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Sample records for del hematoma intracraneal

  1. Postoperative extradural hematomas.

    PubMed

    Pichierri, Angelo; Ruggeri, Andrea; Donnarumma, Pasquale; Delfini, Roberto

    2013-01-01

    Postoperative extradural hematoma (POEH) is a possible complication after head surgery, often neglected in the literature. In a single surgeon experience we found 13 cases of POEH (0.8%). We distinguished two subtypes: (1) larger hematomas (>40 cc) with typical features and overt clinical picture that always needed evacuation, and (2) smaller hematomas (<40 cc) with insidious clinical onset and different radiological features compared with traumatic and spontaneous extradural hematomas. On the basis of our experience, we propose that clinical picture and radiologic appearance lead the decision between conservative or interventional treatment of type II hematomas.

  2. Traumatic epidural hematoma in children.

    PubMed

    Rocchi, Giovanni; Caroli, Emanuela; Raco, Antonino; Salvati, Maurizio; Delfini, Roberto

    2005-07-01

    The purpose of this study was to investigate the characteristics of childhood acute epidural hematoma and to report our experience in recent years. A series of 35 patients below the age of 15 years treated for acute epidural hematoma at our institution between June 1991 and December 2000 was analyzed in detail. Pediatric epidural hematoma presents both age-related and atypical features when compared with epidural hematoma in adults. In selected cases, prompt surgical evacuation of the hematoma results in an excellent outcome. Outcomes seem to be directly related to the patient's preoperative neurologic status and the presence of associated intracranial lesions.

  3. Microwave hematoma detector

    DOEpatents

    Haddad, Waleed S.; Trebes, James E.; Matthews, Dennis L.

    2001-01-01

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

  4. Spontaneous soft tissue hematomas.

    PubMed

    Dohan, A; Darnige, L; Sapoval, M; Pellerin, O

    2015-01-01

    Spontaneous muscle hematomas are a common and serious complication of anticoagulant treatment. The incidence of this event has increased along with the rise in the number of patients receiving anticoagulants. Radiological management is both diagnostic and interventional. Computed tomography angiography (CTA) is the main tool for the detection of hemorrhage to obtain a positive, topographic diagnosis and determine the severity. Detection of an active leak of contrast material during the arterial or venous phase is an indication for the use of arterial embolization. In addition, the interventional radiological procedure can be planned with CTA. Arterial embolization of the pedicles that are the source of the bleeding is an effective technique. The rate of technical and clinical success is 90% and 86%, respectively. PMID:26066549

  5. [Breast hematoma masking a sarcoma].

    PubMed

    Relea Sarabia, A; Bahamonde Cabria, S; González Rebollo, M; Encinas Gaspar, M B

    2015-01-01

    Sarcomas account for less than 1% of malignant breast tumors. We present the case of a sarcoma (malignant fibrous histiocytoma) of the breast that debuted as a lump. The patient associated the lump with trauma, and the clinical, sonographic, and cytological findings were suggestive of a hematoma. The lump grew rapidly, and the follow-up sonogram one month later clearly revealed hypervascular solid poles. This atypical presentation is useful for reviewing the management of lesions suggestive of hematomas, which are often associated with nonspecific findings and occasionally with signs that raise suspicion of malignancy. The emergence of what appears to be a hematoma in the breast, even when accompanied by a history of trauma or a tendency toward bleeding, calls for prudence: very short-term follow-up and biopsy, even excisional biopsy, are recommended if the lesion does not evolve like a hematoma. PMID:26160042

  6. Surgical management of intracerebral hematomas

    SciTech Connect

    Tsementzis, S.A.

    1985-04-01

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

  7. Pocket Hematoma: A Call for Definition.

    PubMed

    DE Sensi, Francesco; Miracapillo, Gennaro; Cresti, Alberto; Severi, Silva; Airaksinen, Kari Eino Juhani

    2015-08-01

    Pocket hematoma is a common complication of cardiac implantable electronic device procedures and a potential risk factor for device infections, especially in patients on oral anticoagulation or antiplatelet treatment. There is a wide variability in the incidence of pocket hematoma and bleeding complications in the literature and the major cause for this seems to be the variability of the used definitions for hematomas. The lack of generally accepted definition for pocket hematoma renders the comparisons across the studies difficult. In this article, we briefly review the current literature on this issue and propose a uniform definition for pocket hematoma and criteria for grading the severity of hematoma in clinical practice and research.

  8. Chronic subdural hematoma

    PubMed Central

    Yadav, Yad R.; Parihar, Vijay; Namdev, Hemant; Bajaj, Jitin

    2016-01-01

    Chronic subdural hematoma (CSDH) is one of the most common neurosurgical conditions. There is lack of uniformity in the treatment of CSDH amongst surgeons in terms of various treatment strategies. Clinical presentation may vary from no symptoms to unconsciousness. CSDH is usually diagnosed by contrast-enhanced computed tomography scan. Magnetic resonance imaging (MRI) scan is more sensitive in the diagnosis of bilateral isodense CSDH, multiple loculations, intrahematoma membranes, fresh bleeding, hemolysis, and the size of capsule. Contrast-enhanced CT or MRI could detect associated primary or metastatic dural diseases. Although definite history of trauma could be obtained in a majority of cases, some cases may be secondary to coagulation defect, intracranial hypotension, use of anticoagulants and antiplatelet drugs, etc., Recurrent bleeding, increased exudates from outer membrane, and cerebrospinal fluid entrapment have been implicated in the enlargement of CSDH. Burr-hole evacuation is the treatment of choice for an uncomplicated CSDH. Most of the recent trials favor the use of drain to reduce recurrence rate. Craniotomy and twist drill craniostomy also play a role in the management. Dural biopsy should be taken, especially in recurrence and thick outer membrane. Nonsurgical management is reserved for asymptomatic or high operative risk patients. The steroids and angiotensin converting enzyme inhibitors may also play a role in the management. Single management strategy is not appropriate for all the cases of CSDH. Better understanding of the nature of the pathology, rational selection of an ideal treatment strategy for an individual patient, and identification of the merits and limitations of different surgical techniques could help in improving the prognosis. PMID:27695533

  9. Chronic subdural hematoma

    PubMed Central

    Yadav, Yad R.; Parihar, Vijay; Namdev, Hemant; Bajaj, Jitin

    2016-01-01

    Chronic subdural hematoma (CSDH) is one of the most common neurosurgical conditions. There is lack of uniformity in the treatment of CSDH amongst surgeons in terms of various treatment strategies. Clinical presentation may vary from no symptoms to unconsciousness. CSDH is usually diagnosed by contrast-enhanced computed tomography scan. Magnetic resonance imaging (MRI) scan is more sensitive in the diagnosis of bilateral isodense CSDH, multiple loculations, intrahematoma membranes, fresh bleeding, hemolysis, and the size of capsule. Contrast-enhanced CT or MRI could detect associated primary or metastatic dural diseases. Although definite history of trauma could be obtained in a majority of cases, some cases may be secondary to coagulation defect, intracranial hypotension, use of anticoagulants and antiplatelet drugs, etc., Recurrent bleeding, increased exudates from outer membrane, and cerebrospinal fluid entrapment have been implicated in the enlargement of CSDH. Burr-hole evacuation is the treatment of choice for an uncomplicated CSDH. Most of the recent trials favor the use of drain to reduce recurrence rate. Craniotomy and twist drill craniostomy also play a role in the management. Dural biopsy should be taken, especially in recurrence and thick outer membrane. Nonsurgical management is reserved for asymptomatic or high operative risk patients. The steroids and angiotensin converting enzyme inhibitors may also play a role in the management. Single management strategy is not appropriate for all the cases of CSDH. Better understanding of the nature of the pathology, rational selection of an ideal treatment strategy for an individual patient, and identification of the merits and limitations of different surgical techniques could help in improving the prognosis.

  10. Whole Spontaneous Spinal Epidural Hematoma

    PubMed Central

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

    2014-01-01

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

  11. Infected renal hematoma complicating anticoagulant therapy.

    PubMed

    Morduchowicz, G; Rabinovitz, M; Neuman, M; Pitlik, S

    1987-03-01

    We describe a case of spontaneous infection of a renal hematoma complicating warfarin sodium anticoagulant therapy. The infected hematoma was successfully drained by sonar-guided fine-needle aspiration. All reported cases of renal hematomas complicating anticoagulant therapy are reviewed.

  12. Spontaneous spinal subdural hematoma concurrent with cranial subdural hematoma.

    PubMed

    Moon, Wonjun; Joo, Wonil; Chough, Jeongki; Park, Haekwan

    2013-07-01

    A 39-year old female presented with chronic spinal subdural hematoma manifesting as low back pain and radiating pain from both legs. Magnetic resonance imaging (MRI) showed spinal subdural hematoma (SDH) extending from L4 to S2 leading to severe central spinal canal stenosis. One day after admission, she complained of nausea and severe headache. Computed tomography of the brain revealed chronic SDH associated with midline shift. Intracranial chronic SDH was evacuated through two burr holes. Back pain and radiating leg pain derived from the spinal SDH diminished about 2 weeks after admission and spinal SDH was completely resolved on MRI obtained 3 months after onset. Physicians should be aware of such a condition and check the possibility of concurrent cranial SDH in patients with spinal SDH, especially with non-traumatic origin.

  13. Spinal Subdural Hematoma Associated with Intracranial Subdural Hematoma.

    PubMed

    Kim, Myoung Soo; Sim, Sook Young

    2015-10-01

    The simultaneous occurrence of an intracranial and a spinal subdural hematoma (SDH) is rare. We describe a case of cranial SDH with a simultaneous spinal SDH. An 82-year-old woman visited the emergency room because of drowsiness and not being able to walk 6 weeks after falling down. A neurological examination showed a drowsy mentality. Brain computed tomography showed bilateral chronic SDH with an acute component. The patient underwent an emergency burr-hole trephination and hematoma removal. She exhibited good recovery after the operation. On the fourth postoperative day, she complained of low-back pain radiating to both lower limbs, and subjective weakness of the lower limbs. Spine magnetic resonance imaging revealed a thoracolumbosacral SDH. A follow-up spinal magnetic resonance imaging study that was performed 16 days later showed a significant decrease in the size of the spinal SDH. We discuss the pathogenesis of this simultaneous occurrence of spinal and cranial SDH. PMID:26587198

  14. Spinal Subdural Hematoma Associated with Intracranial Subdural Hematoma

    PubMed Central

    Sim, Sook Young

    2015-01-01

    The simultaneous occurrence of an intracranial and a spinal subdural hematoma (SDH) is rare. We describe a case of cranial SDH with a simultaneous spinal SDH. An 82-year-old woman visited the emergency room because of drowsiness and not being able to walk 6 weeks after falling down. A neurological examination showed a drowsy mentality. Brain computed tomography showed bilateral chronic SDH with an acute component. The patient underwent an emergency burr-hole trephination and hematoma removal. She exhibited good recovery after the operation. On the fourth postoperative day, she complained of low-back pain radiating to both lower limbs, and subjective weakness of the lower limbs. Spine magnetic resonance imaging revealed a thoracolumbosacral SDH. A follow-up spinal magnetic resonance imaging study that was performed 16 days later showed a significant decrease in the size of the spinal SDH. We discuss the pathogenesis of this simultaneous occurrence of spinal and cranial SDH. PMID:26587198

  15. Spontaneous Spinal Epidural Hematoma Report.

    PubMed

    Kukreja, Sunil; Nanda, Anil

    2016-01-01

    We report a case of spontaneous spinal epidural hematoma in a 12-year-old female, who presented with significant upper and lower extremities weakness preceded by pain around the neck and shoulder girdle. Magnetic resonance imaging revealed epidural hematoma extending from C6-T2 with characteristic heterogeneously hyperintensity on T2 and homogenously isointensity on T1. Emergent spinal decompression was performed. However, the patient remained substantially weak in her lower extremities and was wheelchair bound at 3 months postoperatively. We have discussed clinical features, predisposing events, pathogenesis and treatment guidelines described in the literature. We also aim to reinforce the notion of keeping a high degree of clinical suspicion to identify and intervene at the earliest stage to prevent the physically and socially challenging consequences of SSEH. PMID:27598898

  16. Preputial hematoma in a stallion.

    PubMed

    Memon, M A; McClure, J J; Usenik, E A

    1987-09-01

    An 8-year-old Quarter Horse stallion was admitted with a swelling involving the prepuce, dorsal part of the scrotum, and root of the penis. The swelling was first noticed 10 days after breeding, with no evidence that it had resulted from a kick by the mare. The penis was retracted into the prepuce, except for a 10- to 15-cm protrusion of the glans penis. Treatment included warm hydrotherapy, massage, stockinette compression, antidiuretics, antibiotics, penile support, and exercise, without success. At necropsy, a massive preputial hematoma was found extending forward from the root of the penis to 12 cm proximal to the glans penis. The exact origin of the hematoma could not be determined. Most likely, bleeding had originated from the vascular plexus lying subfascially on the surface of the penis outside the intact tunica albuginea or from a branch of the external pudendal artery.

  17. Histotripsy Liquefaction of Large Hematomas.

    PubMed

    Khokhlova, Tatiana D; Monsky, Wayne L; Haider, Yasser A; Maxwell, Adam D; Wang, Yak-Nam; Matula, Thomas J

    2016-07-01

    Intra- and extra-muscular hematomas result from repetitive injury as well as sharp and blunt limb trauma. The clinical consequences can be serious, including debilitating pain and functional deficit. There are currently no short-term treatment options for large hematomas, only lengthy conservative treatment. The goal of this work was to evaluate the feasibility of a high intensity focused ultrasound (HIFU)-based technique, termed histotripsy, for rapid (within a clinically relevant timeframe of 15-20 min) liquefaction of large volume (up to 20 mL) extra-vascular hematomas for subsequent fine-needle aspiration. Experiments were performed using in vitro extravascular hematoma phantoms-fresh bovine blood poured into 50 mL molds and allowed to clot. The resulting phantoms were treated by boiling histotripsy (BH), cavitation histotripsy (CH) or a combination in a degassed water tank under ultrasound guidance. Two different transducers operating at 1 MHz and 1.5 MHz with f-number = 1 were used. The liquefied lysate was aspirated and analyzed by histology and sized in a Coulter Counter. The peak instantaneous power to achieve BH was lower than (at 1.5 MHz) or equal to (at 1 MHz) that which was required to initiate CH. Under the same exposure duration, BH-induced cavities were one and a half to two times larger than the CH-induced cavities, but the CH-induced cavities were more regularly shaped, facilitating easier aspiration. The lysates contained a small amount of debris larger than 70 μm, and 99% of particulates were smaller than 10 μm. A combination treatment of BH (for initial debulking) and CH (for liquefaction of small residual fragments) yielded 20 mL of lysate within 17.5 minutes of treatment and was found to be most optimal for liquefaction of large extravascular hematomas. PMID:27126244

  18. Histotripsy Liquefaction of Large Hematomas.

    PubMed

    Khokhlova, Tatiana D; Monsky, Wayne L; Haider, Yasser A; Maxwell, Adam D; Wang, Yak-Nam; Matula, Thomas J

    2016-07-01

    Intra- and extra-muscular hematomas result from repetitive injury as well as sharp and blunt limb trauma. The clinical consequences can be serious, including debilitating pain and functional deficit. There are currently no short-term treatment options for large hematomas, only lengthy conservative treatment. The goal of this work was to evaluate the feasibility of a high intensity focused ultrasound (HIFU)-based technique, termed histotripsy, for rapid (within a clinically relevant timeframe of 15-20 min) liquefaction of large volume (up to 20 mL) extra-vascular hematomas for subsequent fine-needle aspiration. Experiments were performed using in vitro extravascular hematoma phantoms-fresh bovine blood poured into 50 mL molds and allowed to clot. The resulting phantoms were treated by boiling histotripsy (BH), cavitation histotripsy (CH) or a combination in a degassed water tank under ultrasound guidance. Two different transducers operating at 1 MHz and 1.5 MHz with f-number = 1 were used. The liquefied lysate was aspirated and analyzed by histology and sized in a Coulter Counter. The peak instantaneous power to achieve BH was lower than (at 1.5 MHz) or equal to (at 1 MHz) that which was required to initiate CH. Under the same exposure duration, BH-induced cavities were one and a half to two times larger than the CH-induced cavities, but the CH-induced cavities were more regularly shaped, facilitating easier aspiration. The lysates contained a small amount of debris larger than 70 μm, and 99% of particulates were smaller than 10 μm. A combination treatment of BH (for initial debulking) and CH (for liquefaction of small residual fragments) yielded 20 mL of lysate within 17.5 minutes of treatment and was found to be most optimal for liquefaction of large extravascular hematomas.

  19. Extraskeletal Ewing's sarcoma mimicking traumatic hematoma.

    PubMed

    Ogose, A; Hotta, T; Yamamura, S; Shioya, Y; Yazawa, T

    1998-01-01

    We describe the clinical course of a 16-year-old baseball player with a history of recurrent hematoma of the thigh. The lesion was aspirated percutaneously several times and curetted under the diagnosis of traumatic hematoma. Microscopical examination revealed massive hemorrhage, necrosis, and a small number of Ewing's sarcoma cells. He died of multiple metastases. With recurrent hematoma in the soft tissue, neoplastic lesions should be ruled out.

  20. Spontaneous extracranial decompression of epidural hematoma.

    PubMed

    Neely, John C; Jones, Blaise V; Crone, Kerry R

    2008-03-01

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

  1. [Computed tomographic semiotics of chronic subdural hematomas].

    PubMed

    El'-Kadi, Kh A; Likhterman, L B; Kornichenko, V N

    1990-01-01

    Analysis of the results of investigation of 72 patients with verified chronic subdural hematomas (CSH) has revealed their CT dense characteristics, the peculiarities of their structure compared with the time of their formation, the patients' age, the clinical stage of disease, and operative findings. Direct and indirect CT signs of uni- and bilateral hemispherical chronic subdural hematomas were described.

  2. A blackhole over brain: Interdural hematoma - A challenging diagnosis.

    PubMed

    Babayev, Rasim; Ekşi, Murat Şakir

    2015-01-01

    Hematoma in between two dura leaves, named as 'interdural hematoma', is a very rare entity in adulthood. Interdural hematoma may emerge spontaneously or secondary to coagulopathies. A 61-year-old male patient, who had a medical history of alcoholic cirrhosis, presented with interdural hematoma. The case has been discussed with a literature review about diagnostic and therapeutic approaches in this pathology. PMID:26048608

  3. A blackhole over brain: Interdural hematoma - A challenging diagnosis.

    PubMed

    Babayev, Rasim; Ekşi, Murat Şakir

    2015-01-01

    Hematoma in between two dura leaves, named as 'interdural hematoma', is a very rare entity in adulthood. Interdural hematoma may emerge spontaneously or secondary to coagulopathies. A 61-year-old male patient, who had a medical history of alcoholic cirrhosis, presented with interdural hematoma. The case has been discussed with a literature review about diagnostic and therapeutic approaches in this pathology.

  4. Subperiosteal Hematoma of the Ankle

    PubMed Central

    Hui, S H; Lui, T H

    2016-01-01

    Introduction: Periosteal reaction has a long list of differential diagnoses ranging from trauma, infection, metabolic disease to malignancy. The morphology of periosteal reaction shown in imaging studies helps to narrow down the list of differential diagnoses. Case report: A 25 year old gentleman had an inversion injury to his left ankle. He complained of lateral ankle and posterior heel pain and swelling after the injury. Radiograph of his left ankle revealed solid, smooth periosteal reaction at posterior aspect of left distal tibia. MRI showed periosteal reaction at the corresponding site, which was better demonstrated in CT scan. Follow up MRI and CT showed maturation of the new bone formation at the site of periosteal reaction. Findings were compatible with subperiosteal hematoma formation from injury, which ossified with time. Conclusion: Smooth, thick periosteal reaction favours benign process, while interrupted pattern is an alarming feature for more aggressive causes.

  5. Subcapsular hematoma after ureteroscopy and laser lithotripsy.

    PubMed

    Paiva, Matheus Miranda; da Silva, Rodrigo Donalisio; Jaworski, Paulo; Kim, Fernando J; Molina, Wilson R

    2016-08-01

    Subcapsular hematoma is an uncommon complication after ureteroscopy and laser lithotripsy. We report on a 38-year-old male with an 8 mm lower pole stone who underwent a left ureteroscopy and laser lithotripsy. The stone was successfully fragmented. Several hours after being discharged home, the patient returned complaining of back pain and hematuria. He was hemodynamically stable. Laboratory exams were normal. A CT study showed a crescent renal subcapsular hematoma surrounding the left kidney. The patient was admitted to the ward for conservative treatment. No additional intervention was necessary. Most subcapsular hematomas tend to resolve spontaneously. PMID:27544565

  6. Massive Preperitoneal Hematoma after a Subcutaneous Injection

    PubMed Central

    Yoshikawa, Kentaro; Lefor, Alan Kawarai; Kubota, Tadao; Mizokami, Ken

    2016-01-01

    Preperitoneal hematomas are rare and can develop after surgery or trauma. A 74-year-old woman, receiving systemic anticoagulation, developed a massive preperitoneal hematoma after a subcutaneous injection of teriparatide using a 32-gauge, 4 mm needle. In this patient, there were two factors, the subcutaneous injection of teriparatide and systemic anticoagulation, associated with development of the hematoma. These two factors are especially significant, because they are widely used clinically. Although extremely rare, physicians must consider this potentially life-threatening complication after subcutaneous injections, especially in patients receiving anticoagulation. PMID:27738545

  7. Cervical Ligamentum Flavum Hematoma: A Case Report.

    PubMed

    Haghnegahdar, Ali; Sedighi, Mahsa; Rahmanian, Abdolkarim; Baghban, Fahim

    2016-02-01

    Study Design Case report. Objective To report the first case of ligamentum flavum hematoma after cervical spine instrumentation 11 years after the index surgery. Methods After performing bilateral C3 and C4 laminectomy, we observed a dark greenish discoloration over the ligamentum flavum, which was opened. We evacuated 15 mL of subacute hematoma. Results The first ligamentum flavum hematoma of the cervical spine that occurred after spinal instrumentation with sublaminar hooks. Conclusion Ligamentum flavum hematoma might happen even after a long delay (in our case, 11 years) from spinal instrumentation (sublaminar hooks). In symptomatic patients, evacuation is the treatment of choice. In cases of instrument adhesion to the surrounding intracanal tissues, removal should be done meticulously after performing a complete release.

  8. Cervical Ligamentum Flavum Hematoma: A Case Report

    PubMed Central

    Haghnegahdar, Ali; Sedighi, Mahsa; Rahmanian, Abdolkarim; Baghban, Fahim

    2015-01-01

    Study Design Case report. Objective To report the first case of ligamentum flavum hematoma after cervical spine instrumentation 11 years after the index surgery. Methods After performing bilateral C3 and C4 laminectomy, we observed a dark greenish discoloration over the ligamentum flavum, which was opened. We evacuated 15 mL of subacute hematoma. Results The first ligamentum flavum hematoma of the cervical spine that occurred after spinal instrumentation with sublaminar hooks. Conclusion Ligamentum flavum hematoma might happen even after a long delay (in our case, 11 years) from spinal instrumentation (sublaminar hooks). In symptomatic patients, evacuation is the treatment of choice. In cases of instrument adhesion to the surrounding intracanal tissues, removal should be done meticulously after performing a complete release. PMID:26835213

  9. Multiple spontaneous visceral hematomas revealing polyarteritis nodosa.

    PubMed

    Allanore, Yannick; Rosenberg, Carole; Vignaux, Olivier; Legmann, Paul; Kanev, K; Menkes, Charles J; Kahan, Andre

    2004-09-01

    Polyarteritis nodosa is a rare life-threatening disease characterized by necrotizing vasculitis of small and median arteries. We describe the exceptional case of a 28-year-old man with successive spontaneous visceral hematomas of the kidney, bladder, and liver. Arteriography was performed for a recent spontaneous hepatic hematoma and a microaneurysm was detected, allowing the diagnosis of polyarteritis nodosa and prescription of appropriate treatment.

  10. Clinical and Pathological Characteristics of Organized Hematoma

    PubMed Central

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

    2013-01-01

    Objective. To study the clinical and pathological characteristics of patients with organized hematoma with malignant features in maxillary sinuses. Subjects and Methods. This was a retrospective study of five patients who were treated surgically for organized hematoma. The preoperative CT and MRI findings were studied clinically. The expressions of CD31, CD34, and periostin in surgical samples were investigated by immunohistochemistry. Results. The clinical features of organized hematoma, such as a mass expanding from the maxillary sinus with bone destruction, resembled those of maxillary carcinoma. However, CT and MRI provided sufficient and useful information to differentiate this condition from malignancy. Surgical resection was the first-line treatment because of the presence of a firm capsule. Characteristic histopathological findings were a mixture of dilated vessels, hemorrhage, fibrin exudation, fibrosis, hyalinization, and neovascularization. The expressions of periostin, CD31, and CD34 were observed in organized hematoma of the maxillary sinus. Conclusion. The expressions of periostin, CD31, and CD34 were observed in organized hematoma of the maxillary sinus. Organized hematoma is characterized pathologically by a mixture of bleeding, dilated vessels, hemorrhage, fibrin exudation, fibrosis, hyalinization, and neovascularization. CT and MRI show heterogeneous findings reflecting a mixture of these pathological entities. PMID:23533421

  11. History of Chronic Subdural Hematoma

    PubMed Central

    2015-01-01

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

  12. History of Chronic Subdural Hematoma.

    PubMed

    Lee, Kyeong-Seok

    2015-10-01

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

  13. Laparoscopic evacuation of a subcapsular renal hematoma causing symptomatic hypertension.

    PubMed

    Graham, C W; Lynch, S C; Muskat, P C; Mokulis, J A

    1998-12-01

    We report the case of a subcapsular hematoma following extracorporeal shockwave lithotripsy which presented as symptomatic hypertension. When medical therapy proved ineffective, laparoscopic decompression of the hematoma corrected the hypertension.

  14. Spontaneous intramural hematoma of the colon.

    PubMed

    Fernandes, Samuel; Gonçalves, Ana Rita; Araújo Correia, Luís

    2016-08-01

    A 73-year-old man was admitted to our clinic with sudden left quadrant abdominal pain and hematochezia. There was no history of trauma. He denied other symptoms or taking off-the-counter medication. His medical history was relevant for ischemic and aortic-mitral valve disease with prosthetic valves for which he was medicated with aspirin and warfarin. On physical examination the patient presented normal vital signs with tenderness on palpation of the left side of the abdomen. Laboratory tests revealed moderate anemia (10.8 g/dl) and thrombocytopenia (135.000x10^9 U/L) with therapeutic international normalized ratio (2.53). Colonoscopy revealed an extensive area of erythematous and bluish mucosa with an apparent torsion of the proximal descending colon around a volumous hematoma measuring 6.5x3 cm (Figure 1 A-C). Urgent abdominal CT confirmed the presence of a large intramural hematoma of the descending colon (Figure 2 A-B). A conservative approach was adopted with temporary suspension of anticoagulation. Given the high thrombotic risk, abdominal ultrasound was performed after 72 hours showing considerable reduction in the size of the hematoma. Anti-coagulation was then resumed without complications. One month later, colonoscopy was repeated showing complete healing of the mucosa. The increasing use of anti-aggregating and anti-coagulant therapy, especially in elderly patients, explains the increasing incidence of bleeding events seen in this population. However, gastrointestinal hematomas are estimated to occur in only 1 for every 250.000 anti-coagulated patients. Diagnosis is based on characteristic radiologic findings. While most parietal hematomas can be approached conservatively, surgery is indicated in the presence of complications or persistence of the hematoma. PMID:27554386

  15. Subcorneal hematomas in excessive video game play.

    PubMed

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

    2016-01-01

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

  16. Subcorneal hematomas in excessive video game play.

    PubMed

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

    2016-01-01

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

  17. [Isolated ipsilateral lateropulsion caused by bulbar hematoma].

    PubMed

    Hommel, M; Borgel, F; Gaio, J M; Lavernhe, G; Perret, J

    1985-01-01

    A case of hematoma involving probably the reticular formation of the medulla oblongata is reported. Examination showed a soft palate paresis and an ipsilateral axial lateropulsion without vertigo or oculomotor disorders. The mechanism of the lateropulsion is discussed. During the spontaneous recovery a transient hydrocephalus was observed.

