during 14 days. High effectiveness and good tolerability of the treatment was shown. In the end of treatment, groups receiving cerebrolysin or placebo were statistically significant differed by the total NIHSS score, Bartel index and the Rankin's modified scale. Moreover, a trend to the decrease of intracranial hemorrhage volume was observed in patients treated with cerebrolysin.

  1. Relationship of cerebral microbleeds with hematoma growth in elderly patients with acute hypertensive intracerebral hemorrhage

    Directory of Open Access Journals (Sweden)

    Shou-feng LIU

    2015-01-01

    Full Text Available Objective To investigate whether cerebral microbleeds (CMBs can predict hematoma growth in elderly patients with acute hypertensive intracerebral hemorrhage.  Methods The clinical records of 98 elderly patients with acute hypertensive intracerebral hemorrhage who underwent initial CT within 6 h and repeated CT and susceptibility-weighted imaging (SWI within 24 h of onset were analyzed. Based on the performance of SWI, patients were divided into microbleeds group and non-microbleeds group. Forward multivariate Logistic regression analysis was used to evaluate the predicting value of CMBs on the growth of intracerebral hematoma.  Results Among 98 patients, hematoma growth was found in 25 cases in the second CT scan. The ratio in microbleeds group was significantly higher than that in non-microbleeds group (43.75% vs 16.67%; χ2 = 8.319, P = 0.004. Multivariate Logistic regression showed that CMBs was independent risk factor for intracerebral hematoma (OR = 0.241, 95%CI: 0.065-0.861; P = 0.017.  Conclusions CMBs in patients with acute intracerebral hematoma can predict high risk of hemotoma growth, and effective treatment should be taken to improve the prognosis of patients. DOI: 10.3969/j.issn.1672-6731.2015.01.012

  2. Bilateral putaminal necrosis in a comatose patient with metabolic acidosis

    Directory of Open Access Journals (Sweden)

    Sudhir Kumar

    2016-01-01

    Full Text Available We present a case of acute-onset coma in a young woman, associated with metabolic acidosis, respiratory distress, and hypotension. Magnetic resonance imaging of the brain done on day 2 of admission showed features of bilateral putaminal necrosis. History of methanol ingestion, though not forthcoming at admission, was confirmed later after the patient regained consciousness. A final diagnosis of methyl alcohol toxicity resulting in severe metabolic acidosis, coma, and bilateral blindness was made. This case is reported to emphasize the point that the finding of bilateral putaminal necrosis in a patient with coma and metabolic acidosis is virtually diagnostic of methyl alcohol toxicity even in the absence of any positive history.

  3. Bilateral optic neuropathy with bilateral putaminal lesions: a case report.

    Science.gov (United States)

    Togawa, Jumpei; Ohi, Takekazu

    2015-01-01

    Bilateral optic neuropathy with bilateral putaminal lesions may be caused by methanol or cyanide poisoning or mitochondrial disorders including Leber hereditary optic neuropathy and Leigh syndrome. We report the case of a 34-year-old Japanese man who developed bilateral visual loss 5 days after the development of gastrointestinal symptoms. Magnetic resonance imaging of the brain on admission revealed high-intensity signal areas in the bilateral putamina on diffusion-weighted and T2-weighted images as well as a high-intensity signal area in the left middle cerebellar peduncle that had been identified 3 years previously. We diagnosed bilateral optic neuropathy with bilateral putaminal lesions caused by preceding infection-triggered demyelination. We administered methylprednisolone, but his vision did not recover.

  4. Protective role of selective nitric oxide synthase inhibitor for treatment of decompensated hemorrhagic shock in normotensive and hypertensive rats.

    Science.gov (United States)

    Khazaei, Majid; Barmaki, Babak; Nasimi, Ali

    2012-01-01

    Different vasoactive factors can modulate cardiovascular adaptation to hemorrhagic shock including Nitric Oxide (NO). In this study we investigated the effect of the NO synthase inhibitor for treatment of decompensated hemorrhagic shock in normotensive and hypertensive rats. Twenty-four male Wistar rats were divided into two groups: The normotensive and hypertensive groups. Hypertension was induced by the DOCA-Salt method for eight weeks. Then, the animals were given hemorrhagic shock by continuously withdrawing blood until the mean arterial pressure (MAP) reached to 40 mmHg. The animals were maintained in the shock state for 120 minutes. Subsequently, they were randomly assigned to L-NAME-treated and non-treated groups and monitored for 60 minutes. The survival time was recorded. Blood samples were taken before and after the shock and 60 minutes after L-NAME administration. Infusion of L-NAME caused a significant increase in MAP in normotensive animals, however, slightly increased MAP in hypertensive animals. The heart rate did not significantly alter. Hemorrhage caused a marked increase in serum nitrite levels in both groups (P<0.05). L-NAME treatment significantly reduced the serum nitrite concentration in the normotensive group (P<0.05), without any change in the hypertensive group. All animals who received L-NAME treatment survived at the end of experiment. Fifty percent of the hypertensive animals died four hours after the experiment. The 72-hour survival rate was similar in the L-NAME treated groups. L-NAME infusion during decompensated hemorrhagic shock plays a protective role in the improvement of hemodynamic responses and short-term survival rate in normotensive animals.

  5. Brain hemorrhage associated with maintenance hemodialysis. CT analysis of 19 cases

    Energy Technology Data Exchange (ETDEWEB)

    Kawahata, Nobuya (Narita Memorial Hospital, Chiba (Japan))

    1994-04-01

    The CT findings of 19 hemodialyzed patients with brain hemorrhage (BH) were evaluated. The 30-day mortality rate was 78.9%. The lesion locations in the 19 cases with BH were putaminal hemorrhage in 8 patients, putaminothalamic (mixed) hemorrhage in 7, thalamic hemorrhage in one, subcortical hemorrhage in one, and cerebellar hemorrhage in one. In the remaining patient, the bleeding was confined to the ventricular system. One remarkable CT finding was the formation of a massive hematoma in most cases. In some cases, the hematoma occupied the greater part of one cerebral hemisphere. Oral anticoagulants and/or antiplatelet drugs, and intravenous heparinization could produce massive accumulations of blood in the brain parenchyma. The second major finding was the low CT absorption values of the hematoma at the acute stage, as compared to that of hypertensive BH. This decreased absorption density resulted from a low hemoglobin concentration in the hematoma itself due to the severe anemia occurring in patients on long-term maintenance hemodialysis. (author).

  6. Influence of Hypertension, Lipometabolism Disorders, Obesity and Other Lifestyles on Spontaneous Intracerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    JUN-FU ZHOU; JI-YUE WANG; YAN-ER LUO; HUAI-HONG CHEN

    2003-01-01

    To investigate whether hypertension, abnormal lipometabolism, obesity, cigarette smoking and alcohol drinking affect the intracerebral hemorrhagic volumes (IHV) in patients with spontaneous intracerebral hemorrhage (SIHP), and to explore the roles of these factors in spontaneous intracerebral hemorrhage (SIH). Methods Five hundred patients with acute SIH and 200 healthy adult volunteers (HAV) were enrolled in a study of independently randomized controlled design, in which the levels of systolic pressure (SP) and diastolic pressure (DP), and total cholesterol (TCH),triacylglycerols (triglycerides, TG), high density lipoprotein cholesterol (HDL-CH), low density lipoprotein cholesterol (LDL-CH) in serum as well as the level of erythrocytic membrane cholesterol (EM-CH) were measured, and the body mass index (BMI), daily cigarette smoking consumption (DCSC) and daily pure alcohol consumption (DPAC) were calculated. Results Compared with the average parameters in the HAV group, those of SP, DP, TG, LDL-CH and BMI in the SIHP group were significantly increased (P<0.0001), while those of HDL-CH and EM-CH were significantly decreased (P<0.0001). The linear regression and correlation analysis showed that with increased SP, DP,LDL-CH, BMI, DCSC, DPAC and aging as well as decreased HDL-CH and EM-CH, the IHV levels in SIHP were increased gradually (P<0.0001-0.01). The linear stepwise regression analysis suggested that there existed a close correlation among the values of SP, DP, TCH, TG, HDL-CH, LDL-CH,EM-CH, BMI, DCSC, DPAC, age and IHV of the SIH patients, and that Y = - 12.4583 + 0.1127SP -1.1977EM-CH + 0.9788LDL-CH + 0.2477BMI + 0.0382DCSC + 0.0248DP, P<0.0001~ 0.05.Conclusions The findings in the present study suggest that significantly increased systolic and diastolic pressure, low density lipoprotein cholesterol, body mass index and daily cigarette smoking consumption, and significantly decreased erythrocytic membrane cholesterol may be likely the main factors

  7. EXPRESSION OF IL-2 AND SIL-2R AND ALTERATION OF CELL IMMUNITY IN PATIENTS WITH HYPERTENSIVE CEREBRAL HEMORRHAGE

    Institute of Scientific and Technical Information of China (English)

    Zhang Yuelin; Qiu Shudong; Shi Wei; Dang Xiaojun

    2006-01-01

    Objective To study the expression of interleukin-2 (IL-2), soluble interleukin-2 receptor (sIL-2R),determine the alteration of erythrocytic immunity and T cell subgroup in the blood of outer circulation in patients with hypertensive cerebral hemorrhage so and to probe into the relationship between them, and to explore the clinical significance. Methods Enzyme linked immnunosorbent assay (ELISA) was used to determine the content of IL-2 and sIL-2R. The immunoadsorption was employed to examine the erythrocytic immune activity and its regulating function.Streptavidin-peroxidase(S-P) was used to determine the cell number of CD3 (cluster of differentiation3), CD4 and CD8. Results The content of IL-2 in the group with hypertensive cerebral hemorrhage was significantly lower than that in the control group (P<0.01), and the content of sIL-2R increased. Red blood cell C3b receptor (RBC. C3b R)and RBC immune adherence enhancing factor (RFEB) dropped greatly (P<0.01), while RBC immune complex rosette (RBC. ICR) and RBC immune adherence inhibiting factor (RFIR) increased greatly. The cell number of CD3 and CD4decreased (P<0.01) and there was no obvious change in CD8 (P<0.05). Conclusion The decrease of immune function was observed in patients with hypertensive cerebral hemorrhage. The determination of the content of IL-2, sIL-2R, erythrocytic immunity and the activity of T subgroup has an important clinical significance in the occurrence,development, treatment, and prognosis of hypertensive cerebral hemorrhage.

  8. Application of frameless stereotactic aspiration in the treatment of hypertension cerebral hemorrhage

    Directory of Open Access Journals (Sweden)

    You-san ZHANG

    2016-09-01

    Full Text Available Objective  To investigate the technical points and clinical outcomes of frameless stereotactic aspiration in treatment of patients with hypertension cerebral hemorrhage (HPCH. Methods  The clinical data of 68 consecutive patients with HPCH, treated with frameless stereotactic aspiration from Jan. 2012 to Jun. 2014, were retrospectively analyzed, and compared to that of 45 patients treated in the meantime by frame-based stereotactic aspiration. The surgical results, procedure-related complications and clinical prognosis were evaluated. Results  For the patients treated with frameless stereotactic aspiration, the median age was 53.3 years (range 36-80, the mean initial Glasgow coma scale score was over 5. Among them seven patients died within a month after operation: 3 died of respiratory failure, 2 of cerebral edema and 2 of rehemorrhage. At the six-months follow-up, the good recovery rate (gradeⅠ-Ⅲof ADL was 77.9%(53/68, better than that of patients treated with frame-based stereotactic aspiration (60.0%, P<0.05. Conclusion  Frameless stereotactic aspiration for HPCH is easy to operate, minimal invasion and safe procedure with low mortality and rehemorrhage rate. DOI: 10.11855/j.issn.0577-7402.2016.08.12

  9. Prognostic value of premorbid hypertension and neurological status in aneurysmal subarachnoid hemorrhage : Pooled analyses of individual patient data in the SAHIT repository

    NARCIS (Netherlands)

    Jaja, Blessing N R; Lingsma, Hester; Schweizer, Tom A.; Thorpe, Kevin E.; Steyerberg, Ewout W.; Macdonald, R. Loch; Louffat-Olivares, Ada; Noble, Adam; Molyneux, Andrew; Quinn, Audrey; Lo, Benjamin; Johnston, Clay; Hanggi, Daniel; Hasan, David; Wong, George K C; Torner, James; Singh, Jeff; Spears, Julian; Vergouwen, Mervyn D I; Cusimano, Michael D.; Todd, Michael; Tseng, Ming; Etminan, Nima; Le, Peter; Mayer, Stephan; Schenk, Thomas; Van, William

    2015-01-01

    OBJECT The literature has conflicting reports about the prognostic value of premorbid hypertension and neurological status in aneurysmal subarachnoid hemorrhage (SAH). The aim of this study was to investigate the prognostic value of premorbid hypertension and neurological status in the SAH Internati

  10. Effect of residue hematoma volume on inflammation factors in hypertensive intracranial hemorrhage

    Directory of Open Access Journals (Sweden)

    You-san ZHANG

    2016-10-01

    Full Text Available Objectives  In this study, the relationships of residue hematoma volume to brain edema and inflammation factors were studied after intracerebral hematoma was evacuated with a frameless stereotactic aspiration. Methods  Eighty-nine patients with hypertensive intracerebral hemorrhage (ICH were treated by frameless stereotactic aspiration. According to residual volume of the hematoma, the patients were divided into gross-total removal of hematoma (GTRH (≤5ml and sub-total removal of hematoma (STRH (≥10ml groups after the operation. The pre-operative and postoperative data of the patients were compared between the two groups. The pre-operative data included age, sex, hematoma volume, time interval from the ictus to the operation, and Glasgow Coma Scale (GCS scores. The post-operative information included edema grade, level of thromboxane B2 (TXB2, 6-keto-prostaglandin F1α(6-K-PGF1α, tumor necrosis factor-α(TNF-α and endothelin (ET in hematoma cavity or cerebral spinal fluid (CSF. Results  There were 46 patients in GTRH group and 43 in STRH group respectively. There was no statistical difference in the pre-operative data between the two groups. The levels of TXB2, 6-K-PGF1α, TNF-αand ET were significantly lower in the GTRH group than in the STRH group at different post-operative time points. There was a significant difference between the two groups. The post-operative CT scan at different time points showed that the brain edema grades were better in the GTRH group than in the STRH group. Conclusions  GTRH is helpful for decreasing ICH-induced injury to brain tissue, which is related to decreased perihematomal edema formation and secondary injury by coagulation end products activated inflammatory cascade. DOI: 10.11855/j.issn.0577-7402.2016.09.12

  11. Nao-Xue-Shu Oral Liquid Protects and Improves Secondary Brain Insults of Hypertensive Cerebral Hemorrhage

    Directory of Open Access Journals (Sweden)

    Hongning Jiang

    2016-01-01

    Full Text Available Aim. To determine one traditional Chinese medicine (TCM Nao-Xue-Shu oral liquid which protects and improves secondary brain insults (SBI in hypertensive cerebral hemorrhage (HCH. Methods. 158 patients with HCH were divided into routine clinical medicine plus Nao-Xue-Shu oral liquid (n=78 as treatment group, and routine clinical medicine (n=80 only served as the control group. The incidence of SBI and the classification of a favorable prognosis and a bad prognosis using the Glasgow outcome scale (GOS were assessed to evaluate the clinical effects. The changes of IL-6 and TNF-α levels were determined to study the mechanism of the effects for the TCM. Results. The incidence of SBI at the end of week 2 was 8.97% in the treatment group and 23.75% in the control group, and the difference was significant (P<0.001. The incidence of a favorable prognosis was 48.72% in the treatment group and 32.72% in the control group, and the difference was significant (P<0.01 at the end of week 2. These findings indicate clear differences for IL-6 and TNF-α at the end of week 1 and week 2 compared with before treatment for the treatment group and a marked difference at the end of week 2 between the two groups. It also shows a significant difference between the end of week 2 and before treatment for IL-6 and TNF-α for the control group, although the difference was much smaller than the treatment group. Conclusion. Nao-Xue-Shu oral liquid could protect against the occurrence of SBI and improve HCH and SBI patients. It may also decrease the damage and the mass effects of the hematoma by reducing IL-6 and TNF-α to obtain the effects, and thus it is a potentially suitable drug for HCH and SBI.

  12. Hypertensive peaks in the pathogenesis of intraventricular hemorrhage in the newborn. Abolition by phenobarbitone sedation

    DEFF Research Database (Denmark)

    Wimberley, P D; Lou, H C; Pedersen, H

    1982-01-01

    Mean arterial blood pressure (MABP) was measured continuously for 3 to 5 days after birth in 27 premature infants with a birth weight under 1500 g, and who required umbilical artery catheterisation. All had respiratory distress syndrome (RDS). Intraventricular hemorrhage (IVH) occurred in 9 infan...

  13. Strategies of experiment standardization and response optimization in a rat model of hemorrhagic shock and chronic hypertension.

    Science.gov (United States)

    Reynolds, Penny S; Tamariz, Francisco J; Barbee, Robert Wayne

    2010-04-01

    Exploratory pilot studies are crucial to best practice in research but are frequently conducted without a systematic method for maximizing the amount and quality of information obtained. We describe the use of response surface regression models and simultaneous optimization methods to develop a rat model of hemorrhagic shock in the context of chronic hypertension, a clinically relevant comorbidity. Response surface regression model was applied to determine optimal levels of two inputs--dietary NaCl concentration (0.49%, 4%, and 8%) and time on the diet (4, 6, 8 weeks)--to achieve clinically realistic and stable target measures of systolic blood pressure while simultaneously maximizing critical oxygen delivery (a measure of vulnerability to hemorrhagic shock) and body mass M. Simultaneous optimization of the three response variables was performed though a dimensionality reduction strategy involving calculation of a single aggregate measure, the "desirability" function. Optimal conditions for inducing systolic blood pressure of 208 mmHg, critical oxygen delivery of 4.03 mL/min, and M of 290 g were determined to be 4% [NaCl] for 5 weeks. Rats on the 8% diet did not survive past 7 weeks. Response surface regression model and simultaneous optimization method techniques are commonly used in process engineering but have found little application to date in animal pilot studies. These methods will ensure both the scientific and ethical integrity of experimental trials involving animals and provide powerful tools for the development of novel models of clinically interacting comorbidities with shock.

  14. Arterial hypertension and skin allergy are risk factors for progression from dengue to dengue hemorrhagic fever: a case control study.

    Science.gov (United States)

    Teixeira, Maria Glória; Paixão, Enny S; Costa, Maria da Conceição N; Cunha, Rivaldo V; Pamplona, Luciano; Dias, Juarez P; Figueiredo, Camila A; Figueiredo, Maria Aparecida A; Blanton, Ronald; Morato, Vanessa; Barreto, Maurício L; Rodrigues, Laura C

    2015-05-01

    Currently, knowledge does not allow early prediction of which cases of dengue fever (DF) will progress to dengue hemorrhagic fever (DHF), to allow early intervention to prevent progression or to limit severity. The objective of this study is to investigate the hypothesis that some specific comorbidities increase the likelihood of a DF case progressing to DHF. A concurrent case-control study, conducted during dengue epidemics, from 2009 to 2012. Cases were patients with dengue fever that progressed to DHF, and controls were patients of dengue fever who did not progress to DHF. Logistic regression was used to estimate the association between DHF and comorbidities. There were 490 cases of DHF and 1,316 controls. Among adults, progression to DHF was associated with self-reported hypertension (OR = 1.6; 95% CI 1.1-2.1) and skin allergy (OR = 1.8; 95% CI 1.1-3.2) with DHF after adjusting for ethnicity and socio-economic variables. There was no statistically significant association between any chronic disease and progression to DHF in those younger than 15 years. Physicians attending patients with dengue fever should keep those with hypertension or skin allergies in health units to monitor progression for early intervention. This would reduce mortality by dengue.

  15. Study on the relationship of cytochrome C expression and cerebral edema in perihematomal brain tissue in patients with hypertensive cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    CAI Heng; LIU Guixiang; XU Chunsheng; LIU Qingxin; XU Xiaobo

    2007-01-01

    Objective To investigate the expression of cytochrome C in perihematomal brain tissue and its relationship with the histopathological change and formation of cerebral edema in patients with hypertensive cerebral hemorrhage. Methods Thirty four patients (23 male, 11 female) of hypertensive cerebral hemorrhage in hospital from Sep. 2001 to Sep. 2002 were selected with a mean age 55.6± 10.2 years (from 35 to 75 years). The mean volume of hemorrhagic blood was 50.4±11.6 ml (from 25 to 85 ml). The perihematomal brain tissue was obtained from the minimally invasive surgery. Histopathological change and expressions of cytochrome C in perihematomal brain tissue was detected by histopathological and immunohistochemical techniques. The volume of perihematomal cerebral edema was determined by computed tomographic scan before operation. The results of staining and the volume of perihematomal cerebral edema were analyzed with double blind fashion. Results Perihematomal cerebral edema were found 12-72h after cerebral hemorrhage. Myelin sheath degeneration, condensation of nucleus and typical apopototic body were observed in perihematomal brain tissue. Expression of cytochrome C in perihematomal brain tissue was observed at 4 h and reached peak around 48-72 h after cerebral hemorrhage. Cytochrome C expressed higher positively in 16 patients and lower positively in 13 patients. Cytochrome C expression was not detected only in 5 patints. There were significant differences in volume of perihematomal cerebral edema with different expression of cytochrome C in perihematomal brain tissue (P<0.01). Conclusions Cytochrome C expression was upregulated in perihematomal brain tissue in patients with hypertensive cerebral hemorrhage. Cytochrome C might involve in the histopathological change and the formation of perihematomal cerebral edema.

  16. Etiology and Management of Hemorrhagic Complications of Portal Hypertension in Children

    Directory of Open Access Journals (Sweden)

    Alejandro Costaguta

    2012-01-01

    Full Text Available Portal hypertension in children represents a particular diagnostic and management challenge for several reasons: (1 treatment outcomes should be evaluated in relationship with a long-life expectancy, (2 pediatric patients with portal hypertension constitute an heterogeneous population, both in terms of individual characteristics and diversity of liver diseases; making comparison between treatment outcomes very difficult, (3 application of techniques and procedures developed in adult patients (v.gr. TIPS face size limitations in small children, and (4 absence of data from well-controlled trials in children forces pediatric specialists to adapt results obtained from adult cohorts suffering from diseases such as HCV and alcoholic cirrhosis. Despite those limitations, substantial progress in the treatment of children with portal hypertension has been achieved in recent years, with better outcomes and survival. Two main factors influence our therapeutic decision: age of the patient and etiology of the liver disease. Therefore, diagnosis and treatment of complications of portal hypertension in children need to be described taking such factors into consideration. This paper summarizes current knowledge and expert opinion.

  17. Hypertension

    Science.gov (United States)

    ... Hypertension Triglycerides Featured Resource Find an Endocrinologist Search Hypertension March 2010 Download PDFs English Espanol Editors Robert ... Additional Resources MedlinePlus (NIH) Mayo Clinic What is hypertension? Hypertension, or chronic (long-term) high blood pressure, ...

  18. Linguistic rehabilitation nursing of pregnancy induced hypertension syndrome associated with cerebral hemorrhage%妊娠高血压综合征并发脑出血的语言康复护理

    Institute of Scientific and Technical Information of China (English)

    刘焕美; 石文利

    2003-01-01

    @@ BACKGROUND:Pregnancy induced hypertension syndrome associated with cerebral hemorrhage is the common cause of obstetric death and even emergency treatment succeeds,living quality is affected because of lalopathy.

  19. Clinical nursing of geriatric hypertension cerebral hemorrhage.%老年高血压脑出血患者的临床护理

    Institute of Scientific and Technical Information of China (English)

    范少华; 宋明浩

    2012-01-01

    Objective: To analyze the clinical symptoms of geriatric hypertension cerebral hemorrhage and summarize nursing highlights. Methods: Retrospectively analyzed in February 2006 - August 2010 were treated geriatric hypertension cerebral hemorrhage with clinical data of 53 cases. Results: The major clinical symptom of geriatric hypertension cerebral hemorrhage is confusion of consciousness while the symptom of intracranial hypertension is not significant , the occurrence of complications is easy. The nursing points includes attention to awareness and vital signs detected, prevention the occurrence of complications. Conclusions: The symptom of geriatric cerebral hemorrhage is not obvious in the early stage, and thus medical treatment may be delayed. Elderly patients are more prone to complications and of a heavy task of nursing.%目的:分析老年高血压脑出血患者的临床表现,总结其临床护理要点.方法:对我院2006年2月~2010年8月所收治的53例老年高血压脑出血患者的临床资料进行回顾性分析.结果:老年高血压脑出血组患者临床表现以意识障碍为主,颅内高压症不明显,易出现并发症.护理要点是注意意识及生命体征的监测,防止并发症的发生.结论:老年高血压脑出血患者早期临床表现不明显,易延误就医,并发症多,护理任务重.

  20. Analyses of prognosis of hypertensive cerebellar hemorrhage after microsurgery%显微手术治疗高血压小脑出血的预后分析

    Institute of Scientific and Technical Information of China (English)

    关靖宇; 熊剑; 陈军; 贺维珍; 季文伟; 杜军; 杨佳明; 王肖亮; 卢天舒

    2012-01-01

    目的 探讨显微手术治疗高血压小脑出血患者预后与相关因素的关系.方法 回顾分析显微手术治疗的高血压小脑出血35例患者的临床指标及预后,利用统计学方法显示临床指标与预后的相关性.结果 高血压小脑出血患者的昏迷程度、血肿量、血肿是否破入脑室与手术预后呈正相关.结论 高血压小脑出血患者的昏迷程度、血肿量、血肿是否破入脑室是影响手术预后的主要因素.%Objective To analyze the relationship between prognosis and correlative factors in hypertensive cerebellar hemorrhage after microsurgery. Methods The clinical indicators and prognosis in 35 patients of hypertensive cerebellar hemorrhage who were treated by microsurgical therapy were analyzed retrospectively. The relationship between some clinical factors and prognosis of patients were analyzed comparatively by statistic method. Results The coma level, hematoma volume and ventricle bematoma have positive correlation with prognosis of hypertensive cerebellar hemorrhage after microsurgery. Conclusion The outcome of patient with hypertensive cerebellar hemorrhage affected seriously by the coma level and hematoma volume and ventricle hematoma.

  1. 高血压脑出血的临床特点及护理要素%Clinical features and nursing elements of hypertensive intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    成杏林

    2014-01-01

    目的:分析高血压脑出血的临床特点及护理要素。方法收集高血压脑出血患者51例的临床病历资料,观察发病构成比、出血部位及危险因素。结果高血压脑出血的发病男∶女≈1.68∶1,以46岁~55岁年龄段居多(37.25%)。高血压脑出血患者出现部位以壳核部最多(41.18%),其次为丘脑部(21.57%)。吸烟、饮酒及基础性疾病为高血压脑出血的危险因素。结论高血压脑出血的发病诱因较多,临床应强化护理干预指导,严格控制基础危险因素,强化基础护理,积极预防并发症,强化心理干预指导及康复护理,以改善患者的预后。%Objective To analyze the clinical features and nursing elements of hypertensive intracerebral hemorrhage.Methods 51 cases of patients with hypertensive cerebral were chosen for the study. The incidence proportions, the bleeding site and risk factors were observed.Results The incidence of hypertensive intracerebral hemorrhage male: female was 1.68:1, and the year of 46 to 55 was the mostly (37.25%). Hypertensive cerebral hemorrhage occurs at most parts of the site of the putamen (41.18%), followed by the thalamus (21.57%). Smoking, drinking and underlying disease were the risk factors for hypertensive intracerebral hemorrhage.Conclusion The incentives incidence of hypertensive cerebral hemorrhage are more and clinical nursing interventions should strengthen the guidance, strictly controll the basis of risk factors, and strengthen primary care, actively prevent complications, strengthen psychological intervention and rehabilitation care to improve patient outcomes.

  2. Intravenous Bevacizumab Therapy in a Patient with Hereditary Hemorrhagic Telangiectasia, ENG E137K, Alcoholic Cirrhosis, and Portal Hypertension.

    Science.gov (United States)

    Bertoli, Luigi F; Lee, Pauline L; Lallone, Lauren; Barton, James C

    2017-01-01

    Intravenous bevacizumab decreased mucosal bleeding in some patients with hereditary hemorrhagic telangiectasia (HHT). We treated a 47-year-old male who had HHT, severe epistaxis, and gastrointestinal bleeding, alcoholic cirrhosis, and portal hypertension with intravenous bevacizumab 2.5 mg/kg every 2 weeks. We tabulated these measures weekly during weeks 1-33 (no bevacizumab); 34-57 (bevacizumab); and 58-97 (no bevacizumab): hemoglobin (Hb) levels; platelet counts; units of transfused packed erythrocytes (PRBC units); and quantities of iron infused as iron dextran to support erythropoiesis. We performed univariate and multivariable analyses. We sequenced his ENG and ACVRL1 genes. Epistaxis and melena decreased markedly during bevacizumab treatment. He reported no adverse effects due to bevacizumab. Mean weekly Hb levels were significantly higher and mean weekly PRBC units and quantities of intravenous iron were significantly lower during bevacizumab treatment. We performed a multiple regression on weekly Hb levels using these independent variables: bevacizumab treatment (dichotomous); weekly platelet counts; weekly PRBC units; and weekly quantities of intravenous iron. There was 1 positive association: (bevacizumab treatment; p = 0.0046) and 1 negative association (PRBC units; p = 0.0004). This patient had the novel ENG mutation E137K (exon 4; c.409G→A). Intravenous bevacizumab treatment 2.5 mg/kg every 2 weeks for 24 weeks was well-tolerated by a patient with HHT due to ENG E137K and was associated with higher weekly Hb levels and fewer weekly PRBC units.

  3. Nontraumatic intracranial hemorrhage.

    Science.gov (United States)

    Fischbein, Nancy J; Wijman, Christine A C

    2010-11-01

    Nontraumatic (or spontaneous) intracranial hemorrhage most commonly involves the brain parenchyma and subarachnoid space. This entity accounts for at least 10% of strokes and is a leading cause of death and disability in adults. Important causes of spontaneous intracranial hemorrhage include hypertension, cerebral amyloid angiopathy, aneurysms, vascular malformations, and hemorrhagic infarcts (both venous and arterial). Imaging findings in common and less common causes of spontaneous intracranial hemorrhage are reviewed.

  4. Hyperbaric oxygen in the treatment of hypertension- induced cerebral hemorrhage on 34 cases%高血压脑出血术后高压氧治疗34例

    Institute of Scientific and Technical Information of China (English)

    程晋成; 沈月萍; 王水平; 吴杨

    2003-01-01

    @@ INTRODUCTION In this study,we investigated effect of hyperbaric oxygen(HBO) on the hypertension- induced basio- cerebral hemorrhage.The affected patients often showed signs of cerebral circulation disorder,spasm of vessels,insufficiency of cerebral blood supply and intracranial hypertension.

  5. Cell apoptosis in perihematomal brain regions and expression of Caspase-3 protein in patients with hypertensive intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Xinqing Zhang; Xiaoliang Yin; Kun Zhang; Zhimin Zhang; Hui Cai; Honglan Xu

    2006-01-01

    BACKGROUND: In patients with intracerebral hemorrhage (ICH), besides the space-occupying effect of hematoma, hematomal component also causes the pathological changes of perihematomal region, including the death of neurons and glial cells, vasogenic brain edema, the destruction of blood brain barrier and so on, which are the important factors to influence the prognosis of patients. Therefore, it is necessary to perform fur ther investigation and study on the pathological characteristics of injury and death of brain nerve cells. OBJECTIVE: To observe the pathological changes of apoptosis and Caspase-3 expression in perihe matomal brain regions in patients with hypertensive ICH (HICH) in different stages of onset, and analyze their relationship. DESIGN: Case-control observation. SETTING: Departments of Neurosurgery and Pathology of Beijing Chuiyangliu Hospital. PARTICIPANTS: Totally 19 patients with HICH, including 12 male, 7 female, aged (58.3±12.8) ranging from 49 to 78 years, whose mean volume of hemorrhage was (48.6±16.4) mL, were involved . All the cases conformed to the diagnostic criteria of intracerebral hemorrhage formulated in the 4th National Cerebrovascular Dis eases Conference and were confirmed by skull CT scanning. Informed consents of operation and specimens were obtained from the patients and relatives.METHODS; ①Patients with HICH who had undergone surgical evacuation of an intracerebral hematoma by traverse temporal lobe approach in the Department of Neurosurgery, Beijing Chuiyangliu Hospital from Jan uary 2004 to July 2005 were involved. Nineteen specimens of brain tissue from perihematomal region of HICH patients in different phases served as patient group. Five specimens were obtained from distant regions of patients in the super-early phase as the control group. According to the time from onset to operation, the 19 cases were divided into 3 groups: 6 cases in super-early phase(onset < 8 hours), 8 cases in early phase (onset about 8 to 24

  6. Outcome assessment of hemiparesis due to intracerebral hemorrhage using diffusion tensor fractional anisotropy.

    Science.gov (United States)

    Koyama, Tetsuo; Marumoto, Kohei; Uchiyama, Yuki; Miyake, Hiroji; Domen, Kazuhisa

    2015-04-01

    This study aimed to evaluate the prognostic efficacy of magnetic resonance diffusion tensor fractional anisotropy (FA) for patients with hemiparesis due to intracerebral hemorrhage. Diffusion tensor FA brain images were acquired 14-21 days after putaminal and/or thalamic hemorrhage. The ratio of FA values within the cerebral peduncles of the affected and unaffected hemispheres (rFA) was calculated for each patient (n = 40) and assessed for correlation with Brunnstrom stage (BRS, 1-6), motor component of the functional independence measure (FIM-motor, 13-91), and the total length of stay (LOS) until discharge from rehabilitation (P hemiparesis due to putaminal and/or thalamic hemorrhage, particularly hand function recovery. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  7. Effect of operative moment and style on postoperative daily life in hypertensive intracerebral hemorrhage%手术时机及手术方式的选择对高血压脑出血患者术后日常生活能力恢复的影响

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    @@ Rational operation in early stage was an important means to promote patients' rehabilitation.Different effects were compared to explore a reasonable classification of hypertensive intracerebral hemorrhage.

  8. Treatment of Serious Hypertensive Intracerebral Hemorrhage with CT-location Drill-crandum Smashing-draw and Analysis of Prognosis Factors

    Institute of Scientific and Technical Information of China (English)

    Huang Panbing

    2000-01-01

    Objective: To study curative effect of CT-location drill-cranium smashing-draw and affective pregniosis factors for serious hypertensive intracerebral hemorrhage (HIH). Methods :15 cases of serious HIH(group A)were treated with CT-location drill-cranium smashing-draw ,other 15 patients treated (group B)were treated with medicine only as controls. Results: The curative rate (20%) anis improvable rate (33.3%)in group A were higher than that of (6.7% and 26.7%)in group B (P<0. 001). The mortality rate (46.7%)in group A was lower than that of (66.6%)in group B significantly (P<0.001). Conclusions: The efffect of the therapy was satisfactory The higher or lower of the mortality rate was closely related to operative time 、 m-hemorrhage 、 location and range of the hemotoma

  9. HIMALAIA (Hypertension Induction in the Management of AneurysmaL subArachnoid haemorrhage with secondary IschaemiA) : a randomized single- blind controlled trial of induced hypertension vs. no induced hypertension in the treatment of delayed cerebral ischemia after subarachnoid hemorrhage

    NARCIS (Netherlands)

    Gathier, C. S.; van den Bergh, W. M.; Slooter, A. J. C.

    2014-01-01

    RationaleDelayed cerebral ischemia (DCI) is a major complication after aneurysmal subarachnoid hemorrhage (SAH). One option to treat delayed cerebral ischemia is to use induced hypertension, but its efficacy on the eventual outcome has not been proven in a randomized clinical trial. This article des

  10. HIMALAIA (Hypertension Induction in the Management of AneurysmaL subArachnoid haemorrhage with secondary IschaemiA) : a randomized single- blind controlled trial of induced hypertension vs. no induced hypertension in the treatment of delayed cerebral ischemia after subarachnoid hemorrhage

    NARCIS (Netherlands)

    Gathier, C. S.; van den Bergh, W. M.; Slooter, A. J. C.

    RationaleDelayed cerebral ischemia (DCI) is a major complication after aneurysmal subarachnoid hemorrhage (SAH). One option to treat delayed cerebral ischemia is to use induced hypertension, but its efficacy on the eventual outcome has not been proven in a randomized clinical trial. This article

  11. The safety of vasopressor-induced hypertension in subarachnoid hemorrhage patients with coexisting unruptured, unprotected intracranial aneurysms.

    Science.gov (United States)

    Reynolds, Matthew R; Buckley, Robert T; Indrakanti, Santoshi S; Turkmani, Ali H; Oh, Gerald; Crobeddu, Emanuela; Fargen, Kyle M; El Ahmadieh, Tarek Y; Naidech, Andrew M; Amin-Hanjani, Sepideh; Lanzino, Giuseppe; Hoh, Brian L; Bendok, Bernard R; Zipfel, Gregory J

    2015-10-01

    Vasopressor-induced hypertension (VIH) is an established treatment for patients with aneurysmal subarachnoid hemorrhage (SAH) who develop vasospasm and delayed cerebral ischemia (DCI). However, the safety of VIH in patients with coincident, unruptured, unprotected intracranial aneurysms is uncertain. This retrospective multiinstitutional study identified 1) patients with aneurysmal SAH and 1 or more unruptured, unprotected aneurysms who required VIH therapy (VIH group), and 2) patients with aneurysmal SAH and 1 or more unruptured, unprotected aneurysms who did not require VIH therapy (non-VIH group). All patients had previously undergone surgical or endovascular treatment for the presumed ruptured aneurysm. Comparisons between the VIH and non-VIH patients were made in terms of the patient characteristics, clinical and radiographic severity of SAH, total number of aneurysms, number of ruptured/unruptured aneurysms, aneurysm location/size, number of unruptured and unprotected aneurysms during VIH, severity of vasospasm, degree of hypervolemia, and degree and duration of VIH therapy. For the VIH group (n = 176), 484 aneurysms were diagnosed, 231 aneurysms were treated, and 253 unruptured aneurysms were left unprotected during 1293 total days of VIH therapy (5.12 total years of VIH therapy for unruptured, unprotected aneurysms). For the non-VIH group (n = 73), 207 aneurysms were diagnosed, 93 aneurysms were treated, and 114 unruptured aneurysms were left unprotected. For the VIH and non-VIH groups, the mean sizes of the ruptured (7.2 ± 0.3 vs 7.8 ± 0.6 mm, respectively; p = 0.27) and unruptured (3.4 ± 0.2 vs 3.2 ± 0.2 mm, respectively; p = 0.40) aneurysms did not differ. The authors observed 1 new SAH from a previously unruptured, unprotected aneurysm in each group (1 of 176 vs 1 of 73 patients; p = 0.50). Baseline patient characteristics and comorbidities were similar between groups. While the degree of hypervolemia was similar between the VIH and non-VIH patients

  12. Intensive blood pressure control during the hyperacute phase of intracerebral hemorrhage in patients at risk for resistant hypertension: a retrospective cohort study.

    Science.gov (United States)

    Mohrien, Kerry M; Elijovich, Lucas; Venable, Garrett T; Taylor, Douglas R; Jones, G Morgan

    2015-04-01

    There are limited data evaluating intensive systolic blood pressure (SBP) control during the hyperacute phase of intracerebral hemorrhage (ICH) in patients with multiple risk factors for resistant hypertension. We evaluated the feasibility and safety of this intervention in a primary population that includes patients with multiple risk factors for resistant hypertension. We conducted a retrospective analysis of ICH patients for which intensive SBP control (risk factors that have been associated with resistant hypertension. Our primary objective was to determine the percentage of patients who achieved goal SBP within 1 hour of ICH diagnosis. Secondary objectives included identifying predictors of achieving goal SBP within 6 hours. Goal SBP within 1 hour was achieved in 8.1% of patients. The total number of risk factors a patient possessed was found to negatively predict ability to achieve goal SBP. For each risk factor possessed, the odds of achieving goal SBP within 6 hours are reduced by 31% (odds ratio, 0.69 [95% confidence interval, 0.54-0.89]). Intensive SBP control after ICH was difficult to achieve within 1 hour in those with risk factors for resistant hypertension. Patients' total risk factors were found to reduce the odds of achieving goal SBP within 6 hours. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Clinical Study on Zhuyu Tongfu(逐瘀通腑) Serial Recipe Combined with Acupuncture and Massotherapy in Treating Hypertensive Cerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Objective: To observe the clinical efficacy and mechanism of Zhuyu Tongfu (逐瘀通腑,ZYTF) Serial Recipe combined with acupuncture and massotherapy in treating hypertensive cerebral hemorrhage (HCH). Methods: One hundred and eighteen patients with hypertensive cerebral hemorrhage, on the basis of conventional Western medicine treatment, were randomly divided into ZYTF combined with acupuncture and massotherapy group (treated group) and simple Western medicine group (control group); the clinical efficacy, neurofunction deficit scoring (NDS) alterations and hematoma absorption rate of both groups were observed, and also the plasma superoxide dismutase (SOD) activity, plasma lipid peroxidase (LPO)content, erythrocyte glutathion peroxidase (GSH-Px) activity, hematocrit (Ht) and the whole blood viscosity(Va) change were also observed. Results: In the treated group, the clinical efficacy, NDS improvement and hematoma absorption rate were superior to that of the control group; comparison between the two groups after treatment showed that plasma SOD activity and GSH-Px activity got more elevated and plasma LPO content, Ht and Va more lowered in the the treated group than those in the control group. Conclusion: ZYTF combined with acupuncture and massotherapy has better effect, its therapeutic mechanism was possibly correlated to the elevation of plasma SOD activity, GSH-Px activity and lowering of plasma LPO content, Ht and Va.

  14. [Hypertension].

    Science.gov (United States)

    Ohishi, Mitsuru

    2014-04-01

    Hypertension is well known to one of the risk factors to reduce cognitive function, however, it is still unclear whether anti-hypertensive therapy is effective to prevent development of dementia or Alzheimer's disease. Epidemiological studies suggested antihypertensive therapy from the middle-age could reduce risk of dementia. The meta-analysis including HYVET also suggested blood pressure lowering from the elderly might be also effective to prevent development of dementia. The network meta-analysis and the cohort study using mega-data bank suggested ARB might be effective to prevent development of dementia or Alzheimer's disease compared to administration with other anti-hypertensive drugs. Although the further major clinical investigation is required, anti-hypertensive treatment might be useful to manage hypertensive patients with dementia.

  15. 两种不同方法治疗高血压脑出血疗效比较%Two Different Treatment of Hypertensive Cerebral Hemorrhage Curative Effect

    Institute of Scientific and Technical Information of China (English)

    赵庆; 单桂梅; 刘建春

    2015-01-01

    Objective To explore the curative effect of different methods on hypertensive intracerebral hemorrhage in the elderly patients. Methods We analyse retrospectively hypertensive intracerebral hemorrhage patients, respectively 40 cases with minimally invasive hematoma aspiration biopsy and removal of small bone window craniotomy hematoma, by comparing the hematoma clearance rate, postoperative complications, mortality and postoperative ADL grading, we can evaluate the curative effect of two methods objectively. Results Through compring the two methods, small bone window craniotomy surgery for removal of hematoma and minimally invasive hematoma aspiration biopsy, has the same therapeu-tic effect, for larger hematoma, surgical indications, and did not happen cerebral hernia, in the treatment of hypertensive ce-rebral hemorrhage, but it is worthy of appling widely in aspect of comparing the two surgical trauma to the patients and saving medical resources. Conclusion Minimally invasive hematoma aspiration biopsy is a kind of safe and effective treatment, which especially suits for the basic-level hospitals, it can effectively save the patients'life, because of shorter operation time, small surgical injury, simple operation, also obvious curative effect and low cost etc.%目的 探讨不同方法在老年人高血压脑出血的治疗效果.方法 回顾性分析高血压脑出血病人80例,随机分为两组,分别采用微创血肿碎吸术和小骨窗开颅血肿清除术,术后并发症,死亡率和术后ADL分级进行比较,所获数据采用2检验.结果 两组血肿清除率与再出血率比较,P>0.05,无显著性差异.两组术后并发症比较,P>0.05,无显著性差异.两组术后功能恢复比较,P>0.05,无显著性差异.结论 微创血肿碎吸术具有手术时间短,创伤小,操作简单,效果确切,能明显降低患者医疗费用等特点,特别适合在基层医院开展.

  16. Hypertension

    OpenAIRE

    2012-01-01

    Hypertension is responsible for roughly one-in-six adult deaths annually in the United States and is associated with five of the top nine causes of death. 1 Ten trillion dollars is the estimated annual cost worldwide of the direct and indirect effects of hypertension. 2,3 In the U.S. alone, costs estimated at almost $74 billion in 2009 placed a huge economic burden on the health care system. 4 The prevalence of hypertension increases with advancing age to the point where more than half of peo...

  17. Hypertension

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — These datasets provide de-identified insurance data for hypertension hyperlipidemia. The data is provided by three managed care organizations in Allegheny County...

  18. Effect of intra-abdominal volume increment technique for the treatment of intra-abdominal hypertension on the liver after resuscitation of hemorrhagic shock in pig

    Directory of Open Access Journals (Sweden)

    Zheng-gang WANG

    2012-02-01

    Full Text Available Objective  To observe the effect of vacuum sealing drainage (VSD assisted intra-abdominal volume increment (IAVI technique on the liver in the treatment of intra-abdominal hypertension (IAH following hemorrhagic shock resuscitation in pigs. Methods  Twelve healthy mini-pigs (Bama, Guangxi were selected for bloodletting from the femoral artery to reproduce hemorrhagic shock model (mean arterial blood pressure, 50mmHg, 1h, and IAH model was successfully reproduced in eight pigs by partial occlusion of portal vein. The eight pigs were randomly divided into the intra-abdominal volume increment treatment (IT group (n=4 and sham operation control (SC group (n=4. Vesical pressure (VP and inferior vena cava pressure (IVCP were observed before shock, 2h after IAH, and 22h after IAVI treatment. Aspartate aminotransferase (AST and alanine aminotransferase (ALT were measured. In addition, the ratio of the abdominal anteroposterior diameter to the transverse diameter was assessed, and the liver CT values were measured after enhanced CT scanning. The pigs were sacrificed 26h after operation. Liver specimens were collected to measure the ratio of wet weight to dry weight and pathological examination. Results  The VP in 8 IAH pigs was 21.16±4.63mmHg. The ratio of abdominal anteroposterior diameter to the transverse diameter increased remarkably 2h after IAH compared with that before shock (1.22±1.41 vs 0.96±0.08, PPvs 42.73±4.92HU, PPPvs 5.14±0.71, PConclusions  The established model could better reproduce the symptoms of IAH after hemorrhagic shock and fluid resuscitation, accompanied by liver damage. IAVI helps to relieve liver functional disturbance after IAH, which is related to decreased intra-abdominal pressure and hypoxia-ischemia of the liver.

  19. Hypertension and hypertensive encephalopathy.

    Science.gov (United States)

    Price, Raymond S; Kasner, Scott E

    2014-01-01

    The definition of hypertension has continuously evolved over the last 50 years. Hypertension is currently defined as a blood pressure greater than 140/90mmHg. One in every four people in the US has been diagnosed with hypertension. The prevalence of hypertension increases further with age, affecting 75% of people over the age of 70. Hypertension is by far the most common risk factor identified in stroke patients. Hypertension causes pathologic changes in the walls of small (diameter<300 microns) arteries and arterioles usually at short branches of major arteries, which may result in either ischemic stroke or intracerebral hemorrhage. Reduction of blood pressure with diuretics, β-blockers, calcium channel blockers, and angiotensin-converting enzyme (ACE) inhibitors have all been shown to markedly reduce the incidence of stroke. Hypertensive emergency is defined as a blood pressure greater than 180/120mmHg with end organ dysfunction, such as chest pain, shortness of breath, encephalopathy, or focal neurologic deficits. Hypertensive encephalopathy is believed to be caused by acute failure of cerebrovascular autoregulation. Hypertensive emergency is treated with intravenous antihypertensive agents to reduce blood pressure by 25% within the first hour. Selective inhibition of cerebrovascular blood vessel permeability for the treatment of hypertensive emergency is beginning early clinical trials. © 2014 Elsevier B.V. All rights reserved.

  20. Recurrent intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Shen jinsong; Lu jianhong

    2000-01-01

    Objective: In order to study the clinical manifestation and risk factor of recurrent intracerebral hemorrhage(ICH).Methods:The 256 patients were analysed who admitted to our hospital for intracerebral hemorrhage between 1995 and 1997.The 15(5 .86%)patients had a recurrent ICH.There were 9 men and 6 women and the mean age of the patients was 63.5 ± 6.4years at the first bleeding episode and 67.8± 8. 5 years at the second. The mean interval between the two bleeding episodes was 44.6 ± 12.5 months. The 73.3%patients were hypertensive .′The site of the first hemorrhage was ganglionic in 8 patients , ]ohar in six paients and brainstem in one .The recurrent hemorrhage occurred at a different location from the previous ICH.The most common pattern of recurrence was “ganglionic -ganglionic” (7 patients), lobar - ganglionic (3 patients), lobar-lobar(three patients), which was always observed in hypertensive patients. The outcome after the recurrent hemorrhage was usually poor. By comparison with 24 patients followed up to average 47.5± 18.7 months with isolated ICH without recurrence .Only lobar hematoma and a younger age were risk factors for recurrences whereas sex and previous hypertension were not. The mechanism of recurrence of ICH were multiple(hypertension, cerebral amyloid angiopathy).Contral of blood pressure and good living habit after the first hemorrhage may prevent ICH recurrences.

  1. Stereotactic therapy for elderly patients with hypertensive cerebral hemorrhage%老年高血压脑出血患者的立体定向治疗

    Institute of Scientific and Technical Information of China (English)

    马长城; 王振宇; 谢京城; 刘彬; 陈晓东

    2012-01-01

    Objective To find the safe and appropriate therapies for elderly patients with hypertensive cerebral hemorrhage. Methods Twenty-one patients with hypertensive cerebral hemorrhage aged over 75 years(with a hematoma volume of 20 ?30 ml in 5 and 30 ?60 ml in 16) were treated with stereotactic puncture and drainage. Results Hematomas were completely removed from all patients. Their Glasgow score (GCS) increased significantly on days 1 and 3 after operation. No severe complication occurred except for recurrent hemorrhage in 1 patient, pneumonia in 2 patients, and transient renal dysfunction in 1 patient after operation. The average hospital stay time of the patients was 13. 2 days. The patients were followed up for 6 months during which 7 patients were well recovered,12 had moderate disability,2 had severe disability,and no patient died. Conclusion Stereotactic puncture and drainage are a minimally invasive,safe and effective procedure for hematoma, which can effectively reduce complications and shorten hospital stay time of patients.%目的 研究老年高血压脑出血患者的治疗方法,为老年高血压脑出血患者寻找合适、安全的治疗途径.方法 利用立体定向穿刺引流治疗年龄>75岁的高血压脑出血患者21例,其中血肿量20~30 ml 5例,30~60 ml 16例.结果 所有患者血肿均得到了有效清除,术后第1、3天格拉斯哥昏迷评分(GCS)明显升高.术后除1例少量再出血,2例肺炎、1例一过性肾功能障碍外,无其他严重并发症出现.所有患者平均住院时间为13.2d.术后随访6个月,恢复良好者7例,中度残疾12例,量度残疾2例,无死亡.结论 立体定向血肿穿刺抽吸引流微创、安全、有效,能有效减少并发症,并缩短住院时间.

  2. Diabetes with hypertension as risk factors for adult dengue hemorrhagic fever in a predominantly dengue serotype 2 epidemic: a case control study.

    Directory of Open Access Journals (Sweden)

    Junxiong Pang

    Full Text Available BACKGROUND: Dengue hemorrhagic fever (DHF is a severe form of dengue, characterized by bleeding and plasma leakage. A number of DHF risk factors had been suggested. However, these risk factors may not be generalized to all populations and epidemics for screening and clinical management of patients at risk of developing DHF. This study explored demographic and comorbidity risk factors for DHF in adult dengue epidemics in Singapore in year 2006 (predominantly serotype 1 and in year 2007-2008 (predominantly serotype 2. METHODS: A retrospective case-control study was conducted with 149 DHF and 326 dengue fever (DF patients from year 2006, and 669 DHF and 1,141 DF patients from year 2007-2008. Demographic and reported comorbidity data were collected from patients previously. We performed multivariate logistic regression to assess the association between DHF and demographic and co-morbidities for year 2006 and year 2007-2008, respectively. RESULTS: Only Chinese (adjusted odds ratio [AOR] = 1.90; 95% confidence interval [CI]: 1.01-3.56 was independently associated with DHF in year 2006. In contrast, age groups of 30-39 years (AOR = 1.41; 95% CI:1.09-1.81, 40-49 years (AOR = 1.34; 95% CI:1.09-1.81, female (AOR = 1.57; 95% CI:1.28-1.94, Chinese (AOR = 1.67; 95% CI:1.24-2.24, diabetes (AOR = 1.78; 95% CI:1.06-2.97, and diabetes with hypertension (AOR = 2.16; 95%CI:1.18-3.96 were independently associated with DHF in year 2007-2008. Hypertension was proposed to have effect modification on the risk of DHF outcome in dengue patients with diabetes. Chinese who had diabetes with hypertension had 2.1 (95% CI:1.07-4.12 times higher risk of DHF compared with Chinese who had no diabetes and no hypertension. CONCLUSIONS: Adult dengue patients in Singapore who were 30-49 years, Chinese, female, had diabetes or diabetes with hypertension were at greater risk of developing DHF during epidemic of predominantly serotype 2. These risk factors

  3. Hypertensive Caudate Hemorrhage therapy and Prognostic Predictor%高血压尾状核头出血的治疗与预后预测因子

    Institute of Scientific and Technical Information of China (English)

    王恩任; 张列; 樊庆荣; 邱治春; 何明杰

    2015-01-01

    Objective To analyze therapy and outcome predictors of caudate hemorrhage and role of external ventricular drainage in acute hydrocephalus. Methods Clinical data from 36 consecutive patients with hypertensive caudate hemorrhage was used in the present study. Age, gender, volume of parenchymal hematoma, hematoma in the internal capsule, initial Glasgow Co-ma Scale ( GCS) , hydrocephalus, severity of intraventricular hemorrhage, and hemorrhagic dilatation of the fourth ventricle were analyzed for effect on outcome. Effect of external ventricle drainage for hydrocephalus was evaluated by comparing preoperative and postoperative GCS scores. Results By univariate analyses, poor outcome was associated with a poor initial GCS score (P=0. 016), hydrocephalus (P<0. 01), intraventricular hemorrhage severity (P<0. 01), and hemorrhagic dilatation of the fourth ventricle (P=0. 02). By multivariate analysis, stepwise logistic regression revealed that hydrocephalus was the most important prognostic factor for poor outcome ( P<0. 01 ) . Postoperative 48-hour GCS score was better than the preoperative score by use of paired-sample t test (P<0. 01). Conclusion Hydrocephalus is the most important predictor of poor outcome. External ventricular drainage response for hydrocephalus was good in the present study, whereas an early decision should be made regarding preoperative neurological condition.%目的:探讨尾状核出血的治疗、预后因子及并发急性脑积水室外引流作用。方法回顾分析36例高血压尾状核出血患者的临床资料:年龄、性别、实质血肿量、内囊血肿、GCS评分、脑积水、脑室内出血的严重程度与四脑室积血扩张对预后的影响,比较术前和术后GCS评分评价脑积水脑室外引流的作用。结果经单因素分析,预后差与初始低GCS评分(P=0.016)、脑积水(P<0.01)、脑室内出血严重性(P<0.01)、四脑室积血扩张(P=0.02)相关。多因素分析, Logistic回归显

  4. A Preliminary Study the Correlation of Blood Uric Acid and Hypertension Cerebral Hemorrhage%初探血尿酸与高血压脑出血的相关性

    Institute of Scientific and Technical Information of China (English)

    沈钦龙; 张延军; 夏海艳

    2016-01-01

    Objective To investigate the relationship between cerebral hemorrhage in the peripheral blood plasma uric acid and hypertension. Methods Group selection into the group of 241 cases of patients with essential hypertension, to head CT imaging diagnosis for cerebral hemorrhage, divided the patients into cerebral hemorrhage group (147 cases) and hyperten-sion group (94 cases). By immune method in the detection of peripheral blood uric acid, uric acid 430 umol/L as the stan-dard of diagnosis of high uric acid hematic disease, hypertension patients with high uric acid hematic disease (156 cases), not in hypertensive patients with high uric acid hematic disease (85 cases). Results Peripheral blood uric acid level is higher than the high blood pressure in patients with hypertensive cerebral hemorrhage group (503.4 ±40.2) than (447.3 ± 38.8), P < 0.05. With high uric acid levels, a higher proportion of hypertensive cerebral hemorrhage in patients with high blood pressure patients (64.7%:9.6%, P< 0.05). Multiariable Logistic regression showed that the risk factors affecting hy-pertensive cerebral hemorrhage with hyperlipidemia (OR =1.08), high uric acid hematic disease (OR =1.04), alcohol (OR =2.30), systolic blood pressure(OR = 1.10), and homocysteine(OR = 1.02), P< 0.01. Conclusion Patients with high uric acid hematic disease high blood pressure are more likely to cerebral hemorrhage, namely high uric acid hematic disease risk of hypertension cerebral hemorrhage is higher.%目的:探讨外周血浆中尿酸与高血压脑出血的关系。方法整群选取2014年1月—2015年12月就诊于郑州市第六人民医院神经内科原发性高血压患者241例,以头颅CT影像学确诊有无脑出血,将患者分为脑出血组(147例)和高血压组(94例)。采用免疫法检测外周血中尿酸,以尿酸≥430 umol/L作为诊断高尿酸血症的标准。结果高血压性脑出血患者外周血中尿酸水平高于高血压组(503.4±40.2)比(447.3

  5. 亚低温治疗高血压脑出血患者改善功能预后及相关因素分析%Function prognosis promotion and relative factor analysis of subhypothermia therapy to hypertension cerebral hemorrhage patients

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective To study the effect of sub hypothermia on hypertension cerebral hemorrhage and content of serum endothelin(ET). Method 87 hypertension cerebral hemorrhage cases were divided into subhypothermia group and control group randomly,patients in subhypothermia group received subhypothermia therapy in NICU-6 hours after operation or hospitalization.We tested serum ET content with specific radioimmunoassay method 24 hours,72 hours and 3 weeks after therapy,and compared them with control group.Result ET content of two groups increased apparently after 24 hours,ET of subhypothermia group was lower than that of control group(P< 0.01);it recovered 3 weeks after therapy.Conclusion Subhypothermia techniques can apparently improve prognosis of hypertension cerebral hemorrhage patients,serum ET level may be one important index to evaluate severity of hypertension cerebral hemorrhage.

  6. Hypertension

    OpenAIRE

    2016-01-01

    Defining hypertension in pregnancy is challenging because blood pressure levels in pregnancy are dynamic, having a circadian rhythm and also changing with advancing gestational age. The accepted definition is a sustained systolic (sBP) of ≥140 mmHg or a sustained diastolic blood pressure (dBP) ≥90 mmHg, by office (or in-hospital) measurement. Measurement of blood pressure in pregnancy should follow standardised methods, as outside pregnancy. Blood pressure measurement may occur in three types...

  7. Analysis of CT Features and Prognosis Related Factors of Hypertensive Cerebral Hemorrhage%高血压脑出血CT特征与预后的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    李娟

    2015-01-01

    目的:分析高血压脑出血CT特征与其与预后的相关性。方法回顾性分析我院2013年1月-2014年12月收治的75例高血压脑出血患者CT影像资料及其他资料,观察高血压脑出血CT特征(包括出血部位、血肿形态、出血量、是否破入脑室等),根据mRS评分将患者分为预后良好组与预后不良组,对CT特征与预后相关性行单因素及多因素Logistic分析。结果高血压脑出血CT特征:基底节区出血占57.3%,血肿形态规则占81.3%;出血量30ml以下占46.7%,出血量60ml以上占18.7%;出血破入脑室占30.7%。30ml以下出血量患者发病3个月mRs评分明显低于30-60ml、60ml以上(P<0.05)。单因素及多因素Logistic分析患者年龄、脑出血量、出血破入脑室是高血压脑出血患者预后不良独立危险因素。结论 CT影像特征可作为高血压脑出血预后评估的重要依据。%Objective To analyze the CT features and their correlation with prognosis of hypertensive cerebral hemorrhage.Methods CT imaging data and other data of 75 patients with hypertensive cerebral hemorrhage who were treated in our hospital during January 2013 to December 2014 were retrospectively analyzed. The CT features (including bleeding site, hematoma shape, bleeding volume and whether breaking into ventricle or not) of hypertensive cerebral hemorrhage were observed. According to mRS score, the patients were divided into the favorable prognosis group and the poor prognosis group. For CT features and their correlation with prognosis, univariate and multiple Logistic analysis were performed.Results CT features of hypertensive cerebral hemorrhage: basal ganglia hemorrhage accounted for 57.3%, regular hematoma shape for 81.3%, bleeding volume less than 30ml for 46.7%, bleeding volume more than 60ml for 18.7% and hemorrhage breaking into ventricle for 30.7%. The mRs score of patients with bleeding volume less than 30ml and 3 months after onset was

  8. 新生儿颅内高压伴消化道大出血1例的护理体会%Nursing experience of neonatal intracranial hypertension complicated with hemorrhage of digestive tract of 1 case

    Institute of Scientific and Technical Information of China (English)

    郭睿

    2015-01-01

    Based on 1 case of nursing of neonatal intracranial hypertension complicated with hemorrhage of digestive tract,we analyzed the nursing experience of massive hemorrhage of digestive tract caused by intracranial hypertension with stress ulcer,to accumulate experience in order to improve the cure rate of the rescue success rate and disease in children.%通过对1例新生儿颅内高压伴消化道大出血的护理,分析颅内高压引起应激性溃疡导致消化道大出血患儿的护理体会,为提高患儿的救护成功率及疾病的治愈率积累经验。

  9. Disrupted Auto-Activation, Dysexecutive and Confabulating Syndrome Following Bilateral Thalamic and Right Putaminal Stroke

    Directory of Open Access Journals (Sweden)

    Lieve De Witte

    2008-01-01

    Full Text Available Objective: Clinical, neuropsychological, structural and functional neuroimaging results are reported in a patient who developed a unique combination of symptoms after a bi-thalamic and right putaminal stroke. The symptoms consisted of dysexecutive disturbances associated with confabulating behavior and auto-activation deficits. Background: Basal ganglia and thalamic lesions may result in a variety of motor, sensory, neuropsychological and behavioral syndromes. However, the combination of a dysexecutive syndrome complicated at the behavioral level with an auto-activation and confabulatory syndrome has never been reported. Methods: Besides clinical and neuroradiological investigations, an extensive set of standardized neuropsychological tests was carried out. Results: In the post-acute phase of the stroke, a dysexecutive syndrome was found in association with confabulating behavior and auto-activation deficits. MRI showed focal destruction of both thalami and the right putamen. Quantified ECD SPECT revealed bilateral hypoperfusions in the basal ganglia and thalamus but no perfusion deficits were found at the cortical level. Conclusion: The combination of disrupted auto-activation, dysexecutive and confabulating syndrome in a single patient following isolated subcortical damage renders this case exceptional. Although these findings do not reveal a functional disruption of the striato-ventral pallidal-thalamic-frontomesial limbic circuitry, they add to the understanding of the functional role of the basal ganglia in cognitive and behavioral syndromes.

  10. Spatial reorganization of putaminal dopamine D2-like receptors in cranial and hand dystonia.

    Science.gov (United States)

    Black, Kevin J; Snyder, Abraham Z; Mink, Jonathan W; Tolia, Veeral N; Revilla, Fredy J; Moerlein, Stephen M; Perlmutter, Joel S

    2014-01-01

    The putamen has a somatotopic organization of neurons identified by correspondence of firing rates with selected body part movements, as well as by complex, but organized, differential cortical projections onto putamen. In isolated focal dystonia, whole putaminal binding of dopamine D2-like receptor radioligands is quantitatively decreased, but it has not been known whether selected parts of the putamen are differentially affected depending upon the body part affected by dystonia. The radioligand [(18)F]spiperone binds predominantly to D2-like receptors in striatum. We hypothesized that the spatial location of [(18)F]spiperone binding within the putamen would differ in patients with dystonia limited to the hand versus the face, and we tested that hypothesis using positron emission tomography and magnetic resonance imaging. To address statistical and methodological concerns, we chose a straightforward but robust image analysis method. An automated algorithm located the peak location of [(18)F]spiperone binding within the striatum, relative to a brain atlas, in each of 14 patients with cranial dystonia and 8 patients with hand dystonia. The mean (left and right) |x|, y, and z coordinates of peak striatal binding for each patient were compared between groups by t test. The location of peak [(18)F]spiperone binding within the putamen differed significantly between groups (cranial dystonia zputamen depending on the body part manifesting dystonia.

  11. Oral methylphenidate challenge selectively decreases putaminal T2 in healthy subjects.

    Science.gov (United States)

    Silveri, Marisa M; Anderson, Carl M; McNeil, Jane F; Diaz, Claudia I; Lukas, Scott E; Mendelson, Jack H; Renshaw, Perry F; Kaufman, Marc J

    2004-11-11

    Despite the recent rise in oral methylphenidate (MPH) abuse, few studies have characterized the time course of oral MPH brain effects in human subjects. Accordingly, this study assessed the hemodynamic effects of oral MPH effects in 11 healthy young adults (six women), by measuring brain transverse relaxation times (T2). T2 can be interpreted as a surrogate marker for, and inversely correlated with, steady-state cerebral blood volume (CBV). Data were acquired from the caudate nucleus, putamen, and thalamus, using a 1.5 T MRI scanner at baseline and serially for 2 h following oral MPH administration (0.5 mg/kg). Physiological and subjective measures and plasma MPH levels also were examined. MPH induced a selective T2 decrease (-1.65+/-0.53 ms) in the putamen (F(6,54)=2.68, PHeartrate, blood pressure and plasma MPH levels increased significantly after drug administration, as well as subjective ratings of "feeling drug effect". T2 decreases may reflect MPH-induced increases in putaminal blood volume. These data suggest that T2 relaxometry can be used to study the time course of regional cerebral blood volume responses to MPH and perhaps to other stimulant drugs.