  18. Factors Associated With Neck Hematoma After Thyroidectomy

    PubMed Central

    Suzuki, Sayaka; Yasunaga, Hideo; Matsui, Hiroki; Fushimi, Kiyohide; Saito, Yuki; Yamasoba, Tatsuya

    2016-01-01

    Abstract To identify risk factors for post-thyroidectomy hematoma requiring airway intervention or surgery (“wound hematoma”) and determine post-thyroidectomy time to intervention. Post-thyroidectomy hematoma is rare but potentially lethal. Information on wound hematoma in a nationwide clinical setting is scarce. Using the Japanese Diagnosis Procedure Combination database, we extracted data from records of patients undergoing thyroidectomy from July 2010 to March 2014. Patients with clinical stage IV cancer or those with bilateral neck dissection were excluded because they could have undergone planned tracheotomy on the day of thyroidectomy. We assessed the association between background characteristics and wound hematoma ≤2 days post-thyroidectomy, using multivariable logistic regression analysis. Among 51,968 patients from 880 hospitals, wound hematoma occurred in 920 (1.8%) ≤2 days post-thyroidectomy and in 203 (0.4%) ≥3 days post-thyroidectomy (in-hospital mortality = 0.05%). Factors significantly associated with wound hematoma ≤2 days post-thyroidectomy were male sex (odds ratio [OR] 1.52, 95% confidence interval [CI] 1.30–1.77); higher age (OR 1.01, 95% CI 1.00–1.02); overweight or obese (OR 1.22, 95% CI 1.04–1.44); type of surgery (partial thyroidectomy for benign tumor compared with: total thyroidectomy, benign tumor [OR 1.95, 95% CI 1.45–2.63]; partial thyroidectomy, malignant tumor [OR 1.21, 95% CI 1.00–1.46]; total thyroidectomy, malignant tumor [OR 2.49, 95% CI 1.82–3.49]; and thyroidectomy for Graves disease [OR 3.88, 95% CI 2.59–5.82]); neck dissection (OR, 1.53, 95% CI 1.05–2.23); antithrombotic agents (OR 1.58, 95% CI 1.15–2.17); and blood transfusion (OR 5.33, 95% CI 2.39–11.91). Closer monitoring of airway and neck is recommended for patients with risk factors, and further cautious monitoring beyond 3 days post-thyroidectomy. PMID:26886632

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

    PubMed

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

    2014-08-01

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

  20. Orbital subperiosteal hematoma from scuba diving.

    PubMed

    Rosenberry, Clark; Angelidis, Matthew; Devita, Diane

    2010-09-01

    Only a few cases of nontraumatic orbital subperiosteal hematoma due to scuba diving have been reported, and this is the first of such cases that underwent surgical intervention. This injury results from negative pressure within the face mask, suctioning orbital tissues into the mask after incomplete equilibration of pressure on descent. Valsalva maneuver is a second mechanism implicated in the etiology of this injury. Recognition of this injury is of the utmost importance because vision loss is a possible complication if there is compression of the optic nerve or increased intraocular pressure. In many cases of nontraumatic orbital hematoma, conservative management is adequate; however, this case was an exception due to worsening exam findings. Divers may be able to prevent this injury by frequent and gentle equilibration of mask pressure on descent.

  1. [Spontaneous retroperitoneal hematoma: a case report].

    PubMed

    Tosato, F; Palermo, S; Carnevale, L; Paolini, A

    2000-01-01

    The A.A. present a case report of retroperitoneal spontaneous hematoma and put in evidence the difficulties in making an etiopathogenetic diagnosis of spontaneous renal cyst rupture. The patient was a 72 years old man admitted to the hospital in emergency for a painful ipogastric syntomatology and biliary vomit. The ecography showed a distanced gallbladder and the endoscopy evidenced a duodenal stenosis with compression of the gastric posterior wall, so that we were initially directed towards a pancreatic tumor even if the modest increase of the serum bilirubinemy and mostly the fact that direct component was almost normal, gave us strong doubts. The spiral TC gave finally the diagnosis of retroperitoneal hematoma and the presence of a bilateral polycystic kidney with several subcapsular cyst, let us suggest, as well as the anamnestic report of a physical stress, a renal origin of the bleeding. A wild literature review did not evidence other similar cases, but the ecclusion of other possible causes of retroperitoneal hematoma, suggested this conclusion.

  2. Spontaneous intrathyroidal hematoma causing airway obstruction

    PubMed Central

    Best, Corliss A.E.; Dhaliwal, Sandeep; Tam, Samantha; Low, T. Hubert; Hughes, Brian; Fung, Kevin; MacNeil, S. Danielle

    2016-01-01

    Abstract Introduction: Spontaneous thyroid hemorrhage is a rare occurrence that results in pain, discomfort, and occasionally compressive symptoms. Infrequently, extensive thyroid hemorrhage can result in a rapidly expanding hematoma resulting in airway compromise. This is a case of an otherwise healthy young woman, 3 months postpartum, with a slowly expanding spontaneous thyroid hemorrhage that measured at 7 × 5.5 × 5 cm by computed tomography. She ultimately required intubation to manage respiratory distress and subsequently a hemithyroidectomy for definitive treatment. The case presentation is followed by a literature review where known etiologies of thyroid hematoma including traumatic and nontraumatic causes, precipitating anticoagulation, and spontaneous rupture of branches of the external carotid artery are outlined. The potential links to pregnancy are explored. The roles of bedside thyroid ultrasound in the emergency department and lateral neck roentgenogram in diagnosis are explored. The importance of airway management and indications for conservative versus surgical treatments are discussed. Conclusions: This is a case of a spontaneous intrathyroidal hemorrhage, which progressed over days to ultimately cause airway compromise. It is imperative that physicians are educated on the appropriate detection and management of the potentially life-threatening spontaneous thyroid hematoma. PMID:27583841

  3. Surgical treatment of supra- and infratentorial epidural hematoma.

    PubMed

    Xiaoyu, Wang; Guoping, Li

    2013-01-01

    Supra- and infratentorial acute epidural hematoma (SIEDH) is a common type of posterior fossa epidural hematoma (PFEDH), representing 11- 64% of all PFEDHs. Although SIEDH is associated with typical characteristics, it might be difficult to diagnose when presenting as infratentorial acute epidural hematoma, which is clinically silent and has nonspecific symptoms. However, this type of hematoma can often be rapidly deteriorating, causing a sharp rise in intracranial pressure that leads to a life-threatening foramen magnum herniation. Early diagnosis and management of SIEDH are imperative. Traditional surgical management has always required relatively large craniotomies, larger than the hematoma itself, to expose its edge, and then tack up the dura matter). It usually opens the window and emphasizes retention of the bone bridge outside the transverse sinus. This method can effectively eliminate the hematoma, but it is associated with larger postoperative wound, longer operation time, larger skull defect, and more complications. Hence, exploration into a better surgical method is direly needed.

  4. New observations in scintigraphy of subdural and extradural hematomas

    SciTech Connect

    Smoak, W.M.; Gilson, A.J.; Janowitz, W.; Zusmer, N.; Maturo, V.

    1980-11-01

    Static radionuclide images of subacute subdural hematomas demonstrate significant variations in findings over a 3-hr period in the same patient. The lesion can appear, disappear, and reconstitute in an entirely different pattern. This transformation has not appeared in extradural hematomas, and may provide a differential diagnostic sign. In patients with a clinical history or physical findings suspicious for these intracranial hematomas, immediate and sequential delayed static imaging is recommended.

  5. Idea on prevention from postoperative intraorbital hematoma in orbital surgery.

    PubMed

    Lee, D G

    2014-01-01

    The retrobulbar hematoma is a rare complication after orbital surgery. Despite of its rareness, the retrobulbar hematoma may be disastrous to the patient's vision (Chen et al. in J Craniofac Surg 20:963--967, 2009). Since 2007, I have applied the combined use of a scalp vein set and a vacuumed blood sampling bottle in all of the orbital surgeries. In my study, I achieved a good result, and I will introduce this simple method as one of alternatives for the prevention from the postoperative intraorbital hematoma including the retrobulbar hematoma. PMID:24533408

  6. A death due to perirenal hematoma complicating extracorporeal shockwave lithotripsy.

    PubMed

    Uemura, Koichi; Takahashi, Sayuri; Shintani-Ishida, Kaori; Nakajima, Makoto; Saka, Kanju; Yoshida, Ken-ichi

    2008-03-01

    Perirenal hematoma is an occasional complication of extracorporeal shockwave lithotripsy (ESWL) which does not usually require treatment. A 79-year-old woman died 23 h after ESWL. Forensic autopsy was performed to determine whether medical treatment contributed to her death. The cause of death was hemorrhagic shock due to massive hematoma from a ruptured small vein in the perirenal adipose capsule. No injury to other organs was found and the patient had neither coagulation abnormality nor venous disease. Perirenal hematoma can easily be diagnosed with abdominal sonography, if pain or symptoms of anemia develop. Doctors must be aware of the possibilities of severe renal hematomas after ESWL.

  7. Coronary Intramural Hematoma Presenting as Acute Coronary Syndrome.

    PubMed

    Shimada, Takenobu; Kadota, Kazushige; Kubo, Shunsuke; Habara, Seiji; Mitsudo, Kazuaki

    2016-01-01

    We herein report a case of intramural hematoma without ongoing myocardial ischemia that healed spontaneously with conservative treatment. A 37-year-old woman was admitted due to chest pain. Acute coronary syndrome was diagnosed by electrocardiography and echocardiography. Coronary angiography showed 90% stenosis in the distal portion of the left anterior descending coronary artery, where intravascular ultrasound showed a hematoma, but optical coherence tomography could not detect the entry point. Therefore, we identified the intramural hematoma as the etiology. Because the coronary flow was maintained and chest pain disappeared, we chose conservative treatment. Fifteen days after admission, coronary computed tomography showed an improvement in the intramural hematoma. PMID:27477409

  8. [Spontaneous spinal epidural hematoma during pregnancy: report of a case].

    PubMed

    Hack, I; Cademartori, M S; Mamani, R S; Beltrame, C M; Cademartori, C G

    1984-03-01

    A case of spontaneous dorso- lumbar spinal epidural hematoma during pregnancy is reported. The hematoma was removed 8 hours after the onset of paraplegia, and there was no evidence of vascular malformation. The motor deficit remained unchanged post-operatively. The etiology, clinical findings and the value of early laminectomy are discussed.

  9. Intracerebral hematoma extends via perivascular spaces and perineurium.

    PubMed

    Yin, Jia; Lü, Tian-Ming; Qiu, Guang; Huang, Rui-Yu; Fang, Min; Wang, Yuan-Yuan; Xiao, Duan; Liu, Xiao-Jia

    2013-01-01

    Intracerebral hemorrhage (ICH) is a devastating disorder associated with high morbidity and mortality. ICH results in the formation of hematoma that affects not only the primary site of injury but also the remote regions. In fact, hematoma can extend via perivascular spaces (also called Virchow-Robin spaces, VRS) and perineurium in an animal model of ICH. In the present study, we used magnetic resonance imaging (MRI) with susceptibility-weighted imaging (SWI) to investigate the characteristics of the perivascular and perineural extensions of hematomas in patients with ICH. A total of 20 ICH patients without secondary subarachnoid and secondary intraventricular hemorrhages were recruited. Brain MRI scans, including SWI, T1, and T2-weighted images, were performed between 17 h to 7 days after the onset of ICH. MRI with SWI revealed that paramagnetic substances spread along the VRS or the perineurium. Such distribution could cause the formation of cerebral microbleeds (CMBs). However, the distribution of remote hemorrhagic lesions varied, depending on the size and location of the original hematoma. The unenhanced CT scans of the 20 patients did not show any hyperdensity around the blood vessels and nerve tracts outside the hematoma. These results indicate the perivascular and perineural extensions of hematomas in patients with ICH, which is formed by the leakage of the original hematoma via the VRS or perineurium. We also provide a new explanation for the series of pathological processes involved in ICH, including the remote effects of hematoma and the formation of CMBs in patients with ICH. PMID:23812162

  10. Epidural Anesthesia Complicated by Subdural Hygromas and a Subdural Hematoma

    PubMed Central

    Marovic, Paul; Ingram, Brendan

    2016-01-01

    Inadvertent dural puncture during epidural anesthesia leads to intracranial hypotension, which if left unnoticed can cause life-threatening subdural hematomas or cerebellar tonsillar herniation. The highly variable presentation of intracranial hypotension hinders timely diagnosis and treatment. We present the case of a young laboring adult female, who developed subdural hygromas and a subdural hematoma following unintentional dural puncture during initiation of epidural anesthesia.

  11. Kernohan's notch phenomenon in chronic subdural hematoma: MRI findings.

    PubMed

    Moon, Kyung-Sub; Lee, Jung-Kil; Joo, Sung-Pil; Kim, Tae-Sun; Jung, Shin; Kim, Jae-Hyoo; Kim, Soo-Han; Kang, Sam-Suk

    2007-10-01

    We report two cases of Kernohan's notch phenomenon secondary to chronic subdural hematoma detected by MRI. In the first case, the patient was drowsy with an oculomotor palsy and a hemiparesis ipsilateral to the chronic subdural hematoma. MRI in the post-operative period showed no abnormal signal or deformity of the crus cerebri. The neurological signs immediately resolved after trephination. In the second case, the patient was admitted with progressive decrease in their level of consciousness and ipsilateral hemiparesis with the chronic subdural hematoma. MRI on admission revealed an abnormal signal in the contralateral crus cerebri against the chronic subdural hematoma. After surgery, the mental state gradually recovered to normal with some degree of residual hemiparesis. In patients with chronic subdural hematoma, a compressive deformity of the crus cerebri, without abnormal signal on MRI, may predict a better neurological recovery in patients with Kernohan's notch phenomenon.

  12. Recurrent subdural hematoma secondary to headbanging: A case report

    PubMed Central

    Jito, Junya; Nozaki, Kazuhiko

    2015-01-01

    Background: “Headbanging” is the slang term used to denote violent shaking of one's head in time with the music. This abrupt flexion-extension movement of the head to rock music extremely rarely causes a subdural hematoma. Case Description: A 24-year-old female was admitted to our department because of right sided partial seizure and acute or subacute subdural hematoma over the left cerebral convexity. She had no history of recent head trauma but performed headbanging at a punk rock concert at 3 days before admission. Since, she had a previous acute subdural hematoma on the same side after an accidental fall from a baby buggy when she was 11 months old, the present was recurrent subdural hematoma probably due to headbanging. Conclusions: Headbanging has the hazardous potential to cause a subdural hematoma. PMID:26664766

  13. Spontaneous subperiosteal hematoma precipitated by anxiety attack.

    PubMed

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

    2013-12-01

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

  14. Spontaneous subperiosteal hematoma precipitated by anxiety attack.

    PubMed

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

    2013-12-01

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

  15. Traumatic extradural hematoma of the cervical spine.

    PubMed

    Garza-Mercado, R

    1989-03-01

    An example of a traumatic extradural hematoma of the cervical spine that occurred in a 32-year-old man who suffered from chronic ankylosing spondylitis is reported. Progressive sensory and motor deficit ensued some 3 hours after the patient fell from a standing position. The patient landed on his back, striking his head on the floor. After being helped up, he was able to walk unassisted to a nearby chair, where he sat down until his left lower extremity--and shortly afterwards, the right one--became numb and weak. On admission, the patient was found to have tetraparesis that was more pronounced in the lower extremities and associated with incomplete sensation to pinprick at level T7-T10. He also had painless distention of the urinary bladder. After a few hours, the weakness in his limbs increased and his sensory level rose to C5 bilaterally. A horizontal diastatic fracture across the vertebral body of C7 was discovered on plain x-ray films of the spine, and an extradural hematoma extending dorsally from C5 to T1 was revealed by emergency magnetic resonance imaging. After an emergency decompressive cervical laminectomy and removal of the clot, the patient rapidly regained complete neurological function, except with regard to both the urinary bladder and the rectum, which remained abnormal for almost 7 weeks after the operation.

  16. Surgical Management of Aneurysmal Hematomas: Prognostic Factors and Outcome.

    PubMed

    Meneghelli, P; Cozzi, F; Hasanbelliu, A; Locatelli, F; Pasqualin, Alberto

    2016-01-01

    From 1991 until 2013, 304 patients with intracranial hematomas from aneurysmal rupture were managed surgically in our department, constituting 17 % of all patients with aneurysmal rupture. Of them, 242 patents presented with isolated intracerebral hematomas (in 69 cases associated with significant intraventricular hemorrhage), 50 patients presented with combined intracerebral and subdural hematomas (in 11 cases associated with significant intraventricular hemorrhage), and 12 presented with an isolated subdural hematoma. The surgical procedure consisted of simultaneous clipping of the aneurysm and evacuation of the hematoma in all cases. After surgery, 16 patients (5 %) submitted to an additional decompressive hemicraniectomy, and 66 patients (21 %) submitted to a ventriculo-peritoneal shunt. Clinical outcomes were assessed at discharge and at 6 months, using the modified Rankin Scale (mRS); a favorable outcome (mRS 0-2) was observed in 10 % of the cases at discharge, increasing to 31 % at 6 months; 6-month mortality was 40 %. Applying uni- and multivariate analysis, the following risk factors were associated with a significantly worse outcome: age >60; preoperative Hunt-Hess grades IV-V; pupillary mydriasis (only on univariate); midline shift >10 mm; hematoma volume >30 cc; and the presence of hemocephalus (i.e., packed intraventricular hemorrhage). Based on these results, an aggressive surgical treatment should be adopted for most cases with aneurysmal hematomas, excluding patients with bilateral mydriasis persisting after rescue therapy. PMID:27637622

  17. 21 CFR 882.1935 - Near Infrared (NIR) Brain Hematoma Detector.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Near Infrared (NIR) Brain Hematoma Detector. 882... Infrared (NIR) Brain Hematoma Detector. (a) Identification. A Near Infrared (NIR) Brain Hematoma Detector... evaluate suspected brain hematomas. (b) Classification. Class II (special controls). The special...

  18. 21 CFR 882.1935 - Near Infrared (NIR) Brain Hematoma Detector.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Near Infrared (NIR) Brain Hematoma Detector. 882... Infrared (NIR) Brain Hematoma Detector. (a) Identification. A Near Infrared (NIR) Brain Hematoma Detector... evaluate suspected brain hematomas. (b) Classification. Class II (special controls). The special...

  19. 21 CFR 882.1935 - Near Infrared (NIR) Brain Hematoma Detector.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Near Infrared (NIR) Brain Hematoma Detector. 882... Infrared (NIR) Brain Hematoma Detector. (a) Identification. A Near Infrared (NIR) Brain Hematoma Detector... evaluate suspected brain hematomas. (b) Classification. Class II (special controls). The special...

  20. Intra-Abdominal Hematoma Following Enoxaparin Injection.

    PubMed

    Chung, Kin Tong

    2016-01-01

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

  1. Intra-Abdominal Hematoma Following Enoxaparin Injection

    PubMed Central

    Chung, Kin Tong

    2016-01-01

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

  2. [Spontaneous hematoma of the atrial wall].

    PubMed

    Iglesias López, A; Rodríguez Pan, A; Pazos Silva, V

    2014-01-01

    The clinical signs of heart masses tend to be nonspecific, generally depending more on their repercussions on heart function caused by their location rather than on their type. Imaging techniques make it possible to limit the differential diagnosis of heart masses based on their location, morphology, and characteristics of echogenicity, density, or intensity, depending on the technique used to study them. We present the case of a woman with squeezing mid chest pain irradiating to her shoulder and positive cardiac markers in whom a left atrial mass was identified at echocardiography. This finding was confirmed at chest CT. The signs at chest CT were compatible with a mural hematoma and this diagnosis was confirmed after intraoperative biopsy.

  3. Epidural hematoma after minor oral trauma.

    PubMed

    Rice, J O; Walters, C; Olson, R E; Pearson, D

    1976-07-01

    A case report was presented in which a 15-year-old boy was beaten about the head with a baseball bat. Intraoral trauma and facial lacerations were repaired. Since results of the neurological examination were within normal limits, the patient was discharged. The next day, the patient became lethargic; however, the patient's mother did not bring the patient back to the hospital until the routine postoperative visit. At that time, the patient had right hemiparesis, was unable to speak, and was clearly obtunded. A carotid angiogram disclosed a left venous epidural hematoma in the parietal area. A craniotomy was performed with good results. The importance of follow-up neurologic examinations in cases of trauma to the face and head is stressed.

  4. Conservative Management of Left Atrial Intramural Hematoma after Catheter Ablation

    PubMed Central

    Oraii, Saeed; Roshanali, Farideh; Ghorbanisharif, Alireza; Mikaeili, Javad; Tahraei, Mahmood

    2016-01-01

    Left atrial intramural hematoma is a very rare complication of radiofrequency ablation procedures. A patient with tachyarrhythmia underwent radiofrequency catheter ablation. Echocardiography performed the following morning showed a large mass in the left atrium, suggestive of intramural hematoma formation. The patient was in a stable condition; therefore, it was decided that follow-up should be conservative and her anticoagulation therapy was continued. The size of the hematoma decreased significantly over the following 50 days. This case highlights a rare complication of a complex catheter ablation procedure in the left atrium that was managed via a noninvasive approach, with which all interventionists should be familiar. PMID:27482270

  5. Intramural esophagic hematoma secondary to coumarinic anticoagulation: a case report

    PubMed Central

    2009-01-01

    Esophagic Intramural Hematoma is an uncommon clinical condition, with a prognosis which is essentially benign. On most cases, a predisposing or precipitating factor may be seen, with the most common ones being the history of esophagic instrumentation, food impactations and thrombocytopenia. In the following manuscript, the authors present the case of a 54-years-old male with history of valve replacement surgery, who was treated at the Clinica Cardiovascular (Medellin, Colombia), with a clinical case of Intramural Esophagic Hematoma that was later confirmed to be due to a Coumarinic overanticoagulation. On this case, it is evidenced that Intramural Esophagic Hematoma is an unrecognized complication of Courmarinic anticoagulation therapy. PMID:20069068

  6. [Retroperitoneal hematoma secondary to traumatic rupture of the psoas muscle].

    PubMed

    Arrizabalaga, M; Benítez, J; Gallardo, C; Garrido, R; Casanueva, T

    1990-01-01

    Rupturing of the psoas muscle by closed injury as a result of the formation of a retroperitoneal hematoma is a very uncommon pathological entity, which may rise problems of differential diagnosis with kidney lesions. Supplementary explorations do not always clear up diagnostic doubts, and it is surgery, if indicated, that confirms the picture. We present a case of retroperitoneal hematoma of traumatic origin in a one-kidney ipsilateral patient, in whom the abdominal CAT revealed affection of the renal capsule associated with rupture of teh psoas. In the surgery carried out due to formation of an abscess in the hematoma we verified that the kidney was undamaged.

  7. Life-threatening paraspinal muscle hematoma after percutaneous vertebroplasty

    PubMed Central

    Jeon, Chang-Hoon; Chung, Nam-Su; Lee, Jae-Heon; Lee, Han-Dong

    2016-01-01

    Bleeding and hematoma formation is rarely reported in percutaneous vertebroplasty procedure. An 84 year old male presented with a large paraspinal muscle hematoma after a percutaneous vertebroplasty. The patient had neither any prior bleeding disorder nor any anticoagulant treatment. Vital signs of the patient were unstable, and his hemoglobin level decreased daily. After a month of conservative treatment, including transfusion, cryotherapy, pain control and bed rest, his hemoglobin level remained stable and he showed relief from pain. Four months later, hematoma resolved spontaneously and he could walk without back pain. PMID:27746502

  8. Dabigatran-related intracerebral hemorrhage resulting in hematoma expansion.

    PubMed

    Simonsen, Claus Z; Steiner, Thorsten; Tietze, Anna; Damgaard, Dorte

    2014-02-01

    Warfarin-related intracerebral hemorrhage carries a particularly high risk of neurologic deterioration and death because of a high rate of hematoma expansion of about 50%. Novel oral anticoagulants (NOACs)--apixaban, dabigatran, and rivaroxaban--have a significantly smaller risk of intracerebral hemorrhage (ICH). However, two facts make this situation complicated: First, the risk of hematoma expansion is unknown for NOACs. Second, there is no specific antidote for neither of the NOACs. We present a case that suggests that hematoma expansion may occur after NOAC-related ICH. PMID:24103671

  9. Spontaneous rectus sheath hematoma in a patient treated with apixaban.

    PubMed

    Aktas, Halil; Inci, Sinan; Dogan, Pinar; Izgu, Ibrahim

    2016-02-01

    Apixaban, a non-vitamin K antagonist oral anticoagulants, is a Factor Xa inhibitor that is prescribed for the treatment of non valvular atrial fibrillation. Rectus sheath hematoma is a rare but significant complication of oral anticoagulant treatment. The important causes of rectus sheath hematoma include treatment with anticoagulants, hematologic diseases, trauma, intense physical activity, coughing, sneezing and pregnancy. In this report, we describe case of a 71-year-old woman undergoing apixaban treatment for non valvular atrial fibrillation who presented with spontaneous rectus sheath hematoma. PMID:26989650

  10. Supraspinatus Intramuscular Calcified Hematoma or Necrosis Associated with Tendon Tear

    PubMed Central

    Lädermann, Alexandre; Genevay, Muriel; Abrassart, Sophie; Schwitzguébel, Adrien Jean-Pierre

    2015-01-01

    Introduction. Rotator cuff intramuscular calcification is a rare condition usually caused by heterotopic ossification and myositis ossificans. Case Presentation. We describe a patient with voluminous calcified mass entrapped in supraspinatus muscle associated with corresponding tendon tear. Histological examination corresponded to a calcified hematoma or necrosis. Patient was surgically managed with open excision of the calcified hematoma and rotator cuff arthroscopic repair. At 6 months, supraspinatus muscle was healed, and functional outcome was good. Discussion and Conclusion. We hypothesized that supraspinatus intramuscular calcified hematoma was responsible for mechanical stress on the tendon. This association has never been described. PMID:26380138

  11. Spontaneous retroperitoneal hemorrhage secondary to subcapsular renal hematoma: MRI findings.

    PubMed

    Balci, N C; Sirvanci, M; Tüfek, I; Onat, L; Duran, C

    2001-10-01

    Spontaneous retroperitoneal hemorrhage is a rare intraabdominal bleeding. In this report we present a case of a nontraumatic retroperitoneal hemorrhage secondary to spontaneous subcapsular renal hematoma. A 54-year-old patient who was under warfarin therapy, developed subcapsular right renal hematoma. Subcapsular and retroperitoneal hemorrhage were low signal on T1- and T2-weighted images consistent with acute stage of blood. The source of subcapsular hematoma was shown to be the rupture of hemorrhagic renal cyst on MRI. Extension of hemorrhage into the retroperitoneal space anterior to right psoas muscle was also successfully shown on MRI. Patient underwent nephrectomy and retroperitoneal blood was evacuated.

  12. [Roentgenographic aspects of subcapsular renal hematomas (author's transl)].

    PubMed

    Lemaitre, G; Villoutreix, H

    1975-03-01

    About four cases, the authors exhibit roentgenographic features of subcapsular hematomas. They particularly emphasize the interest of nephrotomography and angiography two provide the typical signs; i.e.: flattening of the lacteral border of the renal parenchyma, absence of acute edges between normal renal outline and flattened portion, and at last, displaced capsular artery and/or renal capsule itself. Between flattening of kidney and capsular artery or capsule, one may individualize a mass of soft tissue density, convex or biconvex, corresponding to the hematomas. Particular attention is required concerning differential diagnosis with renal cyst, and possibility of a small neoplasm, sometimes indetectable at angiography, as a cause of "spontaneous" subcapsular hematoma.

  13. [Treatment of subungual hematoma in office and outdoor conditions].

    PubMed

    Horn, Benedikt

    2015-01-01

    Treptising with an glowing spike or paperclip can be performed everywhere without local anesthesia and even by non-professionals. Evacuation of hematoma with a Insulin-Syringe/Needle in small nails (children, toe 2 - 5) is an interesting alternative.

  14. [An operated case of a meningioma causing acute subdural hematoma].

    PubMed

    Chonan, Masashi; Niizuma, Kuniyasu; Koyama, Shinya; Kon, Hiroyuki; Sannohe, Seiya; Kurotaki, Hidekachi; Midorikawa, Hiroshi; Sasaki, Tatsuya; Nishijima, Michiharu

    2013-03-01

    We report a rare case of a meningioma causing acute hematoma. A 67-year-old woman presented with sudden headache. No evidence of trauma was seen. CT demonstrated a subdural hematoma in the convexity of the fronto-temporal lobe. Magnetic resonance imaging showed marked signal heterogeneity in the convexity of the frontal lobe. One week later, the patient underwent hematoma evacuation and tumor resection including the attached dura mater. The histological diagnosis was meningothelial meningioma. The clot was connected directly to the tumor and the origin of the subdural hematoma was identified as the meningioma. Postoperative course was uneventful, and the headache improved. Meningiomas have a relatively benign course but rarely present with hemorrhage. Surgical exploration is the effective and recommended treatment.

  15. Hand-held instrument should relieve hematoma pressure

    NASA Technical Reports Server (NTRS)

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

    1967-01-01

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

  16. Epidural Anesthesia Complicated by Subdural Hygromas and a Subdural Hematoma.

    PubMed

    Vien, Christine; Marovic, Paul; Ingram, Brendan

    2016-01-01

    Inadvertent dural puncture during epidural anesthesia leads to intracranial hypotension, which if left unnoticed can cause life-threatening subdural hematomas or cerebellar tonsillar herniation. The highly variable presentation of intracranial hypotension hinders timely diagnosis and treatment. We present the case of a young laboring adult female, who developed subdural hygromas and a subdural hematoma following unintentional dural puncture during initiation of epidural anesthesia. PMID:27651956

  17. Epidural Anesthesia Complicated by Subdural Hygromas and a Subdural Hematoma

    PubMed Central

    Marovic, Paul; Ingram, Brendan

    2016-01-01

    Inadvertent dural puncture during epidural anesthesia leads to intracranial hypotension, which if left unnoticed can cause life-threatening subdural hematomas or cerebellar tonsillar herniation. The highly variable presentation of intracranial hypotension hinders timely diagnosis and treatment. We present the case of a young laboring adult female, who developed subdural hygromas and a subdural hematoma following unintentional dural puncture during initiation of epidural anesthesia. PMID:27651956

  18. [Cervicodorsal subdural hematoma caused by coumarinic rodenticide poisoning].

    PubMed

    Nighoghossian, N; Ruel, J H; Ffrench, P; Froment, J C; Trouillas, P

    1990-01-01

    A 59-year old man developed subacute tetraparesis following severe sudden neck pain. MRI showed a subdural cervical hematoma. Prothrombin complex activity was low. An unusual coagulopathy after rodenticides exposure was found. Diphenacoum, an effective antagonist of vitamin K1, was present in the patients plasma. Specific medical management led to a complete recovery. Follow-up MRI seventy days later confirmed the complete disappearance of the hematoma. PMID:2330467

  19. [Subcapsular hematoma of the liver after extracorporeal shock wave lithotripsy].

    PubMed

    Kobayashi, K; Ishizuka, E; Iwasaki, A; Saito, R

    1998-03-01

    We experienced a case of a hepatic subcapsular hematoma after extracorporeal shock wave lithotripsy (ESWL) for a right renal stone. To our knowledge this presentation is the second case in the Japanese literature. A 63-year-old female with a right renal stone received 2,800 shots of 14.0 kilo-volts shockwave with Sonolith 3,000. Preoperative examination of the blood disclosed no abnormalities in the coagulating system except slight reduction of platelet count and slight impairment of liver function. Postoperative routine ultrasound echograms revealed a hepatic subcapsular hematoma although she had no symptom. The size of the hematoma measured 11.0 x 5.0 cm in computed tomograms (CT). She was carefully observed without any treatments because the hematoma did not increase in size. CT scans 6 months after the ESWL treatment demonstrated neither hematoma nor masses in the liver. As a complication of ESWL for urolithiasis a hepatic subcapsular hematoma is very rare. We herein presented the case and discussed the complications of ESWL briefly in the literature.

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

    PubMed

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

    2015-01-01

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

  1. A tale of two acute extradural hematomas

    PubMed Central

    Adeleye, Amos Olufemi; Jite, Ikechi E.; Smith, Omolara A.

    2016-01-01

    Background: In much of the Western hemisphere, mortality from traumatic acute extradural hematomas (AEDH) has been drastically brought down toward 0%. This is still not the case however in most developing countries. Case Description: This report represents a tragi-comic tale of two cases of traumatic AEDH managed by an academic neurosurgeon in a neurosurgically ill-resourced private health facility during a nationwide industrial strike action preventing clinical-surgical care in the principal author's University Teaching Hospital. A young man presented with altered consciousness, Glasgow Coma Score (GCS) 14/15, following a road accident. The cranial computed tomography (CT) scan was obtained only 9 h after its request, long after the man had actually deteriorated to GCS 7/15 with pupillary changes. The neurosurgeon, summoned from the nearby University Teaching Hospital for the operative care of this man, arrived on-site and was about moving the patient into the operative room when he took the final breaths and died, all within 2 h of the belated neuroimaging. This scenario repeated itself in the same health facility just 24 h later with another young man who presented GCS 7/15 and another identical CT evidence of traumatic AEDH. With more financially able relations, the diagnostic/surgical care of this second patient was much more prompt. He made a very brisk recovery from neurosurgical operative intervention. He is alive and well, 5-month postoperative. Conclusions: In most low-resourced health systems of the developing countries, a significant proportion of potentially salvageable cases of AEDH still perish from this disease condition. PMID:27213108

  2. A case of right renal infarction and subcapsular hematoma that simultaneously developed after cardiac angiography.

    PubMed

    Kwon, S H; Cho, H C; Lee, S W; Kim, D Y; Joo, W C; Lee, W H; Song, J H; Kim, M-J

    2009-01-01

    Of the several complications known to develop after cardiac catheterization, simultaneous acute renal infarction and renal subcapsular hematoma is rare. Here, the authors report a case of acute renal infarction with subcapsular hematoma that developed 4 hours after cardiac catheterization.

  3. Postoperative chronic subdural hematoma following craniotomy--four case reports.

    PubMed

    Takahashi, Y; Ohkura, A; Sugita, Y; Sugita, S; Miyagi, J; Shigemori, M

    1995-02-01

    Postoperative chronic subdural hematoma (CSH) following craniotomy developed in only four of 372 patients undergoing craniotomy for aneurysm surgery (1 patient) and brain tumor surgery (3 patients) between April, 1991 and November, 1993, an incidence of only 1.1%. There were three males and one female, aged from 32 to 66 years (mean 56 yrs). The period between craniotomy and development of CSH ranged from 3 to 5 months (mean 4.3 mos). Postoperative hematomas were located on the operative sides in three patients and the contralateral side in the other. Early postoperative computed tomographic scans found subdural fluid collection in all patients. Magnetic resonance images showed linear meningeal enhancement in all patients. Postoperative CSH may be caused by mixture of blood in subdural cerebrospinal fluid collection which persists due to reduced brain elasticity and wide subarachnoid membrane opening resulting in neomembrane formation and finally development of hematoma. PMID:7753312

  4. [Qualitative histological diagnostics of the remoteness of traumatic subdural hematomas].

    PubMed

    Nedugov, G V

    2011-01-01

    The present histological study was based on the examination of dura mater, capsules, and contents of 200 subdural hematomas (SDH) obtained from the corpses of subjects with a non-penetrating craniocerebral injury within a period from 1 hour to 2.5 years after the trauma. A total of 14 well-reproducible qualitative morphological criteria have been identified for diagnostics of the prescription of subdural hematomas; the probability and the exact earliest and latest times of their manifestation at different dates of the posttraumatic period were calculated. Sensitivity, specificity, and prognostic value of the proposed qualitative morphological criteria for the prescription of traumatic subdural hematomas were evaluated. The results of the study can be used in the practical work of forensic medical experts.

  5. Mesenteric Hematoma: Is there a Role for Selective Management?

    PubMed

    Corzo, Camila; Murdock, Alan; Alarcon, Louis; Puyana, Juan C

    2016-04-01

    Mesenteric hematomas may present as a radiologic finding after blunt abdominal trauma that may be associated with surgically significant mesenteric and/or bowel injury. The question of whether to operate or not to operate on patients with mesenteric hematoma remains a topic of debate, especially with the improved imaging technology. This study sought to identify clinical and radiological characteristics for patient selection for operative management (OM) of mesenteric hematoma. A retrospective review of 33 adults with blunt abdominal trauma and mesenteric hematoma on CT scan (2009-2012) was performed. Patients with other intra-abdominal injuries, penetrating trauma, isolated gastric hematoma, contrast extravasation, extraluminal air, and Glasgow Coma Scale < 14 were excluded. Patients requiring surgical treatment within 24 hours of admission were compared with those who did not using chi-squared test, Fisher's exact test, and t test. Parameters included age, gender, race, Glasgow Coma Scale, vital signs, pain, tenderness, ecchymosis, Injury Severity Score, length of stay, and inhospital mortality. Logistic regression was used to determine positive associations with OM. Of the 33 patients, 19 underwent OM and 14 did not. Both groups were similar at baseline. Regression analysis revealed association for pain [odds ratio (OR) = 9.6, confidence interval (CI) = 1.8-49.9, P < 0.01], tenderness (OR = 32, CI = 4.6-222.2, P < 0.01), and free fluid (OR = 10.3, CI = 1.8-60, P < 0.01) with need for operative intervention. Nonoperative management patients had 100 per cent success rate. Of the OM patients, 100 per cent underwent therapeutic laparotomies. Findings of mesenteric hematoma on CT scan in examinable patients with no abdominal pain, tenderness, or free fluid predict successful nonoperative management.

  6. Enlarged cerebrospinal fluid spaces in infants with subdural hematomas

    SciTech Connect

    Kapila, A.; Trice, J.; Spies, W.G.; Siegel, B.A.; Gado, M.H.

    1982-03-01

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

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

    PubMed Central

    Calhan, Turan; Kahraman, Resul; Soydaş, Barış; Tosun, Ali; Cebeci, Egemen

    2015-01-01

    Duodenal intramural hematoma (DIH) usually occurs in childhood and young adults following blunt abdominal trauma. It may also develop in the presence of coagulation disorders and may rarely be an iatrogenic outcome of endoscopic procedures. Management of DIH is usually a conservative approach. A case of intramural duodenal hematoma that developed following endoscopic epinephrine sclerotherapy and/or argon plasma coagulation and that was nonresponsive to conservative therapy in a patient with chronic renal failure who died from sepsis is being discussed in this report. Clinicians should be aware of such possible complications after endoscopic hemostasis in patients with coagulation disorders. PMID:26697240

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

    PubMed

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

    2015-12-01

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

  9. Traumatic bilateral basal ganglia hematoma: A report of two cases

    PubMed Central

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

    2012-01-01

    Traumatic Basal ganglia hemorrhage is relatively uncommon. Bilateral basal ganglia hematoma after trauma is extremely rare and is limited to case reports. We report two cases of traumatic bilateral basal ganglia hemorrhage, and review the literature in brief. Both cases were managed conservatively. PMID:23293672

  10. Delayed Acute Subdural Hematoma Associated With Percutaneous Coronary Intervention

    PubMed Central

    Arai, Nobuhiko; Nakamura, Akiyoshi; Tabuse, Masanao; Miyazaki, Hiromichi

    2016-01-01

    Background: Delayed acute subdural hematoma (DASH) is a subdural hematoma which is detected later. An initial computed tomography (CT) does not reveal any intracranial hemorrhage at all. Few patients of DASH after mild traumatic brain injury associated with percutaneous coronary intervention (PCI) have been published. Patient Presentation: A 63-year-old woman presented with cardiac pulmonary arrest due to acute myocardial infarction and lethal arrhythmia. She had hit her head on the road. The initial CT did not reveal any hemorrhage in the intra-cranium. She fully recovered after PCI. However, 1 hour after PCI, she lost consciousness and immediate CT showed acute subdural hematoma and subarachnoid hemorrhage. The period from losing consciousness to brain herniation presenting as anisocoria was very short—only 30 minutes in our patient. Although emergent evacuation of hematoma and external decompression were performed, the patient died 1 day after the operation. Conclusion: The authors encountered a patient of DASH after PCI that resulted in death. Clinicians should be aware that subdural hemorrhage can occur after PCI if no hemorrhage is noted in the initial head CT, and the operation should be performed as soon as possible when the consciousness level decreases. PMID:27526240

  11. [MRI semiotics features of experimental acute intracerebral hematomas].

    PubMed

    Burenchev, D V; Skvortsova, V I; Tvorogova, T V; Guseva, O I; Gubskiĭ, L V; Kupriianov, D A; Pirogov, Iu A

    2009-01-01

    The aim of this study was to assess the possibility of revealing intracerebral hematomas (ICH), using MRI, within the first hours after onset and to determine their MRI semiotics features. Thirty animals with experimental ICH were studied. A method of two-stage introduction of autologous blood was used to develop ICH as human spontaneous intracranial hematomas. Within 3-5h after blood introduction to the rat brain. The control MRI was performed in the 3rd and 7th days after blood injections. ICH were definitely identified in the first MRI scans. The MRI semiotics features of acute ICH and their transformations were assessed. The high sensitivity of MRI to ICH as well as the uniform manifestations in all animals were shown. In conclusion, the method has high specificity for acute ICH detection.

  12. [A Case of Spinal Epidural Hematoma Presenting with Transient Hemiplegia].

    PubMed

    Komai, Takanori; Nakashima, Kazuya; Tominaga, Takashi; Nogaki, Hidekazu

    2016-04-01

    We report a rare case of a patient with spinal epidural hematoma who presented with transient hemiplegia. A 90-year-old man awakened from sleep due to sudden neck pain. Fifteen minutes later, the man experienced progressively worsening weakness in his left hand, and was transported in an ambulance to our hospital. At the hospital, he presented with hemiplegia, and we suspected intracranial disease. Therefore, we performed magnetic resonance imaging (MRI), which revealed no intracranial lesions. Shortly after the MRI, the patient showed no signs of hemiplegia. However, since the severe neck pain persisted, we performed cervical MRI, which showed a high-intensity area at the C2-C5 level, predominantly on the left side. Despite recovery from hemiplegia, we performed a laminectomy of C3-C5 with evacuation of a hematoma at the C2-C6 level. After the surgery, the patient had no neck pain. PMID:27056873

  13. Intracranial subdural empyema mimicking a recurrent chronic subdural hematoma

    PubMed Central

    Doan, Ninh; Patel, Mohit; Nguyen, Ha Son; Mountoure, Andrew; Shabani, Saman; Gelsomino, Michael; Janich, Karl; Kurpad, Shekar

    2016-01-01

    Intracranial subdural empyema (ISDE) is a life-threatening condition. The risk for ISDE increases in patients that have undergone prior intracranial procedures. The non-specificity in its clinical presentation often makes ISDE difficult to diagnose. Here, we present a rare case of ISDE mimicking a recurrent chronic subdural hematoma, emphasizing the significance of obtaining early magnetic resonance images of the brain for early diagnosis and treatment to achieve the optimal outcome. PMID:27651110

  14. Congenital afibrinogenemia: a case report of a spontaneous hepatic hematoma

    PubMed Central

    Malaquin, Stephanie; Rebibo, Lionel; Chivot, Cyril; Badoux, Louise; Mahjoub, Yazine; Dupont, Herve

    2016-01-01

    Abstract Introduction: Afibrinogenemia is a rare coagulation disorder. Clinical features of spontaneous bleeding, bleeding after minor trauma, or after surgery have been described as well as thrombo-embolic complications. In this article, we presented the case of a 19-year old female with congenital afibrinogenemia who was admitted with a spontaneous intrahepatic hematoma. Conclusions: Supportive treatment including transfusion and fibrinogen administration, associated with repeated packing surgeries and selective embolization, were successfully performed. PMID:27428204

  15. Are acute subdural hematomas possible without head trauma?

    PubMed Central

    Garbossa, D.; Altieri, R.; Specchia, F. M. Calamo; Agnoletti, A.; Pilloni, G.; Lanotte, M.; Spaziante, R.; Ducati, A.

    2014-01-01

    Acute subdural hematomas (ASDHs) are rarely reported in the literature. In general, it is due to head trauma, but if the traumatic event is very mild, it is inadequate to explain the ASDH occurrence. Risk factors for the development of spontaneous ASDH include hypertension, vascular abnormalities and deficit of coagulation. We present two cases of ASDH in patients with the coagulation deficit and review of the literature to understand the coagulation factors role and platelet role in the management of ASDHs. PMID:25685219

  16. Are acute subdural hematomas possible without head trauma?

    PubMed

    Garbossa, D; Altieri, R; Specchia, F M Calamo; Agnoletti, A; Pilloni, G; Lanotte, M; Spaziante, R; Ducati, A

    2014-01-01

    Acute subdural hematomas (ASDHs) are rarely reported in the literature. In general, it is due to head trauma, but if the traumatic event is very mild, it is inadequate to explain the ASDH occurrence. Risk factors for the development of spontaneous ASDH include hypertension, vascular abnormalities and deficit of coagulation. We present two cases of ASDH in patients with the coagulation deficit and review of the literature to understand the coagulation factors role and platelet role in the management of ASDHs.

  17. Intracranial subdural empyema mimicking a recurrent chronic subdural hematoma.

    PubMed

    Doan, Ninh; Patel, Mohit; Nguyen, Ha Son; Mountoure, Andrew; Shabani, Saman; Gelsomino, Michael; Janich, Karl; Kurpad, Shekar

    2016-01-01

    Intracranial subdural empyema (ISDE) is a life-threatening condition. The risk for ISDE increases in patients that have undergone prior intracranial procedures. The non-specificity in its clinical presentation often makes ISDE difficult to diagnose. Here, we present a rare case of ISDE mimicking a recurrent chronic subdural hematoma, emphasizing the significance of obtaining early magnetic resonance images of the brain for early diagnosis and treatment to achieve the optimal outcome. PMID:27651110

  18. Subdural Hematoma as a Consequence of Epidural Anesthesia

    PubMed Central

    Bishop, Tracy M.; Elsayed, Kareem S.; Kane, Kathleen E.

    2015-01-01

    Regional spinal and epidural anesthesia are used commonly in operative procedures. While the most frequent complication, postdural puncture headache (PDPH), is a clinically diagnosed positional headache that is usually self-limited, subdural hemorrhage (SDH) is a potentially fatal complication that cannot be missed. We report a case of an otherwise healthy female who presented with persistent positional headache and was ultimately found to have a large subdural hematoma with midline shift requiring surgical evacuation. PMID:26697237

  19. Intracranial subdural empyema mimicking a recurrent chronic subdural hematoma

    PubMed Central

    Doan, Ninh; Patel, Mohit; Nguyen, Ha Son; Mountoure, Andrew; Shabani, Saman; Gelsomino, Michael; Janich, Karl; Kurpad, Shekar

    2016-01-01

    Intracranial subdural empyema (ISDE) is a life-threatening condition. The risk for ISDE increases in patients that have undergone prior intracranial procedures. The non-specificity in its clinical presentation often makes ISDE difficult to diagnose. Here, we present a rare case of ISDE mimicking a recurrent chronic subdural hematoma, emphasizing the significance of obtaining early magnetic resonance images of the brain for early diagnosis and treatment to achieve the optimal outcome.

  20. Chronic Subdural Hematoma in the Aged, Trauma or Degeneration?

    PubMed Central

    2016-01-01

    Chronic subdural hematomas (CSHs) are generally regarded to be a traumatic lesion. It was regarded as a stroke in 17th century, an inflammatory disease in 19th century. From 20th century, it became a traumatic lesion. CSH frequently occur after a trauma, however, it cannot occur when there is no enough subdural space even after a severe head injury. CSH may occur without trauma, when there is sufficient subdural space. The author tried to investigate trends in the causation of CSH. By a review of literature, the author suggested a different view on the causation of CSH. CSH usually originated from either a subdural hygroma or an acute subdural hematoma. Development of CSH starts from the separation of the dural border cell (DBC) layer, which induces proliferation of DBCs with production of neomembrane. Capillaries will follow along the neomembrane. Hemorrhage would occur into the subdural fluid either by tearing of bridge veins or repeated microhemorrhage from the neomembrane. That is the mechanism of hematoma enlargement. Trauma or bleeding tendency may precipitate development of CSH, however, it cannot lead CSH, if there is no sufficient subdural space. The key determinant for development of CSH is a sufficient subdural space, in other words, brain atrophy. The most common and universal cause of brain atrophy is the aging. Modifying Virchow's description, CSH is sometimes traumatic, but most often caused by degeneration of the brain. Now, it is reasonable that degeneration of brain might play pivotal role in development of CSH in the aged persons. PMID:26885279

  1. Chronic expanding hematoma with bronchopleural fistula and empyema space.

    PubMed

    Tsubochi, Hiroyoshi; Sato, Nobuyuki; Imai, Tadashi

    2009-06-01

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

  2. Delayed intracranial hematoma following stereoelectroencephalography for intractable epilepsy: case report.

    PubMed

    Derrey, Stéphane; Lebas, Axel; Parain, Dominique; Baray, Marie Gilles; Marguet, Christophe; Freger, Pierre; Proust, François

    2012-12-01

    Intracranial bleeding following stereoelectroencephalography (sEEG) is rare and commonly occurs early after electrode implantation. The authors report the case of a delayed intracranial hematoma following sEEG. This 10-year-old boy was referred to the authors' department to undergo an sEEG study for intractable epilepsy, with the hypothesis of a single localized epileptic zone in the left precentral region. To perform the exploration, 14 depth electrodes were implanted under stereotactic conditions. The results of a postoperative CT scan performed routinely at the end of the surgical procedure were normal. Eight days later, following an epileptic seizure, the child's condition worsened. The neurological examination revealed a left hemiparesis, agitation, and coma due to a right subdural hematoma with intraparenchymal bleeding. Despite a surgical evacuation followed by a decompressive craniectomy, the curative treatments were stopped 1 week later due to severe diffuse ischemic lesions found on MRI studies. This is the first observation of a delayed hematoma following an sEEG procedure. The mechanism underlying this complication remains unclear, but the rupture of a growing pseudoaneurysm caused by the electrode's implantation or the tearing of a neighboring vessel by an electrode were suspected. In consequence, physicians must remain vigilant during the entire sEEG recording period and probably also several days after electrode removal.

  3. Traumatic tentorial hematoma in two-wheeler riders: Correlation with helmet use

    PubMed Central

    Agrawal, Deepak; Dawar, Pankaj

    2016-01-01

    Background: Tentorial hematoma is frequently seen in traumatic brain injury (TBI) patients, especially in motorized two-wheeler riders following head injury. However its relevance and prognostic significance are not known. Objective: To evaluate patients of TBI with tentorial hematoma using a simple grading system and attempt to correlate this grading with factors like helmet use and neurological outcome. Materials and Methods: This prospective study over a 1-year period included patients with TBI who had tentorial hematoma in the initial plain head. Patients were divided into three grades based on the initial CT findings: Grade I: Isolated tentorial hematoma, grade II: tentorial hematoma with midline shift but open cisterns and grade III: Tentorial hematoma with effaced cisterns. Clinical and radiological records of patients including admission GCS and GOS at discharge were assessed in all cases. Observations: A total of 1786 patients of TBI were admitted during the study period. Of these, 106 (5.9%) patients had tentorial hematoma. 84.9% (n = 90) were male and 15.1% (n = 16) were female with the mean age being 36.5 years (range 2-66 years). The mean admission GCS was 13, 11 and 8 in patients with grade I, II and III tentorial hematoma respectively. 43.4% (n = 46) of the patients had grade I, 32.1% (n = 34) had grade II and 24.5% (n = 26) patients had grade III tentorial hematoma. Seventy-one patients (84.5%) were riding motorized two wheelers with 63 (89%) wearing helmets. The majority of the patients wearing helmets (58.8%) had grade I hematoma with 35% (n = 22) having grade II hematoma and only 6.3% (n = 4) having grade III hematoma. Overall, there were 20 deaths. 50% (n = 10) of the deaths were in patients with grade III hematoma and 40% (n = 8) of the deaths were in patients with grade II hematoma. There were two (10%) deaths in patients with grade I hematoma (both unrelated to head injury). The mean GOS at the time of discharge was 5, 4.1 and 2.2 in patients

  4. Traumatic tentorial hematoma in two-wheeler riders: Correlation with helmet use

    PubMed Central

    Agrawal, Deepak; Dawar, Pankaj

    2016-01-01

    Background: Tentorial hematoma is frequently seen in traumatic brain injury (TBI) patients, especially in motorized two-wheeler riders following head injury. However its relevance and prognostic significance are not known. Objective: To evaluate patients of TBI with tentorial hematoma using a simple grading system and attempt to correlate this grading with factors like helmet use and neurological outcome. Materials and Methods: This prospective study over a 1-year period included patients with TBI who had tentorial hematoma in the initial plain head. Patients were divided into three grades based on the initial CT findings: Grade I: Isolated tentorial hematoma, grade II: tentorial hematoma with midline shift but open cisterns and grade III: Tentorial hematoma with effaced cisterns. Clinical and radiological records of patients including admission GCS and GOS at discharge were assessed in all cases. Observations: A total of 1786 patients of TBI were admitted during the study period. Of these, 106 (5.9%) patients had tentorial hematoma. 84.9% (n = 90) were male and 15.1% (n = 16) were female with the mean age being 36.5 years (range 2-66 years). The mean admission GCS was 13, 11 and 8 in patients with grade I, II and III tentorial hematoma respectively. 43.4% (n = 46) of the patients had grade I, 32.1% (n = 34) had grade II and 24.5% (n = 26) patients had grade III tentorial hematoma. Seventy-one patients (84.5%) were riding motorized two wheelers with 63 (89%) wearing helmets. The majority of the patients wearing helmets (58.8%) had grade I hematoma with 35% (n = 22) having grade II hematoma and only 6.3% (n = 4) having grade III hematoma. Overall, there were 20 deaths. 50% (n = 10) of the deaths were in patients with grade III hematoma and 40% (n = 8) of the deaths were in patients with grade II hematoma. There were two (10%) deaths in patients with grade I hematoma (both unrelated to head injury). The mean GOS at the time of discharge was 5, 4.1 and 2.2 in patients

  5. [Acute epidural hematoma with extravasation on cerebral angiogram in an infant (author's transl)].

    PubMed

    Oseki, J; Oana, K; Kobayashi, T; Kawada, Y; Kanaya, H

    1977-03-01

    The authors recently operated on a boy four years of age with acute epidural hematoma showing an extravasation on the cerebral angiogram. The hematoma (hematoma volume 125 ml) was evacuated 7 hours after the head injury. The postoperative course was quite uneventful, and he was discharged a month after surgery without any neurologic deficits. The authors reviewed the literature and found 4 cases of acute epidural hematoma with extravasations in infants and children. In all cases the operative results were good. The age incidence and frequency of occurence overall for acute epidural hematomas, extravasations on cerebral angiograms and their mechanism, and the length of time from injury to operation were also discussed. It should be emphasized that, for acute epidural hematoma in infants and children, the early diagnosis and early surgery are essential to save the patients.

  6. Delayed chronic intracranial subdural hematoma complicating resection of a tanycytic thoracic ependymoma

    PubMed Central

    Maugeri, Rosario; Giugno, Antonella; Graziano, Francesca; Visocchi, Massimiliano; Giller, Cole; Iacopino, Domenico Gerardo

    2016-01-01

    Background: To demonstrate that the diagnosis of an intracranial subdural hematoma should be considered for patients presenting with acute or delayed symptoms of intracranial pathology following resection of a spinal tumor. Case Description: We present a case of a 57-year-old woman found to have a chronic subdural hematoma 1 month following resection of a thoracic extramedullary ependymoma. Evacuation of the hematoma through a burr hole relieved the presenting symptoms and signs. Resolution of the hematoma was confirmed with a computed tomography (CT) scan. Conclusion: Headache and other symptoms not referable to spinal pathology should be regarded as a warning sign of an intracranial subdural hematoma, and a CT scan of the head should be obtained. The mechanism of the development of the hematoma may be related to the leakage of cerebrospinal fluid with subsequent intracranial hypotension leading to an expanding subdural space and hemorrhage. PMID:26862454

  7. Subcapsular hematoma due to ESWL: risk factors. A study of 4,247 patients.

    PubMed

    Kostakopoulos, A; Stavropoulos, N J; Macrychoritis, C; Deliveliotis, C; Antonopoulos, K P; Picramenos, D

    1995-01-01

    A study of 4,247 shockwave lithotripsy treatment was performed to identify and analyze the risk factors for the development of post-extracorporeal shock-wave lithotropsy hematomas. The Dornier HM-3 and HM-4 lithotriptors were used. We recognized 23 hematomas in 23 patients (0.54%). Various factors were examined to identify the certain predisposing risk factors. There was no correlation of sex, age, stone number, stone size, stone location, number of shock waves and voltage used with the occurrence rate of hematoma. We found that patients with pre-existing hypertension and especially those with poor control of it had a significantly increased incidence of perinephric hematoma.