  12. The importance of premotor cortex for supporting speech production after left capsular-putaminal damage.

    Science.gov (United States)

    Seghier, Mohamed L; Bagdasaryan, Juliana; Jung, Dorit E; Price, Cathy J

    2014-10-22

    The left putamen is known to be important for speech production, but some patients with left putamen damage can produce speech remarkably well. We investigated the neural mechanisms that support this recovery by using a combination of techniques to identify the neural regions and pathways that compensate for loss of the left putamen during speech production. First, we used fMRI to identify the brain regions that were activated during reading aloud and picture naming in a patient with left putamen damage. This revealed that the patient had abnormally high activity in the left premotor cortex. Second, we used dynamic causal modeling of the patient's fMRI data to understand how this premotor activity influenced other speech production regions and whether the same neural pathway was used by our 24 neurologically normal control subjects. Third, we validated the compensatory relationship between putamen and premotor cortex by showing, in the control subjects, that lower connectivity through the putamen increased connectivity through premotor cortex. Finally, in a lesion-deficit analysis, we demonstrate the explanatory power of our fMRI results in new patients who had damage to the left putamen, left premotor cortex, or both. Those with damage to both had worse reading and naming scores. The results of our four-pronged approach therefore have clinical implications for predicting which patients are more or less likely to recover their speech after left putaminal damage. Copyright © 2014 Seghier et al.

  13. 血压调控对高血压脑出血患者早期病情的影响%The Effect of Blood Pressure Control for Hypertensive Intracerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    刘关振; 许春梅; 李文杰

    2011-01-01

    Objective To investigate the relationship between blood pressure control and the progression of hypertensive cerebral hemorrhage. Methods According to the situation of cerebral hemorrhage,the 60 patients were divided to two group: the minor and the medium group. At the early stage of pathogenesis, patients accepted the therapy for controlling the hypertension, and then observe the progression of disease. Results 3 days after cerebral hemorrhage, CT examination were conducted for review, suggesting that there was no significant increase of intracranial hematoma in 57 patients, their condition had improved; the rest 3 patients'hematoma expanded contrasting to the situation when admitted to the hospital,disturbance of consciousness also became more severe. Conclusion Hypertensive cerebral hemorrhage may be accompanied hypertensive encephalopathy or hypertensive crisis, and the hypertension may also induce continued bleeding or hematoma expansion, therefore, reducing high blood pressure timely plays a role in the controlling of the disease progression, and improving the patients'early prognosis.%目的 探讨调控血压与控制高血压脑出血病情进展的关系.方法 分析60例高血压脑出血,出血量小到中等,早期行调控血压治疗,观察其病情变化.结果 60例高血压脑出血患者3 d后复查头颅CT,57例颅内血肿无明显扩大,病情好转,只有3例血肿较入院时扩大,意识障碍较入院时加重.结论 高血压脑出血患者,可能同时伴有高血压脑病或高血压危象,也可因过高的血压导致继续出血、血肿扩大,因此,及时地降低过高的血压可控制病情进展,改善患者早期预后.

  14. 高血压性脑出血患者术后抑郁危险因素的Logistic回归分析%Logistic regression analysis of risk factors of depression in patients with hypertensive cerebral hemorrhage after opera- tion

    Institute of Scientific and Technical Information of China (English)

    陈莉; 吕建国; 陈仕芬; 徐文斌

    2015-01-01

    目的:探讨高血压性脑出血患者术后抑郁的危险因素,为其早期预防提供依据。方法对266例高血压性脑出血患者进行了系统性的调查分析,对可能是导致其抑郁的危险因素进行了 Logistic 回归分析。结果266例患者中有91例出现了抑郁,发病率为34.2%。通过 Logistic 回归分析发现:性格、脑出血程度、家庭经济情况和文化程度等是高血压性脑出血患者术后抑郁的独立危险因素。结论高血压性脑出血患者术后抑郁症的发病率较高,早期干预可降低抑郁症的发病率。%Objective To explore the risk factors related to depression in patients with hypertensive cerebral hemorrhage after operation,and to provide the basis for the prevention.Methods For 266 cases of hypertensive cerebral hemorrhage patients,a systematic investigation and analysis,in view of depression as a risk factor,were analyzed by logistic regression analysis.Results In 266 cases,91 cases appeared depression,and the incidence rate was 34.2%.Through Logistic regression analysis,we found that:character,the degree of cerebral hemorrhage, family economic conditions and cultural level are risk factors for depression of hypertensive cerebral hemorrhage patients after operation.Conclusion Patients with hypertensive cerebral hemorrhage surgery have a higher inci-dence of depression,which affects the prognosis and outcome of the disease.We should actively intervene earlier.

  15. Exploring the optimal operation time for patients with hypertensive intracerebral hemorrhage:tracking the expression and progress of cell apoptosis of prehematomal brain tissues

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xin-qing; ZHANG Zhi-min; YIN Xiao-liang; ZHANG Kun; CAI Hui; LING Feng

    2010-01-01

    Background Hypertensive intracerebral hemorrhage (HICH) is a severe disease with high morbidity and mortality.Timely removal of the hematoma through surgical procedures may effectively reduce secondary injuries.However, there has long been a debate over the proper timing of such surgery.In this study, we explored the optimal operation time for HICH patients by observing the pathological changes in perihematomal brain regions during different stages of onset.Methods Twenty-five specimens of brain tissue, obtained from perihematomal region of HICH patients in different phases, were subjected to haematoxylin-eosin (HE) staining, terminal deoxynucleotidyl transferase-mediated deoxyuridine 5-triphosphate nick-end labeling (TUNEL) staining and Caspase-3, matrix metalloproteinases-9 (MMP-9)immunohistochemical staining.The changing roles of necrosis and apoptosis and the expression of MMP-9 and Caspase-3 positive cells were all observed using image analysis.Results The obvious expression of TUNEL positive cells was recognized within 6 hours of ICH onset, reaching its peak between 6 hours and 24 hours in the early phase.Results were highly consistent with Caspase-3 and MMP-9 positive cell counts.Necrosis was found 6 hours after ICH onset and aggravated after 12 hours.Conclusions In the early phase, apoptosis was seen as a major modality of injury in the brain tissue of the perihematomal region and was strongly correlated with the expression of MMP-9 and Caspase-3.The results of the present study suggest that an operation performed as soon as possible after iCH onset may be optimal for preserving the nervous system function.

  16. Analysis on Surgery for Hypertensive Cerebral Hemorrhage in Basal Ganglia Regions%基底节区高血压脑出血手术治疗分析

    Institute of Scientific and Technical Information of China (English)

    汤秉洪; 覃宗明; 杨明彬; 陈建刚

    2012-01-01

    Objective To study the surgical timing, method and curative effect of surgery on hypertensive cerebral hemorrhage in basal ganglia regions. Methods We reviewed the clinical data of 168 patients undergoing operation cures for hypertensive cerebral hemorrhage in basal ganglia regions from January 2006 to January 2011. There were 98 males and 70 females with their age ranging from 35 to 84 years old averaging at 65.2 years. The time between onset of the disease and admission to hospital ranged from 0.5 to 48 hours averaging 7.1 hours. At admission, the conscious status was classified as class I in 32 patients, II in 46, III in 41, IV in 28, and V in 21. Head CT examination at admission showed the lateral type in 51 patients, medial type in 71, and mixed type in 46. The volume of hematoma was 25 to 50 mL in 76 patients, 50 to 80 mL in 53, and larger than 80 mL in 39. The small window craniotomy was performed in 127 cases, and lines of bone flap craniotomy was performed in 41 cases. Results Among the 168 patients, 16 died (9.52%). Re-hemorrhage occurred in 8 patients 4 to 28 hours after operation, among whom immediate operation was performed to remove the hematoma in 6 patients, non operation treatment in 2 cases, and 4 patients died. Six patients died of large volume of hematoma or hemiation. Pulmonary or urinary tract infection occurred in 3 patients, and multiple organ failure in 3 patients. According to Glasgow outcome scale (GOS) score at discharge, the outcome was good in 82 patients, moderate disability in 46, severe disability in 16, persistent vegetative in 8, and 16 died. Patients were followed up for 3 to 6 months, and according to the daily work capacity (ADL) classification, there were 33 cases of class I , 49 of class Ⅱ , 54 of class Ⅲ , 8 of class Ⅳ , and 8 of class Ⅴ . Conclusion Ultra early or early operation done under direct vision, clearing hematoma completely, and reliable coagulation of the bleeding arteries responsible for the hematoma

  17. Minimally invasive intracranial hematoma in patients with hypertensive cerebral hemorrhage%高血压脑出血微创颅内血肿清除术

    Institute of Scientific and Technical Information of China (English)

    赵勇

    2015-01-01

    Objective To observe the clinical effect of minimally invasive intracranial hematoma in treatment of hypertensive in-tracerebral hemorrhage patients. Methods 100 cases of hypertensive cerebral hemorrhage patients were selected as the research object in our hospital from January, 2010 to January, 2014. All the cases are in line with the Chinese Medical Association related diagnostic standard setting the fourth national academic meeting for cerebrovascular disease, 100 patients were randomly divided into observation group and control group with 50 cases in each group, the control group was given the conservative drug treatment, the observation group was given minimally invasive intracranial hematoma. The clinical curative effect and complications incidence and follow-up of quality of life of 6 months were compared between the two groups. Results The clinical efficacy of two groups were compared, the effect of observation group was significantly better than the control group (P<0.05). The observation group there were three cases of digestive tracThemorrhage, pulmonary infection in six cases, cardiac changes in three cases, two cases of cen-tral high fever, the complication rate was 28%; the control group occurred in 7 cases of digestive tracThemorrhage, pulmonary in-fection in 12 cases, cardiac changes in 5 cases, 4 cases of central high fever, the incidence of complications was 56%, group com-parison between observation group than in the control group, with significant difference (P<0.05). The observation group in physio-logical function(RP), social function(SF), the physiological function of overall health (PF), self rating (GH) four aspects of the scores were significantly higher than control group (P<0.05). Conclusion Compared with conservative treatment clinical department of in-ternal medicine, invasive intracranial hematoma is better, which is conducive to the quality of life in patients with recovery, and it has higher security. Therefore, hypertensive

  18. Minimal invasive surgical treatment of primary hypertensive brainstem hemorrhage%原发性高血压脑干出血的微创手术治疗

    Institute of Scientific and Technical Information of China (English)

    陈立华; 魏群; 徐如祥; 李运军; 李文德; 赵浩; 高进宝; 于斌; 张洪钿

    2015-01-01

    Objective To explore the operation method and technique of minimal microsurgical treatment for primary hypertensive brainstem hemorrhage .Methods The clinical data of 32 patients with primary hypertensive brainstem hemorrhage were analyzed retrospectively .All patients were operated on through microsurgery .The surgical indication and approach , operation technique , therapeutic efficacy and follow-up data were reviewed .Volume of bleeding in the patients were ranged from 3.6 to 21 ml,including mesencephalon haematoma in 3 cases,pons haematoma in 22 cases,medulla oblongata haematoma 1 cases,mesencephalon and the pons bleed in 4 cases,medulla oblongata and pons haematoma 2 cases.The haematoma volume were 3.6-21ml(mean 8.6 ml). They were divided into three groups according to the haematoma volume ≤ 5 ml,5.1-10 ml,>10ml.Neurophysiological monitoring was performed in 17 cases, 25 cases of neuronavigation operation.After three months, treatment outcome were assessed according to the Glasgow outcome scale ( GOS ) . Results All cases were successfully removed hematoma through minimal microsurgical technique under neuronavigation and electrophysiologic monitoring without death 1months duration after operation.The hemotomas were total successfully removed in 27 cases, subtotal resection in 5.Postoperatively, 28 cases were survival and 4 died.Intraoperative electrophysiological monitoring had been used in 17 cases and neuronavigation in 13.According to GOS,the following up of three months showed 3 patients were recovered well ,9 moderate disabled , 12 severely disabled,4 vegetatively survived and 4 died.Conclusions The minimal microsurgical technique can significantly improve outcomes in patients with primary hypertension brainstem hemorrhage .The optimal operation approach and exquisite microsurgical technique could raise the successful rate of the hematomas resection .%目的:探讨原发性高血压脑干出血微创手术治疗的方法与手术技巧。方法回顾

  19. Nursing Care of Patients with Hypertensive Intracerebral Hemorrhage after Craniotomy Evacuation of Hematoma%高血压脑出血开颅血肿清除患者手术前后的护理

    Institute of Scientific and Technical Information of China (English)

    赵山鹰

    2012-01-01

    目的:探讨高血压脑出血(Hypertensive intracerebral hemorrhage,HICH)开颅血肿清除术后的护理要点.方法:对54例高血压脑出血患者行开颅血肿清除术的术前护理、术后护理及并发症的护理进行总结.结果:54例患者死亡4例,自动出院3例,植物人2例,重度残疾8例,中度残疾34例,好转3例.结论:高血压脑出血开颅血肿清除术的手术期护理尤其重要,术后应控制血压在正常水平,防止再出血和脑缺血,预防感染,加强功能锻炼以促进患者的恢复.%Objective: To investigate the nursing points of patients with hypertensive intracerebral hemorrhage(HICH) undergoing hematoma evacuation.Methods: The preoperative nursing care,postoperative nursing care and complications nursing care of 54 cases of hypertensive intracerebral hemorrhage,who underwent craniotomy evacuation of hematoma,were summarized.Results: In 54 patients,4 patients died,3 cases automatically discharged,3 cases were in vegetative state,8 cases were severe disability,34 cases were moderate disability,3 cases were improved.Conclusion: Operative nursing care is especially important,should pay attention to maintaining the stability of blood pressure to prevent rebleeding and cerebral ischemia,preventing infection,enhancing functional exercise can promote the recovery of patients.

  20. Evaluate the effect to omeprazole in preventing treatment of hypertensive cerebral hemorrhage with stress ulcer bleeding%奥美拉唑对脑出血应激性溃疡的预防效果

    Institute of Scientific and Technical Information of China (English)

    丁凤英; 罗伟良

    2008-01-01

    Objective To evaluate the effect of omeprazole in preventing treatment of hypertensive cerebral hemorrhage with stress ulcer bleeding. Methods A total of 100 patients with hypertensive cerebral hemorrhage were treated with conventional therapy including dehydration, antihypertensive and supporting treatment. The patients were randomly divided into omeprazole group(n=50) and control group( n = 50). The control group received conventional therapyonly, while the omeprazole group received additional omeprazole 40mg, iv, qd, for 14d. Results Omeprazole group stress ulcer 6 eaess(12.0% ) was significantly lower than the control group 12 cases(24.0% );two groups stress ulcer incidence of severity are increasing with the increase of the disease; the mortalities of cerbral hemorrhage were 6.0 % in the omeprazole group and 16.0 % in the control group and the difference had significant meaning(P>0.05). Conclusion Omeprazole has significant beneficial effect in preventing upper gastrointestinal hemorrhage after hypertensive cerebral hemorrhage.%目的 观察奥美拉唑治疗高血压性脑出血并发应激性溃疡出血的疗效.方法 将100例高血压性脑出血患者分为奥美拉唑组(50例)和对照组(50例),均予常规脱水、降颅压及对症支持治疗,奥美拉唑组加用奥美拉唑40 mg,静脉注射,1次/d,共14 d.结果 奥美拉唑组应激性溃疡6例(12.0%),明显低于对照组12例(24.0%);两组应激性溃疡发生率均随病情程度加重而增加;奥美拉唑组死亡3例(6.0%),明显低于对照组8例(16.0%)(P<0.05).结论 奥美拉唑静脉注射预防高血压性脑出血并发应激性溃疡出血疗效确切,且未见不良反应发生.

  1. Subconjunctival hemorrhage: risk factors and potential indicators

    Directory of Open Access Journals (Sweden)

    Tarlan B

    2013-06-01

    Full Text Available Bercin Tarlan,1 Hayyam Kiratli21Department of Ophthalmology, Kozluk State Hospital, Batman, Turkey; 2Ocular Oncology Service, Hacettepe University Schoolof Medicine, Ankara, TurkeyAbstract: Subconjunctival hemorrhage is a benign disorder that is a common cause of acute ocular redness. The major risk factors include trauma and contact lens usage in younger patients, whereas among the elderly, systemic vascular diseases such as hypertension, diabetes, and arteriosclerosis are more common. In patients in whom subconjunctival hemorrhage is recurrent or persistent, further evaluation, including workup for systemic hypertension, bleeding disorders, systemic and ocular malignancies, and drug side effects, is warranted.Keywords: subconjunctival hemorrhage, contact lens, hypertension, red eye

  2. 高血压性脑出血后血浆凝血酶的动态变化与脑损害的关系%The relation between the developmental change of plasma thrombin and brain damage after hypertension intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    @@ Background:After intracerebral hemorrhage,besides take part in blood coagulation,plasma thrombin also is an important neural media.It can cause cerebral edema, damage blood brain barrier,and have cytotoxicity.We analysed the amount and the release law of plasma thrombin,and their relation to brain damage on the inpatients with hypertension intracerebral hemorrhage (HCH) who came to our hospital from 1999 to 2001.

  3. Hemorrhagic Stroke

    Science.gov (United States)

    A stroke is a medical emergency. There are two types - ischemic and hemorrhagic. Hemorrhagic stroke is the less common type. It happens when ... an artery wall that breaks open. Symptoms of stroke are Sudden numbness or weakness of the face, ...

  4. Analysis of Related Factors of Depression in Patients with Hypertensive Cerebral Hemorrhage after Operation%高血压性脑出血患者术后抑郁的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    叶顶英

    2014-01-01

    Objective:To explore the factors related to depression in patients with hypertensive cerebral hemorrhage after operation,provide the basis for the prevention.Methods:Were investigated and analyzed for the occurrence of depression in 86 patients with hypertensive cerebral hemorrhage patients after surgery,in may and correlated with depression factor was analyzed.Results:In 86 cases,36 cases appeared depression,the incidence rate was 41.86%.Statistical analysis showed that patients' cultural degree,family relations,the character and degree of cerebral hemorrhage,bleeding and depression have certain relevance.Conclusion:Patients with hypertensive cerebral hemorrhage surgery have a higher incidence of depression,affects the prognosis and outcome of the disease,should actively intervene.%目的:探讨高血压性脑出血患者术后抑郁的相关因素,为其预防提供依据。方法:对86例高血压性脑出血患者手术后抑郁的发生情况进行了调查,并对可能与发生抑郁有相关性的因素进行了分析。结果:86例患者中有36例出现了抑郁,发生率为41.86%。统计学分析显示,患者的文化程度、家庭关系、性格、脑出血程度、出血部位等与抑郁的发生有一定的相关性。结论:高血压性脑出血患者术后有较高的抑郁发生率,在一定程度上影响着疾病的预后及转归,对那些有与抑郁密切相关因素的患者应积极进行干预。

  5. Hemorrhagic complications in dermatologic surgery

    Science.gov (United States)

    Bunick, Christopher G.; Aasi, Sumaira Z.

    2014-01-01

    The ability to recognize, manage, and, most importantly, prevent hemorrhagic complications is critical to performing dermatologic procedures that have safe and high quality outcomes. This article reviews the preoperative, intraoperative, and postoperative factors and patient dynamics that are central to preventing such an adverse outcome. Specifically, the role that anticoagulants and antiplatelet agents, hypertension, and other medical conditions play in the development of postoperative hemorrhage are discussed. In addition, this article provides practical guidelines on managing bleeding during and after surgery. PMID:22515669

  6. A comparative analysis 43 cases of intraoperative ultrasound as an auxiliary therapy for hypertensive cerebral hemorrhage%手术治疗高血压脑出血43例B超辅助与否对比分析

    Institute of Scientific and Technical Information of China (English)

    王小龙; 庞永斌; 衣志刚; 张国来; 白茫茫; 周志武

    2011-01-01

    目的:探讨术中B超辅助治疗高血压性脑出血的方法与疗效.方法:将43例需开颅清除血肿的中、重度高血压脑基底节区出血患者随机分为两组,治疗组:22例,术中在B超辅助下清除血肿;对照组:21例,行常规开颅清除血肿,术中不使用B超.并分析、比较两组患者的血肿清除率和临床疗效.结果:术中B超辅助下清除血肿组临床疗效良好率、血肿清除率均优于对照组(P<0.05).结论:术中B超辅助治疗高血压脑出血可显著提高血肿清除率及临床疗效.%Objective: This paper summarizes and explores the therapy and effect of intraoperative ultrasound as an auxiliary therapy for hypertensive cerebral hemorrhage. Methods; 43 cases of medium and severe hypertensive intracerebral ganglionic hematomas, which need clearance of hematoma. Were divided into two groups at random. Group A (experimental group): 22 cases of clearance of hematoma with the assistance of intraoperative ultrasound; Group B (control group): 21 cases of routine craniotomy, without intraoperative ultrasound. A contrast was made between the two experimental groups in clearance rates and curative effects.Results: Group A (experimental group) was superior to Group B( control group) in curative effect and clearance rate and the difference was of statistical significance (p<0. 05). Conclusion: Clearance rates and curative effects of treatment for hypertensive cerebral hemorrhage are remarkably increased with intraoperative ultrasound aa an auxiliary therapy.

  7. Study on prevention of concurrent cerebral infarction after hypertensive intracerebral hemorrhage surgery%高血压脑出血术后并发脑梗死的防治研究

    Institute of Scientific and Technical Information of China (English)

    张晓阳; 刘霄

    2011-01-01

    目的 探讨高血压脑出血术后脑梗死发生的原因及预防和治疗的措施.方法 回顾性分析周口市中心医院收治的90例高血压脑出血术后脑梗死的临床资料.52例术后3d、8例术后6d复查CT见脑梗死征象,其中70例为同侧顶枕叶凸面,14例为同侧额叶,6例为对侧大脑基底节区.并发脑梗死后停用止血药、加强脱水、充分补液、应用血管解痉及改善微循环药物.结果 生存85例,死亡5例.生存者按ADL标准,Ⅰ级+Ⅱ级42例,Ⅲ级+Ⅳ级38例,V级5例.结论 高血压脑出血术后脑梗死是多因素共同作用的结果.术中、术后采取正确的预防和治疗措施,可提高临床疗效.%Objective To explore the causes and prevention of cerebral infarction after hypertensive intracerebral hemorrhage surgery. Methods Retrospectively analyze the data of 90 patients with cerebral infarction after hypertensive intracerebral hemorrhage in our hospital. 52 cases 3 days after surgery and 8 cases 6 days after surgery were reviewed by CT and were found cerebral infarction. 70 of them were hotnolateral parieto - occipital lobe convexity ,14 cases were homolateral frontal lobe,6 cases were contralateral brain basal ganglia. After complication of cerebral infarction stop the hemostatic medicine , strengthen the dehydration, fully rehydration, application of vascular spasmolysis and improving circulation drugs. Results Survival 85 cases,5 cases died. According to the ADL standards,stage Ⅰ and stage Ⅱ 38 cases, stage and stage IV 38 cases, stage V 5 cases. Conclusions Cerebral infarction after hypertensive intracerebral hemorrhage surgery is the consequence of the interaction between multiple factors. Using the correct preventive measures in intraoperation and postoperation can improve the clinical effect.

  8. Analysis of Different Surgical Treatment of Hypertensive Intracerebral Hemorrhage after Cerebral Edema%不同术式治疗高血压脑出血对术后脑水肿的影响分析

    Institute of Scientific and Technical Information of China (English)

    朱冠军

    2015-01-01

    ObjectiveTo investigate the effect on braln edema of different surgical methods for the treatment of hypertensive cerebral hemorrhage.Method For the patients with in our hospital from December 2011 to December 2013 were selected for hypertensive cerebral hemorrhage, 67 patients were randomly divided into two groups were observed and compared, including the control group using the traditional craniotomy operation, experimental group received minimally invasive evacuation of intracranial hematoma for treatment.Results After operation, the volume of edema, cerebral edema duration and idiotic left blood volume, the experimental group was statistically signiifcant difference compared with the control group(P<0.05).Conclusion In the treatment of hypertensive cerebral hemorrhage, intracranial hematoma can signiifcantly shorten the duration of postoperative braln edema, reduce the volume of edema, is worth the clinical promotion.%目的:了解不同术式治疗高血压脑出血对术后脑水肿的影响。方法对我院2011年12月至2013年12月收治的高血压脑出血患者进行抽样,选取67例患者随机分成两组进行对比观察,其中对照组采用传统开颅手术,实验组予以微创颅内血肿清除术进行治疗。结果术后在水肿体积、脑水肿持续时间以及脑残留血液量上,实验组较对照组差异具有显著统计学意义(P<0.05)。结论针对高血压脑出血治疗,微创颅内血肿清除术能显著缩短水肿持续时间,降低术后脑水肿体积,值得临床推广。

  9. 右美托咪定在高血压脑出血开颅术中的应用意义研究%Dexmedetomidine in the Application Significance of Craniotomy in Hypertensive Cerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    曹鸣洋

    2016-01-01

    目的:研究右美托咪定在高血压脑出血开颅术中的应用意义。方法选取2013年10月~2015年8月我院收治的86例高血压脑出血开颅术患者进行分组研究,按照抽签法分为对照组(n=43,应用生理盐水)和试验组(n=43,应用右美托咪定),比较两组临床效果。结果 T0点两组患者的 DBP、SBP、MAP、HR 比较,差异不明显(P >0.05);T1、T2、T3、T4时两组上述指标比较,对照组大于试验组(P <0.05),且自主呼吸恢复时对照组 PaO2低于试验组(P <0.05)。结论在高血压脑出血开颅术中的应用右美托咪定,可有效改善血压、心率,安全可靠。%Objective To study the right supporting the mi in the application of hypertension cerebral hemorrhage open-brain surgery. Methods 86 cases of patients with hypertension cerebral hemorrhage open-brain surgery were chosen as group study from October 2013 to August 2015 in our hospital, according to the draw method is divided into control group (n=43, application of physiological saline) and experimental group (n=43, application dexmedetomidine), compare the clinical effect of two groups. Results The T0 DBP and SBP points two groups of patients, MAP, HR, no significant difference (P>0.05). T1, T2, T3, T4 above index comparison of two groups, control group is greater than the experimental group (P<0.05), and spontaneous breathing recovery control group PaO2 is lower than the experimental group (P<0.05). Conclusion The application in hypertension cerebral hemorrhage open-brain surgery right beautiful mi set, which can effectively improve the blood pressure, heart rate, safe and reliable, has a positive value of clinical use and promotion.

  10. Preretinal hemorrhage

    Directory of Open Access Journals (Sweden)

    Eduardo Felippe

    2004-12-01

    Full Text Available A case of Valsalva hemorrhagic retinopathy treated with Nd:YAGlaser indescribed. The patient presented decreased visual acuityafter coughing, and a preretinal hemorrhage was diagnosed in theposterior pole; puncturing the posterior hyaloid face was performedwith Nd:Yag laser. Rapid hemorrhage absorption was observedafter the therapy proposed and visual acuity was recovered. Nd:Yaglaser proved to be safe and efficient in the management of preretinalhemorrhage.

  11. Surgical treatment of nenroendoscopy with supported channel for hypertensive intraventricular hemorrhage%支撑通道辅助神经内镜对高血压脑室出血患者的疗效

    Institute of Scientific and Technical Information of China (English)

    熊云彪; 杨承勇; 黄生炫; 王超; 王曲; 杨恒; 司书喜; 刘窗溪

    2012-01-01

    Objective To evaluate the value and efficacy of surgical treatment with neuroendoscopy with supported channel for hypertensive intraventricular hemorrhage (HIVH).Methods The clinical data of 32 patients with hypertensive intraventricular hemorrhage were retrospectively analyzed.And they underwent neuroendoscopy with supported channel.Results Computed tomography scans at Day 1 postoperation revealed that the evacuation of intraventricular hematoma was 85.4% in all patients.The Glasgow coma score (GCS) at Week 1 postoperation was significantly higher than that at preoperation.The postoperative outcomes were intracranial infection ( n =1 ),mortality ( n =1 ) and secondary hemorrhage ( n =3).All patients were followed up for 3 months.According to Glasgow outcome scale ( GOS ),there were excellent recovery (n=17),moderate disability (n =7),severe disability (n =5) and vegetative survival (n=3).Conclusion The surgical treatment of neuroendoscopy with supported channel for HIVH offers great advantages with a low rate of complications and favorable outcomes.%目的 探讨神经内镜在胶片为支撑通道下治疗高血压脑室出血的临床应用价值及疗效.方法 对象为2010年4月至2011年10月贵州省人民医院收治的32例高血压脑室出血患者,在胶片为神经内镜支撑通道的辅助下清除脑室内血肿,对其疗效及预后进行分析.结果 32例患者术后第1天头颅CT检查平均血肿清除率85.4%.入院时格拉斯哥昏迷GCS评分(Glasgow Coma Scale)平均分12.6,术后第1周GCS均分9.7.死亡1例,再出血3例,2例发生颅内感染.术后3个月随访,格拉斯哥预后GOS评分(Glasgow Outcome Scale)分级:Ⅴ级17例、Ⅳ级7例、Ⅲ级5例、Ⅱ级3例.结论 神经内镜在胶片为支撑通道辅助下治疗脑室出血具有明显的优势,清除血肿量较多,并发症少.

  12. Pontine hemorrhage in a patient with pheochromocytoma.

    Science.gov (United States)

    Scardigli, K; Biller, J; Brooks, M H; Cespedes, L E; Posniak, H V

    1985-02-01

    A 24-year-old woman with a two-year history of hypertension was hospitalized for coma and quadriplegia secondary to pontine hemorrhage. A seven-year history of intermittent severe headaches, diaphoresis, and anxiety together with persistent severe hypertension led to the diagnosis of pheochromocytoma. This unusual but devastating manifestation of pheochromocytoma illustrates the importance of excluding remedial forms of hypertension in young patients before initiating antihypertensive therapy.

  13. Comparative study on different minimally invasive surgery ofr hypertensive cerebral hemorrhage%不同微创钻孔手术治疗高血压性脑出血的疗效对比

    Institute of Scientific and Technical Information of China (English)

    崔杰; 李树祥; 乔柏林; 崔福义; 黄春刚; 徐常亮

    2014-01-01

    Objective To compare the efficacy of different minimally invasive operation on hypertensive cerebral hemor-rhage.Methods One hundred patients with hypertensive cerebral hemorrhage were chosen.Case-control retrospective study was used.Treatment group (n= 50) was treated by the minimally invasive puncture hematoma suction ,urokinase was used af-ter operation. The control group(n= 50) was treated by small bone window craniotomy for removal of hematoma. NIHSS score ,GOS scores ,and the differences of overall curative effect of two groups were compared. Results The length of stay in hospital ,and NIHSS score of the treatment group were lower than those of the control group (P< 0.05).At the 1 stday thechange of postoperative hematoma of the treatment group ,was more obvious than that of the control group ,but at the 7th day after surgery ,the changes of postoperative hematoma between the two groups had a statistical significance (P<0.05). The volume of finally residual hematoma of the treatment group was less than that of the control group.Conclusion The minimally invasive puncture hematoma suction combined with urokinase is an effective intervention and treatment of hypertensive cerebral hemorrhage ,and is worth of clinical popularization.%目的:比较不同微创钻孔手术治疗高血压性脑出血的临床疗效。方法纳入合格的高血压性脑出血患者100例。试验组(n=50)采用微创穿刺血肿抽吸术,术后用尿激酶。对照组(n=50)行小骨窗开颅血肿清除术。比较2组NIHSS评分、GOS评分以及疗效。结果试验组住院时间、NIHSS评分低于对照组(P<0.05)。术后1 d血肿变化,试验组明显多于对照组,但术后7 d时,2组比较差异有统计学意义(P<0.05)。试验组最终残留血肿量低于对照组。结论微创穿刺血肿抽吸术联合尿激酶是有效干预和治疗高血压性脑出血的手术方案,值得在临床中推广。

  14. 浅谈冠心病合并高血压脑出血的护理方法%Nursing care of coronary heart disease complicated with hypertension cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    孙淑萍

    2014-01-01

    目的:探讨冠心病合并高血压脑出血的临床护理对策。方法选取我科室收治的68例冠心病合并高血压脑出血的患者进行治疗并进行分析讨论,随机将其分两组,对一组患者实施常规护理措施设为对照组,对另一组患者在实施常规护理基础上给予有效的护理措施为观察组,比较两组患者的神经功能、运动功能以及并发症的发生率。结果观察组患者经过有效的护理对策干预后,并发症的发生率、神经功能以及运动功能均明显优于对照组,经比较差异显著(P<0.05),有临床统计学意义。结论实施有效的护理对策干预于措施能够提高冠心病合并高血压脑出血患后患者的临床疗效,减少并发症的发生率,提高患者的满意度及术后生活质量。%Objective to explore the clinical nursing of coronary heart disease complicated with hypertension cerebral hemorrhage. Methods our department treated 68 cases ofcoronary heart disease complicated with hypertension cerebral hemorrhage were treated and analyzed, and randomly divided two groups, one group were given routine care measures set as control group, nursing measures. for the observation group to another group of patients treated in the implementation of the basis of conventional care, incidence rates were compared between the two groups of neurological function,motor function and complications. Results the observation group patients aftereffective nursing measures after the intervention, the incidence of neurologicalcomplications, and motor function were signiifcantly better than the control group, the difference was signiifcant (P<0.05), clinical signiifcance. Conclusion nursingcountermeasures of effective intervention measures to improve the clinical efifcacy inpatients with coronary heart disease complicated with hypertension cerebralhemorrhage patients, reduce the incidence of complications, improve patient satisfaction and

  15. The significance of changes in cerebral oxygen and glucose metabolism in patients with cerebral hemorrhage caused by acute hypertension%急性高血压脑出血患者脑糖氧代谢变化及意义

    Institute of Scientific and Technical Information of China (English)

    马骏; 陈锷峰; 屠传建; 钱辉; 骆明; 顾志伟; 张建民

    2014-01-01

    Objective To study the clinical significance of early changes in cerebral oxygen and glucose metabolism in patients with cerebral hemorrhage and with Glasgow coma score (GCS) of 5-8 caused by acute hypertension in order to find relationship between those changes and prognosis.Methods From January 1,2011 to June 30,2012,a cohort of 43 patients with cerebral hemorrhage caused by acute hypertension were enrolled for retrospective study.Radial artery and internal jugular vein were separately cannulated retrogradely for collecting blood for blood gas analysis and blood glucose tests carried out 24 hours after the onset of the cerebral hemorrhage and then every 6-8 hours and as any major changes in physical signs of patients occurred.And this monitoring kept for consecutive 3 days.The data of these laboratory findings were analyzed and calculated to determine internal jugular vein oxygen saturation (SjVO2),cerebral oxygen utilization rate (CEO2),cerebral arterio-venous oxygen difference (AVDO2),arterio-venous blood glucose difference (V-Aglu),arterio-venous lactic acid difference (V-Alac) and absolute value of carbon dioxide pressure difference between jugular vein and artery (V-APCO2).All patients met the diagnostic criteria of hypertensive cerebral hemorrhage revised by the 4th National Academic Conference on cerebrovascular disease in 1995 requiring diagnosis confirmed by brain CT,admitted within 24 hours of onset,Glasgow coma score (GCS) 5-8 and a history of hypertension.Exclusion criteria were:cerebral hemorrhage caused by traumatic intracranial hematoma,spontaneous subarachnoid hemorrhage,arteriovenous malformation and Moyamoya disease,intracranial tumor apoplexy,cerebral bleeding derived from the disturbance of blood coagulation system,and cerebral hemorrhagic infarction.According to the short-term prognosis,the patients were divided into the death group and the survival group.Then the differences in biomarkers mentioned above between two groups were compared to

  16. [Alveolar hemorrhage].

    Science.gov (United States)

    Parrot, A; Fartoukh, M; Cadranel, J

    2015-04-01

    Alveolar hemorrhage occurs relatively rarely and is a therapeutic emergency because it can quickly lead to acute respiratory failure, which can be fatal. Hemoptysis associated with anemia and pulmonary infiltrates suggest the diagnosis of alveolar hemorrhage, but may be absent in one third of cases including patients in respiratory distress. The diagnosis of alveolar hemorrhage is based on the findings of a bronchoalveolar lavage. The causes are numerous. It is important to identify alveolar hemorrhage due to sepsis, then separate an autoimmune cause (vasculitis associated with antineutrophil cytoplasmic antibody, connective tissue disease and Goodpasture's syndrome) with the search for autoantibodies and biopsies from readily accessible organs, from a non-immune cause, performing echocardiography. Lung biopsy should be necessary only in exceptional cases. If the hemorrhage has an immune cause, treatment with steroids and cyclophosphamide may be started. The indications for treatment with rituximab are beginning to be established (forms that are not severe and refractory forms). The benefit of plasma exchange is unquestionable in Goodpasture's syndrome. In patients with an immune disease that can lead to an alveolar hemorrhage, removing any source of infection is the first priority. Copyright © 2014 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  17. Treatment of portal hypertension

    Institute of Scientific and Technical Information of China (English)

    Khurram Bari; Guadalupe Garcia-Tsao

    2012-01-01

    Portal hypertension is the main complication of cirrhosis and is defined as an hepatic venous pressure gradient (HVPG) of more than 5 mmHg.Clinically significant portal hypertension is defined as HVPG of 10 mmHg or more.Development of gastroesophageal varices and variceal hemorrhage are the most direct consequence of portal hypertension.Over the last decades significant advancements in the field have led to standard treatment options.These clinical recommendations have evolved mostly as a result of randomized controlled trials and consensus conferences among experts where existing evidence has been reviewed and future goals for research and practice guidelines have been proposed.Management of varices/variceal hemorrhage is based on the clinical stage of portal hypertension.No specific treatment has shown to prevent the formation of varices.Prevention of first variceal hemorrhage depends on the size/characteristics of varices.In patients with small varices and high risk of bleeding,nonselective β-blockers are recommended,while patients with medium/large varices can be treated with either β-blockers or esophageal band ligation.Standard of care for acute variceal hemorrhage consists of vasoactive drugs,endoscopic band ligation and antibiotics prophylaxis.Transjugular intrahepatic portosystemic shunt (TIPS) is reserved for those who fail standard of care or for patients who are likely to fail ("early TIPS").Prevention of recurrent variceal hemorrhage consists of the combination of β-blockers and endoscopic band ligation.

  18. Clinical Research of Reoperation Reasons for Hypertension Cerebral Hemorrhage%高血压性脑出血术后再手术原因的临床研究

    Institute of Scientific and Technical Information of China (English)

    宋明浩; 李志祥; 马文斌

    2012-01-01

    目的 对高血压性脑出血术后再手术的原因进行临床研究,为以后的临床工作提供理论及实践依据. 方法 回顾性分析我院自2002年2月~2011年6月所有因高血压性脑出血行手术治疗213例,其中因各种原因再次手术治疗36例的临床资料. 结果 因颅内再出血再次行手术治疗29例,因大面积脑梗塞再次行手术治疗7例.再出血再手术组患者的GOS结果提示,Ⅰ~Ⅲ级者明显多于再出血未再手术组,差异有显著统计学意义(P<0.01);GOSⅣ者差异无统计学意义(P>0.05);GOSV级者明显少于未再手术组,差异有显著统计学意义(P<0.01).脑梗塞再手术组患者的GOS结果提示,Ⅰ~Ⅲ级明显多于脑梗塞未再手术组,差异有统计学意义(P<0.05);GOSⅣ级者,差异无统计学意义(P>0.05);GOSⅤ级者明显少于未再手术组,差异有显著统计学意义(P<0.05). 结论 术前认真评估患者的整体状况,手术切口的选择,手术的规范化操作,术中及术后规范化治疗以及避免医源性损伤都是防止因再出血和脑梗塞而再手术的关键.%Objective To explore the reoperation causes for hypertensive cerebral hemorrhage, so as to provide theoretical and practical basis for the future clinical work. Method The clinical data of 36 patients with reoperation out of 213 patients who received surgical operation for hypertension cerebral hemorrhage in our hospital from February 2002 to June 2011 were reviewed and analyzed. Results There were 29 cases of rebleeding and 7 cases with a large area of cerebral infarct received reoperation. In the reoperation group of rebleeding patients, the rate of I ~ III GOS stage was obviously higher than the non-reoperation group ( P 0. 05 ). And the rate of V stage was much lower ( P 0. 05). And the rate of V stage was much lower( P < 0. 05). Conclusion Careful evaluation of the overall condition, suitable surgical incision, standardized operation and

  19. Green Channel in the Emergency Rescue Hypertension Cerebral Hemorrhage Patients to Explore the Value%急诊绿色通道在抢救高血压脑出血患者中的价值探讨

    Institute of Scientific and Technical Information of China (English)

    曾贵成

    2013-01-01

    Objective to study retrospectively the green channel in the rescue hypertension cerebral hemorrhage patients in clinical application value.Methods a retrospective analysis in our hospital rescue hypertension cerebral hemorrhage patients 126 cases material, according to whether to of prehospital emergency treatment group: of prehospital emergency treatment group 66 examples, not of prehospital emergency treatment group of 60 cases first aid after statistical patients mortality, final y statistical methods to test the dif erences have statistical significance.Results the death of prehospital emergency treatment group 7 cases (10.6%), not of prehospital emergency treatment group of death 23 cases (38.3%), statistical methods to test showed that with statistical dif erence (P<0.05). 1 hours emergency person 2 cases died (5.6%), 1~5 hours the first aid death 10 cases (20%).Conclusion emergency green channel in the rescue hypertension cerebral hemorrhage patients play an important role, is to reduce the mortality of patients with first aid ef ective means.%目的探讨急诊绿色通道在抢救高血压脑出血患者中的临床应用价值。方法回顾性分析在我院抢救高血压脑出血患者126例病例资料,按照是否进行院前急救分组:院前急救组66例,非院前急救组60例,急救后统计患者死亡率情况,再按急救时间分组:1h内急救者36例,1~5h内急救者50例,5h以上者40例,急救后统计患者死亡率,最后统计学方法检验各组间的差异是否具有统计学意义。结果院前急救组死亡7例(10.6%),非院前急救组死亡23例(38.3%),统计学方法检验表明具有统计学差异(P<0.05)。1h内急救者死亡2例(5.6%),1~5h内急救者死亡10例(20%),5h以上者死亡19例(47.5%)。结论急诊绿色通道在抢救高血压脑出血患者中发挥重要作用,是降低患者急救死亡率的有效手段。

  20. 妊高症产妇产后出血实施优质护理的效果观察%Effect of high quality nursing on postpartum hemorrhage in patients with pregnancy induced hypertension

    Institute of Scientific and Technical Information of China (English)

    杨小艳

    2016-01-01

    Objective:To observe and analyze the clinical effect of high quality nursing on postpartum hemorrhage in patients with pregnancy induced hypertension.Methods:in treated in our hospital in September 2014 to 2016 February of pregnancy induced hypertension (PIH),postpartum hemorrhage patients randomly selected 58 cases included in the study,according to the principle of random grouping of group study,group 1 as control group included disease in 29 patients,take the routine nursing care,another group as observation group accepted into the disease suffer from 29 cases.On the basis of high quality nursing intervention.Results:the average amount of bleeding in the observation group was (521.5±29.3) mL,the neonatal Apgar score was (9.6±0.7),the nursing satisfaction rate was 100%,compared with the control group,there was a significant improvement (P<0.05).Conclusion:on the base of routine nursing in patients with pregnancy induced hypertension (PIH),postpartum hemorrhage to be high quality nursing intervention can effectively reduce the patients with the amount of bleeding,improve neonatal health level,but also help to improve nursing satisfaction.%目的:观察并分析妊高症产妇产后出血应用优质护理的临床效果。方法:在某医院收治的妊高症产妇产后出血患者中随机选择58例,依据随机分组原则进行研究分组,对照组29例,采取常规护理;观察组29例,在常规护理基础上加用优质护理干预。结果:观察组患者24h出血量平均为(521.5±29.3)mL,新生儿Apgar评分平均为(9.6±0.7)分,护理满意率为100%,相较于对照组而言均有明显改善(P<0.05)。结论:在常规护理基础上对妊高症产妇产后出血患者予以优质护理干预可有效降低患者的出血量,提高新生儿的健康水平,而且也有助于提高护理满意度。

  1. 高血压性基底节区出血实施微创血肿清除术的临床观察%Clinical observation of hypertensive basal ganglia hemorrhage implement minimally invasive hematoma removal

    Institute of Scientific and Technical Information of China (English)

    王翠香

    2015-01-01

    Objective To evaluate the effect of minimally invasive surgery for the treatment of hematoma hypertensive basal ganglia hemorrhage.Methods Randomly selected in our hospital in August 2012~2014 September hypertensive basal ganglia hemorrhage in 60 patients,according to whether the implementation of surgery were divided into experimental and control groups,including the implementation of conservative treatment of patients in the control group,the experimental patients using minimally invasive hematoma treatment,clinical treatment groups were compared and analyzed.Results Excellent rate of clinical treatment of patients in the experimental group was significantly higher in patients,the difference was significant(P<0.05);patients in the experimental group NIHSS score,BI scores than the control group of patients,the difference was significant(P<0.05).Conclusion Minimally invasive hematoma on hypertensive basal ganglia hemorrhage treatment,can effectively reduce brain damage,and promote the recovery of nerve function in patients,a significant effect,safe and reliable,it is recommended to further promote in clinical practice.%目的:探讨采用微创血肿清除术治疗高血压性基底节区出血的疗效。方法随机选取我院2012年8月~2014年9月收治的高血压基底节区出血患者60例,按照是否实施手术治疗将其分为实验组和对照组,对照组患者实施保守治疗,实验组患者采用微创血肿清除术进行治疗,对两组患者的疗效进行对比分析。结果实验组患者的临床治疗优良率明显高于对照组患者,差异具有统计学意义(P<0.05);实验组患者术后NIHSS评分、BI评分明显优于对照组患者,差异具有统计学意义(P<0.05)。结论采用微创血肿清除术对高血压性基底节区脑出血进行治疗,能够有效降低脑损伤,促进患者的神经功能恢复,疗效显著,安全可靠,建议在临床上进一步推广。

  2. The value of putaminal diffusion imaging versus 18-fluorodeoxyglucose positron emission tomography for the differential diagnosis of the Parkinson variant of multiple system atrophy.

    Science.gov (United States)

    Baudrexel, Simon; Seifried, Carola; Penndorf, Bianca; Klein, Johannes C; Middendorp, Marcus; Steinmetz, Helmuth; Grünwald, Frank; Hilker, Rüdiger

    2014-03-01

    Differentiating the Parkinson variant of multiple system atrophy (MSA-P) from idiopathic Parkinson's disease (PD) and other forms of atypical parkinsonism can be difficult because symptoms overlap considerably. 18-Fluorodeoxyglucose positron emission tomography (FDG-PET) is a powerful imaging technique that can assist in the diagnosis of MSA-P via detection of putaminal and cerebellar hypometabolism. Recent studies suggest that diffusion-weighted imaging (DWI) might be of similar diagnostic value, as it can detect microstructural damage in the putamen by means of an increased mean diffusivity (MD). The aim of this study was a direct comparison of DWI and FDG-PET by using both methods on the same subject cohort. To this end, combined DWI and FDG-PET were employed in patients with MSA-P (n = 11), PD (n = 13), progressive supranuclear palsy (n = 8), and in 6 control subjects. MD values and FDG uptake ratios were derived from volumetric parcellations of the putamen and subjected to further analysis of covariance (ANCOVA) and receiver operating characteristics analyses. MSA-P was found to be associated with an increased posterior putaminal MD (P < 0.001 in all subgroup comparisons) that correlated strongly with local reductions in FDG uptake (r = -0.85, P = 0.002). DWI discriminated patients with MSA-P from other subgroups nearly as accurately as FDG-PET (area under the curve = 0.89 vs 0.95, P = 0.27 [pooled data]). Our data suggest a close association between the amount of putaminal microstructural damage and a reduced energy metabolism in patients with MSA-P. The clinical use of DWI for the differential diagnosis of MSA-P is encouraged.

  3. The effect of prehospital emergency care in the treatment of patients with severe hypertensive cerebral hemorrhage%院前急救在重症高血压脑出血患者救治中的作用

    Institute of Scientific and Technical Information of China (English)

    毕学志; 王国兴; 黄富

    2015-01-01

    Objective To explore the effect of prehospital emergency care in the treatment of patients with severe hy-pertensive cerebral hemorrhage. Methods Retrospectively analyzed the clinical data and follow-up results of 143 patients , they were divided into two groups (study group and control group) according to whether received prehospital emergency care. Comparatively analyzed the preoperative time, aspiration and pulmonary infection rate, decompressive craniotomy rate, GOS score and mortality rate between the two groups. Results The preoperative time of study group that received prehospital e-mergency care was shorter than control group (P0.05), but the mortality rate of study group was lower than control group (P<0.05). Conclusion The prehospital emergency care has an important role in the treatment of patients with severe hypertensive cerebral hemorrhage , which can give appropriate treatment to patients earlier and reduce mortality effectively.%目的:探讨院前急救在重症高血压脑出血患者救治中的作用。方法回顾性分析143例重症高血压脑出血患者的临床资料及随访结果,根据患者是否进行院前急救分为研究组与对照组,比较分析两组患者的术前时间、误吸及肺部感染发生率、去骨瓣减压率、GOS评分及死亡率。结果行院前急救的研究组患者术前时间较短(P<0.05),误吸及术后肺部感染率、因脑肿胀而行去骨瓣减压率较低(P<0.05),两组患者GOS评分差异无统计学意义(P>0.05),但研究组患者的死亡率低于对照组(P<0.05)。结论院前急救在重症高血压脑出血患者的救治中有重要作用,可使患者更早地得到合适的治疗并降低死亡率。

  4. An Investigation on Severe Hypertensive Cerebral Hemorrhage of Prehospital Care in Primary Hospital%基层医院重症高血压性脑出血院前救护效果分析

    Institute of Scientific and Technical Information of China (English)

    覃华勤

    2013-01-01

    Objective:To analyze the successful rescue rate importance of the patients with fast and effective method on severe hypertension cerebral hemorrhage in Prehospital care. Methods:Totally 166 cases of the emergency department from 2008 January to 2011 December were divided into 2 groups. Prehospital first aid patients were in observation group, Families admitted were in the control group, Statistics the death toll within 24 hours after. Hospitalization . Results:In 106 cases, 18 cases of death in prehospital first aid, mortality is 17% . In 60 cases, 26 cases of death in families admitted, mortality is 43% .Conclusion:The mortality differences between prehospital emergency measures disposing and not disposing of the patients have significant differences(P<0.01). These Descriptors that Prehospital emergency and safety transfer is the key to reduce severe hypertensive cerebral hemorrhage prehospital patients' mortality, and improve the success rate.%  目的:探讨基层医院快速有效的对重症高血压性脑出血病人院前救护对提高病人抢救成功率的重要性.方法:对急诊科2008年1月~2011年12月收治的166例病人分成2组.院前急救病人为观察组,家属自行送入医院的为对照组,统计入院抢救后24小时内死亡人数.结果:经院前救护的106例中死亡18例,死亡率17%,未经院前救护家属自行送入的60例中死亡26例,死亡率43%.结论:经过院前急救措施处置的重症高血压性脑出血病人死亡率与未经院前处置的病人死亡率差异有统计学意义(P<0.01),说明院前急救、安全转送是降低重症高血压性脑出血院前死亡率,提高抢救成功率的关键.

  5. 微创穿刺引流术治疗高血压脑出血患者的护理体会%Nursing experience of patients with hypertensive cerebral hemorrhage treated by minimally invasive puncture drainage

    Institute of Scientific and Technical Information of China (English)

    王力伟; 李学良; 周晓满; 湛金梅; 郝晓; 付刚; 史琳

    2014-01-01

    目的:总结32例高血压脑出血患者行微创穿刺引流术的护理经验。方法应用微创颅内血肿粉碎穿刺针对32例高血压脑出血患者进行血肿抽吸、粉碎冲洗、液化及引流,并采取积极的术前及术后护理方法。结果本组治愈16例(50%),显著进步8例(25%),进步4例(12.5%),无变化2例(6.25%),死亡2例(6.25%),总有效率为87.5%。结论微创颅内血肿穿刺术治疗高血压脑出血疗效确切,加强基础护理、密切监测病情、预防和及时发现潜在并发症、及早进行康复锻炼、家庭访视,对患者预后起着积极作用,可提高患者生活质量。%Objective To summarize the experience of 32 patients with hypertensive cere-bral hemorrhage treated by minimally invasive puncture drainage.Methods Minimally invasive intracranial hematoma needle was used to pump,crush and flush,liquidate and drain hematoma. There were 16 cured cases (50%),8 improved cases (25%),4 progressive cases (12.5%),2 un-changed cases (6.25%)and 2 died patients (6.25%),the total effective rate was 87.5%.Con-clusion Minimally invasive treatment of intracranial hematoma puncture for hypertensive cerebral hemorrhage could strengthen basic nursing,closely monitor of the disease,prevent and timely de-tect potential complications,early do rehabilitation exercises,conduct home visits early.So it could promote the prognosis of patients and enhance the quality of life of patients.

  6. 小骨窗手术治疗基底节区高血压脑出血40例临床疗效观察%Observation of clinical effects of small bone window surgery on 40 cases with basal ganglia hypertensive intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    刘鹏鹏; 李军

    2014-01-01

    目的:评价小骨窗开颅微侵袭手术治疗基底节区高血压脑出血的临床疗效。方法:回顾分析采用小骨窗开颅微侵袭手术治疗基底节区高血压脑出血的临床过程。结果:40例采取小骨窗开颅微侵袭手术治疗的基底节区高血压脑患者随访半年,死亡6例,按 ADL 分级法进行测评:I 级7例,II 级13例,III 级9例,IV 级3例,V 级2例。结论:小骨窗开颅微侵袭手术治疗基底节区高血压脑出血是一种较为理想的手术方法。%Objective:To investigate the clinical effect of minimally invasive surgery by small bone window on basal ganglia hy-pertensive intracerebral hemorrhage. Methods:The clinical course of basal ganglia hypertensive intracerebral hemorrhage treated with minimally invasive surgery by small bone window was retrospectively analyzed. Results: In 40 cases of basal ganglia hypertensive in-tracerebral hemorrhage with minimally invasive surgery by small bone window, according to ADL scale, six month-follow up was per-formed: 7 cases got I-class, 13 cases were II-class, 9 cases were III-class, 3 cases were IV-class, and 2 cases were V-class. Con-clusions: Minimally invasive surgery by small bone window is an ideal surgical way for basal ganglia hypertensive intracerebral hemor-rhage.

  7. 综合护理对高血压脑出血患者肺部感染的预防效果观察%Observation of the Effect of Comprehensive Nursing on Pulmonary Infection in Patients With Hypertensive Cerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    张萍萍

    2016-01-01

    Objective To observe the comprehensive nursing to prevent hypertension cerebral hemorrhage patients with pulmonary infection. Methods 102 patients with hypertensive cerebral hemorrhage were randomly divided into experimental group and control group, respectively adopt comprehensive care and routine nursing. Results experimental lung infection rate and quality of life scores were better than control group (P<0.05). Conclusion Comprehensive nursing in patients with hypertension cerebral hemorrhage, the effect is better.%目的:观察综合护理对预防高血压脑出血患者肺部感染的护理效果。方法102例高血压脑出血患者被随机分成实验组与对照组,分别采取综合护理和常规化护理。结果实验组肺部感染率与生活质量评分均优于对照组(P <0.05)。结论对高血压脑出血患者实施综合护理,效果较好。

  8. Cataleptic postures in thalamic hemorrhage: case report

    Directory of Open Access Journals (Sweden)

    Saposnik Gustavo

    2001-01-01

    Full Text Available We report a case of catalepsy associated with thalamic hemorrhage. A 72 year-old hypertensive woman had acute onset of right-sided weakness and speech disturbances. She was on anticoagulants because of aortic valve replacement. When postures were imposed, the patient maintained the left upper limb raised for several minutes, even in uncomfortable or bizarre positions. A CT scan of the head revealed a left thalamic hemorrhage. Cataleptic postures have been reported in few cases with acute stroke.

  9. 妊高征与新生儿视网膜出血关系探讨%The Relationship Between Pregnancy Induced Hypertension and Retina Hemorrhage of Newborn

    Institute of Scientific and Technical Information of China (English)

    杨君; 王世进; 扈瑞丽; 杨华; 王保君

    2005-01-01

    目的:探讨妊娠高血压综合征(简称妊高征)与新生儿视网膜出血(retina hemorrhage,RH)的关系.方法:对我院467例妊高征患者病例进行回顾性分析.结果:轻度、中度、重度妊高征孕妇分娩的新生儿中分别有14例、21例、26例出现RH;阴道分娩的261例中,新生儿RH 53例(20.3%),剖宫产的206例中,新生儿RH 8例(3.9%).结论:新生儿RH程度与妊高征的严重程度有关;剖宫产新生儿视网膜出血明显低于阴道分娩.

  10. Migraine and risk of hemorrhagic stroke

    DEFF Research Database (Denmark)

    Gaist, David; González-Pérez, Antonio; Ashina, Messoud

    2014-01-01

    BACKGROUND: We investigated the association between hemorrhagic stroke and migraine using data from The Health Improvement Network database. FINDINGS: We ascertained 1,797 incident cases of intracerebral hemorrhage (ICH) and 1,340 of subarachnoid hemorrhage (SAH). Density-based sampling was used...... to select 10,000 controls free from hemorrhagic stroke. Using unconditional logistic regression models, we calculated the risk of hemorrhagic stroke associated with migraine, adjusting for age, sex, calendar year, alcohol, body mass index, hypertension, previous cerebrovascular disease, oral contraceptive...... use, and health services utilization.The risk (odds ratio [OR]) of ICH among migraineurs was 1.2 (95% confidence interval [CI] 0.9-1.5), and of SAH was (1.2, 95% CI 0.9-1.5). The association with ICH was stronger for migraine diagnosed ≥20 years prior to ICH (OR 1.6, 95% CI 1.0-2.4), but not with SAH...

  11. Management of Hypertension in Pregnancy

    OpenAIRE

    Nurike S Mudjari; Nur Samsu

    2015-01-01

    Hypertension-related maternal mortality reaches 16% when it is compared to other causes of maternal mortality such as sepsis, bleeding or abortus. Pregnant women with hypertension disorder are at increased risk for experiencing numerous complications including disseminated intravascular coagulation (DIC), cerebral hemorrhage, liver dysfunction and acute renal failure; while to the fetus, it may cause intrauterine growth retardation, prematurity and perinatal mortality. Hypertension in pregnan...

  12. Concurrence of Crossed Cerebellar Diaschisis and Parakinesia Brachialis Oscitans in a Patient with Hemorrhagic Stroke

    Directory of Open Access Journals (Sweden)

    Yung-Tsan Wu

    2013-01-01

    Full Text Available Crossed cerebellar diaschisis (CCD is defined as a reduction in blood flow in the cerebellar hemisphere contralateral to the supratentorial focal lesion. The phenomenon termed parakinesia brachialis oscitans (PBO in which stroke patients experience involuntary stretching of the hemiplegic arm during yawning is rarely reported. The concurrence of CCD and PBO has never been described. A 52-year-old man had putaminal hemorrhage and demonstrated no significant recovery in his left hemiplegia after intensive rehabilitation, but his gait improved gradually. Two months after the stroke, the single photon emission computed tomography (SPECT showed CCD. Four months after the stroke, the patient noticed PBO. The follow-up SPECT showed persistent CCD and the patient’s arm was still plegic. The frequency and intensity of PBO have increased with time since the stroke. We speculate that the two phenomena CCD and PBO might share similar neuroanatomical pathways and be valuable for predicting clinical recovery after stroke.

  13. Ocular Hypertension

    Science.gov (United States)

    ... Español Eye Health / Eye Health A-Z Ocular Hypertension Sections What Is Ocular Hypertension? Ocular Hypertension Causes ... Hypertension Diagnosis Ocular Hypertension Treatment What Is Ocular Hypertension? Written By: Kierstan Boyd Reviewed By: J Kevin ...

  14. Hemorrhagic disorder

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930167 Relationship among changes of bloodpicture and hemorrhage to skin,fundus occuliand brain in 220 cases of hematologic disease.WU Bingquan(吴秉权),et al.Blood Dis Hosp,CMAS.Tianjin Med J 1992;20(9):515-517.Changes of blood picture related to bleedingof the skin,fundus occuli and brain were ana-lyzed in 220 cases of blood diseases.Resultsshowed,in iron deficient anemia with pro-

  15. [Infratentorial hemorrhage following supratentorial surgery].

    Science.gov (United States)

    Tomii, M; Nakajima, M; Ikeuchi, S; Ogawa, T; Abe, T

    1999-10-01

    Hemorrhage in regions remote from the site of initial intracranial operations is rare, but does occur. We report three cases of cerebellar hemorrhage that developed after supratentorial surgery, all of which had similar clinical findings and CT images. The first case was a 37-year-old man with a craniopharyngioma in the suprasellar lesion. Partial removal of the tumor was performed through frontal craniotomy and the translaminaterminals approach. A large quantity of cerebospinal fluid (CSF) was suctioned from the third ventricle during the operation, resulting in marked brain shrinkage. The second and third cases were 34- and 51-year-old women with unruptured right middle cerebral aneurysms. Clipping of the aneurysms through the pterional approach was performed in both cases. In the second case, CSF was suctioned in large quantity from the carotid and prechiasmal cistern at the operation, resulting in marked brain shrinkage. In the third case, however, only a small volume of CSF was suctioned from the carotid and prechiasmal cistern during the operation, and no marked brain shrinkage was observed. CT scan showed that the hematomas were located mainly in the subdural or the subarachnoid spaces over the cerebellar hemisphere and partially extending into the cerebellar cortex. The mechanism of cerebellar hemorrhage in these series of patients was thought to be multifactorial. The possible etiology for cerebellar hemorrhage in the three cases presented was examined, including the role of CSF suction during surgery and disturbance of venous circulation in the posterior fossa. Suction of the CSF may cause intracranial hypotension. Further reduction of intracranial pressure leads to an increased transluminal venous pressure. There was no episode of hypertension or disturbed blood coagulation during or after the operation. The preoperative angiogram also revealed no abnormality at the region of the posterior fossa. Neuroimaging of infratentorial hemorrhage after

  16. Research Progress in Association of Matrix Metalloproteinases with Cerebral Edema after Hypertensive Intracerebral Hemorrhage%基质金属蛋白酶与高血压脑出血后脑水肿相关性的研究进展

    Institute of Scientific and Technical Information of China (English)

    周德生; 李煦昀; 王仙伟

    2012-01-01

    Hypertensive intracerebral hemorrhage is one of the critical diseases in neurological system. In addition to the mass effect of hematoma,the blood brain barrier damage and cerebral edema caused by hema-toma components and the secondary nerve damage caused by cerebral edema are the main causes of deterioration and death the cerebral hemorrhage patients. Recent studies suggested that matrix metalloproteinases increased expression after hypertensive intracerebral hemorrhage, which participated in and mediated cerebral edema, and the expression and adjustment of which has become the new target for the treatment of cerebral e-dema.%高血压脑出血是神经系统的危重病之一.除了血肿本身的占位效应外,血肿成分引发的血脑屏障的破坏和脑水肿反应,以及脑水肿导致的继发性神经损害,是脑出血患者病情恶化和引起死亡的主要原因.基质金属蛋白酶在高血压脑出血后表达增高,参与和介导了脑水肿的发生、发展,其表达和调控成为研究脑水肿的治疗靶点.