  8. Absorption fever characteristics due to percutaneous renal biopsy-related hematoma.

    PubMed

    Hu, Tingyang; Liu, Qingquan; Xu, Qin; Liu, Hui; Feng, Yan; Qiu, Wenhui; Huang, Fei; Lv, Yongman

    2016-09-01

    This study aims to describe the unique characteristics of absorption fever in patients with a hematoma after percutaneous renal biopsy (PRB) and distinguish it from secondary infection of hematoma.We retrospectively studied 2639 percutaneous renal biopsies of native kidneys. We compared the clinical characteristics between 2 groups: complication group (gross hematuria and/or perirenal hematoma) and no complication group. The axillary temperature of patients with a hematoma who presented with fever was measured at 06:00, 10:00, 14:00, and 18:00. The onset and duration of fever and the highest body temperature were recorded. Thereafter, we described the time distribution of absorption fever and obtained the curve of fever pattern.Of 2639 patients, PRB complications were observed in 154 (5.8%) patients. Perirenal hematoma was the most common complication, which occurred in 118 (4.5%) of biopsies, including 74 small hematoma cases (thickness ≤3 cm) and 44 large hematoma cases (thickness >3 cm). Major complications were observed in only 6 (0.2%) cases resulting from a large hematoma. Of 118 patients with a perirenal hematoma, absorption fever was observed in 48 cases. Furthermore, large hematomas had a 5.23-fold higher risk for absorption fever than the small ones.Blood pressure, renal insufficiency, and prothrombin time could be risk factors for complications. Fever is common in patients with hematoma because of renal biopsy and is usually noninfectious. Evaluation of patients with post-biopsy fever is necessary to identify any obvious infection sources. If no focus is identified, empiric antibiotic therapy should not be initiated nor should prophylactic antibiotics be extended for prolonged durations. Absorption fevers will resolve in time without specific therapeutic interventions.

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

    NASA Astrophysics Data System (ADS)

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

    2014-03-01

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

  10. Absorption fever characteristics due to percutaneous renal biopsy-related hematoma.

    PubMed

    Hu, Tingyang; Liu, Qingquan; Xu, Qin; Liu, Hui; Feng, Yan; Qiu, Wenhui; Huang, Fei; Lv, Yongman

    2016-09-01

    This study aims to describe the unique characteristics of absorption fever in patients with a hematoma after percutaneous renal biopsy (PRB) and distinguish it from secondary infection of hematoma.We retrospectively studied 2639 percutaneous renal biopsies of native kidneys. We compared the clinical characteristics between 2 groups: complication group (gross hematuria and/or perirenal hematoma) and no complication group. The axillary temperature of patients with a hematoma who presented with fever was measured at 06:00, 10:00, 14:00, and 18:00. The onset and duration of fever and the highest body temperature were recorded. Thereafter, we described the time distribution of absorption fever and obtained the curve of fever pattern.Of 2639 patients, PRB complications were observed in 154 (5.8%) patients. Perirenal hematoma was the most common complication, which occurred in 118 (4.5%) of biopsies, including 74 small hematoma cases (thickness ≤3 cm) and 44 large hematoma cases (thickness >3 cm). Major complications were observed in only 6 (0.2%) cases resulting from a large hematoma. Of 118 patients with a perirenal hematoma, absorption fever was observed in 48 cases. Furthermore, large hematomas had a 5.23-fold higher risk for absorption fever than the small ones.Blood pressure, renal insufficiency, and prothrombin time could be risk factors for complications. Fever is common in patients with hematoma because of renal biopsy and is usually noninfectious. Evaluation of patients with post-biopsy fever is necessary to identify any obvious infection sources. If no focus is identified, empiric antibiotic therapy should not be initiated nor should prophylactic antibiotics be extended for prolonged durations. Absorption fevers will resolve in time without specific therapeutic interventions. PMID:27631225

  11. Late onset of subdural hematoma after bifrontal contusion

    PubMed Central

    Gürer, Bora; Kertmen, Hayri; Dolgun, Habibullah; Sekerci, Zeki

    2016-01-01

    Cerebral cortical contusions are one of the most common computed tomography findings in head-injured patients and common sequel of traumatic brain injury. These contusions tend to show a progressive increase in mass effect on repeated imaging, most small contusions do not require surgical evacuation. However, progression to subdural hematoma (SDH) in a late aspect is unique. Here we present a 71-year-old man with bifrontal contusion, who deteriorated 43 days after initial trauma with sudden onset of acute SDH. This unusual case suggests that neurosurgeons should be alert for the possibility of very late onset of acute SDH after bifrontal contusions.

  12. Cortical membranectomy in chronic subdural hematoma: Report of two cases

    PubMed Central

    Altinel, Faruk; Altin, Cihan; Gezmis, Esin; Altinors, Nur

    2015-01-01

    Different surgical procedures have been used in the management of chronic subdural hematoma (CSDH). Nowadays treatment with burr hole is more preferable than craniotomy in most clinics. We present two cases of CSDH, which caused neurological deficits. In both cases cortical membranectomy was performed following craniotomy. After this procedure, significant improvement was observed in patients neurological deficits. We recommend that craniotomy and subtotal membranectomy may be a more adequate choice in such cases. This report underlined that craniotomy is still an acceptable, safe, efficient and even a better procedure in selected patients with CSDH. PMID:26396617

  13. Late onset of subdural hematoma after bifrontal contusion

    PubMed Central

    Gürer, Bora; Kertmen, Hayri; Dolgun, Habibullah; Sekerci, Zeki

    2016-01-01

    Cerebral cortical contusions are one of the most common computed tomography findings in head-injured patients and common sequel of traumatic brain injury. These contusions tend to show a progressive increase in mass effect on repeated imaging, most small contusions do not require surgical evacuation. However, progression to subdural hematoma (SDH) in a late aspect is unique. Here we present a 71-year-old man with bifrontal contusion, who deteriorated 43 days after initial trauma with sudden onset of acute SDH. This unusual case suggests that neurosurgeons should be alert for the possibility of very late onset of acute SDH after bifrontal contusions. PMID:27695560

  14. Primary Renal Lymphoma Mimicking a Subcapsular Hematoma: A Case Report

    PubMed Central

    Dedekam, Erik; Graham, Jess; Strenge, Karen; Mosier, Andrew D.

    2013-01-01

    Primary renal lymphoma (PRL) is a rare entity with a history of controversy regarding its existence. Lymphomatous involvement of the kidney is more commonly seen secondarily to spread from an adjacent lymphomatous mass, rather than arising primarily from the kidney. PRL can mimic other renal lesions such as renal cell carcinoma, renal abscess, and metastasis; therefore, an early diagnosis is crucial to guide treatment and properly assess prognosis. We present a rare case of a 77 year-old male who presented with hematuria and PRL mimicking a subcapsular hematoma. PMID:24421949

  15. Primary renal lymphoma mimicking a subcapsular hematoma: a case report.

    PubMed

    Dedekam, Erik; Graham, Jess; Strenge, Karen; Mosier, Andrew D

    2013-08-01

    Primary renal lymphoma (PRL) is a rare entity with a history of controversy regarding its existence. Lymphomatous involvement of the kidney is more commonly seen secondarily to spread from an adjacent lymphomatous mass, rather than arising primarily from the kidney. PRL can mimic other renal lesions such as renal cell carcinoma, renal abscess, and metastasis; therefore, an early diagnosis is crucial to guide treatment and properly assess prognosis. We present a rare case of a 77 year-old male who presented with hematuria and PRL mimicking a subcapsular hematoma. PMID:24421949

  16. Seventeen cases with subungual hematoma treated by CO2 laser

    NASA Astrophysics Data System (ADS)

    Deng, Deming

    1996-09-01

    In order to find a therapy which doesn't have any influence upon the patients working and living and also makes no pain to the patients, CO2 laser is used to treat the 17 patients with subungual hematoma (SM). Satisfactory curative effect is obtained. Through the clinical observation on the treatment of the 17 cases with SM, the effective rate reached 98 percent. CO2 laser is sure to provide safe, simple operation and short curative course with no pain to the patients, it has a certain practical value for clinical application.

  17. Epidural hematoma secondary to sinusitis: a case report and review of the literature.

    PubMed

    Aviner, Shraga; Olshinka, Noam; Cherniavsky, Evgenia; Forer, Boaz; Bibi, Haim

    2014-02-01

    Epidural hematoma is a potentially life threatening event that demands prompt diagnosis and surgical treatment, usually following head trauma. We present a case of a 9-year-old boy with no history of head trauma, and who was diagnosed with epidural hematoma secondary to frontal sinusitis; and the medical literature was reviewed. PMID:24370469

  18. Computed tomography of intramural hematoma of the small intestime: a report of 3 cases

    SciTech Connect

    Plojoux, O.; Hauser, H.; Wettstein, P.

    1982-08-01

    CT findings in 3 cases of intramural hematoma of the small intestine are described. One patient needed surgery. CT characteristics were specific and included a region of increased density (50-80 H) representing the hematoma. The differential diagnosis includes tumor (lymphoma or melanoma) and inflammatory disease (Crohn disease or pancreatic cyst.)

  19. CT Fluoroscopy-guided Aspiration of Intracerebral Hematomas: Technique and Outcomes

    PubMed Central

    Hwang, Kihwan; Kwon, O-Ki; Bang, Jae Seung; Oh, Chang Wan

    2015-01-01

    Objective The authors evaluated the feasibility and targeting accuracy of CT fluoroscopy (CTF)-guided catheter placement and aspiration of intracerebral hematoma (ICH)s. Materials and Methods Nine patients (mean age, 63.3 ± 15.3 years) were treated by CTF-guided hematoma aspiration under local anesthesia. The targeting errors in the lesion center, volume of the aspirated hematoma, accuracy of the final catheter position, procedure time, and clinical outcomes were evaluated. Results All catheters were successfully placed in the center of the hematoma. The mean volume of the aspirated hematoma was 20.6 ± 8.8 mL (pre-treatment, 44.7 ± 20.1 mL; post-treatment, 24.1 ± 13.8 mL). The average procedure time was 25.1 minutes (range, 18-32 minutes). In one case with a scanty residual hematoma, the catheter was removed at the end of the procedure. In the remaining eight cases, the catheter was left in the residual hematoma for drainage and all catheter tips were accurately located in the final position. There were no procedure-related complications, including rebleeding and infection. Conclusion CTF-guided ICH aspiration is a feasible, quick, and accurate procedure which could substitute for stereotactic methods. The accurate catheter position provided by real-time observation enables an effective aspiration and drainage of hematomas. PMID:25874179

  20. Spontaneous intestinal intramural hematoma: What to do and not to do

    PubMed Central

    Yoldaş, Tayfun; Erol, Varlık; Çalışkan, Cemil; Akgün, Erhan; Korkut, Mustafa

    2013-01-01

    Objective: Spontaneous intestinal intramural hematoma is a rare complication of anticoagulant treatment. In this study, we retrospectively evaluated 14 patients with the diagnosis of intramural hematoma of the small intestine who were followed-up and treated in our clinic, and we aimed to determine current approaches in the diagnosis and treatment of intramural hematoma. Material and Methods: Between February 2010–October 2012, 14 patients diagnosed with small intestinal intramural hematoma were retrospectively analyzed. Nine patients were followed due to clinical findings and 5 patients underwent operation with a histopathological diagnosis of intramural hematoma. Results: Abdominal computed tomography demonstrated ileal and jejunal wall thickening in 10 patients, while findings were consistent with mesenteric vascular disease in four. Five patients were operated due to mechanical bowel obstruction and acute abdomen. The other 9 patients were followed up with medical treatment and 8 of these patients were already using warfarin due to cardiac bypass and valve replacement. Conclusion: Spontaneous intestinal intramural hematoma is a rare cause of small bowel obstruction due to intramural hematoma, which is encountered even more rarely. An intramural hematoma should be considered among differential diagnosis of patients who present with abdominal pain and symptoms of obstruction with a history of anticoagulant drug use and elevated International Normalized Ratio (INR) levels. Early diagnosis and medical follow-up can provide a good response to treatment in the majority of patients without requiring surgery. PMID:25931850

  1. Spontaneous sublingual space hematoma secondary to hypertension: A case report and review of literature

    PubMed Central

    Satpathy, Shouvanik; Guha, Rajdeep; Satpathy, Anupama; Guha, Paromita

    2015-01-01

    Sublingual hematoma is a rare complication of oral anticoagulant use. Spontaneous sublingual hematoma secondary to hypertension is even rarer and their management remains enigmatic. We present such a case that we successfully managed conservatively along with a review of relevant literatures. PMID:26668463

  2. Noninvasive, optoacoustic detection and characterization of intra- and extracranial hematomas and cerebral hypoxia

    NASA Astrophysics Data System (ADS)

    Petrov, Andrey; Prough, Donald S.; Petrov, Yuriy; Petrov, Irene Y.; Robertson, Claudia S.; Asokan, Vasantha; Agbor, Adaeze; Esenaliev, Rinat O.

    2015-03-01

    Early diagnosis of intracranial hematomas is necessary to improve outcome in patients with traumatic brain injury (TBI). CT and MRI can diagnose intracranial hematomas, but cannot be used until the patient arrives at a major healthcare facility, resulting in delayed diagnosis. Near infrared spectroscopy may suggest the presence of unilateral intracranial hematomas, but provides minimal information on hematoma type and location due to limitations associated with strong light scattering. We have used optoacoustics (which combines high endogenous optical contrast with the resolution of ultrasound) to diagnose hematomas and monitor cerebral oxygenation. We performed animal and clinical studies on detection and characterization of hematomas and on monitoring cerebral hypoxia by probing the superior sagittal sinus (SSS). Recently, we built a medical grade, multi-wavelength, OPO-based optoacoustic system tunable in the near infrared spectral range. We developed new patient interfaces for noninvasive, transcranial measurements in the transmission mode in the presence of dense hair and used it in patients with TBI. The optoacoustic system was capable of detecting and characterizing intra- and extracranial hematomas. SSS blood oxygenation was measured as well with the new interface. The obtained results indicate that the optoacoustic system in the transmission mode provides detection and characterization of hematomas in TBI patients, as well as cerebral venous blood oxygenation monitoring. The transmission mode approach can be used for optoacoustic brain imaging, tomography, and mapping in humans.

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

    PubMed Central

    Nwosu, Jones N; Nnadede, Peter C

    2015-01-01

    Background Nasal hematoma/abscess is an uncommon entity, but capable of leading to serious consequences if not handled meticulously, and with urgency. Objective To present the management, and outcome of nasal septal hematoma/abscess in a Nigerian tertiary institution. Method Consecutive patients diagnosed with nasal septal hematoma/abscess over a 10-year period, treated at the University of Nigeria Teaching Hospital, Enugu, Nigeria, were prospectively studied. The processes leading to diagnosis, treatment, and outcome were sequentially evaluated. Results Fifty-three patients (37 males and 16 females), age 5–65 years (with mean age of 23.10 years), were included. Surgical drainage of the hematoma/abscess, intranasal packing with insertion of drain was performed with total resolution of problem in all the cases. Conclusion Incision and drainage, and intranasal packing with insertion of drain was effective in treating nasal septal hematoma/abscess. PMID:26251577

  4. The annular hematoma of the shrew yolk-sac placenta.

    PubMed

    King, B F; Enders, A C; Wimsatt, W A

    1978-05-01

    The annular hematoma of the shrew, Blarina brevicauda, is a specialized portion of the yolk-sac wall. In this study, we have examined the fine structure of the different cellular components of the anular hematoma. Small pieces of the gestation sacs from seven pregnant shrews were fixed in glutaraldehyde and osmium tetroxide and processed for transmission electron microscopy. In the area of the trophoblastic curtain, the maternal capillary endothelial cells were hypertrophied and syncytial trophoblast surrounded the capillaries. Cellular trophoblast covered part of the luminal surface of the curtain region, whereas masses of apparently degenerating syncytium were present on other areas of the surface. Maternal erythrocytes, released into the uterine lumen from the curtain region, were phagocytized and degraded by the columnar cells of the trophoblastic annulus. No evidence of iron or pigment accumulation was evident in the parietal endodermal cells underlying the annular trophoblast. Parietal endodermal cells were characterized by cuboidal shape, widely dilated intercellular spaces, and cytoplasm containing granular endoplasmic reticulum. Endodermal cells of the visceral yolk-sac accumulated large numbers of electron-dense granules as well as glycogen in their cytoplasm. Hemopoietic areas and vitelline capillaries were found subjacent to the visceral endoderm. The various portions of the yolk-sac wall of Blarina appear to perform complementary functions which are probably important in maternal-fetal iron transfer. PMID:677046

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

    PubMed Central

    Tamura, Ryota; Kuroshima, Yoshiaki; Nakamura, Yoshiki

    2016-01-01

    Background. Large craniotomy for acute subdural hematoma is sometimes too invasive. We report good outcomes for two cases of neuroendoscopic evacuation of hematoma and contusion by 1 burr hole surgery. Case Presentation. Both patients arrived by ambulance at our hospital with disturbed consciousness after falling. Case 1 was an 81-year-old man who took antiplatelet drugs for brain infarction. Case 2 was a 73-year-old alcoholic woman. CT scanning showed acute subdural hematoma and frontal contusion in both cases. In the acute stage, glycerol was administered to reduce edema; CTs after 48 and 72 hours showed an increase of subdural hematoma and massive contusion of the frontal lobe. Disturbed consciousness steadily deteriorated. The subdural hematoma and contusion were removed as soon as possible by neuroendoscopy under local anesthesia, because neither patient was a good candidate for large craniotomy considering age and past history. 40%~70% of the hematoma was removed, and the consciousness level improved. Conclusion. Neuroendoscopic removal of acute subdural hematoma and contusion has advantages and disadvantages. For patients with underlying medical issues or other risk factors, it is likely to be effective. PMID:26981295

  6. Rupture of uterine serosal hematoma: delayed complication of uterine perforation.

    PubMed

    Seol, H J; Ki, K D

    2015-01-01

    Uterine perforation, a major complication of dilatation and curettage (D&C), is typically recognized at the time of the procedure. Large defects in the uterine wall or injury to other intraabdominal organs can result in an acute abdomen requiring immediate surgical treatment. On the other hand, small perforations usually resolve on their own without any long-term consequences. Here, the authors report a case of delayed hemoperitoneum, ten days after the D&C evacuation of an early pregnancy. Initially, intramural pregnancy was the suspected etiology. However, histopathology suggested that the inciting event was the rupture of a serosal uterine hematoma, which likely resulted from an incomplete uterine perforation during D&C. The patient did well after undergoing an uneventful laparoscopy.

  7. Different perceived foreign accents in one patient after prerolandic hematoma.

    PubMed

    Christoph, D H; de Freitas, G R; Dos Santos, D P; Lima, M A S D; Araújo, A Q C; Carota, A

    2004-01-01

    Foreign accent syndrome (FAS), a rare disorder characterized by the emergence of a new accent perceived as foreign by listeners, is usually reported with left brain damage. We here report the case of a 28-year-old native Brazilian who appeared, to the examiner, to show a North American accent during recovery from Broca's aphasia. The lesion was due to a frontal hematoma. Without referring specifically to speech, we asked 10 independent observers to comment on a videotape of the patient's interview. Seven reported that the patient had a foreign accent, while 3 simply noted a 'strange' accent. The observers did not agree on the origin of the accent, 5 identifying it as Spanish, 1 as German, and 1 as south Brazilian. These findings suggest that FAS is not due to the acquisition of a specific foreign accent, but to impairment of the suprasegmental linguistic abilities (tone, accent, pauses, rhythm, and vocal stress) that make it possible to distinguish native language.

  8. [Intramural hematoma of the ileum complicating anticoagulant therapy].

    PubMed

    Acea Nebril, B; Sánchez González, F; Aguirrezabalaga González, J; Crespo García, C; Lago Novoa, M; Blanco Freire, N

    1994-07-01

    The development of abdominal pain in the patient receiving anticoagulant therapy is more likely to pose a diagnostic dilemma. A group of intra-abdominal bleeding syndromes, which are extremely rare in patients with normal haemostasis, have been described in patients on anticoagulant therapy. Theses syndromes are of particular interest to surgeons because they simulate acute surgical conditions of the abdomen. We herein report the preoperative diagnosis of a spontaneous intramural hematoma of the small bowel by computed tomography. The authors conclude that CT should be used early in the diagnostic evaluation of abdominal pain and of acute abdomen in patients receiving anticoagulant therapy. Indications for the operative management of these patients include active bleeding, pneumoperitoneum, failure to improve with conservative management within 72 hours, worsening of symptoms, and uncertain diagnosis.

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

    PubMed Central

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

    2016-01-01

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

  10. Successful Nonoperative Management of Spontaneous Splenic Hematoma and Hemoperitoneum due to CMV Infection

    PubMed Central

    Lianos, Georgios; Ignatiadou, Eleftheria; Bali, Christina; Harissis, Haralampos; Katsios, Christos

    2012-01-01

    Introduction. Spontaneous splenic hematoma or splenic rupture due to CMV infection in immunocompetent adults is rare and life-threatening. Case Report. Herein we report a rare case of spontaneous splenic hematoma and hemoperitoneum due to CMV infection in a 23-year-old Caucasian male in whom conservative management was successful. Conclusion. Spontaneous splenic hematoma and spontaneous splenic rupture are extremely rare conditions during primary CMV infection. Though rare, they must be always considered by the operating surgeon, because any misinterpretation may result in unfavorable outcomes. PMID:23227374

  11. Percutaneous radiofrequency ablation-induced perinephric hematoma with acute renal failure in a solitary kidney.

    PubMed

    Zhao, Lee C; Chan, Sarah W; Macejko, Amanda M; Lin, William W

    2008-07-01

    Iatrogenic occurrences (including radiologically guided renal biopsy, shockwave lithotripsy, and minimally invasive ablative procedures) of subcapsular hematoma that lead to acute renal failure are rare but serious. The advancement of minimally invasive procedures has led to an increase in this complication, especially in patients with a solitary kidney. Fortunately, prompt surgical evacuation of the hematoma in these patients allows decompression of the renal parenchyma and recovery of renal function. We report a case of acute renal failure in a patient with a solitary kidney that resulted from a subcapsular hematoma as a complication of radiofrequency ablation.

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

    PubMed Central

    Cincu, Rafael; de Asis Lorente, Francisco; Rivero, David; Eiras, José; Ara, José Ramón

    2009-01-01

    Spinal subdural hematoma is a rare disorder and can be caused by abnormalities of coagulation, blood dyscrasias, lumbar puncture, trauma, underlying neoplasm, and arteriovenous malformation. We discuss an unusual case of an elderly woman who presented with spontaneous spinal subdural hematoma and developed massive rebleeding on the third day following initial evacuation of hematoma. This case illustrates that a patient with routine normal coagulation profile and adequate hemostasis can still harbor platelet dysfunction (in present case due to polycythemia) and later on can manifest as rebleeding and neurological deterioration. PMID:19838395

  13. Laparoscopic drainage of a post-traumatic intramural duodenal hematoma in a child.

    PubMed

    Banieghbal, Behrouz; Vermaak, Cobus; Beale, Peter

    2008-06-01

    Duodenal intramural hematoma owing to blunt abdominal trauma is a relatively rare condition and is normally managed non-operatively. In this paper, we present the case of an 11-year-old boy with a post-traumatic duodenal hematoma, who after failing conservative management, underwent laparoscopic drainage. A four-port approach in a similar position to the laparoscopic cholecystectomy was used. After disentangling the inflammatory mass, the duodenal serosa was opened by simple hook diathermy and the hematoma evacuated. The child recovered uneventfully and was discharged home 48 hours later. To our knowledge, this is the first time that this condition has been successfully treated laparoscopically.

  14. Acute Scrotum Following Traumatic Spermatic Cord Hematoma: A Case Report and Review

    PubMed Central

    Pepe, Pietro; Bonaccorsi, Astrid; Candiano, Giuseppe; Pietropaolo, Francesco; Panella, Paolo; Pennisi, Michele

    2015-01-01

    Acute scrotum constitutes the most common urological emergency secondary to spermatic cord torsion, testicular trauma, orchiepididymitis and hernias. We report a very rare case of unique traumatic spermatic cord hematoma following scrotum injury occurred during a football match. Clinical exam showed an increased volume of the left spermatic cord; the color Doppler ultrasound (CDU) demonstrated left testicular ischemia secondary to a large spermatic cord hematoma that needs surgical exploration. Spermatic cord hematoma rarely induces acute scrotum, however it could be treated conservatively surgery is mandatory when pain is persistent or testicular ischemia is confirmed by CDU. PMID:26793493

  15. Acute Scrotum Following Traumatic Spermatic Cord Hematoma: A Case Report and Review.

    PubMed

    Pepe, Pietro; Bonaccorsi, Astrid; Candiano, Giuseppe; Pietropaolo, Francesco; Panella, Paolo; Pennisi, Michele

    2015-03-01

    Acute scrotum constitutes the most common urological emergency secondary to spermatic cord torsion, testicular trauma, orchiepididymitis and hernias. We report a very rare case of unique traumatic spermatic cord hematoma following scrotum injury occurred during a football match. Clinical exam showed an increased volume of the left spermatic cord; the color Doppler ultrasound (CDU) demonstrated left testicular ischemia secondary to a large spermatic cord hematoma that needs surgical exploration. Spermatic cord hematoma rarely induces acute scrotum, however it could be treated conservatively surgery is mandatory when pain is persistent or testicular ischemia is confirmed by CDU. PMID:26793493

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

    PubMed

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

    2016-01-01

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

  17. Treatment of thoracic hemorrhage due to rupture of traumatic mediastinal hematoma.

    PubMed

    Yu, Hui-Jie; Zhang, Ling-Fang; Cao, Wei-Zhong

    2016-01-01

    Patients in traffic accidents are usually presented with pain and bleeding due to fractures or soft tissue injury. On some occasions, more severe complications may be triggered by the trauma. A review of the published English language literature reveals no survival case once the traumatic mediastinal hematoma is ruptured. In our case, a 54-year-old man suffering motorcycle accident was admitted to emergency department. Computed tomography scan revealed subdural hematoma combined with posterior mediastinal hematoma. The patient was saved and discharged with a satisfactory outcome. Here we hope to share our treatment experience in dealing with the patient with severe multiple trauma. PMID:27033275

  18. CD163 promotes hematoma absorption and improves neurological functions in patients with intracerebral hemorrhage

    PubMed Central

    Xie, Wen-jing; Yu, Hong-quan; Zhang, Yu; Liu, Qun; Meng, Hong-mei

    2016-01-01

    Clinical outcomes are positively associated with hematoma absorption. The monocyte-macrophage scavenger receptor, CD163, plays an important role in the metabolism of hemoglobin, and a soluble form of CD163 is present in plasma and other tissue fluids; therefore, we speculated that serum CD163 affects hematoma absorption after intracerebral hemorrhage. Patients with intracerebral hemorrhage were divided into high- and low-level groups according to the average CD163 level (1,977.79 ± 832.91 ng/mL). Compared with the high-level group, the low-level group had a significantly slower hematoma absorption rate, and significantly increased National Institutes of Health Stroke Scale scores and modified Rankin Scale scores. These results suggest that CD163 promotes hematoma absorption and the recovery of neurological function in patients with intracerebral hemorrhage.

  19. CD163 promotes hematoma absorption and improves neurological functions in patients with intracerebral hemorrhage.

    PubMed

    Xie, Wen-Jing; Yu, Hong-Quan; Zhang, Yu; Liu, Qun; Meng, Hong-Mei

    2016-07-01

    Clinical outcomes are positively associated with hematoma absorption. The monocyte-macrophage scavenger receptor, CD163, plays an important role in the metabolism of hemoglobin, and a soluble form of CD163 is present in plasma and other tissue fluids; therefore, we speculated that serum CD163 affects hematoma absorption after intracerebral hemorrhage. Patients with intracerebral hemorrhage were divided into high- and low-level groups according to the average CD163 level (1,977.79 ± 832.91 ng/mL). Compared with the high-level group, the low-level group had a significantly slower hematoma absorption rate, and significantly increased National Institutes of Health Stroke Scale scores and modified Rankin Scale scores. These results suggest that CD163 promotes hematoma absorption and the recovery of neurological function in patients with intracerebral hemorrhage. PMID:27630696

  20. Case report: chronic sub-dural hematoma following high-speed ejection.

    PubMed

    Warburton, R

    1993-06-01

    This paper reports a case of chronic sub-dural hematoma occurring in a pilot after a high-speed ejection that was within the survival envelope of the Mark 10 Martin Baker ejection seat. The events leading up to the ejection, his subsequent hospitalization for treatment of immediate injuries and late development of neurological signs, 6 weeks after the ejection, are presented. (A thorough search of literature has failed to reveal any previously published account of chronic sub-dural hematoma as a post-ejection complication.) His surgical treatment, recovery, and final assessment are discussed together with the possible causes of his sub-dural hematoma. Flight surgeons should take careful note of the events in this case. Sub-dural hematoma is frequently difficult to diagnose but it should not be discounted as a potential late complication from an ejection which is within the parameters of survivability and which yields, initially, only signs of relatively minor injury. PMID:8338501

  1. CD163 promotes hematoma absorption and improves neurological functions in patients with intracerebral hemorrhage

    PubMed Central

    Xie, Wen-jing; Yu, Hong-quan; Zhang, Yu; Liu, Qun; Meng, Hong-mei

    2016-01-01

    Clinical outcomes are positively associated with hematoma absorption. The monocyte-macrophage scavenger receptor, CD163, plays an important role in the metabolism of hemoglobin, and a soluble form of CD163 is present in plasma and other tissue fluids; therefore, we speculated that serum CD163 affects hematoma absorption after intracerebral hemorrhage. Patients with intracerebral hemorrhage were divided into high- and low-level groups according to the average CD163 level (1,977.79 ± 832.91 ng/mL). Compared with the high-level group, the low-level group had a significantly slower hematoma absorption rate, and significantly increased National Institutes of Health Stroke Scale scores and modified Rankin Scale scores. These results suggest that CD163 promotes hematoma absorption and the recovery of neurological function in patients with intracerebral hemorrhage. PMID:27630696

  2. Bilateral Traumatic Basal Ganglia Hemorrhage Associated With Epidural Hematoma: Case Report and Literature Review

    PubMed Central

    Calderon-Miranda, Willem Guillermo; Alvis-Miranda, Hernando Raphael; Alcala-Cerra, Gabriel; M. Rubiano, Andres; Moscote-Salazar, Luis Rafael

    2014-01-01

    Traumatic basal ganglia hematoma is a rare condition defined as presence of hemorrhagic lesions in basal ganglia or adjacent structures suchas internal capsule, putamen and thalamus. Bilateral basal ganglia hematoma are among the devastating and rare condition. We herein report a 28-year old man, a victim of car-car accident who was brought to our surgical emergency room by immediate loss of consciousness and was diagnosed to have hyperdense lesion in the basal ganglia bilaterally, with the presence of right parietal epidural hematoma. Craniotomy and epidural hematoma drainage were considered, associated to conservative management of gangliobasal traumatic contusions. On day 7 the patient had sudden neurologic deterioration, cardiac arrest unresponsive to resuscitation. Management of these lesions is similar to any other injury in moderate to severe traumatic injury. The use of intracranial pressure monitoring must be guaranteed. PMID:27162882

  3. Nontraumatic orbital subperiosteal hematoma in a scuba diver: CT and MR findings.

    PubMed

    Chen, J C; Kucharczyk, W

    1988-01-01

    We report a case of nontraumatic orbital subperiosteal hematoma occurring in a young adult scuba diver. The clinical presentation, imaging findings (CT and magnetic resonance), and pathogenesis are discussed.

  4. Expanding Hematoma's Life-Threatening Neck and Face Emergency Management of Ballistic Injuries.

    PubMed

    Shuker, Sabri T

    2016-07-01

    This article aims to bring attention to the morbidity and fatality of hemorrhage, how expanding hematoma and air compromise neck/face N/F injuries and present challenges. Large neck vessel ballistic injuries may lead to hemorrhage and expanding hematoma, resulting in airway compromise, due to injuries to the internal and/or external carotid arteries, internal jugular veins "internal carotid artery, external carotid artery, internal jugular vein," and the external carotid artery deep branches. This also leads to injuries to the cervical fascial layers (barriers of deep spaces) that facilitate pooling blood and hematoma into compartmental and large potential space which effects the pharynx, larynx, esophagus, and trachea.The expanding hematomas distort neck anatomical landmarks so "no neck zones" classifications are applicable. As the spectrum of injuries continues to evolve, the clinical characterization needs a new categorization based on compartmental hematoma and potential space anatomical location like retropharyngeal, parapharyngeal, sublingual, submandibular spaces, retrobulbar, and cheek compartment space hematomas.Presence of symptoms and location of the hematoma generally dictate what type of procedure is needed and how urgently it needs to be appropriately performed.Two unusual patients of pseudoaneurysms facial artery injuries with extravasation of blood producing a pulsating hematoma are referred to. Another patient considers large internal carotid artery injuries pseudoaneurysms revealed in angiography.The immediate management of life-saving patients requires aggressive airway maintenance at the scene, conscious victim will often obtain a posture that clears his airway and the semiconscious or unconscious put him in prone position. Air compromise may need emergency intubation, large bore cannula cricothyroidotomy, cricothyrotomy and at medical facilities tracheostomy. PMID:27315316

  5. Interventricular Septal Hematoma and Coronary-Ventricular Fistula: A Complication of Retrograde Chronic Total Occlusion Intervention

    PubMed Central

    Abdel-karim, Abdul-rahman R.; Main, Michael L.

    2016-01-01

    Interventricular septal hematoma is a rare complication of retrograde chronic total occlusion (CTO) percutaneous coronary interventions (PCI) with a typically benign course. Here we report two cases of interventricular septal hematoma and coronary-cameral fistula development after right coronary artery (RCA) CTO-PCI using a retrograde approach. Both were complicated by development of ST-segment elevation and chest pain. One case was managed actively and the other conservatively, both with a favorable outcome.

  6. Adrenal Hematoma and Right Hemothorax after Echis Carinatus Bite: An Unusual Manifestation

    PubMed Central

    Lakhotia, Manoj; Pahadiya, Hans Raj; Singh, Jagdish; Gandhi, Ronak; Bhansali, Shashank

    2014-01-01

    Common bleeding manifestations after viperine bite include bleeding from site of bite, bleeding gums, epistaxis, hemoptysis, hematuria, hematemesis, and intracranial bleed. Bleeding in the adrenal gland is a rare manifestation. We report here a patient of viperine bite who developed right adrenal hematoma and right hemothorax after 3 days of bite. To the best of our knowledge this is the first case report of adrenal hematoma and right hemothorax after Echis carinatus bite. PMID:25948976

  7. Interventricular Septal Hematoma and Coronary-Ventricular Fistula: A Complication of Retrograde Chronic Total Occlusion Intervention

    PubMed Central

    Abdel-karim, Abdul-rahman R.; Main, Michael L.

    2016-01-01

    Interventricular septal hematoma is a rare complication of retrograde chronic total occlusion (CTO) percutaneous coronary interventions (PCI) with a typically benign course. Here we report two cases of interventricular septal hematoma and coronary-cameral fistula development after right coronary artery (RCA) CTO-PCI using a retrograde approach. Both were complicated by development of ST-segment elevation and chest pain. One case was managed actively and the other conservatively, both with a favorable outcome. PMID:27668097

  8. Intramural hematoma of duodenum: An unusual complication after endoscopic therapy for a bleeding peptic ulcer

    PubMed Central

    Kumar, Ramesh; Sharma, Manoj Kumar; Bhatia, Vikram; Garg, Hitendra Kumar; Sundar, Shyam

    2011-01-01

    Intramural hematoma of duodenum (IDH) is a relatively unusual complication associated with endoscopic treatment of bleeding peptic ulcer. This unusual condition is usually seen in children following blunt trauma to the abdomen. We describe here a case of IDH occurring following endoscopic therapy for bleeding duodenal ulcer in an adult patient with end-stage renal disease. The hematomas appeared on the second day of endoscopic intervention, caused transient duodenal obstruction and resolved spontaneously with conservative treatment in a week. PMID:21814382

  9. Interventricular Septal Hematoma and Coronary-Ventricular Fistula: A Complication of Retrograde Chronic Total Occlusion Intervention.

    PubMed

    Abdel-Karim, Abdul-Rahman R; Vo, Minh; Main, Michael L; Grantham, J Aaron

    2016-01-01

    Interventricular septal hematoma is a rare complication of retrograde chronic total occlusion (CTO) percutaneous coronary interventions (PCI) with a typically benign course. Here we report two cases of interventricular septal hematoma and coronary-cameral fistula development after right coronary artery (RCA) CTO-PCI using a retrograde approach. Both were complicated by development of ST-segment elevation and chest pain. One case was managed actively and the other conservatively, both with a favorable outcome. PMID:27668097

  10. Vaccum drainage system application in the management of operation-related non-regional epidural hematoma

    PubMed Central

    2013-01-01

    Background Epidural intracranial hematoma is one of the most common complications of surgeries for intracranial tumors. The non-regional epidural hematoma is related to severe fluctuation of the intracranial pressure during the operation. The traditional management of hematoma evacuation through craniotomy is time-consuming and may aggravate intracranial pressure imbalance, which causes further complications. We designed a method using vaccum epidural drainage system, and tried to evaluate advantage and the disadvantage of this new technique. Methods Seven patients of intracranial tumors were selected. All of the patients received tumor resection and intra-operative non-regional epidural hematoma was confirmed through intra-operative ultrasound or CT scan. The vaccum drainage system was applied. Another ten patients who received craniotomy for intra-operative non-regional epidural hematoma evacuation were selected as comparison. Regular tests, like serial CT scan, were performed afterward to evaluate the effectiveness and to help deciding when to remove the drainage system. Results The vaccum drainage method was effective in epidual hemotoma clearance and prevented recurrent epidural hemorrhage. The drainage systems were removed within 4 days. All of the patients recovered well. No complications related to the drainage system were observed. Conclusions Compared to the traditional craniotomy, the new method of epidural hemoatoma management using vaccum epidural drainage system proved to be as effective in hematoma clearance, and was less-invasive and easier to perform, with less complication, shorter hospitalization, less economic burden, and better prognosis. PMID:23842198

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

    PubMed

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

    2014-09-01

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

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

    PubMed

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

    2014-09-01

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

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

    SciTech Connect

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

    2000-02-11

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

  14. Prenatal diagnosis of a placental infarction hematoma associated with fetal growth restriction, preeclampsia and fetal death: clinicopathological correlation.

    PubMed

    Aurioles-Garibay, Alma; Hernandez-Andrade, Edgar; Romero, Roberto; Qureshi, Faisal; Ahn, Hyunyoung; Jacques, Suzanne M; Garcia, Maynor; Yeo, Lami; Hassan, Sonia S

    2014-01-01

    The lesion termed 'placental infarction hematoma' is associated with fetal death and adverse perinatal outcome. Such a lesion has been associated with a high risk of fetal death and abruption placentae. The fetal and placental hemodynamic changes associated with placental infarction hematoma have not been reported. This paper describes a case of early and severe growth restriction with preeclampsia, and progressive deterioration of the fetal and placental Doppler parameters in the presence of a placental infarction hematoma.

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

    NASA Astrophysics Data System (ADS)

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

    2016-03-01

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

  16. Chronic subdural hematoma associated with an arachnoid cyst in a juvenile taekwondo athlete: a case report and review of the literature.

    PubMed

    Kertmen, Hayri; Gürer, Bora; Yilmaz, Erdal Resit; Sekerci, Zeki

    2012-01-01

    Both chronic subdural hematoma and arachnoid cysts are common lesions in neurosurgical practice. Arachnoid cysts are a well-known predisposing factor for chronic subdural hematoma. Here, we present a 12-year-old taekwondo athlete with chronic subdural hematoma associated with arachnoid cysts. The chronic subdural hematoma was evacuated through 2 burr holes and the patient was discharged in good condition. To our knowledge, this is the first case of chronic subdural hematoma with associated arachnoid cysts in a taekwondo athlete. We also review the literature on sports-related chronic subdural hematomas associated with arachnoid cysts in children. PMID:22832284

  17. Endoscopic drainage of orbital subperiosteal hematoma secondary to acute rhinosinusitis in a child.

    PubMed

    Nomura, Kazuhiro; Honkura, Yohei; Ozawa, Daiki; Okumura, Yuri; Hidaka, Hiroshi; Ogawa, Takenori; Yamauchi, Daisuke; Watanabe, Kenichi; Katori, Yukio

    2014-01-01

    Acute rhinosinusitis is frequently associated with secondary orbital infection, most commonly subperiosteal abscess. Although orbital subperiosteal abscess is a deadly disease that might lead to blind and cavernous sinus thrombosis, recent review of literature showed that immediate surgical intervention might not always be necessary for subperiosteal abscess. Orbital inflammation secondary to sinusitis is common in children, whereas orbital subperiosteal hematoma secondary to sinusitis is extremely rare, with only 11 reported cases, including one case in children. All the cases were treated with surgical intervention. Here we present a 12-year-old girl with rhinosinusitis and proptosis. Emergent endoscopic sinus surgery with partial removal of the lamina papyracea revealed dark brown fluid in the subperiosteal space. The patient was symptom-free 2 weeks after surgery. The present case was treated exclusively via an endonasal approach, whereas all 11 previous cases of subperiosteal hematoma were treated with external incision. The endonasal approach is favorable, especially for young female patients. Our review of literature shows that sudden onset, afebrile, and few signs of inflammation on blood test in patients with subperiosteal lesion may indicate subperiosteal hematoma. Surgery rather than antibiotic administration should be considered for the treatment of suspected subperiosteal hematoma. Treatment through only the endonasal approach is possible even if the hematoma is located in the roof of the orbit. PMID:24965687

  18. [Acute epidural hematoma of the posterior fossa in a case of von Willebrand's disease].

    PubMed

    Takenaka, N; Mine, T; Ikeda, E; Iwai, H; Kusano, S

    1988-01-01

    A rare case of acute epidural hematoma of the posterior fossa associated with von Willebrand's disease is reported. A 9-year-old boy fell down and hit his occipital region against a floor. Soon after he came home and slept, but three hours later he began to vomit and became drowsiness. He visited our hospital and his Glasgow Coma Scale showed 13 points. CT scan on admission showed acute epidural hematoma of left posterior fossa and contusional hematoma in the right temporal lobe. The bleeding time was over 18 minutes. He had been suspected to be suffering from von Willebrand's disease two years ago. Then fresh blood, fresh frozen plasma and anti-hemophilic globulin were prepared. Ten hours after injury, the operation was begun. Fresh epidural hematoma existed as a clot beyond transverse sinus. During the procedure of dural tenting suture, diffuse bleeding from bone, muscle, subcutaneous tissue and dura occurred and it was difficult to stop the bleeding. By using fresh blood and anti-hemophilic globulin, the bleeding was controlled, and then the operation was achieved. In the postoperative course a new epidural hematoma was found in the left temporal region and a new but asymptomatic retinal hemorrhage was found in his right eye. He was discharged without any neurological deficits 25 days after operation.

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

    PubMed

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

    2009-04-01

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

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

    PubMed

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

    2009-04-01

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

  1. Delayed Femoral Nerve Palsy Associated with Iliopsoas Hematoma after Primary Total Hip Arthroplasty

    PubMed Central

    Kumar, Sandeep

    2016-01-01

    Femoral nerve neuropathy after total hip arthroplasty is rare but catastrophic complication. Pain and quadriceps muscle weakness caused by this complication can significantly affect the functional outcome. Here we present a case report, describing delayed onset femoral nerve palsy associated with iliopsoas hematoma following pseudoaneurysm of a branch of profunda femoris artery after 3 months of primary total hip arthroplasty in an 80-year-old female patient with single kidney. Hip arthroplasty was done for painful primary osteoarthritis of left hip. Diagnosis of femoral nerve palsy was made by clinical examination and computed tomography imaging of pelvis. Patient was managed by surgical evacuation of hematoma and physiotherapy. The patient's clinical symptoms were improved after surgical evacuation of hematoma. This is the first case report of its kind in English literature regarding delayed onset femoral nerve palsy after primary total hip arthroplasty due to pseudoaneurysm of a branch of profunda femoris artery without any obvious precipitating factor. PMID:27752378

  2. Pure tentorial subdural hematoma from rupture of aneurysm along the transmastoid branches of the occipital artery

    PubMed Central

    Nguyen, Ha Son; Doan, Ninh; Shabani, Saman; Gelsomino, Michael; Zaidat, Osama

    2016-01-01

    Background: Pure subdural hematoma (without subarachnoid, intraventricular, or intraparenchymal hemorrhage) due to a ruptured intracranial aneurysm is rare. Most reported cases involve an aneurysm along the internal carotid artery, posterior communicating artery, or middle cerebral artery. No reports have described an aneurysm along the transmastoid branches of the occipital artery. Case Description: A 70-year-old female presented with sudden-onset, excruciating headaches, associated with dizziness, nausea, and emesis. There was no history of trauma. Computed tomography (CT) head demonstrated a pure tentorial subdural hematoma. Vascular imaging revealed bilateral aneurysms along the transmastoid branches of the intracranial portion of both the occipital arteries. Consequently, these branches were embolized, with no residual filling of the aneurysms. After the procedure, the patient remained neurologically well. The patient was monitored appropriately for vasospasm, and was discharged home 10 days after presentation. Conclusion: Rupture of aneurysms along intracranial branches of the occipital artery can lead to pure subdural hematoma along the tentorium. PMID:27583173

  3. A “Pseudo-cavernoma” – an encapsulated Hematoma of the Choroid Plexus

    PubMed Central

    Dey, Mahua; Turner, Michael S.; Pytel, Peter; Awad, Issam A.

    2011-01-01

    We present the first report of an intraventricular encapsulated hematoma, mimicking cavernous malformation on imaging and gross lesion appearance. A 47-year-old female on anticoagulation therapy for atrial fibrillation presented with left upper extremity apraxia, neglect, and mild gait imbalance. Her brain CT scan and MRI revealed multilobulated lesions involving the choroid plexus in the atria of both lateral ventricles. The intraoperative appearance was that of encapsulated mass, with blood clots at different stages of liquefaction and organization, all consistent with the gross appearance of a cavernous malformation. However, histopathologic examination demonstrated hematoma with components at different ages, and normal vessel infiltration without any hint of cavernous malformation histology, or underlying neoplasia. Encapsulated hematoma should be considered in the differential diagnosis of hemorrhagic intraventricular masses. PMID:21435884

  4. A "pseudo-cavernoma" - an encapsulated hematoma of the choroid plexus.

    PubMed

    Dey, Mahua; Turner, Michael S; Pytel, Peter; Awad, Issam A

    2011-06-01

    We present the first report of an intraventricular encapsulated hematoma, mimicking cavernous malformation on imaging and gross lesion appearance. A 47-year-old female on anticoagulation therapy for atrial fibrillation presented with left upper extremity apraxia, neglect, and mild gait imbalance. Her brain CT scan and MRI revealed multilobulated lesions involving the choroid plexus in the atria of both lateral ventricles. The intraoperative appearance was that of encapsulated mass, with blood clots at different stages of liquefaction and organization, all consistent with the gross appearance of a cavernous malformation. However, histopathologic examination demonstrated hematoma with components at different ages, and normal vessel infiltration without any hint of cavernous malformation histology, or underlying neoplasia. Encapsulated hematoma should be considered in the differential diagnosis of hemorrhagic intraventricular masses.

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

    PubMed

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

    2016-01-01

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

  6. Identification of Hematomas in Mild Traumatic Brain Injury Using an Index of Quantitative Brain Electrical Activity

    PubMed Central

    Naunheim, Rosanne; Bazarian, Jeffrey; Mould, W. Andrew; Hanley, Daniel

    2015-01-01

    Abstract Rapid identification of traumatic intracranial hematomas following closed head injury represents a significant health care need because of the potentially life-threatening risk they present. This study demonstrates the clinical utility of an index of brain electrical activity used to identify intracranial hematomas in traumatic brain injury (TBI) presenting to the emergency department (ED). Brain electrical activity was recorded from a limited montage located on the forehead of 394 closed head injured patients who were referred for CT scans as part of their standard ED assessment. A total of 116 of these patients were found to be CT positive (CT+), of which 46 patients with traumatic intracranial hematomas (CT+) were identified for study. A total of 278 patients were found to be CT negative (CT−) and were used as controls. CT scans were subjected to quanitative measurements of volume of blood and distance of bleed from recording electrodes by blinded independent experts, implementing a validated method for hematoma measurement. Using an algorithm based on brain electrical activity developed on a large independent cohort of TBI patients and controls (TBI-Index), patients were classified as either positive or negative for structural brain injury. Sensitivity to hematomas was found to be 95.7% (95% CI=85.2, 99.5), specificity was 43.9% (95% CI=38.0, 49.9). There was no significant relationship between the TBI-Index and distance of the bleed from recording sites (F=0.044, p=0.833), or volume of blood measured F=0.179, p=0.674). Results of this study are a validation and extension of previously published retrospective findings in an independent population, and provide evidence that a TBI-Index for structural brain injury is a highly sensitive measure for the detection of potentially life-threatening traumatic intracranial hematomas, and could contribute to the rapid, quantitative evaluation and treatment of such patients. PMID:25054838

  7. Indium-111-labeled leukocyte localization in hematomas: a pitfall in abscess detection

    SciTech Connect

    Wing, V.W.; vanSonnenberg, E.; Kipper, S.; Bieberstein, M.P.

    1984-07-01

    Indium-111-labeled white-blood-cell scanning is a useful modality in abscess detection and has replaced gallium scanning in many institutions. Sensitivities of 72% to 90% and specificities of 90% to 100% have been reported. In searching for abscesses seven cases of indium-111-labeled leukocyte uptake were encountered in collections subsequently proved to be noninfected hematomas. Abundant red blood cells with few or no white blood cells, no bacteria, and a benign clinical course identified these noninfected hematomas. Five of the patients were being treated with hemodialysis and three were recent allograft recipients. The results indicate some limitation and nonspecificity in indium-111 scanning, despite its many benefits.

  8. Subcapsular Renal-Infected Hematoma After Retrograde Intrarenal Surgery: A Rare but Serious Complication

    PubMed Central

    Consigliere, Lucas; Gallegos, Hector; Rojas, Francisco; Astroza, Gastón

    2016-01-01

    Abstract We report a case of a 53-year-old woman affected by a left kidney stone and persistent positive urinary culture treated by retrograde intrarenal surgery. During postoperative day 1, she developed a sudden back pain associated with a decrease in hemoglobin. CT scan showed a subcapsular hematoma giving the impression of partial compression of kidney and upper urinary tract. For that reason, in the first instance, a Double-J ureteral stent was installed. Unfortunately, an open surgical drainage was necessary because a secondary infection of the hematoma was evident during the following days. PMID:27579416

  9. PET/CT imaging of abdominal aorta with intramural hematomas, penetrating ulcer, and saccular pseudoaneurysm.

    PubMed

    Nguyen, Vien X; Nguyen, Ba D

    2014-05-01

    Acute aortic syndromes, encompassing intramural hematoma, penetrating ulcer, and pseudoaneurysm, are best demonstrated by angiographic CT and magnetic resonance imaging. These imaging modalities provide an accurate evaluation and allow timely therapies of these frequently symptomatic lesions, thus reducing their morbidity and mortality. The inflammatory pathogenesis of these acute aortic syndromes may exhibit positive PET findings predictive of prognosis and outcomes of these vascular events. The authors present a case of PET/CT imaging showing asymptomatic intramural hematomas with penetrating ulcer and saccular pseudoaneurysm of the proximal abdominal aorta.

  10. Traumatic spinal epidural hematoma in a 1-year-old boy.

    PubMed

    Tarbé de Saint Hardouin, A-L; Grévent, D; Sainte-Rose, C; Angoulvant, F; Chéron, G

    2016-07-01

    Traumatic spinal epidural hematoma is uncommon in children, making rapid diagnosis difficult. In this report, we present a case of traumatic cervical epidural hematoma in a 1-year-old boy, diagnosed with computed tomography scanning and magnetic resonance imaging (MRI). Management was conservative and the lesion regressed spontaneously. The presentation in childhood is often nonspecific. MRI is the imaging modality of choice for diagnosing these lesions. Conservative treatment has to be considered in cases with a benign clinical course and provided that the patient is followed up neurologically with repeated MRI.

  11. Bilateral Chronic Subdural Nontraumatic Hematoma in a Woman Affected by AL Amyloidosis

    PubMed Central

    Luongo, M.; Grassi, M.; Godano, U.

    2015-01-01

    Chronic subdural hematoma (CSDH) is a condition frequently seen in neurosurgical practice, especially among the elderly. It is often preceded by head injury, even a trivial trauma. Light chain (AL) amyloidosis is a disorder involving extracellular tissue deposition of misfolded native proteins called amyloids. The several types of amyloidosis differ by source of proteins, organ involvement, treatment, and prognosis. We describe the case of a 59-year-old woman affected by AL amyloidosis, harboring surgically treated bilateral chronic nontraumatic subdural hematoma, and we suggest a possible correlation between the clinical entities of CSDH and AL amyloidosis. PMID:26251797

  12. Delayed onset of a spinal epidural hematoma after facet joint injection

    PubMed Central

    Velickovic, Mirko; Ballhause, Tobias M

    2016-01-01

    The treatment of chronic back pain is a challenging problem. Facet joint infiltration is an established treatment for chronic low back pain caused by arthrosis of the lumbar facet joints. Due to the increasing number of patients with chronic low back pain, this therapy has become more frequent. We treated a 51-year-old male patient, who developed an epidural hematoma 2 months after infiltration therapy. Our case shows that even a delayed onset of spinal epidural hematoma is possible and should be kept in mind as a possible cause of acute myelopathy after spinal intervention. PMID:27803810

  13. Retropharyngeal hematoma secondary to whiplash injury in childhood: a case report.

    PubMed

    Nurata, Hakan; Yilmaz, Muhammet Bahadır; Borcek, Alp Ozgun; Oner, Ali Yusuf; Baykaner, M Kemali

    2012-01-01

    Whiplash Associated Disorders (WAD) has been reported as an adult phenomenon. Whiplash injury has classically been described as a cervical soft tissue hyperextension- flexion injury after a trauma such as a rear end impact car crash, contact sport injuries, blows to the head from a falling object or a punch and shaken baby syndrome and is mostly seen in adults . It is important as it may cause severe disability due to spinal cord injury, decrease work productivity and even retropharyngeal hematoma resulting airway obstruction and mortality due to bleeding amongst deep cervical fascias. We describe a case of retropharyngeal hematoma after whiplash injury in a childhood.

  14. Subcapsular Renal-Infected Hematoma After Retrograde Intrarenal Surgery: A Rare but Serious Complication.

    PubMed

    Salvadó, José A; Consigliere, Lucas; Gallegos, Hector; Rojas, Francisco; Astroza, Gastón

    2016-01-01

    We report a case of a 53-year-old woman affected by a left kidney stone and persistent positive urinary culture treated by retrograde intrarenal surgery. During postoperative day 1, she developed a sudden back pain associated with a decrease in hemoglobin. CT scan showed a subcapsular hematoma giving the impression of partial compression of kidney and upper urinary tract. For that reason, in the first instance, a Double-J ureteral stent was installed. Unfortunately, an open surgical drainage was necessary because a secondary infection of the hematoma was evident during the following days. PMID:27579416

  15. Spontaneous Spinal Epidural Hematoma Coexisting Guillan-Barré Syndrome in a Child: A Case Report

    PubMed Central

    Lee, Chi Hyung; Kim, Young Ha; Son, Dong Wuk; Lee, Sang Weon

    2016-01-01

    Spontaneous spinal epidural hematoma (SSEH) has been reported as a rare cause of spinal cord compression, especially in children. Clinical features are usually nonspecific, although cervicothoracic location of hematoma could be presented with progressive paraplegia. Guillian-Barré syndrome (GBS) is clinically defined as an acute peripheral neuropathy causing progressive limb weakness. Because SSEH and GBS have very similar signs and symptoms, SSEH could be misdiagnosed as GBS. Nevertheless, they can be presented together. We describe a rare case of SSEH coexisting with GBS. PMID:27800000

  16. Blunt traumatic superior gluteal artery pseudoaneurysm presenting as gluteal hematoma without bony injury: A rare case report.