  17. 尼莫地平联合依达拉奉治疗高血压脑出血的Meta分析%Efficacy of nimodipine combined with edaravone in treatment of hypertensive intracerebral hemorrhage: a meta-analysis

    Institute of Scientific and Technical Information of China (English)

    陈谦学; 丁大成; 秦军

    2014-01-01

    Objective To systematically evaluate the clinical efficacy and safety of nimodipine combined with edaravone in the treatment of hypertensive intracerebral hemorrhage (HICH).Methods The databases of PubMed,Cochrane Database of System Reviews,EMbase,CNKI,VIP,Wanfang Data,and CBM were searched for randomized controlled trials (RCTs) on the efficacy of nimodipine combined with edaravone in the treatment of HICH,which strictly met the inclusion and exclusion criteria.And a meta-analysis was performed using software RevMan (version 5.1).Results A total of 8 RCTs involving 610 patients with HICH were evaluated.The meta-analysis showed that the overall response rate of the combination therapy group was significantly higher than that of the control group (OR =3.15,95% CI:2.06-4.83).After treatment,both groups showed significantly reduced neurologic impairment score and volumes of cephalophyma and brain edema (P < 0.05),but the neurologic impairment score and volumes of cephalophyma and brain edema in the therapy group were significantly lower than those in the control group (P < 0.05),and the volume of cephalophyma in the therapy group was significantly reduced compared with that in the control group (SMD =-5.14,95% CI:-5.83-(-4.45)).Conclusions For patients with HICH,nimodipine combined with edaravone has significant clinical efficacy in the treatment of hypertensive cerebral hemorrhage,and can improve the functional rehabilitation of the nerves and effectively reduce the volumes of intracranial hematoma and peripheral edema.%目的 系统评价尼莫地平联合依达拉奉治疗高血压脑出血的临床疗效和安全性.方法 严格按照纳入、排除标准,检索PubMed、Cochrane Database of Systematic Reviews、EMbase、CNKI、VIP、Wanfang Data及CBM中关于尼莫地平联合依达拉奉治疗高血压脑出血的随机对照试验(RCT),采用RevMan 5.1软件进行Meta分析.结果 共纳入8篇文献,包括610例患者.Meta分析结果显示:尼莫地

  18. 显微手术治疗幕上高血压性脑出血的体会%Experience of Microsurgical Operation in the Treatment of Supratentorial Hypertensive Intracerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    孙郑春; 曹新亮; 马旭东

    2014-01-01

    Objective To explore the curative effects of microsurgical clearance for supratentorial hypertensive intracerebral hemorrhage. Methods A retrospective analysis of clinical data of 30 cases of supratentorial hypertensive intracerebral hemorrhage in our hospital from January 2010 to January 2013 was carried out. According to the head CT images, the position of incision was determined. Under orotracheal intubation general anesthesia, a bone flap craniotomy was performed. A cortex fistula 2-3 cm in length was made. Then by using an automatic retraction device, the hematoma was revealed from the shallower to the deeper, and microscopic clearance of hematoma was completed. Results All the 30 cases of operation were successful. Re-examination of head CT scans on the first postoperative day showed hematoma was completely removed in 14 cases, was 90%cleared in 11 cases, and 80%in 5 cases. Four patients died within 4 weeks after operation (13.3%):2 patients died of cerebral hernia caused by brainstem function failure, 1 patient died of lung infection, and 1 patient died of multiple organ failure. The postoperative survival rate was 86.7%.The ADL grade assessment 3 months after operation showed gradeⅠin 7 cases, grade Ⅱin 9 cases, grade Ⅲin 6 cases, grade Ⅳ in 3 cases, and grade Ⅴin 1 case. Conclusion Microscopic hematoma clearance and open haemostatic intervention has advantages of little brain tissue damage, good haemostatic results, and satisfactory efficacy.%目的:探讨显微镜下清除幕上高血压性脑出血的疗效。方法我院2010年1月~2013年1月显微手术治疗30例幕上高血压性脑出血,根据头颅CT影像定位确定手术切口,游离骨瓣开颅,做一长2~3 cm皮层瘘口,用自动牵开器由浅入深显露血肿,显微镜下清除血肿。结果30例手术均获得成功。术后次日复查头颅CT,14例血肿完全清除,11例血肿清除率达到90%,5例清除率达到80%。术后死亡4例(13.3

  19. Cerebellar hemorrhage after embolization of ruptured vertebral dissecting aneurysm proximal to PICA including parent artery

    Directory of Open Access Journals (Sweden)

    Akira Tamase

    2014-01-01

    Full Text Available Background: Some complications related to vertebral artery occlusion by endovascular technique have been reported. However, cerebellar hemorrhage after vertebral artery occlusion in subacute phase is rare. In this report, we describe a patient who showed cerebellar hemorrhage during hypertensive therapy for vasospasm after embolization of a vertebral dissecting aneurysm. Case Description: A 56-year-old female with a ruptured vertebral dissecting aneurysm proximal to the posterior inferior cerebellar artery developed cerebellar hemorrhage 15 days after embolization of the vertebral artery, including the dissected site. In this patient, the preserved posterior inferior cerebellar artery fed by retrograde blood flow might have been hemodynamically stressed during hypertensive and antiplatelet therapies for subarachnoid hemorrhage, resulting in cerebellar hemorrhage. Conclusion: Although cerebellar hemorrhage is not prone to occur in the nonacute stage of embolization of the vertebral artery, it should be taken into consideration that cerebellar hemorrhage may occur during hypertensive treatment.

  20. 高血压脑出血患者护理的伦理困境和对策%Ethical Dilemmas and Countermeasures in Hypertensive Cerebral Hemorrhage Patient Nursing

    Institute of Scientific and Technical Information of China (English)

    俞素卿; 娄志玲; 季林玲; 邵吉红; 周莉丽

    2012-01-01

    高血压脑出血因其致死率和致残率高,导致预期治疗效果与患者实际状况之间、医院诊疗结果与传统死亡观之间、患者亲属之间产生一系列伦理冲突,也使密切和他们接触的护理人员不得不面对伦理困境.建议护理人员尊重生命,尊重患者和家属的价值观和信仰,加强护理管理,合理安排护理人员编制,加强伦理知识的学习和应用,促进护患和谐,提高患者和家属的生活质量.%Hypertension cerebral hemorrhage patients have high fatality rate and disability rate, which resulted in the ethical conflicts between treatment expection and the patients actual condition, hospital diagnosis results and the traditional view of life and death, and between the patients and their families, also bring some dilemmas for nursing staff who have close contact with them. This paper proposed that nursing staff should show respect for the values and believes of patients and their families'concept, enhancing care management, rationalizing the arrangements of nursing management and strengthening the learning and application of ethics knowledge so as to establish a harmonious relationship between the nursing staff and patients and thus improve the life quality of patients their families.

  1. CT灌注成像在急性自发性高血压性脑出血中的应用%Application of CT perfusion imaging in acute spontaneous hypertension intracerebral hemorrhage patients

    Institute of Scientific and Technical Information of China (English)

    许化致; 曹国全; 王美豪; 朱姬莹; 谢福荣

    2012-01-01

    Objective To quantify hemodynamic changes in patients with acute spontaneous hypertensive intracerebral hemorrhage (shICH) using computed tomography perfusion (CTP) imaging. Methods 26 patients (22 men and 4 women, age range 33~74, mean age 55. 08 years) who suffered from a supratentorial shICH, were at admission and received CTP scanning within 8~19 h (mean 14. 88 h) after symptom onset. At the maximum levels of the hematoma, cerebral blood flow (CBF) , cerebral blood volume (CBV) and mean transit time (MTT) were measured in three different regions of interest (ROI)manually outlined on CT scan: ① hemorrhagic core( hyperdense on unenhanced CT image); ② perihematomal area (isodense within 1 cm rim of perilesion area); ③ normal area far from ipsilateral hemorrhage, and ④ a mirrored area(CBVn, CBFn, MTTn) , including the clot and the perihematomal region located in the contralateral hemisphere. rCBF, rCBV, rMTT were calculated (rCBV=CBV/CBVn, rCBF=CBF/CBFn, rMTT= MTT/MTTn). Results The CBF, CBV, and MTT color maps showed a centrifugal distribution with a gradual improvement from the core of hematoma to the periphery. The CBV, CBF, and MTT value of perihematoma area were (16. 48 ± 17. 38) ml ·100g-1 · min-1), (1.61±1. 53) ml· 100g-1), (9.12 ± 2.57) s, respectively. There was significantly decreased CBF, CBV and prolonged MTT in perihematomal group against contralateral mirrored area (ZCBV=-2. 603, ZCBF=-4. 178, tMTT = 4. 747, P0. 05). Mean CBF value of perihematomal group was lower than that of remote area ( Z =-2. 288, P 0. 05). Conclusion Multi parametric CTP imaging can indicate low perfusion states around hematoma in acute shICH patients, but there is no evidence of ischemic penumbra.%目的 应用CT灌注成像(CT perfusion,CTP)对急性自发性高血压出血性脑卒中(acute spontaneously hypertensive intracerebral hemorrhage,shICH)血肿周围脑血液动力学变化进行定量研究,验证血肿周围是否存在缺血半暗带.方法 对26

  2. Recurrent craniospinal subarachnoid hemorrhage in cerebral amyloid angiopathy

    Directory of Open Access Journals (Sweden)

    Mathew Alexander

    2013-01-01

    Full Text Available Cerebral amyloid angiopathy (CAA usually manifests as cerebral hemorrhage, especially as nontraumatic hemorrhages in normotensive elderly patients. Other manifestations are subarachnoid (SAH, subdural, intraventricular hemorrhage (IVH and superficial hemosiderosis. A 52-year-old hypertensive woman presented with recurrent neurological deficits over a period of 2 years. Her serial brain magnetic resonance imaging and computed tomography scans showed recurrent SAH hemorrhage, and also intracerebral, IVH and spinal hemorrhage, with superficial siderosis. Cerebral angiograms were normal. Right frontal lobe biopsy showed features of CAA. CAA can present with unexplained recurrent SAH hemorrhage, and may be the initial and prominent finding in the course of disease in addition to superficial cortical siderosis and intracerebal and spinal hemorrhages.

  3. 高血压脑出血无创颅内压及脑灌注压监测临床研究%Monitoring noninvasive intracranial pressure and cerebral perfusion pressure in treatment of patients with hypertensive intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    张文德; 张湘; 邹志浩; 吴勤奋; 殷捷; 王建江; 郑玺; 莫拉丁

    2012-01-01

    Objective To evaluate clinical significance of monitoring noninvasive intracranial pressure (NICP) and cerebral perfusion pressure (CPP) in treatment of patients with hypertensive intracerebral hemorrhage. Methods This clinical randomized controlled trial enrolled 120 patients with hypertensive intracerebral hemorrhage who had sought medical treatment in our department from June 2008 through May 2010. They were randomized equally into a monitoring group where NICP and CPP were continuously monitored before and after operation and a non-monitoring group where no monitoring of NICP and CPP was performed. Results In the monitoring group,increased NICP and decreased CPP were shown in 50 patients and only 10 patients were shown with normal NICP (<26.6mmHg) and CPP (> 124.3 mm Hg). The abnormal NICP and CPP continuously monitored were treated with specific interventions like further operation or medication. In the non-monitoring group,patients received only conventional treatments.According to the Glasgow Outcome Scale (GOS), 31 patients (51.7%) had good recovery,20 (33.3%) were moderately disabled,5 (8.3%) severely disabled and 4 (6.7%) dead in the monitoring group while 23 (38.3%) patients had good recovery,18 (30.0%)were moderately disabled,10 (16.7%) severely disabled and 9 (15.0%) dead in the non-monitoring group.The outcomes of the monitoring group were significantly better than those of the non-monitoring group (P<0.05). Conclusion Continuous monitoring of NICP and CPP before and after operation should be performed in the treatment of patients with hypertensive intracerebral hemorrhage because it is helpful for clinical medication and reducing complications and mortality as well.%目的 探讨高血压脑出血手术前后监测无创颅内压(NICP)、脑灌注压(CPP)变化的临床意义. 方法 收集解放军第474医院神经外科自2008年6月至2010年5月收治的120例高血压脑出血手术患者,按照随机数字表法分为

  4. Efficacy Observation of the Sequential Therapy of Traditional Chinese Medicine for Hypertensive Cerebral Hemorrhage%中药序贯治疗高血压性脑出血的疗效观察

    Institute of Scientific and Technical Information of China (English)

    王中甫; 王静雅

    2011-01-01

    OBJECTIVE: To observe the clinical efficacy of traditional Chinese medicine for hypertensive cerebral hemorrhage. METHODS: 179 patients with hypertensive cerebral hemorrhage were randomly divided into study group (90 cases) and control group (89 cases). Two groups were treated by routine western medicine, such as to reduce blood pressure and keep the stability of the vital sign during acute phase, rehabilitative exercises during convalescence. Study group was additionally given sequential therapy of traditional Chinese medicine using Tongqiao huoxue decoction of acute phase and Buyang huanwu decoction of convalescence phase as routine therapy. We record the survival status for 90 days, changes of hematoma volume for 14 days, score of neurological impairment before treatment, 14 days, 30 days and 90 days after treatment, and evaluation of ability of daily living (ADL) for 90 days after treatment. RESULTS: (1) Survival rate of study group and control group were 83.3% and 79.8% (Kaplan Meier method), respectively, Log Rank (Mantel-Cox)x2=0.359,P=0.549. (2)Hematoma absorption, reduction, fixation or enlargement were 24 cases, 46 cases and 12 cases in study group at 14 days, and 10 cases, 56 cases and 14 cases in control group (Z=-2.092, P=0.036). (3)The score of neurological impairment of both groups were decreasing,F=503.114,P=0.000; The decrease of the score of neurological impairment in study group was more significant than control group, F= 178.481 ,P=0.000. The trend of the score of neurological impairment of both groups were not parallel,F=11.816,P=0.000. (4) Possibility of grade Ⅰ ADL in study group was 1.992 times as in control group (Wald x2=5.184,P=0.023). CONCLUSION: The sequential therapy of traditional Chinese medicine for hypertensive cerebral hemorrhage could accelerate hernatoma absorption, protect nerve cell, and improve ability of daily living.%目的:观察中药治疗高血压性脑出血的临床效果.方法:将179例高血压脑出

  5. Role of permissive hypotension, hypertonic resuscitation and the global increased permeability syndrome in patients with severe hemorrhage: adjuncts to damage control resuscitation to prevent intra-abdominal hypertension.

    Science.gov (United States)

    Duchesne, Juan C; Kaplan, Lewis J; Balogh, Zsolt J; Malbrain, Manu L N G

    2015-01-01

    Secondary intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are closely related to fluid resuscitation. IAH causes major deterioration of the cardiac function by affecting preload, contractility and afterload. The aim of this review is to discuss the different interactions between IAH, ACS and resuscitation, and to explore a new hypothesis with regard to damage control resuscitation, permissive hypotension and global increased permeability syndrome. Review of the relevant literature via PubMed search. The recognition of the association between the development of ACS and resuscitation urged the need for new approach in traumatic shock management. Over a decade after wide spread application of damage control surgery damage control resuscitation was developed. DCR differs from previous resuscitation approaches by attempting an earlier and more aggressive correction of coagulopathy, as well as metabolic derangements like acidosis and hypothermia, often referred to as the 'deadly triad' or the 'bloody vicious cycle'. Permissive hypotension involves keeping the blood pressure low enough to avoid exacerbating uncontrolled haemorrhage while maintaining perfusion to vital end organs. The potential detrimental mechanisms of early, aggressive crystalloid resuscitation have been described. Limitation of fluid intake by using colloids, hypertonic saline (HTS) or hyperoncotic albumin solutions have been associated with favourable effects. HTS allows not only for rapid restoration of circulating intravascular volume with less administered fluid, but also attenuates post-injury oedema at the microcirculatory level and may improve microvascular perfusion. Capillary leak represents the maladaptive, often excessive, and undesirable loss of fluid and electrolytes with or without protein into the interstitium that generates oedema. The global increased permeability syndrome (GIPS) has been articulated in patients with persistent systemic inflammation failing

  6. 高血压脑出血偏瘫患者早期肢体康复训练及护理效果观察%The clinical therapeutic effect of early limb rehabilitation training on hypertensive cerebral hemorrhage hemiplegia patients

    Institute of Scientific and Technical Information of China (English)

    万宝珍; 徐雪梅

    2015-01-01

    Objective: To explore the clinical therapeutic effect of early limb rehabilitation training on hypertensive cerebral hemorrhage hemiplegia patients. Methods: 100 patients of hypertensive cerebral hemorrhage hemiplegia, admitted to our hospital from April 2013 to June 2015, were randomized into the observation group and the control group evenly. The control group received routine treatment while the observation group received an early limb rehabilitation training, the therapeutic effects were compared. Results: The total efficiency of the observation group(96.0%) was significantly better than that of the control group(80.0%), the difference was statistically significant (P<0.05). Conclusion:The early limb rehabilitation training had a remarkable effect in treating hypertensive cerebral hemorrhage hemiplegia patients and it was worth clinical application.%目的:分析临床高血压脑出血偏瘫患者行早期肢体康复训练的临床效果.方法:选取我院2013年4月—2015年6月接收高血压脑出血偏瘫100例患者作为调查对象,分成两组,对照组行基础疗法,研究组行早期肢体康复训练疗法,于临床预后评定疾病效果.结果:研究组患者预后疾病缓解率96.0%高于对照组80.0%,存在临床差异(P<0.05).结论:临床针对高血压脑出血偏瘫患者行早期肢体康复疗法作用显著,可加快康复进度,改善神经缺损度,值得借鉴.

  7. Treatment of ectopic varices with portal hypertension

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Ectopic varices are unusual with portal hypertension andcan involve any site along the digestive tract outsidethe gastroesophageal region. Hemorrhage from ectopicvarices generally are massive and life threatening.Diagnosis of ectopic varices is difficult and subsequenttreatment is also difficult; the optimal treatment hasnot been established. Recently, interventional radiologyand endoscopic treatments have been carried outsuccessfully for hemorrhage from ectopic varices.

  8. Cerebral hemorrhage associated with sildenafil (Revatio) in an infant.

    Science.gov (United States)

    Samada, Kazunori; Shiraishi, Hirohiko; Aoyagi, Jun; Momoi, Mariko Y

    2009-10-01

    A case of cerebral hemorrhage associated with sildenafil (Revatio) use in an infant is presented. Sildenafil is increasingly used in the treatment of primary and secondary pulmonary arterial hypertension and pulmonary arteriovenous fistula. In the reported case, sildenafil used to treat pulmonary arteriovenous fistula improved right-to-left shunting across the pulmonary fistula but resulted in cerebral hemorrhage. Cerebral hemorrhage, a previously reported complication of sildenafil, developed in an infant after a rapid increase in dose, to 4.7 mg/kg/day. Therefore, sildenafil doses must be increased only with care, and cerebral hemorrhage must be considered a potential complication.

  9. 预见性干预对高血压脑出血患者去骨瓣减压联合血肿引流术后便秘与上消化道出血的预防效果%Effect of predictive intervention in preventing constipation and upper digestive tract hemorrhage after decompressive craniectomy and drainage hematoma operation in patients with hypertensive cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    马晓红; 张爱华; 彭玉洁; 陈香林

    2016-01-01

    Objective To explore the effect of predictive nursing intervention in preventing constipation and upper digestive tract hemorrhage after decompressive craniectomy and drainage hematoma operation in patients with hypertensive cerebral hemorrhage.Methods Fifty patients with hypertensive cerebral hemorrhage from June 2014 to June 2015 were enrolled as observation group,and were given predictive nursing;50 patients with hypertensive cerebral hemorrhage from May 2013 to May 2014 were enrolled as control group,and were given conventional nursing.The volume and position of hemorrhage,incidences of postoperative constipation and upper gastrointestinal bleeding were observed and recorded.Results The volume and position of hemorrhage were not significantly different between groups (P > 0.05).The incidences of difficult defecation,scleroma defecation,abdominal pain,abdominal distension,anorexia,anxiety and upper digestive tract hemorrhage in observation group were significantly lower than those in control group [16.0% (8/50) vs 42.0% (21/50),4.0% (2/50) vs26.0% (13/50),10.0% (5/50) vs 32.0% (16/50),24.0% (12/50) vs 46.0% (23/50),30.0%(15/50) vs54.0% (27/50),14.0% (7/50) vs 36.0% (18/50),2.0% (1/50) vs 20.0% (10/50)](P <0.05).Conclusion Predictive nursing intervention can effectively reduce the incidence of upper gastrointestinal hemorrhage and improve the constipation in patients with hypertensive cerebral hemorrhage after operation.%目的 探讨预见性干预对高血压脑出血患者去骨瓣减压联合血肿引流术后便秘与上消化道出血的预防效果.方法 回顾性分析2014年6月至2015年6月解放军第四二二医院收治的50例高血压脑出血患者(观察组)和2013年5月至2014年5月收治的50例高血压脑出血患者(对照组)的临床资料.观察组采用预见性干预措施;对照组采用常规护理模式.观察并比较2组患者脑出血部位、出血量、术后便秘以及上消化

  10. Subarachnoid hemorrhage in pituitary tumor

    Directory of Open Access Journals (Sweden)

    Ashis Patnaik

    2013-01-01

    Full Text Available Subarachnoid hemorrhage (SAH is the bleeding into the subarachnoid space containing cerebrospinal fluid. The most common cause of SAH is trauma. Rupture of aneurysms, vascular anomalies, tumor bleeds and hypertension are other important etiologies. SAH in the setting of pituitary tumor can result from various causes. It can be due to intrinsic tumor related pathology, injury to surrounding the vessel during the operative procedure or due to an associated aneurysm. We discuss the pathological mechanisms and review relevant literature related to this interesting phenomenon. Early and accurate diagnosis of the cause of the SAH in pituitary tumors is important, as this influences the management.

  11. 微创碎吸术手术时机对高血压脑出血患者血清 IL-6、TNF-α水平的影响%The influence of minimally invasive aspiration operation time on the clinical effect,serum IL-6,TNF-αlevel in pa-tients with hypertensive cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    房晓勇; 郭春光; 李志涛; 房巧英; 王金丽; 张秋菊; 李桂文

    2015-01-01

    Objective To explore the influence of minimally invasive aspiration operation time on the clinical effect , serum IL-6,TNF-αlevel in patients with hypertensive cerebral hemorrhage .Methods 220 patients with hypertensive cerebral hemorrhage were randomly divided into observation group and control group ,110 cases of each .All patients were treated by diu-resis dehydration ,blood sugar and blood pressure control ,neurotrophic therapy and other symptomatic treatment .The observa-tion group was received minimally invasive aspiration operation in 6 hours after hypertensive cerebral hemorrhage , while the control group was treated after hypertensive cerebral hemorrhage 6 hours but in 24 hours.The serum level of IL-6 and TNF-α, therapy effect of two groups were tested and compared the differences .Results Total effective rate of observation group (91.82%) was higher than that of the control group (74.55%),the difference was statistically significant (P0.05). After treatment ,the serum levels of two groups were significantly lower than that before treatment , and with the extension of treatment time,serum IL-6 and TNF-αlevels decreased gradually .The serum IL-6 and TNF-αlevels in treatment of 2, 3, 5,7d were lower than the control group ,the differences were statistically significant (P<0.05).Conclusion Taking the minimally invasive aspiration operation within 6 hours after hypertensive cerebral hemorrhage can improve the effectiveness .%目的:探讨微创碎吸术手术时机对高血压脑出血患者血清IL-6、TNF-α水平的影响。方法将220例高血压脑出血患者随机分为观察组及对照组各110例。2组患者均常规给予脱水降颅内压、控制血糖和血压及神经营养支持等治疗。观察组患者脑出血6h内进行微创碎吸术手术,对照组患者脑出血6~24h内进行微创碎吸术手术。检测2组患者手术前后血清IL-6及TNF-α的含量水平,并比较2组的临床疗效。结果观察组总有效率为91

  12. Pregnancy-induced Hypertension Syndrome Combined Contractions Fatigue Analysis of the Nursing Countermeasure of Postpartum Hemorrhage%妊娠高血压综合症合并宫缩乏力性产后出血的护理对策分析

    Institute of Scientific and Technical Information of China (English)

    覃京珠

    2015-01-01

    目的:探讨妊娠高血压综合征患者合并宫缩乏力性产后出血的护理对策。方法收集100例妊娠高血压综合征合并宫缩乏力性后出血患者,随机分为观察组和对照组,各50例。结果两组患者在经过护理后均有一定的效果,但观察组患者的护理效果明显优于对照组患者,有统计学差异。结论在对妊娠高血压综合征合并宫缩乏力性产后出血患者进行临床护理的过程中,使用护理干预的护理方法能够显著提升护理效果。%Objective To explore the patients with pregnancy-induced hypertension syndrome with contractions fatigue sex nursing countermeasures of postpartum hemorrhage. Methods Collecting 100 cases of pregnancy-induced hypertension syndrome patients with bleeding after the merger contractions fatigue sex, were randomly divided into observation group and control group, 50 cases each.Results Two groups of patients after nursing all have certain effect, but the observation group of patients with nursing effect was better than control group patients, statistically significant.Conclusion In clinical of pregnancy-induced hypertension syndrome complicated contractions fatigue sex in the process of postpartum hemorrhage patients for nursing care, the nursing methods of using the nursing intervention can signiifcantly improve the nursing effect.

  13. Viral Hemorrhagic Fevers

    Science.gov (United States)

    ... 4 viruses that cause two other hemorrhagic fevers, dengue hemorrhagic fever and yellow fever. Virus Families Information ... 2014 Content source: Centers for Disease Control and Prevention National Center for Emerging and Zoonotic Infectious Diseases ( ...

  14. Pure Sensory Stroke due to Lenticulocapsular Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    杨益阶; 王国瑾; 潘松青

    2003-01-01

    @@ Pure sensory stroke (PSS) caused by lenticulo-capsular hemorrhage is rare. In this article, we re-ported 4 patients with PSS due to lenticulocapsularhemorrhage, including 3 men and 1 woman (mean age,58 years; range, 54 to 65 years), whose lesions couldbe identified by head computed tomographic (CT)scan and clinical findings correlated with the radio-logical lesions. All patients except 1 had hyperten-sion.

  15. The enlarged burr-hole craniotomy for treatment of hypertensive intracerebral hemorrhage in geriatric patients%小骨窗开颅手术治疗老年性高血压脑出血51例临床分析

    Institute of Scientific and Technical Information of China (English)

    徐已奕; 钟春龙; 郑彦; 张明坤; 崔振文; 吴增宝; 王勇; 江基尧; 罗其中

    2011-01-01

    目的 研究老年性高血压脑出血的微创治疗策略.方法 回顾性分析51例应用小骨窗开颅技术治疗的老年(>65岁)高血压脑出血患者.均在直视下清除血肿,术后血肿残余大于15 ml者辅助尿激酶稀释液灌注引流.结果 血肿近全清除36例,大部清除14例,再出血后二次手术清除1例.由于老年病人存在脑萎缩,血肿清除后减压均较充分.随访6个月至2年,GOS优28例,中残15例.重残7例,死亡1例.恢复良好率达84.3%.结论 小骨窗开颅手术治疗高血压脑出血,具有微创、可视、省时、病人恢复快等优点.%Objective To investigate the strategy of minimally invasive treatment for hypertensive intracerebral hemorrhage in geriatric patients. Methods Review the clinical date of fifty- one aged patients(>65years old) who were treated with the enlarged burr-hole craniotomy because of hypertensive intracerebral hemorrhage. All hematomas were evacuated under direct visualization. If the volume of residual hematoma on follow-up CT was more than 15ml, a drainage procedure would be performed after the perfusion of the urokinase. Results Nearly total e-vacuation of hematoma was achieved in 36 cases , subtotal evacuation in 14 cases, but in 1 case rebleeding occurred and reoperation was done. The decompression was sufficient because of the shrinkage of brain tissues in aged patients. Followed up for 6 months to 2 years, good recovery was found in 28 cases, moderate disability in 15 cases, severe disability in 7 cases and death in 1 case according to the glasgow outcome scale ( GOS) . The rate of favorable outcomes was 84. 3%. Conclusion The advantages of enlarged burr-hole craniotomy in the treatment of hypertensive intracerebral hemorrhage are minimally invasive, visible, less time consuming and quick recovery of patients.

  16. A Comparison of Curative Effect of Ganglioside and Piracetam in treatment of Patients with Hypertensive Cerebral Hemorrhage%神经节苷酯与吡拉西坦治疗高血压性脑出血的疗效比较

    Institute of Scientific and Technical Information of China (English)

    李学良; 郝晓

    2011-01-01

    目的 对比研究单唾液酸神经节苷酯与吡拉西坦治疗高血压性脑出血的效果.方法 将96例急性高血压性脑出血的患者分为神经节苷酯组和吡拉西坦组,每组48例.神经节苷酯组给于神经节苷酯40 mg/d静脉滴注;吡拉西坦组给予吡拉西坦20 g/d静脉滴注,3周为1个疗程.两组患者均给于脱水降颅压、维持电介质平衡、调控血压及防治并发症等治疗.比较两组治疗后神经功能缺损及日常生活活动能力的改善情况.结果 3周后两组临床疗效比较差异有统计学意义(P<0.05).结论 神经节苷酯治疗高血压性脑出血有良好的疗效,能促进脑出血患者的神经功能恢复,提高生活质量.%Objective To observe the effects of ganglioside and piracetam in improving the neurological function in patients with hypertensive cerebral hemorrhage.Methods Ninety-six patients with hypertensive cerebral hemorrhage Were randomly divided into 2 groups,ganglioside group(48 patients)and piracetam group(48 patients).Ganglioside group used the amount 40mg ganglioside mixed with sodium chloride injection(100ml,concentration 0.9%),and the piracetam group uesd piracetam(20g)mixed with the same injection.Both the patients of the 2 groups were given intravenous drip once a day,then after continuous 3 weeks,the general information and the improvement of nerve were observed.Results The effective rate and excellent rate of ganglioside group were remarkably higher than piracetam group,there was significant difference between the two groups(P<0.05).Conclusion Ganglioside was better than pimcetam in improving clinical symptoms and the neurological deficit of the patients with hypertensive cerebral hemorrhage.

  17. Application of timing nursing care in the treatment of patients with hypertensive cerebral hemorrhage and observation on its efficacy%时间护理在高血压脑出血患者中的应用及效果观察

    Institute of Scientific and Technical Information of China (English)

    江淑萍

    2012-01-01

    目的:探讨时间护理在高血压脑出血患者中的应用方法及临床效果.方法:将86例高血压脑出血患者按照随机数字表法分为干预组和对照组各43例,对照组给予常规护理,干预组在常规护理基础上实施时间护理.对比分析两组临床疗效、护理前后肢体运动、生活自理能力情况及护理满意度.结果:干预组临床疗效、肢体运动功能、日常生活自理能力及护理满意度均优于对照组(P<0.05).结论:时间护理可提高高血压脑出血患者的治疗效果及护理满意度,值得临床推广使用.%Objective: To explore the approaches and clinical effect of timing nursing care in the treatment of patients with hypertensive cerebral hemorrhage. Methods: 86 patients with hypertensive cerebral hemorrhage were divided into an intervention group and a control group ( 43 cases in each group ) according to random number table. The routine nursing care was taken in the control group and the timing nursing care was additionally implemented in the intervention group. The clinical efficacy,limb movements before and after nursing care, activities of daily living and patients satisfaction with nursing care were analyzed and compared between the two groups. Results:The clinical efficacy,limb motor function,activities of daily living and patients satisfaction were better in the intervention group than those in the control group ( P <0. 05 ). Conclusion:The timing nursing care can improve the curative effect and patients satisfaction in the treatment of hypertensive cerebral hemorrhage.

  18. 早期肠内营养干预对预防高血压脑出血患者应激性溃疡的作用%The kole effect of early enteral nutritionon preventing of patients with hypertensive intracerebral hemorrhage to stress ulcer

    Institute of Scientific and Technical Information of China (English)

    范玉梅; 吴修凤

    2014-01-01

    Objective To analyze the effect of early enteral nutrition intervention on preventing patients with hypertensive intracerebral hemorrhage from stress ulcer.Methods One hundred and fifty- patients with hypertensive cerebral hemorrhage admitted to our hospital from July 2012 to July 2013 were selected as research subjects ,conventional therapy or enteral nutrition intervention was taken respectively ,the stress ulcer symptoms such as the amount of bleeding ,total hospitalization time , poor prognosis ,of the two groups were compared.Results In the observation group ,the incidence of stress ulcer (11.54% ) , bleeding (43.42 ± 11.65) mL , bleeding time (3.35 ± 1.04 ) d , total hospitalization time (8.42 ± 2.04 ) d , poor prognosis (1.28% ) were significantly lower than those of the control group (P< 0.05).Conclusion Early enteral nutrition interventions may be effective in preventing patients with hypertensive cerebral hemorrhage from stress ulcer ,promoting the rehabilitation of patients and improving their prognosis.%目的:分析早期肠内营养干预对预防高血压脑出血患者应激性溃疡的效果。方法选择本院于2012-07-2013-07收治的156例高血压脑出血患者为研究对象,分别采取常规治疗措施及早期肠内营养干预,比较2组患者应激性溃疡各项症状出现情况、出血量及总住院时间、不良预后发生情况等差异。结果观察组应激性溃疡发生率11.54%,出血量(43.42±11.65)m L ,出血停止时间(3.35±1.04)d ,住院时间(8.42±2.04)d ,不良预后(1.28%),明显低于对照组( P<0.05)。结论早期肠内营养干预可有效预防高血压脑出血患者出现应激性溃疡,促进患者康复,改善其预后。

  19. Comparative analysis of minimally invasive hematoma puncture drainage and small bone window craniotomy for treating hypertensive cerebral hemorrhage%微创血肿穿刺引流术与小骨窗开颅术治疗高血压脑出血疗效的对比分析

    Institute of Scientific and Technical Information of China (English)

    黄春明; 张宏祥; 朱亚平

    2012-01-01

    Objective To investigate the efficacy of minimally invasive hematoma puncture drainage and small bone window craniotomy for treating hypertensive cerebral hemorrhage to provide a reference for a reasonable choice of surgical ways. Methods 120 cases hypertensive intracerebral hemorrhage patients were equally randomly divided into treatment group and control group of 60 cases, the control group were given with small bone window craniotomy, the treatment group were treated with CT-guided minimally invasive hematoma puncture drainage. Results No patients were died after surgery and follow-up, the re-bleeding, lung infection, gastrointestinal bleeding rate, the excellent rates of short-term efficacy and follow-up efficacy were better than the control group (P<0.05). Conclusion Hypertensive cerebral hemorrhage patients should as soon as possible to imply CT-guided minimally invasive hematoma puncture drainage for reducing patient morbidity and improving the prognosis of efficacy.%目的:探讨微创血肿穿刺引流术与小骨窗开颅术治疗高血压脑出血疗效对比情况,为合理选择手术方法提供参考.方法:高血压脑出血患者120例,根据随机原则分为治疗组与对照组各60例,对照组采用小骨窗开颅术,治疗组采用CT引导下微创血肿穿刺引流术.结果:两组术后都无死亡患者,两组的再次出血率、肺部感染率、消化道出血率均无显著性差异(P>0.05).随访中也无死亡病例,治疗组的近期疗效优良率好于对照组(P<0.05),治疗组的远期疗效也明显好与对照组(P<0.05).结论:高血压脑出血患者应尽早实施CT引导下微创血肿穿刺引流术与,降低患者的致残率,提高预后疗效.

  20. Maternal mortality from hemorrhage.

    Science.gov (United States)

    Haeri, Sina; Dildy, Gary A

    2012-02-01

    Hemorrhage remains as one of the top 3 obstetrics related causes of maternal mortality, with most deaths occurring within 24-48 hours of delivery. Although hemorrhage related maternal mortality has declined globally, it continues to be a vexing problem. More specifically, the developing world continue to shoulder a disproportionate share of hemorrhage related deaths (99%) compared with industrialized nations (1%). Given the often preventable nature of death from hemorrhage, the cornerstone of effective mortality reduction involves risk factor identification, quick diagnosis, and timely management. In this monograph we will review the epidemiology, etiology, and preventative measures related to maternal mortality from hemorrhage.

  1. Effect of holistic nursing intervention on negative emotion and quality of life of patients with hypertensive cerebral hemorrhage%整体护理干预对高血压脑出血患者负性情绪和生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    韩红梅

    2009-01-01

    Objective To investigate the effect of hotistic nursing intervention on negative emotion and quality of life of patients with hypertensive cerebral hemorrhage. Methods One hundred and twelve hypertensive cerebral hemorrhage inpatients with negative emotion disorder from 2006 June to 2008 December were randomly divided into the routine nursing group and the holistie nursing intervention group with 56 patients in each group. The routine nursing group were given the normal nursing care of hypertensive cerebral hemorrhage,the holistic nursing group received psychological nursing, health education and rehabilitative intervention on the basis of normal nursing care for 4 weeks. All patients were evaluated with self rating depression scale (SDS), self rating anxiety scale (SAS) and GQOIL before and after investigation. Results There was no difference in GQOIL, SDS and SAS between the two groups before nursing intervention. After the holistie nursing intervention, the scores of SDS and SAS of the holistic nursing intervention group were significantly lower than that of the routine nursing group, the score of GQOIL was better than that of the routine nursing group. Conclusions The holistie nursing intervention obtains a better effect on managing the hypertensive cerebral hemorrhage patients with negative emotion disorder, it is effective in alleviating negative emotion and raising their quality of life.%目的 观察整体护理干预对高血压脑出血患者的负性情绪和生活质量的影响.方法 收集2006年6月-2008年12月住院的高血压脑出血伴负性情绪障碍患者112例,随机分为常规组和整体组各56例.常规组行高血压脑出血常规护理,整体组在常规护理基础上增加心理护理、健康教育和康复干预等措施,疗程4周.比较2组患者干预前后抑郁自评量表(SDS)、焦虑自评量表(SAS)以及生活质量综合评定问卷(GQOIL)评定的差异.结果 整体护理前2组的GQOIL、SDS

  2. Antithrombotic drugs and risk of hemorrhagic stroke in the general population

    DEFF Research Database (Denmark)

    García-Rodríguez, Luis A; Gaist, David; Morton, Jonathan;

    2013-01-01

    -based sampling was used to select 10,000 controls free from hemorrhagic stroke. Risk of hemorrhagic stroke was evaluated in current users and nonusers of antiplatelets and warfarin. Unconditional logistic regression models were used to adjust for age, sex, calendar year, alcohol, body mass index, hypertension...

  3. 产后出血患者的液体管理及其继发腹高压的危险因素%Fluid management and risk factors of intra-abdominal hypertension secondary to postpartum hemorrhage

    Institute of Scientific and Technical Information of China (English)

    王胤佳; 李超; 李志伟; 李立

    2016-01-01

    mol/L,t=5.33]均较治疗前降低,白蛋白[(24.45±4.80)与(21.35±5.69)g/L,t=-4.47]升高,差异均有统计学意义(P值均<0.05). 结论 产后出血患者合并子痫前期、大量输液及液体出量过少,均是发生腹高压的危险因素.腹高压对肝肾功能不利,并延长住院时间.采用液体负平衡治疗能降低腹内压,改善肝肾功能.%Objective To investigate fluid management and risk factors of intra-abdominal hypertension (IAH) after postpartum hemorrhage.Methods Clinical data of 64 patients of postpartum hemorrhage who were admitted to Intensive Care Unit (ICU) of the First People's Hospital of Kunming from January 2013 to January 2015 were collected.The patients were divided into IAH group and non-IAH group based on intra-abdominal pressure on admission to ICU.Diuresis or dialysis were offered to patients whose output exceeded 1 000 ml of their input after hospitalization.The background information,including maternal age,existence of pre-eclampsia and whether hysterectomy and transcatheter arterial embolization were performed,intra-abdominal pressure,liver and renal function and length of stay in hospital between the two groups were compared.The intra-abdominal pressure and liver and renal function before and 24 h after negative fluid administration of all subjects were compared as well.Independent-samples t test,paired-samples t test,Chisquare test and logistic regression analysis were applied for statistics.Results Among all of the 64 patients,15(23,4%) presented with IAH on admission,25 (39.1%) were complicated with preeclampsia,one (1.6%) had the uterus removed,and 16 (25.0%) had transcatheter arterial embolization performed.Within 12 h before admission,the average blood loss of the 64 women was (4 022± 1 275) ml,crystal solution input was (8 894±2 597) ml,colloidal fluid input was (343 ± 87) ml,blood products input was (1 370± 346) ml,total fluid input was (10 607± 2 825) ml,total fluid output was (5 176±2 334) ml

  4. Management of severe hypertension in pregnancy.

    Science.gov (United States)

    Moroz, Leslie A; Simpson, Lynn L; Rochelson, Burton

    2016-03-01

    While hemorrhage is the leading cause of maternal death in most of the world, hypertensive disorders of pregnancy are the leading cause of maternal mortality in the United States. The opportunity to improve outcomes lies in timely and appropriate response to severe hypertension. The purpose of this article is to review the diagnostic criteria for severe hypertension, choice of antihypertensive agents, and recommended algorithms for evaluation and management of acute changes in clinical status. Adhering to standard practices ensures that care teams can timely and appropriate care to these high risk patients. With heightened surveillance and prompt evaluation of signs and symptoms of worsening hypertension, maternal morbidity and mortality can be decreased.

  5. Post-thyroidectomy hemorrhage

    DEFF Research Database (Denmark)

    Godballe, Christian; Madsen, Anders Rørbaek; Pedersen, Henrik Baymler;

    2009-01-01

    risk factors for hemorrhage. Increased hospital stay and infection rates were found in patients treated with drainage. The median time for onset of postoperative hemorrhage was 3 h (range 0-105). Compared with international literature our incidence of post-thyroidectomy hemorrhage is relatively high....... Improvement might be reached by the exchange of experience between departments with focus on adequate surgical technique and careful hemostasis....

  6. The value of spiral CT in diagnose and curativ e effect of cerebral infarction following surgery for hypertensive cerebral hemorrhage%螺旋CT在高血压脑出血术后继发性脑梗死诊断及疗效观察中的价值

    Institute of Scientific and Technical Information of China (English)

    祝华强; 罗东梅; 邱其良; 刘奕仕; 陈建乐; 周才金

    2015-01-01

    目的:探讨螺旋CT在高血压脑出血术后早期脑缺血/脑梗死诊断及疗效观察中的价值。方法回顾分析我院2008—2014年间收治的25例高血压脑出血术后脑梗死病例影像资料。结果25例脑出血中基底节区15例,皮层区9例,脑室内1例,血肿破入脑室5例。术后出现脑梗死共72处(按脑叶统计),其中额叶12处(17%)、颞叶12处(17%)、顶叶11处(15%)、枕叶21处(29%)、小脑3处(4%)、脑干5处(7%)、基底节区8处(11%)。随诊观察治疗效果,经治疗除了6例病例死亡,其余病例经8~40 d随诊复查,10例脑梗死区密度恢复正常,4例病情好转转院治疗,5例脑梗死区出现脑软化灶。25例患者进行随访,按照目前常用的日常生活能力分级(GOS评分):GOS评分Ⅰ级3例(12%);GOS评分Ⅱ级8例(32%);GOS评分Ⅲ级5(20%),GOS评分Ⅳ级2例(8%),GOS评分Ⅴ级1例(4%);死亡6例(24%)。结论螺旋CT扫描速度快,检查时间短,对早期发现高血压脑出血术后继发脑梗死病变、及时治疗以提高患者的生存率,降低病残率以及估计其预后有重要的意义。%Objective To study the value of spiral CT in diagnose and curative effect of cerebral ischemia/infarction following surgery for hypertensive cerebral hemorrhage (HCH). Methods Retrospective analysis the CT image data 25 cases with cerebral infarction following the surgery for HCH, who were treated in our department from, 2008 to 2014. Results In 25 cases of cerebral infarction following surgery for hypertensive cerebral Hemorrhage. There were 15 cases of basis festival area cerebral hemorrhage, 9 cases of cortical hemorrhage, 1 cases of in-traventricular hemorrhage, 5 cases of hematoma broken into ventricles. Postoperative cerebral infarction were 72 points (according to the statistics), the frontal lobe were 12 points(17%), temporal lobe were 12 points(17%), parietal

  7. Brain computed tomography of the hypertensive patients

    Energy Technology Data Exchange (ETDEWEB)

    Bae, W. K.; Park, C. K.; Cho, O. K.; Hahm, C. K. [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

    1980-12-15

    Now a day, hypertension is more increasing in frequency and ranked the top of the causes of death in Korea and other nations. Most of cerebrovascular accidents in hypertensive patients are composed of vascular occlusive changes and hemorrhages. In cerebral angiogram, we can only detect occlusion of large artery and large mass effect from hematoma or cerebral infarction without identification of its entity. The computed tomogram, however, is the best way for evaluation of cerebrovascular diseases including detection of nature, location, amount, and associated changes. This study includes evaluation of computed tomograms of 106 patients with hypertension during the period of 17 months from Feb. 1979 to June 1980 in the department of radiology, college of Medicine, Hanyang University. The results were as follows. 1. Age distribution of the total 106 patients was broad ranging from 25 years to 76 years. 67.9% of patients were over the age of 50. The male and female sex ratio was 3:2. 2. 28 out of 106 patients were normal and 78 patients revealed abnormal on C. T. findings; those were intracranial hemorrhage (35 patients), cerebral infarction (32 patients) and brain atrophy (11 patients). 3. All of the intracranial hemorrhage except one were intracerebral hemorrhage; those were located in the cerebral hemisphere (19 patients), basal ganglia (15 patients) and brain stem (1 patient). The except one case of intracranial hemorrhage was subdural hematoma. 7 patients of intraventricular hemorrhage and 1 patient of subarachnoid hemorrhage were combined with intracerebral hemorrhage. 2/3 of patients who had hemorrhage in cerebral hemisphere revealed lesions in the parietal and temporal lobes. 4. In cases of cerebral infarction, the cerebral hemisphere was most common site of lesion (20 cases), and the next was basal ganglia (11 cases). Most of the infarcts in cerebral hemisphere were located in the parietal and temporal lobes. The left basal ganglia was more commonly involved

  8. The Clinical Value of MSCT in Forecasting the Upper Gastrointestinal Hemorrhage Caused by Portal Hypertension%多排螺旋CT在预测门静脉高压致上消化道大出血中的临床价值

    Institute of Scientific and Technical Information of China (English)

    杨肖华; 张锡龙; 汪国祥; 汪和平; 黄新宇; 周运锋

    2012-01-01

    目的 用多排CT测量门静脉系血管内径大小,从而评估其在预测门静脉高压致上消化道大出血中的临床价值.资料与方法 将门静脉高压患者分为上消化道出血组和未出血组,所有患者行64排螺旋CT增强扫描,以获取两组患者的门静脉、脾静脉、胃冠状静脉、食管胃底曲张静脉的直径,再将各血管直径分为不同等级资料,分别用方差分析两组间差异性、卡方分析不同等级资料间的差异性及各等级资料的出血患者百分比例、Logistic回归分析各血管在出血中的独立危险因素.结果 两组患者的门静脉、胃冠状静脉、食管胃底曲张静脉直径之间有显著差异性(P<0.05);各等级资料间有明显差异性(P<0.05),当门]静脉宽度≥18mm、胃冠状静脉宽度≥8mm、食管胃底曲张静脉宽度≥6 mm时出血的比例明显增加;胃冠状静脉、食管胃底曲张静脉宽度在该出血中是独立危险因素.结论 门静脉、胃冠状静脉、食管胃底曲张静脉的直径在预测上消化道出血中有明显意义.%Objective To investigate the clinical value of MSCT in forecasting the upper gastrointestinal hemorrhage caused by portal hypertension. Materials and Methods All the patients with portal hypertension received 64 slice CT enhanced scan,then patients were divided into bleeding group and no bleeding group. The diameter of portal vein,gastric coronary vein, spleen vein and gastroesophageal varices were measured, then the data were divided into three different grades. F test was used to detect the difference of the diameter of the two group, x2 test was used to detect the difference of the three grades,Logistic regression analysis was used to reveal the independent risk factor in all the blood vessel. Results There was difference between the diameter of the two groups, and also significant difference existed in the three grades, the percent of the patient with upper gastrointestinal

  9. Intraventricular hemorrhage of the newborn

    Science.gov (United States)

    ... bleeding. Grade 1 is also referred to as germinal matrix hemorrhage (GMH). Grades 3 and 4 involve ... Saunders; 2015:chap 60. Volpe JJ. Intracranial hemorrhage: germinal matrix-intraventricular hemorrhage. In Volpe JJ, ed. Neurology ...

  10. Management of Hypertension in Pregnancy

    Directory of Open Access Journals (Sweden)

    Nurike S Mudjari

    2015-03-01

    Full Text Available Hypertension-related maternal mortality reaches 16% when it is compared to other causes of maternal mortality such as sepsis, bleeding or abortus. Pregnant women with hypertension disorder are at increased risk for experiencing numerous complications including disseminated intravascular coagulation (DIC, cerebral hemorrhage, liver dysfunction and acute renal failure; while to the fetus, it may cause intrauterine growth retardation, prematurity and perinatal mortality. Hypertension in pregnancy should be managed appropriately to reduce maternal and fetal morbidity and mortality rate, i.e. by preventing women from getting the risks of increased blood pressure, preventing disease progression and preventing the development of seizure and considering termination of pregnancy in lifethreatening situation for maternal and fetal health. Key words: blood pressure, hypertension, eclampsia, preeclampsia, pregnant women, gestational.

  11. Clinical features of multiple spontaneous intracerebral hemorrhages

    Directory of Open Access Journals (Sweden)

    Tao CHANG

    2016-01-01

    Full Text Available Objective To analyze the clinical features of multiple spontaneous intracerebral hemorrhages (MICH. Methods Conservative therapy, puncture and drainage, hematoma removal and/or decompressive craniectomy were used in the treatment of 630 intracerebral hemorrhage (ICH patients, who were divided into 2 groups: 30 cases with MICH and another 600 cases with solitary intracerebral hemorrhage (SICH. Three months after onset, modified Rankin Scale (mRS was used to evaluate the prognosis of all cases. Results Compared with patients in SICH group, the occurrence rate of hypertension > 5 years (P = 0.008, diabetes mellitus (P = 0.024, hypercholesterolemia (P = 0.050 and previous ischemic stroke (P = 0.026 were all significantly higher in MICH group. The mean arterial pressure (MAP level (P = 0.002 and the incidence of limb movement disorder (P = 0.000 were significantly higher in patients with MICH than those with SICH. Basal ganglia and thalamus were the predilection sites of hematoma (P = 0.001. Patients with MICH had worse prognosis compared to those with SICH 3 months after onset (P = 0.006. Conclusions Hypertension > 5 years, diabetes mellitus, hypercholesterolemia and ischemic stroke were identified to be the pathophysiological basis of MICH in this study. All patients with MICH had more serious clinical manifestations after onset and worse prognosis. DOI: 10.3969/j.issn.1672-6731.2016.01.008

  12. Hemorrhagic prepatellar bursitis

    Energy Technology Data Exchange (ETDEWEB)

    Donahue, F. [Dept. of Radiology, Musculoskeletal Section, Univ. of Miami/Jackson Memorial Hospital, Miami, FL (United States); Turkel, D. [Dept. of Radiology, Musculoskeletal Section, Univ. of Miami/Jackson Memorial Hospital, Miami, FL (United States); Mnaymneh, W. [Dept. of Orthopedics, Univ. of Miami/Jackson Memorial Hospital, Miami, FL (United States); Ghandur-Mnaymneh, L. [Dept. of Pathology, Univ. of Miami/Jackson Memorial Hospital, Miami, FL (United States)

    1996-04-01

    Simple prepatellar bursitis is easily diagnosed both clinically and by MRI. MRI shows the typical T1 and T2 lengthening of fluid within the bursa. However, because of complex MRI appearance of hemorrhage, chronic hemorrhagic bursitis and the size of the prepatellar mass the clinical and MRI appearance can be very different. (orig.)

  13. Clinical Feature And Pathogeny Analysis Of Brain Hemorrhage In Young Adult Group

    Institute of Scientific and Technical Information of China (English)

    Wang Jianming; Zeng Xiaoyun

    2000-01-01

    Objection: The trend of brain hemorrhage cases of young adults have increased recently. In this article, We studied brain hemorrhage clinical feature and pathogenic causes of 72 young adults, Whose ages are all beneath 45Y. We found That the major pathogen reasons of young adult brain hemorrhage are blood system diseases、 arteriovenous malformation of cerebral blood vessel、 hypertension arteriosclerosis、 arteritis and rheumatic heart disease et. We also found that the trend can be related to hard work、 tense life、 drinking too much alcohol and eating high lipid food, and cercbral vascular disease family history. So in order to reduce the incidence of young adult brain hemorrhage, Young adults should not drink and smoke heavily, should not eat too much high lipid food. Young adults who have hypertension and brain vessel disease family history should be regularly measured blood pressure and blood lipid. If they had hypertension, should be treated regularly.

  14. Association of plasma levels of homocysteine,endothelin-1 and nitric oxide and hypertension with cerebral hemorrhage%高血压性脑出血与血浆同型半胱氨酸、内皮素1和一氧化氮的关系

    Institute of Scientific and Technical Information of China (English)

    王军; 张均

    2011-01-01

    Objective To investigate the relationship of plasma levels of homocysteine(Hcy), endothelin-1 (ET-1) and nitric oxide (NO) and hypertension with cerebral hemorrhage. Methods Plasma levels of Hcy, ET-1 and NO were examined in 62 patients with hypertension (group A), 45 patients with cerebral hemorrhage without hypertension(group B),60 hypertensive patients with cerebral hemorrhage(group C) and 40 healthy volunteers (group D). Results For groups of A,B,C and D,plasma levels of Hcy were (17. 6±6. 6) μmol/L, (18. 2±7. 2) μmol/L, (21. 9±6. 7) μmol/L and (10. 8±4. 6) μmol/L,those of ET-1 were (100. 7±11. 8) μg/L,(101. 2±12.1) μg/L,(120. 8+ 15. 9) μg/L and (44. 7±10. 6) μg/L,and those of NO were (57. 2±11. 7) mg/L,(58. 6±11. 2) mg/L, (41. 8±13. 2) mg/L and (120. 8±12. 6) mg/L,respectively. Compared with group D, plasma levels of Hcy and ET-1 were higher,but NO was lower in groups of A,B and C(P<0. 05). Plasma levels of Hcy and ET-1 were higher, but NO was lower in group C than those in groups of A and B(P<0. 05). The amount of cerebral hemorrhage was positively correlated to Hcy and ET-1, but negatively correlated with NO(P<0. 05). Conclusion The damage and dysfunction of the endothelial cells exist in the patients with hypertensive cerebral hemorrhage.%目的 探讨血浆同型半胱氨酸(Hcy)、内皮素1(ET-1)和一氧化氮(NO)水平与高血压及其合并脑出血的关系.方法 检测62例单纯高血压患者(A组)、45例单纯脑出血患者(B组)、60例高血压性脑出血患者(C组)和40名健康体检者(D组)血浆Hcy、ET-1和NO的水平.结果 A、B、C和D组的血浆Hcy分别为(17.6±6.6) μmol/L、(18.2±7.2)μmol/L、(21.9±6.7)μmol/L和(10.8±4.6)μmol/L;ET-1分别为(100.7±11.8)μg/L、(101.2±12.1)μg/L、(120.8±15.9)μg/L和(44.7±10.6)μg/L;NO分别为(57.2±11.7) mg/L、(58.6±11.2)m g/L、(41.8±13.2) mg/L和(120.8±12.6)mg/L.与D组比较,A、B和C组Hcy和ET-1水平升高,NO水平降低(P<0.05);C组Hcy和ET-1

  15. Risk factors for medical complications of acute hemorrhagic stroke

    Institute of Scientific and Technical Information of China (English)

    Jangala Mohan Sidhartha; Aravinda Reddy Purma; Nagaswaram Krupa Sagar; Marri Prabhu Teja; Meda Venkata subbaiah; Muniswami Purushothaman

    2015-01-01

    Objective: To assess the risk factors leading to medical complications of hemorrhagic stroke. Methods: We conducted an observational study in neurology, emergency and general medicine wards at a tertiary care teaching hospital in Kadapa. We recruited hemorrhagic stroke patients, and excluded the patients have evidence of trauma or brain tumor as the cause of hemorrhage. We observed the subjects throughout their hospital stay to assess the risk factors and complications. Results: During period of 12 months, 288 subjects included in the study, 89% of them identified at least 1 prespecified risk factor for their admission in hospital and 75% of them experienced at least 1 prespecified complication during their stay in hospital. Around 47% of subjects deceased, among which 64% were females. Conclusions: Our study has assessed that hypertension followed by diabetes mellitus are the major risk factors for medical complications of hemorrhagic stroke. Female mortality rate was more when compared to males.

  16. PECULIAR PROPERTIES OF ANTITHROMBOTIC THERAPY IN PATIENTS WITH ARTERIAL HYPERTENSION. IS IT POSSIBLE TO DO THE TREATMENT SAFE?

    Directory of Open Access Journals (Sweden)

    I. V. Zotova

    2011-01-01

    Full Text Available Arterial hypertension (HT is a reason for raising a question about need for antithrombotic therapy. At the same time, increased blood pressure associated with an increased risk of hemorrhagic complications. Possible ways to minimize the hemorrhagic risk in different groups of hypertensive patients who need in antithrombotic therapy are discussed.

  17. Clinic application of serum low-density lipoprotein cholesterol level in predicting expansion hematoma in elderly male patients with acute hypertensive intracerebral hemorrhage%血清LDL-C水平对老年男性高血压性脑出血血肿扩大的预测作用

    Institute of Scientific and Technical Information of China (English)

    周红霞; 刘首峰; 李玉旺; 王欣; 徐小林

    2015-01-01

    Objective To investigate whether serum level of low-density lipoprotein cholesterol can predict the expan⁃sion of hemorrhage growth in elderly male patients with acute hypertensive intracerebral hemorrhage. Methods Patients (n=108) who visited our hospital with from June 2012 until May 2014 spontaneous hypertensive intracerebral hemorrhage with⁃in 6 hours of onset which is confirmed by initial computed tomography (CT) were sent to repeated CT within 24 hours of on⁃set. All selected patients were divided into the LDL-C≥2.49 mmol/L group and LDL-C<2.49 mmol/L group. Clinical data of these 2 groups were compared and the relationships of hematoma growth and its risk factors were analyzed. Results Baseline blood pressure, the level of blood glucose, PT, APTT, FIB, PLT and hemorrhage volume did not differ significantly between the LDL-C≥2.49 mmol/L group and LDL-C<2.49 mmol/L group. The ratio of hemorrhage growth in LDL-C<2.49 mmol/L group was significantly higher than that in LDL-C≥2.49 mmol/L group (34.21%vs 11.43%). Multiple logistic regres⁃sion analysis showed that LDL-C<2.49 mmol/L was the only risk factor contribute to hemorrhage growth. Conclusion Pa⁃tients with LDL-C<2.49 mmol/L in acute intracerebral hemorrhage are of high risk of hemorrhage growth so early attention and appropriate procedure are needed to prevent or slow its growth.%目的:探讨血清低密度脂蛋白胆固醇(LDL-C)水平对老年男性高血压性脑出血急性期血肿扩大有无预测作用。方法收集我院2012年6月—2014年5月发病6 h以内的老年男性高血压性脑出血患者108例,按发病时LDL-C水平分为LDL-C<2.49 mmol/L组和LDL-C≥2.49 mmol/L组,对2组患者入院时的收缩压(SBP)、舒张压(DBP)、血糖水平、凝血酶原时间(PT)、部分活化凝血酶时间(APTT)、纤维蛋白原(FIB)、血小板计数、血肿体积进行对比分析,并于发病24 h复查头CT了解2组血肿扩大情况并进

  18. Research progress of vasculopathy in portal hypertension

    Institute of Scientific and Technical Information of China (English)

    Tao Li; Zhen Yang

    2005-01-01

    Portal hypertension, one of the vascular diseases, not only has lesions in liver, but also changes in vascular structures and functions of extrahepatic portal system, systemic system and pulmonary circulation. The pathological changes of vasculopathy in portal hypertension include remodeling of arterialized visceral veins, intimal injury of visceral veins and destruction of contractile structure in visceral arterial wall. The mechanisms of vasculopathy in portal hypertension may be attributed to the changes of hemodynamics in portal system, immune response, gene modulation, vasoactive substances, and intrahepatic blood flow resistance. Portal hypertension can cause visceral hyperdynamic circulation, and the development and progression of visceral vasculopathy,while visceral vasculopathy can promote the development and progression of portal hypertension and visceral hyperdynamic circulation in turn. The aforementioned three factors interact in the pathogenesis of hepatic cirrhosisinduced portal hypertension and are involved in hemorrhage due to varicose vein rupture.