    PubMed

    Babu, Annu; Gupta, Amit; Sharma, Pawan; Ranjan, Piyush; Kumar, Atin

    2016-08-01

    Blunt traumatic injuries to the superior gluteal artery are rare in clinic. A majority of injuries present as aneurysms following penetrating trauma, fracture pelvis or posterior dislocation of the hip joint. We reported a rare case of superior gluteal artery pseudoaneurysm following blunt trauma presenting as large expanding right gluteal hematoma without any bony injury. The gluteal hematoma was suspected clinically, confirmed by ultrasound and the arterial injury was diagnosed by CT angiography that revealed a large right gluteal hematoma with a focal contrast leakage forming a pseudoaneurysm within the hematoma. Pseudoaneurysm arose from the superior gluteal branch of right internal iliac artery, which was successfully angioembolized. The patient was discharged on day 4 of hospitalization with resolving gluteal hematoma. This report highlighted the importance of considering an arterial injury following blunt trauma to the buttocks with subsequent painful swelling. Acknowledgment of this rare injury pattern was necessary to facilitate rapid diagnosis and appropriate treatment. PMID:27578385

  17. Acute symptomatic hematoma with defined etiology seven years after breast reconstruction: A case report and literature review

    PubMed Central

    Seth, Akhil K; Kim, John YS

    2010-01-01

    Augmentation mammaplasty with implants can be complicated by hematoma formation. The majority of hematomas occur in the immediate postoperative period. There are, however, some reports of hematomas with a delayed presentation. These hematomas in the late postoperative period are rare, and many of these cases do not have a definitive mechanism of injury or develop symptoms immediately after the triggering event. A case of late capsular hematoma seven years after breast reconstruction with a saline implant following mastectomy is presented. In contrast to the majority of published cases, the patient presented with both a known and traceable cause of her bleed and with symptoms that developed immediately after the initial event. Furthermore, the mechanism of her injury was consistent with a bleeding capsular tear that was observed intraoperatively. The present case emphasizes the importance of thorough evaluation and management of patients with a history of breast reconstruction. PMID:21629619

  18. Outcomes and management of type A intramural hematoma

    PubMed Central

    Sandhu, Harleen K.; Tanaka, Akiko; Charlton-Ouw, Kristofer M.; Afifi, Rana O.; Miller, Charles C.; Safi, Hazim J.

    2016-01-01

    Background Initial optimal management of acute type A aortic dissection (ATAAD) with intramural hematoma (ATAIMH) remains controversial, especially between centers in the Eastern vs. Western worlds. We examined the literature and our experience to report outcomes after repair of ATAIMH. Methods We reviewed the hospital, follow-up clinic records and online mortality databases for all patients who presented to our center for open repair of ATAAD between 1999 and 2014. Preoperative characteristics, early and long-term outcomes were compared between classic ATAAD vs. ATAIMH. Survival was analyzed using Kaplan-Meier and log-rank statistics. Results Of the 523 repaired ATAAD, 101 patients (19%) presented with IMH and 422 (81%) had classic dissection. ATAIMH were significantly older (64.8±12.9 vs. 56.8±14.6 years; P<0.001), more commonly females (39% vs. 26%; P=0.010), had poor baseline renal function (i.e., glomerular filtration rate) (P<0.017), more retrograde dissections (27% vs. 8.3%; P<0.001), and less distal malperfusion (5% vs. 15%; P<0.001). Age greater than 60 years, female sex, retrograde dissection, and Marfan syndrome were strongly correlated with ATAIMH. Time to repair for ATAIMH was longer (median, 55.3 vs. 9.8 hours; P<0.001) with one death in ATAIMH within three days of presentation (0.9% vs. 6%; P=0.040). In all, 30-day mortality in ATAIMH was not different from classic ATAAD (12% vs.16%; P=0.289). A significantly lower incidence of postoperative dialysis in ATAIMH was noted (10% vs. 19%; P=0.034). When adjusted for age and renal function, late survival was improved with IMH (P<0.039). Conclusions ATAIMH continues to be associated with significant morbidity and mortality, comparable to classic aortic dissection. A multidisciplinary management approach involving aggressive medical management and risk stratification for timely surgical intervention, along with genetic profiling, is recommended for optimal care. Long-term monitoring is mandatory to assess

  19. Management for traumatic chronic subdural hematoma patients with well-controlled shunt system for hydrocephalus.

    PubMed

    Yamada, Shoko Mitrrt; Tomia, Yusuke; Murakami, Hideki; Nakane, Makoto

    2015-07-01

    Traumatic CSDH enlarged in two cases with VP or LP shunt system although the shunt valve pressure was increased to 200 mmH2O. In surgery, the hematoma cavity pressure was found to be 130 and 140 mmH2O, suggesting that to raise the shunt valve pressure is not effective for decreasing CSDH volume.

  20. 77 FR 16925 - Medical Devices; Neurological Devices; Classification of the Near Infrared Brain Hematoma Detector

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-23

    ... HUMAN SERVICES Food and Drug Administration 21 CFR Part 882 Medical Devices; Neurological Devices; Classification of the Near Infrared Brain Hematoma Detector AGENCY: Food and Drug Administration, HHS. ACTION: Final rule. SUMMARY: The Food and Drug Administration (FDA) is classifying the Near Infrared (NIR)...

  1. Fatal retropleural hematoma complicating internal jugular vein catheterization. A case report.

    PubMed

    Kontozoglou, T; Mambo, N

    1983-06-01

    This report describes a case of fatal retropleural hematoma complicating percutaneous insertion of a central vein catheter. The patient was a 55-year-old female undergoing surgery for severe rheumatic mitral valve disease. Factors responsible for this catastrophic incident are the anticoagulation of the patient, the edematous state of the soft tissues, and the multiple punctures of the wall of the jugular vein.

  2. Spontaneously Resolved Recurrent Cervical Epidural Hematoma in a 37-Week Primigravida.

    PubMed

    Iwatsuki, Katsuyuki; Deguchi, Masao; Hirata, Hitoshi; Kanamono, Toshihisa

    2015-10-01

    Study Design Case report. Objective To describe a patient with a recurrent spontaneous spinal epidural hematoma (SSEH) during pregnancy that had spontaneous remission. Methods A 27-year-old primigravida at 37 weeks' gestation suddenly felt a strong left shoulder pain without any trauma. She had a history of fenestration for a spontaneous cervical hematoma when she was 18 years old. An emergency magnetic resonance imaging revealed a recurrence of the cervical epidural hematoma at the C4-T1 level, but she had no paralysis. Results The patient subsequently underwent a cesarean section and delivered a healthy male infant. Her spinal epidural hematoma disappeared. Multislice computed tomography showed no evidence for a vascular malformation or tumor. Three years after the initial cesarean section, she underwent a second one and delivered another male infant. Conclusions We report on a rare case of recurrent SSEH during pregnancy with no neurologic deficits that was treated nonoperatively with close observation and resulted in spontaneous resolution. In such patients with no neurologic deficits, nonoperative management with close observation may be a reasonable alternative. PMID:26430600

  3. Spinal Epidural Hematoma Following Cupping Glass Treatment in an Infant With Hemophilia A.

    PubMed

    Fruchtman, Yariv; Dardik, Rima; Barg, Assaf Arie; Livnat, Tami; Feldman, Zeev; Rubinstein, Marina; Grinberg, Gahl; Rosenberg, Nurit; Kenet, Gili

    2016-06-01

    A 6 months old infant, diagnosed with a rare mutation causing severe hemophilia A, presented with spinal epidural hematoma. Parents later admitted the infant had glass cupping therapy performed within 2 weeks of the onset of symptoms. The rare mutation, rare bleeding complication, and the eventual course of therapy applied in this case will be discussed in our case report.

  4. Spinal Epidural Hematoma Following Cupping Glass Treatment in an Infant With Hemophilia A.

    PubMed

    Fruchtman, Yariv; Dardik, Rima; Barg, Assaf Arie; Livnat, Tami; Feldman, Zeev; Rubinstein, Marina; Grinberg, Gahl; Rosenberg, Nurit; Kenet, Gili

    2016-06-01

    A 6 months old infant, diagnosed with a rare mutation causing severe hemophilia A, presented with spinal epidural hematoma. Parents later admitted the infant had glass cupping therapy performed within 2 weeks of the onset of symptoms. The rare mutation, rare bleeding complication, and the eventual course of therapy applied in this case will be discussed in our case report. PMID:26844816

  5. Outcome and prognostic factors for dogs with a histological diagnosis of splenic hematoma following splenectomy: 35 cases (2001-2013).

    PubMed

    Patten, Steve G; Boston, Sarah E; Monteith, Gabrielle J

    2016-08-01

    Canine splenic hematoma can be indistinguishable from hemangiosarcoma on clinical presentation and grossly at the time of surgery. However, hemangiosarcoma represents an aggressive malignancy and a misdiagnosis of hematoma would forgo indications for chemotherapy. This study describes a long-term follow-up of cases with a histologic diagnosis of splenic hematoma following splenectomy to determine if the clinical course of the disease corroborated the diagnosis. Thirty-five dogs were evaluated to determine survival and prognostic associations with signalment and clinical data. Overall median survival time was 647 days (range: 0 to 3287 days). Statistically significant variables included a palpable abdominal mass during physical examination, sub-clinical coagulopathy, and metastasis. Four cases (11%) had reported evidence of metastasis at the time of euthanasia; 1 case was histologically confirmed. Overall prognosis for splenic hematoma appears excellent, as expected, but a small proportion of cases may have an undiagnosed malignant component. PMID:27493283

  6. [A Case of Organizing Chronic Subdural Hematoma Treated with Endoscopic Burr-Hole Surgery Using a Curettage and Suction Technique].

    PubMed

    Miki, Koichi; Oshiro, Shinya; Koga, Takaomi; Inoue, Tooru

    2016-09-01

    A 70-year-old man presented to our hospital because of difficulty with discrete movement of the right upper limb and dysarthria. Computed tomography(CT)of the head revealed a chronic subdural hematoma(CSDH)on the left side. The patient underwent single burr-hole irrigation and drainage on the same day. In addition to the burr hole, a cross-shaped dural incision was made which revealed a thick outer membrane and solidified hematoma. We removed as much of the clotted hematoma as possible using a curved suction tube under neuroendoscopy. The postoperative CT revealed that the hematoma was partially removed and the mass effect was reduced. As a result, the patient's neurological deficits improved. We reached a diagnosis of organizing CSDH following histologic examination of the removed hematoma that showed inflammatory cell infiltration and multiplication of fibroblasts. Neuroendoscopic hematoma evacuation via a burr hole is minimally invasive and may be a useful procedure in the treatment of some cases of organizing CSDH. PMID:27605476

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

    PubMed Central

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

    2015-01-01

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

  8. Bilateral posterior fossa chronic subdural hematoma treated with craniectomy: Case report and review of the literature

    PubMed Central

    Takemoto, Yushin; Matsumoto, Jun; Ohta, Kazutaka; Hasegawa, Shu; Miura, Masaki; Kuratsu, Jun-ichi

    2016-01-01

    Background: Posterior chronic subdural hematomas (pCSHs) are rare. Their diagnosis and treatment are difficult. Description: A 69-year-old woman was admitted to our hospital with nausea, headache, and mild consciousness disturbance. Computed tomography and magnetic resonance imaging showed bilateral pCSH. To prevent further neurological deterioration, we performed surgery under general anesthesia by midline suboccipital craniectomy. Unexpected bleeding from a developed circuitous occipital sinus was stopped with hemoclips. After hematoma removal, she recovered and was transferred to a rehabilitation hospital. By the 19th postoperative day, she had developed no neurologic deficits. Conclusion: This experience demonstrates the risk of blind surgical therapy in patients with pCSH. In such patients, posterior fossa craniectomy may be preferable in terms of diagnosis and safe treatment. PMID:27213111

  9. Extradural hematoma surgery in a child with Hutchinson-Gilford progeria syndrome: Perioperative concerns.

    PubMed

    Hansda, Upendra; Agarwal, Jyotsna; Patra, Chitralekha; Ganjoo, Pragati

    2013-05-01

    Hutchinson-Gilford progeria syndrome (HGPS) is a very rare genetic disorder characterized by premature ageing, severe growth failure, and very early onset atherosclerosis. Psychologically and emotionally child-like, these patients suffer from physiological changes of old age. Early and progressive atherosclerosis of intra-cranial vessels in HGPS patients, along with a thin skin and fragile vessels, make these patients susceptible to intra-cranial hematomas following relatively trivial injuries and to severe intra-cranial disease. Anesthetizing HGPS patients for surgery can be challenging due to the presence of a possible difficult airway, multi-system derangements, and associated skin, bone and joint disease. We report here one such child with HGPS who underwent craniotomy and evacuation of an extradural hematoma that developed after minor head trauma. Securing his airway during surgery was difficult.

  10. Spontaneous Resolution of a Large Chronic Subdural Hematoma Which Required Surgical Decompression.

    PubMed

    Lee, Gun Seok; Park, Young Seok; Min, Kyung Soo; Lee, Mou Seop

    2015-09-01

    We report on a case of an 87-year-old woman who showed spontaneous resolution of a large chronic subdural hematoma which required surgical decompression. She had suffered from confused mentality and right side weakness of motor grade II for 10 days. The initial brain CT scan showed a 22 mm thick low density lesion located in the left fronto-temporo-parietal region with midline shift (12 mm) which required emergency decompression. However, because she and her family did not want surgery, she was followed up in the outpatient clinic. Five months later, follow up brain CT showed that the CSDH had disappeared and the patient became neurologically normal. The reasons for spontaneous resolution of CSDH remain unclear. We discuss the possible relation between mechanisms of physio-pathogenesis and spontaneous resolution of a large chronic subdural hematoma (CSH) in an elderly patient. PMID:26539279

  11. A missed Behçet’s case presenting with spontaneous epidural hematoma

    PubMed Central

    Karataş, Levent; Mengi, Gönen; Özyemişçi-Taşkıran, Özden

    2015-01-01

    Spinal vascular events related to Behçet’s disease are relatively uncommon. Deep vein thrombosis is the most frequent vascular involvement. Anticoagulant therapy is a debated issue in Behçet’s disease. In this case report, we present a patient with a delayed diagnosis of Behçet’s disease after development of cervical epidural hematoma following anticoagulant therapy due to deep venous thrombosis. Anticoagulant therapy without immunosuppressive therapy leading to uncontrolled systemic inflammation may be the cause of spinal epidural hematoma. On the other hand, epidural vascular involvement as a vasculitic manifestation of Behçet’s disease in conjunction with anticoagulant therapy may have predisposed to spontaneous bleeding via increased fragility or microaneurysms in epidural arteries. In this case report, the importance of a multidisciplinary approach to Behçet’s disease is emphasized.

  12. Rivaroxaban-Induced Nontraumatic Spinal Subdural Hematoma: An Uncommon Yet Life-Threatening Complication

    PubMed Central

    Zaarour, Mazen; Hassan, Samer; Thumallapally, Nishitha; Dai, Qun

    2015-01-01

    In the last decade, the desire for safer oral anticoagulants (OACs) led to the emergence of newer drugs. Available clinical trials demonstrated a lower risk of OACs-associated life-threatening bleeding events, including intracranial hemorrhage, compared to warfarin. Nontraumatic spinal hematoma is an uncommon yet life-threatening neurosurgical emergency that can be associated with the use of these agents. Rivaroxaban, one of the newly approved OACs, is a direct factor Xa inhibitor. To the best of our knowledge, to date, only two published cases report the incidence of rivaroxaban-induced nontraumatic spinal subdural hematoma (SSDH). Our case is the third one described and the first one to involve the cervicothoracic spine. PMID:26543654

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

    PubMed Central

    Park, Hey-Ran; Bae, Hack-Gun

    2013-01-01

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

  14. Traumatic pelvic hematoma after a military static-line parachute jump: a case series.

    PubMed

    Barbee, George A; Booms, Zachary

    2014-01-01

    The authors report five cases of pelvic hematoma without associated pelvic fracture after military static-line parachute operations, a significantly underreported injury. The case reports and discussion include initial emergency department presentation, stabilization requirements, and imaging, disposition, and management recommendations. Data were collected retrospectively through review of medical records from a single institution over the course of a single calendar year, 2012-2013. Pelvic hematoma should be strongly considered in the patient with lower abdominal, hip, or pelvic pain after blunt injury from parachute landing fall even in the absence of associated fracture. The cases discussed display this underreported injury and highlight the frequent necessity for admission to a high-acuity care center for close monitoring. PMID:25344704

  15. Traumatic pelvic hematoma after a military static-line parachute jump: a case series.

    PubMed

    Barbee, George A; Booms, Zachary

    2014-01-01

    The authors report five cases of pelvic hematoma without associated pelvic fracture after military static-line parachute operations, a significantly underreported injury. The case reports and discussion include initial emergency department presentation, stabilization requirements, and imaging, disposition, and management recommendations. Data were collected retrospectively through review of medical records from a single institution over the course of a single calendar year, 2012-2013. Pelvic hematoma should be strongly considered in the patient with lower abdominal, hip, or pelvic pain after blunt injury from parachute landing fall even in the absence of associated fracture. The cases discussed display this underreported injury and highlight the frequent necessity for admission to a high-acuity care center for close monitoring.

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

    SciTech Connect

    Han, Young-Min Kwak, Ho-Sung; Jin, Gong-Young; Chung, Gyung-Ho; Song, Kyung-Jin

    2006-06-15

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

  17. Spontaneous subdural hematoma and antiplatelet therapy: Does efficacy of Ticagrelor come with added risk?

    PubMed

    Suryanarayana Sharma, Pattanagere Manjunatha; Tekkatte Jagannatha, Aniruddha; Javali, Mahendra; Hegde, Anupama Venkatasubba; Mahale, Rohan; Madhusudhan; Srinivasa, Rangasetty

    2015-12-01

    Antiplatelet therapy has established clinical benefit on cardiovascular outcome and has reduced the rates of re-infarction/in stent thrombosis following percutaneous coronary intervention in acute coronary syndromes. Major bleeding episodes can occur with antiplatelet therapy and intracranial hemorrhage (ICH) is one of the most feared complications resulting in significant morbidity and mortality. Identification of high risk groups and judicious use of antiplatelet therapy reduces the bleeding risk. Ticagrelor is a newer P2Y12 receptor antagonist with established clinical benefit. However, risks of having an ICH with these newer molecules cannot be ignored. Here, we report a case of spontaneous acute subdural hematoma developing in a patient on antiplatelet therapy with aspirin and ticagrelor. Early recognition, discontinuation of the medication and appropriate management resulted in resolution of hematoma and good clinical outcome. Authors have reviewed the antithrombotic drugs and their tendencies in causing intracranial bleeds from a neurophysicians perspective. PMID:26995425

  18. Intracranial Vasospasm without Intracranial Hemorrhage due to Acute Spontaneous Spinal Subdural Hematoma

    PubMed Central

    Oh, Jung-Hwan; Jwa, Seung-Joo; Yang, Tae Ki; Lee, Chang Sub; Oh, Kyungmi

    2015-01-01

    Spontaneous spinal subdural hematoma (SDH) is very rare. Furthermore, intracranial vasospasm (ICVS) associated with spinal hemorrhage has been very rarely reported. We present an ICVS case without intracranial hemorrhage following SDH. A 41-year-old woman was admitted to our hospital with a complaint of severe headache. Multiple intracranial vasospasms were noted on a brain CT angiogram and transfemoral cerebral angiography. However, intracranial hemorrhage was not revealed by brain MRI or CT. On day 3 after admission, weakness of both legs and urinary incontinence developed. Spine MRI showed C7~T6 spinal cord compression due to hyperacute stage of SDH. After hematoma evacuation, her symptoms gradually improved. We suggest that spinal cord evaluation should be considered in patients with headache who have ICVS, although intracranial hemorrhage would not be visible in brain images. PMID:26713084

  19. [Post-traumatic hematoma simulating a left-sided adrenal gland tumor].

    PubMed

    Will, C H; Hoeppener, H J; Beutler, W

    1990-01-01

    Typical signs of posttraumatic adrenal gland haematoma in computer-tomography are, besides an enlargement of the adrenal gland, a stripy infiltration of surrounding tissue and a thickening of the homolateral crus of the diaphragma, located primarily in the right adrenal gland. We report a case of an isolated enlargement of the left adrenal gland with normal surrounding tissue, which histologically proved to be a posttraumatic hematoma within the adrenal gland medulla.

  20. Time interval to surgery and outcomes following the surgical treatment of acute traumatic subdural hematoma.

    PubMed

    Walcott, Brian P; Khanna, Arjun; Kwon, Churl-Su; Phillips, H Westley; Nahed, Brian V; Coumans, Jean-Valery

    2014-12-01

    Although the pre-surgical management of patients with acute traumatic subdural hematoma prioritizes rapid transport to the operating room, there is conflicting evidence regarding the importance of time interval from injury to surgery with regards to outcomes. We sought to determine the association of surgical timing with outcomes for subdural hematoma. A retrospective review was performed of 522 consecutive patients admitted to a single center from 2006-2012 who underwent emergent craniectomy for acute subdural hematoma. After excluding patients with unknown time of injury, penetrating trauma, concurrent cerebrovascular injury, epidural hematoma, or intraparenchymal hemorrhage greater than 30 mL, there remained 45 patients identified for analysis. Using a multiple regression model, we examined the effect of surgical timing, in addition to other variables on in-hospital mortality (primary outcome), as well as the need for tracheostomy or gastrostomy (secondary outcome). We found that increasing injury severity score (odds ratio [OR] 1.146; 95% confidence interval [CI] 1.035-1.270; p=0.009) and age (OR1.066; 95%CI 1.006-1.129; p=0.031) were associated with in-hospital mortality in multivariate analysis. In this model, increasing time to surgery was not associated with mortality, and in fact had a significant effect in decreasing mortality (OR 0.984; 95%CI 0.971-0.997; p=0.018). Premorbid aspirin use was associated with a paradoxical decrease in mortality (OR 0.019; 95%CI 0.001-0.392; p=0.010). In this patient sample, shorter time interval from injury to surgery was not associated with better outcomes. While there are potential confounding factors, these findings support the evaluation of rigorous preoperative resuscitation as a priority in future study. PMID:25065950

  1. No more Doritos and lobster tails: a case report of life-threatening sublingual hematoma.

    PubMed

    Kausar, Huma; Gilani, Javed M; Khan, Omar A

    2009-07-01

    This case report highlights a life-threatening complication of mild hemophilia A. We report the onset of airway compromise through a massive sublingual hematoma in a 67-year-old male suffering from the mild form of hemophilia A. This case emphasizes the need for prompt medical attention and recognition of potentially serious complications of the disease in patients suffering with even mild form of this bleeding diathesis. PMID:19902776

  2. [Retroperitoneal hematoma revealing a tumor of the inferior vena cava: about a case].

    PubMed

    Lakhdar, Karim; Malki, Sidi Mohamed; Er-Raji, Ihssane; Derkaoui, Ali; Shimi, Abdelkrim; Khatouf, Mohamed

    2016-01-01

    Tumors of the inferior vena cava are rare, their most common histology is represented by leiomyosarcoma. They have few specific clinical features, however, the literature does not report hemorrhagic manifestations. Preoperative diagnosis is based on tomodensitometry and magnetic resonance imaging (MRI); it is confirmed by histology. We report a case with retroperitoneal hematoma revealing a tumor of the inferior vena cava. The diagnosis was made on the basis of clinical and radiological findings. PMID:27642432

  3. Ultrasonographic evaluation of neck hematoma and block salvage after failed neurostimulation-guided interscalene block.

    PubMed

    Howell, Stephen M; Unger, M W Todd; Colson, James D; Serafini, Mario

    2010-11-01

    Ultrasound-guided regional anesthetic techniques have shown some advantages over conventional paresthesia and neurostimulation techniques. We report the case of a neurostimulation-guided continuous interscalene block that would have ended in complication were it not for experience with ultrasound-guided regional anesthesia. Familiarity with ultrasound-guided block techniques permitted assessment of a neck hematoma during interscalene block and ultimately allowed successful peripheral nerve block.

  4. Ventricular tachycardia from intracardiac hematoma in the setting of blunt thoracic trauma.

    PubMed

    Solhpour, Amirreza; Ananaba-Ekeruo, Ijeoma; Memon, Nada B; Kantharia, Bharat K

    2014-01-01

    In the victims of motor vehicle accidents, unrecognized myocardial injuries may pose diagnostic and therapeutic challenges. Herein, we present a case of a 17-year-old man who developed multiple ventricular premature complexes and nonsustained ventricular tachycardia in the setting of blunt chest trauma from a motor vehicle accident. We discuss significance of the electrocardiographic abnormalities in making an accurate diagnosis of cardiac hematoma and its management. PMID:24581106

  5. Delayed Diagnosis of Pelvic Hematoma without Fracture Due to Military Parachuting.

    PubMed

    Cunningham, Cord W; Kotwal, Russ S; Kragh, John F

    2013-01-01

    The U.S. military has been conducting static-line parachute jumps for nearly a century. Beginning with World War II, military forces have also employed full-scale airborne operations as a method for insertion into combat. Through the years, injuries from blunt trauma as a result of static-line parachute jumps have evolved little with the refinement of equipment, training, and tactics. Parachute jumps continue to invoke primarily musculoskeletal injuries, especially to the lower extremities, back, neck, and head. These injuries are usually straightforward in their presentation and diagnosis. We describe the delayed diagnosis of a pelvic hematoma due to an uncommon blunt trauma jump injury. The purpose of this case report is to increase awareness of injury patterns during paratrooper operations, as well as to review the diagnosis and management of occult hemorrhage. Specific objectives for the readers are to (1) know the common injury types and patterns for airborne operations, (2) know the descent rate of T-10C/D parachutes and factors influencing the rate, (3) recognize signs and symptoms associated with a pelvic hematoma, and (4) recognize common complications resulting from a pelvic hematoma.

  6. [Postoperative epidural hematoma remote from the site of craniotomy for STA-MCA anastomosis].

    PubMed

    Ohata, Hiroto; Yamada, Tadanori; Dohi, Shuji

    2008-06-01

    We experienced a case in which the cause of acute brain swelling following resection of dura matter could not be recognized until the postoperative CT scan. A 30-year-old woman presented with a 4-year history of Moyamoya disease. Right hemiplegia developed a month before operation, so that the anti-platelet therapy was continued. At the end of dural resection the brain started to bulge and the brain swelling increased progressively. The patient was immediately placed on a head up position and received a rapid administration of mannitol for the treatment. The operator performed the echo examination for clarifying the cause of the brain swelling, but they could not find it. As the brain swelling slightly improved by the treatment, the surgery was performed continuously At the end of the operation the patient was moved for a CT scan and it showed mass effect caused by epidural hematoma over the left temporal region distant from the site of craniotomy. Evacuation of the hematoma was carried out urgently. At discharge, she was conscious and had no focal neurological deficits. The occurrence of the epidural hematoma is one of the reasons for unknown brain swelling during surgery. We strongly recommend that any sudden deterioration during the operation should be treated with emergency CT scan. PMID:18546910

  7. [Improvement of MRI effectiveness in the detection of intracerebral hematoma. Double inversion recovery].

    PubMed

    Burenchev, D V; Skvortsova, V I; Guseva, O I; Shumm, B A; Fomenkov, S A; Prokhorov, A V; Khetchikov, G V; Barkova, L A

    2009-01-01

    A study aimed at developing the pulse consequence, the double inversion recovery (DIR), using low field magnetic tomography, and assessing its effectiveness in the detection of intracerebral hematoma. The research has been conducted at "Ellipse" MR tomograph. The new pulse sequence has been created by the modification of the regular FLAIR, its technical parameters were as follows: the first TI - 90 ms, the second TI - 1300 ms, TR - 4665 ms, echo - 3. Twenty-seven patients have been enrolled in the study. The tissue contrast coefficients on FLAIR and DIR images have been compared. It has been shown that the contrast coefficient of normal brain structures and brain lesions on the DIR images in regard to the white matter are significantly higher than on the FLAIR images. Results of the study revealed that the dynamics of MR symptoms of intracerebral hematoma is faster on the DIR images compared to the FLAIR ones. This finding can be used for detection of intracerebral hematoma in difficult clinical cases.

  8. Rare complication after a transrectal ultrasound guided prostate biopsy: a giant retroperitoneal hematoma.

    PubMed

    Chiancone, Francesco; Mirone, Vincenzo; Fedelini, Maurizio; Meccariello, Clemente; Pucci, Luigi; Carrino, Maurizio; Fedelini, Paolo

    2016-05-24

    Common complications related to transrectal ultrasound (TRUS) guided prostatic needle biopsy are hematuria, hematospermia, and hematochezia. To the best of our knowledge, we report the second case of a very large hematoma extending from the pelvis into the retroperitoneal space in literature.A 66-year-old man with a serum prostate-specific antigen (PSA) of 5.4 ng/ml was admitted to our department for a TRUS-guided prostatic needle biopsy. Laboratory values on the day before biopsy, including coagulation studies, were all normal. The patients did not take any anticoagulant drugs. No immediate complications were encountered. Nevertheless, 7 hours after the biopsy, the patient reached our emergency department with severe diffuse abdominal pain, hypotension, tachycardia, and confusional state. He underwent an ultrasonography and then a computed tomography (CT) scan that showed "a blood collection in the pelvis that extending to the lower pole of left kidney associated with a focus of active contrast extravasation, indicating active ongoing prostate bleeding." Consequently, he underwent a diagnostic angiography that showed no more contrast extravasation, without the need of embolization. Management of hematoma has been conservative and hematoma was completely reabsorbed 4 months later.