  19. 微创联合依达拉奉对高血压脑出血患者 MMP-9的影响及疗效观察%Influence of minimally invasive combined edaravone on MMP-9 of hypertensive patients with cerebral hemor-rhage and its curative effect

    Institute of Scientific and Technical Information of China (English)

    苏彦果; 袁发东; 李建明; 贾婕; 高钟生

    2014-01-01

    Objective To observe the minimally invasive combined edaravone on the serum of patients with hypertensive cerebral hemorrhage matrix metalloproteinase-9 (MMP-9) impact.Methods A retrospective analysis of 80 cases of cerebral hemorrhage patients in our hospital from January 2011-2013 in December ,who were randomly divided into observation group and control group ,40 cases in each group ,the control group was given conventional treatment ,the observation group was ob-served in the conventional treatment group based on the use of edaravone ,continued drug were used for about 2 weeks ,the ser-um levels of MMP-9 ,and recorded the NIHSS score and BI index were detected.Results Serum MMP-9 levels before treat-ment showed no significant difference (P> 0.05) ,and significant differences after treatment (t= 11.2636 , P0.05) ,and BI con-tent MESSS significant difference after treatment in both groups (respective t=3.1762 ,3.9890 ,all P<0.01).Conclusion Min-imally invasive and edaravone on MMP-9 in patients with hypertensive intracerebral hemorrhage are mainly for inhibition , which can effectively reduce the patients 'inflammatory response after cerebral hemorrhage ,protect brain cells function ,it is worthy of promotion and application.%目的:观察微创联合依达拉奉对高血压脑出血患者血清基质金属蛋白酶-9(MMP-9)的影响。方法回顾性分析我院2011-01-2013-12收治的80例脑出血患者,随机分为观察组和对照组各40例,对照组给予常规治疗,观察组在常规治疗的基础上加用依达拉奉治疗,持续用药2周,检测2组血清 MMP-9水平,并记录NIHSS评分和BI指数。结果血清MMP-9含量治疗前差异无统计学意义(P>0.05),治疗后差异有统计学意义(t=11.2636,P<0.01);治疗前2组MESSS和BI差异无统计学意义(P均>0.05),治疗后2组中MESSS和BI含量差异有统计学意义(t=3.1762、3.9890,P均<0.01)。结论微创联合依达拉奉对高

  20. Clinical observation of treatment of hypertensive cerebral hemorrhage with minimally invasive surgery combined with mild hypothermia therapy%微创血肿清除术联合亚低温治疗高血压脑出血临床观察

    Institute of Scientific and Technical Information of China (English)

    张卫华; 韩增灿; 张玉清

    2010-01-01

    目的 研究微创血肿清除术联合亚低温治疗高血压脑出血的临床疗效.方法 将128例高血压脑出血患者分为3组:常规治疗组行内科保守治疗;微创治疗组在常规治疗的同时行微创血肿清除术;联合治疗组行常规治疗+微创血肿清除术+亚低温治疗.比较3组治疗前后神经功能缺损评分(NIHSS)和治疗后随访90 d时的日常生活能力Barthel指数.结果 治疗30、90 d后NIHSS评分联合治疗组[(6.4±4.2)分、(1.9±1.2)分]低于微创治疗组[(8.1±2.7)分、(3.2±2.4)分],微创治疗组低于常规治疗组[(9.9±3.2)分、(5.4±1.7)分](均P<0.05);治疗90 d后Barthel指数微创治疗组为(56.4±36.2)分,大于常规治疗组的(40.6±21.2)分,联合治疗组为(78.7±51.9)分,大于微创治疗组,差异均有统计学意义(P<0.05).结论 微创血肿清除术和亚低温联合治疗高血压脑出血可明显降低病死率和致残率,有利于神经功能恢复.%Objective To explore the clinical effect of minimally invasive surgery combined with mild hypothermia in treatment of hypertensive cerebral hemorrhage. Methods One hundred and twenty-eight cases with hypertensive cerebral hemorrhage were divided into three groups randomly: standard therapy group with medical conservative treatment; minimally invasive surgery group with cleaning intracranial hemorrhage at the time of medical therapy; combined therapy group with medical therapy and cleaning intracranial hemorrhage at the time of mild hypothermia therapy. Three groups with the National institute of Health Stroke scale (NIHSS) score was compared. The clinical therapeutic effects and Barthel index which was accessed in both groups before treatment and ninety days later. Results The total clinical NIHSS was lower than minimally invasive surgery group,the NIHSS in minimally invasive surgery group was lower than the medical therapy group ( P < 0.05 ); after 90 days, the barthel index ( 56.36 ±36.16) in the minimally

  1. 颅内血肿钻孔引流术后早期应用补阳还五汤治疗高血压脑出血的效果观察%Effect observation of early application of Buyang Huanwu decoction in the treatment of hypertensive cerebral hemorrhage after the operation of drilling drainage

    Institute of Scientific and Technical Information of China (English)

    景志军; 杨建青; 刘亚宁; 李永利; 杨维艳; 周瑞涛; 毕艳平

    2015-01-01

    Objective To explore the effect of early application of Buyang Huanwu decoction in the treatment of hyper-tensive cerebral hemorrhage after the operation of drilling drainage. Methods 150 patients with hypertensive cerebral hemorrhage from March 2013 to February 2015 in our hospital were selected and randomly divided into the treatment group and the control group,75 cases in each group.The control group was treated with drilling drainage and taken care of in routine treatment of western medicine,the treatment group was treated with Buyang Huanwu decoction by orally or nasal feeding on the basis of the control group.The effect in two groups was compared. Results The proportion of con-scious awareness in the treatment group was higher than that in the control group,the recovery time of the conscious-ness in the treatment group was shorter than that in the control group,with significant difference (P<0.05).The recovery condition of limb muscle strength in the treatment group was better than that in the control group,with significant differ-ence (P<0.05). The proportion of language clarity in the treatment group was higher than that in the control group,with significant difference (P<0.05).The cure rate,the healing rate and the total effective rate in the treatment group was higher than that in the control group,with significant difference (P<0.05). Conclusion The curative effect of early appli-cation of Buyang Huanwu decoction in the treatment of hypertensive cerebral hemorrhage after the operation of drilling drainage is significant better than that in simple surgical treatment.%目的:探讨高血压脑出血患者行钻孔引流术后早期应用补阳还五汤的效果。方法选取本院2013年3月~2015年2月收治的150例高血压脑出血患者作为研究对象,随机分为治疗组和对照组,各75例。对照组采用颅内血肿钻孔引流术,并给予西医常规治疗,治疗组在对照组的基础上给予补阳还五汤加减鼻饲或口

  2. 经额上沟入路神经内镜手术治疗高血压脑出血疗效分析%Curative effect analysis of neuroendoscopic surgery via superior frontal sulcus in the treatment of ;hypertensive intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    陶亮; 陈治标; 张华平

    2016-01-01

    Objective To investigate the surgical technique and the curative effects of neuroendoscopic surgery via superior frontal sulcus in the treatment of hypertensive intracerebral hemorrhage. Methods The clinical data of 63 patients with hypertensive intracerebral hemorrhage were analyzed retrospectively. Thirty-one of them were treated by neuroendoscopic surgery via superior frontal sulcus(neuroendoscopic surgery group), and 32 of them were treated by mini- invasive drainage (conventional therapy group). All of them were followed up for 6 months, and were assessed by the activity of daily living (ADL) scale. Results After treatment, all patients reviewed CT. The clear rate of hematoma in neuroendoscopic surgery group was 86.0%, in conventional therapy group was 23.3%, and there was significant difference (P<0.05). There were one death case in neuroendoscopic surgery group and 2 death cases in conventional therapy group. The survival patients were followed up for 6 months .The rate of better prognosis in neuroendoscopic surgery group was 83.3%(25/30), in conventional therapy group was 53.3%(16/30), and there was significant difference (P<0.05). Conclusions The surgical technique of neuroendoscopic surgery via superior frontal sulcus in the treatment of hypertensive intracerebral hemorrhage is safe and effective.%目的:探讨经额上沟入路神经内镜辅助脑内血肿清除术治疗高血压脑出血的手术策略及治疗效果。方法63例高血压脑出血患者,31例行经额上沟入路神经内镜辅助脑内血肿清除术(内镜辅助组),32例行常规微创穿刺引流术(常规治疗组)。术后随访6个月,应用日常生活量表(ADL)进行评定并比较。结果术后复查头颅CT,内镜辅助组血肿清除率为86.0%。常规治疗组血肿清除率为23.3%,两组血肿清除率比较差异有统计学意义(P<0.05)。内镜辅助组死亡1例,常规治疗组死亡2例。存活患者术后随访6个月,内镜

  3. 护理干预对尼莫地平治疗老年高血压脑出血患者依从性及满意度的影响%Influence of Nursing InterVention on the Compliance and Nursing Satisfaction Degree for Elderly Patients with HypertensiVe Cerebral Hemorrhage Treated by Nimodipine

    Institute of Scientific and Technical Information of China (English)

    万丽萍

    2015-01-01

    目的 探讨护理干预对尼莫地平治疗老年高血压脑出血患者依从性、护理满意度的影响.方法 将80例接受尼莫地平治疗的老年高血压脑出血患者随机分为对照组(常规护理)和观察组(护理干预),各40例,比较两组日常生活活动能力评定量表(Barthel指数)、功能独立性评定量表(FIM),以及患者对治疗的依从性和护理满意度.结果 与对照组相比,观察组Barthel评分(79. 6 ± 7. 2比64. 1 ± 8. 3)分和 FIM 评分(92. 3 ± 9. 1 比 81. 4 ± 8. 6)分均明显升高( P<0. 05);与对照组相比,观察组患者对治疗依从性(95. 00% 比75. 00%)明显提高( P<0. 05 );与对照组相比,观察组患者对护理服务的满意度(95. 00% 比77. 50%)明显提升( P<0. 05).结论 尼莫地平治疗老年高血压脑出血期间,有效的护理干预能明显提高患者对治疗的依从性,提升患者预后质量及护理满意度.%Objective To study the effect of nursing intervention on the compliance and nursing satisfaction degree for elderly patients with hypertensive cerebral hemorrhage treated by nimodipine. Methods 80 elderly patients with hypertensive cerebral hemorrhage treated by nimodipine in the hospital during the period were randomly divided into the control group ( routine nursing ) and the observation group ( nursing intervention ) , 40 cases in each group. The quality of life scores ( Barthel ) , the ability scores of daily living activity ( FIM ) , the patients' adherence to treatment and nursing satisfaction degree in the two groups were compared. Results Compared with the control group, the scores of Barthel(79. 6 ± 7. 2 vs 64. 1 ± 8. 3)and FIM(92. 3 ± 9. 1 vs 81. 4 ± 8. 6)were significantly increased in the observation group ( P < 0. 05 );compared with the control group, the patients' adherence to treatment (95. 00% vs 75. 00%)was obviously increased in the observation group ( P < 0. 05 );compared with the control group, the patients' satisfaction degree

  4. Intervention effect of nimodipine in the treatment of patients both with hypertensive ventricular hemorrhage and central fever in early stage%早期应用尼莫地平对高血压性脑室出血患者中枢性发热的干预作用

    Institute of Scientific and Technical Information of China (English)

    黄志研

    2012-01-01

    目的 探讨早期应用尼莫地平对高血压性脑室出血患者中枢性发热的干预作用.方法 选择我科2008年2月至2010年7月收治的经确诊为高血压性脑室出血的病例46例,并随机分为实验组(实施尼莫地平治疗)及对照组(不实施尼莫地平治疗)各23例,随访1个月后,比较两组患者并发中枢性发热病例的分布差异.结果 随访1个月,无中途退出病例,其中,实验组并发中枢性发热13例(高热3例,中低热10例),无死亡病例;对照组并发中枢性发热15例(高热10例,中低热5例),死亡1例.两组患者中枢性发热病例的分布差异无统计学意义(x2=0.807,P=0.369>0.05),而中枢性高热病例的分布差异则具有统计学意义(x2=3.939,P=0.047<0.05).结论 早期应用尼莫地平可降低高血压性脑室出血并发中枢性发热患者的发热程度,可能对于改善该类患者的预后具有肯定意义.%Objective To explore the effect of nimodipine on treating patients both with hypertensive ventricular hemorrhage and central fever in the early stage. Methods Forty-six patients with hypertensive ventricular hemorrhage from Feb.2008 to JuL 2010 were selected and randomly divided into experimental group (23 cases, treated with nimodipine) and controlled group (23 cases, treated with nimodipine). Distribution of patients with central fever was compared in both groups after following up for 1 month. Results After following up for 1 month, 13 patients were found with central fever and 3 with hyperpyrexia, 10 with rnild-moderate fever in the experimental group, but in the controlled group, 15 patients were found with central fever and 10 with hyperpyrexia, 5 with mild-moderate fever. There was no dead case in the experimental group but 1 case in the controlled group. The distribution of patients with central fever in both groups has no statistical significance (x2=0.807, P=0.369), but when compared with the distribution of patients with central high

  5. Blood and cerebrospinal fluid levels of brain-derived neurotrophic factor in patients with hypertensive cerebral hemorrhage and their correlation with recovery of neurological functions%高血压脑出血患者脑源性神经营养因子水平变化及其与神经功能的相关性研究

    Institute of Scientific and Technical Information of China (English)

    陈胜利; 龚涛; 李长清; 张书琼; 李莉

    2011-01-01

    Brain-derived neurotropic factor (BDNF) contents in blood and cerebrospinal fluid (CSF) were detected by ELISA method in 30 cases of hypertensive cerebral hemorrhage (HCH group) and 30 healthy subjects (control group).The performance and neurological functions of patients were evaluated by National Institutes of Health Stroke Scale( NIHSS),Hamilton Depression Scale ( HAMD),Barthel Index of Daily Living Skills.The result showed that the contents of BDNF in blood and CSF of HCH patients in recovery stage were significantly higher than those in acute stage and those of control group ( P < 0.05 ) ; the contents of BDNF in blood and CSF were negatively correlated with neurological impairment degree ( P <0.05).The results suggest that BDNF in the blood or the CSF may promote the recovery of neurological function in patients with hypertensive cerebral hemorrhage.%采用ELISA法检测30例高血压脑出血患者(观察组,因检测时间点不同而分为M1、M2亚组),30名正常人(对照组)血液和脑脊液中脑源性神经营养因子(BDNF)的含量;用美国国立卫生院神经功能评分量表(NIHSS)、汉密顿抑郁量表(HAMD)、日常生活能力Barthel指数对观察组患者按不同的时间点(发病后≤7 d,发病后≥21 d)进行评分.结果显示高血压脑出血患者恢复期血液和脑脊液BDNF显著高于急性期患者和对照组(P<0.05);血液和脑脊液BDNF含量与出院时神经功能缺损程度呈显著负相关(P<0.05).脑脊液或血液中的BDNF对高血压脑出血患者神经功能的恢复具有促进作用.

  6. Hypertensive Crisis

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Hypertensive Crisis: When You Should Call 9-1-1 for ... 18,2017 Know the two types of HBP crisis to watch for A hypertensive ( high blood pressure ) ...

  7. Portal Hypertension

    Science.gov (United States)

    ... Obesity to Liver Cancer Additional Content Medical News Portal Hypertension By Steven K. Herrine, MD, Thomas Jefferson ... Liver Hepatic Encephalopathy Jaundice in Adults Liver Failure Portal Hypertension (See also Overview of Liver Disease .) Portal ...

  8. Pulmonary Hemorrhage in Cryoglobulinemia

    Directory of Open Access Journals (Sweden)

    G Kirkpatrick

    2015-01-01

    Full Text Available Pulmonary manifestations of cryoglobulinemia are uncommon and their clinical behaviour is unpredictable, ranging from mild dyspnea to life-threatening presentations. A patient with cryoglobulinemia who presented with hypoxic respiratory failure attributed to pulmonary hemorrhage is reported.

  9. Title:- retrobulbar hemorrhage

    African Journals Online (AJOL)

    Dr.Gagan

    Department of Oral and Maxillofacial Surgery, AB Shetty Memorial Institute of Dental Sciences, Mangalore. 1. Department of .... technique of orbital decompression that involves fracturing the orbital ... hemorrhage after retrobulbar anesthesia.

  10. Unidentified coagulation disorders in post-tonsillectomy hemorrhage.

    Science.gov (United States)

    Windfuhr, Jochen P; Chen, Yue-Shih; Remmert, Stephan

    2004-01-01

    We conducted a retrospective study of 6,966 patients who had undergone tonsillectomy or adenotonsillectomy to evaluate the incidence and clinical features of previously unidentified coagulation disorders in patients who experienced postoperative hemorrhage (n = 201). We found that post-tonsillectomy hemorrhage secondary to unidentified coagulation disorders is extremely rare. However, normal coagulation values and an insignificant history do not rule out coagulation disorders. If diffuse, persistent, and bilateral bleeding is not related to arterial hypertension, dissection technique, or local infection, a rapid and detailed analysis of coagulation factors should be considered.

  11. Management of hypertension in pregnancy.

    Science.gov (United States)

    Mudjari, Nurike S; Samsu, Nur

    2015-01-01

    Hypertension-related maternal mortality reaches 16% when it is compared to other causes of maternal mortality such as sepsis, bleeding or abortus. Pregnant women with hypertension disorder are at increased risk for experiencing numerous complications including disseminated intravascular coagulation (DIC), cerebral hemorrhage, liver dysfunction and acute renal failure; while to the fetus, it may cause intrauterine growth retardation, prematurity and perinatal mortality. Hypertension in pregnancy should be managed appropriately to reduce maternal and fetal morbidity and mortality rate, i.e. by preventing women from getting the risks of increased blood pressure, preventing disease progression and preventing the development of seizure and considering termination of pregnancy in life-threatening situation for maternal and fetal health.

  12. Efficacy of Stereotactic Catheter Indwelt Hematoma Aspiration in Patients with Hypertensive Intracerebral Hemorrhage:Meta-analysis%立体定向软通道颅内血肿清除术与内科保守治疗高血压性脑出血疗效的Meta分析

    Institute of Scientific and Technical Information of China (English)

    孟曙庆; 张洪; 黎黎

    2014-01-01

    Objective To evaluate stereotactic catheter indwelt hematoma aspiration in patients with hypertensive intracerebral hemorrhage. Methods Cochrane database of systematic review (CENTRAL), MEDLINE, Excerpta Medica Database (EMbase), Physiotherapy Evidence Database, Open System for Information on Grey Literature in Europe (OpenSIGLE), National Technical Information Service (NTIS), China National Knowledge Infrastructure (CNKI), VIP, Wanfang data, and China Biology Medicine disc (CBMdisc) were searched for the randomized controlled trials (RCTs) of stereotactic catheter indwelt hematoma aspiration in patients with hypertensive intracerebral hemorrhage from the data of establishment of the databases to December 2012. The bibliographies of included studies were searched, too. Two researchers evaluated the included studies using grading of recommendations assessment, development and evaluation (GRADE). The extract data were analyzed by RevMan 5.2 and GRADE proifler 4.0.3. Results A total of 11 trials were discovered. Meta-analysis showed that there were significant differences in clinical beneift, fatality rate, infection, and rebleeding in stereotactic catheter indwelt hematoma aspiration in patients with hypertensive intracerebral hemorrhage compared with initial conservative treatment (odds ratio [OR] 3.34, 95%conifdence interval [CI] 2.13 to 5.22;OR 0.42, 95%CI 0.29 to 0.60;OR 0.42, 95%CI 0.27 to 0.64;and OR 0.47, 95%CI 0.28 to 0.77). The four outcomes were all of low quality in the GRADE system. Conclusion The current evidence shows stereotactic catheter indwelt hematoma aspiration in patients with hypertensive intracerebral hemorrhage was effective whereas reduction in the numbers of fatality rate, infection and rebleeding and increase at clinical benefit at the end of 3 months, compared with initial conservative treatment. The clinician should recommend it for its simplicity, low input costs, low operating costs and fewer side effects. Due to the limitations of the

  13. 高血压脑出血手术后合并糖尿病非酮症高渗性昏迷的临床抢救措施%After Operation of Hypertensive Intracerebral Hemorrhage Combined With Clinical Measures to Rescue the Diabetic non Ketotic Hyperosmolar Coma

    Institute of Scientific and Technical Information of China (English)

    田振宇

    2015-01-01

    Objective To study the analysis of operation treatment of hypertensive cerebral hemorrhage, diabetic non ketotic hyperosmolar coma first-aid measures.Method select 2014.01—2015.01 during operation in our hospital to accept the treatment of patients with hypertensive cerebral hemorrhage in 25 cases, postoperative were complicated with diabetes in non with hyperosmolar coma, timely according to the rescue and treatment of.Results after the rescue after the treatment, all the patients blood glucose, serum sodium, serum potassium and plasma osmotic pressure of water on average significantly decrease, the difference has statistical significanceP<0.05. This group of 25 patients, 13 cases of self-care, 5 cases of partial self-care, 5 cases of vegetative state, 2 cases of death.Conclusion the effect of operation treatment and prognosis after intracerebral hemorrhage complicated with diabetic nonketotic hyperosmolar coma is very poor, clinical must be early diagnosis, timely correct dehydration, rehydration, maintain water electrolyte balance, rational application of insulin, most likely to improve the success rate of rescue.%目的:研究分析高血压脑出血手术治疗后,并发糖尿病非酮症高渗性昏迷的急救措施。方法选择2014年1月—2015年1月期间在该院接受手术治疗的25例高血压脑出血患者,术后均并发糖尿病非同症高渗性昏迷,及时给予针对性的抢救治疗。结果经抢救治疗后,全部患者的血糖、血钠、血钾以及血浆渗透压水平均显著降低,差异有统计学意义P<0.05。本组25例患者中,生活自理者13例,部分生活自理者5例,植物生存者5例,死亡者2例。结论手术治疗高血压脑出血后合并糖尿病非酮症高渗性昏迷的预后效果很差,临床必须及早确诊,及时纠正脱水、补液、维持水电解质平衡,合理应用胰岛素,最可能提高抢救的成功率。

  14. Portal hypertensive enteropathy

    Institute of Scientific and Technical Information of China (English)

    Parit Mekaroonkamol; Robert Cohen; Saurabh Chawla

    2015-01-01

    Portal hypertensive enteropathy (PHE) is a conditionthat describes the pathologic changes and mucosalabnormalities observed in the small intestine of patientswith portal hypertension. This entity is being increasinglyrecognized and better understood over the past decadedue to increased accessibility of the small intestine madepossible by the introduction of video capsule endoscopyand deep enteroscopy. Though challenged by its diverseendoscopic appearance, multiple scoring systems havebeen proposed to classify the endoscopic presentationand grade its severity. Endoscopic findings can be broadlycategorized into vascular and non-vascular lesions withmany subtypes of both categories. Clinical manifestationsof PHE can range from asymptomatic incidental findingsto fatal gastrointestinal hemorrhage. Classic endoscopicfindings in the setting of portal hypertension may leadto a prompt diagnosis. Occasionally histopathologyand cross sectional imaging like computed tomographyor magnetic resonance imaging may be helpful inestablishing a diagnosis. Management of overt bleedingrequires multidisciplinary approach involving hepatologists,endoscopists, surgeons, and interventionalradiologists. Adequate resuscitation, reduction of portalpressure, and endoscopic therapeutic intervention remainthe main principles of the initial treatment. This articlereviews the existing evidence on PHE with emphasison its classification, diagnosis, clinical manifestations,endoscopic appearance, pathological findings, and clinicalmanagement. A new schematic management of ectopicvariceal bleed is also proposed.

  15. A retrospective study of spontaneous intracranial hemorrhage

    Directory of Open Access Journals (Sweden)

    Eka J. Wahjoepramono

    2016-02-01

    Full Text Available Spontaneous intracerebral hemorrhage (SICH is a serious disease despite progressing medical knowledge. SICH appears suddenly without warning, unlike ischemic strokes that are often preceded by a transient ischemic attack. Outcome is determined by the initial severity of the bleeding; mortality and morbidity of SICH are high. The aim of this study was to describe the characteristics of type, location, and outcome of SICH. A retrospective review was conducted on the records of 2042 cases admitted to a private hospital in Karawaci, Tangerang, between 1 January 1996 to 31 December 2008. Analysis was done on type, location, and the final outcome measures by the Glasgow Outcome Scale (GOS. The results of the study showed that the most prevalent type of SICH was hypertensive stroke, amounting to 1698 cases (83.1%, and the least commonly encountered type was dural fistula totaling  5 cases (0.3%. SICH due to hypertensive stroke frequently occurred in the basal ganglia (50.8% comprising the putamen, caudate nucleus and globus pallidus. On average, the outcome at the time of dismissal was good, where 105 cases (88.2% were GOS 4 and 5. SICH requires prompt and appropriate management. Therefore the signs and symptoms of intracranial hemorrhage should be promptly recognized and followed by appropriate ancillary examinations in order to promptly determine the management required, including possible surgical interventions.

  16. Remote cerebellar hemorrhage after lumbar spinal surgery

    Energy Technology Data Exchange (ETDEWEB)

    Cevik, Belma [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Cad. 10. sok. No: 45, Bahcelievler, Ankara 06490 (Turkey)], E-mail: belmac@baskent-ank.edu.tr; Kirbas, Ismail; Cakir, Banu; Akin, Kayihan; Teksam, Mehmet [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Cad. 10. sok. No: 45, Bahcelievler, Ankara 06490 (Turkey)

    2009-04-15

    Background: Postoperative remote cerebellar hemorrhage (RCH) as a complication of lumbar spinal surgery is an increasingly recognized clinical entity. The aim of this study was to determine the incidence of RCH after lumbar spinal surgery and to describe diagnostic imaging findings of RCH. Methods: Between October 1996 and March 2007, 2444 patients who had undergone lumbar spinal surgery were included in the study. Thirty-seven of 2444 patients were scanned by CT or MRI due to neurologic symptoms within the first 7 days of postoperative period. The data of all the patients were studied with regard to the following variables: incidence of RCH after lumbar spinal surgery, gender and age, coagulation parameters, history of previous arterial hypertension, and position of lumbar spinal surgery. Results: The retrospective study led to the identification of two patients who had RCH after lumbar spinal surgery. Of 37 patients who had neurologic symptoms, 29 patients were women and 8 patients were men. CT and MRI showed subarachnoid hemorrhage in the folia of bilateral cerebellar hemispheres in both patients with RCH. The incidence of RCH was 0.08% among patients who underwent lumbar spinal surgery. Conclusion: RCH is a rare complication of lumbar spinal surgery, self-limiting phenomenon that should not be mistaken for more ominous pathologic findings such as hemorrhagic infarction. This type of bleeding is thought to occur secondary to venous infarction, but the exact pathogenetic mechanism is unknown. CT or MRI allowed immediate diagnosis of this complication and guided conservative management.

  17. The Variation of CRP and the TNF-α in the Vupratentorial Hypertensive Cerebral Hemorrhage after Surgical Treated with Small Bone and the Relationship to the Patient's Condition and Prognostic%幕上高血压脑出血小骨窗开颅术后C反应蛋白及TNF-α的变化及对转归影响的临床分析

    Institute of Scientific and Technical Information of China (English)

    廖鑫; 王佳唐; 罗东; 何俊; 吴昌松; 梁敬心

    2012-01-01

    Objective: To investigate the role and the rules of Tumor necrosis factor alpha and C-reactive protein of patients after surgical treated with small bone with supratentorial hypertensive cerebral hemorrhage and relation with the GCS. Methods: 38 cases diagnosed supratentorial hypertensive intracerebral hemorrhage were given surgery underwent eraniotomy with small bone window after a clear indication. The levels of CRP and TNF-αwere detected before and at 1 day, 7 days and 14 days after surgical treatment, and the Glasgow coma score (GCS) also determination. We also have 30 cases as control of the CRP and TNF-α. Results: Preoperative serum CRP and TNF-α levels were significantly higher than the control group. Postoperative CRP and TKF-α levels continued to rise,but decreased after 7 days of surgical treatment. The levels of CRP and TNF-α are closely associated with the GCS score. Conclusions: CRP and TNF-α levels may reflect patient's condition and prognostic with hypertensive intracerebral hemorrhage.%目的:探索幕上高血压脑出血术前及小骨窗开颅术后C反应蛋白(CRP)及肿瘤坏死因子α(TNF-α)的变化与病情的关系及对患者临床预后的预测价值.方法:38例诊断为幕上高血压脑出血的患者,在明确手术指征后行小骨窗开颅术,于术前,术后第1天,第7天,第14天监测患者的CRP及TNF-α的水平;并同时测定格拉斯哥昏迷评分(GSS).另设30例作为正常对照病例,一次性抽取静脉血进行CRP及TNF-α进行检测.结果:①术前脑出血患者血中CRP与TNF-α的水平显著高于正常对照组;②术后CRP与TNF-α的水平仍继续上升,术后第7天显著下降;③CRP及TNF-α的水平与GCCS评分密切相关.结论:CRP与TNF-α的水平可反映脑出血患者的病情,对病情转归有预测意义.

  18. Reversible Cerebral Vasoconstriction Syndrome with Intracranial Hypertension: Should Decompressive Craniectomy Be Considered?

    Science.gov (United States)

    Mrozek, Ségolène; Lonjaret, Laurent; Jaffre, Aude; Januel, Anne-Christine; Raposo, Nicolas; Boetto, Sergio; Albucher, Jean-François; Fourcade, Olivier; Geeraerts, Thomas

    2017-01-01

    Background Reversible cerebral vasoconstriction syndrome (RCVS) is a rare cause of intracerebral hemorrhage (ICH) causing intracranial hypertension. Methods Case report. Results We report a case of RCVS-related ICH leading to refractory intracranial hypertension. A decompressive craniectomy was performed to control intracranial pressure. We discuss here the management of RCVS with intracranial hypertension. Decompressive craniectomy was preformed to avoid the risky option of high cerebral perfusion pressure management with the risk of bleeding, hemorrhagic complications, and high doses of norepinephrine. Neurological outcome was good. Conclusion RCVS has a complex pathophysiology and can be very difficult to manage in cases of intracranial hypertension. Decompressive craniectomy should probably be considered.

  19. Marburg Hemorrhagic Fever (Marburg HF)

    Science.gov (United States)

    ... CDC Cancel Submit Search The CDC Marburg hemorrhagic fever (Marburg HF) Note: Javascript is disabled or is ... first recognized in 1967, when outbreaks of hemorrhagic fever occurred simultaneously in laboratories in Marburg and Frankfurt, ...

  20. Ebola hemorrhagic Fever.

    Science.gov (United States)

    Burnett, Mark W

    2014-01-01

    Ebola hemorrhagic fever is an often-fatal disease caused by a virus of the Filoviridae family, genus Ebolavirus. Initial signs and symptoms of the disease are nonspecific, often progressing on to a severe hemorrhagic illness. Special Operations Forces Medical Providers should be aware of this disease, which occurs in sporadic outbreaks throughout Africa. Treatment at the present time is mainly supportive. Special care should be taken to prevent contact with bodily fluids of those infected, which can transmit the virus to caregivers. 2014.

  1. Intracranial hemorrhage revealing pseudohypoparathyroidism as a cause of fahr syndrome.

    Science.gov (United States)

    Swami, Abhijit; Kar, Giridhari

    2011-01-01

    Pseudohypoparathyroidism is an infrequently encountered disease. It is one of the causes of Fahr syndrome which also is a rare clinical entity caused by multiple diseases. A 4-year-old man hospitalized for sudden onset left hemiparesis and hypertension was diagnosed to have right thalamic and midbrain hemorrhage on plain CT scan of the head which also revealed co-existent extensive intracranial calcifications involving the basal ganglia and cerebellum bilaterally. General physical examination revealed features of Albright hereditary osteodystrophy, goitre, hypertension, left hemiparesis, and signs of cerebellar dysfunction. Laboratory findings suggested hypocalcemia, hyperphosphatemia along with high TSH, low FT(4), low FT(3), and high anti-TPO antibody. Though bilateral intracranial calcifications are usually encountered as an incidental radiological finding in the CT scan of brain, in this case, the patient admitted for thalamic and midbrain hemorrhage was on investigation for associated intracranial calcification, and goitre was also found to have coexisting pseudohypoparathyroidism and autoimmune hypothyroidism.

  2. Delayed intracerebellar hemorrhage secondary to lumboperitoneal shunt insertion

    Science.gov (United States)

    Er, Uygur; Akyol, Çetin; Bavbek, Murad

    2016-01-01

    Aim of this paper is to present and discuss a case of a delayed cerebellar parenchymal hemorrhage developing after L/P shunt placement with a NPH patient. A hypertensive patient admitted to our clinic with a diagnosis of NPH. The patient was placed a pressure adjustable L/P shunt without any surgical complication. He was discharged with an uneventful period. The patient was admitted to the emergency clinic of our hospital with a 1.5 × 1.5 cm diameter hematoma at the left cerebellar hemisphere on 2 days after his discharge. CSF drainage by an L/P shunt can generate intracerebellar hemorrhages especially in hypertensive patients. PMID:27695558

  3. Intracranial Hemorrhage Revealing Pseudohypoparathyroidism as a Cause of Fahr Syndrome

    Directory of Open Access Journals (Sweden)

    Abhijit Swami

    2011-01-01

    Full Text Available Pseudohypoparathyroidism is an infrequently encountered disease. It is one of the causes of Fahr syndrome which also is a rare clinical entity caused by multiple diseases. A 4-year-old man hospitalized for sudden onset left hemiparesis and hypertension was diagnosed to have right thalamic and midbrain hemorrhage on plain CT scan of the head which also revealed co-existent extensive intracranial calcifications involving the basal ganglia and cerebellum bilaterally. General physical examination revealed features of Albright hereditary osteodystrophy, goitre, hypertension, left hemiparesis, and signs of cerebellar dysfunction. Laboratory findings suggested hypocalcemia, hyperphosphatemia along with high TSH, low FT4, low FT3, and high anti-TPO antibody. Though bilateral intracranial calcifications are usually encountered as an incidental radiological finding in the CT scan of brain, in this case, the patient admitted for thalamic and midbrain hemorrhage was on investigation for associated intracranial calcification, and goitre was also found to have coexisting pseudohypoparathyroidism and autoimmune hypothyroidism.

  4. Cerebral salt-wasting syndrome due to hemorrhagic brain infarction: a case report

    OpenAIRE

    Tanaka, Tomotaka; Uno, Hisakazu; Miyashita, Kotaro; Nagatsuka, Kazuyuki

    2014-01-01

    Introduction Cerebral salt-wasting syndrome is a condition featuring hyponatremia and dehydration caused by head injury, operation on the brain, subarachnoid hemorrhage, brain tumor and so on. However, there are a few reports of cerebral salt-wasting syndrome caused by cerebral infarction. We describe a patient with cerebral infarction who developed cerebral salt-wasting syndrome in the course of hemorrhagic transformation. Case presentation A 79-year-old Japanese woman with hypertension and ...

  5. 大剂量乌司他丁对高血压相关早期重型脑桥出血患者血浆穿透素-3基质金属蛋白酶-9和S100B水平的影响%Effects of large-dose Ulinastatin on levels of plasma pentraxin-3, matrix metalloproteinase-9 and S100B pro-tein in patients with hypertension-related early severe pons hemorrhage

    Institute of Scientific and Technical Information of China (English)

    王宏纲; 王国平; 郭庆彦; 栾静; 韩贵荣; 魏红彦; 侯丽英

    2015-01-01

    Objective To investigate the effects of large-dose ulinastatin on the levels of plasma pentraxin-3 (PTX-3), matrix metalloproteinase-9 (MMP-9) and serum S100B protein in patients with hypertension-related early se-vere pons hemorrhage. Methods Thirty patients (26 males and 4 females; mean age: 47 years old) with hypertension and pons hemorrhage, who were hospitalized in the Department of Cardology, People′s Hospital of Pingshun County in Shanxi Province and the ICU and Department of Neurology, Changzhi Municipal People′s Hospital Affiliated to Shanxi Medical University between January 2013 and December 2014, were included as the subjects in the study. A prospective controlled study was used, and all 30 patients were divided into two groups. The regular hypertension and pons hemorrhage group (n=15) received the conventional drug therapy, and the Ulinastatin group (n=15) received in-travenous drip infusion of high-dose ulinastatin 800 000 U) based on the conventional drug therapy, once daily. Meanwhile, another 20 patients with hypertension and basal ganglia hemorrhage were included as the conventional control group. All patients underwent the routine examination, including blood pressure, blood lipid, body mass index (BMI), blood glucose, and homeostasis model assessment of insulin resistance (HOMA-IR). The changes of plasma PTX-3, serum S100B protein and MMP-9 in the three groups were determined before and after the treatment, respec-tively. Results The levels of plasma PXT-3 and MMP-9 in the ulinastatin group and regular hypertension and pons hemorrhage group were significantly increased compared with those in the control group [plasma PTX-3: (25.5 ±4.3), (25.1±3.9), (12.8±3.2) ng/ml, F=1.98, P<0.05;MMP-9:(108±11), (110±14), (94±17) ng/L, F=2.41, P<0.05.]. Compared with the regular hypertension and pons hemorrhage group and conventional control group after one-week treatment, the levels of plasma PXT-3, serum S100B protein and MMP-9 were significantly

  6. [Hypertensive emergency and urgence].

    Science.gov (United States)

    Gegenhuber, Alfons; Lenz, Kurt

    2003-12-01

    gradual reduction on an out-patient basis, depending on the patient's medical history and on any underlying chronic disease. Organ manifestations in the course of a hypertensive emergency concern the cardiovascular system and are associated with the symptoms of acute left-ventricular heart failure, the acute coronary syndrome or acute aortic dissection. In the brain the patient may have symptoms of hypertensive encephalopathy, hemorrhage, ischemia; in the kidney he/she may develop acute failure. The patient's blood pressure should be reduced rapidly during the treatment. It should not be reduced to the normal value, but by approximately 20-30% of the baseline value. The reason for a stepwise reduction in blood pressure is the fact that patients with chronic hypertension have an altered autoregulation curve. Acute normotension would lead to hypoperfusion in these patients. Those with aortic dissection or pulmonary edema are excepted from the rule of gradual blood pressure reduction. In the presence of these diseases, blood pressure must be reduced rapidly to normal values. Patients with a hypertensive emergency should always be admitted to the hospital. Parenteral treatment is given preference, since the effect of the treatment is rapid and occurs within a calculable period of time. Thus, parenteral treatment can also be better regulated than medication administered orally or by the sublingual route. Several antihypertensives are available for this purpose. The selection of the substance greatly depends on the existing organ failure as well as the reliable effectiveness and the regulability of the applied antihypertensive.

  7. Acute brain hemorrhage in dengue

    Institute of Scientific and Technical Information of China (English)

    Somsri Wiwanitkit; Viroj Wiwanitkit

    2014-01-01

    Dengue is a tropical arboviral infection that can have severe hemorrhagic complication.Acute brain hemorrhage in dengue is rare and is a big challenge in neurosurgery.To perform surgery for management of acute brain hemorrhage in dengue is a controversial issue.Here, the authors try to summarize the previous reports on this topic and compare neurosurgery versus conservative management.

  8. Sinistral Portal Hypertension. A Case Report

    Directory of Open Access Journals (Sweden)

    Dinesh Singhal

    2006-11-01

    Full Text Available Sinistral portal hypertension is a clinical syndrome of gastric variceal hemorrhage in the setting of splenic vein thrombosis due to a primary pancreatic pathology. The distinguishing features from other forms of portal hypertension are preserved liver function and a patent extrahepatic portal vein. The important causes include acute and chronic pancreatitis, pancreatic pseudocysts and pancreatic carcinomas. Benign pancreatic neoplasms only rarely cause sinistral portal hypertension. Splenic vein thrombosis complicates 7-20% of patients having pancreatitis or a pancreatic pseudocyst; however, bleeding occurs in only approximately 5% of patients. The diagnosis of sinistral portal hypertension is achieved by a combination of gastroscopy, liver function tests, ultrasound examination (with Doppler and/or contrast-enhanced CT scan of the abdomen.A mere demonstration of sinistral portal hypertension does not warrant intervention. An expectant management is justifiable in asymptomatic patients with pancreatitis. However, concomitant splenectomy may be considered in patients undergoing operative treatment of symptomatic chronic pancreatitis if sinistral portal hypertension and gastroesophageal varices are present. In patients presenting with gastric variceal hemorrhage, splenectomy (with treatment for the primary pancreatic pathology, e.g. distal pancreatectomy is curative with excellent long term results.

  9. Massive antenatal fetomaternal hemorrhage

    DEFF Research Database (Denmark)

    Dziegiel, Morten Hanefeld; Koldkjaer, Ole; Berkowicz, Adela

    2005-01-01

    Massive fetomaternal hemorrhage (FMH) can lead to life-threatening anemia. Quantification based on flow cytometry with anti-hemoglobin F (HbF) is applicable in all cases but underestimation of large fetal bleeds has been reported. A large FMH from an ABO-compatible fetus allows an estimation...

  10. Major obstetric hemorrhage.

    Science.gov (United States)

    Mercier, Frederic J; Van de Velde, Marc

    2008-03-01

    Major obstetric hemorrhage remains the leading cause of maternal mortality and morbidity worldwide, and is associated with a high rate of substandard care. A well-defined and multidisciplinary approach that aims to act quickly and avoid omissions or conflicting strategies is key. The most common etiologies of hemorrhage are abruptio placenta, placenta previa/accreta, uterine rupture in the antepartum period and retained placenta, uterine atony, and genital-tract trauma in the postpartum period. Basic treatment of postpartum hemorrhage relies on manual removal of the placenta or manual exploration of the uterus plus bladder emptying and oxytocin administration. If this does not arrest bleeding, or if there is any suspicion of genital-tract trauma, examination of the vagina and cervix with appropriate valves and analgesia/anesthesia must follow quickly. Postpartum uterine atony resistant to oxytocin must be treated with prostaglandin within 15 to 30 minutes; uterine balloon tamponade can be also useful at this stage. Aggressive transfusion therapy and resuscitation are mandatory in major obstetric hemorrhage. Specific invasive treatment must be considered within no more than 30 to 60 minutes, if previous measures have failed -- and even earlier in some particular etiologies. The two main options are radiologic embolization and surgical artery ligations. Recombinant factor VIIa may also be considered, but should not delay the performance of a life-saving procedure such as embolization or surgery. Hysterectomy must be implemented when all other interventions have failed.

  11. Intraarticular hemorrhage due to bevacizumab in a patient with metastatic colorectal cancer: a case report

    Directory of Open Access Journals (Sweden)

    Uysal Mukremin

    2012-07-01

    Full Text Available Abstract Introduction Bevacizumab is a monoclonal antibody against vascular endothelial growth factor. It is widely used in the treatment of metastatic colorectal cancer. It has some specific side effects including severe bleeding, wound healing problems, gastrointestinal perforation, proteinuria and hypertension. Case presentation We present the case of a 65-year old Asian man with synovial metastasis of the knee who experienced intraarticular hemorrhage after bevacizumab treatment. He presented with monoarthritis of the left knee. Conclusion Bevacizumab-related hemorrhage can cause serious morbidity and unusual sites of hemorrhage may be seen.

  12. Effects of Tongfu Xingshen Granule on Brain Pathomorphological Features inRats with Hypertensive Cerebral Hemorrhage%通腑醒神胶囊对高血压性脑出血大鼠脑组织病理及超微结构的影响

    Institute of Scientific and Technical Information of China (English)

    梁伟雄; 陈根成; 黄燕; 杨志敏; 石灵春; 区勇全; 孙景波; 刘茂才; 雷娓娓

    2001-01-01

    【Objective】 To explore the mechanism of Tongfu Xingshen Granule(TXG) for hypertensive middle- and large-amount cerebral hemorrhage.【Methods】Rat mod e ls with renal vascular hypertensive cerebral hemorrhage were established by occl usion of bilateral renal arteries and injection of collagenase and heparin,and t hen were allocated to TXG treatment group(Group A),mannitol treatment group(grou p B)and model control group (Group C).Indices such as brain pathomorphological f eatures,ultrastructure,vascular permeabilit y and water volume were observed.【Results】The above indices were improved in G roup A as compared Group C(P<0.05). 【Conclusion】 TXG can protect brain tissue and improve nervous fu n ction.Its possible mechanism is by reducing the permeability of cerebral capilla ries and brain water volume,enhancing the absorption of hematoma,lowering the c erebral pressure,improving microcirculation and the supply of blood and oxygen.%【目的】探讨中药通腑醒神胶囊(由番泻叶、虎杖、人工牛黄粉等组成)治疗高血压性中、大量脑出血的作用机理。【方法】观察该方对双肾双夹法和注射胶原酶Ⅶ及肝素造成肾血管性高血压性脑出血模型大鼠的脑组织病理学、超微结构、脑血管通透性和脑组织含水量等指标的影响。【结果】通腑醒神胶囊灌胃组大鼠在脑组织病理学、超微结构的损伤方面较模型对照组轻,在改善脑血管通透性和降低脑组织含水量等方面与模型对照组比较差异均有显著性(P<0.05)。【结论】该方可以改善脑出血后大鼠脑毛细血管通透性及减轻脑水肿,促进血肿吸收,减轻脑组织受压,改善微循环和脑组织供血供氧而达到保护脑组织、改善神经功能的目的,这是该方治疗高血压性中、大量脑出血临床有效的可能作用机理之一。

  13. Effect of Operation Time on the Curative Efficacy in Hypertensive Intracerebral Hemorrhage in Basal Ganglia Treating With Small Window Craniotomy Microsurgical Operation%小骨窗显微手术时机对基底节区高血压性脑出血疗效的影响

    Institute of Scientific and Technical Information of China (English)

    李建; 高觉民

    2014-01-01

    Objective To investigate the effect of operation time on the curative efficacy in hypertensive intracerebral hemorrhage (HICH) in basal ganglia treating with small window craniotomy microsurgical operation. Methods 80 cases of HICH in basal ganglia treating with small window craniotomy microsurgical operation meeting the inclusion criteria were randomly divided into ultra-early group (within 6 h) and early group (6~24 h) equally. Then the curative efficacy and life quality scores were observed and compared. Results The rate of recurrent hemorrhage in the ultra-early group was 10.0%, which was statistically same with that of 15.0% in the early group (P>0.05). Meanwhile, the ultra-early group had a mortality rate of 5.0%, which was statistically lower than that of 20.0% in the early group (P0.05). Three months after, life quality scores in the ultra-early group was significantly statistically higher than that in the early group (P<0.05). Conclusion The ultra-early small window craniotomy microsurgical operation can significant reduce mortality rate of patients with HICH in basal ganglia, improve life quality and prognosis, without increasing the rate of recurrent hemorrhage. And the ultra-early operation time is ideal for patients with optimum conditions.%目的:探讨小骨窗显微手术时机对基底节区高血压性脑出血(HICH)疗效的影响。方法80例符合纳入标准的行小骨窗显微手术的基底节区 HICH 患者随机分为超早期组(发病6 h 内手术)和早期组(发病6~24 h 内手术),每组各40例,观察治疗疗效及患者生活质量评分变化情况。结果超早期组和早期组的再出血率分别为10.0%和15.0%,两组比较无统计学差异(P >0.05)。超早期组的手术死亡率为5.0%,明显低于早期20.0%的死亡率,比较有统计学差异(P <0.05)。术前,两组患者生活质量评分比较无统计学差异(P >0.05)。术后3个月,超早期组的生活质量

  14. Mortality after hemorrhagic stroke

    DEFF Research Database (Denmark)

    González-Pérez, Antonio; Gaist, David; Wallander, Mari-Ann

    2013-01-01

    OBJECTIVE: To investigate short-term case fatality and long-term mortality after intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) using data from The Health Improvement Network database. METHODS: Thirty-day case fatality was stratified by age, sex, and calendar year after ICH...... during the first year of follow-up compared with controls (ICH: hazard ratio [HR] 2.60, 95% confidence interval [CI] 2.09-3.24, p year (ICH: HR 2.02, 95% CI 1.75-2.32, p ... and SAH using logistic regression. Cox proportional hazards regression analyses were used to estimate the risk of death during the first year of follow-up and survivors at 1 year. RESULTS: Case fatality after ICH was 42.0%, compared with 28.7% after SAH. It increased with age (ICH: 29.7% for 20-49 years...

  15. Phenylpropanolamine and cerebral hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    McDowell, J.R.; LeBlanc, H.J.

    1985-05-01

    Computerized tomography, carotid angiograms, and arteriography were used to diagnose several cases of cerebral hemorrhage following the use of phenylpropanolamine. The angiographic picture in one of the three cases was similar to that previously described in association with amphetamine abuse and pseudoephedrine overdose, both substances being chemically and pharmacologically similar to phenylpropanolamine. The study suggests that the arterial change responsible for symptoms may be due to spasm rather than arteriopathy. 14 references, 5 figures.

  16. Hypertension screening

    Science.gov (United States)

    Foulke, J. M.

    1975-01-01

    An attempt was made to measure the response to an announcement of hypertension screening at the Goddard Space Center, to compare the results to those of previous statistics. Education and patient awareness of the problem were stressed.

  17. Hypertension screening

    Science.gov (United States)

    Foulke, J. M.

    1975-01-01

    An attempt was made to measure the response to an announcement of hypertension screening at the Goddard Space Center, to compare the results to those of previous statistics. Education and patient awareness of the problem were stressed.

  18. Endokrin hypertension

    DEFF Research Database (Denmark)

    Poulsen, Per Løgstrup; Ibsen, Hans

    2009-01-01

    Endocrine hypertension is rare, but frequently refractory. Adenomas are common incidental findings. Biochemical tests confirm the diagnosis. Primary aldosteronism is the most common form. Hypokalaemia is an important sign, but 50% of patients may be normokalaemic. The plasma-aldosterone-to-renin ......Endocrine hypertension is rare, but frequently refractory. Adenomas are common incidental findings. Biochemical tests confirm the diagnosis. Primary aldosteronism is the most common form. Hypokalaemia is an important sign, but 50% of patients may be normokalaemic. The plasma...

  19. Pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Lauro Martins Júnior

    2014-12-01

    Full Text Available Pulmonary hypertension is a pathological condition associated with various diseases, which must be remembered by the physicians, since early diagnosis may anticipate and avoid dangerous complications and even death if appropriate measures were not taken. The relationship with chronic obstructive pulmonary disease (COPD, important pathological process that is in increasing prevalence in developing countries, and leading position as cause of death, emphasizes its importance. Here are presented the classifications, pathophysiology, and general rules of treatment of pulmonary hypertension.

  20. Pulmonary hypertension

    OpenAIRE

    2016-01-01

    In 2015, more than 800 papers were published in the field of pulmonary hypertension. A Clinical Year in Review article cannot possibly incorporate all this work and needs to be selective. The recently published European guidelines for the diagnosis and treatment of pulmonary hypertension contain an inclusive summary of all published clinical studies conducted until very recently. Here, we provide an overview of papers published after the finalisation of the guideline. In addition, we summaris...

  1. Cranial Imaging Findings of Hypertension in Pregnancy

    Directory of Open Access Journals (Sweden)

    Yusuf Tamam

    2005-01-01

    Full Text Available The aim of this study was to find out the cranial imaging findings of complicated hypertensive disorders of pregnancy. Forty two patients with preeclampsia, eclampsia and HELLP syndrome were admitted to the study at Obstetrics Division of Dicle University from January 2001 to December 2004. Computed Tomography was made to the forty two patients. The Computed Tomograpy findings of 20 (47.62% patients were normal whereas computed Tomograpy findings of 22 (52.28% patients were pathological. Eight patients (19% had intracranial hemorrhage, 5 (11.9 % patients had infarct, 9 (21.42% patients had specific lesions. A wide imaging spectrum from ischemic area to intracranial hemorrhages can be detected in hypertensive disorders of pregnancy. Thus it is essential to make cranial imaging in patients with symptoms and neurological deficit.

  2. Recurrent Intracerebral Hemorrhage

    DEFF Research Database (Denmark)

    Schmidt, Linnea Boegeskov; Goertz, Sanne; Wohlfahrt, Jan;

    2016-01-01

    the use of any of the investigated medicines with antithrombotic effect (ATT, SSRI's, NSAID's) and recurrent ICH. CONCLUSIONS: The substantial short-and long-term recurrence risks warrant aggressive management of hypertension following a primary ICH, particularly in patients treated surgically...... treatment and renal insufficiency were associated with increased recurrence risks (RR 1.64, 95% CI 1.39-1.93 and RR 1.72, 95% CI 1.34-2.17, respectively), whereas anti-hypertensive treatment was associated with a reduced risk (RR 0.82, 95% CI 0.74-0.91). We observed non-significant associations between...

  3. Epidemiological and clinical characteristics of 266 cases of intracerebral hemorrhage in Hangzhou, China

    Institute of Scientific and Technical Information of China (English)

    Yun-zhen HU; Jian-wen WANG; Ben-yan LUO

    2013-01-01

    Ethnicity and socioeconomic factors can influence disease susceptibility,clinical presentation,and outcome.We investigated the clinical characteristics (age,sex,seasonal variation,lesion site,symptoms,complications,prognosis,and sequelae) and risk factors for intracerebral hemorrhage (ICH) in 266 cases treated at our hospital in Hangzhou City,China,from January 2011 to December 2011.Risk of ICH increased dramatically with age; only 4.3%of cases were <30 years old,while 44.4% were >60 years of age.Men outnumbered women by 2:1 (67.3% vs.32.7%).Single hemorrhage was most often located in the cerebral lobes (37.2% of cases),basal ganglia (34.2%),thalamus (8.3%),cerebellum (6.8%),ventricle (1.5%),and brainstem (1.1%),while 10.9% of cases exhibited hemorrhages at multiple sites.Hypertension was also a major risk factor for ICH,as 47% of all patients were hypertensive and the percentage increased with age.In hypertensive patients,the most common hemorrhage site was the basal ganglia and ICH was often associated with thrombopenia.In patients with leukemia (all forms),most hemorrhages were lobar.Warfarin-and encephalic operation-associated ICHs were all lobar.Headache was the major symptom of occipital,temporal,and frontal lobe hemorrhage.Dizziness,nausea,and vomiting were the major symptoms of cerebellum hemorrhage.Limb dysfunction was the major symptom of thalamic and basal ganglia hemorrhage.Disturbed level of consciousness was the major symptom in multisite,ventricular,parietal lobe,and brainstem hemorrhage.Hyperspasmia occurred most often in lobar hemorrhage and blurred vision in occipital lobe hemorrhage.Hospital mortality was 24.4% (n=65) with a mean delay from presentation to death of (10.5±18.5) d.The majority of fatalities were cerebral hernia cases (58.5%) and these patients also had the shortest time to death [(2.9±3.5) d].Mortality was 100%in brainstem ICH and hemorrhagic conversion of cerebral infarct

  4. Diagnostic usefulness of periIesional edema around intracerebral hemorrhage in predicting underlying causes

    Energy Technology Data Exchange (ETDEWEB)

    Yim, Nam Yeol; Seo, Jeong Jin; Yoon, Woong; Shin, Sang Soo; Lim, Hyo Soon; Chung, Tae Woong; Jeong, Gwang Woo; Kang, Heoung Keun [Chonnam National Univ. Hospital, Gwangju (Korea, Republic of)

    2004-07-01

    We attempted to evaluate the diagnostic usefulness of the degree of perilesional edema around intracerebral hematoma in predicting the underlying cause. This study included 54 patients with intracerebral hematoma for whom the underlying cause was confirmed by biopsy, radiological or clinical methods. Cases of subarachnoid hemorrhage, hemorrhagic transformation of cerebral infarction and intraventricular hemorrhage were excluded. The lesion size was defined as the average value of the longest axis and the axis perpendicular to this. The size of the perilesional edema was defined as the longest width of the edema. In all cases, the sizes of the lesion and edema were measured on the T2 weighted image. We defined the edema ratio as the edema size divided by the lesion size. 23 cases were diagnosed as intracerebral hemorrhage due to neoplastic conditions, such as metastasis (n=17), glioblastoma (n=5), hemangioblastoma (n=1). 31 cases were caused by non-neoplastic conditions, such as spontaneous hypertensive hemorrhage (n=23), arteriovenous malformation (n=4), cavernous angioma (n=3), and moya-moya disease (n=1). In fourteen cases, which were confirmed as malignant intracerebral hemorrhage, the edema ratio was more than 100%. Of the other cases, only 8 were confirmed as malignant intracerebral hemorrhage. It was found that the larger the edema ratio, the more malignant the intracerebral hemorrhage, and this result was statistically significant (p<0.001). Measurement of perilesional edema and the intracerebral hematoma ratio may be useful in predicting the underlying causes.

  5. Management of portal hypertension in children

    Institute of Scientific and Technical Information of China (English)

    Roberto Gugig; Philip Rosenthal

    2012-01-01

    Portal hypertension can be caused by a wide variety of conditions.It frequently presents with bleeding from esophageal varices.The approach to acute variceal hemorrhage in children is a stepwise progression from least invasive to most invasive.Management of acute variceal bleeding is straightforward.But data on primary prophylaxis and long term management prevention of recurrent variceal bleeding in children is scarce,therefore prospective multicenter trials are needed to establish best practices.

  6. 无创血液动力学检测于妊娠12周预测妊娠期高血压疾病的应用价值%The study on predicting hypertensive disorders in pregnancy by noninvasive hemorrhage dynamics at the 12th gastation week

    Institute of Scientific and Technical Information of China (English)

    王玢

    2015-01-01

    Objective To explore the feasibility about predict the hypertensive diseases at the 12th gestation week by the measurement of noninvasive hemorrhage dynamic. Method 472 cases of pregnant women adhered to no secondary disorders and no complications were recruited randomly. They were divided into two groups: the observation group (233 cases)and the control group(239 cases). The observation group cases were measured at their 12th gestation week with the method of noninvasive hemorrhage dynamics, and the area of mean pulse graph2 (AMP2) ≥90% or the central artery pressure(CASP)≥100 mmHg was designed as the positive predict norm; the control group cases were tested at their 20th gestation week with the method of mean artery pressure, whose ≥85 mmHg was appointed as the positive standard. Result In the observation group, the area of mean pulse graph2 (AMP2) ranged from 71.30% to 134.51%,the average 87.91%±20.93%, the medium 85.90%, the central artery systolic pressure(CASP) arrayed from 81.22 mmHg to 115.43 mmHg, the average (83.76±22.59) mmHg, the median 83.21 mmHg, the predict patient number 14, the predict morbidity 6.01 %, the actual patient number 12, the actual morbidity 5.15%, the sensitiveness 85.71%, the specificity 99.10%. In the control group, the mean artery pressure (MAP) ranged from 69.33 mmHg to 106.15 mmHg,the average(81.33±18.47)mmHg, the median 80.27 mmHg, the predict patient number 41, the predict morbidity 17.67%, the actual patient number 13, the actual morbidity 5.60%, the sensitiveness 31.70%, the specificity 88.66%. The differences in the sensitiveness and the specificity between the two groups relatively were very significant(P<0.05). Conclusion The method noninvasive hemorrhage dynamics adopted AMP2≥90% or CASP≥100 mmHg measured at 12th gestation week as positive predict standard is feasible for the superiority of earlier predicting, higher sensitiveness, keener specificity, etc.%目的:探讨无创血液动力学检测于妊娠12

  7. Perioperative hypertension

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    G. Pinna

    2013-05-01

    Full Text Available BACKGROUND Perioperative hypertension is a situation whose management is suggested by the clinical judgement much more than clinical evidences. JNC 7 guidelines give a classification of blood pressure (BP, without any mention specifically dedicated to patients undergoing surgery. The ACC/AHA guidelines recommend deferring surgery if diastolic BP is above 110 mmHg and systolic BP is above 180 mmHg. AIM OF THE STUDY In this review we considered pathogenetic, clinical and therapeutic factors related to perioperative management of hypertensive patients. DISCUSSION In actual trend of the preoperative evaluation, alone hypertension is considered as a minor risk factor. BP values ≤ 180/110 mmHg do not influence the outcomes in patients who underwent noncardiac surgery. Therefore, in these conditions it’s not necessary to delay surgery. Hypertensive picks are possible during the operation, mostly because of the intubation, but, much more dangerous, falls of pressure are possible. The intraoperative arterial pressure should be maintained within 20% of the best estimated preoperative arterial pressure, especially in patients with markedly elevated preoperative pressures. After surgery the arterial BP can increase for stress factors, pain, hypoxia and hypercapnia, hypothermia and infusional liquids overload. For all these reasons a careful monitoring is mandatory. Anti-hypertensive medication should be continued during the postoperative period in patients with known and treated hypertension, as unplanned withdrawal of treatment can result in rebounded hypertension. The decision to give anti-hypertensive drugs must be made for each patient, taking into account their normal BP and their postoperative BP. With regard to the optimal treatment of the patient with poorly or uncontrolled hypertension in the perioperative evaluation, recent guidelines suggest that the best treatment may consider cardioselective β-blockers therapy, but also clonidin by

  8. Posterior Chamber Hemorrhage during Fluorescein Angiography

    Directory of Open Access Journals (Sweden)

    Manuel A. P. Vilela

    2015-01-01

    Full Text Available This paper provides the first reported case of acute posterior chamber hemorrhage during fluorescein angiography (FA. This is a case review with serial color photographs of the anterior segment. A 76-year-old male was referred for angiographic control of age-related macular degeneration. He was pseudophakic OU, BCVA 20/40 OU. He had mild hypertension, but not diabetes. He had had two previous angiograms without adverse effects. Difficulty was experienced in obtaining the images owing to a progressive reduction in the transparency of the media. A dense hemorrhage in the posterior chamber of the right eye was found, involving the visual axis. Thorough biomicroscopy, gonioscopy, and ultrasonic biomicroscopy showed that part of one of the haptics of the right intraocular lens (IOL was touching and tearing the posterior face of the iris, without any visible synechiae, iris, or angle neovascularization. Anterior segment FA and posterior ultrasonography were normal. No similar case has been described in the literature involving dense progressive bleeding located in the capsular bag and posterior chamber, without any detectable triggering ocular event other than mydriasis and fluorescein injection. Contact of the iris or sulcus with part of the intraocular lens, aggravated by the intense use of mydriatics during the FA procedure, probably caused bleeding to happen.

  9. Hypercoagulability in hereditary hemorrhagic telangiectasia with epilepsy

    Directory of Open Access Journals (Sweden)

    Josef Finsterer

    2015-01-01

    Full Text Available Recent data indicate that in patients with hereditary hemorrhagic teleangiectasia (HHT, low iron levels due to inadequate replacement after hemorrhagic iron losses are associated with elevated factor-VIII plasma levels and consecutively increased risk of venous thrombo-embolism. Here, we report a patient with HHT, low iron levels, elevated factor-VIII, and recurrent venous thrombo-embolism. A 64-year-old multimorbid Serbian gipsy was diagnosed with HHT at age 62 years. He had a history of recurrent epistaxis, teleangiectasias on the lips, renal and pulmonary arterio-venous malformations, and a family history positive for HHT. He had experienced recurrent venous thrombosis (mesenteric vein thrombosis, portal venous thrombosis, deep venous thrombosis, insufficiently treated with phenprocoumon during 16 months and gastro-intestinal bleeding. Blood tests revealed sideropenia and elevated plasma levels of coagulation factor-VIII. His history was positive for diabetes, arterial hypertension, hyperlipidemia, smoking, cerebral abscess, recurrent ischemic stroke, recurrent ileus, peripheral arterial occluding disease, polyneuropathy, mild renal insufficiency, and epilepsy. Following recent findings, hypercoagulability was attributed to the sideropenia-induced elevation of coagulation factor-VIII. In conclusion, HHT may be associated with hypercoagulability due to elevated factor-VIII associated with low serum iron levels from recurrent bleeding. Iron substitution may prevent HHT patients from hypercoagulability.

  10. 门静脉高压上消化道大出血介入断流术与外科断流术效果比较%Comparison of intervertional devascularization and surgical devascularization in treatment of upper gastrointestinal hemorrhage for portal hypertensive

    Institute of Scientific and Technical Information of China (English)

    刘伟; 陈根生; 孙慧伶; 陈洪波; 张卫平; 姚红响; 曾群

    2009-01-01

    methods.Results The 12 months, 24 months and 36 months cumulative rebleeding rates after intervertional devascularization were 12.5% (6/47) ,24.5% (11/45), 27.9% (12/43) respectively.The rate after surgical devaacularization were 29.2% (14/48) ,44.7% (21/47), 48.9% (22/45) respectively.There were statistically significant differences between the intervertional and surgical groups (X2=3.843,4.150,4.083, P < 0.05).The complications of intervertional devascularization included fever 85.4% (41/48), bellyache 81.3% (39/48), portalvein thrombosis 4.2% (2/48), intraabdominal hemorrhage 2.1% (1/48), infection 2.1% (1/48) and death 2.1% (1/48).The complications of surgical devaacularization included fever 68.6% (35/51), bellyache 62.7% (32/51), generous hydroperitoneum 25.5% (13/51), portalvein thrombosis 37.3% (19/51), splenic vein thrombosis 11.8% (6/51), hepatic encephalopathy 3.9% (2/51), hepatorenal syndrome 2.0% (1/51), intraabdominal hemorrhage 2.0% (1/51), death 3.9% (2/51) and infection 15.7% (8/51).There were statistically significant differences of fever, bellyache, generous hydroperitoneum, portalvein thrombosis, splenic vein thrombosis between the intervertional and surgical groups(X2=4.174,3.098,16.199,6.011,5.536,14.085,P <0.05).Conclusions The intervertional devascularization procedure is simple, safe and effective method for treating upper gastrointestinal hemorrhage for portal hypertensive.The clinical effect is better than that of surgical devascularization.

  11. Hypertensive Encephalopathy

    Directory of Open Access Journals (Sweden)

    Mostafa SHARIFIAN

    2012-09-01

    Full Text Available How to cite this article: Sharifian M. Hypertensive Encephalopathy. Iran J Child Neurol 2012; 6(3:1-7.Hypertension is called the silent killer and vital organs such as the brain, eyes,kidneys and the heart are the targets. Seizure, central nervous system (CNShemorrhage, and cerebrovascular accident (CVA, blindness and heart attacksare the end points.The prevalence of hypertension in children is much less than adults, but evidencereveals that the source of hypertension in adulthood goes back to childhood. In70-80% of cases hypertension is due to renal diseases. In children, hypertensiveencephalopathy (HE may be the first manifestation of renal diseases. Seizure isone of the most common manifestations of HE.In this article, definitions, etiology, pathophysiology and finally the acute andchronic managements of HE will be discussed.ReferencesSawicka K, Szczyrek M, Jastrzębska I, Prasal M, ZwolakA, Jadwiga D. Hypertension – The silent killer. J Pre-Clin Clin Res 2011;5(2:43-6.Croix B, Feig DI. Childhood hypertension is not a silent disease. Pediatr Nephrol 2006 Apr;21(4:527-32.Wong TY, Mitchell P. Hypertensive retinopathy. N Engl J Med 2004 Nov;351(22:2310-7.Krzesinski JM, Cohen EP.Hypertension and the kidney.Acta Clin Belg 2007 Jan-Feb;62(1:5-14.Report of the Second Task Force on Blood Pressure Control in Children – 1987. Task Force on Blood Pressure Control in Children. National Heart, Lung, and Blood Institute, Bethesda, Maryland. Pediatrics 1987Jan;79(1:1-25.Update on the 1987 Task Force Report on High Blood Pressure in Children and Adolescents: a working group report from the National High Blood Pressure Education Program. National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents. Pediatrics 1996 Oct;98(4 Pt1:649-58.Ataei N, Aghamohammadi A, Yousefi E, Hosseini M, Nourijelyani K, Tayebi M, et al. Blood pressure nomograms for school children in Iran. Pediatr Nephrol 2004 Feb;19

  12. Hemorrhagic Fever with Renal Syndrome (HFRS)

    Science.gov (United States)

    ... this page: About CDC.gov . Share Compartir Hemorrhagic Fever with Renal Syndrome (HFRS) On this Page What ... is HFRS prevented? Suggested Reading What is hemorrhagic fever with renal syndrome? Hemorrhagic fever with renal syndrome ( ...

  13. Post-tonsillectomy hemorrhage

    DEFF Research Database (Denmark)

    Heidemann, Christian; Wallén, Mia; Aakesson, Marie;

    2008-01-01

    Post-tonsillectomy hemorrhage (PTH) is a relatively common and potentially life-threatening complication. The objective of this study was to examine the rate of PTH and identify risk factors. A retrospective cohort study was carried out including all tonsillectomies (430 patients) performed...... as surgical technique" [relative risk (RR) = 5.3], "peritonsillar abscess as indication for surgery" (RR = 0.3) and "age equal to or above 15 years at the time of surgery" (RR = 5.4). It is concluded that patient age, PTA as indication for surgery and the use of coblation significantly affect the occurrence...

  14. Types of Pulmonary Hypertension

    Science.gov (United States)

    ... from the NHLBI on Twitter. Types of Pulmonary Hypertension The World Health Organization divides pulmonary hypertension (PH) ... are called pulmonary hypertension.) Group 1 Pulmonary Arterial Hypertension Group 1 PAH includes: PAH that has no ...

  15. 结合需要层次理论的护理干预在高血压脑出血患者中的应用价值%Value of nursing intervention based on Maslow's Hierarchy of Needs in patients with hypertensive cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    崔翱; 林容旭; 张宝月; 罗针

    2016-01-01

    Objective To analyze the value of nursing intervention based on Maslow's Hierarchy of Needs in pa-tients with hypertensive cerebral hemorrhage. Methods A total of 118 patients of hypertensive cerebral hemorrhage treat-ed in West China Hospital, Sichuan University from December 2011 to December 2014 were chosen as study subjects, which were divided into observation group and control group according to random number table, each with 59 patients. Af-ter admission, the patients in the control group received routine nursing care, while those in the observation group received nursing intervention based on Maslow's Hierarchy of Needs. The recovery-related indicators, nerve function and activities of daily living, mental status and quality of life were compared between the two groups. Results (1) The score of basic nursing care quality in the observation group was (96.17 ± 3.28), significantly higher than (78.55 ± 5.82) in the control group. The time for consciousness recovery, limb function recovery, hospital stay in the observation group were shorter than those in the control group [(5.62 ± 0.92) d vs (9.81 ± 2.16) d, (8.72 ± 2.83) d vs (14.68 ± 3.07) d, (13.27 ± 3.78) d vs (25.16 ± 5.73) d], with statistically significant difference (P<0.05). (2) After nursing treatment, the National Institutes of Health Stroke Scale (NIHSS) score, Barthel Index (BI) score in the observation group were higher than those in the con-trol group [(59.72 ± 7.11) vs (42.38 ± 5.67), (63.29 ± 7.93) vs (41.26 ± 5.45)], with statistically significant difference (P<0.05). (3) After nursing treatment, the Self-Rating Anxiety Scale (SAS) score, Hamilton Depression Scale (HAMD) score in the observation group were significantly lower than those in the control group [(17.39 ± 3.11) vs (28.54 ± 4.57), (19.53 ± 3.26) vs (31.42 ± 4.78)], and the Short Form 36 health survey questionnaire (SF-36) score in the observation group was significantly higher than that in the control group [(83.11

  16. Clinical predictors of hemorrhagic transformation in non lacunar ischemic stroke

    Directory of Open Access Journals (Sweden)

    Natalia R. Balian

    2017-04-01

    Full Text Available Hemorrhagic transformation is a complex phenomenon where brain tissue bleeds, which could be associated or not to an increase in the neurological deficit after the acute ischemic stroke. The aim of our study was to evaluate clinical predictors of hemorrhagic transformation in patients with non-lacunar ischemic stroke. We performed a prospective analysis of the clinical records and images of patients with non-lacunar ischemic stroke. Demographics, vascular risk factors, previous medications and the information of the event in patients with and without hemorrhagic transformation were here compared. We included in this study 747 patients with non-lacunar stroke, the mean age was 77 ± 11 years and 61% were females. In the univariate analysis, the age, a history of hypertension, atrial fibrillation, chronic kidney disease and the previous use of oral anticoagulation resulted statistically significant. In the multivariate analysis of logistic regression adjusted by age and vascular risk factors: the age > 80 years (OR 3.6, CI 95% 1.8-7.6, the pulse pressure > 60 mmHg at admission (OR 5.3, CI 95% 3.2-9.1, the chronic kidney disease (OR 3, CI 95% 2.5-3.8 and the presence of previous atrial fibrillation (OR 3.5, CI 95% 2.1-6.1 were associated with and increased risk of hemorrhagic transformation. The predictors of hemorrhagic transformation in our cohort showed a relationship with severe vascular illness. The identification of these patients could influence therapeutic decisions that could increase the risk of hemorrhagic transformation

  17. 高血压脑出血患者应激性高血糖与微创碎吸术后血清炎性细胞因子水平的相关性研究%Investigation of stress hyperglycemia and inflammatory cytokines in hypertensive cerebral hemorrhage after micro-injury operations

    Institute of Scientific and Technical Information of China (English)

    湛小波; 周勇; 史忠

    2013-01-01

    目的 观察高血压脑出血患者应激性高血糖对微创碎吸术后血清细胞因子水平的影响.方法 80例高血压脑出血患者按入院24小时内血糖分为正常血糖组(56例)和高血糖组(24例),同时选10例健康人血清做对照,连续监测血清中肿瘤坏死因子α(TNFα)、白细胞介素6(IL-6)的动态变化.结果 两组患者的TNFα、IL-6含量均高于健康对照组.正常血糖组患者其TNFα、IL-6含量达峰时间早.高血糖组患者TNFα、IL-6含量达峰时间较晚,且TNFα、IL-6水平较高.结论 脑出血患者血浆炎性细胞因子水平水平升高与应激反应有关,且对预后产生不利影响.%Objective To investigate the effect of stress hyperglycemia on inflammatory cytokines in serum of hypertensive cerebral hemorrhage after micro-injury operations. Methods 80 patients accepted micro-injury operation according their blood glucose with 24 hours after their enrollment were divided two groups: hyperglycemia group (n = 24) and normoglycemia group (n=56). 10 serum samples of healthy persons were tested as control. The changes of TNFα, IL-6 were observed continuously. Results The levels of TNFo.IL-6 of patients are higher than that of healthy control. That of group hyperglycemia was higher than normoglycemia group. Patients' peak levels of TNFa,IL-6 of appeared earlier in hyperglycemia group than normoglycemia group. Conclusion There is a relationship between the high level of inflammatory cytokines in serum and stress hyperglycemia and stress hyperglycemia makes the curative effect worse.