  9. Spontaneous intramural duodenal hematoma in type 2B von Willebrand disease

    PubMed Central

    Eichele, Derrick D; Ross, Meredith; Tang, Patrick; Hutchins, Grant F; Mailliard, Mark

    2013-01-01

    Intramural duodenal hematoma is a rare cause of a proximal gastrointestinal tract obstruction. Presentation of intramural duodenal hematoma most often occurs following blunt abdominal trauma in children, but spontaneous non-traumatic cases have been linked to anticoagulant therapy, pancreatitis, malignancy, vasculitis and endoscopy. We report an unusual case of spontaneous intramural duodenal hematoma presenting as an intestinal obstruction associated with acute pancreatitis in a patient with established von Willebrand disease, type 2B. The patient presented with abrupt onset of abdominal pain, nausea, and vomiting. Computed tomography imaging identified an intramural duodenal mass consistent with blood measuring 4.7 cm × 8.7 cm in the second portion of the duodenum abutting on the head of the pancreas. Serum lipase was 3828 units/L. Patient was managed conservatively with bowel rest, continuous nasogastric decompression, total parenteral nutrition, recombinant factor VIII (humateP) and transfusion. Symptoms resolved over the course of the hospitalization. This case highlights an important complication of an inherited coagulopathy. PMID:24222967

  10. Chronic Subdural Hematoma Associated with Spontaneous Intracranial Hypotension: Therapeutic Strategies and Outcomes of 55 Cases

    PubMed Central

    TAKAHASHI, Koichi; MIMA, Tatsuo; AKIBA, Yoichi

    2016-01-01

    Spontaneous intracranial hypotension (SIH) has increasingly been recognized, and it is well known that SIH is sometimes complicated by chronic subdural hematoma (SDH). In this study, 55 cases of SIH with SDH were retrospectively analyzed, focusing on therapeutic strategies and outcomes. Of 169 SIH cases (75 males, 84 females), 55 (36 males, 19 females) were complicated by SDH. SIH was diagnosed based on clinical symptoms, neuroimaging, and/or low cerebrospinal fluid pressure. Presence of orthostatic headache and diffuse meningeal enhancement on magnetic resonance imaging were regarded as the most important criteria. Among 55 SIH with SDH cases, 13 improved with conservative treatment, 25 initially received an epidural blood patch (EBP), and 17 initially underwent irrigation of the hematomas. Of the 25 initially treated with EBP, 7 (28.0%) needed SDH surgery and 18 (72.0%) recovered fully without surgery. Of 17 SDH cases initially treated with surgery, 6 (35.7%) required no EBP therapy and the other 11 (64.3%) needed EBP and/or additional SDH operations. In the latter group, 2 cases had transient severe complications during and after the procedures. One of these 2 cases developed a hoarse voice complication. Despite this single, non-severe complication, all enrolled in this study achieved good outcomes. The present study suggests that patients initially receiving SDH surgery may need additional treatments and may occasionally have complications. If conservative treatment is insufficient, EBP should be performed prior to hematoma irrigation. PMID:26489406

  11. Acute carotid artery dissection treated with stenting and hematoma aspiration guided by ultrasonography.

    PubMed

    Geng, Liming; Zha, Changsong; Liu, Hao; Xu, Jianjun; Xiang, Yuexia; Zou, Zhongmin

    2013-10-01

    We report the successful treatment of dissection with stenosis of the carotid artery by stenting and aspiration of hematoma. A male patient, presenting with acute blurred vision and weakness and numbness of the right side of his body, was diagnosed with common carotid artery (CCA) dissection and severe stenosis of the internal carotid artery and CCA by digital subtraction arteriography and color Doppler ultrasonography (CDU). Two stents were separately implanted into the left internal carotid artery and CCA to restore blood flow and seal the opening of the dissection. The hematoma inside the CCA dissection was transcutaneously aspirated under CDU guidance after thrombolysis with tissue plasminogen activator. Three days after the operation, the dissection was still sealed. The patient was discharged 1 week later without any signs or symptoms. Follow-up examination at 70 days confirmed complete healing of the CCA dissection. Transcutaneous intradissection hematoma aspiration with CDU guidance may be applicable in treating arterial dissection, especially when conservative treatments cannot be expected to improve severe flow disturbances. PMID:22941665

  12. Spontaneous spinal epidural hematoma management with minimally invasive surgery through tubular retractors

    PubMed Central

    Fu, Chao-Feng; Zhuang, Yuan-Dong; Chen, Chun-Mei; Cai, Gang-Feng; Zhang, Hua-Bin; Zhao, Wei; Ahmada, Said Idrissa; Devi, Ramparsad Doorga; Kibria, Md Golam

    2016-01-01

    Abstract To report a minimally invasive paraspinal approach in the treatment of a case of spontaneous spinal epidural hematoma (SSEH). We additionally aim to review the relevant literature to enhance our knowledge of this disease. SSEH is an uncommon but potentially catastrophic disease. Currently, most appropriate management is emergence decompression laminectomy and hematoma evacuation. An 81-year-old woman was admitted to the neurology department with a chief complaint of bilateral numbness and weakness of the lower limbs and difficulty walking for 4 days with progressive weakness developed over the following 3 days accompanied with pain in the lower limbs and lower back. No history of trauma was reported. Magnetic resonance imaging of the thoracolumbar spine demonstrated an epidural hematoma extending from T-12 to L-5 with thecal sac and cauda equina displacement anterior. The patient was treated in our department with a minimally invasive approach. This operation method had been approved by Chinese Independent Ethics Committee. Three months following the operation, the patient had regained the ability to walk with the aid of a cane and myodynamia tests revealed normal results for the left lower limb and a 4/5 grade for the right limb. Importantly, no complications were exhibited from the surgical operation. The minimally invasive paraspinal approach through tubular retractors is demonstrated here as an effective alternative method for the treatment of SSEH. PMID:27367986

  13. [A case of acute intracranial epidural hematoma caused by chronic nasal sinusitis].

    PubMed

    Kihara, Kazunori; Sato, Motoki; Kado, Ken; Fukuda, Kazumasa; Nakamura, Takao; Yamakami, Iwao

    2015-01-01

    Non-traumatic intracranial acute epidural hematoma(EDH)is rare. It is mostly caused by coagulation disorders, dural metastasis, or vascular malformations of the dura. We report a case of non-traumatic acute EDH caused by chronic nasal sinusitis and review the literature comprising 10 cases of acute EDH caused by chronic nasal sinusitis. A 16-year-old boy visited our outpatient clinic with a 2-day history of severe headache. He did not have fever or neurological abnormalities and showed no evidence of head trauma. Cranial computed tomography(CT)revealed sphenoid sinusitis and a small amount of epidural air in the middle fossa, but no other intracranial abnormalities. After eight days with no subsequent history of trauma, radiological exams showed a massive acute epidural hematoma in the left middle fossa and temporal convexity without any vascular lesion or skull fracture. The patient underwent a hematoma evacuation that revealed neither a skull fracture nor a vascular abnormality. In this adolescent, chronic nasal sinusitis caused fragility of the meningeal artery wall, an air collection in the epidural space, and the detachment of the dura mater from the inner surface of the skull, thereby resulting in a non-traumatic acute EDH.

  14. Non-traumatic spontaneous acute epidural hematoma in a patient with sickle cell disease.

    PubMed

    Serarslan, Yurdal; Aras, Mustafa; Altaş, Murat; Kaya, Hasan; Urfalı, Boran

    2014-01-01

    A 19-year-old female with sickle cell anemia (SCD) was referred to our hospital after two days of hospitalization at another hospital for a headache crisis. This headache crisis was due to a raised intracranial pressure; these symptoms were noted and included in her comprehensive list of symptoms. There was an acute drop in the hemoglobin and hematocrit levels. The cranial CT scan demonstrated a left fronto-parietal acute epidural hematoma (AEH) and a calvarial bone expansion, which was suggestive of medullary hematopoiesis. The patient underwent emergent craniotomy and evacuation of the hematoma. There were no abnormal findings intra-operatively apart from the AEH, except skull thickening and active petechial bleeding from the dural arteries. Repeated CT scan showed a complete evacuation of the hematoma. The possible underlying pathophysiological mechanisms were discussed. In addition to the factors mentioned in the relevant literature, any active petechial bleeding from the dural arteries on the separated surface of the dura from the skull could have contributed to the expanding of the AEH in our patient. Neurosurgeons and other health care providers should be aware of spontaneous AEH in patients with SCD.

  15. Non-traumatic spontaneous acute epidural hematoma in a patient with sickle cell disease.

    PubMed

    Serarslan, Yurdal; Aras, Mustafa; Altaş, Murat; Kaya, Hasan; Urfalı, Boran

    2014-01-01

    A 19-year-old female with sickle cell anemia (SCD) was referred to our hospital after two days of hospitalization at another hospital for a headache crisis. This headache crisis was due to a raised intracranial pressure; these symptoms were noted and included in her comprehensive list of symptoms. There was an acute drop in the hemoglobin and hematocrit levels. The cranial CT scan demonstrated a left fronto-parietal acute epidural hematoma (AEH) and a calvarial bone expansion, which was suggestive of medullary hematopoiesis. The patient underwent emergent craniotomy and evacuation of the hematoma. There were no abnormal findings intra-operatively apart from the AEH, except skull thickening and active petechial bleeding from the dural arteries. Repeated CT scan showed a complete evacuation of the hematoma. The possible underlying pathophysiological mechanisms were discussed. In addition to the factors mentioned in the relevant literature, any active petechial bleeding from the dural arteries on the separated surface of the dura from the skull could have contributed to the expanding of the AEH in our patient. Neurosurgeons and other health care providers should be aware of spontaneous AEH in patients with SCD. PMID:24447643

  16. Delayed Diagnosis of Pelvic Hematoma without Fracture Due to Military Parachuting.

    PubMed

    Cunningham, Cord W; Kotwal, Russ S; Kragh, John F

    2013-01-01

    The U.S. military has been conducting static-line parachute jumps for nearly a century. Beginning with World War II, military forces have also employed full-scale airborne operations as a method for insertion into combat. Through the years, injuries from blunt trauma as a result of static-line parachute jumps have evolved little with the refinement of equipment, training, and tactics. Parachute jumps continue to invoke primarily musculoskeletal injuries, especially to the lower extremities, back, neck, and head. These injuries are usually straightforward in their presentation and diagnosis. We describe the delayed diagnosis of a pelvic hematoma due to an uncommon blunt trauma jump injury. The purpose of this case report is to increase awareness of injury patterns during paratrooper operations, as well as to review the diagnosis and management of occult hemorrhage. Specific objectives for the readers are to (1) know the common injury types and patterns for airborne operations, (2) know the descent rate of T-10C/D parachutes and factors influencing the rate, (3) recognize signs and symptoms associated with a pelvic hematoma, and (4) recognize common complications resulting from a pelvic hematoma. PMID:24419827

  17. Elucidation of the role of biological factors and device design in cerebral NIRS using an in vivo hematoma model based on high-intensity focused ultrasound

    NASA Astrophysics Data System (ADS)

    Wang, Jianting; Huang, Stanley; Myers, Matthew; Chen, Yu; Welle, Cristin; Pfefer, Joshua

    2016-03-01

    Near-Infrared Spectroscopy (NIRS) is an emerging medical countermeasure for rapid, field detection of hematomas caused by traumatic brain injury (TBI). Bench and animal tests to determine NIRS sensitivity and specificity are needed. However, current animal models involving non-invasively induced, localized neural damage are limited. We investigated an in vivo murine hematoma model in which cerebral hemorrhage was induced noninvasively by high-intensity focused ultrasound (HIFU) with calibrated positioning and parameters. To characterize the morphology of induced hematomas, we used skull-intact histological evaluation. A multi-wavelength fiber-optic NIRS system with three source-detector separation distances was used to detect hematoma A 1.1 MHz transducer produced consistent small-to-medium hematoma localized to a single hemisphere, along with bruising of the scalp, with a low mortality rate. A 220 kHz transducer produced larger, more diffuse hematomas, with higher variability in size and a correspondingly higher mortality rate. No skin bruising or blood accumulation between the skin and skull was observed following injury application with the 220 kHz transducer. Histological analysis showed higher sensitivity for larger hematomas (>4x4 mm2). NIRS optical density change after HIFU was able to detect all hematomas, with sensitivity dependent on wavelength and separation distance. While improvements in methods for validating cerebral blood distribution are needed, the HIFU hematoma model provided useful insights that will inform development of biologically relevant, performance test methods for cerebral NIRS systems.

  18. Complementary role of CT and In-111 leukocyte scans in the diagnosis of infected hematoma and thrombosis

    SciTech Connect

    Kim, E.E.; Pjura, G.A.; Floyd, W.; Raval, B.; Sandler, C.; Gobuty, A.H.

    1984-01-01

    Patients with traumatic hematomas or those with indwelling catheters who subsequently develop fever and sepsis without clinical localizing signs to indicate an inflammatory focus can present a diagnostic dilemma. Early diagnosis of an infected hematoma or thrombus is important to optimal management. CT can provide, exquisite delineation of anatomy identifying and localizing a post-traumatic fluid collection but cannot reliably distinguish hematoma from abscess in all cases. A thrombus at a catheter tip may be too small to be resolved; when identified, the question of infection again remains. In-111 leukocyte scanning provides a method for identifying or ruling out infection in these situations. The authors performed In-111 leukocyte scans on 15 patients with indwelling catheters. Five of these patients were febrile with positive blood cultures. In-111 leukocyte scans showed positive findings in 8 patients: 5 showed surgically confirmed infected hematomas in the abdomen (3 in the pelvis, 1 in a kidney, 1 in the splenic bed), and 3 showed infected thrombosis in catheter tips. The authors conclude that CT scanning and In-111 leukocyte scanning play complementary roles in the evaluation of traumatic hematomas and thrombosis, the former providing precise anatomic delineation and the latter providing evidence of inflammation.

  19. Upper Airway Hematoma Secondary to Warfarin Therapy: A Systematic Review of Reported Cases

    PubMed Central

    Karmacharya, Paras; Pathak, Ranjan; Ghimire, Sailu; Shrestha, Pragya; Ghimire, Sushil; Poudel, Dilli Ram; Khanal, Raju; Shah, Shirin; Aryal, Madan Raj; Alweis, Richard L

    2015-01-01

    Upper airway hematoma (UAH) is a rare but life-threatening complication of oral anticoagulants requiring early recognition. However, no consensus exists regarding the best approach to treatment. We therefore, sought to systematically review the published literature on UAH to elaborate its demographic and clinical characteristics, treatment, complications, and outcomes. A systematic electronic search of PubMed and EMBASE for case reports, case series, and related articles of UAH related to warfarin published from inception (November 1950) to March 2015 was carried out. Categorical variables were expressed as percentage and continuous variables as mean ± standard deviation (SD). Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 20.0. All cases were reported to have UAH as a complication of anticoagulation therapy with warfarin. Demographic and clinical characteristics, treatment, complications and outcomes of UAH were studied. Thirty-eight cases of UAH were identified from 34 reports in the literature. No gender preponderance (male = 52.78%) was seen and the average age of presentation was 60.11 ± 12.50 years. Dysphagia, sore throat, and neck swelling were the most common symptoms and the mean international normalized ratio (INR)at presentation was 8.07 ± 4.04. Most cases had sublingual hematoma (66.57%) followed by retropharyngeal hematoma (27.03%). Of the cases, 48.65% were managed conservatively while the rest underwent either cricothyrotomy or intubation with the time to resolution being 7.69 ± 5.44 days. UAH is a rare butpotentially serious complication of warfarin therapy. It is more common in the elderly population with supratherapeutic INR; inciting events were present in many cases. Overall, it has a good prognosis with significant morbidity present only if concomitant respiratory compromise is present. Reversal of anticoagulation with low threshold for artificial airway placement in the event of airway

  20. Renal Subcapsular Hematoma after Intravenous Thrombolysis in a Patient with Acute Cerebral Infarction

    PubMed Central

    La, Yun Kyung; Kim, Ji Hwa

    2016-01-01

    A 74-year-old female with acute cerebral infarction was treated with intravenous recombinant tissue plasminogen activator. Subsequent percutaneous transfemoral angiography and mechanical thrombectomy were performed due to a right middle cerebral artery occlusion, which was successfully recanalized. Two days after treatment, the patient complained of vague right abdominal pain and a laboratory test showed anemia. Abdominal computed tomography showed a right renal subcapsular hematoma. After conservative management, the patient was discharged without complications. We report a rare complication after intravenous thrombolysis in a patient with acute cerebral infarction. PMID:27621950

  1. Renal Subcapsular Hematoma after Intravenous Thrombolysis in a Patient with Acute Cerebral Infarction.

    PubMed

    La, Yun Kyung; Kim, Ji Hwa; Lee, Kyung-Yul

    2016-09-01

    A 74-year-old female with acute cerebral infarction was treated with intravenous recombinant tissue plasminogen activator. Subsequent percutaneous transfemoral angiography and mechanical thrombectomy were performed due to a right middle cerebral artery occlusion, which was successfully recanalized. Two days after treatment, the patient complained of vague right abdominal pain and a laboratory test showed anemia. Abdominal computed tomography showed a right renal subcapsular hematoma. After conservative management, the patient was discharged without complications. We report a rare complication after intravenous thrombolysis in a patient with acute cerebral infarction. PMID:27621950

  2. Intramural Hematoma of the Thoracic Aorta as a Form of Aortic Dissection

    SciTech Connect

    Juszkat, Robert Pukacki, Fryderyk; Oszkinis, Grzegorz; Zarzecka, Anna; Majewski, Waclaw

    2007-09-15

    Intramural hematoma (IMH) of the thoracic aorta is a complication with unknown etiology and a poorly predictable prognosis. There is also considerable controversy about the management and prognosis of IMH as well as the treatment. We present two cases of endovascular treatment of IMH with stent-graft placement. On the basis of references, we discuss risks of progression of the given pathology and possible complications. Despite the lack of uniform opinion about the management of this disorder, we present our observations of and experiences with endovascular treatment of IMH of the thoracic aorta.

  3. Renal Subcapsular Hematoma after Intravenous Thrombolysis in a Patient with Acute Cerebral Infarction

    PubMed Central

    La, Yun Kyung; Kim, Ji Hwa

    2016-01-01

    A 74-year-old female with acute cerebral infarction was treated with intravenous recombinant tissue plasminogen activator. Subsequent percutaneous transfemoral angiography and mechanical thrombectomy were performed due to a right middle cerebral artery occlusion, which was successfully recanalized. Two days after treatment, the patient complained of vague right abdominal pain and a laboratory test showed anemia. Abdominal computed tomography showed a right renal subcapsular hematoma. After conservative management, the patient was discharged without complications. We report a rare complication after intravenous thrombolysis in a patient with acute cerebral infarction.

  4. Pin-site epidural hematoma: A catastrophic complication of cranial fixation in a child

    PubMed Central

    Krishnan, Prasad; Kumar, Soumen Kanti; Kartikueyan, Rajaraman; Patel, Sachinkumar Maheshbhai

    2016-01-01

    Cranial fixation with pins is a routine adjunct in neurosurgery and is usually considered safe. A rarely reported complication is skull fracture at the pin site and consequent epidural hematoma. Usually, these are picked up only postoperatively and rarely, intraoperatively if there is unexplained “brain bulge” in which case the operation should be terminated and urgent imaging has to be done. We describe such a complication that occurred while operating on a 12-year-old child with a posterior fossa tumor and review the available literature dealing with such events. PMID:27114664

  5. Dialysis-induced Subdural Hematoma in an Arachnoid Cyst Associated with Autosomal Dominant Polycystic Kidney Disease.

    PubMed

    Takata, Tadayuki; Kokudo, Yohei; Kume, Kodai; Ikeda, Kazuyo; Kamada, Masaki; Touge, Tetsuo; Deguchi, Kazushi; Masaki, Tsutomu

    2016-01-01

    Arachnoid cyst (AC) is a neurological complication of autosomal dominant polycystic kidney disease (ADPKD). Although an AC can increase the risk of a subdural hematoma, the clinical presentation of bleeding into an AC associated with ADPKD is not well known. We herein report the case of a 59-year-old woman in whom the initiation of hemodialysis for renal failure led to AC bleeding. A change of anticoagulant from heparin to nafamostat mesilate allowed dialysis to continue without rebleeding. These findings suggest that hemodialysis in patients with an AC associated with ADPKD may increase the risk of bleeding. Nafamostat mesilate may be useful in such cases. PMID:27477416

  6. [Acute Subdural Hematoma in Snowboarders:A Multivariate Analysis of 79 Cases].

    PubMed

    Koyama, Shinya; Fukuda, Osamu; Kuroda, Satoshi

    2016-07-01

    Snowboarding-related head injuries have become less common as the number of snowboarders has decreased;however, severe head injuries, such as acute subdural hematomas, occur every snowboarding season. We investigated the characteristics of cases of snowboarding-related acute subdural hematoma treated at our hospital. A total of 3,632 patients with snowboarding-related head injuries seen at our hospital between the 1995/96 and 2012/13 snowboarding seasons were enrolled in this study. Seventy-nine(2.2%)patients were diagnosed with acute subdural hematomas using computed tomography. We statistically analyzed the patient questionnaire responses, clinical records, and radiological findings. We compared the findings of the acute subdural hematoma(ASDH)group with those of the non-ASDH group. Among beginners, falling on a slope, incidents involving gentle slopes, and injuries of unknown origin were significantly more common in the ASDH group. On the other hand, among the intermediate snowboarders, incidents involving jumps, jump failure, and collisions with other snowboarders were more common in the non-ASDH group. Secondly, in an analysis involving subjects who had an ASDH, we compared the beginner group with the intermediate/advanced group. Falling on a slope, incidents involving gentle slopes, pure ASDH, diffuse brain swelling, and death were more common in the beginner group, and ASDH combined with contusions or subarachnoid hemorrhaging and incidents involving a jump were more common in the intermediate/advanced group. Finally, we summarized the cases of 10 subjects with an ASDH as well as diffuse brain swelling. Nine of the 10 patients died, 8 were first-timers or beginners, 6 had incidents involving flat or gentle slopes, and 5 had fallen on a slope. Snowboarding is a recreational sport;therefore, snowboarders must take responsibility for their actions. However, snowboarders, especially beginners, could decrease their risk of ASDH if they are informed about ASDH and

  7. [Percutaneous gastrostomy complicated with abdominal wall hematoma; severe anemia secondary to percutaneous endoscopic gastrostomy].

    PubMed

    Chu, D; Chamorro, S; Arrieta, F; Cobo, M E; Calañas, A; Botella, J I; Balsa, J; Zamarrón, I; Vázquez, C

    2012-01-01

    Endoscopic percutaneous gastrostomy (PEG) is a safe and effective procedure that offers clear advantages over nasogastric tube feeding to ensure adequate nutrition in patients with swallowing problems who have an intact digestive tract. With proper placement and monitoring methodology there are few complications in both the peritrack procedure as in the long run. However, despite being considered a safe technique it is not devoided of serious complications. We report a patient with dysphagia, requiring percutaneous endoscopic gastrostomy placement developing a severe anemia with severe subcutaneous hematoma, given the exceptional case and literature review.

  8. Rate of Contrast Extravasation on CT Angiography Predicts Hematoma Expansion and Mortality in Primary Intracerebral Hemorrhage

    PubMed Central

    Brouwers, H. Bart; Battey, Thomas W.K.; Musial, Hayley H.; Ciura, Viesha A.; Falcone, Guido J.; Ayres, Alison M.; Vashkevich, Anastasia; Schwab, Kristin; Viswanathan, Anand; Anderson, Christopher D.; Greenberg, Steven M.; Pomerantz, Stuart R.; Ortiz, Claudia J.; Goldstein, Joshua N.; Gonzalez, R. Gilberto; Rosand, Jonathan; Romero, Javier M.

    2015-01-01

    Background and Purpose In primary intracerebral hemorrhage (ICH), the presence of contrast extravasation following CT angiography (CTA), termed the ‘spot sign’, predicts hematoma expansion and mortality. Since the biological underpinnings of the spot sign are not fully understood, we investigated whether the rate of contrast extravasation - which may reflect the rate of bleeding - predicts expansion and mortality beyond the simple presence of the spot sign. Methods Consecutive ICH patients with first-pass CTA followed by a 90-second delayed post-contrast CT (delayed CTA) were included. CTAs were reviewed for spot sign presence by two blinded readers. Spot sign volumes on first-pass and delayed CTA and ICH volumes were measured using semi-automated software. Extravasation rates were calculated and tested for association with hematoma expansion and mortality using uni- and multivariable logistic regression. Results 162 patients were included, 48 (30%) of whom had ≥1 spot sign. Median spot sign volume was 0.04mL on first-pass CTA and 0.4mL on delayed CTA. Median extravasation rate was 0.23mL/min overall, and 0.30mL/min among expanders versus 0.07mL/min in non-expanders. Extravasation rates were also significantly higher in patients who died in hospital: 0.27mL/min versus 0.04mL/min. In multivariable analysis, the extravasation rate was independently associated with in-hospital mortality (OR1.09 [95%CI 1.04–1.18], p=0.004), 90-day mortality (OR1.15 [95%CI 1.08–1.27], p=0.0004), and hematoma expansion (OR1.03 [95%CI 1.01–1.08], p=0.047). Conclusions Contrast extravasation rate, or spot sign growth, further refines the ability to predict hematoma expansion and mortality. Our results support the hypothesis that the spot sign directly measures active bleeding in acute ICH. PMID:26243220

  9. Spinal subdural hematoma with cauda equina syndrome: A complication of combined spinal epidural anesthesia

    PubMed Central

    Singhal, Neha; Sethi, Priyanka; Jain, Jitesh Kumar; Agarwal, Saurabh

    2015-01-01

    Combined spinal-epidural anesthesia (CSE) is considered safe in lower limb surgeries. We report a case of sudden neurological deterioration in a stable postoperative patient who was given CSE for total knee replacement and low molecular weight heparin in postoperative period. On the 4th postoperative day, she developed sudden onset weakness in left lower limb along with bladder incontinence. Magnetic resonance imaging spine revealed a subdural hematoma at L2-L3 level. Immediate laminectomy along with cord decompression was done and patient recovered well except for a persistent foot drop on left side. PMID:25948911

  10. Renal Subcapsular Hematoma after Intravenous Thrombolysis in a Patient with Acute Cerebral Infarction.

    PubMed

    La, Yun Kyung; Kim, Ji Hwa; Lee, Kyung-Yul

    2016-09-01

    A 74-year-old female with acute cerebral infarction was treated with intravenous recombinant tissue plasminogen activator. Subsequent percutaneous transfemoral angiography and mechanical thrombectomy were performed due to a right middle cerebral artery occlusion, which was successfully recanalized. Two days after treatment, the patient complained of vague right abdominal pain and a laboratory test showed anemia. Abdominal computed tomography showed a right renal subcapsular hematoma. After conservative management, the patient was discharged without complications. We report a rare complication after intravenous thrombolysis in a patient with acute cerebral infarction.

  11. HELLP Syndrome Complicated with Postpartum Subcapsular Ruptured Liver Hematoma and Purtscher-Like Retinopathy

    PubMed Central

    Cernea, Daniela; Dragoescu, Alice; Novac, Marius

    2012-01-01

    Purtscher's retinopathy is usually associated with trauma, acute pancreatitis, vasculitis, lupus, and bone fractures. It was rarely described postpartum in patients with preeclampsia as well as associated with HELLP syndrome. We present a case of a multiparous patient aged 44 with severe preeclampsia and postpartum HELLP syndrome complicated with Purtscher-like retinopathy and large ruptured subcapsular liver hematoma that required emergency abdominal surgery after premature delivery of a dead fetus. Postsurgical outcome was favorable regarding both liver function and visual acuity. PMID:22852104

  12. [Intramural duodenal hematoma and acute pancreatitis as a complication of diagnostic biopsy of a duodenal 6-year-old boy].

    PubMed

    Krzesiek, Elżbieta; Iwańczak, Barbara; Zaleska-Dorobisz, Urszula; Patkowski, Dariusz

    2016-01-01

    Hematoma duodenum is a very rare complication of diagnostic endoscopy of the upper gastrointestinal tract when biopsy of the duodenum is performed (average frequency is estimated as 1:1,250 biopsies). Most often, it affects children and young adults without any risk factors. Symptoms result from obstruction of the duodenum and compression of the adjacent structures. Conservative treatment, which consists of parenteral nutrition and aspiration of gastric contents until the absorption of hematoma and patency of the gastrointestinal tract returns, is preferred. This paper describes a 6-year-old boy diagnosed due to short stature and low weight in whom the diagnostic biopsy of the duodenum caused formation of a hematoma in the descending duodenum and led to total ileus and acute pancreatitis. The boy was treated conservatively with good result and complete resolution of symptoms was achived.