  18. Anosmia After Perimesencephalic Nonaneurysmal Hemorrhage

    NARCIS (Netherlands)

    Greebe, Paut; Rinkel, Gabriel J. E.; Algra, Ale

    2009-01-01

    Background and Purpose-Anosmia frequently occurs after aneurysmal subarachnoid hemorrhage not only after clipping, but also after endovascular coiling. Thus, at least in part, anosmia is caused by the hemorrhage itself and not only by surgical treatment. However, it is unknown whether anosmia is rel

  19. Impacts of acupuncture on blood pressure and hematoma in patients of cerebral hemorrhage at the early stage

    Institute of Scientific and Technical Information of China (English)

    陶文强

    2014-01-01

    Objective To explore the therapeutic effect of acupuncture for hypertensive cerebral hemorrhage at the early stage.Methods Fifty-four cases of small-amount cerebral hemorrhage were randomized into an acupuncture group and a conventional treatment group,27 cases in each.In the conventional treatment group,special care,oxygen therapy,nerve nutrition and symptomatic support were applied.If necessary,dehydrant and hypotensive drugs were prescribed for antihypertension,or surgery

  20. Hypertension Associated with Coarctation of the Aorta Revisited: Case-Based Update from Experience of Three Children

    Directory of Open Access Journals (Sweden)

    Ali Baykan

    2013-01-01

    Full Text Available Coarctation of the aorta (CoA can present with different clinical pictures depending on the severity of the narrowness in the coarcted aortic segment in an age range between newborn and adolescence. Sometimes, it can cause intracranial hemorrhage or infarction when diagnosis and treatment are delayed. The aim of this report is taking attention to CoA as a cause of systemic hypertension and is also emphasizing the differences of diagnostic approach for hypertension in children from adults. Two cases of hypertensive cerebral hemorrhage and one case of hypertensive cerebellar infarction associated with CoA are reported. These cases help us to pay attention to the possibility of CoA in adolescents with hypertensive stroke. We want to emphasize the importance of physical examination for evaluation of hypertension and to impress the diagnostic approach for secondary hypertension in children.

  1. Hemorrhagic stroke in the Stroke Prevention by Aggressive Reduction in Cholesterol Levels study

    DEFF Research Database (Denmark)

    Goldstein, L.B.; Amarenco, P.; Szarek, M.;

    2008-01-01

    risk was higher in those having a hemorrhagic stroke as the entry event (HR 5.65, 95% CI 2.82 to 11.30, p age (10 y increments, HR 1.42, 95% CI 1.16 to 1.74, p = 0.001). There were no statistical interactions between these factors......: Hemorrhagic stroke was more frequent in those treated with atorvastatin, in those with a hemorrhagic stroke as an entry event, in men, and increased with age. Those with Stage 2 hypertension at the last visit prior to the hemorrhagic stroke were also at increased risk. Treatment did not disproportionately......BACKGROUND: In the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) study, atorvastatin 80 mg/day reduced the risk of stroke in patients with recent stroke or TIA. Post hoc analysis found this overall benefit included an increase in the numbers of treated patients having...

  2. [Hypertensive crisis and sudden change of vision in young patients].

    Science.gov (United States)

    Cortés Fernández, M S; Martín-Castillejos, C; Armario, P

    2016-01-01

    The sudden change in vision is a medical emergency that must be evaluated immediately to rule out important institutions as systemic vasculitis or ischemic stroke. Its association with hypertensive crisis makes it necessary to rule out accelerated-malignant hypertension, which is accompanied by other retinal disorders (exudates and hemorrhages) and adrenal involvement. Nonarteritic anterior ischemic optic neuropathy (AION) is another entity to consider, as is it not uncommon in the young (12.7% in a series of 848 cases). Its association with hypertension has been described in 32% of cases.

  3. Endokrin hypertension

    DEFF Research Database (Denmark)

    Poulsen, Per Løgstrup; Ibsen, Hans

    2009-01-01

    Endocrine hypertension is rare, but frequently refractory. Adenomas are common incidental findings. Biochemical tests confirm the diagnosis. Primary aldosteronism is the most common form. Hypokalaemia is an important sign, but 50% of patients may be normokalaemic. The plasma-aldosterone-to-renin ...

  4. Correlation Factor Analysis of Retinal Microvascular Changes in Patients With Essential Hypertension

    Institute of Scientific and Technical Information of China (English)

    Huang Duru; Huang Zhongning

    2006-01-01

    Objectives To investigate correlation between retinal microvascular signs and essential hypertension classification. Methods The retinal microvascular signs in patients with essential hypertension were assessed with the indirect biomicroscopy lens, the direct and the indirect ophthalmoscopes were used to determine the hypertensive retinopathy grades and retinal arteriosclerosis grades.The rank correlation analysis was used to analysis the correlation these grades with the risk factors concerned with hypertension. Results Of 72 cases with essential hypertension, 28 cases complicated with coronary disease, 20 cases diabetes, 41 cases stroke,17 cases renal malfunction. Varying extent retinal arterioscleroses were found in 71 cases, 1 case with retinal hemorrhage, 2 cases with retina edema, 4 cases with retinal hard exudation, 5 cases with retinal hemorrhage complicated by hard exudation, 2 cases with retinal hemorrhage complicated by hard exudation and cotton wool spot, 1 case with retinal hemorrhage complicated by hard exudation and microaneurysms,1 case with retinal edema and hard exudation, 1 case with retinal microaneurysms, 1 case with branch retinal vein occlusion. The rank correlation analysis showed that either hypertensive retinopathy grades or retinal arteriosclerosis grades were correlated with risk factor lamination of hypertension (r=0.25 or 0.31, P<0.05), other correlation factors included age and blood high density lipoprotein concerned about hypertensive retinopathy grades or retinal arteriosclerosis grades, but other parameters, namely systolic or diastolic pressure, total cholesterol, triglyceride, low density lipoprotein cholesterol, fasting blood glucose,blood urea nitrogen and blood creatinine were not confirmed in this correlation analysis (P > 0.05).Conclusions Either hypertensive retinopathy grade or retinal arteriosclerosis grade is close with the hypertension risk factor lamination, suggesting that the fundus examination of patients with

  5. Embolization for gastrointestinal hemorrhages

    Energy Technology Data Exchange (ETDEWEB)

    Kraemer, S.C.; Goerich, J.; Rilinger, N.; Aschoff, A.J.; Vogel, J.; Brambs, H.J. [Dept. of Diagnostic Radiology, University of Ulm (Germany); Siech, M. [Dept. of Abdominal Surgery, University of Ulm (Germany)

    2000-05-01

    Retrospective evaluation of interventional embolization therapy in the treatment of gastrointestinal hemorrhage over a long-term observation period from 1989 to 1997. Included in the study were 35 patients (age range 18-89 years) with gastrointestinal bleeding (GI) referred for radiological intervention either primarily or following unsuccessful endoscopy or surgery. Sources of GI bleeding included gastric and duodenal ulcers (n = 7), diverticula (n = 3), erosion of the intestinal wall secondary to malignancy (n = 6), vascular malformations (n = 4), and hemorrhoids (n = 2), as well as from postoperative (n = 6), posttraumatic (n = 2), postinflammatory (n = 4) or unknown (n = 1) causes. Ethibloc (12 cases) or metal coils (14 cases) were predominantly used as embolisates. In addition, combinations of tissue adhesive and gelfoam particles and of coils and Ethibloc were used (six cases). Finally, polyvinyl alcohol particles, a coated stent, and an arterial wire dissection were utilized in one case each. Bleeding was stopped completely in 29 of 35 cases (83 %). In one case (3 %) the source of bleeding was recognized but the corresponding vessel could not be catheterized. In five other cases (14 %) there was partial success with reduced, though still persistent, bleeding. The rate of complications was 14 %, including four instances of intestinal ischemia with fatal outcome in the first years, and, later, one partial infarction of the spleen without serious consequences. Gastrointestinal hemorrhage can be controlled in a high percentage of patients, including the seriously ill and those who had previously undergone surgery, with the use of minimally invasive interventional techniques. The availability of minicoils instead of fluid embolization agents has reduced the risk of serious complications. (orig.)

  6. Hemostasis in Intracranial Hemorrhage

    Science.gov (United States)

    Gulati, Deepak; Dua, Dharti; Torbey, Michel T.

    2017-01-01

    Spontaneous non-traumatic intracerebral hemorrhage (ICH) is associated with high morbidity and mortality throughout the world with no proven effective treatment. Majority of hematoma expansion occur within 4 h after symptom onset and is associated with early deterioration and poor clinical outcome. There is a vital role of ultra-early hemostatic therapy in ICH to limit hematoma expansion. Patients at risk for hematoma expansion are with underlying hemostatic abnormalities. Treatment strategy should include appropriate intervention based on the history of use of antithrombotic use or an underlying coagulopathy in patients with ICH. For antiplatelet-associated ICH, recommendation is to discontinue antiplatelet agent and transfuse platelets to those who will undergo neurosurgical procedure with moderate quality of evidence. For vitamin K antagonist-associated ICH, administration of 3-factor or 4-factor prothrombin complex concentrates (PCCs) rather than fresh frozen plasma to patients with INR >1.4 is strongly recommended. For patients with novel oral anticoagulant-associated ICH, administering activated charcoal to those who present within 2 h of ingestion is recommended. Idarucizumab, a humanized monoclonal antibody fragment against dabigatran (direct thrombin inhibitor) is approved by FDA for emergency situations. Administer activated PCC (50 U/kg) or 4-factor PCC (50 U/kg) to patients with ICH associated with direct thrombin inhibitors (DTI) if idarucizumab is not available or if the hemorrhage is associated with a DTI other than dabigatran. For factor Xa inhibitor-associated ICH, administration of 4-factor PCC or aPCC is preferred over recombinant FVIIa because of the lower risk of adverse thrombotic events. PMID:28360881

  7. Intracranial hemorrhage in late hemorrhagic disease of the newborn.

    Science.gov (United States)

    Pooni, Puneet A; Singh, Daljit; Singh, Harmesh; Jain, B K

    2003-03-01

    This study was conducted to evaluate the clinical profile and outcome in late hemorrhagic disease of the newborn (HDN) with particular reference to intracranial hemorrhage. Infants (n = 42) presenting with late HDN from January 1998 to December 2001 were studied. Majority (76%) were in the age group of 1-3 months. All were term babies on exclusive breast-feeding and none received vitamin K at birth. 71% patients presented with intracranial hemorrhage, commonest site being intracerebral and multiple ICH. Visible external bleeding was noted in 1/3rd of patients only. Three patients expired. Late HDN is still an important cause of mortality and morbidity in developing countries where vitamin K prophylaxis is not routinely practiced. Isolated intracranial hemorrhage is a common mode of presentation.

  8. Analysis of the mechanisms of rabbit’s brainstem hemorrhage complicated with irritable changes in the alvine mucous membrane

    Science.gov (United States)

    Jin, Xue-Long; Zheng, Yang; Shen, Hai-Ming; Jing, Wen-Li; Zhang, Zhao-Qiang; Huang, Jian-Zhong; Tan, Qing-Lin

    2005-01-01

    AIM: To explore the dynamic changes in the pressure of the lateral ventricle during acute brainstem hemorrhage and the changes of neural discharge of vagus nerve under the load of intracranial hypertension, so as to analyze their effects on the congestive degree of intestinal mucous membrane and the morphologic changes of intestinal mucous membrane. METHODS: An operation was made to open the skull to obtain an acute brainstem hemorrhage animal model. Microcirculatory microscope photography device and video recording system were used to determine the changes continuously in the caliber of jejunal mesenteric artery during brainstem hemorrhage and the changes with time in the congestion of jejunal mucosal villi. We used HE stain morphology to analyze the changes of duodenal mucosal villi. A recording electrode was used to calculate and measure the electric discharge activities of cervical vagus nerve. RESULTS: (1) We observed that the pressure of lateral cerebral ventricle increased transiently during acute brainstem hemorrhage; (2) The caliber of the jejunal mesenteric artery increased during brainstem hemorrhage. Analysis of red color coordinate values indicated transient increase in the congestion of jejunal mucous membrane during acute brainstem hemorrhage; (3) Through the analysis of the pathologic slice, we found enlarged blood vessels, stagnant blood, and transudatory red blood cells in the duodenal submucous layer; (4) Electric discharge of vagus nerve increased and sporadic hemorrhage spots occurred in duodenal mucous and submucous layer, when the lateral ventricle was under pressure. CONCLUSION: Brainstem hemorrhage could cause intracranial hypertension, which would increase the neural discharge of vagus nerve and cause the transient congestion of jejunal mucous membrane. It could cause hyperemia and diffused hemorrhage in the duodenal submucous layer 48 h after brainstem hemorrhage. PMID:15786536

  9. Analysis of the mechanisms of rabbit's brainstem hemorrhage complicated with irritable changes in the alvine mucous membrane

    Institute of Scientific and Technical Information of China (English)

    Xue-Long Jin; Yang Zheng; Hai-Ming Shen; Wen-Li Jing; Zhao-Qiang Zhang; Jian-Zhong Huang; Qing-Lin Tan

    2005-01-01

    AIM: To explore the dynamic changes in the pressure of the lateral ventricle during acute brainstem hemorrhage and the changes of neural discharge of vagus nerve under the load of intracranial hypertension, so as to analyze their effects on the congestive degree of intestinal mucous membrane and the morphologic changes of intestinal mucous membrane.METHODS: An operation was made to open the skull to obtain an acute brainstem hemorrhage animal model.Microcirculatory microscope photography device and video recording system were used to determine the changes continuously in the caliber of jejunal mesenteric artery during brainstem hemorrhage and the changes with time in the congestion of jejunal mucosal villi. We used HE stain morphology to analyze the changes of duodenal mucosal villi. A recording electrode was used to calculate and measure the electric discharge activities of cervical vagus nerve.RESULTS: (1) We observed that the pressure of lateral cerebral ventricle increased transiently during acute brainstem hemorrhage; (2) The caliber of the jejunal mesenteric artery increased during brainstem hemorrhage.Analysis of red color coordinate values indicated transient increase in the congestion of jejunal mucous membrane during acute brainstem hemorrhage; (3) Through the analysis of the pathologic slice, we found enlarged blood vessels, stagnant blood, and transudatory red blood cells in the duodenal submucous layer; (4) Electric discharge of vagus nerve increased and sporadic hemorrhage spots occurred in duodenal mucous and submucous layer, when the lateral ventricle was under pressure.CONCLUSION: Brainstem hemorrhage could causeintracranial hypertension, which would increase the neural discharge of vagus nerve and cause the transient congestion of jejunal mucous membrane. It could cause hyperemia and diffused hemorrhage in the duodenal submucous layer 48 h after brainstem hemorrhage.

  10. Hemorrhagic Lacrimation and Epistaxis in Acute Hemorrhagic Edema of Infancy

    Directory of Open Access Journals (Sweden)

    Shireen Mreish

    2016-01-01

    Full Text Available Acute hemorrhagic edema of infancy is an uncommon benign cutaneous vasculitis. Despite its worrisome presentation, it carries good prognosis with rarely reported systemic involvement. Management of these cases has been an area of debate with majority of physicians adopting conservative modalities. We report a case that presented with classic triad of rash, low grade fever, and peripheral edema along with two rarely reported manifestations in literature: hemorrhagic lacrimation and epistaxis.

  11. Intracranial hemorrhages and late hemorrhagic disease associated cholestatic liver disease

    OpenAIRE

    2012-01-01

    Deficiency of vitamin K predisposes to early, classic or late hemorrhagic disease of the newborn (HDN); of which late HDN may be associated with serious and life-threatening intracranial hemorrhage. Late HDN is characterized intracranial bleeding in infants aged 1 week to 6 months due to severe vitamin K deficiency. Late HDN is still an important cause of mortality and morbidity in developing countries where vitamin K prophylaxis is not routinely practiced. Children with cholestatic liver dis...

  12. An 8-month-old boy with congenital fibromuscular dysplasia presenting with shock caused by sudden renal hemorrhage.

    Science.gov (United States)

    Takano, K; Kawasaki, Y; Imaizumi, T; Ohara, S; Takeyama, A; Suyama, K; Hashimoto, K; Hosoya, M

    2010-11-01

    Fibromuscular dysplasia (FMD) is a non-atheromatous, non-inflammatory, multifocal segmental angiopathy. FMD is the most common cause of pediatric renovascular hypertension. Aneurysmal formation of the main renal artery and distal branches is a rare complication of FMD in infancy. We report an 8-month-old boy with FMD presenting with shock caused by sudden renal hemorrhage that necessitated removal of one kidney. A diagnosis of renovascular hypertension resulting from intimal type FMD with aneurysmal formation was made on the basis of the presence of hypertension, elevation of PRA and aldosterone activity, pathological findings and the results of renal angiography. Our findings suggest that it is therefore necessary to consider FMD with aneurysmal formation as a possible cause of hypertension and renal hemorrhage in infants.

  13. Acute glomerulonephritis in dengue hemorrhagic fever: A rare case report

    Directory of Open Access Journals (Sweden)

    K R Meena

    2013-01-01

    Full Text Available An 11-year-old male child presented with fever, bodyache, swelling over the whole body, and oliguria. He had hypertension. Urine microscopy showed hematuria and glomerular casts. Renal functions were deranged and had low complement C3 level. Chest X-ray showed plural effusion and ultrasonography abdomen showed mild ascitis. The immunoglobulin (IgM and IgG enzyme-linked immunosorbent essay for dengue virus were positive. Diagnosis of dengue hemorrhagic fever with acute glomerulonephritis was made. He was managed with maintenance fluid, antihypertensive medicine and supportive care. He recovered gradually and was discharged 12 days after admission.

  14. Tegmental pontine hemorrhages: clinical features and prognostic factors.

    Science.gov (United States)

    Lancman, M; Norscini, J; Mesropian, H; Bardeci, C; Bauso, T; Granillo, R

    1992-05-01

    We report six patients with partial, predominantly paramedian, tegmental pontine hemorrhages. Constant clinical manifestations consisted of: ipsilateral miosis, horizontal gaze paresis, lower motor neuron facial paresis, contralateral hemisensory loss and mild and transitory hemiparesis, dysarthria and mild or no compromise of consciousness. Five out of six were hypertensive. All patients survived with mild sequelae, oculomotor disturbances being the most persistent deficit. We found in our patients that a transverse diameter of less than 17 mm, unilaterality of the injury and absence of coma were the major indicators of a favorable outcome.

  15. Hypertension Subtypes among Hypertensive Patients in Ibadan

    Directory of Open Access Journals (Sweden)

    Abiodun M. Adeoye

    2014-01-01

    Full Text Available Background. Certain hypertension subtypes have been shown to increase the risk for cardiovascular morbidity and mortality and may be related to specific underlying genetic determinants. Inappropriate characterization of subtypes of hypertension makes efforts at elucidating the genetic contributions to the etiology of hypertension largely vapid. We report the hypertension subtypes among patients with hypertension from South-Western Nigeria. Methods. A total of 1858 subjects comprising 76% female, hypertensive, aged 18 and above were recruited into the study from two centers in Ibadan, Nigeria. Hypertension was identified using JNCVII definition and was further grouped into four subtypes: controlled hypertension (CH, isolated systolic hypertension (ISH, isolated diastolic hypertension (IDH, and systolic-diastolic hypertension (SDH. Results. Systolic-diastolic hypertension was the most prevalent. Whereas SDH (77.6% versus 73.5% and IDH (4.9% versus 4.7% were more prevalent among females, ISH (10.1% versus 6.2% was higher among males (P=0.048. Female subjects were more obese (P<0.0001 and SDH was prevalent among the obese group. Conclusion. Gender and obesity significantly influenced the distribution of the hypertension subtypes. Characterization of hypertension by subtypes in genetic association studies could lead to identification of previously unknown genetic variants involved in the etiology of hypertension. Large-scale studies among various ethnic groups may be needed to confirm these observations.

  16. Hypertension Briefing

    OpenAIRE

    2012-01-01

    Blood pressure is the force exerted on artery walls as the heart pumps blood through the body. Hypertension, or high blood pressure, occurs when blood pressure is constantly higher than the pressure needed to carry blood through the body. The Chronic Conditions Hub is a website that brings together information on chronic health conditions. It allows you to easily access, manage and share relevant information resources. The Chronic Conditions Hub includes the Institute of Public Health in Irel...

  17. Resistant hypertension.

    Science.gov (United States)

    Armario, P; Oliveras, A; de la Sierra, A

    2013-11-01

    A 53 year old woman with hypercholesterolemia treated with statins, with no history of cardiovascular disease, was referred to the Hypertension and Vascular Risk Unit for management of hypertension resistant to 4 antihypertensive agents at full doses. The patient had obesity, with a body mass index of 36.3kg/m(2) and office blood pressure 162/102mm Hg. Physical examination showed no data of interest. glucose 120mg/dl, glycated Hb: 6.4%, albuminuria 68mg/g, kidney function and study of the renin angiotensin system and other biochemical parameters were normal. Echocardiography: left ventricular mass, 131g/m(2) (normal, <110g/m(2)). True resistant hypertension was confirmed by ambulatory monitoring of blood pressure during 24h (153/89mm Hg). Spironolactone treatment (25mg/day) was added and was well tolerated, with no change in renal function and kaliemia within normal (4.1mmol/l) following the treatment. After 8 weeks, blood pressure was well controlled: office blood pressure 132/86mm Hg and 24h-ambulatory blood pressure: 128/79mm Hg. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  18. Pathogenesis of arenavirus hemorrhagic fevers.

    Science.gov (United States)

    Moraz, Marie-Laurence; Kunz, Stefan

    2011-01-01

    Viral hemorrhagic fevers (VHFs) caused by arenaviruses belong to the most devastating emerging human diseases and represent serious public health problems. Arenavirus VHFs in humans are acute diseases characterized by fever and, in severe cases, different degrees of hemorrhages associated with a shock syndrome in the terminal stage. Over the past years, much has been learned about the pathogenesis of arenaviruses at the cellular level, in particular their ability to subvert the host cell's innate antiviral defenses. Clinical studies and novel animal models have provided important new information about the interaction of hemorrhagic arenaviruses with the host's adaptive immune system, in particular virus-induced immunosuppression, and have provided the first hints towards an understanding of the terminal hemorrhagic shock syndrome. The scope of this article is to review our current knowledge on arenavirus VHF pathogenesis with an emphasis on recent developments.

  19. Let's Talk about Hemorrhagic Stroke

    Science.gov (United States)

    ... Thromboembolism Aortic Aneurysm More Let's Talk About Hemorrhagic Stroke Updated:Dec 9,2015 About 13 percent of ... Should I Limit Sodium? How Do I Understand "Nutrition Facts" Labels? How Can I Quit Smoking? How ...

  20. HYPERTENSION IN PSYCHIATRIC PATIENTS

    OpenAIRE

    Chaturvedi, Santosh K.; Michael, Albert

    1986-01-01

    SUMMARY Known cases of hypertension and those fulfilling WHO criteria for diagnosis of hypertension were identified in psychiatric patients and compared with non - hypertensive psychiatric patients. Hypertension was detected in 141 (9.98%) cases, and was significantly more associated with elder age, married status, urban background and neurotic illness. The implications are in early detection and effective management of hypertension in psychiatric patients.

  1. Hypertension hos gravide

    DEFF Research Database (Denmark)

    Mathiesen, Elisabeth R; Johansen, Marianne; Kamper, Anne Lise;

    2009-01-01

    There are four major hypertensive disorders in pregnancy: chronic hypertension, gestational hypertension, preeclampsia and chronic hypertension with superimposed preeclampsia. The indications and efficacy of antihypertensive treatment of the different hypertensive disorders are assessed. Advantages...... and disadvantages of different classes of antihypertensive drugs during pregnancy and lactation are described....

  2. [Hypertension during pregnancy

    DEFF Research Database (Denmark)

    Mathiesen, E.R.; Johansen, M.; Kamper, A.L.;

    2009-01-01

    There are four major hypertensive disorders in pregnancy: chronic hypertension, gestational hypertension, preeclampsia and chronic hypertension with superimposed preeclampsia. The indications and efficacy of antihypertensive treatment of the different hypertensive disorders are assessed. Advantages...... and disadvantages of different classes of antihypertensive drugs during pregnancy and lactation are described Udgivelsesdato: 2009/6/15...

  3. Intraventricular Hemorrhage of the Newborn

    OpenAIRE

    1999-01-01

    Intraventricular hemorrhage IVH of the premature newborn is an important complication which determines its prognosis Intravascular vascular and extravascular factors should be considered in its etiology Cranial ultrasonography is the most suitable medical imagery technique IVH is graded from 1 to 4 according to its severity Prevention is the most crucial point in its management The literature and the management of IVH is reviewed Key words: Newborn Premature Intraventricular Hemorrhage

  4. 小骨窗开颅显微手术时机对高血压脑出血患者疗效、神经功能及生存质量的影响%Effects of operation time of small skull-window craniotomy on curative effect, nerve function and life quality in patients with hypertensive intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    莫合特尔·阿布力米提; 柳琛

    2015-01-01

    Objective To investigate the effects of different operation time on curative effect ,nerve function and life quali‐ty in patients with hypertensive intracerebral hemorrhage(HICH).Methods Ninety cases of HICH meeting the inclusion crite‐ria were divided into super‐early group(0.05). Compared with the early group ,there were lower mortality rate and higher GOS score in the super‐early group(P<0.05). Compared with the early group ,there were lower SSS score (3 weeks and 6 weeks after operation) and higher life quality in the super‐early group (3 months and 6 months after operation) (P<0.05).Conclusion Super‐early small skull‐window craniotomy can lower mortality rate ,improve curative effect and life quality in patients with HICH ,which is worthy of application.%目的:探讨小骨窗开颅显微手术不同手术时机治疗对高血压脑出血患者疗效、神经功能及生存质量的影响。方法90例符合纳入标准的高血压脑出血患者根据发病至手术时间不同分为超早期组(≤6 h , n=45)和早期组(6~24 h , n=45)。比较术后患者疗效、神经功能及生存质量。结果术后,早期组再出血率、病死率及GOS评分优良率分别为13.3%、26.7%和68.9%,超早期组分别为8.9%、6.7%和88.9%。在术后再出血率方面,2组比较无统计学差异( P>0.05)。与早期治疗组相比,超早期组患者病死率明显降低,GOS评分优良率明显增加,差异均有统计学意义(P均<0.05)。治疗后,与早期组相比,超早期组治疗后3周和6周的SSS评分均明显降低,治疗后3个月和6个月的生存质量评分均明显升高差异有统计学意义( P均<0.05)。结论超早期小骨窗开颅显微手术能降低患者的病死率,提高疗效,改善神经功能和生存质量,值得临床推广。

  5. Changes and clinical value of heart-type fatty acid binding protein in patients with acute hypertensive cerebral hemorrhage%急性高血压脑出血患者血清h-FABP水平变化及其临床应用价值

    Institute of Scientific and Technical Information of China (English)

    杨文东

    2012-01-01

    目的 通过观察急性高血压脑出血患者血清心脏型脂肪酸结合蛋白(h-FABP)水平变化,探讨其临床检测价值.方法 血清h-FABP采用双抗体夹心酶联免疫一步法定量检测;cTnI采用固相酶联免疫吸附实验(ELISA);CK-MB采用免疫抑制法测定HT5"H〗结果 急性高血压脑出血患者组血清h-FABP水平显著高于对照组(P<0.01),大量出血者及意识不清者血清h-FABP水平分别显著高于小量出血者及意识清醒者(P<0.01);血清h-FABP阳性率显著高于血清cTnI、CK-MB及心电图的阳性率(P<0.01);死亡率为25.5%(28/110),血清h-FABP、cTnI、CK-MB及心电图异常组的死亡率显著高于正常组(P<0.01);血清h-FABP预测发生死亡具有高的敏感性和阴性预测值,特异性和准确度较低,但心电图具有较高的特异性(64.5%)和准确度(69.1%).结论 血清h-FABP定量测定可作为判断急性高血压脑出血病情轻重及评价发生意外的1项客观指标,联合心电图监测临床价值更高.%Objective To understand the clinical value of heart-type fatty acid binding protein (h-FABP) in patients with acute hypertensive cerebral hemorrhage(AHCE) through the variation analysis of its serum level. Methods Serum level of h-FABP was determined by enzyme-linked immunosorbent one-step quantitative detection, cardiac troponin I(cTnl) was detected by solid-phase enzyme-linked immunosorbent assay (ELISA) and isoenzyme MB of creatine kinase(CK-MB) was assayed by immunosuppression assay. Results The h-FABP level in(AHCE) group was significantly higher than healthy control group(P<0. 01) and that in AHCE patients with massive haemorrhage and unconsciousness was significantly higher than in patients with small heamorrhage and consciousness. The positive rate of h-FABP was significantly higher than cTnI,CK-MB and electrocardiogram(P<0. 01). The mortality rate in patients, with abnormality of serum level of h-FABP,cTnl and CK-MB and ECG, was higher than patients

  6. Risk factors and management strategy of intraperitoneal hemorrhage following surgical treatment of portal hypertension%肝硬化门静脉高压症术后腹腔内出血风险因素分析及治疗对策

    Institute of Scientific and Technical Information of China (English)

    徐威; 李敬东; 田云鸿; 李强; 李德新

    2012-01-01

    目的 探讨肝硬化门静脉高压症(PH)术后发生腹腔内出血(PITH)的风险因素和治疗对策.方法 回顾性分析2004年1月至2011年1月川北医学院附属医院手术治疗的259例PH临床资料.二分类Logistic回归行发生PITH的单因素和多因素分析.ROC曲线确定截点值.结果 259例PH术后发生PITH 15例(5.8%),4例行非手术治疗,11例再次手术探查止血.多因素分析显示INR>1.5、AFP≥6.245 μg/L和门静脉内径>1.3cm是PH手术治疗后发生PITH的风险因素.不同风险等级PH手术治疗后PITH发生率差异有统计学意义(73.3% vs.1.6%,P=0.000).结论 PH手术治疗后发生PITH是潜在致命性并发症,风险等级划分有助于预测和治疗.%Objective To explore the risk factors of postoperative intraperitoneal hemorrhage (PITH) following surgical treatment of portal hypertension (PH) and study management strategy. Methods The clinical data of 259 cases of PH ? treated surgically from January 2004 to January 2011 in the Affiliated Hospital of North Sichuan Medical College were analyzed retrospectively. Clinical factors were explored for their possible association with occurrence of PITH in univariate and multivariate analysis using Logistic regression model. Receiver operating characteristics (ROC) analysis with calculation of the area under the curve (AUC), sensitivity and specificity were applied to define cutoff values for continuous variables appropriated. Results Among 259 cases, PITH occurred in 15 cases (5.8%). Among 15 cases, haemostasis was achieved successfully with conservative treatment in 4 cases, while re-laparotomy was performed in the rest 11 cases to confirm possible bleeding sites. Multivariate analysis revealed that INR> 1.500, AFP≥6.245μg/L and portal vein diameter > 1.3cm were independent risk factors predicting occurrence of PITH. Risk stratification showed statistically significant difference of PITH occurrence (73.3%vs.l.6%, P=0.000). Conclusion

  7. New Line of Investigation in Rehabilitation of Patients Suffered from Hemorrhagic Fever with Renal Syndrome

    Directory of Open Access Journals (Sweden)

    G. M. Khasanova

    2011-01-01

    Full Text Available A new educational program for patients suffered from hemorrhagic fever with renal syndrome was worked out and applied into practice for the first time. It was revealed that patient teaching increased patient complianceand improved rehabilitation results for sure. Asthenia symptoms, arterial hypertension and inflammatory processes in uringenital system were recorded more rarely with such patients for certain. The efficiency of this educational program in combined rehabilitation after cases of hemorrhagic fever with renal syndrome proves its advisability of wide application in medical and preventive treatment institutions.

  8. Statins and intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Zheng Haiping; Hu Zhiping; Lu Wei

    2014-01-01

    Objective To briefly review the literature regarding the impact of statins on the prevention and treatment of stroke,especially on intracerebral hemorrhage (ICH).We described statins' effects,mechanism of ICH,serum total cholesterol and ICH,and the relationship between statins and ICH.Data sources All articles used in this review were mainly searched from the PubMed database with no limitations of language and year of publication.Study selection Randomized controlled studies,prospective cohort studies,animal experiments,and meta-analysis articles related to this topic in the past decade were selected.Results Statins play an important role in the primary and secondary prevention of cardiovascular diseases and also have an impact on the treatment of vascular diseases.There still exist controversies about the relationship between statins and ICH.More clinical and experimental trials indicate that statins do not increase the risk of ICH.Conclusion A low or a regular dose of statins would not increase the risk of ICH.

  9. Quantitative Intracerebral Hemorrhage Localization

    Science.gov (United States)

    Muschelli, John; Ullman, Natalie L.; Sweeney, Elizabeth M.; Eloyan, Ani; Martin, Neil; Vespa, Paul; Hanley, Daniel F.; Crainiceanu, Ciprian M.

    2015-01-01

    Background and Purpose The location of intracerebral hemorrhage (ICH) is currently described in a qualitative way; we provide a quantitative framework for estimating ICH engagement and its relevance to stroke outcomes. Methods We analyzed 111 patients with ICH from the MISTIE II clinical trial. We estimated ICH engagement at a population level using image registration of CT scans to a template and a previously labeled atlas. Predictive regions of NIHSS and GCS stroke severity scores, collected at enrollment, were estimated. Results The percent coverage of the ICH by these regions strongly outperformed the reader-labeled locations. The adjusted R2 almost doubled from 0.129 (reader-labeled model) to 0.254 (quantitative-location model) for NIHSS and more than tripled from 0.069 (reader-labeled model) to 0.214 (quantitative-location model). A permutation test confirmed that the new predictive regions are more predictive than chance: p<.001 for NIHSS and p<.01 for GCS. Conclusions Objective measures of ICH location and engagement using advanced CT imaging processing provide finer, objective, and more quantitative anatomic information than that provided by human readers. PMID:26451031

  10. Pulmonary Arterial Hypertension

    Science.gov (United States)

    Pulmonary Arterial Hypertension What Is Pulmonary Hypertension? To understand pulmonary hypertension (PH) it helps to understand how blood ows throughout your body. While the heart is one organ, it ...

  11. Hypertensive Disorders of Pregnancy

    OpenAIRE

    Mammaro, Alessia; Carrara, Sabina; Cavaliere, Alessandro; Ermito, Santina; Dinatale, Angela; Pappalardo, Elisa Maria; Militello, Mariapia; Pedata, Rosa

    2009-01-01

    Hypertension is the most common medical problem encountered during pregnancy, complicating 2-3% of pregnancies. Hypertensive disorders during pregnancy are classified into 4 categories, as recommended by the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy: 1) chronic hypertension, 2) preeclampsia-eclampsia, 3) preeclampsia superimposed on chronic hypertension, and 4) gestational hypertension (transient hypertension of pregnancy or chronic hyper...

  12. Treating Hypertension in Pregnancy.

    Science.gov (United States)

    Schlembach, Dietmar; Homuth, Volker; Dechend, Ralf

    2015-08-01

    Hypertension is present in about 10 % of all pregnancies. The frequency of chronic hypertension and that of gestational hypertension is increasing. The management of pregnant women with hypertension remains a significant, but controversial, public health problem. Although treatment of hypertension in pregnancy has shown to reduce maternal target organ damage, considerable debate remains concerning treatment. We review current evidence regarding treatment goals, the ideal treatment starting time, and which drugs are available for the treatment of hypertension in pregnancy.

  13. Intracranial hemorrhages and late hemorrhagic disease associated cholestatic liver disease.

    Science.gov (United States)

    Per, Hüseyin; Arslan, Duran; Gümüş, Hakan; Coskun, Abdulhakim; Kumandaş, Sefer

    2013-01-01

    Deficiency of vitamin K predisposes to early, classic or late hemorrhagic disease of the newborn (HDN); of which late HDN may be associated with serious and life-threatening intracranial hemorrhage. Late HDN is characterized intracranial bleeding in infants aged 1 week to 6 months due to severe vitamin K deficiency. Late HDN is still an important cause of mortality and morbidity in developing countries where vitamin K prophylaxis is not routinely practiced. Children with cholestatic liver disease are at risk for developing secondary vitamin K deficiency because of fat malabsorbtion and inadequate dietary intake. In this study, we described 11 infants with cholestatic liver disease with different etiologies exhibiting intracranial hemorrhage (ICH). Six patients underwent surgical evacuation of ICH, following the administration of vitamin K and/or fresh frozen plasma. The possibility of cholestatic liver disease should be considered in the treatment of ICH due to vitamin K deficiency.

  14. How Is Pulmonary Hypertension Treated?

    Science.gov (United States)

    ... from the NHLBI on Twitter. How Is Pulmonary Hypertension Treated? Pulmonary hypertension (PH) has no cure. However, ... Types of Pulmonary Hypertension." ) Group 1 Pulmonary Arterial Hypertension Group 1 pulmonary arterial hypertension (PAH) includes PH ...

  15. Pneumatic displacement without tissue plasminogen activator in premacular subhyaloid hemorrhage

    Directory of Open Access Journals (Sweden)

    Rumita S. Kadarisman

    2007-06-01

    Full Text Available To assess the efficacy and safety of intravitreal injection of Sulfur Hexafluoride (SF6 gas without the use of tissue Plasminogen Activator (tPA in premacular Subhyaloid Hemorrhage (SHH, 5 eyes of 5 patients with premacular SHH were enrolled. After performing paracentesis of the anterior chamber, 0.3 ml pure SF6 gas was injected through pars plana with a 30 gauge needle. Facedown position was maintained for 5 days. Subhyaloid Hemorrhage was displaced in 4/5 (80% eyes with a duration of SHH less than 2 weeks. The pre-injection visual acuity of all 5 eyes was finger counting and improved in 4/5 ( 80% eyes within 3 days to 7 days post-injection to 6/20 - 6/6. The underlying disease was hypercoagulation in 1 patient, diabetes mellitus in 2 patients, hypertension in 1 patient and unknown in 1 patient. No complications were encountered. In conclusion, SF6 gas injected into the vitreous without the use of tPA, can displace SHH if performed within 14 days of duration, and results in rapid visual recovery. This procedure is proven to be safe. (Med J Indones 2007; 16:104-7 Keywords: subhyaloid hemorrhage, pneumatic displacement, sulfur hexafluoride gas

  16. Circulatory contributors to the phenotype in hereditary hemorrhagic telangiectasia

    Directory of Open Access Journals (Sweden)

    Claire L Shovlin

    2015-04-01

    Full Text Available Hereditary hemorrhagic telangiectasia (HHT is mechanistically and therapeutically challenging, not only because of the molecular and cellular perturbations that generate vascular abnormalities, but also the modifications to circulatory physiology that result, and are likely to exacerbate vascular injury. First, most HHT patients have visceral arteriovenous malformations (AVMs. Significant visceral AVMs reduce the systemic vascular resistance: supra-normal cardiac outputs are required to maintain arterial blood pressure, and may result in significant pulmonary venous hypertension. Secondly, bleeding from nasal and gastrointestinal telangiectasia leads to iron losses of such magnitude that in most cases, diet is insufficient to meet the ‘hemorrhage adjusted iron requirement.’ Resultant iron deficiency restricts erythropoiesis, leading to anemia and further increases in cardiac output. Low iron levels are also associated with venous and arterial thromboses, elevated Factor VIII, and increased platelet aggregation to circulating 5HT (serotonin. Third, recent data highlight that reduced oxygenation of blood due to pulmonary AVMs results in a graded erythrocytotic response to maintain arterial oxygen content, and higher stroke volumes and/or heart rates to maintain oxygen delivery. Finally, HHT-independent factors such as diet, pregnancy, sepsis and other intercurrent illnesses also influence vascular structures, hemorrhage, and iron handling in HHT patients. These considerations emphasize the complexity of mechanisms that impact on vascular structures in HHT, and also offer opportunities for targeted therapeutic approaches.

  17. Prolonged Paroxysmal Sympathetic Storming Associated with Spontaneous Subarachnoid Hemorrhage

    Directory of Open Access Journals (Sweden)

    Yan Liu

    2013-01-01

    Full Text Available Paroxysmal sympathetic storming (PSS is a rare disorder characterized by acute onset of nonstimulated tachycardia, hypertension, tachypnea, hyperthermia, external posturing, and diaphoresis. It is most frequently associated with severe traumatic brain injuries and has been reported in intracranial tumors, hydrocephalous, severe hypoxic brain injury, and intracerebral hemorrhage. Although excessive release of catecholamine and therefore increased sympathetic activities have been reported in subarachnoid hemorrhage (SAH, there is no descriptive report of PSS primarily caused by spontaneous SAH up to date. Here, we report a case of prolonged PSS in a patient with spontaneous subarachnoid hemorrhage and consequent vasospasm. The sympathetic storming started shortly after patient was rewarmed from hypothermia protocol and symptoms responded to Labetalol, but intermittent recurrence did not resolve until 3 weeks later with treatment involving Midazolam, Fentanyl, Dexmedetomidine, Propofol, Bromocriptine, and minimizing frequency of neurological and vital checks. In conclusion, prolonged sympathetic storming can also be caused by spontaneous SAH. In this case, vasospasm might be a precipitating factor. Paralytics and hypothermia could mask the manifestations of PSS. The treatment of the refractory case will need both timely adjustment of medications and minimization of exogenous stressors or stimuli.

  18. Paraplegia caused by aortic coarctation complicated with spinal epidural hemorrhage.

    Science.gov (United States)

    Tsai, Yi-Da; Hsu, Chin-Wang; Hsu, Chia-Ching; Liao, Wen-I; Chen, Sy-Jou

    2016-03-01

    Aortic coarctation complicated with spinal artery aneurysm rupture is exceptionally rare and can be source of intraspinal hemorrhage with markedly poor prognosis. A 21-year-old man visited the emergency department because of chest and back pain along with immobility of bilateral lower limbs immediately after he woke up in the morning. Complete flaccid paraplegia and hypoesthesia in dermatome below bilateral T3 level and pain over axial region from neck to lumbar region were noted. A computed tomography excluded aortic dissection. Magnetic resonance imaging revealed a fusiform lesion involving the anterior epidural space from C7 to T2 level suspected of epidural hemorrhage, causing compression of spinal cord. He started intravenous corticosteroid but refused operation concerning the surgical benefits. Severe chest pain occurred with newly onset right bundle branch block that developed the other day. Coronary artery angiography revealed myocardial bridge of left anterior descending coronary artery at middle third and coarctation of aorta. He underwent thoracic endovascular aortic repair uneventfully. The patient was hemodynamically stable but with slow improvement in neurologic recovery of lower limbs. Aortic coarcation can cause paralysis by ruptured vascular aneurysms with spinal hemorrhage and chest pain that mimics acute aortic dissection. A history of hypertension at young age and aortic regurgitated murmurs may serve as clues for further diagnostic studies. Cautious and prudent evaluation and cross disciplines cares are essential for diagnosis and successful management of the disease.

  19. "Downhill" varices: A rare cause of esophageal hemorrhage Varice "Downhill": Una causa extraña de sangrado esofágico

    Directory of Open Access Journals (Sweden)

    M. Areia

    2006-05-01

    Full Text Available "Downhill" varices or upper esophageal varices are a rare cause of proximal digestive tract hemorrhage with only 16 cases described in the literature. In our series, hemorrhage due to "Downhill" varices represents 0.1% of all acute esophageal variceal bleeding. Their etiology differs from that of the usual "uphill' varices secondary to portal hypertension, and the clinical management should be directed to vascular obstruction if present. We report a case of an 89-year-old male with hemorrhagic "Downhill" varices not associated, as usually, with superior vena cava obstruction or compression, but with severe pulmonary hypertension and drug-related hemorrhagic risk factors, whose removal proved sufficient to prevent rebleeding.

  20. Intracerebral hemorrhage and cognitive impairment.

    Science.gov (United States)

    Xiong, Li; Reijmer, Yael D; Charidimou, Andreas; Cordonnier, Charlotte; Viswanathan, Anand

    2016-05-01

    Vascular cognitive impairment and vascular dementia are composed of cognitive deficits resulted from a range of vascular lesions and pathologies, including both ischemic and hemorrhagic. However the contribution of spontaneous intracerebral hemorrhage presumed due to small vessel diseases on cognitive impairment is underestimated, in contrast to the numerous studies about the role of ischemic vascular disorders on cognition. In this review we summarize recent findings from clinical studies and appropriate basic science research to better elucidate the role and possible mechanisms of intracerebral hemorrhage in cognitive impairment and dementia. This article is part of a Special Issue entitled: Vascular Contributions to Cognitive Impairment and Dementia edited by M. Paul Murphy, Roderick A. Corriveau and Donna M. Wilcock.

  1. Crimean-Congo Hemorrhagic Fever (CCHF)

    Science.gov (United States)

    ... Cancel Submit Search The CDC Crimean-Congo Hemorrhagic Fever (CCHF) Note: Javascript is disabled or is not ... on Facebook Tweet Share Compartir Crimean-Congo hemorrhagic fever (CCHF) is caused by infection with a tick- ...

  2. Fatal hemorrhage in irradiated esophageal cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Nemoto, Kenji; Takai, Yoshihiro; Ogawa, Yoshihiro; Kakuto, Yoshihisa; Ariga, Hisanori; Matsushita, Haruo; Wada, Hitoshi; Yamada, Shogo [Tohoku Univ., Sendai (Japan). Dept. of Radiology

    1998-09-01

    Between 1980 and 1994, 423 patients with esophageal cancer were given curative radiation therapy. Of these patients, 31 died of massive hemorrhage and were used as the subjects of analysis in this study. The incidence of massive hemorrhage in all patients was 7% (31/423). In the 31 patients who died of massive hemorrhage, 27 had local tumors and two had no tumors at hemorrhage (two unknown cases). The mean time interval from the start of radiation to hemorrhage was 9.2 months. In 9 autopsy cases the origin of hemorrhage was a tear of the aorta in 5 cases, necrotic local tumor in 3 cases and esophageal ulcer in 1 case. The positive risk factors for this complication seemed to be excess total dose, infection, metallic stent, and tracheoesophageal fistula. Chest pain or sentinel hemorrhage proceeding to massive hemorrhage was observed in about half of the patients. (orig.)

  3. [Sheehan's syndrome after obstetric hemorrhage].

    Science.gov (United States)

    Ramos-López, L; Pons-Canosa, V; Juncal-Díaz, J L; Núñez-Centeno, M B

    2014-12-01

    Sheehan's syndrome is described as panhypopituitarism secondary to a pituitary hypoperfusion during or just after obstetric hemorrhage. Advances in obstetric care make this syndrome quite unusual, but some cases are reported in underdeveloped countries. Clinical presentation may change depending on the severity of the hormone deficiencies. The diagnosis is clinical, but abnormalities are observed in the magnetic resonance in up to 70% of patients. We present a case of a woman with hypotension, hypothermia and edemas in relation to a previous massive postpartum hemorrhage. Failure in lactation was the clue to the diagnosis. A review of its main features, its diagnosis and treatment in the current literature is also presented.

  4. TIPSS for variceal hemorrhage after living related liver transplantation: A dangerous indication

    Institute of Scientific and Technical Information of China (English)

    Peter Schemmer; Boris Radeleff; Christa Flechtenmacher; Arianeb Mehrabi; G(o)tz M Richter; Markus W Büchler; Jan Schmidt

    2006-01-01

    The introduction of transjugular intrahepatic portalsystemic stent-shunt (TIPSS) has been a major breakthrough in the treatment of portal hypertension,which has evolved to a large extent, into a routine procedure. A 21-year-old male patient with progressive graft fibrosis/cirrhosis requiring TIPSS for variceal hemorrhage in the esophagus due to portal hypertension was unresponsive to conventional measures two years after living related liver transplantation (LDLT).Subsequently, variceal hemorrhage was controlled,however, liver function decreased dramatically with consecutive multi organ failure. CT scan revealed substantial necrosis in the liver. The patient underwent successful "high urgent" cadaveric liver transplantation and was discharged on postoperative d 20 in a stable condition.

  5. Symptomatic Tarlov Cyst Following Spontaneous Subarachnoid Hemorrhage

    OpenAIRE

    Kong, Woo Keun; Cho, Keun-Tae; Hong, Seung-Koan

    2011-01-01

    Most of Tarlov or perineurial cysts remain asymptomatic throughout the patient's life. The pathogenesis is still unclear. Hemorrhage has been suggested as one of the possible causes and trauma with resultant hemorrhage into subarachnoid space has been suggested as an origin of these cysts. However, Tarlov cysts related to spontaneous subarachnoid hemorrhage has not been reported. The authors report a case of Tarlov cyst which was symptomatic following spontaneous subarachnoid hemorrhage.

  6. Symptomatic tarlov cyst following spontaneous subarachnoid hemorrhage.

    Science.gov (United States)

    Kong, Woo Keun; Cho, Keun-Tae; Hong, Seung-Koan

    2011-08-01

    Most of Tarlov or perineurial cysts remain asymptomatic throughout the patient's life. The pathogenesis is still unclear. Hemorrhage has been suggested as one of the possible causes and trauma with resultant hemorrhage into subarachnoid space has been suggested as an origin of these cysts. However, Tarlov cysts related to spontaneous subarachnoid hemorrhage has not been reported. The authors report a case of Tarlov cyst which was symptomatic following spontaneous subarachnoid hemorrhage.

  7. Tentorial hemorrhage associated with vacuum extraction

    Energy Technology Data Exchange (ETDEWEB)

    Huang, L.T. [Dept. of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung (Taiwan, Province of China); Lui, C.C. [Diagnostic Radiology, Chang Gung Memorial Hospital, Kaohsiung (Taiwan, Province of China)

    1995-11-01

    Neuroimages of tentorial hemorrhage associated with vacuum extraction have been rarely reported. The authors present the case of a 5-day-old newborn with this entity. CT showed retrocerebellar hemorrhage and MRI demonstrated tentorial hemorrhage extending inferiorly over the cerebellum and superiorly over the occipital regions. We believe that these imaging modalities are helpful in delineating the extent of the hemorrhage and assessing the prognosis. (orig.)

  8. Propilthiouracil-induced diffuse pulmonary hemorrhage: a case report with the clinical and radiologic findings

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Young Jun; Kim, Joung Sook; Kim, Ji Young; Choi, Soo Jeon [Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2007-05-15

    Propylthiouracil (PTU) is a drug that's used to manage hyperthyroidism and it can, on rare occasions, induce antineutrophil cytoplasmic antibody-associated vasculitis that involved multiple organ systems and it can also cause extremely rare isolated or diffuse pulmonary hemorrhage. We report here on a case of a patient who develop diffuse pulmonary hemorrhage after she had been taking PTU for five years. The patient is a 33-year-old woman who presented with hemoptysis. Simple chest radiographs and the chest CT showed bilateral ground-glass opacity, consolidation and pulmonary arterial hypertension. The bronchoalveolar lavage fluid revealed alveolar hemorrhage. The laboratory values showed increased perinuclear-antineutrophil cytoplasmic antibody ({rho} - ANCA) and anti-peroxidase antibody titers.

  9. Hypertensive Emergencies in Pregnancy.

    Science.gov (United States)

    Olson-Chen, Courtney; Seligman, Neil S

    2016-01-01

    The prevalence of hypertensive disorders in pregnancy is increasing. The etiology and pathophysiology of hypertensive disorders in pregnancy remain poorly understood. Hypertensive disorders are a major cause of maternal and perinatal morbidity and mortality. Treatment of hypertension decreases the incidence of severe hypertension, but it does not impact rates of preeclampsia or other pregnancy complications. Several antihypertensive medications are commonly used in pregnancy, although there is a lack of randomized controlled trials. Severe hypertension should be treated immediately to prevent maternal end-organ damage. Appropriate antepartum, intrapartum, and postpartum management is important in caring for patients with hypertensive disorders.

  10. Alveolar hemorrhage and kidney disease: characteristics and therapy.

    Science.gov (United States)

    Fatma, Lilia Ben; El Ati, Zohra; Lamia, Rais; Aich, Dorra Ben; Madiha, Krid; Wided, Smaoui; Maiz, Hedi Ben; Beji, Somaya; Karim, Zouaghi; Moussa, Fatma Ben

    2013-07-01

    Anti-neutrophil cytoplasmic antibody-associated vasculitis and Goodpasture's glomerular basement membrane disease are the most common causes of diffuse alveolar hemorrhage, a life-threatening disease. Systemic lupus erythematosus and the antiphospholipid syndrome are also causes of alveolar hemorrhage. We retrospectively reviewed 15 cases of diffuse alveolar hemorrhage (DAH) associated with renal diseases. Diagnosis of DAH was based on the presence of bloody bronchoalveolar lavage fluid. There were three men and 12 women, with a mean age of 50.5 years (extremes: 24-74 years). Proteinuria and hematuria were observed, respectively, in 15 and 14 cases. Six patients revealed arterial hypertension. Crescentic glomerulonephritis was diagnosed with kidney biopsies in ten cases. The etiology of renal disease was microscopic polyangiitis (MPA) in seven cases, Wegener disease in four cases, systemic lupus erythematous in one case, cryoglobulinemia in one case, myeloma in one case and propyl-thiouracil-induced MPA in one case. Hemoptysis occurred in 14 cases. The mean serum level of hemoglobin was 7.1 g/dL (5.1-10 g/dL). The mean serum creatinine concentration was 7.07 mg/dL (2.4-13.7 mg/dL). Gas exchange was severely compromised, with an oxygenation index <80 mmHg in 14 patients and <60 mmHg in seven patients. Bronchoalveolar lavage was performed in 11 cases, and had positive findings for hemorrhage in all. Methylprednisolone pulses and cyclophosphamide were used in 14 patients. Plasmapheresis was performed in three cases. One patient received cycles of Dexamethasome-Melphalan. Three patients died as a result of DAH. The mortality rate in our study was 20%.

  11. Alveolar hemorrhage and kidney disease: Characteristics and therapy

    Directory of Open Access Journals (Sweden)

    Lilia Ben Fatma

    2013-01-01

    Full Text Available Anti-neutrophil cytoplasmic antibody-associated vasculitis and Goodpasture′s glomerular basement membrane disease are the most common causes of diffuse alveolar hemorrhage, a life-threatening disease. Systemic lupus erythematosus and the antiphospholipid syndrome are also causes of alveolar hemorrhage. We retrospectively reviewed 15 cases of diffuse alveolar hemorrhage (DAH associated with renal diseases. Diagnosis of DAH was based on the presence of bloody bronchoalveolar lavage fluid. There were three men and 12 women, with a mean age of 50.5 years (extremes: 24-74 years. Proteinuria and hematuria were observed, respectively, in 15 and 14 cases. Six patients revealed arterial hypertension. Crescentic glomerulonephritis was diagnosed with kidney biopsies in ten cases. The etiology of renal disease was microscopic polyangiitis (MPA in seven cases, Wegener disease in four cases, systemic lupus erythematous in one case, cryoglobulinemia in one case, myeloma in one case and propyl-thiouracil-induced MPA in one case. Hemoptysis occurred in 14 cases. The mean serum level of hemoglobin was 7.1 g/dL (5.1-10 g/dL. The mean serum creatinine concentration was 7.07 mg/dL (2.4-13.7 mg/dL. Gas exchange was severely compromised, with an oxygenation index <80 mmHg in 14 patients and <60 mmHg in seven patients. Bronchoalveolar lavage was performed in 11 cases, and had positive findings for hemorrhage in all. Methylprednisolone pulses and cyclophosphamide were used in 14 patients. Plasmapheresis was performed in three cases. One patient received cycles of Dexamethasome-Melphalan. Three patients died as a result of DAH. The mortality rate in our study was 20%.

  12. Mortality Prediction in Patients with Spontaneous Supratentorial Intracerebral Hemorrhage

    Directory of Open Access Journals (Sweden)

    Alexis Suárez Quesada

    2016-03-01

    Full Text Available Background: spontaneous intracerebral hemorrhage is the deadliest, most disabling, and least treatable form of stroke. No therapy has proven to improve its outcome or reduce its mortality. Objective: to identify predictors of mortality in patients with spontaneous supratentorial intracerebral hemorrhage. Methods: a single cohort study was conducted involving 176 patients admitted consecutively to the stroke ward of the Carlos Manuel de Céspedes Provincial General Hospital with neuroimaging and clinical diagnosis of spontaneous supratentorial intracerebral hemorrhage from January 2013 to November 2015. Independent predictors were obtained using multivariable logistic regression. Results: seventy four point four percent of the patients were hypertensive. The median age among those who died was 67.45 ± 14.84 years. Forty three point eight percent of the patients under study died. Subjects with fatal outcome had lower score on the Glasgow Coma Scale (10.00 ± 3.47 vs. 14.00 ± 1.93, higher hematoma volume expressed in cubic centimeters (26.27 ± 36.86 vs. 6.19 ± 19.59, and displacement of the midline structures (2.00 ± 5.95 vs. 0.00 ± 4.49. The following predictors were identified: Glasgow score ≤ 10 points (Exp (B: 10.74; 95 % CI=4.69 to 24.59, hematoma volume ≥ 20 cm3 (Exp (B: 4.44; 95 % CI= 1.95 to 10.06, and pulse pressure ≥ 60 mmHg (Exp (B: 2.42, 95 % CI=1.10 to 5.33. The area under the ROC curve was 0.85. Conclusions: the Glasgow Coma Scale is the most significant independent variable to predict mortality in patients with spontaneous intracerebral hemorrhage.

  13. Cerebral Hemodynamic Changes Induced by a Lumbar Puncture in Good-Grade Subarachnoid Hemorrhage

    OpenAIRE

    Schmidt, Eric A.; Stein Silva; Jean François Albucher; Aymeric Luzi; Isabelle Loubinoux; Anne Christine Januel; Christophe Cognard; Pierre Payoux; François Chollet

    2012-01-01

    Background Patients with good-grade subarachnoid hemorrhage (SAH) are those without initial neurological deficit. However, they can die or present severe deficit due to secondary insult leading to brain ischemia. After SAH, in a known context of energy crisis, vasospasm, hydrocephalus and intracranial hypertension contribute to unfavorable outcome. Lumbar puncture (LP) is sometimes performed in an attempt to reduce intracranial pressure (ICP) and release headaches. We hypothesize that in good...

  14. Cardiac abnormalities after subarachnoid hemorrhage

    NARCIS (Netherlands)

    Bilt, I.A.C. van der

    2016-01-01

    Aneurysmal subarachnoid hemorrhage(aSAH) is a devastating neurological disease. During the course of the aSAH several neurological and medical complications may occur. Cardiac abnormalities after aSAH are observed often and resemble stress cardiomyopathy or Tako-tsubo cardiomyopathy(Broken Heart Syn

  15. Reducing postpartum hemorrhage in Africa

    DEFF Research Database (Denmark)

    Lazarus, Jeff; Lalonde, A

    2005-01-01

    Postpartum hemorrhage (PPH) is the leading cause of maternal mortality in sub-Saharan Africa. This is being addressed by leading professional organizations, which point to the importance of a skilled attendant at birth. But they also emphasize that the active management of the third stage of labo...

  16. Adrenal hemorrhage in a newborn.

    Science.gov (United States)

    Abdu, Arebu T; Kriss, Vesna M; Bada, Henrietta S; Reynolds, Eric W

    2009-09-01

    Sometimes in the course of care in a neonatal intensive care unit, there may be a rush to intervene in cases where limited intervention is actually the correct course. One such example is that of neonatal adrenal hemorrhage. We present the case of a male term neonate with shock, metabolic acidosis, distended abdomen, and falling hematocrit. His prenatal and delivery histories were uneventful except for a nuchal cord. Apgar scores were 9 and 9. Because of his dramatic presentation, certain members of the medical team suggested immediate surgical intervention. However, a calm and careful evaluation revealed the true diagnosis and course of action. Ultrasound of the abdomen showed a mass between the liver and kidney, but the origin was difficult to identify. A computed tomography scan supported the diagnosis of right adrenal hemorrhage. His serum cortisol level was normal. The patient was managed conservatively and discharged home after a 1-week stay in the hospital. Subsequent abdominal ultrasound showed resolving adrenal hemorrhage with minimal calcification. A review of the pertinent literature is presented. Physicians should remember adrenal hemorrhage when evaluating a newborn infant with shock, acidosis, abdominal distention, and falling hematocrit and that conservative management is usually indicated.

  17. Portal hypertensive colopathy in patients with liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Keiichi Ito; Katsuya Shiraki; Takahisa Sakai; Hitoshi Yoshimura; Takeshi Nakano

    2005-01-01

    AIM: In patients with liver cirrhosis and porlal hypertension, portal hypertensive colopathy is thought to be an important cause of lower gastrointestinal hemorrhage. In this study, we evaluated the prevalence of colonic mucosal changes in patients with liver cirrhosis and its clinical significance. METHODS: We evaluated the colonoscopic findings and liver function of 47 patients with liver cirrhosis over a 6-year period. The main cause of liver cirrhosis was post-viral hepatitis (68%) related to hepatitis B (6%) or C (62%)infection. All patients underwent upper gastrointestinal endoscopy to examine the presence of esophageal varices, cardiac varices, and congestive gastropathy, as well as a full colonoscopy to observe changes in colonic mucosa. Portal hypertensive colopathy was defined endoscopically in patients with vascular ectasia, redness, and blue vein. Vascular ectasia was classified into two types: type 1, solitary vascular ectasia; and type 2, diffuse vascular ectasia.RESULTS: Overall portal hypertensive colopathy was present in 31 patients (66%), including solitary vascular ectasia in 17 patients (36%), diffuse vascular ectasia in 20 patients (42%), redness in 10 patients (21%) and blue vein in 6 patients (12%). As the Child-Pugh class increased in severity, the prevalence of portal hypertensive colopathy rose. Child-Pugh class B and C were significantly associated with portal hypertensive colopathy. Portal hypertensive gastropathy, esophageal varices, ascites and hepatocellular carcinoma were not related to occurrence of portal hypertensive colopathy. Platelet count was significantly associated with portal hypertensive colopathy, but prothrombin time, serum albumin level, total bilirubin level and serum ALT level were not related to occurrence of portal hypertensive colopathy. CONCLUSION: As the Child-Pugh class worsens and platelet count decreases, the prevalence of portal hypertensive colopathy increases in patients with liver cirrhosis. A colonoscopic

  18. 手术时机对小骨窗显微手术治疗高血压脑出血患者预后的影响%The influence of operation time on prognosis of patients with hypertensive intracerebral hemorrhage undergoing small skull window micro-surgical operation

    Institute of Scientific and Technical Information of China (English)

    施鹏; 鲍波; 邵珠平

    2015-01-01

    目的 探究小骨窗显微手术治疗高血压脑出血的最佳手术时机.方法 连续纳入2010年6月至2014年6月来我院神经外科高血压脑出血发病24 h内接受小骨窗显微手术治疗患者.前瞻性队列研究方法进行研究设计,根据入院接受手术时间分为对照组(>6h)27例及研究组(≤6h) 31例.两组患者均全麻下进行小骨窗开颅显微手术.术后1周内检测死亡、并发症及再出血例数.手术前后对患者进行GOS评分,手术后1周及半年对患者进行随访,并进行ADL评分及WHOQOL-BREF评分.结果 术前两组GOS评分无统计学差异(P>0.05),术后研究组患者GOS评分显著高于对照组(P<0.05).术后1周,两组ADL评分无统计学差异(P>0.05);术后半年,研究组患者ADL评分显著高于对照组(P<0.05).术后1周,两组WHOQOL-BREF评分无统计学差异(P>0.05);术后半年,研究组患者WHOQOL-BREF评分显著高于对照组(P<0.05).通过多重线性回归发现,在校正性别、年龄、术前GOS评分后,手术时机与术后GOS评分呈线性关系,发病到手术的时间越短,其术后GOS评分越高(P<0.05).结论 发病到手术的时间越短,患者术后预后越好,在发病后6h内进行手术能够显著提高患者的预后,促进日常生活活动功能的恢复,提高患者的生存质量,具有重要意义.%Objective To explore the optimal operation time of small skull window micro-surgical operation in the treatment of hypertensive intracerebral hemorrhage (HICH).Methods Consecutively included patients with HICH who underwent small skull window micro-surgical operation within 24 h admitted in department of neurosurgery of our hospital from June 2010 to June 2014.The study was designed with prospective cohort study method.According to the operation time,all patients were divided into control group (more than 6 h,27 cases) and study group (within 6 h,31 cases).Under general anesthesia,patients in both groups underwent small skull

  19. Glycemia in Spontaneous Intracerebral Hemorrhage: Clinical Implications

    Directory of Open Access Journals (Sweden)

    Alvis-Miranda Hernando

    2014-10-01

    Full Text Available Spontaneous cerebral hemorrhage or intracranial hemorrhage accounts for 10-15% of all strokes. Intracranial hemorrhage is much less common than ischemic stroke, but has higher mortality and morbidity, one of the leading causes of severe disability. Various alterations, among these the endocrine were identified when an intracerebral hemorrhage, these stress-mediated mechanisms exacerbate secondary injury. Deep knowledge of the injuries which are directly involved alterations of glucose, offers insight as cytotoxicity, neuronal death and metabolic dysregulations alter the prognosis of patients with spontaneous intracerebral hemorrhage.

  20. Hypertension Canada's 2017 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hypertension in Adults.

    Science.gov (United States)

    Leung, Alexander A; Daskalopoulou, Stella S; Dasgupta, Kaberi; McBrien, Kerry; Butalia, Sonia; Zarnke, Kelly B; Nerenberg, Kara; Harris, Kevin C; Nakhla, Meranda; Cloutier, Lyne; Gelfer, Mark; Lamarre-Cliche, Maxime; Milot, Alain; Bolli, Peter; Tremblay, Guy; McLean, Donna; Tobe, Sheldon W; Ruzicka, Marcel; Burns, Kevin D; Vallée, Michel; Prasad, G V Ramesh; Gryn, Steven E; Feldman, Ross D; Selby, Peter; Pipe, Andrew; Schiffrin, Ernesto L; McFarlane, Philip A; Oh, Paul; Hegele, Robert A; Khara, Milan; Wilson, Thomas W; Penner, S Brian; Burgess, Ellen; Sivapalan, Praveena; Herman, Robert J; Bacon, Simon L; Rabkin, Simon W; Gilbert, Richard E; Campbell, Tavis S; Grover, Steven; Honos, George; Lindsay, Patrice; Hill, Michael D; Coutts, Shelagh B; Gubitz, Gord; Campbell, Norman R C; Moe, Gordon W; Howlett, Jonathan G; Boulanger, Jean-Martin; Prebtani, Ally; Kline, Gregory; Leiter, Lawrence A; Jones, Charlotte; Côté, Anne-Marie; Woo, Vincent; Kaczorowski, Janusz; Trudeau, Luc; Tsuyuki, Ross T; Hiremath, Swapnil; Drouin, Denis; Lavoie, Kim L; Hamet, Pavel; Grégoire, Jean C; Lewanczuk, Richard; Dresser, George K; Sharma, Mukul; Reid, Debra; Lear, Scott A; Moullec, Gregory; Gupta, Milan; Magee, Laura A; Logan, Alexander G; Dionne, Janis; Fournier, Anne; Benoit, Geneviève; Feber, Janusz; Poirier, Luc; Padwal, Raj S; Rabi, Doreen M

    2017-05-01

    Hypertension Canada provides annually updated, evidence-based guidelines for the diagnosis, assessment, prevention, and treatment of hypertension. This year, we introduce 10 new guidelines. Three previous guidelines have been revised and 5 have been removed. Previous age and frailty distinctions have been removed as considerations for when to initiate antihypertensive therapy. In the presence of macrovascular target organ damage, or in those with independent cardiovascular risk factors, antihypertensive therapy should be considered for all individuals with elevated average systolic nonautomated office blood pressure (non-AOBP) readings ≥ 140 mm Hg. For individuals with diastolic hypertension (with or without systolic hypertension), fixed-dose single-pill combinations are now recommended as an initial treatment option. Preference is given to pills containing an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker in combination with either a calcium channel blocker or diuretic. Whenever a diuretic is selected as monotherapy, longer-acting agents are preferred. In patients with established ischemic heart disease, caution should be exercised in lowering diastolic non-AOBP to ≤ 60 mm Hg, especially in the presence of left ventricular hypertrophy. After a hemorrhagic stroke, in the first 24 hours, systolic non-AOBP lowering to hypertension arising from fibromuscular dysplasia. The specific evidence and rationale underlying each of these guidelines are discussed. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  1. Progressive hemorrhagic injury in patients with traumatic intracerebral hemorrhage: characteristics, risk factors and impact on management.

    Science.gov (United States)

    Wan, Xueyan; Fan, Ting; Wang, Sheng; Zhang, Suojun; Liu, Shengwen; Yang, Hongkuan; Shu, Kai; Lei, Ting

    2017-02-01

    Progressive hemorrhagic injury (PHI) is a common occurrence in clinical practice; however, how PHI affects clinical management remains unclear. We attempt to evaluate the characteristics and risk factors of PHI and also investigate how PHI influences clinical management in traumatic intracerebral hemorrhage (TICH) patients. This retrospective study included a cohort of 181 patients with TICH who initially underwent conservative treatment and they were dichotomized into a PHI group and a non-PHI group. Clinical data were reviewed for comparison. Multivariate logistic regression analysis was applied to identify predictors of PHI and delayed operation. Overall, 68 patients (37.6%) experienced PHI and 27 (14.9%) patients required delayed surgery. In the PHI group, 17 patients needed late operation; in the non-PHI group, 10 patients received decompressive craniectomy. Compared to patients with non-PHI, the PHI group was more likely to require late operation (P = 0.005, 25.0 vs 8.8%), which took place within 48 h (P = 0.01, 70.6 vs 30%). Multivariate logistic regression identified past medical history of hypertension (odds ratio [OR] = 4.56; 95% confidence interval [CI] = 2.04-10.45), elevated international normalized ratio (INR) (OR = 20.93; 95% CI 7.72-71.73) and linear bone fracture (OR = 2.11; 95% CI = 1.15-3.91) as independent risk factors for PHI. Hematoma volume of initial CT scan >5 mL (OR = 3.80; 95% CI = 1.79-8.44), linear bone fracture (OR = 3.21; 95% CI = 1.47-7.53) and PHI (OR = 3.49; 95% CI = 1.63-7.77) were found to be independently associated with delayed operation. Past medical history of hypertension, elevated INR and linear bone fracture were predictors for PHI. Additionally, the latter was strongly predictive of delayed operation in the studied cohort.

  2. Hypertension in Danish seafarers

    DEFF Research Database (Denmark)

    Tu, Mingshan; Jepsen, Jørgen Riis

    2016-01-01

    intake, and body mass index. Results: The overall prevalence of hypertension in the study population was 44.7% (95% CI 40.8–48.6). In a comparison sample of adult Danes, the crude rate of hypertension was 12.6%. In addition, 41.8% (95% CI 38.0–45.7) of seafarers were pre-hypertensive. Hypertension......Background: Due to the high prevalence of arterial hypertension and its role in the development of athe- rosclerosis, myocardial infarction and stroke, hypertension is a major public health challenge worldwide. There is limited knowledge of the prevalence of hypertension among seafarers who......, however, are known to have an excess morbidity and mortality from these disorders. This article addresses the prevalence of hypertension among Danish seafarers and discusses potential risk factors for hypertension in maritime settings. Materials and methods: A representative sample of 629 Danish seafarers...

  3. Intracranial hemorrhage due to late hemorrhagic disease in two siblings.

    Science.gov (United States)

    Per, Hüseyin; Kumandaş, Sefer; Ozdemir, Mehmet Akif; Gümüş, Hakan; Karakukcu, Musa

    2006-07-01

    Deficiency of vitamin K predisposes to early, classic or late hemorrhagic disease of the newborn (HDN); late HDN may be associated with serious and life-threatening intracranial hemorrhage. Late HDN is characterized by intracranial bleeding in infants aged 1 week to 6 months due to severe vitamin K deficiency, occurring particularly in exclusively breastfed infants. Late HDN is still an important cause of mortality and morbidity in developing countries where vitamin K prophylaxis is not routinely practiced. In this study, we report on two siblings with intracranial bleeding who were fully breastfed without a routine supplementation of vitamin K. Vitamin K should be given to all newborns as a single, intramuscular dose of 1 mg.

  4. Dengue hemorrhagic fever: A rare cause of pituitary tumor hemorrhage and reversible vision loss

    Directory of Open Access Journals (Sweden)

    Vimal Kumar

    2011-01-01

    Full Text Available Dengue hemorrhagic fever leading to hemorrhage in pituitary adenoma is not reported till date: We herein report the first case of bilateral visual loss secondary to pituitary adenoma hemorrhage associated with dengue hemorrhagic fever. Urgent transnasal trans sphenoidal decompression of the macroadenoma prevented permanent visual loss in this patient. Pituitary apoplexy should be considered as differential diagnosis of visual deterioration apart from retinal hemorrhage, maculopathy, and optic neuropathy in cases of dengue hemorrhagic fever. Early decompression of optic nerves helped in the restoration of vision.

  5. Effect of HSH on oxygen free radicals and histopathological change of brain tissue in dog with acute intracranial hypertension and hemorrhagic shock%高渗氯化钠羟乙基淀粉注射液输注对急性颅内高压伴失血性休克犬脑组织病理学及氧自由基的影响

    Institute of Scientific and Technical Information of China (English)

    徐翔; 古妙宁; 肖金仿; 肖华平; 赵振龙; 刘高望

    2008-01-01

    Objective To observe the effects of hypertonic sodium chloride hydroxyethyl starch 40 injection(HSH) on recovering of circulating blood volume, lessening edema of brain tissue and decreasing oxygen free radicals in dog with acute intracranial hypertension and hemorrhagic shock. Methods 20 healthy dogs were randomly divided into 4 groups: Group hydroxyethyl starch (HES), Group Ringer- lactate solution (RL), Group hypertonic saline solution (HS) and Group HSH. Acute intracranial hypertension and hemorrhagic shock were made by injecting water into epidural balloon and bleeding artery. Corresponding injections were infused respectively 1h after shock. Mean arterial blood pressure (MAP), central venous pressure (CVP), heart rate (HR) and intracranial pressure (ICP) were monitored, and the level of superoxide dismutase (SOD) and malondialdehyde (MDA) in brain tissue were examined. Specimens of brain tissue were prepared for pathological examination. Results After resuscitation, injections of 4 groups can effectively increase MAP( P < 0.05 )while ICP of Group HES and Group RL significantly increased (P < 0.05 ). Two hours after resuscitation, MAP of Group HS began to decrease (P < 0.05 ). Four hours after resuscitation, only Group HSH can maintain an higher MAP and lower ICP. MDA and SOD levels in Group HSH were evidently lower than other groups at four hours after resuscitation (P < 0. 05). Pathological examination revealed less injury in Group HSH than other groups. Conclusion HSH could effectively resuscitate hemorrhagic shock, decrease ICP, reduce oxygen free radicals levels in brain tissue and relieve tissue ischemia/reperfusion injury.%目的 观察高渗氯化钠羟乙基淀粉40注射液(HSH)在犬急性颅内高压伴失血性休克模型中恢复循环血容量、减轻脑组织水肿和降低脑组织氧自由基含量的作用.方法 健康杂种犬20只,采用硬膜外球囊注水和动脉放血的方法复制急性颅内高压伴失血性休克模型.动物

  6. Recent progress in hemorrhagic moyamoya disease.

    Science.gov (United States)

    Wan, Ming; Duan, Lian

    2015-04-01

    Moyamoya disease (MMD) is a chronic progressive cerebrovascular disease, which can be divided into three types: ischemic, hemorrhagic, and asymptomatic. Hemorrhagic MMD has attracted considerable attention due to its distinctive imaging features and the controversy over the treatment. This report presents a comprehensive review of the literature on hemorrhagic MMD, focusing on the epidemiological characteristics, etiology and pathogenesis, imaging features, predictors of hemorrhage, and treatment options and their efficacy of hemorrhagic MMD. Hemorrhagic MMD mainly occurs in adult patients in Asian countries, and many factors may contribute to the etiology and development of this disease. Hemorrhagic MMD has two major imaging features: the dilatation and abnormal branching of anterior choroidal artery or posterior communicating artery, and multiple microbleeds, which may predict subsequent hemorrhage. The treatment for hemorrhagic MMD is not standardized, and large sample prospective randomized clinical trials may help to determine which method is better. In hemorrhagic MMD patients, more attention should be paid to cognitive function and quality of life, and these assessments should be included in the evaluation of effectiveness of treatment modalities.

  7. Intracranial Hemorrhage Annotation for CT Brain Images

    Directory of Open Access Journals (Sweden)

    Tong Hau Lee

    2011-01-01

    Full Text Available In this paper, we created a decision-making model to detect intracranial hemorrhage and adopted Expectation Maximization(EM segmentation to segment the Computed Tomography (CT images. In this work, basically intracranial hemorrhage is classified into two main types which are intra-axial hemorrhage and extra-axial hemorrhage. In order to ease classification, contrast enhancement is adopted to finetune the contrast of the hemorrhage. After that, k-means is applied to group the potential and suspicious hemorrhagic regions into one cluster. The decision-making process is to identify whether the suspicious regions are hemorrhagic regions or non-regions of interest. After the hemorrhagic detection, the images are segmented into brain matter and cerebrospinal fluid (CSF by using expectation-maximization (EM segmentation. The acquired experimental results are evaluated in terms of recall and precision. The encouraging results have been attained whereby the proposed system has yielded 0.9333 and 0.8880 precision for extra-axial and intra-axial hemorrhagic detection respectively, whereas recall rate obtained is 0.9245 and 0.8043 for extra-axial and intra-axial hemorrhagic detection respectively.

  8. Pregnancy and pulmonary hypertension

    NARCIS (Netherlands)

    Pieper, Petronella G.; Lameijer, Heleen; Hoendermis, Elke S.

    Pulmonary hypertension during pregnancy is associated with considerable risks of maternal mortality and morbidity. Our systematic review of the literature on the use of targeted treatments for pulmonary arterial hypertension during pregnancy indicates a considerable decrease of mortality since a

  9. HIV and Pulmonary Hypertension

    Science.gov (United States)

    ... 03-13T18:29:11+00:00 PH and HIV Print PH and HIV Brochure (PDF) Order Copies ... to know about pulmonary hypertension in connection with HIV? Although pulmonary hypertension and HIV are two separate ...

  10. Hypertension (High Blood Pressure)

    Science.gov (United States)

    ... Surgery? A Week of Healthy Breakfasts Shyness Hypertension (High Blood Pressure) KidsHealth > For Teens > Hypertension (High Blood Pressure) Print ... rest temperature diet emotions posture medicines Why Is High Blood Pressure Bad? High blood pressure means a person's heart ...

  11. Risk factors associated with recurrent hemorrhage after the initial improvement of colonic diverticular bleeding.

    Science.gov (United States)

    Nishikawa, Hiroki; Maruo, Takanori; Tsumura, Takehiko; Sekikawa, Akira; Kanesaka, Takashi; Osaki, Yukio

    2013-03-01

    We elucidated risk factors contributing to recurrent hemorrhage after initial improvement of colonic diverticular bleeding. 172 consecutive hospitalized patients diagnosed with colonic diverticular bleeding were analyzed. Recurrent hemorrhage after initial improvement of colonic diverticular bleeding is main outcome measure. We analyzed factors contributing to recurrent hemorrhage risk in univariate and multivariate analyses. The length of the observation period after improvement of colonic diverticular bleeding was 26.4 +/- 14.6 months (range, 1-79 months). The cumulative recurrent hemorrhage rate in all patients at 1 and 2 years was 34.8% and 41.8%, respectively. By univariate analysis, age > 70 years (P = 0.021), BMI > 25 kg/m2 (P = 0.013), the use of anticoagulant drugs (P = 0.034), the use of NSAIDs (P = 0.040), history of hypertension (P = 0.011), history of smoking (P = 0.030) and serum creatinine level > 1.5 mg/dL (P bleeding. By multivariate analysis, age > 70 years (Hazard ratio (HR), 1.905, 95% confidence interval (CI), 1.067-3.403, P = 0.029), history of hypertension (HR, 0.493, 95% CI, 0.245-0.993, P = 0.048) and serum creatinine level > 1.5 mg/dL (HR, 95% CI, 0.288-0.964, P = 0.044) were shown to be significant independent risk factors. Close observation after the initial improvement of colonic diverticular bleeding is needed, especially in elderly patients or patients with history of hypertension or renal deficiency.

  12. Hypertension in pregnancy

    Directory of Open Access Journals (Sweden)

    Andrea Ungar

    2007-03-01

    Full Text Available Hypertension is the most common medical problem encountered during pregnancy, complicating 2-3% of pregnancies. Hypertensive disorders during pregnancy are classified into 4 categories: chronic hypertension, pre-eclampsia/eclampsia, pre-eclampsia superimposed on chronic hypertension, and gestational hypertension. A relative paucity of investigative data, as well as the frequent difficulty in making an etiological diagnosis, may lead to problems in its management. This case report analyses current concepts regarding the hypertensive disorders of gestation, focusing on chronic hypertension. Chronic hypertension is defined as blood pressure exceeding 140/90 mmHg before pregnancy or before 20 weeks gestation. Hypertensive disorders in pregnancy may cause maternal and fetal morbidity and remain a leading source of maternal mortality. A prompt diagnosis is needed also because hypertension may be an indicator of pre-eclampsia, a condition which can evolve into serious complications. Maintaining blood pressure below 140/90 mmHg is recommended, although treatment should be determined on an individual basis. Many anti-hypertensive agents appear to be safe for use during pregnancy: methildopa has been the most studied of the anti-hypertensive drugs and has the best safety record. Labetalol, idralazine and nifedipine also have been found to be safe; ACE-inhibitors are absolutely contraindicated, because they are associated with intrauterine growth retardation.

  13. Hypertension in developing countries.

    Science.gov (United States)

    Tibazarwa, Kemi B; Damasceno, Albertino A

    2014-05-01

    The past 2 decades have seen a considerable global increase in cardiovascular disease, with hypertension remaining by far the most common. More than one-third of adults in Africa are hypertensive; as in the urban populations of most developing countries. Being a condition that occurs with relatively few symptoms, hypertension remains underdetected in many countries; especially in developing countries where routine screening at any point of health care is grossly underutilized. Because hypertension is directly related to cardiovascular disease, this has led to hypertension being the leading cause of adverse cardiovascular outcomes, as a result of patients living, often unknowingly, with uncontrolled hypertension for prolonged periods of time. In Africa, hypertension is the leading cause of heart failure; whereas at global levels, hypertension is responsible for more than half of deaths from stroke, just less than half of deaths from coronary artery disease, and for more than one-tenth of all global deaths. In this review, we discuss the escalating occurrence of hypertension in developing countries, before exploring the strengths and weaknesses of different measures to control hypertension, and the challenges of adopting these measures in developing countries. On a broad level, these include steps to curb the ripple effect of urbanization on the health and disease profile of developing societies, and suggestions to improve loopholes in various aspects of health care delivery that affect surveillance and management of hypertension. Furthermore, we consider how the industrial sectors' contributions toward the burden of hypertension can also be the source of the solution.

  14. Genetik og hypertension

    DEFF Research Database (Denmark)

    Ellervik, Christina; Tarnow, Lise; Pedersen, Erling Bjerregaard

    2009-01-01

    Monogenic forms of hypertension are very rare, but have a well-characterized heredity. Primary hypertension is very common with a complex and polygenic heredity. Primary hypertension arises due to an interaction between multiple genetic and environmental factors. Its heredity is unknown, although...

  15. Pulmonary Hypertension Association

    Science.gov (United States)

    ... at www.AHeartCures.org . Help Kickoff November’s Pulmonary Hypertension Awareness Month Want to help raise awareness for ... Heart2CurePH | Help promote Awareness Month Chronic Thromboembolic Pulmonary Hypertension (CTEPH) Awareness Chronic thromboembolic pulmonary hypertension (CTEPH) is ...

  16. Risk factors of intracranial hemorrhage in premature neonates.

    Directory of Open Access Journals (Sweden)

    Nasrin Khalessi

    2014-09-01

    Full Text Available Intraventricular hemorrhage (IVH is an important cause of brain injury in premature neonates. Current study tries to define associated risk factors of IVH in preterm neonates in Aliasghar Children Hospital during 2008 to 2011. In this study, the risk factors have been evaluated in premature neonates with IVH, who had at least one brain sonography since their admission in NICU. A total of 63 premature neonates with IVH were assessed. Mean gestational age was 29.81 (24-34 weeks and mean birth weight was 1290.83±382.96 gr. Other risk factors such as sex, mode of delivery, history of using infertility drugs, maternal disease, maternal hypertension and preeclampsia, lumbar puncture, ventilator therapy and pneumothorax were considered. Because no absolute treatment for IVH is available, identifying risk factors is important in prevention and management of IVH.

  17. [Clinical aspects of viral hemorrhagic fever].

    Science.gov (United States)

    Saijo, Masayuki

    2005-12-01

    Viral hemorrhagic fever (VHF) is defined as virus infections that usually cause pyrexia and hemorrhagic symptoms with multiple organ failure. VHF includes following viral infections: Ebola hemorrhagic fever (EHF), Marburg hemorrhagic fever (MHF), Crimean-Congo hemorrhagic fever (CCHF) and Lassa fever. In particular, the causative agents of EHF, MHF, CCHF, and Lassa fever are Ebola, Marburg, CCHF, Lassa viruses, respectively, and regarded as biosafety level-4 pathogens because of their high virulence to humans. Recently, relatively large outbreaks of EHF and MHF have occurred in Africa, and areas of EHF- and MHF-outbreaks seem to be expanding. Although outbreaks of VHF have not been reported in Japan, there is a possibility that the deadly hemorrhagic fever viruses would be introduced to Japan in future. Therefore, preparedness for possible future outbreaks of VHF is necessary in areas without VHF outbreaks.

  18. A Case of Sudden Deafness with Intralabyrinthine Hemorrhage Intralabyrinthine Hemorrhage and Sudden Deafness

    National Research Council Canada - National Science Library

    Park, Jeong Jin; Jeong, Se Won; Lee, Jae Wook; Han, Su-Jin

    2015-01-01

    .... The prognosis SSNHL by intralabyrintine hemorrhage is generally known to be poor. We report a case of sudden deafness with intralabyrintine hemorrhage who has a history of anticoagulant administration, with a review of literature.

  19. Multidisciplinary In Situ Simulation-Based Training as a Postpartum Hemorrhage Quality Improvement Project.

    Science.gov (United States)

    Lutgendorf, Monica A; Spalding, Carmen; Drake, Elizabeth; Spence, Dennis; Heaton, Jason O; Morocco, Kristina V

    2017-03-01

    obstetric emergencies and postpartum hemorrhage after simulation training compared to before training. For managing hypertensive emergencies, the post-training mean score was 4.14 compared to a pretraining mean score of 3.88 (p = 0.01, 95% confidence interval [CI] = 0.06-0.47). For shoulder dystocia, the post-training mean score was 4.29 compared to a pretraining mean score of 3.66 (p = 0.001, 95% CI = 0.41-0.88). For postpartum hemorrhage, the post-training mean score was 4.35 compared to pretraining mean score of 3.86 (p = 0.001, 95% CI = 0.36-0.63). We also observed a decrease in the time to prepare simulated blood products over the course of the simulation, and a decreasing trend of postpartum hemorrhage cases, which continued after initiating the postpartum hemorrhage simulation exercise. Postpartum hemorrhage remains a leading cause of maternal morbidity and mortality in the United States. Comprehensive hemorrhage protocols have been shown to improve outcomes related to postpartum hemorrhage, and a critical component in these processes include communication, teamwork, and team-based practice/simulation. As medicine becomes increasingly complex, the ability to practice in a safe setting is ever more critical, especially for low-volume, high-stakes events such as postpartum hemorrhage. These events require well-functioning teams and systems coupled with rapid assessment and appropriate clinical action to ensure best patient outcomes. We have shown that a multidisciplinary in situ simulation exercise improves self-reported comfort with managing obstetric emergencies, and is a safe and effective way to practice skills and improve systems processes in the health care setting. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  20. 盐酸氟桂利嗪对高血压脑出血患者经颅多普勒血流参数脑血肿体积及神经功能影响的研究%Study of the effect of flunarizine hydrochloride on transcranial Doppler dynamic observation changes and size of ceph-alophyma and neurological function after hypertensive intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    李芳

    2015-01-01

    Objective To explore the effect of flunarizine hydrochloride on transcranial Doppler ultrasound (TCD) observation and size of cephalophyma in acute hypertensive intracerebral hemorrhage (HICH) patients . Methods Seventy‐six patients of acute HICH were randomized to the flunarizine hydrochloride‐therapy group and control group .The TCD and CT were applied to monitor the blood flow parameters of intracranial arteries and the size of cephalophyma .Scoring of neurological function deficit and survival skills were used to assess overall neuro‐logical function .Results In the flunarizine hydrochloride‐therapy group ,the reductions of mean velocity in in‐tracranial arteries were less than control group ,the neurological function scoring was significantly better than con‐trol group (P<0 .05) ,but the size of cephalophyma was not significantly reduced than control group .Conclusion Flunarizine hydrochloride can improve cerebral blood supply ,and is beneficial to neurological function recovery with no enlargement in size of cephalophyma in HICH patients .%目的:探讨盐酸氟桂利嗪对高血压脑出血患者经颅多普勒血流参数和脑血肿体积及神经功能的影响。方法将76例高血压脑出血患者根据入院时间分为盐酸氟桂利嗪治疗组和对照组,相同时间点采用经颅多普勒诊断技术检测颅内动脉血流参数的变化,通过头颅计算机X射线断层扫描技术检测颅内血肿大小,进行神经功能评分。结果盐酸氟桂利嗪治疗组颅内动脉平均流速的下降程度明显低于对照组,神经功能评分优于对照组,但血肿体积较对照组无明显减小。结论在不扩大脑血肿情况下,盐酸氟桂利嗪能改善脑出血患者的脑部血供,有利于神经功能恢复。

  1. The medieval origins of the concept of hypertension

    Directory of Open Access Journals (Sweden)

    Mojtaba Heydari

    2014-01-01

    The definition, symptoms and treatments presented for the Imtela are compared with the current knowledge on hypertension. Akhawayni believed that Imtela could result from the excessive amount of blood within the blood vessels. It can manifest with symptoms including the presence of a pulsus magnus, sleepiness, weakness, dyspnea, facial blushing, engorgement of the vessels, thick urine, vascular rupture, and hemorrhagic stroke. He also suggested some ways to manage al-Imtela′. These include recommendations of changes in lifestyle (staying away from anger and sexual intercourse and dietary program for patients (avoiding the consumption of wine, meat, and pastries, reducing the volume of food in a meal, maintaining a low-energy diet and the dietary usage of spinach and vinegar. Al-Akhawayni′s description of "Imtela," despite of its numerous differences with current knowledge of hypertension, can be considered as medieval origin of the concept of hypertension.

  2. Clinicopathological Features and Treatment of Ectopic Varices with Portal Hypertension

    Directory of Open Access Journals (Sweden)

    Takahiro Sato

    2011-01-01

    Full Text Available Bleeding from ectopic varices, which is rare in patients with portal hypertension, is generally massive and life-threatening. Forty-three patients were hospitalized in our ward for gastrointestinal bleeding from ectopic varices. The frequency of ectopic varices was 43/1218 (3.5% among portal hypertensive patients in our ward. The locations of the ectopic varices were rectal in thirty-two, duodenal in three, intestinal in two, vesical in three, stomal in one, and colonic in two patients. Endoscopic or interventional radiologic treatment was performed successfully for ectopic varices. Hemorrhage from ectopic varices should be kept in mind in patients with portal hypertension presenting with lower gastrointestinal bleeding.

  3. Insulin Resistance and Hypertension

    Institute of Scientific and Technical Information of China (English)

    张建华; 张春秀

    2002-01-01

    Summary: The insulin sensitivity in hypertensive patients with normal glucose tolerance (NGT),impaired glucose tolerance (IGT) and type 2 diabetes mellitus (DM) and the insulin resistance(IR) under the disorder of glucose metabolism and hypertension were studied. By glucose toler-ance test and insulin release test, insulin sensitivity index (ISI) and the ratio of area under glucosetolerance curve (AUCG) to area under insulin release curve (AUC1) were calculated and analyzed.The results showed that ISI was decreased to varying degrees in the patients with hypertension,the mildest in the group of NGT with hypertension, followed by the group of IGT without hyper-tension, the group of IGT with hypertension and DM (P=0). There was very significant differ-ence in the ratio of AUCG/AUC1 between the hypertensive patients with NGT and controls (P=0). It was concluded that a significant IR existed during the development of IGT both in hyperten-sion and nonhypertension. The increase of total insulin secretion (AUC1) was associated with non-hypertension simultaneously. IR of the hypertensive patients even existed in NGT and was wors-ened with the deterioration of glucose metabolism disorder, but the AUC1 in the HT groupchanged slightly. A relative deficiency of insulin secretion or dysfunction of β-cell of islet existed inIGT and DM of the hypertensive patients.

  4. Secondary Hypertension in Pregnancy.

    Science.gov (United States)

    Malha, Line; August, Phyllis

    2015-07-01

    Hypertension is a common medical complication of pregnancy. Although 75-80 % of women with preexisting essential hypertension will have uncomplicated pregnancies, the presence of secondary forms of hypertension adds considerably to both maternal and fetal morbidity and mortality. Renovascular hypertension, pheochromocytoma, and Cushing's syndrome in particular are associated with accelerating hypertension, superimposed preeclampsia, preterm delivery, and fetal loss. Primary aldosteronism is a more heterogeneous disorder; there are well-documented cases where blood pressure and hypokalemia are improved during pregnancy due to elevated levels of progesterone. However, superimposed preeclampsia, worsening hypertension, and early delivery are also reported. When possible, secondary forms of hypertension should be diagnosed and treated prior to conception in order to avoid these complications.

  5. Metabolomics in hypertension.

    Science.gov (United States)

    Nikolic, Sonja B; Sharman, James E; Adams, Murray J; Edwards, Lindsay M

    2014-06-01

    Hypertension is the most prevalent chronic medical condition and a major risk factor for cardiovascular morbidity and mortality. In the majority of hypertensive cases, the underlying cause of hypertension cannot be easily identified because of the heterogeneous, polygenic and multi-factorial nature of hypertension. Metabolomics is a relatively new field of research that has been used to evaluate metabolic perturbations associated with disease, identify disease biomarkers and to both assess and predict drug safety and efficacy. Metabolomics has been increasingly used to characterize risk factors for cardiovascular disease, including hypertension, and it appears to have significant potential for uncovering mechanisms of this complex disease. This review details the analytical techniques, pre-analytical steps and study designs used in metabolomics studies, as well as the emerging role for metabolomics in gaining mechanistic insights into the development of hypertension. Suggestions as to the future direction for metabolomics research in the field of hypertension are also proposed.

  6. Hypertension, pre-eclampsia and eclampsia: Monitoring and outcome of pregnancy

    Directory of Open Access Journals (Sweden)

    Grujić Ilija

    2006-01-01

    Full Text Available Introduction. Pregnancy-induced hypertension, pre-eclampsia and eclampsia are parts of the hypertensive syndrome which is a life-threatening condition both for mother and fetus. Apart from being associated with unpredictable onset, it is incurable, except by ending the pregnancy. Its incidence is approximately between 6 - 10% of pregnant women. There is no unique definition and classification of the hypertensive syndrome in pregnancy, i.e. they differ from one expert group to another. Risks of pregnancy-induced hypertension. Pregnancy-induced hypertension syndrome can cause placental abruption, intracranial hemorrhage, liver lesions, acute renal disorders and disseminated intravascular coagulation (DIC, adult respiratory distress syndrome (ARDS, hypervolemia and inhalation of gastric content, due to deep sedation. Treatment of pregnancy-induced hypertension. Delivery is always appropriate therapy for the mother, but may not be a good solution for the fetus. Standard treatment of pre-eclampsia includes: anticonvulsive therapy, antihypertensive therapy, excessive fluid administration, and if necessary, management of oliguria, DIC, pulmonary edema and recovery of liver function. The outcome of pregnancy-induced hypertension (perinatal and maternal mortality. Maternal mortality due to pregnancy-induced hypertension is 15 - 33% out of the total number of maternal deaths. Newborn infants of mothers with pregnancy-induced hypertension present with intrauterine growth retardation, prematurity, dysmaturity and necrotizing enterocolitis. Pregnancy-induced hypertension is one of the major causes of maternal and fetal/neonatal morbidity and mortality. .

  7. [Gastrontestinal hemorrhage following thoracic surgery].

    Science.gov (United States)

    Durić, O; Tvrtković, R; Budalica, M

    1976-01-01

    The authors discuss eight cases who suffered hemorrhaging stress ulcers out of 200 cases on whom Thoracotomies were performed. Presented is the common factor of the onset of this complication, it's diagnosis, and therapy. Listed below are the diagnoses and operative procedures used on these eight patients. Cysta Aerea Permagna Lobi Inf. Pulm. Dexter/operation: Mytomis Longitudinalis Ooesophagi. Caverna Bronchiectatica Permagna Lobi Inferior Pulmo Dexter/operation: Lobestomia Typica. Echinococcus Heaptis Complicatus, Empyema Pleurae Dexter/opetation: Decorticatio. Haemathorax Spontaneous Lobus Sinister/operation: Decorticatio Pleurae Sinister. Echi Comp. Cupolae Hepatis Permagnus/operation: Thoracotomia Phrenotomia, evacuatio, Triplex Drainage. Bronchiectasiae Lobi Medius et Inferior Pulmo Dexter/operation: Biblobectomia Typica. Carcinoma Bronchi Lobi Inferior Pulmo Dexter/operation: Lobectomia Typica. Gastric problems had troubled four of these eight patients in their past history. Bleeding in three patients occurred three days postoperatively, and in the remaining five, thirty days following their operation. Six patients had to be treated conservatively because of serious contraindications to reoperation. Four of them expired. Autopsy revealed: Pyothorax, Dehiscention Bronchi, Empyema, and Gastritis Errosiva with multiulcerations, hemoragia, and dilatation of the right heart. Two patients with recent stress ulcers were reoperated on, and were cured. The authors estimate that the occurrence of hemorrhaging stress ulcer following thoracic surgery are basically due to Hypoxia. The chain of events whic brought about the stress ulcer, however, began even before the operation, continued throughout the operation, and appeared postoperatively due to postoperative complications. The authors point out that these complications can be foreseen (early and late), but firstly, an attempt should be made to treat the patient with conservative therapy. Inasmuch as the hemorrhaging

  8. Pulmonary hemorrhage resulting from leptospirosis

    Directory of Open Access Journals (Sweden)

    Mauro Razuk Filho

    2016-07-01

    Full Text Available Leptospirosis is one of the most widespread zoonoses in the world, although the mechanisms responsible for the pathogenesis of spirochetes of the genus Leptospira are largely unknown. Human infection occurs either by direct contact with infected animals or indirectly, through contact with water or soil contaminated with urine, as the spirochetes easily penetrate human skin. The present report exposes the case of a female patient, diagnosed with leptospirosis after having had contact with a dog infected by Leptospira sp. that developed pulmonary hemorrhage, acute respiratory distress syndrome and acute renal failure.

  9. How I treat patients with massive hemorrhage

    DEFF Research Database (Denmark)

    Johansson, Pär I; Stensballe, Jakob; Oliveri, Roberto

    2014-01-01

    Massive hemorrhage is associated with coagulopathy and high mortality. The transfusion guidelines up to 2006 recommended that resuscitation of massive hemorrhage should occur in successive steps using crystalloids, colloids and red blood cells (RBC) in the early phase, and plasma and platelets in...

  10. Safety of anticoagulation after hemorrhagic infarction.

    Science.gov (United States)

    Pessin, M S; Estol, C J; Lafranchise, F; Caplan, L R

    1993-07-01

    Cerebral hemorrhagic infarction visualized on CT, secondary to embolic stroke in an anticoagulated individual, is usually associated with clinically stable or improving neurologic signs; fear of transforming the hemorrhagic infarction into a hematoma, however, usually prompts cessation of anticoagulation until the blood has cleared on CT, despite the recognized risk of recurrent embolism during this non-anticoagulated period. We now report our experience with 12 patients with hemorrhagic infarction who remained anticoagulated. Eleven men and one woman, ages 33 to 77, developed hemorrhagic infarction while on heparin, warfarin, or both, for prevention of recurrent embolism. Patients were either continued on uninterrupted anticoagulation from stroke onset (n = 6), or anticoagulation was withheld for several days and then resumed (n = 4), or it was withheld for 5 and 14 days (n = 2) after stroke onset and then continued uninterrupted despite the CT appearance of hemorrhagic infarction. Eleven patients had a definite cardioembolic source for stroke (atrial fibrillation, seven; ventricular thrombus, two; and ventricular dyskinesia, two). One patient had carotid occlusion with local intra-arterial embolism. Hemorrhagic infarcts varied in size and were located in the middle cerebral artery territory in 11 patients and posterior cerebral artery territory in one. All patients remained clinically stable or improved on anticoagulation. Serial CTs showed fading hemorrhagic areas. When the risk of recurrent embolism is high, anticoagulation may be safely used in some patients with hemorrhagic infarction.

  11. First Outbreak of Dengue Hemorrhagic Fever, Bangladesh

    OpenAIRE

    Rahman, Mahbubur; Rahman, Khalilur; Siddque, A. K.; Shoma, Shereen; A. H. M. Kamal; Ali, K.S.; Nisaluk, Ananda; Breiman, Robert F

    2002-01-01

    During the first countrywide outbreak of dengue hemorrhagic fever in Bangladesh, we conducted surveillance for dengue at a hospital in Dhaka. Of 176 patients, primarily adults, found positive for dengue, 60.2% had dengue fever, 39.2% dengue hemorrhagic fever, and 0.6% dengue shock syndrome. The Dengue virus 3 serotype was detected in eight patients.

  12. Placenta previa and maternal hemorrhagic morbidity.

    Science.gov (United States)

    Gibbins, Karen J; Einerson, Brett D; Varner, Michael W; Silver, Robert M

    2017-02-21

    Placenta previa is associated with maternal hemorrhage, but most literature focuses on morbidity in the setting of placenta accreta. We aim to characterize maternal morbidity associated with previa and to define risk factors for hemorrhage. This is a secondary cohort analysis of the NICHD Maternal-Fetal Medicine Units Network Cesarean Section Registry. This analysis included all women undergoing primary Cesarean delivery without placenta accreta. About 496 women with previa were compared with 24,201 women without previa. Primary outcome was composite maternal hemorrhagic morbidity. Non-hemorrhagic morbidities and risk factors for hemorrhage were also evaluated. Maternal hemorrhagic morbidity was more common in women with previa (19 versus 7%, aRR 2.6, 95% CI 1.9-3.5). Atony requiring uterotonics (aRR 3.1, 95% CI 2.0-4.9), red blood cell transfusion (aRR 3.8, 95% CI 2.5-5.7), and hysterectomy (aRR 5.1, 95% CI 1.5-17.3) were also more common with previa. For women with previa, factors associated with maternal hemorrhage were pre-delivery anemia, thrombocytopenia, diabetes, magnesium use, and general anesthesia. Placenta previa is an independent risk factor for maternal hemorrhagic morbidity. Some risk factors are modifiable, but many are intrinsic to the clinical scenario.

  13. Upper gastrointestinal hemorrhage caused by superwarfarin poisoning

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Superwarfarins are a class of rodenticides. Gastrointestinal hemorrhage is a fatal complication of superwarfarin poisoning, requiring immediate treatment. Here, we report a 55-year-old woman with tardive upper gastrointestinal hemorrhage caused by superwarfarin poisoning after endoscopic cold mucosal biopsy.

  14. Spontaneous bilateral adrenal hemorrhage following cholecystectomy.

    Science.gov (United States)

    Dahan, Meryl; Lim, Chetana; Salloum, Chady; Azoulay, Daniel

    2016-06-01

    Postoperative bilateral adrenal hemorrhage is a rare but potentially life-threatening complication. This diagnosis is often missed because the symptoms and laboratory results are usually nonspecific. We report a case of bilateral adrenal hemorrhage associated with acute primary adrenal insufficiency following laparoscopic cholecystectomy. The knowledge of this uncommon complication following any abdominal surgery allows timey diagnosis and rapid treatment.

  15. Prediction of outcomes in young adults with aneurysmal subarachnoid hemorrhage.

    Science.gov (United States)

    Chotai, Silky; Ahn, Sung-Yong; Moon, Hong-Joo; Kim, Jong-Hyun; Chung, Heung-Seob; Chung, Yong-Gu; Kwon, Taek-Hyun

    2013-01-01

    Subarachnoid hemorrhage (SAH) is rare in young adults and little is known about aneurysms in this subgroup. The effect of clinical and prognostic factors on the outcome based on the Glasgow Outcome Scale (GOS) scores and the predictors of unfavorable outcomes were analyzed in young adults with aneurysmal SAH. A retrospective review of the clinical parameters, including age, sex, hypertension, smoking status, hyperlipidemia, location of the cerebral aneurysm, size of the aneurysm, multiplicity, perioperative complication such as hydrocephalus, vasospasm, and hematoma, and Hunt and Hess and Fisher grading on presentation, was conducted in 108 young adults (mean age 34.8 years) managed at our institute. The outcome was classified based on GOS grading into unfavorable (GOS scores 1-3) or favorable (GOS scores 4 or 5). The overall mortality rate was 3.7% (4/108 patients). Univariate regression analysis for the outcomes at discharge found that age at the time of presentation, male sex, size of aneurysm, multiple aneurysms, hyperlipidemia, and poor Hunt and Hess and Fischer grades were associated with unfavorable outcome. Multivariate regression analysis found independent effects of sex, multiple aneurysms, size of aneurysm, and Hunt and Hess grade on the outcome at discharge. Size of aneurysm, presence of multiple aneurysms, Hunt and Hess grade, and hypertension were the predictors of outcome at mean 2-year follow up based on multivariate exact regression analysis. The multimodal approach with aggressive medical management, early intervention, and surgical treatment might contribute to favorable long-term outcomes in patients with poor expected outcomes.

  16. Spontaneous ipsilateral subconjunctival hemorrhage and the related risk factors

    Directory of Open Access Journals (Sweden)

    Nikolas Ziakas

    2011-06-01

    Full Text Available The aim of the report is to assess the risk factors among patients with spontaneous ipsilateral subconjunctival hemorrhage (SCH who presented to the outpatients’ department in General Hospital of Veria, Veria, Greece. Thirty-five patients with SCH participated in the study. A thorough case history was taken and a full ophthalmic examination was performed to identify the risk factors related to the clinical finding. The common hematological parameters associated with the coagulation profile of each patient were evaluated. With the exception of SCH, the ophthalmic examination was normal in all patients. Identified risk factors include history of systemic hypertension (21 patients [60%], mean systolic value: 170 mmHg±15 mmHg, strenuous exercise [19 patients (54%] and minor ocular trauma [5 patients (14%]. Other risk factors [each in 2 patients (6%] included: diabetes mellitus, smoking, severe cough, straining at stool, and weight lifting. Seven patients (20% were under medication related to bleeding diathesis. The values of the blood coagulation parameters were within the normal limits in all patients. Twenty-nine patients (83% had elevated blood pressure during the ophthalmological examination. Our study provides documentation regarding the potential risk factors associated with SCH. It is interesting to observe the high incidence of hypertension among the patients with SCH. Therefore, it is highly recommended that the blood pressure be checked in all patients with SCH and that the patients be referred to a general practitioner for further management if indicated.

  17. Troponin elevation in subarachnoid hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Ioannis N Mavridis; Maria Meliou; Efstratios-Stylianos Pyrgelis

    2015-01-01

    Troponin (tr) elevation in aneurysmal subarachnoid hemorrhage (SAH) patients is often difficult to be appropriately assessed by clinicians, causing even disagreements regarding its management between neurosurgeons and cardiologists. The purpose of this article was to review the literature regarding the clinical interpretation of tr elevation in SAH. We searched for articles in PubMed using the key words:“troponin elevation”and“subarachnoid hemorrhage”. All of them, as well as relative neurosurgical books, were used for this review. Some type of cardiovascular abnormality develops in most SAH patients. Neurogenic stunned myocardium is a frequent SAH complication, due to catecholamine surge which induces cardiac injury, as evidenced by increased serum tr levels, electrocardiographic (ECG) changes and cardiac wall motion abnormalities. Tr elevation, usually modest, is an early and specific marker for cardiac involvement after SAH and its levels peak about two days after SAH. Cardiac tr elevation predictors include poor clinical grade, intraventricular hemorrhage, loss of consciousness at ictus, global cerebral edema, female sex, large body surface area, lower systolic blood pressure, higher heart rate and prolonged Q-Tc interval. Elevated tr levels are associated with disability and death (especially tr>1μg/L), worse neurological grade, systolic and diastolic cardiac dysfunction, pulmonary congestion, longer intensive care unit stay and incidence of vasospasm. Tr elevation is a common finding in SAH patients and constitutes a rightful cause of worry about the patients’ cardiac function and prognosis. It should be therefore early detected, carefully monitored and appropriately managed by clinicians.

  18. Recurrent bleeding after perimesencephalic hemorrhage.

    Science.gov (United States)

    Kauw, Frans; Velthuis, Birgitta K; Kizilates, Ufuk; van der Schaaf, Irene C; Rinkel, Gabriel J E; Vergouwen, Mervyn D I

    2017-08-31

    Perimesencephalic hemorrhage (PMH) is a type of subarachnoid hemorrhage with excellent long-term outcomes. Only one well-documented case of in-hospital rebleeding after PMH is described in the literature, which occurred after initiating antithrombotic treatment because of myocardial ischemia. In this case report we describe a patient with PMH without antithrombotic treatment who had two episodes of recurrent bleeding on the day of ictus. In order to validate the radiological findings we conducted a case-control study. Six neuroradiologists and two neuroradiology fellows performed a blinded assessment of serial unenhanced head CT scans of eight patients with a perimesencephalic bleeding pattern (1 index patient, 6 patients with PMH, 1 patient with a perimesencephalic bleeding pattern and basilar artery aneurysm) to investigate a potential increase in amount of subarachnoid blood. A 56-year-old woman with a perimesencephalic bleeding pattern and negative CT angiography had after the onset headache two episodes with a sudden increase of the headache. Blinded assessment of serial head CTs of eight patients with a perimesencephalic bleeding pattern identified the patient who was clinically suspected to have two episodes of recurrent bleeding to have an increased amount of subarachnoid blood on two subsequent CT scans. Recurrent bleeding after PMH may also occur in patients not treated with antithrombotics. Even after early rebleeding, prognosis of PMH is excellent. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. A case of idiopathic omental hemorrhage

    Directory of Open Access Journals (Sweden)

    Toshimitsu Hosotani

    2016-05-01

    Full Text Available With the exception of trauma, intraperitoneal hemorrhage in young women is caused by the high frequency of ectopic pregnancy and ovarian bleeding. Here, we describe a case of idiopathic omental hemorrhage, which is a rare cause of intraperitoneal hemorrhage. Intraperitoneal hemorrhage was suspected in a 38-year-old Japanese woman based on contrast-enhanced computed tomography. Her last menstrual period was 23 days prior, and ovarian bleeding was considered based on bloody ascites revealed by culdocentesis. She underwent emergency surgery for hypovolemic shock. Although both ovaries were of normal size and no abnormal findings were observed, we performed a partial omentectomy because multiple clots were attached only to the greater omentum. Postoperatively, no rebleeding occurred, and she was discharged 11 days after the surgery. Because she did not have a clear history of trauma and underlying disease, idiopathic omental hemorrhage was diagnosed.

  20. Clinical outcome prediction in aneurysmal subarachnoid hemorrhage using Bayesian neural networks with fuzzy logic inferences.

    Science.gov (United States)

    Lo, Benjamin W Y; Macdonald, R Loch; Baker, Andrew; Levine, Mitchell A H

    2013-01-01

    The novel clinical prediction approach of Bayesian neural networks with fuzzy logic inferences is created and applied to derive prognostic decision rules in cerebral aneurysmal subarachnoid hemorrhage (aSAH). The approach of Bayesian neural networks with fuzzy logic inferences was applied to data from five trials of Tirilazad for aneurysmal subarachnoid hemorrhage (3551 patients). Bayesian meta-analyses of observational studies on aSAH prognostic factors gave generalizable posterior distributions of population mean log odd ratios (ORs). Similar trends were noted in Bayesian and linear regression ORs. Significant outcome predictors include normal motor response, cerebral infarction, history of myocardial infarction, cerebral edema, history of diabetes mellitus, fever on day 8, prior subarachnoid hemorrhage, admission angiographic vasospasm, neurological grade, intraventricular hemorrhage, ruptured aneurysm size, history of hypertension, vasospasm day, age and mean arterial pressure. Heteroscedasticity was present in the nontransformed dataset. Artificial neural networks found nonlinear relationships with 11 hidden variables in 1 layer, using the multilayer perceptron model. Fuzzy logic decision rules (centroid defuzzification technique) denoted cut-off points for poor prognosis at greater than 2.5 clusters. This aSAH prognostic system makes use of existing knowledge, recognizes unknown areas, incorporates one's clinical reasoning, and compensates for uncertainty in prognostication.

  1. Early recognition of intraventricular hemorrhage in the setting of thrombocytosis in the emergency department

    Science.gov (United States)

    Charles, Marvinia; Fontoura, Romy; Sugalski, Gregory

    2016-01-01

    Thrombocytosis is frequently encountered as an incidental laboratory finding since isolated thrombocytosis is often asymptomatic. Even though thrombocytosis is benign and self-limiting in most cases, it can at times result in thrombosis or hemorrhage. The most common type of thrombocytosis is reactive (secondary) thrombocytosis and can be due to infections, trauma, surgery, or occult malignancy. Since thrombocytosis is a known risk factor for thrombosis, it is commonly a concern for ischemic stroke and myocardial infarction. Much less common are hemorrhagic events associated with thrombocytosis. Studies have shown that when hemorrhage is present in patients with thrombocytosis, it is most often seen in the setting of chronic myelogenous leukemia and essential thrombocythemia. In essential thrombocythemia, the overall risk of bleeding and thrombosis is 0.33% per patient-year and 6.6% per patient-year, respectively. In the general population, the risk of bleeding and thrombosis is 0% and 1.2%, respectively. The present study is a case report of an 83-year-old man who presented to the emergency department with hypertension and headache, who was then found to have significant thrombocytosis (platelets >1,000×109/L) and acute right intraventricular hemorrhage without any signs of neurological deficits, or evidence of vascular malformations or mass. We present this case report for review and discussion of some of the challenges and considerations associated with the management of such patients. PMID:27307770

  2. Hypertensive crisis in children.

    Science.gov (United States)

    Chandar, Jayanthi; Zilleruelo, Gastón

    2012-05-01

    Hypertensive crisis is rare in children and is usually secondary to an underlying disease. There is strong evidence that the renin-angiotensin system plays an important role in the genesis of hypertensive crisis. An important principle in the management of children with hypertensive crisis is to determine if severe hypertension is chronic, acute, or acute-on-chronic. When it is associated with signs of end-organ damage such as encephalopathy, congestive cardiac failure or renal failure, there is an emergent need to lower blood pressures to 25-30% of the original value and then accomplish a gradual reduction in blood pressure. Precipitous drops in blood pressure can result in impairment of perfusion of vital organs. Medications commonly used to treat hypertensive crisis in children are nicardipine, labetalol and sodium nitroprusside. In this review, we discuss the pathophysiology, differential diagnosis and recent developments in management of hypertensive crisis in children.

  3. Hypertension in young adults.

    Science.gov (United States)

    De Venecia, Toni; Lu, Marvin; Figueredo, Vincent M

    2016-01-01

    Hypertension remains a major societal problem affecting 76 million, or approximately one third, of US adults. While more prevalent in the older population, an increasing incidence in the younger population, including athletes, is being observed. Active individuals, like the young and athletes, are viewed as free of diseases such as hypertension. However, the increased prevalence of traditional risk factors in the young, including obesity, diabetes mellitus, and renal disease, increase the risk of developing hypertension in younger adults. Psychosocial factors may also be contributing factors to the increasing incidence of hypertension in the younger population. Increased left ventricular wall thickness and mass are increasingly found in young adults on routine echocardiograms and predict future cardiovascular events. This increasing incidence of hypertension in the young calls for early surveillance and prompt treatment to prevent future cardiac events. In this review we present the current epidemiological data, potential mechanisms, clinical implications, and treatment of hypertension in young patients and athletes.

  4. TCM Dietotherapy for Hypertension

    Institute of Scientific and Technical Information of China (English)

    DENG Zi; DUAN Shu-min

    2010-01-01

    @@ Hypertension is a common cardiovascular disease with a group of symptoms and signs, mainly the increased blood pressure of the arteries.It may be primary or secondary.The former, accounting for90%, refers to an independent disease mainly manifested by increased blood pressure with the cause unknown.Primary hypertension is related to nervousness, emotional fluctuation, heredity, obesity and high-salt diet.Secondary hypertension is one of the manifestations in certain disorders.

  5. Hypertension og hyperlipidaemi

    DEFF Research Database (Denmark)

    Hansen, Henrik Steen; Larsen, Mogens Lytken

    2009-01-01

    Hypertension and hyperlipidemia are well-established and partially overlapping risk factors for cardiovascular disease. Analyses of cardiovascular morbidity in relationship to changes in blood pressure and in serum cholesterol levels have shown that combined reduction of both risk factors...... are important to achieve a reduction in morbidity. Statins have been shown to be effective in preventing both coronary and cerebrovascular events in both hypertensive and normotensive cases. Consequently, most recent guidelines recommend that statin treatment be considered in hypertensive patients aged less...

  6. Valproate Induced Hypertensive Urgency

    Directory of Open Access Journals (Sweden)

    Mauran Sivananthan

    2016-01-01

    Full Text Available Valproate is a medication used in the treatment of seizures, bipolar disorder, migraines, and behavioral problems. Here we present a case of an 8-year-old boy who presented with hypertensive urgency after initiation of valproate. Primary treatment of his hypertension was ineffective. Blood pressure stabilization was achieved following discontinuation of valproate. Clinicians should be aware of the risk of developing hypertensive urgency with administration of valproate.

  7. Obesity-Related Hypertension

    OpenAIRE

    Re, Richard N.

    2009-01-01

    Obesity-associated arterial hypertension is characterized by activation of the sympathetic nervous system, activation of the renin-angiotensin system, and sodium retention, among other abnormalities. In this review, the following 3 facets of the obesity/hypertension nexus will be discussed: the potential mechanisms by which obesity can lead to elevated arterial pressure, the interaction of obesity with the sequelae of hypertension, and the therapies that are believed to optimally treat obesit...

  8. Severe systolic hypertension and the search for safer motherhood.

    Science.gov (United States)

    Martin, James N

    2016-03-01

    Timely and appropriate response to severe hypertension during gestation is an important component of quality, safe care for pregnant or puerperal mothers regardless of causation. The reduction of severe maternal morbidity and maternal mortality in the hypertensive mother is clearly enhanced by the addition of standard protocols for provider response to severe hypertension, particularly severe systolic hypertension. The program developed in New York State via the Safe Motherhood Initiative promotes the implementation of unit-specific safety bundles, especially one that is focused upon a standardized approach to handling the obstetric emergency of severe hypertension usually associated with preeclampsia/eclampsia. The comprehensive preeclampsia/eclampsia safety bundle as summarized by Drs. Moroz and colleagues is reviewed especially from the perspective of its focus on the timely and specific responses for health care providers to make when severe hypertension is detected in the pregnant patient. Evidence-based guidance to practice considerations and clinical care of patients with preeclampsia/eclampsia is embedded within the program outlined for New York State by Moroz and her District II ACOG colleagues. There is a central focus on timely and appropriate antepartum/postpartum management of severe hypertension, a core concept to lessen maternal risk for cerebral hemorrhage. Ten considerations for further integration into the New York program are suggested. Beyond blood pressure control, there is a need for systematic review of interventions and outcomes over time, attention to possible future variations of the protocol for racial/ethnic patient groups at highest risk for maternal morbidity and mortality, and the identification of biomarker(s) that further specify and quantify risk to the maternal brain and other organ systems when severe hypertension develops. Safer motherhood will happen when evidence for best practice is integrated into systems of care for all

  9. 42. Hypertension: Morbidity review

    Directory of Open Access Journals (Sweden)

    Hamzullah khan

    2015-10-01

    Conclusions: hypertension is a major modifiable risk factor for coronary artery disease, stroke, eye abnormalities and end stage renal disease, which require proper counseling and management of patients.

  10. Dopamine receptor and hypertension.

    Science.gov (United States)

    Zeng, Chunyu; Eisner, Gilbert M; Felder, Robin A; Jose, Pedro A

    2005-01-01

    Dopamine plays an important role in the pathogenesis of hypertension by regulating epithelial sodium transport and reactive oxygen and by interacting with vasopressin, renin-angiotensin, and the sympathetic nervous system. Decreased renal dopamine production and/or impaired dopamine receptor function have been reported in hypertension. Disruption of any of the dopamine receptors (D(1), D(2), D(3), D(4), and D(5)) results in hypertension. In this paper, we review the mechanisms by which hypertension develops when dopamine receptor function is perturbed.

  11. [Hypertension in women].

    Science.gov (United States)

    Tagle, Rodrigo; Tagle V, Rodrigo; Acevedo, Mónica; Valdés, Gloria

    2013-02-01

    The present review examines the types of hypertension that women may suffer throughout life, their physiopathological characteristics and management. In early life, the currently used low-dose oral contraceptives seldom cause hypertension. Pregnancy provokes preeclampsia, its main medical complication, secondary to inadequate transformation of the spiral arteries and the subsequent multisystem endothelial damage caused by deportation of placental factors and microparticles. Hypertension in preeclampsia is an epiphenomenon which needs to be controlled at levels that reduce maternal risk without impairing placental perfusion. The hemodynamic changes of pregnancy may unmask a hypertensive phenotype, may exacerbate a chronic hypertension, or may complicate hypertension secondary to lupus, renovascular lesions, and pheochromocytoma. On the other hand a primary aldosteronism may benefit from the effect of progesterone and present as a postpartum hypertension. A hypertensive pregnancy, especially preeclampsia, represents a risk for cardiac, vascular and renal disease in later life. Menopause may mimic a pheochromocytoma, and is associated to endothelial dysfunction and salt-sensitivity. Among women, non-pharmacological treatment should be forcefully advocated, except for sodium restriction during pregnancy. The blockade of the renin-angiotensin system should be avoided in women at risk of pregnancy; betablockers could be used with precautions during pregnancy; diuretics, ACE inhibitors and angiotensin receptor antagonists should not be used during breast feeding. Collateral effects of antihypertensives, such as hyponatremia, cough and edema are more common in women. Thus, hypertension in women should be managed according to the different life stages.

  12. Retinal changes in pregnancy-induced hypertension

    Directory of Open Access Journals (Sweden)

    Akash Pankaj Shah

    2015-01-01

    Full Text Available Aims: The aim was to determine the prevalence of retinal changes in pregnancy-induced hypertension (PIH and any association between the retinal changes and age, parity, blood pressure, proteinuria, and severity of the disease. Settings and Design: Hospital-based cross-sectional study. Materials and Methods: All the patients admitted with a diagnosis of PIH were included in this study. Age, gravida, gestation period, blood pressure, and proteinuria were noted from the case records. Fundus examination was done with a direct ophthalmoscope. The findings were noted and were analyzed using SPSS program. Results: A total of 150 patients of PIH were examined. The mean age of patients was 25.1 years. The gestation period ranged from 27 weeks to 42 weeks; 76 (50.67% were the primi gravida. 92 (61.33% patients had gestational hypertension, 49 (32.67% patients had preeclampsia, and 9 (6% had eclampsia. Retinal changes (hypertensive retinopathy were noted in 18 (12% patients - Grade 1 in 12 (8% and Grade 2 in 6 (4%. Hemorrhages or exudates or retinal detachment were not seen in any patient. There was statistically significant positive association of retinal changes and blood pressure (P = 0.037, proteinuria (P = 0.0005, and severity of the PIH (P = 0.004. Conclusions: Retinal changes were seen in 12% of patients with PIH. Occurrence of hypertensive retinopathy in PIH cases has been decreased due to better antenatal care and early detection and treatment of PIH cases. There is a greater chance of developing retinopathy with increase in blood pressure, severity of PIH, and proteinuria in cases of PIH.

  13. Trashepatic left gastric vein embolization in the treatment of recurrent hemorrhaging in patients with schistosomiasis previously submitted to non-derivative surgery

    Directory of Open Access Journals (Sweden)

    Paulo Fernandes Saad

    2012-12-01

    Full Text Available CONTEXT: Non-derivative surgical techniques are the treatment of choice for the control of upper digestive tract hemorrhages after schistosomotic portal hypertension. However, recurrent hemorrhaging due to gastroesophagic varices is frequent. OBJECTIVE: To evaluate the outcome of treatment based on embolization of the left gastric vein to control the reoccurrence of hemorrhages caused by gastroesophagic varices in patients with schistosomiasis previously submitted to non-derivative surgery. METHODS: Rates of reoccurrence of hemorrhages and the qualitative and quantitative reduction of gastroesophagic varices in patients undergoing transhepatic embolization of the left gastric vein between December 1999 and January 2009 were studied based on medical charts and follow-up reports. RESULTS: Seven patients with a mean age of 39.3 years underwent percutaneous transhepatic embolization of the left gastric vein. The mean time between azigoportal disconnections employed in combination with splenectomy and the percutaneous approach was 8.4 ± 7.3 years, and the number of episodes of digestive hemorrhaging ranged from 1 to 7 years. No episodes of reoccurrence of hemorrhaging were found during a follow-up period which ranged from 6 months to 7 years. Endoscopic postembolization studies revealed reductions in gastroesophagic varices in all patients compared to preembolization endoscopy. CONCLUSIONS: Percutaneous transhepatic embolization of the left gastric vein in patients with schistosomiasis previously submitted to surgery resulted in a decrease in gastroesophagic varices and was shown to be effective in controlling hemorrhage reoccurrence.

  14. Late hemorrhagic disease of newborn.

    Science.gov (United States)

    D'Souza, I E; Rao, S D Subba

    2003-03-01

    The clinical features of 14 infants diagnosed with late hemorrhagic disease of newborn (LHDN), of which 10 did not receive vitamin K prophylaxis, are presented. All infants were exclusively breast-fed and 12 did not have any underlying illness to explain the abnormal coagulation profile. The common presenting symptoms were seizures (71%), vomiting (57%), poor feeding (50%) and altered sensorium (36%). Physical examination shared pallor in all infants and a bulging anterior fontanel in 64%. Intracranial bleed was the predominant manifestation (93%), with CT scan showing intracranial bleed in 78%. Eight infants (57%) succumbed to their illness, while 36%had neurological sequelae. Since LHDN leads to significant morbidity and mortality, it should be prevented by providing vitamin K prophylaxis to all newborns.

  15. Troponin elevation in subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Ioannis N. Mavridis

    2015-03-01

    Full Text Available Troponin (tr elevation in aneurysmal subarachnoid hemorrhage (SAH patients is often difficult to be appropriately assessed by clinicians, causing even disagreements regarding its management between neurosurgeons and cardiologists. The purpose of this article was to review the literature regarding the clinical interpretation of tr elevation in SAH. We searched for articles in PubMed using the key words: “troponin elevation” and “subarachnoid hemorrhage”. All of them, as well as relative neurosurgical books, were used for this review. Some type of cardiovascular abnormality develops in most SAH patients. Neurogenic stunned myocardium is a frequent SAH complication, due to catecholamine surge which induces cardiac injury, as evidenced by increased serum tr levels, electrocardiographic (ECG changes and cardiac wall motion abnormalities. Tr elevation, usually modest, is an early and specific marker for cardiac involvement after SAH and its levels peak about two days after SAH. Cardiac tr elevation predictors include poor clinical grade, intraventricular hemorrhage, loss of consciousness at ictus, global cerebral edema, female sex, large body surface area, lower systolic blood pressure, higher heart rate and prolonged Q-Tc interval. Elevated tr levels are associated with disability and death (especially tr >1 μg/L, worse neurological grade, systolic and diastolic cardiac dysfunction, pulmonary congestion, longer intensive care unit stay and incidence of vasospasm. Tr elevation is a common finding in SAH patients and constitutes a rightful cause of worry about the patients' cardiac function and prognosis. It should be therefore early detected, carefully monitored and appropriately managed by clinicians.

  16. Treatment of TBI and Concomitant Hemorrhage with Ghrelin

    Science.gov (United States)

    2010-07-01

    battlefield setting. 15. SUBJECT TERMS Traumatic brain injury ; hemorrhagic shock; ghrelin; treatment 16. SECURITY CLASSIFICATION OF: U 17...hemorrhagic shock. 2. Ghrelin treatment improves sensorimotor and reflex function after traumatic brain injury and uncontrolled hemorrhagic shock...3. Ghrelin treatment reduces cortical apoptosis after traumatic brain injury and uncontrolled hemorrhagic shock. 4. Ghrelin treatment

  17. Meckel's cave meningiomas with subarachnoid hemorrhage.

    Science.gov (United States)

    Rosenberg, G A; Herz, D A; Leeds, N; Strully, K

    1975-06-01

    Two patients with Meckel's Cave meningiomas were initially hospitalized as a result of subarachnoid hemorrhage. Four-vessel angiography was necessary to exclude other causes of bleeding while demonstrating these lesions. Apoplectic presentation in both cases led to early diagnosis and successful surgical therapy. A review of the literature reveals subarachnoid hemorrhage to be a rarity in association with meningiomas. The two patients currently reported are believed to be the only examples on record of hemorrhagic meningiomas arising from the region of Meckel's Cave.

  18. Hemorrhagic chondroid chordoma mimicking pituitary apoplexy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, H.J.; Kalnin, A.J.; Holodny, A.I. [Dept. of Radiology, University Hospital, Newark, NJ (United States); Schulder, M.; Grigorian, A. [Dept. of Neurosurgery, University Hospital, Newark, NJ (United States); Sharer, L.R. [Dept. of Pathology, University Hospital, Newark, NJ (United States)

    1998-11-01

    We describe a hemorrhagic chondroid chordoma involving the sella turcica with suprasellar extension. The CT and MRI appearances mimiked a hemorrhagic pituitary adenoma. Chondroid chordoma is a variant composed of elements of both chordoma and cartilaginous tissue. An uncommon bone neoplasm, located almost exclusively in the spheno-occipital region, it is usually not considered in the differential diagnosis of a tumor with acute hemorrhage in the sellar region. We discuss the clinical and radiological characteristics which may allow one to differentiate chondroid chordoma from other tumors of this area. (orig.) With 3 figs., 9 refs.

  19. Hypertension after clonidine withdrawal.

    Science.gov (United States)

    Husserl, F E; deCarvalho, J G; Batson, H M; Frohlich, E D

    1978-05-01

    Rebound hypertension occurred in two patients upon clonidine withdrawal. Treatment of the hypertensive crisis consists of both alpha- and beta-adrenergic receptor blockade, reserpine, or the reintroduction of clonidine. With effective control of pressure during the crisis, long-term antihypertensive therapy must be resumed.

  20. Hypertension and liver disease

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren

    2004-01-01

    Arterial hypertension is a common disorder with a frequency of 10% to 15% in subjects in the 40- to 60-year age group. Yet most reports find the prevalence of arterial hypertension in patients with chronic liver disease (cirrhosis) much lower. In this review, we consider the alterations in systemic...

  1. Hypertension Briefing: Technical documentation

    OpenAIRE

    Institute of Public Health in Ireland

    2012-01-01

    Blood pressure is the force exerted on artery walls as the heart pumps blood through the body. Hypertension, or high blood pressure, occurs when blood pressure is constantly higher than the pressure needed to carry blood through the body. This document details how the IPH uses a systematic and consistent method to produce prevalence data for hypertension on the island of Ireland.

  2. Hypertension (High Blood Pressure)

    Science.gov (United States)

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Hypertension (High Blood Pressure) KidsHealth > For Teens > Hypertension (High Blood Pressure) A ... rest temperature diet emotions posture medicines Why Is High Blood Pressure Bad? High blood pressure means a person's heart ...

  3. Pregnancy and pulmonary hypertension

    NARCIS (Netherlands)

    Pieper, Petronella G.; Lameijer, Heleen; Hoendermis, Elke S.

    2014-01-01

    Pulmonary hypertension during pregnancy is associated with considerable risks of maternal mortality and morbidity. Our systematic review of the literature on the use of targeted treatments for pulmonary arterial hypertension during pregnancy indicates a considerable decrease of mortality since a pre

  4. Pulmonary Hypertension Overview

    Science.gov (United States)

    ... chest X-ray, a breathing test called a pulmonary function test and an echocardiogram (sometimes called an “echo”). Your doctor may also need to do other tests to find out whether another medical condition is causing your pulmonary hypertension. TreatmentHow is pulmonary hypertension treated?If the ...

  5. Noncirrotisk intrahepatisk portal hypertension

    DEFF Research Database (Denmark)

    Dam Fialla, Annette; Havelund, Troels

    2007-01-01

    Non-cirrhotic intrahepatic portal hypertension is characterized by portal hypertension in the absence of liver cirrhosis or portal vein thrombosis. The disease is common in the East and rarely seen in the West. Two cases with oesophageal varices are described. The histopathology is heterogeneous...

  6. Hypertension og hjernen

    DEFF Research Database (Denmark)

    Christensen, Hanne; Strandgaard, Svend

    2009-01-01

    Hypertension is a major and modifiable risk factor of stroke and dementia. Hypertension causes remodelling of the cerebral resistance vessels, impairing their tolerance to very low blood pressure. In primary prevention of stroke, the effect of beta-blockers is inferior to other classes...

  7. Noncirrotisk intrahepatisk portal hypertension

    DEFF Research Database (Denmark)

    Dam Fialla, Annette; Havelund, Troels

    2007-01-01

    Non-cirrhotic intrahepatic portal hypertension is characterized by portal hypertension in the absence of liver cirrhosis or portal vein thrombosis. The disease is common in the East and rarely seen in the West. Two cases with oesophageal varices are described. The histopathology is heterogeneous...... but includes vascular lesions and portal fibrosis. Patient management follows the current recommendations for variceal bleeding....

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

    Directory of Open Access Journals (Sweden)

    Suri A

    2002-10-01

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

  9. Hypertension in the Elderly

    Directory of Open Access Journals (Sweden)

    Blas Gil-Extremera

    2012-01-01

    Full Text Available Background. The incidence of hypertension in the Western countries is continuously increasing in the elderly population and remains the leading cause of cardiovascular and morbidity. Methods. we analysed some significant clinical trials in order to present the relevant findings on those hypertensive population. Results. Several studies (SYST-EUR, HYVET, CONVINCE, VALUE, etc. have demonstrated the benefits of treatment (nitrendipine, hydrochrotiazyde, perindopril, indapamide, verapamil, or valsartan in aged hypertensive patients not only concerning blood pressure values but also the other important risk factors. Conclusion. Hypertension is the most prevalent cardiovascular disorder in the Western countries, and the relevance of receiving pharmacological treatment of hypertension in aged patients is crucial; in addition, the results suggest that combination therapy—nitrendipine plus enalapril—could have more benefits than those observed with the use of nitrendipine alone.

  10. Chronic thromboembolic pulmonary hypertension.

    Science.gov (United States)

    Schölzel, B E; Snijder, R J; Mager, J J; van Es, H W; Plokker, H W M; Reesink, H J; Morshuis, W J; Post, M C

    2014-12-01

    Chronic pulmonary thromboembolic disease is an important cause of severe pulmonary hypertension, and as such is associated with significant morbidity and mortality. The prognosis of this condition reflects the degree of associated right ventricular dysfunction, with predictable mortality related to the severity of the underlying pulmonary hypertension. Left untreated, the prognosis is poor. Pulmonary endarterectomy is the treatment of choice to relieve pulmonary artery obstruction in patients with chronic thromboembolic pulmonary hypertension and has been remarkably successful. Advances in surgical techniques along with the introduction of pulmonary hypertension-specific medication provide therapeutic options for the majority of patients afflicted with the disease. However, a substantial number of patients are not candidates for pulmonary endarterectomy due to either distal pulmonary vascular obstruction or significant comorbidities. Therefore, careful selection of surgical candidates in expert centres is paramount. The current review focuses on the diagnostic approach to chronic thromboembolic pulmonary hypertension and the available surgical and medical therapeutic options.

  11. Hypertension in pregnancy.

    Science.gov (United States)

    Vest, Amanda R; Cho, Leslie S

    2014-03-01

    Hypertensive disorders of pregnancy represent the second commonest cause of direct maternal death and complicate an estimated 5-10 % of pregnancies. Classification systems aim to separate hypertension similar to that seen outside pregnancy (chronic and gestational hypertension) from the potentially fatal pregnancy-specific conditions. Preeclampsia, HELLP syndrome, and eclampsia represent increasing severities of this disease spectrum. The American College of Obstetricians and Gynecologists' 2013 guidelines no longer require proteinuria as a diagnostic criterion, because of its variable appearance in the disease spectrum. The cause involves inadequate cytotrophoblastic invasion of the myometrium, resulting in placental hypoperfusion and diffuse maternal endothelial dysfunction. Changes in angiogenic and antiangiogentic peptide profiles precede the onset of clinical preeclampsia. Women with preeclampsia should be closely monitored and receive magnesium sulfate intravenously if severe features, HELLP syndrome, or eclampsia occur. Definitive therapy is delivery of the fetus. Hypertension in pregnancy increases future maternal risk of hypertension and cardiovascular disorders.

  12. [Hypertension and arteriosclerosis].

    Science.gov (United States)

    Sasamura, Hiroyuki; Itoh, Hiroshi

    2011-01-01

    Hypertension is a known risk factor for arteriosclerosis, and causes both atherosclero= sis of medium-large arteries and arteriolosclerosis of the arterioles. Elevated blood pressure causes damage to the endothelium and vascular wall through both mechanical and humoral factors. We and others have shown that inhibition of the renin-angiotensin system at a 'critical period' during the development of hypertension results in a permanent suppression of hypertension in animal models. We have also reported that high-dose renin-angiotensin inhibition results in regression of hypertension, possibly by regression of renal arteriolar hypertrophy. These results suggest that understanding the process of arterial remodeling may play a key role in the development of new strategies for prevention and regression of hypertension and arteriosclerosis.

  13. Overweight, adipocytokines and hypertension

    DEFF Research Database (Denmark)

    Seven, Ekim; Husemoen, Lise L N; Wachtell, Kristian

    2014-01-01

    , adiponectin, and CRP levels with both prevalent and 5-year incident hypertension (IHT) in a general population of Danish adults (n = 5,868, 51.3% women, mean age 45.8 ± 7.9 years). RESULTS: We recorded 2195 prevalent and 379 incident cases of hypertension. In models including leptin, CRP, adiponectin, sex......OBJECTIVE: The adipocytokines, leptin, adiponectin, and interleukin-6, which stimulate liver C-reactive protein (CRP) production, are regarded as potential candidate intermediates between adipose tissue and overweight-induced hypertension. METHODS: We examined the associations between leptin.......023) in the fully adjusted model. The population attributable risk estimate of IHT owing to overweight was 31%. CONCLUSION: Leptin, but not adiponectin or CRP, may play a mediating role in overweight-induced hypertension. However, as BMI was a strong independent predictor of hypertension, other factors than leptin...

  14. Hypertension in pregnancy.

    Science.gov (United States)

    Lindheimer, Marshall D; Taler, Sandra J; Cunningham, F Gary

    2010-01-01

    Hypertension complicates 5% to 7% of all pregnancies. A subset of preeclampsia, characterized by new-onset hypertension, proteinuria, and multisystem involvement, is responsible for substantial maternal and fetal morbidity and is a marker for future cardiac and metabolic disease. This American Society of Hypertension (ASH) position paper summarizes the clinical spectrum of hypertension in pregnancy, focusing on preeclampsia. Recent research breakthroughs relating to etiology are briefly reviewed. Topics include classification of the different forms of hypertension during pregnancy, and status of the tests available to predict preeclampsia, and strategies to prevent preeclampsia and to manage this serious disease. The use of antihypertensive drugs in pregnancy, and the prevention and treatment of the convulsive phase of preeclampsia, eclampsia, with intravenous MgSO(4) is also highlighted. Of special note, this guideline article, specifically requested, reviewed, and accepted by ASH, includes solicited review advice from the American College of Obstetricians and Gynecologists.

  15. Three cases of digestive tract hemorrhage of portal hypertension combine portal vein wide embolism after transjugular intrahepatic portosystemic stent shunt treatment%颈静脉肝内门体分流术治疗门静脉高压并门静脉广泛栓子后消化道出血三例

    Institute of Scientific and Technical Information of China (English)

    张军华; 张金龙; 张弢; 张素静; 徐慧军; 李玉

    2013-01-01

    目的 探讨经颈静脉肝内门体分流术(TIPS)治疗门静脉高压并门静脉内栓子广泛形成后消化道出血的治疗效果.方法 3例急性上消化道出血患者,均经CT明确诊断为门静脉、肠系膜上静脉内(含1例脾静脉内栓子形成)广泛栓子形成,行TIPS止血治疗,将支架放置于造影所见栓子的远端.结果 TIPS治疗后,随访4~6周3例患者均未再发生出血,不适症状消失.结论 TIPS治疗门静脉高压并门静脉内广泛栓子形成后消化道出血,安全可行,疗效可靠,值得推广.%Objective To investigate the effect of transjugular intrahepatic portosystemic stent shunt (TIPS) on gastrointestinal bleeding after portal hypertension and portal vein wide embolism.Methods Three patients with acute upper gastrointestinal bleeding were diagnosed by CT with wide embolus formation in portal vein and superior mesenteric vein,of which,1 case was with spleen vein embolism formation.TIPS hemostatic treatment was applied to stop bleeding,and stents was placed where distal embolus can be observed by angiography.Results After TIPS treatment,no patients were re-bleeding during following-up periods (4-6 weeks).Uncomfortable symptoms of 3 cases were disappeared.Conclusion TIPS was a safe and effective way to treat gastrointestinal bleeding caused by portal hypertension and wide embolus formation.

  16. Incidence of Intraventricular Hemorrhage and Post Hemorrhagic Hydrocephalus in Preterm Infants

    Directory of Open Access Journals (Sweden)

    Negar Sajjadian

    2010-07-01

    Full Text Available "nGerminal matrix-intraventricular hemorrhage (IVH is the most common variety of neonatal intracranial hemorrhage and is characteristics of the premature infant. The importance of the lesion relates not only to its high incidence but to their attendant complications (IC: hydrocephalus. Brain sonography is the procedure of choice in diagnosis of germinal matrix- intraventricular hemorrhage and hydrocephalus. In this study we have used brain sonography for detection of intraventricular hemorrhage and post hemorrhagic hydrocephalus and their incidences. The studied population was consisted of premature neonate (birth weight equal or less than 1500g and gestational age equal or less than 37 weeks who admitted in Mofid Hospital NICU (Tehran, Iran during a one year period. For all neonate (including criteria brain sonography in first week of life was done and in presence of IVH, serial Brain sonography was done weekly for detection of hydrocephalus. A total of 57 neonate entered the study. Intraventicular-germinal matrix hemorrhage was seen in 64.4% (35 patients. Forty percent of patients with intraventricular-germinal matrix hemorrhage had grade I, 11% grade II, 25.7% grade III, 2.8% grade VI. Hydrocephalus was detected in 20 percent of patients who had intraventricular-germinal matrix hemorrhage. That incidence of IVH in our study in comparison with other area and situation is higher. Hydrocephaly had direct relation with severity of IVH. This shows that with control of risk factor of IVH, we can control Post hemorrhagic hydrocephalus.

  17. Delayed Intracerebral Hemorrhage Secondary to Ventriculoperitoneal Shunt

    Science.gov (United States)

    Ma, Li; Chen, Yi-Li; Yang, Shu-Xu; Wang, Yi-Rong

    2015-01-01

    Abstract The ventriculoperitoneal (VP) shunt is a routine procedure for cerebrospinal fluid (CSF) diversion, and is associated with many complications. A delayed hemorrhage after the VP shunt surgery, however, is quite rare. In this study, we report a case involving late-onset hemorrhage. The 67-year-old male patient with a history of head trauma and brain surgery underwent a VP shunt placement for hydrocephalus. The surgery course was uneventful and no bleeding was revealed in the first computed tomographic (CT) scan after the procedure. However, a massive intraparenchymal and intraventricular hemorrhage occurred 8 h following adjustment of the valve system on the 8th day after surgery. Erosion of the vasculature by catheter cannulation and a sudden reduction of CSF pressure after downregulation of the valve could be one of the possible causes of the intracerebral hemorrhage (ICH). PMID:26632700

  18. Factor XIII Deficiency and Intracranial Hemorrhage

    OpenAIRE

    1990-01-01

    A 38 month old boy with excessive bleeding following circumcision as a newborn and two episodes of intracranial hemorrhage at four months and at 85 months of age is reported from the Scott and White Clinic, Temple, TX.

  19. Aspirin-Induced Neonatal Intracranial Hemorrhage

    OpenAIRE

    1994-01-01

    A term newborn infant with intracranial hemorrhage associated with maternal acetylsalicylic acid ingestion before delivery is reported from the Departments of Pediatrics and Neurology, Eastern Virginia Medical School, Norfolk, VA.

  20. [Hemorrhagic complications of anti-vitamin K].

    Science.gov (United States)

    Al-Hajje, A; Calop, N; Bosson, J L; Calop, J; Allenet, B

    2009-03-01

    Adverse events related to oral anticoagulants represent a major public health problem. Hemorrhagic episodes are the most frequent complications and can be life-threatening. A 10 month prospective survey on all cases treated with anti-vitamin K (AVK), and admitted to emergency room of CHU Grenoble, was conducted to identify the hemorrhagic adverse drug events (HADE). The evaluation support was a directive questionnaire and consisted of 3 parts: patient characteristics, patient's medicated treatment and the hemorrhagic event. 216 patients treated with AVK were identified and 68 of them presented a hemorrhagic adverse drug event. 60 patients older than 65 years out of 158, presented HADE (38%); versus 8 patients or = 5, 79% developed HADE versus 16% in the group who had their INR AVK were significant. Concerning missed dose, 48 patients declared taking the missed dose with the next dose or when they remembered: 35% of them developed HADE (p = 0.49).

  1. Splenic Involvement in Hereditary Hemorrhagic Telangiectasia

    Directory of Open Access Journals (Sweden)

    Susumu Takamatsu

    2016-01-01

    Full Text Available A 33-year-old man who presented with prolonged epigastric pain was referred to our hospital. He had experienced recurrent epistaxis and had a family history of hereditary hemorrhagic telangiectasia. Computed tomography and magnetic resonance imaging revealed splenomegaly and a 9 cm hypervascular mass in his spleen. Computed tomography also showed a pulmonary arteriovenous malformation and heterogeneous enhancement of the liver parenchyma, suggesting the presence of arteriosystemic shunts and telangiectases. Based on these findings, the patient was definitely diagnosed with hereditary hemorrhagic telangiectasia according to Curaçao criteria. He underwent splenectomy, and his symptoms disappeared after surgery. Pathological examination of the resected specimen revealed that the hypervascular lesion of the spleen was not a tumor but was composed of abnormal vessels associated with hereditary hemorrhagic telangiectasia. Symptomatic splenic involvement may be a rare manifestation of hereditary hemorrhagic telangiectasia but can be revealed by imaging modalities.

  2. Previously undiagnosed hemophilia patient with intracerebral hemorrhage

    Directory of Open Access Journals (Sweden)

    Eray Atalay

    2015-09-01

    Full Text Available Intracranial bleeding in hemophilia patients is a rare but a mortal complication. Diagnosis of hemophilia in adulthood is an uncommon occurrence. In this case report an adult patient with intracranial hemorrhage is presented.

  3. Current management of massive hemorrhage in trauma

    DEFF Research Database (Denmark)

    Johansson, Pär I; Stensballe, Jakob; Ostrowski, Sisse R

    2012-01-01

    ABSTRACT: Hemorrhage remains a major cause of potentially preventable deaths. Trauma and massive transfusion are associated with coagulopathy secondary to tissue injury, hypoperfusion, dilution, and consumption of clotting factors and platelets. Concepts of damage control surgery have evolved...

  4. Pulmonary hemorrhage resulting from roller coaster.

    Science.gov (United States)

    Yin, Ming; Tian, Qing; Shen, Hong

    2011-03-01

    Roller coasters are probably one of the more popular rides at amusement parks around the world, and there are few reported injuries. We report a case of symmetric diffuse upper lobe hemorrhage resulting from roller coaster in a previously healthy woman. The clinical course, management, and etiology of her case are discussed; and the literature is reviewed. To our knowledge, pulmonary hemorrhage in this setting has not yet been described.

  5. Argentine hemorrhagic fever: a primate model.

    Science.gov (United States)

    Weissenbacher, M C; Calello, M A; Colillas, O J; Rondinone, S N; Frigerio, M J

    1979-01-01

    Experimental Junin virus infection of a New World primate, Callithrix jacchus, was evaluated. The virus produced anorexia, loss of weight, thrombocytopenia, leukopenia, and hemorrhagic and neurological symptoms and terminated in death. Virus was recovered from urine, blood samples and all tissues taken at autopsy. These preliminary observations show that several aspects of the experimental disease in C. jacchus are quite similar to severe natural Argentine hemorrhagic fever of man.

  6. Spontaneous Splenic Hemorrhage in the Newborn

    OpenAIRE

    2015-01-01

    Spontaneous splenic hemorrhage in the newborn is a rare entity. The presentation is usually with a triad of bleeding, abdominal distension, and hemoperitoneum. Rapid diagnosis is essential as left untreated, death is inevitable. We present a case with an unusual initial presentation of a scrotal hematocele and ultrasonography suggesting an adrenal hemorrhage. At laparotomy, splenic preservation was unsuccessful, and therefore, splenectomy was performed. The child recovered well from the proce...

  7. Ultrasound diagnosis of adrenal hemorrhage in meningococcemia

    Energy Technology Data Exchange (ETDEWEB)

    Sarnaik, A.P.; Sanfilippo, D.J.K.; Slovis, T.L.

    1988-07-01

    Adrenal hemorrhage (AH) is a well-described complication of the neonatal period, anticoagulant therapy, and overwhelming bacterial infection especially with N. meningitis. Until recently the diagnosis of acute AH was based predominantly on autopsy findings. Ultrasound and computed tomography examinations have been successfully used for antemortem detection of AH in neonates and anticoagulated patients. We report two patients with fulminant meningococcal infection who demonstrated bilateral adrenal hemorrhages on ultrasonography.

  8. Reperfusion hemorrhage following superior mesenteric artery stenting.

    LENUS (Irish Health Repository)

    Moore, Michael

    2012-02-03

    Percutaneous transluminal angioplasty and stent placement is now an established treatment option for chronic mesenteric ischemia and is associated with low mortality and morbidity rates. We present a case of reperfusion hemorrhage complicating endovascular repair of superior mesenteric artery stenosis. Although a recognized complication following repair of carotid stenosis, hemorrhage has not previously been reported following mesenteric endovascular reperfusion. We describe both spontaneous cessation of bleeding and treatment with coil embolization.

  9. Closed-Loop Resuscitation of Hemorrhagic Shock

    Science.gov (United States)

    2011-02-21

    of care arterial blood pressure. We collected data from hemorrhaged sheep experiments (funded by this ONR grant), and from a series of hemorrhaged...ongoing, and is the focus of engineering graduate student Ben Voigt. 9) We continued close collaborations with the Institute of Surgical Research on...finger), and pigs (tail). This provides the opportunity to perform testing in reproducible animal models. CareTaker will have to be tested in patients

  10. Isolated trochlear nerve palsy with midbrain hemorrhage

    Directory of Open Access Journals (Sweden)

    Raghavendra S

    2010-01-01

    Full Text Available Midbrain hemorrhage causing isolated fourth nerve palsy is extremely rare. Idiopathic, traumatic and congenital abnormalities are the most common causes of fourth nerve palsy. We report acute isolated fourth nerve palsy in an 18-year-old lady due to a midbrain hemorrhage probably due to a midbrain cavernoma. The case highlights the need for neuroimaging in selected cases of isolated trochlear nerve palsy.

  11. Impaired Fracture Healing after Hemorrhagic Shock

    Directory of Open Access Journals (Sweden)

    Philipp Lichte

    2015-01-01

    Full Text Available Impaired fracture healing can occur in severely injured patients with hemorrhagic shock due to decreased soft tissue perfusion after trauma. We investigated the effects of fracture healing in a standardized pressure controlled hemorrhagic shock model in mice, to test the hypothesis that bleeding is relevant in the bone healing response. Male C57/BL6 mice were subjected to a closed femoral shaft fracture stabilized by intramedullary nailing. One group was additionally subjected to pressure controlled hemorrhagic shock (HS, mean arterial pressure (MAP of 35 mmHg for 90 minutes. Serum cytokines (IL-6, KC, MCP-1, and TNF-α were analyzed 6 hours after shock. Fracture healing was assessed 21 days after fracture. Hemorrhagic shock is associated with a significant increase in serum inflammatory cytokines in the early phase. Histologic analysis demonstrated a significantly decreased number of osteoclasts, a decrease in bone quality, and more cartilage islands after hemorrhagic shock. μCT analysis showed a trend towards decreased bone tissue mineral density in the HS group. Mechanical testing revealed no difference in tensile failure. Our results suggest a delay in fracture healing after hemorrhagic shock. This may be due to significantly diminished osteoclast recruitment. The exact mechanisms should be studied further, particularly during earlier stages of fracture healing.

  12. Occult hemorrhage in children with severe ITP.

    Science.gov (United States)

    Flores, Adolfo; Buchanan, George R

    2016-03-01

    Little is known about the frequency and significance of clinically unapparent or occult hemorrhage in ITP. Therefore, we prospectively explored the sites and frequency of occult bleeding in children with severe ITP at diagnosis or upon symptomatic relapse in a prospective, single-institution cohort study of patients ≤ 18 years of age and a platelet count ≤ 10,000/mm(3) . Data collected included bleeding severity assessment, urinalysis, fecal occult blood testing, and non-contrast brain MRI. Stool and urine samples were tested within 7 days of diagnosis or symptomatic relapse. Three months after diagnosis or relapse a noncontrast brain MRI evaluated hemosiderin deposits resulting from prior localized hemorrhage. Fifty-two ITP patients were enrolled with a mean platelet count of 4,000/mm(3) . A significant occurrence of occult hemorrhage was identified in the urine (27%) compared with clinically overt hematuria (0.91%, P occult bleeding in the urinary tract. There was no relationship between occult hemorrhage and bleeding manifestations on physical examination. Occult hemorrhage was not a harbinger of subsequent bleeding. Our findings suggest that occult hemorrhage occurs with greater frequency than overt bleeding in children with severe ITP. CNS microbleeding is a potential risk in this patient population. Assessment of brain microbleeds and microscopic hematuria in this patient population require additional study.

  13. Hypertension: physiology and pathophysiology.

    Science.gov (United States)

    Hall, John E; Granger, Joey P; do Carmo, Jussara M; da Silva, Alexandre A; Dubinion, John; George, Eric; Hamza, Shereen; Speed, Joshua; Hall, Michael E

    2012-10-01

    Despite major advances in understanding the pathophysiology of hypertension and availability of effective and safe antihypertensive drugs, suboptimal blood pressure (BP) control is still the most important risk factor for cardiovascular mortality and is globally responsible for more than 7 million deaths annually. Short-term and long-term BP regulation involve the integrated actions of multiple cardiovascular, renal, neural, endocrine, and local tissue control systems. Clinical and experimental observations strongly support a central role for the kidneys in the long-term regulation of BP, and abnormal renal-pressure natriuresis is present in all forms of chronic hypertension. Impaired renal-pressure natriuresis and chronic hypertension can be caused by intrarenal or extrarenal factors that reduce glomerular filtration rate or increase renal tubular reabsorption of salt and water; these factors include excessive activation of the renin-angiotensin-aldosterone and sympathetic nervous systems, increased formation of reactive oxygen species, endothelin, and inflammatory cytokines, or decreased synthesis of nitric oxide and various natriuretic factors. In human primary (essential) hypertension, the precise causes of impaired renal function are not completely understood, although excessive weight gain and dietary factors appear to play a major role since hypertension is rare in nonobese hunter-gathers living in nonindustrialized societies. Recent advances in genetics offer opportunities to discover gene-environment interactions that may also contribute to hypertension, although success thus far has been limited mainly to identification of rare monogenic forms of hypertension. © 2012 American Physiological Society

  14. Mechanisms responsible for pulmonary hypertension

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ Pulmonary hypertension is a pathophysiologic process characterized by progressive elevation of pulmonary vascular resistance and right heart failure, which is a common complication of many diseases. Pulmonary hypertension with no apparent causes (unknown etiology) is termed primary pulmonary hypertension or, more recently, idiopathic pulmonary arterial hypertension (IPAH).

  15. Hypertension in pregnancy.

    Science.gov (United States)

    Solomon, Caren G; Seely, Ellen W

    2011-12-01

    Hypertension is a common complication of pregnancy. Preeclampsia, in particular, is associated with substantial risk to both the mother and the fetus. Several risk factors have been recognized to predict risk for preeclampsia. However, at present no biomarkers have sufficient discriminatory ability to be useful in clinical practice, and no effective preventive strategies have yet been identified. Commonly used medications for the treatment of hypertension in pregnancy include methyldopa and labetalol. Blood pressure thresholds for initiating antihypertensive therapy are higher than outside of pregnancy. Women with prior preeclampsia are at increased risk of hypertension, cardiovascular disease, and renal disease.

  16. Anesthesia and pulmonary hypertension.

    Science.gov (United States)

    McGlothlin, Dana; Ivascu, Natalia; Heerdt, Paul M

    2012-01-01

    Anesthesia and surgery are associated with significantly increased morbidity and mortality in patients with pulmonary hypertension due mainly to right ventricular failure, arrhythmias, postoperative hypoxemia, and myocardial ischemia. Preoperative risk assessment and successful management of patients with pulmonary hypertension undergoing cardiac surgery involve an understanding of the pathophysiology of the disease, screening of patients at-risk for pulmonary arterial hypertension, analysis of preoperative and operative risk factors, thorough multidisciplinary planning, careful intraoperative management, and early recognition and treatment of postoperative complications. This article will cover each of these aspects with particular focus on the anesthetic approach for non-cardiothoracic surgeries.

  17. Hemorrhagic aspects of Gaucher disease.

    Science.gov (United States)

    Rosenbaum, Hanna

    2014-10-01

    Gaucher disease (GD) is an inherited lysosomal disorder, originating from deficient activity of the lysosomal enzyme glucocerebrosidase (GCase). Normally, GCase hydrolyzes glucocerebroside (GC) to glucose and ceramide; however, impaired activity of this enzyme leads to the accumulation of GC in macrophages, termed "Gaucher cells." Gaucher disease is associated with hepatosplenomegaly, cytopenias, skeletal complications and in some forms involves the central nervous system. Coagulation abnormalities are common among GD patients due to impaired production and chronic consumption of coagulation factors. Bleeding phenomena are variable (as are other symptoms of GD) and include mucosal and surgical hemorrhages. FOUR MAIN ETIOLOGICAL FACTORS ACCOUNT FOR THE HEMOSTATIC DEFECT IN GD: thrombocytopenia, abnormal platelet function, reduced production of coagulation factors, and activation of fibrinolysis. Thrombocytopenia relates not only to hypersplenism and decreased megakaryopoiesis by the infiltrated bone marrow but also to immune thrombocytopenia. Autoimmunity, especially the induction of platelet antibody production, might cause persistent thrombocytopenia. Enzyme replacement therapy reverses only part of the impaired coagulation system in Gaucher disease. Other therapeutic and supportive measures should be considered to prevent and/or treat bleeding in GD. Gaucher patients should be evaluated routinely for coagulation abnormalities especially prior to surgery and dental and obstetric procedures.

  18. Tamoxifen treatment for intracerebral hemorrhage.

    Science.gov (United States)

    Xie, Qing; Guan, Jian; Wu, Gang; Xi, Guohua; Keep, Richard F; Hua, Ya

    2011-01-01

    Tamoxifen is a selective estrogen receptor modulator. In this study we investigated whether or not tamoxifen reduces intracerebral hemorrhage (ICH)-induced brain injury in rats. In all experiments, adult male Sprague-Dawley rats received an injection of 100 μL autologous whole blood into the right basal ganglia. In the first set of experiments, rats were treated with tamoxifen (2.5 mg/kg or 5 mg/kg, i.p.) or vehicle 2 and 24 h after ICH and were killed at day 3 for brain edema measurement. In the second set of experiments, rats were treated with tamoxifen (5 mg/kg) or vehicle and magnetic resonance imaging (MRI), and behavior tests were performed at days 1, 7, 14 and 28. Rats were killed at day 28 for brain histology. We found that tamoxifen at 5 but not at 2.5 mg/kg reduced perihematomal brain edema at day 3 (ptamoxifen reduced caudate atrophy at day 28 (pTamoxifen also improved functional outcome (ptamoxifen-treated rats. However, two out of five rats treated with tamoxifen developed hydrocephalus. These results suggest that tamoxifen has neuroprotective effects in ICH, but the cause of hydrocephalus development following tamoxifen treatment needs to be examined further.

  19. Hemorrhagic Aspects of Gaucher Disease

    Directory of Open Access Journals (Sweden)

    Hanna Rsenbaum

    2014-10-01

    Full Text Available Gaucher disease (GD is an inherited lysosomal disorder, originating from deficient activity of the lysosomal enzyme glucocerebrosidase (GCase. Normally, GCase hydrolyzes glucocerebroside (GC to glucose and ceramide; however, impaired activity of this enzyme leads to the accumulation of GC in macrophages, termed “Gaucher cells.” Gaucher disease is associated with hepatosplenomegaly, cytopenias, skeletal complications and in some forms involves the central nervous system. Coagulation abnormalities are common among GD patients due to impaired production and chronic consumption of coagulation factors. Bleeding phenomena are variable (as are other symptoms of GD and include mucosal and surgical hemorrhages. Four main etiological factors account for the hemostatic defect in GD: thrombocytopenia, abnormal platelet function, reduced production of coagulation factors, and activation of fibrinolysis. Thrombocytopenia relates not only to hypersplenism and decreased megakaryopoiesis by the infiltrated bone marrow but also to immune thrombocytopenia. Autoimmunity, especially the induction of platelet antibody production, might cause persistent thrombocytopenia. Enzyme replacement therapy reverses only part of the impaired coagulation system in Gaucher disease. Other therapeutic and supportive measures should be considered to prevent and/or treat bleeding in GD. Gaucher patients should be evaluated routinely for coagulation abnormalities especially prior to surgery and dental and obstetric procedures.

  20. Spinal syringomyelia following subarachnoid hemorrhage.

    Science.gov (United States)

    Nakanishi, Kinya; Uchiyama, Takuya; Nakano, Naoki; Fukawa, Norihito; Yamada, Kimito; Yabuuchi, Tomonari; Kato, Amami

    2012-04-01

    Subarachnoid blood has been reported as a cause of chronic spinal arachnoiditis. Although syringomyelia has been thought to be caused by spinal arachnoiditis, reports of syringomyelia following aneurysmal subarachnoid hemorrhage (SAH) are very rare. We describe two patients with syringomyelia associated with chronic spinal arachnoiditis following SAH. From January 2001 to December 2010, 198 patients with aneurysmal SAH were treated at Kinki University School of Medicine. Two of the 198 patients had syringomyelia following aneurysmal SAH; thus the rate of syringomyelia associated with aneurysmal SAH was 1.0%. Patient 1 was a 54-year-old woman who presented with back pain, back numbness and gait disturbance 20 months after SAH. Her MRI revealed syringomyelia of the spinal cord from C2 to T10. She underwent shunting of the syrinx to the subarachnoid space. Patient 2 was a 49-year-old man, who was admitted to the hospital with headache, diplopia, hoarseness, dysphagia and ataxia five months after SAH. MRI revealed syringomyelia from the medulla oblongata to C6, and an enlargement of the lateral and fourth ventricles. After foramen magnum decompression and C1 laminectomy, a fourth ventricle-subarachnoid shunt was placed by insertion of a catheter. Spinal arachnoiditis and spinal syringomyelia are rare but important chronic complications after SAH.

  1. PLACENTAL PATHOLOGY IN PREGNANCY INDUCED HYPERTENSION

    Directory of Open Access Journals (Sweden)

    Sreechithra

    2014-08-01

    Full Text Available BACKGROUND: Hypertensive disorders complicating pregnancy are common and form one of the deadly triad along with hemorrhage and infection, that results in a large number of maternal deaths and there of fetal deaths. Since all anabolites needed for foetal metabolism come from the mothers blood and foetal catabolites are passed back into the mothers circulation through the placenta, the examination of placenta gives a clear idea of what had happened with it, when it was in the mother, s womb and what is going to happen with the foetus in future. With this objective the present study was carried out. MATERIALS AND METHODS: Retrospective study was done for a period of 21 months from April1st 2008 to December 31st 2009..Fifty mothers with uncomplicated pregnancy (control group and 100 mothers (test group diagnosed as having pregnancy induced hypertension were selected from patients of our institution of the age range from 20-40 years, and parity –primi, para2 and 3.Placental morphometric parameters, gross and histopathological features were examined in both test and control groups. STATISTICAL ANALYSIS USED: Fishers exact test RESULTS: Placental morphometric parameters were significantly reduced in the control group. Acute atherosis, endothelial proliferation and fibrinoid necrosis were the significant histological findings noted in our study. CONCLUSION: Placental findings can be confirmatory of PIH, but its absence does not exclude the diseases. These findings will become more evident only when there is significant reduction in the uteroplacental bloodflow

  2. Therapeutic Exercise and Hypertension

    African Journals Online (AJOL)

    Nekky Umera

    focus of this review is to discuss the therapeutic efficacy of exercise on ... as high level of sodium in diet, alcohol consumption, obesity, physical inactivity, age, and .... idiopathic (essential) hypertension, there are two modes or approaches.

  3. Hypertension and liver disease

    DEFF Research Database (Denmark)

    Henriksen, Jens H; Møller, Søren

    2004-01-01

    Arterial hypertension is a common disorder with a frequency of 10% to 15% in subjects in the 40- to 60-year age group. Yet most reports find the prevalence of arterial hypertension in patients with chronic liver disease (cirrhosis) much lower. In this review, we consider the alterations in systemic......, neuropituitary release of vasopressin), and resistance to vasopressors. The vasodilatory state is mediated through nitric oxide, calcitonin gene-related peptide, adrenomedullin, and other vasodilators, and is most pronounced in the splanchnic area. This constitutes an effective (although relative) counterbalance...... to increased arterial blood pressure. Subjects with established arterial hypertension (essential, secondary) may become normotensive during the development of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin...

  4. Diabetes + Hypertension (comorbidity)

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This data set provides de-identified population data for diabetes and hypertension comorbidity prevalence in Allegheny County.

  5. High Blood Pressure (Hypertension)

    Science.gov (United States)

    ... Print Page Text Size: A A A Listen High Blood Pressure (Hypertension) Nearly 1 in 3 American adults has ... weight. How Will I Know if I Have High Blood Pressure? High blood pressure is a silent problem — you ...

  6. High Blood Pressure (Hypertension)

    Science.gov (United States)

    ... already been diagnosed with high blood pressure. Try yoga and meditation. Yoga and meditation not only can strengthen your body ... Accessed Sept. 21, 2015. Hu B, et al. Effects of psychological stress on hypertension in middle-aged ...

  7. Hydrogen sulfide in hypertension

    NARCIS (Netherlands)

    van Goor, Harry; van den Born, Joost C; Hillebrands, Jan-Luuk; Joles, Jaap A

    2016-01-01

    PURPOSE OF REVIEW: Hypertension is an important determinant of cardiovascular disease, and strict blood pressure regulation is beneficially associated with the risk for cardiovascular events or all-cause mortality. However, intensive antihypertensive treatment is not always sufficient to reach

  8. Allegheny County Hypertension Hospitalization

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This data provides hypertension prevalence data for each Zip Code in Allegheny County. The information was produced by Pennsylvania Health Care Cost Containment...

  9. A Case of Sudden Deafness with Intralabyrinthine Hemorrhage Intralabyrinthine Hemorrhage and Sudden Deafness.

    Science.gov (United States)

    Park, Jeong Jin; Jeong, Se Won; Lee, Jae Wook; Han, Su-Jin

    2015-12-01

    Sudden hearing deterioration may occur in our population, but it is difficult to explain the exact pathophysiology and the cause. Magnetic resonance imaging (MRI) in sudden sensorineural hearing loss (SSNHL) is usually useful to evaluate neural lesions such as acoustic schwannoma and hemorrhage in labyrinth. Recently some cases of SSNHL caused by intralabyrintine hemorrhage were reported by the advance of MRI. In the case of intralabyrintine hemorrhage, MRI showed a hyperintense signal in the labyrinth on the pre-contrast and contrast enhanced T1-weighted image and relatively weak intensity on T2-weighted image. The prognosis SSNHL by intralabyrintine hemorrhage is generally known to be poor. We report a case of sudden deafness with intralabyrintine hemorrhage who has a history of anticoagulant administration, with a review of literature.

  10. Supernova hemorrhage: obliterative hemorrhage of brain arteriovenous malformations following γ knife radiosurgery.

    Science.gov (United States)

    Alexander, Matthew D; Hetts, Steven W; Young, William L; Halbach, Van V; Dowd, Christopher F; Higashida, Randall T; English, Joey D

    2012-09-01

    Hemorrhage represents the most feared complication of cerebral arteriovenous malformations (AVMs) in both untreated patients and those treated with gamma knife radiosurgery. Radiosurgery does not immediately lead to obliteration of the malformation, which often does not occur until years following treatment. Post-obliteration hemorrhage is rare, occurring months to years after radiosurgery, and has been associated with residual or recurrent AVM despite prior apparent nidus elimination. Three cases are reported of delayed intracranial hemorrhage in patients with cerebral AVMs treated with radiosurgery in which no residual AVM was found on catheter angiography at the time of delayed post-treatment hemorrhage. That the pathophysiology of these hemorrhages involves progressive venous outflow occlusion is speculated and the possible mechanistic link to subsequent vascular rupture is discussed.

  11. [Hypertension and pregnancy. Diagnosis, physiopathology and treatment].

    Science.gov (United States)

    Fournier, A; Fievet, P; el Esper, I; el Esper, N; Vaillant, P; Gondry, J

    1995-11-25

    This review on hypertension in pregnancy focuses mainly on the pathophysiology and prevention of pregnancy induced hypertension which, when associated with proteinuria, is usually called preeclampsia. Rather than a genuine hypertensive disease, preeclampsia is mainly a systemic endothelial disease causing activation of platelets and diffuse ischemic disorders whose most obvious clinical manifestations involve the kidney (hence the proteinuria, edema and hyperuricemia), the liver (hence the hemolytic elevated liver enzymes and low platelets, or HELLP syndrome), and the brain (hence eclamptic convulsions). Hypertension is explained by increased vascular reactivity rather than by an imbalance between vasoconstrictive and vasodilating circulating hormones. This increased reactivity is due to endothelial dysfunction with imbalance between prostacyclin and thromboxane A2 and possibly dysfunction of NO and endothelin synthesis. The aggressive substances for endothelium are thought to be of placentar origin and the cause of their release is explained by placentar ischemia related to a defect of trophoblastic invasion of the spiral arteries. The etiology of this latter defect is unknown but involves immunologic mechanisms with genetic predisposition. The only effective treatment for PIH is extraction of the baby with the whole placenta. The decision for extraction is often a very delicate obstetric problem. Antihypertensive drugs are mainly indicated in severe hypertension (> 160-100 mm Hg), with the aim of preventing cerebral hemorrhage in the mother, but have not been shown to improve fetal morbidity or mortality. Eclamptic seizures can be prevented and treated more effectively with magnesium sulfate than with diazepam or phenytoin. Prevention of preeclampsia remains the main challenge. Whereas antihypertensive drugs are ineffective, calcium supplementation and low dose aspirin have proven effective but mainly in selected populations with a relatively high incidence of

  12. Apelin and pulmonary hypertension

    DEFF Research Database (Denmark)

    Andersen, Charlotte Uggerhøj; Hilberg, Ole; Mellemkjær, Søren;

    2011-01-01

    Pulmonary arterial hypertension (PAH) is a devastating disease characterized by pulmonary vasoconstriction, pulmonary arterial remodeling, abnormal angiogenesis and impaired right ventricular function. Despite progress in pharmacological therapy, there is still no cure for PAH. The peptide apelin...... vasoconstriction, and has positive inotropic and cardioprotective effects. Apelin attenuates vasoconstriction in isolated rat pulmonary arteries, and chronic treatment with apelin attenuates the development of pulmonary hypertension in animal models. The existing literature thus renders APLNR an interesting...

  13. Hypertension and pregnancy.

    Science.gov (United States)

    Deak, Teresa M; Moskovitz, Joshua B

    2012-11-01

    Hypertension in pregnancy is increasing in prevalence and incidence and its treatment becoming more commonplace. Associated complications of pregnancy, including end-organ damage, preeclampsia, eclampsia, and postpartum eclampsia, are leading sources of maternal and fetal morbidity and mortality, requiring an emergency physician to become proficient with their identification and treatment. This article reviews hypertension in pregnancy as it relates to outcomes, with special emphasis on preeclampsia, eclampsia, and postpartum eclampsia.

  14. Idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Yri, Hanne M; Jensen, Rigmor H

    2015-01-01

    AIMS: The aims of this article are to characterize the headache in idiopathic intracranial hypertension (IIH) and to field-test the ICHD diagnostic criteria for headache attributed to IIH. MATERIALS AND METHODS: We included 44 patients with new-onset IIH. Thirty-four patients with suspected...... tinnitus may suggest intracranial hypertension. Based on data from a well-defined IIH cohort, we propose a revision of the ICDH-3 beta diagnostic criteria with improved clinical applicability and increased sensitivity and specificity....

  15. Clinical analysis of suprachoroidal hemorrhage complicated by intraocular surgery

    Directory of Open Access Journals (Sweden)

    Man-Hong Li

    2017-02-01

    Full Text Available AIM:To explore clinical characteristics of supracho-roidal hemorrhage(SCHcomplicated by intraocular surgery and to observe visual prognosis. METHODS:A total of 13 eyes(13 caseswith SCH related to intraocular surgery from June 2005 to June 2015 were included and respectively studied. The age of our cases ranged from 22 to 76. Of all, 4 eyes(31%were concomitant with hypertension, 6 eyes(46%with high myopia and 6 eyes(46%with oculi hypertonia, respectively. Intraoperative expulsive SCH occurred in 8 eyes, while postoperative delayed SCH in 5 eyes. The most SCH(7 eyeshappened during the surgery of removing silicone oil, 4 eyes with SCH were related to extracapsular cataract extraction(ECCE, 1 SCH eye was complicated by ECCE combined with trabeculectomy and 1 SCH eye by lensectomy and vitrectomy. As for treatment, 5 eyes took medication alone, 4 eyes were performed drainage sclerotomy and gas tamponade, while the other 4 eyes were accomplished vitrectomy with adjunctive perfluoro-carbon liquids and silicone oil tamponade. RESULTS:At the 10-month of follow-up, all eyes with SCH were resolved. Except 1 eye with no light perception owing to abandoning treatment, the sights of the other 12 eyes were between light perception and 0.4. CONCLUSION:SCH complicated by intraocular surgery was rare but with devastating outcome. Aged patients, hypertension, high myopia and oculi hypertonia may be risk factors. In addition, surgical methods in the early years were likely correlated to the occurrence of SCH. Certain sight of the patients with SCH may be maintained after positive treatment.

  16. Resistant Hypertension and Chronotherapy

    Science.gov (United States)

    Prkacin, Ingrid; Balenovic, Diana; Djermanovic-Dobrota, Vesna; Lukac, Iva; Drazic, Petra; Pranjic, Iva-Klara

    2015-01-01

    Resistant hypertension is defined as blood pressure that remains above 140/90 mmHg in spite of the continuous use of three antihypertensive agents in optimal dose, including diuretic, and lifestyle changes. According to data from United States of America and Europe, the prevalence ranges from 10 up to 30% in patients with hypertension. Numerous biological and lifestyle factors can contribute to the development of resistant hypertension: medications, volume overload, obesity, diabetes mellitus, older age, renal parenchymal and renovascular disease, primary aldosteronism, obstructive sleep apnea, pheochormocytoma, Cushing’s syndrome, thyroid diseases, aortic coarctation. For diagnosing patient’s history is important, assessing compliance, regular blood pressure measurement, physical examination, biochemical evaluation and noninvasive imaging. The evaluation including 24h ambulatory monitoring of blood pressure (ABPM) in the identification of “non-dipper” hypertension. Non-dipper has particular importance and the prevalence of abnormally high sleep blood pressure is very often in chronic kidney patients. Therapeutic restoration of normal physiologic blood pressure reduction during night-time sleep (circadial variation) is the most significant independent predictor of decreased risk and the basis for the chronotherapy. The resistant hypertension treatment is achieved with nonpharmacological and pharmacological approach, treating secondary hypertension causes and invasive procedures. PMID:26005390

  17. MR detection of retinal hemorrhages: correlation with graded ophthalmologic exam

    Energy Technology Data Exchange (ETDEWEB)

    Beavers, Angela J.; Allbery, Sandra M. [University of Nebraska Medical Center, Department of Radiology, Omaha, NE (United States); Children' s Hospital and Medical Center, Department of Radiology, Omaha, NE (United States); Stagner, Anna M.; Hejkal, Thomas W. [University of Nebraska Medical Center, Department of Ophthalmology, Omaha, NE (United States); Children' s Hospital and Medical Center, Department of Ophthalmology, Omaha, NE (United States); Lyden, Elizabeth R. [University of Nebraska Medical Center, College of Public Health, Omaha, NE (United States); Haney, Suzanne B. [Children' s Hospital and Medical Center, Department of Pediatrics, Omaha, NE (United States); University of Nebraska Medical Center, Department of Pediatrics, Omaha, NE (United States)

    2015-08-15

    Dilated fundoscopic exam is considered the gold standard for detecting retinal hemorrhage, but expertise in obtaining this exam is not always immediately available. MRI can detect retinal hemorrhages, but correlation of the grade or severity of retinal hemorrhage on dilated fundoscopic exam with retinal hemorrhage visibility on MRI has not been described. To determine the value of standard brain protocol MRI in detecting retinal hemorrhage and to determine whether there is any correlation with MR detection of retinal hemorrhage and the dilated fundoscopic exam grade of hemorrhage. We conducted a retrospective chart review of 77 children <2 years old who were seen for head trauma from April 2007 to July 2013 and had both brain MRI and dilated fundoscopic exam or retinal camera images. A staff pediatric radiologist and radiology resident reviewed the MR images. Retinal hemorrhages were graded by a chief ophthalmology resident on a 12-point scale based on the retinal hemorrhage type, size, location and extent as seen on review of retinal camera images and detailed reports by ophthalmologists. Higher scores indicated increased severity of retinal hemorrhages. There was a statistically significant difference in the median grade of retinal hemorrhage examination between children who had retinal hemorrhage detected on MRI and children who did not have retinal hemorrhage detected on MRI (P = 0.02). When examination grade was categorized as low-grade (1-4), moderate-grade (5-8) or high-grade (>8) hemorrhage, there was a statistically significant association between exam grade and diagnosis based on MRI (P = 0.008). For example, only 14% of children with low-grade retinal hemorrhages were identified on MRI compared to 76% of children with high-grade hemorrhages. MR detection of retinal hemorrhage demonstrated a sensitivity of 61%, specificity of 100%, positive predictive value of 100% and negative predictive value of 63%. Retinal hemorrhage was best seen on the gradient

  18. A case of subarachnoid hemorrhage revealed by an acute coronary syndrome (ACS).

    Science.gov (United States)

    Hatim, Abdedaim; El Otmani, Wafae; Houssa, Mehdi Ait; Atmani, Noureddine; Moutakiallah, Younes; Haimeur, Charqui; Drissi, Mohammed

    2015-01-01

    The subarachnoid hemorrhage (SAH) is definitely the best descriptive model of the interaction between cardiovascular system and cerebral damage. The underlying mechanism of cardiovascular alterations after SAH is linked to the adrenergic discharge related to aneurysm rupture. Cardiac and pulmonary complications are common after severe brain injury, especially the aneurismal subarachnoid hemorrhage. Acute neurogenic pulmonary edema is not exceptional; it may occur in 20% of cases and commonly follows a severe subarachnoid hemorrhage. Severe myocardial damage with cardiogenic shock may possibly reveal the SAH (3% of cases) and mislead to wrong diagnosis of ACS with dramatic therapeutic consequences. The contribution of CT and cerebral angiography is essential for diagnosis and treatment. Surgical or endovascular treatment depends on location, size and shape of the aneurysm, on patient's age, neurological status and existence of concomitant diseases. We report the case of a 58 years old patient, with a past medical history of diabetes and hypertension, admitted for acute pulmonary edema with cardiogenic shock. This case illustrates an unusual presentation of aneurismal SAH in a patient presenting with an acute coronary syndrome.

  19. Tegmental-type primary pontine hemorrhage with mesencephalic extension. Clinico-CT-anatomic correlations

    Energy Technology Data Exchange (ETDEWEB)

    Goto, Noboru; Ishikawa, Hiroshi; Kaneko, Mitsuo; Tanaka, Keisei

    1983-06-01

    In nine autopsy cases of tegmental-type primary pontine hemorrhage, two cases with a mesencephalic extension which was not accurately diagnosed symptomatologically, but which was clearly detected on CT films, were found. Correlative clinico-CT-anatomic reports on this kind of pontine hemorrhage have not been included in the literature. The two patients were both females, 73 and 53 years old. Both were hypertensive and under medical care. They showed disturbances of consciousness and respiration, pin-point pupils, fixed eyes in the midposition, right hemiplegia, right extensor plantar response, etc., but both responded well to painful stimuli on the left half of the body. CT examinations detected a continuous high-density area in the left-sided tegmentum of the pons and midbrain. They died 9 and 21 days later respectively. With the help of an electronic image analyser, a great volume of hematoma was measured in the postmortem brainstem in these cases (17 ml and 14 ml). Precise analyses of the correlations among clinical symptomatology, CT, and anatomical findings, and histological examinations were carried out in an attempt to find the pathogenesis of this disease. In the diagnosis of tegmental-type primary pontine hemorrhage, attention should be paid to a possible mesencephalic involvement as one of the modes of hematoma extension, although it may be rather rare.

  20. Transjugular intrahepatic portosystemic shunt for the management of acute variceal hemorrhage.

    Science.gov (United States)

    Loffroy, Romaric; Estivalet, Louis; Cherblanc, Violaine; Favelier, Sylvain; Pottecher, Pierre; Hamza, Samia; Minello, Anne; Hillon, Patrick; Thouant, Pierre; Lefevre, Pierre-Henri; Krausé, Denis; Cercueil, Jean-Pierre

    2013-10-07

    Acute variceal hemorrhage, a life-threatening condition that requires a multidisciplinary approach for effective therapy, is defined as visible bleeding from an esophageal or gastric varix at the time of endoscopy, the presence of large esophageal varices with recent stigmata of bleeding, or fresh blood visible in the stomach with no other source of bleeding identified. Transfusion of blood products, pharmacological treatments and early endoscopic therapy are often effective; however, if primary hemostasis cannot be obtained or if uncontrollable early rebleeding occurs, transjugular intrahepatic portosystemic shunt (TIPS) is recommended as rescue treatment. The TIPS represents a major advance in the treatment of complications of portal hypertension. Acute variceal hemorrhage that is poorly controlled with endoscopic therapy is generally well controlled with TIPS, which has a 90% to 100% success rate. However, TIPS is associated with a mortality of 30% to 50% in such a setting. Emergency TIPS should be considered early in patients with refractory variceal bleeding once medical treatment and endoscopic sclerotherapy failure, before the clinical condition worsens. Furthermore, admission to specialized centers is mandatory in such a setting and regional protocols are essential to be organized effectively. This review article discusses initial management and then focuses on the specific role of TIPS as a primary therapy to control acute variceal hemorrhage, particularly as a rescue therapy following failure of endoscopic approaches.

  1. Surgical therapy for portal hypertension in patients with cirrhosis in China: present situation and prospects

    Institute of Scientific and Technical Information of China (English)

    ZHOU Guang-wen; LI Hong-wei

    2009-01-01

    @@ Surgical therapy for portal hypertension (PHT) in patients with cirrhosis has long been controversial,and various operative approaches have been used to prevent or manage such lethal complications as gastroesophageal variceal hemorrhage. However, over a century various portazygos devascularization and shunt approaches have been developed or modified, but the therapeutic effects have not been satisfactory till 1963 when Starzl did the first liver transplantation in the world, which provides a new hope to the surgical treatment of PHT.

  2. [Endoscopic sclerotherapy in the combined treatment of portal hypertension in children].

    Science.gov (United States)

    Ul'rikh, E V; Korolev, M P; Kupatadze, F D; Sevriugov, B L; Nabokov, V V

    1992-01-01

    The authors have performed 28 sessions of endoscopic sclerotherapy of dilated esophagus veins in children. The 70% ethyl alcohol was used. Six sessions were carried out in patients with gastroesophageal hemorrhage. In 22 patients the sclerotherapy was carried on according to plan. The fiber gastroscope with a standard injector was used. A conclusion is made of expediency of using endoscopic sclerotherapy in complex treatment of portal hypertension in children.

  3. [Sodium and hypertension].

    Science.gov (United States)

    de Wardener, H E

    1996-09-01

    Over several million years the human race was programmed to eat a diet which contained about 15 mmol of sodium (1 g of sodium chloride) per day. It is only five to ten thousand years ago that we became addicted to salt. Today we eat about 150 mmol of sodium (9-12 g of salt) per day. It is now apparent that this sudden rise in sodium intake (in evolutionary terms) is the most likely cause for the rise in blood pressure with age that occurs in the majority of the world's population. Those which consume less than 60 mmol/day do not develop hypertension. The reason for the rise in sodium intake is not known but it is probable that an important stimulus was the discovery that meat could be preserved by immersion into a concentrated salt solution. This seemingly miraculous power endowed salt with such magical and medicinal qualities that it became a symbol of goodness and health. It was not until 1904 Ambard and Beaujard suggested that on the contrary dietary salt could be harmful and raise the blood pressure. At first the idea did not prosper and it continues to be opposed by a diminishing band. The accumulated evidence that sodium intake is related to the blood pressure in normal man and animals and in inherited forms of hypertension has been obtained from experimental manipulations and studies of human populations. The following observation links sodium and hypertension. An increase in sodium intakes raises the blood pressure of the normal rat, dog, rabbit, baboon, chimpanzee and man. Population studies have demonstrated a significant correlation between sodium intake and the customary rise in blood pressure with age. The development of hypertensive strains of rats has revealed that the primary genetic lesion which gives rise to hypertension resides in the kidney where it impairs the urinary excretion of sodium. There is similar but less convincing evidence in essential hypertension. The kidney in both essential hypertension and hypertensive strains of rats share a

  4. The medieval origins of the concept of hypertension.

    Science.gov (United States)

    Heydari, Mojtaba; Dalfardi, Behnam; Golzari, Samad E J; Habibi, Hamzeh; Zarshenas, Mohammad Mehdi

    2014-07-01

    Despite the well-known history of hypertension research in the modern era, like many other cardiovascular concepts, main points in the medieval concept of this disease and its early management methods remain obscure. This article attempts to make a brief review on the medieval origin of the concept of this disease from the Hidayat of Al-Akhawayni (?-983 AD). This article has reviewed the chapter of "Fi al-Imtela" (About the Fullness) from the Hidβyat al-Muta'allimin fi al-Tibb (The Students' Handbook of Medicine) of Al-Akhawayni. The definition, symptoms and treatments presented for the Imtela are compared with the current knowledge on hypertension. Akhawayni believed that Imtela could result from the excessive amount of blood within the blood vessels. It can manifest with symptoms including the presence of a pulsus magnus, sleepiness, weakness, dyspnea, facial blushing, engorgement of the vessels, thick urine, vascular rupture, and hemorrhagic stroke. He also suggested some ways to manage al-Imtela'. These include recommendations of changes in lifestyle (staying away from anger and sexual intercourse) and dietary program for patients (avoiding the consumption of wine, meat, and pastries, reducing the volume of food in a meal, maintaining a low-energy diet and the dietary usage of spinach and vinegar). Al-Akhawayni's description of "Imtela," despite of its numerous differences with current knowledge of hypertension, can be considered as medieval origin of the concept of hypertension.

  5. COMPARATIVE MORPHOFUNCTIONAL CHARACTERISTIC OF ADRENAL GLANDS IN ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    S. Yu. Alyabyeva

    2015-01-01

    Full Text Available The article is devoted to the study of morphological changes of the adrenal glands in arterial hyperten-sion. Adrenals investigated persons who do not suffer in life and suffering from hypertension during the life of hypertension and died from various causes – is incompatible with the life of a mechanical trauma, cerebral hemorrhage, and acute left ventricular failure. In each case, each of the adrenal glands were assessed: the presence and severity of focal and diffuse mononuclear infiltration, the number of lympho-cytes, monocytes, plasma cells and fibroblasts arranged in the respective zones of the cortex and medulla, the severity of hyperemia and edema of various structural parts, the number of zones cortex and medulla endocrinocytes with pycnotic nuclei in the reticular zone evaluated the distribution of secretory cells with lipofuscin and the degree of saturation of the cytoplasm of the secretory cells, in secretory cells of medul-la evaluated nuclear-cytoplasmic ratio, the severity of vacuolization and basophils cytoplasm revealed a number of regularities of morphological changes depending from the various clinical manifestations of hypertension, defining the ultimate option of dying. At the heart tanatogenesis version are more pro-nounced morphological features hyperfunctions glomerular zone – namely delipidization left and right glands. The beam and netted areas contralateral glands embodiment of dying of a heart compared to the brain, is more pronounced hyperemia. When cardiac variant tanatogenesis more pronounced focal lym-phoid infiltration and vacuolization in secretory cells of left adrenal medulla.

  6. Computed tomography and intracranial hemorrhages in the neonate

    Energy Technology Data Exchange (ETDEWEB)

    Shibata, Iekado; Kushida, Yoshimasa; Shishido, Masaru; Nagasawa, Sadatsugu; Seiki, Yoshikatsu (Toho Univ., Tokyo (Japan). School of Medicine)

    1983-02-01

    Thirty-two of 290 neonates admitted to the Perinatal Intensive Care Unit, Toho University Medical School, were examined by CT scan because of tentative clinical diagnosis of intracranial hemorrhage. CT scanner employed in this study was TCT-60 A from the Toshiba The Electric Co., Ltd. Fourteen cases (44%) were confirmed by the CT scan to have intracranial hemorrhage. Four cases had hemorrhage in the ventricle, while the remaining ten cases had subarachnoid hemorrhage. Subdural hemorrhage was not revealed in our series. Three of the four cases with intraventricular hemorrhage showed a typical subependymal germinal matrix hemorrhage. The prognosis of intraventricular hemorrhage in neonates seemed to be poor; two of the four cases died within a week. Their body weight at birth was apparently under the standard, and their Apgar score was 3 points. The subarachnoid hemorrhage was the main type of intracranial neonatal hemorrhages. In our series, it was constituted approximately 70% of the intracranial hemorrhages. The CT images of the subarachnoid hemorrhage in neonate were greatly different from those in adults. An irregular, wide high-density area around the falxtentorial junction was characteristic of the CT in many neonatal subarachnoid hemorrhages. In severe subarachnoid hemorrhages, a characteristic Y-shaped, high-density figure was demonstrated. In cases of subarachnoid hemorrhage from the deep venous system, high-density spreading immediately ventral to the falx-tentrium junction was demonstrated. These high-density areas due to blood in the subarachnoid space rapidly disappeared with the lapse of time. On the other hand, high-density areas in cerebral cisterns and/or fissures were rarely demonstrated in neonatal subarachnoid hemorrhages. The prognosis of subarachnoid hemorrhage in neonates was fairly good in the sense of life and cerebral functions.

  7. Plug-assisted retrograde transvenous obliteration for the treatment of gastric variceal hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Min Yung; Kim, Man Deuk; Shin, Won Seon; Shin, Min Woo; Kim, Gyoung Min; Won, Jong Yun; Park, Sung Il; Lee, Do Yun [Dept. of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Tae Hwan [Dept. of Radiology, National Health Insurance Serivce Ilsan Hospital, Goyang (Korea, Republic of)

    2016-04-15

    To evaluate the feasibility, safety, and clinical outcomes of plug-assisted retrograde transvenous obliteration (PARTO) to treat gastric variceal hemorrhage in patients with portal hypertension. From May 2012 to June 2014, 19 patients (11 men and 8 women, median age; 61, with history of gastric variceal hemorrhage; 17, active bleeding; 2) who underwent PARTO using a vascular plug and a gelfoam pledget were retrospectively analyzed. Clinical and laboratory data were examined to evaluate primary (technical and clinical success, complications) and secondary (worsening of esophageal varix [EV], change in liver function) end points. Median follow-up duration was 11 months, from 6.5 to 18 months. The Wilcoxon signed-rank test was used to compare laboratory data before and after the procedure. Technical success (complete occlusion of the efferent shunt and complete filling of gastric varix [GV] with a gelfoam slurry) was achieved in 18 of 19 (94.7%) patients. The embolic materials could not reach the GV in 1 patient who had endoscopic glue injection before our procedure. The clinical success rate (no recurrence of gastric variceal bleeding) was the same because the technically failed patient showed recurrent bleeding later. Acute complications included fever (n = 2), fever and hypotension (n = 2; one diagnosed adrenal insufficiency), and transient microscopic hematuria (n = 3). Ten patients underwent follow-up endoscopy; all exhibited GV improvement, except 2 without endoscopic change. Five patients exhibited aggravated EV, and 2 of them had a bleeding event. Laboratory findings were significantly improved after PARTO. PARTO is technically feasible, safe, and effective for gastric variceal hemorrhage in patients with portal hypertension.

  8. Plug-Assisted Retrograde Transvenous Obliteration for the Treatment of Gastric Variceal Hemorrhage.

    Science.gov (United States)

    Chang, Min-Yung; Kim, Man-Deuk; Kim, Taehwan; Shin, Wonseon; Shin, Minwoo; Kim, Gyoung Min; Won, Jong Yun; Park, Sung Il; Lee, Do Yun

    2016-01-01

    To evaluate the feasibility, safety, and clinical outcomes of plug-assisted retrograde transvenous obliteration (PARTO) to treat gastric variceal hemorrhage in patients with portal hypertension. From May 2012 to June 2014, 19 patients (11 men and 8 women, median age; 61, with history of gastric variceal hemorrhage; 17, active bleeding; 2) who underwent PARTO using a vascular plug and a gelfoam pledget were retrospectively analyzed. Clinical and laboratory data were examined to evaluate primary (technical and clinical success, complications) and secondary (worsening of esophageal varix [EV], change in liver function) end points. Median follow-up duration was 11 months, from 6.5 to 18 months. The Wilcoxon signed-rank test was used to compare laboratory data before and after the procedure. Technical success (complete occlusion of the efferent shunt and complete filling of gastric varix [GV] with a gelfoam slurry) was achieved in 18 of 19 (94.7%) patients. The embolic materials could not reach the GV in 1 patient who had endoscopic glue injection before our procedure. The clinical success rate (no recurrence of gastric variceal bleeding) was the same because the technically failed patient showed recurrent bleeding later. Acute complications included fever (n = 2), fever and hypotension (n = 2; one diagnosed adrenal insufficiency), and transient microscopic hematuria (n = 3). Ten patients underwent follow-up endoscopy; all exhibited GV improvement, except 2 without endoscopic change. Five patients exhibited aggravated EV, and 2 of them had a bleeding event. Laboratory findings were significantly improved after PARTO. PARTO is technically feasible, safe, and effective for gastric variceal hemorrhage in patients with portal hypertension.

  9. Nontraumatic frontal lobe hemorrhages: Clinical-computed tomographic correlations

    Energy Technology Data Exchange (ETDEWEB)

    Weisberg, L.A.; Stazio, A.

    1988-12-01

    Correlation of lesion location and appearance with clinical sequelae in 25 patients with CT-proven frontal lobe hematomas reveals 10 of 25 hematomas were located above the frontal horns of the lateral ventricles. Nine of the 10 patients were normotensive. All presented with contralateral motor and sensory deficits. Four of 25 hematomas were situated inferior to the frontal horns. All these patients were hypertensive, rapidly became comatose and exhibited hemiplegia, hemianestesia and gaze preference contralateral to the hemiplegia. Five patients had frontal hematomas which extended inward from the interhemispheric fissure or caval-septal region. All were normotensive. All had anterior cerebral-anterior communicating artery aneurysms on angiography. Four patients had hematomas involving both the frontal and temporal region. All were normotensive with no known cause for hemorrhage. Two patients had bifrontal hematomas; one had butterfly appearance extending across the interhemispheric fissure and the other was midline but had no interhemispheric blood. Both were normotensive. One had an anterior cerebral-anterior communicating artery aneurysm.

  10. Medical image of the week: intraventricular hemorrhage casting

    Directory of Open Access Journals (Sweden)

    Parasram M

    2016-11-01

    Full Text Available No abstract available. Article truncated at 150 words. An 80-year-old woman with a past medical history of hypertension and hypercholesterolemia presented to an outlying hospital at 11:00 hours with slurred speech, left arm drift, and headache. A non-contrast CT of the head revealed an intraparenchymal hematoma in the right thalamus measuring 3.4 x 4.2 cm with an associated intraventricular rupture (Figure 1A, blue arrow. An intraventricular hemorrhage cast with secondary hydrocephalus was also noted on initial imaging (Figure 1A, red arrow. She was placed on a nicardipine drip for blood pressure control and subsequently transferred to OSF St. Francis Medical Center (OSFMC for a higher level of care. Upon arrival to OSFMC, the patient was poorly responsive, non-verbal, and could not follow commands. She was directly admitted to the Neuroscience Intensive Care Unit for further management. Vitals signs were stable on presentation. Neurologic examination revealed a comatose patient with asymmetric and minimally reactive pupils, absent gag reflex, right ...

  11. Cerebral hemorrhage without manifest motor paralysis. Reports of 5 cases

    Energy Technology Data Exchange (ETDEWEB)

    Taketani, T.; Dohi, I.; Miyazaki, T.; Handa, A. (Central Hospital of JNR, Tokyo (Japan))

    1982-01-01

    Before the introduction of computerized tomography (CT) there were some cases of intracerebral bleeding who were wrongly diagnosed as hypertensive encephalopathy or senile psychosis. We here report 5 cases who did not show any sign of motor paralysis. The clinical aspects of these cases were nausea and vomiting with dizziness (case 1), nausea and vomiting with slight headache (case 2), agnosia of left side with several kinds of disorientation (case 3), nausea and vomiting (case 4), and visual disturbance of right, lower quadrant (case 5). All of these cases showed no motor paralysis or abnormal reflex activities. By examination with CT each of them exhibited a high density area in the subcortical area of the right parietal lobe, the subcortical area of the right occipital lobe, the right temporal and parietal lobe, rather small portion of the left putamen and external capsule, and the subcortical area of left occipital lobe, respectively. Patients of cerebral hemorrhage without motor or sensory disturbances might often be taken for some psychic abnormality. We here have emphasized the importance of CT in such a group of patients. But for this technique, most of them would not be given adequate treatment and might be exposed to lifethreatening situations.

  12. Hemorrhagic Colloid Cyst Presenting with Acute Hydrocephaly

    Science.gov (United States)

    Akhavan, Reza; Zandi, Behrouz; Pezeshki-Rad, Masoud; Farrokh, Donya

    2017-01-01

    Colloid cysts are benign slow-growing cystic lesions located on the roof of the third ventricle that usually present with symptoms related to gradual rise of intracranial pressure. They mostly remain asymptomatic and sometimes grow progressively and cause diverse symptoms associated with increased intracranial pressure such as headache, diplopia, and sixth cranial nerve palsy. Here we report a 47-year-old female who presented to the emergency department with acute severe headache and nausea/vomiting. On MRI examination acute hydrocephaly due to hemorrhagic colloid cyst was detected. Acute hemorrhage in colloid cysts is extremely rare and may present with symptoms of acute increase in the intracranial pressure. Intracystic hemorrhage is very rarely reported as a complication of colloid cyst presenting with paroxysmal symptoms of acute hydrocephaly. PMID:28210514

  13. Mediastinal hemorrhage: An evaluation of radiographic manifestations

    Energy Technology Data Exchange (ETDEWEB)

    Woodring, J.H.; Loh, F.K.; Kryscio, R.J.

    1984-04-01

    Eleven common radiographic signs of mediastinal hemorrhage were evaluated by two observers for the following three patient groups: normal subjects, patients with mediastinal hemorrhage and no arterial injury, and patients with major thoracic arterial injury. Supine chest radiographs were studied in all cases. Four major conclusions can be made based upon these finding. M/C ratio (mediastinal width to chest width), tracheal deviation, left hemothorax, paraspinal line widening, and aorto-pulmonary window opacification do not reliably separate these three groups of patients. The diagnosis of mediastinal hemorrhage may be made if the aortic contour is abnormal or if one of the following signs is positive: abnormal mediastinal width, apical cap, widening of the right paratracheal stripe, or deviation of the nasogastric tube. Due to interobserver variation, there is good agreement between observers for the following four signs only: transverse mediastinal width, tracheal deviation, nasogastric tube deviation, nasogastric tube deviation, and right paratracheal stripe widening.

  14. Pulmonary arterial hypertension in pregnancy.

    Science.gov (United States)

    Običan, Sarah G; Cleary, Kirsten L

    2014-08-01

    Pulmonary hypertension is a medical condition characterized by elevated pulmonary arterial pressure and secondary right heart failure. Pulmonary arterial hypertension is a subset of pulmonary hypertension, which is characterized by an underlying disorder of the pulmonary arterial vasculature. Pulmonary hypertension can also occur secondarily to structural cardiac disease, autoimmune disorders, and toxic exposures. Although pregnancies affected by pulmonary hypertension and pulmonary arterial hypertension are rare, the pathophysiology exacerbated by pregnancy confers both high maternal and fetal mortality and morbidity. In light of new treatment modalities and the use of a multidisciplinary approach to care, maternal outcomes may be improving.

  15. [Hypertensive crisis in kidney patients].

    Science.gov (United States)

    Scrivano, Jacopo; Giuliani, Anna; Pettorini, Laura; Punzo, Giorgio; Mene', Paolo; Pirozzi, Nicola

    2011-01-01

    The classification and management of hypertensive crisis have been recently reviewed in the context of both European and American guidelines. The key points for proper blood pressure control in severe arterial hypertension are: 1 - Distinction between urgent intervention and emergencies 2 - Choice of the best drug(s) 3 - Choice of the correct route of administration. In patients with renal disease, beside the common causes of hypertension/ hypertensive crises, kidney-specific causes should be taken into account such as renal parenchymal hypertension, renovascular hypertension, sclerodermic crises, and preeclampsia.

  16. Endocrine hypertension in small animals.

    Science.gov (United States)

    Reusch, Claudia E; Schellenberg, Stefan; Wenger, Monique

    2010-03-01

    Hypertension is classified as idiopathic or secondary. In animals with idiopathic hypertension, persistently elevated blood pressure is not caused by an identifiable underlying or predisposing disease. Until recently, more than 95% of cases of hypertension in humans were diagnosed as idiopathic. New studies have shown, however, a much higher prevalence of secondary causes, such as primary hyperaldosteronism. In dogs and cats, secondary hypertension is the most prevalent form and is subclassified into renal and endocrine hypertension. This review focuses on the most common causes of endocrine hypertension in dogs and cats.

  17. Pharm GKB: Conjunctivitis, Acute Hemorrhagic [PharmGKB

    Lifescience Database Archive (English)

    Full Text Available NDFRT: Conjunctivitis, Acute Hemorrhagic (N0000000834) Common Searches Search Medline Plus Search CTD Pharm GKB: Conjunctivitis, Acute Hemorrhagic ... ...Overview Alternate Names: PharmGKB Accession Id: PA166048914 External Vocabularies

  18. Malignant solid pseudopapillary tumor of pancreas causing sinistral portal hypertension

    Directory of Open Access Journals (Sweden)

    Nisar Ahmad Wani

    2011-01-01

    Full Text Available Solid pseudopapillary tumor (SPT of the pancreas is a rare benign or low-grade malignant epithelial tumor that occurs mainly in young females in second to fourth decades of life. Pathologic and imaging findings include a well-defined, encapsulated pancreatic mass with cystic and solid components with evidence of hemorrhage. We report a 23-year-old female who presented with upper abdominal pain of long duration and epigastric mass on palpation. Multidetector-row CT (MDCT demonstrated a large well-defined heterogeneous attenuation mass, containing hyperdense areas of hemorrhage mixed with solid enhancing and cystic non-enhancing areas, arising from the pancreatic body and tail. Splenic vein thrombosis was present with dilated splenoportal collateral vessels between splenic hilum and portal/superior mesenteric veins, with dilated vessels seen in the gastric wall, with patent portal vein, compatible with sinistral portal hypertension. Typical imaging features and age and sex of the patient suggested a diagnosis of SPT of pancreas complicated by segmental portal hypertension due to splenic vein thrombosis. Histopathology of the biopsy material was confirmatory.

  19. URAPIDIL: MODERN MEDICINE FOR THE TREATMENT OF HYPERTENSIVE CRISES

    Directory of Open Access Journals (Sweden)

    A. V. Melekhov

    2013-01-01

    Full Text Available Aim. To study the antihypertensive efficacy of urapidil, as well as to determine the optimal target level of systolic blood pressure (BP in patients with hypertensive crisis complicated by a hemorrhagic stroke.Material and methods. Patients (n=86 aged 46-87 years (42 men and 44 women who were admitted to hospital with hypertensive crisis complicated by a hemorrhagic stroke were included into the study. Patients were randomized into two groups: standard treatment (n=20 or urapidil treatment (n=66. The efficacy of treatment was assessed by clinical data, BP and heart rate dynamics. Patient survival was also assessed.Results. Mortality in urapidil group was 33% vs 70% in standard therapy group. Systolic BP in urapidil group decreased from 208 (203-222 mm Hg to 159 (149-180 and to145 (141-153 mm Hg after 20 and 220 minutes, respectively, (p<0.001 for both, and diastolic BP from 108 (102-119 mm Hg to 90 (82-97 and 82 (80-90 mm Hg, re- spectively. Significant BP dynamics was also observed in standard therapy group. The target systolic BP level of 136-147 mm Hg was associated with better patient survival. Conclusion. The patients in urapidil group reached the target BP by the 20-th minute from the start of treatment, and this was accompanied by a better survival.

  20. URAPIDIL: MODERN MEDICINE FOR THE TREATMENT OF HYPERTENSIVE CRISES

    Directory of Open Access Journals (Sweden)

    A. V. Melekhov

    2015-09-01

    Full Text Available Aim. To study the antihypertensive efficacy of urapidil, as well as to determine the optimal target level of systolic blood pressure (BP in patients with hypertensive crisis complicated by a hemorrhagic stroke.Material and methods. Patients (n=86 aged 46-87 years (42 men and 44 women who were admitted to hospital with hypertensive crisis complicated by a hemorrhagic stroke were included into the study. Patients were randomized into two groups: standard treatment (n=20 or urapidil treatment (n=66. The efficacy of treatment was assessed by clinical data, BP and heart rate dynamics. Patient survival was also assessed.Results. Mortality in urapidil group was 33% vs 70% in standard therapy group. Systolic BP in urapidil group decreased from 208 (203-222 mm Hg to 159 (149-180 and to145 (141-153 mm Hg after 20 and 220 minutes, respectively, (p<0.001 for both, and diastolic BP from 108 (102-119 mm Hg to 90 (82-97 and 82 (80-90 mm Hg, re- spectively. Significant BP dynamics was also observed in standard therapy group. The target systolic BP level of 136-147 mm Hg was associated with better patient survival. Conclusion. The patients in urapidil group reached the target BP by the 20-th minute from the start of treatment, and this was accompanied by a better survival.

  1. Screening for renovascular hypertension.

    Science.gov (United States)

    Dunnick, N R; Sfakianakis, G N

    1991-05-01

    The most common curable cause of high blood pressure is renovascular hypertension. Although hypertension is common in the United States, only a minority, approximately 1%, of patients have a renovascular cause. Using clinical criteria, a subgroup of these patients can be selected in which the prevalence of renovascular hypertension will be approximately 15%. In these selected patients, it is appropriate to proceed to a radiographic screening modality to look for a significant renal artery stenosis. The choice of modality should reflect the strengths and expertise of each specific institution. Hypertensive urography is no longer recommended for screening. Excellent results have been reported with intravenous DSRA in institutions where a strong interest in this procedure exists. Furthermore, intravenous DSRA is easily coupled with the collection of renal vein samples for renin assay. Intravenous DSRA, however, has not maintained widespread use. Although the radionuclide renogram is no longer adequate as a radiographic screening tool, stimulation with an ACE inhibitor, such as captopril or enalaprilat, may produce excellent results. In many institutions, this is the most appropriate examination. Furthermore, it is relatively noninvasive. Merely detecting a significant renal artery stenosis does not, however, mean the patient has renovascular hypertension. Both hypertension and a renal artery stenosis may be present and not be causally related. Because renovascular hypertension is, at least initially, renin mediated, the demonstration of increased renin production by the ipsilateral kidney should confirm renovascular hypertension. Prospective application of these results to patients undergoing revascularization techniques, however, has been disappointing. This may be related to problems in patient preparation, sample collection, renin assay, or even the physiology of chronic hypertension, which is incompletely renin mediated. Thus, offering revascularization only to

  2. Hypertension in postmenopausal women: how to approach hypertension in menopause.

    Science.gov (United States)

    Modena, Maria Grazia

    2014-09-01

    During fertile life women are usually normo or hypotensive. Hypertension may appear during pregnancy and this represents a peculiar phenomenon increasing nowadays for delay time of pregnancy. Gestational hypertension appears partially similar to hypertension in the context of metabolic syndrome for a similar condition of increased waste circumference. Parity, for the same pathogenesis, has been reported to be associated to peri and postmenopausal hypertension, not confirmed by our study of parous women with transitional non persistent perimenopausal hypertension. Estrogen's deficiency inducing endothelial dysfunction and increased body mass index are the main cause for hypertension in this phase of life. For these reasons lifestyle modification, diet and endothelial active drugs represent the ideal treatment. Antioxidant agents may have a role in prevention and treatment of hypertension. In conclusion, hypertension in women represents a peculiar constellation of different biological and pathogenic factors, which need a specific gender related approach, independent from the male model.

  3. Electrocardiographic abnormalities in patients with subarachnoid hemorrhage.

    Science.gov (United States)

    Sommargren, Claire E

    2002-01-01

    Subarachnoid hemorrhage is a serious neurological disorder that is often complicated by the occurrence of electrocardiographic abnormalities unexplained by preexisting cardiac conditions. These morphological waveform changes and arrhythmias often are unrecognized or misinterpreted, potentially placing patients at risk for inappropriate management. Many previous investigations were retrospective and relied on data collected in an unsystematic manner. More recent studies that included use of serial electrocardiograms and Holter recordings have provided new insight into the high prevalence of electrocardiographic changes in subarachnoid hemorrhage. Research on the prevalence, duration, and clinical significance of these electrocardiographic abnormalities and on associated factors and etiological theories is reviewed.

  4. Cryptococcal meningitis presenting as pseudosubarachnoid hemorrhage.

    Science.gov (United States)

    Hoque, Romy; Gonzalez-Toledo, Eduardo; Jaffe, Stephen L

    2008-12-01

    A 50-year-old man presented with progressive visual loss, headache, and two days of confusion. A computed tomography of his head suggested subarachnoid hemorrhage with accompanying right parietal ischemic infarction. The magnetic resonance image was consistent with right parietal perisulcal pial and superficial cortical inflammation; a subjacent vasogenic edema with a 1 cm diameter abscess was also present. Funduscopy revealed bilateral multifocal choroidal lesions and retinal perivascular sheathing. He was diagnosed with pseudosubarachnoid hemorrhage secondary to cryptococcal meningitis and choroidal microabscesses with retinal inflammation after a cerebrospinal fluid (CSF) examination revealed cryptococcal yeast forms, as well as high titers of CSF cryptococcal antigen, but no CSF red blood cells.

  5. Migraine and hypertension

    Directory of Open Access Journals (Sweden)

    G. R. Tabeeva

    2015-01-01

    Full Text Available Investigations of a relationship between migraine and hypertension are being continued. In spite of numerous studies, the association of some types of migraine (migraine with aura and migraine without aura with hypertension has not been fully elucidated. This issue is particularly relevant since these forms differ both clinically and pathophysiologically. Of even greater importance are the analysis and prediction of associations between migraine and cardiovascular diseases (ischemic stroke, myocardial infarction, coronary heart disease. The review deals with the clinical and pathophysiological features of the relationship between hypertension and migraine. There is evidence for the anatomic and functional correlation between the antinociceptive system and blood pressure (BP regulation control. It has been speculated that the increase in pain threshold is not the result of just hypertension as a disease, but it is caused by elevated BP-related hypalgesia. The efficacy of antihypertensive drugs is the fact that supports the association between hypertension and endothelial dysfunction. Identification of groups of patients having migraine and a high cardiovascular risk will allow timely early primary prevention and therapy. Introduction of a stratification approach at diagnostic stages may cause a reduction in cardiovascular morbidity and mortality rates.

  6. Dopamine receptors and hypertension.

    Science.gov (United States)

    Banday, Anees Ahmad; Lokhandwala, Mustafa F

    2008-08-01

    Dopamine plays an important role in regulating renal function and blood pressure. Dopamine synthesis and dopamine receptor subtypes have been shown in the kidney. Dopamine acts via cell surface receptors coupled to G proteins; the receptors are classified via pharmacologic and molecular cloning studies into two families, D1-like and D2-like. Two D1-like receptors cloned in mammals, the D1 and D5 receptors (D1A and D1B in rodents), are linked to adenylyl cyclase stimulation. Three D2-like receptors (D2, D3, and D4) have been cloned and are linked mainly to adenylyl cyclase inhibition. Activation of D1-like receptors on the proximal tubules inhibits tubular sodium reabsorption by inhibiting Na/H-exchanger and Na/K-adenosine triphosphatase activity. Reports exist of defective renal dopamine production and/or dopamine receptor function in human primary hypertension and in genetic models of animal hypertension. In humans with essential hypertension, renal dopamine production in response to sodium loading is often impaired and may contribute to hypertension. A primary defect in D1-like receptors and an altered signaling system in proximal tubules may reduce dopamine-mediated effects on renal sodium excretion. The molecular basis for dopamine receptor dysfunction in hypertension is being investigated, and may involve an abnormal posttranslational modification of the dopamine receptor.

  7. Hypertensive Disorders of Pregnancy.

    Science.gov (United States)

    Leeman, Lawrence; Dresang, Lee T; Fontaine, Patricia

    2016-01-15

    Elevated blood pressure in pregnancy may represent chronic hypertension (occurring before 20 weeks' gestation or persisting longer than 12 weeks after delivery), gestational hypertension (occurring after 20 weeks' gestation), preeclampsia, or preeclampsia superimposed on chronic hypertension. Preeclampsia is defined as hypertension and either proteinuria or thrombocytopenia, renal insufficiency, impaired liver function, pulmonary edema, or cerebral or visual symptoms. Proteinuria is not essential for the diagnosis and does not correlate with outcomes. Severe features of preeclampsia include a systolic blood pressure of at least 160 mm Hg or a diastolic blood pressure of at least 110 mm Hg, platelet count less than 100 × 103 per µL, liver transaminase levels two times the upper limit of normal, a doubling of the serum creatinine level or level greater than 1.1 mg per dL, severe persistent right upper-quadrant pain, pulmonary edema, or new-onset cerebral or visual disturbances. Preeclampsia without severe features can be managed with twice-weekly blood pressure monitoring, antenatal testing for fetal well-being and disease progression, and delivery by 37 weeks' gestation. Preeclampsia with any severe feature requires immediate stabilization and inpatient treatment with magnesium sulfate, antihypertensive drugs, corticosteroids for fetal lung maturity if less than 34 weeks' gestation, and delivery plans. Preeclampsia can worsen or initially present after delivery. Women with hypertensive disorders should be monitored as inpatients or closely at home for 72 hours postpartum.

  8. Management of diabetic hypertensives

    Directory of Open Access Journals (Sweden)

    Jai Ganesh

    2011-01-01

    Full Text Available Hypertension occurs twice as commonly in diabetics than in comparable nondiabetics. Patients with both disorders have a markedly higher risk for premature microvascular and macrovascular complications. Aggressive control of blood pressure (BP reduces both micro- and macrovascular complications. In diabetic hypertensives, angiotensin converting enzyme inhibitors (ACEIs are the first line in management of hypertension, and can be replaced by angiotensin II receptor blockers (ARBs if patients are intolerant of them. Recent studies suggest ARBs to be on par with ACEI in reducing both macro- and microvascular risks. Adding both these agents may have a beneficial effect on proteinuria, but no extra macrovascular risk reduction. Thiazides can also be used as first line drugs, but are better used along with ACEI/ARBs. Beta-blockers [especially if the patient has coronary artery disease] and calcium channel blockers are used as second line add-on drugs. Multidrug regimens are commonly needed in diabetic hypertensives. Achieving the target BP of <130/80 is the priority rather than the drug combination used in order to arrest and prevent the progression of macro- and microvascular complications in diabetic hypertensives.

  9. Nonnarcotic analgesics and hypertension.

    Science.gov (United States)

    Gaziano, J Michael

    2006-05-01

    In 2004, individuals in the United States spent >$2.5 billion on over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs) and filled >100 million NSAID prescriptions. The most commonly used OTC analgesics include aspirin, acetaminophen, and nonaspirin NSAIDs. Nonnarcotic analgesics are generally considered safe when used as directed but do have the potential to increase blood pressure in patients with hypertension treated with antihypertensives. This is important because hypertension alone has been correlated with an increased risk of cardiovascular disease or stroke. Small increases in blood pressure in patients with hypertension also have been shown to increase cardiovascular morbidity and mortality. Therefore, when nonnarcotic analgesics are taken by patients with hypertension, there may be important implications. This review explores the potential connection among analgesic agents, blood pressure, and hypertension, and discusses possible mechanisms by which analgesics might cause increases in blood pressure. This is followed by a summary of data on the relation between analgesics and blood pressure from both observational and randomized trials.

  10. Nursing experience of patients with epidemic hemorrhagic fever

    Directory of Open Access Journals (Sweden)

    Ling-yan ZHANG

    2014-04-01

    Full Text Available Objective: To explore the nursing methods of patients with epidemic hemorrhagic fever. Methods: Through careful nursing, 1 case of patients with epidemic hemorrhagic fever, summed up the experience. Results: Patients with epidemic hemorrhagic fever were 2 days later improved, within 6 months to fully recover. Conclusion: With proper treatment and careful nursing, patients with epidemic hemorrhagic fever are able to fully recover.

  11. Acute viral hemorrhage disease:A summary on new viruses

    Institute of Scientific and Technical Information of China (English)

    Somsri Wiwanitkit; Viroj Wiwanitkit

    2015-01-01

    Acute hemorrhagic disease is an important problem in medicine that can be seen in many countries, especially those in tropical world. There are many causes of acute hemorrhagic disease and the viral infection seems to be the common cause. The well-known infection is dengue, however, there are many new identified viruses that can cause acute hemorrhagic diseases. In this specific short review, the authors present and discuss on those new virus diseases that present as “acute hemorrhagic fever”.

  12. Remote hemorrhage from the site of craniotomy Hemorragia à distância da área da craniotomia

    Directory of Open Access Journals (Sweden)

    José Alberto Landeiro

    2004-09-01

    Full Text Available Postoperative intracranial hemorrhage is a serious and sometimes a fatal neurosurgical complication. Hemorrhage occurring at regions remote from the site of intracranial operations comprises an uncommon affection, most ignored by the assistant physicians. It bares a still incomprehensive pathophysiology, despite several theories trying to explain it. Looks like a common sense that the presence of the remote site hemorrhage cannot be related to concomitant presence of hypertension, coagulopathy or undiscovered lesions. We report three cases of postoperative hemorrhages occurring in a remote site of supratentorial craniotomies, two patients presented cavernous sinus meningeoma and one patient was submitted to intracranial vascular surgery.Hemorragia intracraniana de ocorrência em pós-operatório é grave complicação das cirurgias intracranianas. O aparecimento de foco hemorrágico em regiões distantes ao sítio operatório original é considerado incomum, e muitas vezes ignorado pelos médicos assistentes. A fisiopatologia envolvida no processo não é de todo compreendida, apesar das diversas teorias já propostas. São apresentados três casos de hemorragia á distancia da área cirúrgica, no pós-operatório de dois pacientes portadores de meningeoma do seio cavernoso e de um submetido à clipagem de aneurisma intracraniano.

  13. Prognostic value of intraventricular bleeding in spontaneous intraparenchymal cerebral hemorrhage of small volume: a prospective cohort study.

    Science.gov (United States)

    Fortes Lima, Telmo Tiburcio; Prandini, Mirto Nelso; Gallo, Pasquale; Cavalheiro, Sérgio

    2012-04-01

    The literature is controversial on whether intraventricular bleeding has a negative impact on the prognosis of spontaneous intracerebral hemorrhage. Nevertheless, an association between intraventricular bleeding and spontaneous intracerebral hemorrhage volumes has been consistently reported. To evaluate the prognostic value of intraventricular bleeding in deep intraparenchymal hypertensive spontaneous hemorrhage with a bleeding volume bleeding was calculated by the LeRoux scale. Clinical data, including neurological complications, were collected daily during hospitalization. Neurological outcome was evaluated 30 days after the event by using the Glasgow outcome scale. Patients were assigned to 1 of 3 groups according to intraventricular bleeding: Control, no intraventricular bleeding; LR 1, intraventricular bleeding with LeRoux scale scores of 1 to 8; or LR 2, intraventricular bleeding with LeRoux scale scores >8. There were no significant differences among groups concerning age, mean blood pressure, and time from onset to brain CT scan. Patients with greater intraventricular bleeding presented lower initial Glasgow coma scale scores, increased ventricular index and width of temporal horns, increased number of clinical and neurological complications, and longer hospitalization. Furthermore, their relative risk for unfavorable clinical outcome was 1.9 (95% confidence interval 1.25-2.49). Intraventricular bleeding with a LeRoux scale score >8 appears to have a negative effect on deep spontaneous intraparenchymal cerebral hemorrhage of small volume.

  14. SURGICAL TACTICS REGARDING CEREBRAL METASTASES WITH HEMORRHAGES

    Directory of Open Access Journals (Sweden)

    E. V. Prozorenko

    2015-01-01

    Full Text Available Cerebral metastases occur with 10 to 30 % of all oncological patients. Hemorrhages into cerebral metastases are one of the most dangerous complications of the metastatic process. With that, cerebral metastases of such widespread solid malignant tumors as melanoma, kidney cancer, germ cell tumors, less frequently, lung cancer and breast cancer are prone to hemorrhages. The purpose of the work is to improve the results of surgical treatment of patients with brain metastases complicated with hemorrhages.Materials  and  methods. Surgical  treatment  of  69  patients  with  brain  metastases complicated  with  hemorrhages was  performed in N.N. Blokhin Russian Cancer Research Center. Hemorrhage on the macroscopic level was confirmed intraoperatively and in accordance with the results of the morphological study of surgical drugs. Total microsurgical resection of one or several cerebral metastases with hemor rhages was performed regarding all patients studied. The time interval of observation of patients after the surgical treatment comprises 1 to 72 months. There were 27 women and 42 men. The age range was from 18 to 74 y.o. Besides, the state of veins of lower extremities and the state of the coagulation blood system in accordance with the data of coagulograms was studies. The analysis of the macrostructure and the microstructure of metastases with hemorrhages as well as the morphological study of the brain tissue adjacent to hematomas was performed with a morphological study and histological techniques. The patients were distributed in accordance with the RPA (recursive partitioning analysis classes: I class (n = 7, II class (n = 39, III class (n = 23; in accordance with the hemorrhage type: intratumoral type (26 metastases, perifocal type (20, mixed type (32; in accordance with the histological principle: melanoma (n = 25, lung cancer (n = 13, kidney cancer (n = 17, breast cancer (n = 4, colorectal cancer (n = 1, soft tissue sarcoma (n

  15. Knowing hypertension and diabetes

    DEFF Research Database (Denmark)

    Whyte, Susan Reynolds

    2016-01-01

    In Uganda, hypertension and diabetes have only recently been included in the health policy agenda. As they become treatable disorders, they take on more distinct contours in people's minds. This article relates knowledge about these two conditions to health institutions and technology for diagnos......In Uganda, hypertension and diabetes have only recently been included in the health policy agenda. As they become treatable disorders, they take on more distinct contours in people's minds. This article relates knowledge about these two conditions to health institutions and technology...... for diagnosing and treating them. The response to the AIDS epidemic in Uganda provides an important context for, and contrast with, the emergence of hypertension and diabetes as social phenomena. Ethnographic fieldwork shows the interplay between experience of these conditions and the political economy...

  16. Hypertension and Atrial Fibrillation

    DEFF Research Database (Denmark)

    Dzeshka, Mikhail S.; Shahid, Farhan; Shantsila, Alena

    2017-01-01

    Atrial fibrillation (AF) is the most prevalent sustained arrhythmia found in clinical practice. AF rarely exists as a single entity but rather as part of a diverse clinical spectrum of cardiovascular diseases, related to structural and electrical remodeling within the left atrium, leading to AF o...... of complications as the first clinical manifestation of the disease. Antithrombotic prevention in AF combined with strict blood pressure control is of primary importance, since stroke risk and bleeding risk are both greater with underlying hypertension....... onset, perpetuation, and progression. Due to the high overall prevalence within the AF population arterial hypertension plays a significant role in the pathogenesis of AF and its complications. Fibroblast proliferation, apoptosis of cardiomyocytes, gap junction remodeling, accumulation of collagen both...... in atrial and ventricular myocardium all accompany ageing-related structural remodeling with impact on electrical activity. The presence of hypertension also stimulates oxidative stress, systemic inflammation, rennin-angiotensin-aldosterone and sympathetic activation, which further drives the remodeling...

  17. [Hypertension and heart].

    Science.gov (United States)

    Hennersdorf, Marcus G; Strauer, Bodo E

    2006-03-22

    The term hypertensive heart disease covers the entities left ventricular hypertrophy, microangiopathy, diastolic and systolic dysfunction, und increased risk of arrhythmias. From the pathophysiological point of view this is caused by hypertrophy of cardiac myocytes, interstitial fibrosis and media hypertrophy of the arterioles. As an earliest sign of hypertensive heart disease a microangiopathy can be diagnosed. Also a diastolic dysfunction can be found as an early change. In further persisting arterial hypertension left ventricular hypertrophy develops (often asymmetric), and later a systolic dysfunction. Clinically, the patients suffer from angina pectoris, dyspnea and rhythm disorders. Left ventricular hypertrophy is associated with an increased risk of ventricular malignant arrhythmias. Thus, the main therapeutic principle should be antihypertensive therapy with the goal of regression of hypertrophy and, as a consequence, a decreased mortality risk.

  18. Snakes and Hypertension.

    Science.gov (United States)

    Miller, Edward D

    2017-02-01

    Inhibition of Angiotensin Conversion in Experimental Renovascular Hypertension. By Miller ED Jr, Samuels A, Haber E, and Barger AC. Science 1972; 177:1108-9. Reprinted with permission from AAAS.Constriction of the renal artery and controlled reduction of renal perfusion pressure is followed by a prompt increase in systemic renin activity and a concomitant rise in blood pressure in trained, unanesthetized dogs. The elevated blood pressure induced by the renal artery stenosis can be prevented by prior treatment with the nonapeptide Pyr-Trp-Pro-Arg-Pro-Gln-Ile-Pro-Pro, which blocks conversion of angiotensin I to angiotensin II. Further, the nonapeptide can restore systemic pressure to normal in the early phase of renovascular hypertension. These results offer strong evidence that the renin- angiotensin system is responsible for the initiation of hypertension in the unilaterally nephrectomized dog with renal artery constriction.

  19. [Obesity and hypertension].

    Science.gov (United States)

    Simonyi, Gábor; Kollár, Réka

    2013-11-01

    The frequency of hypertension and obesity is gradually growing in Hungary. At present 68.5% of men and 78% of women are obese. Hypertension and obesity are the most important risk factors of morbidity and mortality from cardiovascular disease. The relationship between increased sympathetic activity and hypertension is well known. Waist circumference and body fat mass correlate significantly with sympathetic activity, in which hyperlipidemia plays also a role. The increased activity of renin-angiotensin-aldosterone system via its vascular and renal effects also contributes to an increase of blood pressure. Increased sympathetic activity with decreasing vagal tone accompanying the imbalance of the autonomous nervous system is independent and significant risk factor of cardiovascular events including sudden cardiac death.

  20. Hypertension og det metaboliske syndrom

    DEFF Research Database (Denmark)

    Olsen, Michael Hecht; Jeppesen, Jørgen; Larsen, Mogens Lytken

    2009-01-01

    The metabolic syndrome is a relatively prevalent condition characterized by co-existence of several metabolic and cardiovascular risk factors including hypertension. Patients with hypertension have an increased risk of developing the metabolic syndrome which, in turn, increases the cardiovascular...

  1. Pulmonary arterial hypertension : an update

    NARCIS (Netherlands)

    Hoendermis, E. S.

    2011-01-01

    Pulmonary arterial hypertension (PAH), defined as group 1 of the World Heart Organisation (WHO) classification of pulmonary hypertension, is an uncommon disorder of the pulmonary vascular system. It is characterised by an increased pulmonary artery pressure, increased pulmonary vascular resistance

  2. [Cardiovascular complications of hypertensive crisis].

    Science.gov (United States)

    Rosas-Peralta, Martín; Borrayo-Sánchez, Gabriela; Madrid-Miller, Alejandra; Ramírez-Arias, Erick; Pérez-Rodríguez, Gilberto

    2016-01-01

    It is inexorable that a proportion of patients with systemic arterial hypertension will develop a hypertensive crisis at some point in their lives. The hypertensive crises can be divided in hypertensive patients with emergency or hypertensive emergency, according to the presence or absence of acute end-organ damage. In this review, we discuss the cardiovascular hypertensive emergencies, including acute coronary syndrome, congestive heart failure, aortic dissection and sympathomimetic hypertensive crises (those caused by cocaine use included). Each is presented in a unique way, although some patients with hypertensive emergency report non-specific symptoms. Treatment includes multiple medications for quick and effective action with security to reduce blood pressure, protect the function of organs remaining, relieve symptoms, minimize the risk of complications and improve patient outcomes.

  3. Lung Transplantation for Pulmonary Hypertension

    Science.gov (United States)

    ... the page. Answers about Lung Transplantation for PULMONARY HYPERTENSION Part One: Overview From the development of epoprostenol ... decades, expansion of medical treatment of pulmonary arterial hypertension (PAH) has improved survival and quality of life ...

  4. Immune mechanisms in hypertension.

    Science.gov (United States)

    De Ciuceis, Carolina; Rossini, Claudia; La Boria, Elisa; Porteri, Enzo; Petroboni, Beatrice; Gavazzi, Alice; Sarkar, Annamaria; Rosei, Enrico Agabiti; Rizzoni, Damiano

    2014-12-01

    Low grade inflammation may have a key role in the pathogenesis of hypertension and cardiovascular disease. Several studies showed that both innate and adaptive immune systems may be involved, being T cells the most important players. Particularly, the balance between Th1 effector lymphocytes and Treg lymphocytes may be crucial for blood pressure elevation and related organ damage development. In the presence of a mild elevation of blood pressure, neo-antigens are produced. Activated Th1 cells may then contribute to the persistent elevation of blood pressure by affecting vasculature, kidney and perivascular fat. On the other hand, Tregs represent a lymphocyte subpopulation with an anti-inflammatory role, being their activity crucial for the maintenance of cardiovascular homeostasis. Indeed, Tregs were demonstrated to be able to protect from blood pressure elevation and from the development of organ damage, including micro and macrovascular alterations, in different animal models of genetic or experimental hypertension. In the vasculature, inflammation leads to vascular remodeling through cytokine activity, smooth muscle cell proliferation and oxidative stress. It is also known that a consistent part of ischemia-reperfusion-induced acute kidney injury is mediated by inflammatory infiltration and that Treg cell infusion have a protective role. Also the central nervous system has an important role in the maintenance of cardiovascular homeostasis. In conclusion, hypertension development involves chronic inflammatory process. Knowledge of cellular and molecular players in the progression of hypertension has dramatically improved in the last decade, by assessing the central role of innate and adaptive immunity cells and proinflammatory cytokines driving the development of target organ damage. The new concept of role of immunity, especially implicating T lymphocytes, will eventually allow discovery of new therapeutic targets that may improve outcomes in hypertension and

  5. Oxidative stress and hypertension.

    Science.gov (United States)

    Harrison, David G; Gongora, Maria Carolina

    2009-05-01

    This review has summarized some of the data supporting a role of ROS and oxidant stress in the genesis of hypertension. There is evidence that hypertensive stimuli, such as high salt and angiotensin II, promote the production of ROS in the brain, the kidney, and the vasculature and that each of these sites contributes either to hypertension or to the untoward sequelae of this disease. Although the NADPH oxidase in these various organs is a predominant source, other enzymes likely contribute to ROS production and signaling in these tissues. A major clinical challenge is that the routinely used antioxidants are ineffective in preventing or treating cardiovascular disease and hypertension. This is likely because these drugs are either ineffective or act in a non-targeted fashion, such that they remove not only injurious ROS Fig. 5. Proposed role of T cells in the genesis of hypertension and the role of the NADPH oxidase in multiple cells/organs in modulating this effect. In this scenario, angiotensin II stimulates an NADPH oxidase in the CVOs of the brain, increasing sympathetic outflow. Sympathetic nerve terminals in lymph nodes activate T cells, and angiotensin II also directly activates T cells. These stimuli also activate expression of homing signals in the vessel and likely the kidney, which attract T cells to these organs. T cells release cytokines that stimulate the vessel and kidney NADPH oxidases, promoting vasoconstriction and sodium retention. SFO, subfornical organ. 630 Harrison & Gongora but also those involved in normal cell signaling. A potentially important and relatively new direction is the concept that inflammatory cells such as T cells contribute to hypertension. Future studies are needed to understand the interaction of T cells with the CNS, the kidney, and the vasculature and how this might be interrupted to provide therapeutic benefit.

  6. Hypertension in postmenopausal women.

    Science.gov (United States)

    Lima, Roberta; Wofford, Marion; Reckelhoff, Jane F

    2012-06-01

    Blood pressure is typically lower in premenopausal women than in men. However, after menopause, the prevalence of hypertension in women is higher than it is in men. Hypertension is a major risk factor for cardiovascular disease in women and men, but cardiovascular disease is the leading cause of death in women. Furthermore, there is evidence that blood pressure may not be as well-controlled in women as in men, despite the fact that most women adhere better to their therapeutic regimens and medications than do men, and have their blood pressures measured more frequently than do men. This review describes possible mechanisms by which blood pressure may be increased in postmenopausal women.

  7. Hypertension and renovascular disease

    DEFF Research Database (Denmark)

    Hasbak, P; Ibsen, H; Jensen, Lars Thorbjørn

    2002-01-01

    The clinical value of renal vein renin sampling (RVRS) as a prognostic tool in the treatment of renovascular hypertension was evaluated. One hundred consecutive patients were included over a 4-year period of time. About half of the patients (49%) were treated interventionally by PTRA (21%), nephr......The clinical value of renal vein renin sampling (RVRS) as a prognostic tool in the treatment of renovascular hypertension was evaluated. One hundred consecutive patients were included over a 4-year period of time. About half of the patients (49%) were treated interventionally by PTRA (21...

  8. Subarachnoid hemorrhage after aneurysm surgery

    Directory of Open Access Journals (Sweden)

    Carlos Gilberto Carlotti Junior

    1996-06-01

    Full Text Available The surgical treatment of intracranial aneurysms by clipping is recognized as effective and definitive. However some cases that suffered a new subarachnoid hemorrhage (SAH some time after they were submitted to aneurysm clipping have raised doubts about the concept of "cure"after this treatment. Eleven patients previously submitted to aneurysm clipping who presented a new SAH were analyzed. The time elapsed from surgery to SAH varied from 3 to 10 years. After SAH four patients had a poor outcome. The new episode of SAH occurred due to intrinsic factors of the cerebral vasculature: 1. a weak point of the vessel wall near the previous aneurysm, 2. a weak point of another vessel far from the previous aneurysm, 3. a previous infundibular dilation of the posterior communicating artery; and due to technical problems: 1. aneurysm not identified during the previous treatment, 2. aneurysm deliberately left untreated, 3. persistence of the aneurysm due to inappropriate surgery, 4. persistency of part of the aneurysm neck after clipping and 5. slipping of the clip from the neck of the aneurysm. The measures to prevent new SAH after surgery start with adequate preoperative angiographic studies, a careful inspection of the position of the clip and emptying of the aneurysm. Early angiography studies may reveal a persistent neck and later ones may reveal newly developed aneurysms. In conclusion, SAH after aneurysm clipping is a late and severe phenomenon and the concept of "cure" after this surgery should be interpreted with caution.O tratamento cirúrgico dos aneurismas cerebrais através de sua clipagem é reconhecido como eficaz e definitivo. Entretanto alguns casos sofrem nova hemorragia algum tempo após a cirurgia, deixando dúvidas sobre a "cura" pelo tratamento. Onze pacientes submetidos anteriormente a clipagem do aneurisma e que apresentaram nova hemorragia foram analisados. O intervalo de tempo da cirurgia para a nova hemorragia foi de 3 a 10 anos

  9. Malignant hypertension: a preventable emergency.

    Science.gov (United States)

    van der Merwe, Walter; van der Merwe, Veronica

    2013-08-16

    The Waitemata Hypertension Clinic Database 2009-2012 (Auckland, New Zealand) was searched for patients meeting the definition of Malignant Hypertension. Eighteen of 565 patients met the criteria. All patients had essential hypertension which was either undiagnosed, untreated or undertreated. Most cases responded satisfactorily to standard drug therapy, but a number were left with significant chronic kidney disease. Malignant hypertension is a life-threatening disease which should be entirely preventable with regular blood pressure checks in primary care.

  10. A contrast study on the curative effect between trepanation and drainage and decompressive craniotomy for treating cerebellar hemorrhage

    Directory of Open Access Journals (Sweden)

    Jie ZHUO

    2014-06-01

    Full Text Available Thirty-three cases of hypertensive cerebellar hemorrhage were involved in this survey, with the bleeding volume over 10 ml. All of them were given external ventricular drainage and then taken continuous monitoring of intracranial pressure (ICP after admission. Within 7-24 h after the onset, they all underwent trepanation and drainage under local anesthesia. In the same period, another 33 cases of cerebellar hemorrhage patients were collected as the control, who met the inclusion criteria and were treated with conventional posterior fossa decompressive craniotomy. As results, the total efficiency of the drilling group was 81.82% (27/33, which was much better than the control group (63.64%, 21/33. However, there was no statistical significance between 2 groups (χ2 = 2.750, P = 0.097. doi: 10.3969/j.issn.1672-6731.2014.06.014

  11. Dengue hemorrhagic fever complicated by pancreatitis

    Directory of Open Access Journals (Sweden)

    Guido Ricardo Gonzalez Fontal

    2011-10-01

    Full Text Available Acute pancreatitis is an atypical complication of dengue fever and is rarely described. We are reporting a case of dengue hemorrhagic fever complicated by acute pancreatitis in a patient with history of diabetes mellitus type 1 and end stage renal disease on hemodialysis.

  12. Alkhurma Hemorrhagic Fever in Saudi Arabia

    Centers for Disease Control (CDC) Podcasts

    2010-10-28

    This podcast looks at the epidemiologic characteristics of Alkhurma Hemorrhagic Fever in humans in Najran City, Saudi Arabia. CDC epidemiologist Dr. Adam MacNeil discusses the severity and risk factors for the illness.  Created: 10/28/2010 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 11/17/2010.

  13. [Arbovirus causing hemorrhagic fever at IMSS].

    Science.gov (United States)

    Navarrete-Espinosa, Joel; Gómez-Dantés, Héctor

    2006-01-01

    To know the arbovirus causing hemorrhagic fever in patients at the Mexican Institute of Social Security. A follow-up study was made in patients with probable diagnosis of hemorrhagic dengue. Blood samples were taken to look for dengue fever, yellow fever and San Luis, Tonate and Mayaro encephalitis viruses. Frequencies and proportions of the interest variables were analyzed. 35 patients were studied. Isolation and PCR results of the 13 samples were negative in 12 of them and positive to denguevirus-3 in one of them. The determination of IgM was positive for dengue fever in 25 cases; 2 were positive to Mayaro virus and 8 were negative to what was looked for. Hemorrhages and thrombocytopenia were more frequent in patients infected with dengue and Mayaro viruses; jaundice and encephalopathy were more frequent in the latter, and renal dysfunction, in patients with a negative result. Evolution was satisfactory in all cases, except for one (Mayaro), which presented hemorrhages, thrombocytopenia, jaundice and encephalopathy that lead to death. The results show the risk of appearance and dissemination of several vector-born diseases in Mexico. Thus, they require intensive epidemiological surveillance to identify them and to know their real occurrence and specific clinical profile.

  14. Prior Exercise Alters Responses to Hemorrhage

    Science.gov (United States)

    2010-07-01

    similarly in both groups. Posthemorrhage lactate and glucose concentrations were lower in exercise. The increase in plasma epinephrine was reduced in...exercise, with significantly lower levels in epinephrine and norepinephrine noted posthemorrhage. Vasopressin levels and plasma renin activity were...of a patient with hemorrhage caused by traumatic injuries. KEYWORDS—Cardiac output, blood pressure, vasopressin, catecholamines, plasma renin activity

  15. Unilateral adrenal hemorrhagic infarction in essential thrombocythemia.

    Science.gov (United States)

    Burnet, G; Lambert, M; Annet, L; Lefebvre, C

    2015-12-01

    Adrenal hemorrhage is a rare disease associated with various conditions. We report a case of a 68-year-old woman with abdominal and back pain. The diagnostic work-up showed a left adrenal gland infarction associated with essential thrombocythemia. Treatment consisted in painkillers and treating the underlying condition in order to prevent further thrombotic events.

  16. [Selective embolization to treat obstetric hemorrhage].

    Science.gov (United States)

    Ferrer Puchol, M D; Lanciego, C; Esteban, E; Ciampi, J J; Edo, M A; Ferragud, S

    2014-01-01

    To describe cases of obstetric hemorrhage that have called for selective intra-arterial embolization and the different embolization techniques used. To assess the clinical outcomes and postprocedural fertility. We studied 27 women with obstetric hemorrhage. In 24 patients, embolization was performed by catheterizing both uterine arteries and in 2 patients only one uterine artery was catheterized (pseudoaneurysm). The materials used for embolization consisted of Spongostan in 17/27, particles in 9/27, and coils in 1/27. Clinical follow-up included an analysis of early and late complications and of postprocedural fertility. Hemorrhage was classified as primary (25/27) or secondary (2/27). The cause of bleeding was vaginal delivery (20), cesarean sections (5), abortion (1), and cervical ectopic pregnancy (1). The initial technical success rate was 100% and the clinical success rate was 92.6% (25 of the 27 patients). Bleeding ceased and the outcome was satisfactory in 25 patients. During clinical follow-up ranging from one to seven years, 23 patients had normal menstruation and 6 patients completed 7 full-term pregnancies. Intra-arterial embolization for obstetric hemorrhage leads to good outcomes and few complications and it preserves fertility. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

  17. Continuous EEG Monitoring in Aneurysmal Subarachnoid Hemorrhage

    DEFF Research Database (Denmark)

    Kondziella, Daniel; Friberg, Christian Kærsmose; Wellwood, Ian

    2015-01-01

    BACKGROUND: Continuous EEG (cEEG) may allow monitoring of patients with aneurysmal subarachnoid hemorrhage (SAH) for delayed cerebral ischemia (DCI) and seizures, including non-convulsive seizures (NCSz), and non-convulsive status epilepticus (NCSE). We aimed to evaluate: (a) the diagnostic...

  18. EMERGENCY STATES IN ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    M. A. Gurevich

    2014-01-01

    Full Text Available The article describes in detail potential emergency states in patients with different stages of arterial hypertension with special attention to diagnosis and rational management of hypertensive crisis. Differentiated approach to management of different forms of hypertensive crisis is specified.

  19. Hypertension--forekomst og behandling

    DEFF Research Database (Denmark)

    Ibsen, Hans; Jørgensen, Torben; Jensen, Gorm B

    2009-01-01

    Hypertension is the most important modifiable risk factor for cardiovascular disease. However, less than half of all hypertensives have their blood pressure reduced to relevant goals. The prevalence of hypertension in Denmark was found to be between 26% and 40% of the adult population. Just over...

  20. Unraveling the distinctive features of hemorrhagic and non-hemorrhagic snake venom metalloproteinases using molecular simulations

    Science.gov (United States)

    de Souza, Raoni Almeida; Díaz, Natalia; Nagem, Ronaldo Alves Pinto; Ferreira, Rafaela Salgado; Suárez, Dimas

    2016-01-01

    Snake venom metalloproteinases are important toxins that play fundamental roles during envenomation. They share a structurally similar catalytic domain, but with diverse hemorrhagic capabilities. To understand the structural basis for this difference, we build and compare two dynamical models, one for the hemorrhagic atroxlysin-I from Bothrops atrox and the other for the non-hemorraghic leucurolysin-a from Bothrops leucurus. The analysis of the extended molecular dynamics simulations shows some changes in the local structure, flexibility and surface determinants that can contribute to explain the different hemorrhagic activity of the two enzymes. In agreement with previous results, the long Ω-loop (from residue 149 to 177) has a larger mobility in the hemorrhagic protein. In addition, we find some potentially-relevant differences at the base of the S1' pocket, what may be interesting for the structure-based design of new anti-venom agents. However, the sharpest differences in the computational models of atroxlysin-I and leucurolysin-a are observed in the surface electrostatic potential around the active site region, suggesting thus that the hemorrhagic versus non-hemorrhagic activity is probably determined by protein surface determinants.

  1. Effects of hemorrhage on cytokine gene transcription.

    Science.gov (United States)

    Shenkar, R; Abraham, E

    1993-08-01

    Injury and blood loss are often followed by infection and the rapid development of organ system dysfunction, frequently involving mucosal sites, such as the lung and intestine. To examine possible mechanisms contributing to these conditions, we used semiquantitative polymerase chain reactions to determine cytokine mRNA expression among cellular populations isolated from mucosal and systemic anatomic sites of mice at predetermined time points following 30% blood volume hemorrhage with resuscitation 1 hr later. Within 1 hr after hemorrhage, significant increases were observed in mRNA levels for IL-1 alpha, IL-1 beta, IL-5, and TGF-beta in intraparenchymal pulmonary mononuclear cells. The levels of TGF-beta transcripts among alveolar macrophages were increased 1 hr following blood loss, and increase in IL-1 alpha transcripts was found starting 2 hr posthemorrhage. Cells from Peyer's patches showed significant increases in mRNA levels for IL-1 beta, IL-2, IL-5, IL-6, IFN-gamma, and TGF-beta during the 4 hr following hemorrhage. Significant increases in mRNA levels for IL-1 beta, TNF-alpha, and TGF-beta were present within 4 hr of blood loss among cells isolated from mesenteric lymph nodes. The expression of mRNA for most cytokines was not significantly altered in splenocytes or peripheral blood mononuclear cells at any time point following hemorrhage. These experiments demonstrate that blood loss, even if resuscitated, produces significant increases in proinflammatory and immunoregulatory cytokine gene transcription as early as 1 hr following hemorrhage. These posthemorrhage alterations in cytokine mRNA expression were particularly prominent at mucosal sites, suggesting a mechanism for the increased incidence of pulmonary and intestinal involvement in organ system failure following severe blood loss and injury.

  2. Predictors of Hemorrhage Volume after Intravenous Thrombolysis.

    Science.gov (United States)

    Shon, Sang Hyun; Heo, Sung Hyuk; Kim, Bum Joon; Choi, Hye-Yeon; Kwon, Youngnam; Yi, Sang Hun; Lee, Ji Sung; Kim, Young Seo; Kim, Hyun Young; Koh, Seong-Ho; Chang, Dae-Il

    2016-10-01

    Symptomatic intracerebral hemorrhage (sICH) is one of the most feared complications after administration of intravenous recombinant tissue plasminogen activator (IV rtPA). The aim of this study was to determine correlations between hemorrhage volume (HV) after IV rtPA treatment and risk factors for sICH. We analyzed 318 patients from the stroke registries of 4 hospitals in Korea. We confirmed hemorrhage by computed tomography (CT) or magnetic resonance imaging within 36 hours. Patient groups were classified by HV (0, 0-10, 10-25, and greater than 25 mL). Based on the HV, we evaluated the following: (1) predictors for hemorrhage; (2) rates of sICH according to various sICH definitions; and (3) 3-month functional outcomes after IV rtPA treatment. Among the 318 patients, hemorrhage occurred in 72 patients. HV was significantly correlated with atrial fibrillation (OR = 3.38, 95% CI = 1.87-6.09), early CT changes (OR = 3.17, 95% CI = 1.69-5.93), and dense artery sign (OR = 1.90, 95% CI = 1.07-3.39). Compared with the groups with HV less than 25 mL, patients with an HV of greater than 25 mL were more likely to have higher mortality rates (33.3% versus 11.8%) and worse outcomes at 3 months (good: 8.3% versus 50.3%; excellent: 0% versus 33.7%). HV after IV rtPA is an important predictor of clinical outcomes. Atrial fibrillation, early CT changes, and dense artery sign were significantly associated with large HVs; therefore, these patient factors might be considered before and after thrombolytic treatment. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  3. Hemorrhagic Cholecystitis in an Elderly Patient Taking Aspirin and Cilostazol

    Directory of Open Access Journals (Sweden)

    David S. Morris

    2008-06-01

    Full Text Available Hemorrhage is a rare complication of acute cholecystitis. Patients who develop this complication often are receiving anticoagulation therapy or have a pathologic coagulopathy. We present a case of an elderly patient who developed hemorrhagic cholecystitis while taking aspirin and cilostazol, a phosphodiesterase inhibitor. The patient underwent an emergent abdominal exploration. A large, blood-filled gallbladder was found along with a large hematoma between the liver and gallbladder. We also briefly review the literature regarding hemorrhagic cholecystitis, hemorrhage into the biliary tree, and hemorrhage as a complication of aspirin and phosphodiesterase inhibitor therapy.

  4. Gender differences in hypertension and hypertension awareness among young adults.

    Science.gov (United States)

    Everett, Bethany; Zajacova, Anna

    2015-01-01

    Previous research has shown that men have higher levels of hypertension and lower levels of hypertension awareness than women, but it remains unclear if these differences emerge among young adults. Using the National Longitudinal Study of Adolescent to Adult Health (Add Health), this study examines gender differences in hypertension and hypertension awareness among U.S. young adults, with special focus on factors that may contribute to observed disparities (N = 14,497). Our results show that the gender disparities in hypertension status were already evident among men and women in their twenties: women were far less likely to be hypertensive compared to men (12% vs. 27%). The results also reveal very low levels of hypertension awareness among young women (32% of hypertensive women were aware of their status) and even lower levels among men (25%). Finally, this study identifies key factors that contribute to these observed gender disparities. In particular, health care use, while not related to the actual hypertension status, fully explains the gender differences in hypertension awareness. The findings thus suggest that regular medical visits are critical for improving hypertension awareness among young adults and reducing gender disparities in cardiovascular health.

  5. Hypertension and cardiac arrhythmias

    DEFF Research Database (Denmark)

    Lip, Gregory Y.H.; Coca, Antonio; Kahan, Thomas

    2017-01-01

    of Cardiology (ESC) Council on Hypertension convened a Task Force, with representation from the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE), with the remit to comprehensively review the available...

  6. Hypertension and Cardiac Arrhythmias

    DEFF Research Database (Denmark)

    Lip, Gregory Y H; Coca, Antonio; Kahan, Thomas

    2017-01-01

    ) Council on Hypertension convened a Task Force, with representation from the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS) and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE), with the remit of comprehensively reviewing the available evidence...

  7. Fermented milk for hypertension

    DEFF Research Database (Denmark)

    Usinger, Lotte; Reimer, Christina; Ibsen, Hans

    2012-01-01

    Fermented milk has been suggested to have a blood pressure lowering effect through increased content of proteins and peptides produced during the bacterial fermentation. Hypertension is one of the major risk factors for cardiovascular disease world wide and new blood pressure reducing lifestyle...... interventions, such as fermented milk, would be of great importance....

  8. Combination treatment for hypertension

    African Journals Online (AJOL)

    On average, one in four adults has hypertension.1 This figure is higher in certain regions of the world, .... doses favours the development of diabetes and should be ... New and old evidence strongly supports combination treatment .... cardiovascular death, stroke and myocardial infarction, cognitive function and dementia.

  9. Hypertension og nyresygdom

    DEFF Research Database (Denmark)

    Kamper, Anne-Lise; Pedersen, Erling B; Strandgaard, Svend

    2009-01-01

    hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive...

  10. [Hypertension and renal disease

    DEFF Research Database (Denmark)

    Kamper, A.L.; Pedersen, E.B.; Strandgaard, S.

    2009-01-01

    hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive...

  11. What Is Pulmonary Hypertension?

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Pulmonary Hypertension - High Blood Pressure in the Heart-to-Lung System Updated:Sep ... Pressure" This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP Introduction What ...

  12. Hypertension og hjertet

    DEFF Research Database (Denmark)

    Wachtell, Kristian; Andersen, Niels Holmark; Svendsen, Tage Lysbo

    2009-01-01

    of left ventricular mass is associated with substantial and significant reduction of cardiovascular morbidity and mortality. Hypertension is strongly associated with increased risk of subsequent heart failure. Meta analysis data suggests that reduction in blood pressure is also associated with very...

  13. Hypertensive Heart Disease

    DEFF Research Database (Denmark)

    Wachtell, Kristian

    2011-01-01

    Abstract Hypertensive heart disease is prevalent and during the last decade it has been determined that patients with left ventricular (LV) hypertrophy have increased cardiovascular morbidity and mortality. However, many have doubted the effectiveness of LV mass assessment because it is difficult...

  14. Hydrogen sulfide in hypertension

    NARCIS (Netherlands)

    van Goor, Harry; van den Born, Joost C.; Hillebrands, Jan-Luuk; Joles, Jaap A.

    2016-01-01

    PURPOSE OF REVIEW: Hypertension is an important determinant of cardiovascular disease, and strict blood pressure regulation is beneficially associated with the risk for cardiovascular events or all-cause mortality. However, intensive antihypertensive treatment is not always sufficient to reach normo

  15. Hypertension og hjertet

    DEFF Research Database (Denmark)

    Wachtell, Kristian; Svendsen, Tage Lysbo; Andersen, Niels Holmark

    2009-01-01

    of left ventricular mass is associated with substantial and significant reduction of cardiovascular morbidity and mortality. Hypertension is strongly associated with increased risk of subsequent heart failure. Meta analysis data suggests that reduction in blood pressure is also associated with very...

  16. Nitroglycerin kan give hypertension

    DEFF Research Database (Denmark)

    Mørup, Peter; Levinsen, Tine Holbæk; Hovind, Peter

    2011-01-01

    Hg. The conclusion was that her response was a paradoxical response to glycerylnitrate, orthostatism and a pathological response to massage of the carotid artery. This is the third reported case on paradoxical hypertension induced by glyceryl nitrates. It is speculated that dysfunction of the cerebral bloodflow...

  17. Decoding white coat hypertension.

    Science.gov (United States)

    Bloomfield, Dennis A; Park, Alex

    2017-03-16

    There is arguably no less understood or more intriguing problem in hypertension that the "white coat" condition, the standard concept of which is significantly blood pressure reading obtained by medical personnel of authoritative standing than that obtained by more junior and less authoritative personnel and by the patients themselves. Using hospital-initiated ambulatory blood pressure monitoring, the while effect manifests as initial and ending pressure elevations, and, in treated patients, a low daytime profile. The effect is essentially systolic. Pure diastolic white coat hypertension appears to be exceedingly rare. On the basis of the studies, we believe that the white coat phenomenon is a common, periodic, neuro-endocrine reflex conditioned by anticipation of having the blood pressure taken and the fear of what this measurement may indicate concerning future illness. It does not change with time, or with prolonged association with the physician, particularly with advancing years, it may be superimposed upon essential hypertension, and in patients receiving hypertensive medication, blunting of the nighttime dip, which occurs in about half the patients, may be a compensatory mechanisms, rather than an indication of cardiovascular risk. Rather than the blunted dip, the morning surge or the widened pulse pressure, cardiovascular risk appears to be related to elevation of the average night time pressure.

  18. Studies in portal hypertension

    NARCIS (Netherlands)

    H.R. van Buuren (Henk)

    2002-01-01

    textabstractOur work focussed on one of the most frequent and serious complications of portal hypertension i.e. variceal bleeding. In particular, studies were initiated aimed at developing a more effective therapeutic strategy for the primary and secondary prevention of variceal bleeding. Aspects of

  19. MRI blood-brain barrier permeability measurements to predict hemorrhagic transformation in a rat model of ischemic stroke.

    Science.gov (United States)

    Hoffmann, Angelika; Bredno, Jörg; Wendland, Michael F; Derugin, Nikita; Hom, Jason; Schuster, Tibor; Zimmer, Claus; Su, Hua; Ohara, Peter T; Young, William L; Wintermark, Max

    2012-12-01

    Permeability imaging might add valuable information in the risk assessment of hemorrhagic transformation. This study evaluates the predictive value of blood-brain barrier permeability (BBBP) measurements extracted from dynamic contrast-enhanced MRI for hemorrhagic transformation in ischemic stroke. Spontaneously hypertensive and Wistar rats with 2 h filament occlusion of the right MCA underwent MRI during occlusion, at 4 and 24 h post reperfusion. BBBP was imaged by DCE imaging and quantified by Patlak analysis. Cresyl-violet staining was used to characterize hemorrhage in sacrificed rats at 24 h, immediately following the last imaging study. BBBP changes were evaluated at baseline, 4 and 24 h after reperfusion. Receiver-operating characteristic (ROC) analysis was performed to determine the most accurate BBBP threshold to predict hemorrhagic transformation. In animals showing macroscopic hemorrhage at 24 h, 95th BBBP percentile values ipsilateral were 0.323 [0.260, 0.387], 0.685 [0.385, 0.985], and 0.412 [0.210, 0.613] ml/min·100 g (marginal mean [95%CI]) during occlusion, at 4 and 24 h post reperfusion, respectively. The BBBP values on the infarcted and contralateral side were significantly different at 4 (p = 0.034) and 24 h post reperfusion (p = 0.031). The predictive value of BBBP in terms of macroscopic hemorrhage was highest 4 h after reperfusion (ROC area under the curve = 84 %) with a high negative predictive value (98.3 %) and limited positive predictive value (14.9 %) for a threshold of 0.35 ml/min·100g. Altered BBBP is a necessary but not sufficient condition to cause hemorrhagic transformation in rats with an infarct. Further research is needed to identify those additional risk factors that are required for hemorrhagic transformation to develop in the setting of ischemic stroke.

  20. Angiographic findings in 2 children with cerebral paragonimiasis with hemorrhage.

    Science.gov (United States)

    Chen, Zhi; Chen, Jingyu; Miao, Hongpin; Li, Fei; Feng, Hua; Zhu, Gang

    2013-05-01

    Hemorrhagic events associated with cerebral paragonimiasis are not rare, especially in children and adolescents; however, angiographic evidence of cerebrovascular involvement has not been reported. The authors describe angiographic abnormalities of the cerebral arteries seen in 2 children in whom cerebral paragonimiasis was associated with hemorrhagic stroke. The patients presented with acute intracerebral and subarachnoid hemorrhage. Angiography revealed a beaded appearance and long segmental narrowing of arteries, consistent with arteritis. In both patients, involved vessels were seen in the area of the hemorrhage. The vascular changes and the hemorrhage, together with new lesions that developed close to the hemorrhage and improved after praziquantel treatment, were attributed to paragonimiasis. Further study of the frequency and mechanism of hemorrhagic cerebrovascular complications associated with cerebral paragonimiasis is needed.