  13. Effects of human umbilical cord mesenchymal stem cell transplantation combined with minimally invasive hematoma aspiration on intracerebral hemorrhage in rats

    PubMed Central

    Zhang, Qinghua; Shang, Xiao; Hao, Maolin; Zheng, Maoyong; Li, Yanxia; Liang, Zhigang; Cui, Yuanxiao; Liu, Zhenhua

    2015-01-01

    This study is to investigate the effects of human umbilical cord-mesenchymal stem cells (HUC-MSCs) transplantation combined with minimally invasive hematoma aspiration on neural functional recovery and p53 gene expression in rats with intracerebral hemorrhage (ICH). Collagenase type-IV was injected to the caudate nucleus of the rats to make ICH models. One hundred and twenty Sprague-Dawley rats with successful modeling were randomly divided into 4 groups, including the ICH group, hematoma aspiration group, HUC-MSCs transplantation group and HUC-MSCs transplantation combined with hematoma aspiration group (combination group). Neural functional status of the rats was assessed by modified neurological severity score (mNSS). Expression of p53 in the cerebral tissues surrounding ICH was detected by immunohistochemical assays. The scores of mNSS and the expression of p53 gene in the hematoma aspiration group, the HUC-MSCs transplantation group and the combination group were significantly lower than those in the ICH group at each indicated time point (p < 0.05). Intriguingly, mNSS scores and p53 expression in the combination group were significantly lower than those in the hematoma aspiration group on day 7, 14 and 30 (p < 0.05), and significantly lower than those in the HUC-MSCs transplantation group on day 14 and 30 (p < 0.05). HUC-MSCs transplantation combined with minimally invasive hematoma aspiration is more effective than either therapy alone in rats with ICH and could distinctly reduce the damage of nerve cells. PMID:26807166

  14. Transcatheter Arterial Embolization of Concurrent Spontaneous Hematomas of the Rectus Sheath and Psoas Muscle in Patients Undergoing Anticoagulation

    SciTech Connect

    Basile, Antonio; Medina, Jose Garcia; Mundo, Elena; Medina, Vicente Garcia; Leal, Rafael

    2004-11-15

    We report a case of concurrent rectus sheath and psoas hematomas in a patient undergoing anticoagulant therapy, treated by transcatheter arterial embolization (TAE) of inferior epigastric and lumbar arteries. Computed tomography (CT) demonstrated signs of active bleeding in two hematomas of the anterior and posterior abdominal walls. Transfemoral arteriogram confirmed the extravasation of contrast from the right inferior epigastric artery (RIEA). Indirect signs of bleeding were also found in a right lumbar artery (RLA). We successfully performed TAE of the feeding arteries. There have been few reports in the literature of such spontaneous hemorrhages in patients undergoing anticoagulation, successfully treated by TAE.

  15. Subdural Hematoma Associated with Dasatinib and Intrathecal Methotrexate Treatment in Philadelphia Chromosome-positive Acute Lymphoblastic Leukemia.

    PubMed

    Ureshino, Hiroshi; Nishioka, Atsujiro; Kojima, Kensuke; Kizuka, Haruna; Sano, Haruhiko; Shindo, Takero; Kubota, Yasushi; Ando, Toshihiko; Kimura, Shinya

    2016-01-01

    Dasatinib has been associated with an increased risk of bleeding, with the most prominent risk noted in patients with advanced-stage chronic myeloid leukemia and thrombocytopenia. We herein report two cases of Philadelphia chromosome-positive acute lymphoblastic leukemia in which a subdural hematoma developed in association with low-dose (40-50 mg/day) dasatinib treatment and lumbar puncture for intrathecal methotrexate injection. Both patients were in complete remission, with normal platelet counts and coagulation status. We suggest that dasatinib, even at a low dose, may impair platelet aggregation and that lumbar puncture may increase the risk of a subdural hematoma (occasionally bilateral) in patients receiving dasatinib. PMID:27629971

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

    PubMed

    Heller, Benjamin; Levine, Adam

    2015-10-01

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

  17. Life-threatening large subcutaneous hematoma after minor head trauma: A young female patient who was suspected of having new Ehlers-Danlos syndrome.

    PubMed

    Fujimoto, So; Ota, Takahiro; Mizutani, Tohru

    2015-01-01

    Life-threatening large subcutaneous hematomas after minor injury are rare clinical states for young people; however these patients may have hidden diseases, which can cause a tendency to bleed. A 31-year-old woman visited our hospital after minor injury. The first computed tomography (CT) scan revealed a small subcutaneous hematoma, but her head bulged and the second CT scan revealed her subcutaneous hematoma had become enlarged. Two surgeries were needed to stop the bleeding and. Though she received intensive care, she died 48 days after onset. The new Ehlers-Danlos syndrome (EDS), known as EDS Kosho type (EDSKT), is a connective tissue disease, in which patients often experience large subcutaneous hematomas. We suspected our patient had EDSKT because her clinical features were compatible with this syndrome. Our findings support the notion that large subcutaneous hematomas in young patients with connective tissue disease can be fatal; a careful follow-up is required. PMID:25972953

  18. Local Inflammation in Fracture Hematoma: Results from a Combined Trauma Model in Pigs

    PubMed Central

    Horst, K.; Eschbach, D.; Pfeifer, R.; Hübenthal, S.; Sassen, M.; Steinfeldt, T.; Wulf, H.; Ruchholtz, S.; Pape, H. C.; Hildebrand, F.

    2015-01-01

    Background. Previous studies showed significant interaction between the local and systemic inflammatory response after severe trauma in small animal models. The purpose of this study was to establish a new combined trauma model in pigs to investigate fracture-associated local inflammation and gain information about the early inflammatory stages after polytrauma. Material and Methods. Combined trauma consisted of tibial fracture, lung contusion, liver laceration, and controlled hemorrhage. Animals were mechanically ventilated and under ICU-monitoring for 48 h. Blood and fracture hematoma samples were collected during the time course of the study. Local and systemic levels of serum cytokines and diverse alarmins were measured by ELISA kit. Results. A statistical significant difference in the systemic serum values of IL-6 and HMGB1 was observed when compared to the sham. Moreover, there was a statistical significant difference in the serum values of the fracture hematoma of IL-6, IL-8, IL-10, and HMGB1 when compared to the systemic inflammatory response. However a decrease of local proinflammatory concentrations was observed while anti-inflammatory mediators increased. Conclusion. Our data showed a time-dependent activation of the local and systemic inflammatory response. Indeed it is the first study focusing on the local and systemic inflammatory response to multiple-trauma in a large animal model. PMID:25694748

  19. Transversus abdominal plane block as a sole anesthetic technique for abdominal wall hematoma drainage.

    PubMed

    Varela, N; Golvano, M; Monedero, P

    2016-10-01

    Transversus abdominal plane (TAP) block is a known and useful technique, widely used for postoperative pain management of abdominal wall incisions. During the past years, and following the expansion of ultrasound guided techniques, its use has even gained more adepts. It is usually used as an adjuvant technique, primarily in order to control postoperative pain and reduce opioids consumption. We report the case of an 82 years old patient admitted for drainage of a postoperative abdominal wall hematoma after correction of a McBurney incisional hernia. The corrective surgery had gone on without incident, under general anesthesia with laryngeal mask. Two weeks later, the patient came back to our emergency department with a clear hematoma of the abdominal wall. Surgery was decided. A sole local anesthetic technique was achieved, using a TAP block. The block was performed under ultrasound guidance, using a subcostal approach. The surgery went on without complications. Therefore, TAP block offers a hemodynamic stability, appropriate intra-operative anesthesia and post-surgical analgesia of the abdominal wall.

  20. Fatal endocarditis with methicilin-sensible Staphylococcus aureus and major complications: rhabdomyolysis, pericarditis, and intracerebral hematoma

    PubMed Central

    Georgescu, Anca Meda; Azamfirei, Leonard; Szalman, Krisztina; Szekely, Edit

    2016-01-01

    Abstract Background: Over the last decades Staphylococcus aureus (SA) has become the dominant etiology of native valve infective endocarditis, with the community-acquired methicillin-sensible Staphylococcus aureus (CA-MSSA) strains being the prevailing type. Case: We report here a case of extremely severe CA-MSSA aortic valve acute endocarditis associated with persistent Staphylococcus aureus bacteremia (SAB) in a previously healthy man and include a literature review. The patient developed severe and rare complications (purpura, purulent pericarditis, intracerebral hematoma, and rhabdomyolysis) through systemic embolism; they required drainage of pericardial empyema and cerebral hematoma, the latter eventually caused a fatal outcome. The strains recovered from sequential blood culture sets and pericardial fluid were MSSA negative for genes encoding for staphylococcal toxic shock syndrome toxin (TSST)-1 and Panton–Valentine leukocidin. C, G, and I enterotoxin genes were detected. Conclusions: This case with unusually severe evolution underlines the limited ability of vancomycin to control some MSSA infections, possibly due to potential involvement of SA virulence factors, hence the importance of clinical vigilance for community SAB cases. PMID:27741135

  1. Acute Spontaneous Subdural Hematoma due to Rupture of a Tiny Cortical Arteriovenous Malformation.

    PubMed

    Choi, Hyuk Jin; Lee, Jae Il; Nam, Kyoung Hyup; Ko, Jun Kyeung

    2015-12-01

    Acute subdural hematoma (SDH) of arterial origin is rare, especially SDH associated with an arteriovenous malformation (AVM) is extremely rare. The authors report a case of acute spontaneous SDH due to rupture of a tiny cortical AVM. A 51-year-old male presented with sudden onset headache and mentality deterioration without a history of trauma. Brain CT revealed a large volume acute SDH compressing the right cerebral hemisphere with subfalcine and tentorial herniation. Emergency decompressive craniectomy was performed to remove the hematoma and during surgery a small (5 mm sized) conglomerated aciniform mass with two surrounding enlarged vessels was identified on the parietal cortex. After warm saline irrigation of the mass, active bleeding developed from a one of the vessel. The bleeding was stopped by coagulation and the vessels were removed. Histopathological examination confirmed the lesion as an AVM. We concluded that a small cortical AVM existed at this area, and that the cortical AVM had caused the acute SDH. Follow up conventional angiography confirmed the absence of remnant AVM or any other vascular abnormality. This report demonstrates rupture of a cortical AVM is worth considering when a patient presents with non-traumatic SDH without intracerebral hemorrhage or subarachnoid hemorrhage. PMID:26819690

  2. PRM/NIR sensor for brain hematoma detection and oxygenation monitoring

    NASA Astrophysics Data System (ADS)

    Zheng, Liu; Lee, Hyo Sang; Lokos, Sandor; Kim, Jin; Hanley, Daniel F.; Wilson, David A.

    1997-06-01

    The pseudo-random modulation/near IR sensor (PRM/NIR Sensor) is a low cost portable system designed for time-resolved tissue diagnosis, especially hematoma detection in the emergency care facility. The sensor consists of a personal computer and a hardware unit enclosed in a box of size 37 X 37 X 31 cm3 and of weight less than 10 kg. Two pseudo-random modulated diode lasers emitting at 670 nm and 810 nm are used in the sensor as light sources. The sensor can be operated either in a single wavelength mode or a true differential mode. Optical fiber bundles are used for convenient light delivery and color filters are used to reject room light. Based on a proprietary resolution- enhancement correlation technique, the system achieves a time resolution better than 40 ps with a PRM modulation speed of 200 MHz and a sampling rate of 1-10 Gs/s. Using the prototype sensor, phantom experiments have been conducted to study the feasibility of the sensor. Brain's optical properties are simulated with solutions of intralipid and ink. Hematomas are simulated with bags of paint and hemoglobin immersed in the solution of varies sizes, depths, and orientations. Effects of human skull and hair are studied experimentally. In animal experiment, the sensor was used to monitor the cerebral oxygenation change due to hypercapnia, hypoxia, and hyperventilation. Good correlations were found between NIR measurement parameters and physiological changes induced to the animals.

  3. Intracranial subdural hematoma and pneumocephalus after spinal instrumentation of myelodysplastic scoliosis.

    PubMed

    Nowak, Roman; Maliszewski, Mariusz; Krawczyk, Lech

    2011-01-01

    To report a case of acute intracranial subdural hematoma, pneumocephalus, and pneumorachis, which occurred because of cerebrospinal fluid (CSF) leak caused by a malpositioned transpedicular screw during spinal surgery for severe myelodysplastic scoliosis accompanied with hydrocephalus. Intracranial hemorrhage may occur as a consequence of dural sac penetration and CSF leakage after various medical procedures at the spinal level. The awareness of this severe complication is especially important during spinal instrumentation procedures in which inadvertent dural sac violation and CSF loss may be overlooked. A case report and literature review are presented here. A 12-year-old girl with a history of myelomeningocele and hydrocephalus underwent instrumentation for severe myelodysplastic scoliosis. Postoperatively, she became aphasic and increasingly somnolent. An urgent computed tomographic scan of the head and spine showed massive intracranial hematoma, pneumocephalus, pneumorachis, and a malpositioned pedicular screw that caused CSF leakage, intracranial hypotension, and bleeding remote from the surgical site. The patient needed neurosurgical cranial decompression and subsequent spinal reoperation with dural tear repair. The final outcome was an uneventful complete recovery. The increasing use of pedicular screws in spinal surgery carries a potential risk of occult dural sac violation with subsequent CSF leakage, intracranial hypotension, and the possibility of intracranial bleeding and pneumocephalus remote from the surgical site. This potentially fatal complication should always be considered after spinal surgery in the presence of early signs of neurological deterioration and necessitates an urgent cranial and spinal imaging to confirm the diagnosis and to make adequate treatment decisions. PMID:20829719

  4. The role of subgaleal suction drain placement in chronic subdural hematoma evacuation

    PubMed Central

    Yadav, Yad Ram; Parihar, Vijay; Chourasia, Ishwar D.; Bajaj, Jitin; Namdev, Hemant

    2016-01-01

    Introduction: There is lack of uniformity about the preferred surgical treatment, role of drain, and type of drain among various surgeons in chronic subdural hematoma (CSDH). The present study is aimed to evaluate role of subgaleal drain. Materials and Methods: This was a prospective study of 260 patients of CSDH treated surgically. Burr-hole irrigation with and without suction drain was done in 140 and 120 patients, respectively. Out of 120 patients without suction drain 60 each were managed by single and two burr holes. Pre- and postoperative GCS was recorded. Recurrent hematomas, CSDH secondary to tumor, due to intracranial hypotension, coagulopathy, children below 18 years, and patients treated by twist drill craniostomy or craniotomy were excluded. Subgaleal closed-system drainage with low negative pressure was used. Results: Age of the patients ranged from 18 to 75 years with mean age of 57 years. There were 9, 47, 204 patients in GCS of 3-8, 9-12, and 13-15, respectively. Both the groups were comparable in terms of age, etiology, gender, and neurological status. There was no difference in the mortality in both the group. The recurrence and postoperative pneumocephalus was significantly less in suction drain group as compared to without drain group. There was no infection or any other complication related to suction drainage. Conclusion: Subgaleal closed suction drainage was safe, simple, and effective in the management of CSDH. Recurrence rate was low in the suction drain group. PMID:27366247

  5. Acute posterior fossa epidural hematoma in a newborn infant with Menkes disease.

    PubMed

    Takeuchi, Satoru; Horikawa, Masahiro; Wakamatsu, Hajime; Hashimoto, Jyunya; Nawashiro, Hiroshi

    2014-02-01

    Epidural hematoma (EDH) in newborn infants is rare compared with other types of intracranial hemorrhages. Furthermore, posterior fossa EDH is extremely rare. We present a case of posterior fossa EDH in an infant with Menkes disease with accessory bones in the occiput. A male infant with a condition diagnosed with Menkes disease by prenatal testing was born at 39 weeks via vacuum extraction. The patient presented with a mild tremor at 2 days after delivery. A brain computed tomography (CT) scan showed an acute EDH in the posterior fossa, extending into the occipitoparietal area. Three-dimensional CT and bone window CT scan revealed several accessory bones, diastasis of 1 accessory suture, a communicated fracture, and a linear fracture in the occipital bone. Furthermore, a bone fragment from a communicated fracture displaced toward the inside. The patient was treated conservatively for EDH because of his good general condition. The hematoma gradually resolved, and his tremor did not recur. We suggest the following mechanism of posterior fossa EDH development in our patient: (1) external force was applied to the occiput inside the birth canal during delivery, resulting in diastasis; (2) a communicated fracture occurred, and a bone fragment displaced toward the inside (linear fracture was caused indirectly by the force); (3) a transverse sinus was injured by the fragment; and (4) EDH developed in both the posterior fossa and supratentorial region. Copper deficiency can also cause fragility of connective tissues, vessels, and bones.

  6. Spinal Epidural Hematoma after Thoracolumbar Posterior Fusion Surgery without Decompression for Thoracic Vertebral Fracture

    PubMed Central

    Minato, Tsuyoki; Miyagi, Masayuki; Saito, Wataru; Shoji, Shintaro; Nakazawa, Toshiyuki; Inoue, Gen; Imura, Takayuki; Minehara, Hiroaki; Matsuura, Terumasa; Kawamura, Tadashi; Namba, Takanori; Takahira, Naonobu; Takaso, Masashi

    2016-01-01

    We present a rare case of spinal epidural hematoma (SEH) after thoracolumbar posterior fusion without decompression surgery for a thoracic vertebral fracture. A 42-year-old man was hospitalized for a thoracic vertebral fracture caused by being sandwiched against his back on broken concrete block. Computed tomography revealed a T12 dislocation fracture of AO type B2, multiple bilateral rib fractures, and a right hemopneumothorax. Four days after the injury, in order to promote early orthostasis and to improve respiratory status, we performed thoracolumbar posterior fusion surgery without decompression; the patient had back pain but no neurological deficits. Three hours after surgery, he complained of acute pain and severe weakness of his bilateral lower extremities; with allodynia below the level of his umbilicus, postoperative SEH was diagnosed. We performed immediate revision surgery. After removal of the hematoma, his symptoms improved gradually, and he was discharged ambulatory one month after revision surgery. Through experience of this case, we should strongly consider the possibility of preexisting SEH before surgery, even in patients with no neurological deficits. We should also consider perioperative coagulopathy in patients with multiple trauma, as in this case. PMID:26989542

  7. Subdural hematoma

    MedlinePlus

    ... or walking Headache Lethargy or confusion Loss of consciousness Nausea and vomiting Numbness Seizures Slurred speech Visual ... Inability to speak Lethargy or confusion Loss of consciousness Nausea and vomiting Numbness Recent cognitive decline in ...

  8. Epidural hematoma

    MedlinePlus

    ... that results in even a brief loss of consciousness , or if there are any other symptoms after a head injury (even without loss of consciousness). The typical pattern of symptoms that indicate an ...

  9. Subungual Hematoma

    MedlinePlus

    ... Sections of the JAOCD JAOCD Archive Published Members Online Dermatology Journals Edit This Favorite Name: Category: Share: Yes ... 2/2017 2017 AOCD Spring Current Concepts in Dermatology Meeting more Latest News ... Surveys About AOCD The AOCD was recognized in ...

  10. Surgical Treatment of a Life-Threatening Large Retropharyngeal Hematoma after Minor Trauma : Two Case Reports and a Literature Review.

    PubMed

    Park, Jin Hoon; Jeong, Eui-Kyun; Kang, Dong-Ho; Jeon, Sang Ryong

    2015-09-01

    Only a few cases of anterior longitudinal ligament (ALL) injury related with retropharyngeal hematoma without fracture have previously been reported. The treatment of choice for retropharyngeal hematoma is generally considered to be conservative care, but we believe that early surgery of this pathology would be better in certain situations. Here, we describe two cases with life-threatening large retropharyngeal hematomas related with ALL injuries and operated on at an early stage. Two previously healthy patients visited the emergency room with neck pain and dyspnea after falling. Serious neck swelling was observed and lateral neck X-ray showed severe widening of the prevertebral space. Due to dyspnea progression, emergency endotracheal intubation was performed. Although there was no primary cause of the retropharyngeal hematoma on preoperative examination, ALL tearing was intraoperatively confirmed during early surgery. The in-hospital evolutions of the patients were favorable after surgery. We should bear in mind the possibility of ALL injury and perform early surgery where possible given the earlier convalescence and good prognosis. PMID:26539280

  11. [Shock secondary to extrinsic compression of the right atrium by postoperative mediastinal hematoma. Pseudotumor echocardiography image in right atrium].

    PubMed

    Jordán, A J; García, M; Santos, F; González, M; Gómez, J; García De Burgos, F

    2001-03-01

    We present the case of a 64 year-old patient in whom an aortic Saint Jude prosthesis, a Cosgrove's mitral annulus and triple coronary artery by-pass graft were implanted, and who presented with shock related to extrinsic compression of the right atrium by a mediastinal hematoma within the first postoperative month. Transthoracic echocardiogram showed a right atrial , hampering right atrium drainage. The extrapericardial location of the hematoma is of note and was diagnosed with the aid of thoracic computerized tomography. We present the case of a 64 year-old patient in whom an aortic Saint Jude prosthesis, a Cosgrove's mitral annulus and triple coronary artery by-pass graft were implanted, and who presented with shock related to extrinsic compression of the right atrium by a mediastinal hematoma within the first postoperative month. Transthoracic echocardiogram showed a right atrial , hampering right atrium drainage. The extrapericardial location of the hematoma is of note and was diagnosed with the aid of thoracic computerized tomography.

  12. Treatment Efficacy of the Transsylvian Approach Versus the Transtemporal Cortex Approach to Evacuate Basal Ganglia Hematoma Under a Microscope.

    PubMed

    Xu, Tao; Liu, Hao; Peng, Lin; Li, Hao; Wang, Jiying; Jiang, Yong; Gu, Yingjiang

    2016-03-01

    This study aimed to evaluate the clinical efficacy of the transsylvian approach versus the transtemporal cortex approach to evacuate basal ganglia hemorrhage under a microscope. The relevant literature was collected from PubMed, Embase, Cochrane Central Register of Controlled Trials, Chinese Biomedical Literature database, and China National Knowledge Infrastructure databases. The meta-analysis was conducted by Stata 12.0 software. Seven studies were included in the meta-analysis. There were 659 patients, including 329 patients who were treated by the transsylvian approach and 330 patients who were treated by the transtemporal cortex approach. There were significant advantages in the transsylvian approach group, including a high clearance rate of hematoma (OR = 2.361; 95% CI: 1.443-3.861) and a better postoperative recovery (OR = 2.248; 95% CI: 1.598-3.160). A better postoperative recovery could also be found in patients with a history of hypertension (OR = 2.063; 95% CI: 1.429-2.980) and patients whose volume of hematoma ranged from 25 to 60 mL (OR = 2.275; 95% CI: 1.466-3.529). The authors conclude that there are significant advantages to the transsylvian approach, such as a high clearance rate of hematoma and a good postoperative recovery. These advantages should be taken into account when devising appropriate therapeutic strategies for patients with basal ganglia hematoma. PMID:26967068

  13. Day-night variability of hematoma expansion in patients with spontaneous intracerebral hemorrhage.

    PubMed

    Yao, Xiaoying; Wu, Bo; Xu, Ye; Siwila-Sackman, Erica; Selim, Magdy

    2015-06-01

    The levels of several coagulation factors, able to influence hemostatic balance, display circadian variations. We hypothesized that the onset and extent of hematoma expansion (HE) following intracerebral hemorrhage (ICH) also display diurnal patterns. We reviewed clinical, laboratory, and radiological data from 111 consecutive patients with spontaneous ICH who had baseline head computed tomography (CT) scans within 3 h of ICH onset and follow-up CT during the following 72 h. We defined any HE (AHE) as any increase in hematoma volume from baseline to follow-up CT and significant HE (SHE) as an absolute increase in hematoma volume >6 mL or relative increase >33%. We categorized the patients into 2 groups based on the timing of the initial CT scans--day group (from 0800 to 2000 h) and night group (from 2000 to 0800 h)--and performed logistic regression analyses. We also analyzed the differences in the rates of HE between the groups during six 4-h periods spanning 24 h, using χ(2) tests. We found that the rates of AHE and SHE were higher in the day versus night group (75% vs. 48%; p = 0.009 for AHE and 47.6% vs. 25.9%; p = 0.047 for SHE). On multivariable logistic regression, day group assignment was independently associated with AHE (adjusted odds ratio = 3.53; p = 0.008) but not with SHE. Both AHE and SHE peaked in the early afternoon (1200-1600 h) and reached a nadir during the 2000 to 2400 h time period, and they were significantly different between the time periods (0000-0400, 0400-0800, 0800-1200, 1200-1600, 1600-2000, and 2000-2400 h); p = 0.002 and 0.029, respectively. These exploratory findings support the presence of a daily pattern in the occurrence of HE, with a higher risk during the day hours. Our results could have implications for future therapeutic efforts targeting HE in ICH and for the triage of ICH patients. They require further validation. PMID:25994102

  14. Spine subdural hematoma: a rare complication associated with vitamin K antagonist (VKA).

    PubMed

    Flato, Uri Adrian Prync; Rheder, Paulo Sérgio; Guimarães, Helio Penna; Flato, Elias Silva; Cretella, Paulo

    2009-01-01

    Spinal subdural hematoma (SSDH) is a rare condition, which is difficult to diagnose, related to Vitamin K Antagonist. This a case report of a life-threatening situation in a octogenarian patient with a history of recent atrial fibrillation that received K-Vitamin Antagonist (KVA) therapy. The history and the clinical assessment were normal at the admission, associated with increase in the coagulation parameters (INR >10). Twenty-four hours after the admission, the patient developed progressive tetraparesis and a Magnetic Resonance Imaging (MRI) was performed, disclosing the evidence of a SSDH (Figure 1). An emergency neurosurgical intervention was performed associated with normalization of the coagulation parameters. After the procedure, the patient presented improvement of the neurological symptoms.

  15. Middle Meningeal Artery Embolization in Recurrent Chronic Subdural Hematoma Combined with Arachnoid Cyst

    PubMed Central

    Kang, Jiin; Whang, Kum; Hong, Soon-Ki; Pyen, Jin-Soo; Kim, Jong-Yeon; Kim, So-Hyun

    2015-01-01

    Chronic subdural hematoma (CSDH) is a collection of old blood and its breakdown products between the surface of the brain parenchyma and the outermost layer called the dura. The most common treatment option for primary CSDH is burr-hole trephination; however, the treatment method for recurrent CSDH is still widely debated. An arachnoid cyst (AC) is a sac filled with cerebrospinal fluid located between the brain or spinal cord and the arachnoid membrane, which is one of the three meninges covering the brain or spinal cord. Although it is rare, the cyst is associated with CSDH in juveniles, and the recurrence rate of CSDH increases in such cases. Much of the literature has supported the preventive role of middle meningeal artery (MMA) embolization in recurrent CSDH. We report a 13-year-old male patient with recurrent CSDH and AC where the early intervention of MMA embolization was proven effective in preventing the further recurrence of CSDH. PMID:27169092

  16. Esophageal dissection and hematoma associated with obstruction in an Indian elephant (Elephas maximus indicus).

    PubMed

    Phair, Kristen A; Sutherland-Smith, Meg; Pye, Geoffrey W; Pessier, Allan P; Clippinger, Tracy L

    2014-06-01

    A 42-year-old female Indian elephant (Elephas maximus indicus) developed a sudden onset of excessive salivation and dysphagia. Esophageal obstruction was suspected; possibly related to palm frond ingestion. Esophageal endoscopy revealed a mat of plant material in the distal esophagus. An initial attempt at relieving the obstruction was unsuccessful, but subsequent use of custom-made instruments along with insufflation and hydropulsion enabled partial removal of the material. Postimmobilization care included aggressive intravenous and rectal fluids, anti-inflammatory and antibiotic administration, and fasting. Despite treatment, the dysphagia persisted and the elephant was euthanized due to lack of improvement and grave prognosis. Postmortem examination revealed remaining plant material in the esophagus, complicated by an esophageal dissection, mural hematoma, and secondary bacterial infection. Iatrogenic trauma may have contributed to the extent of esophageal injury. Although treatment was ultimately unsuccessful, the supportive care employed could potentially aid recovery in cases of less severe esophageal trauma. PMID:25000713

  17. Abdominal wall injuries: rectus abdominis strains, oblique strains, rectus sheath hematoma.

    PubMed

    Johnson, Rob

    2006-04-01

    Abdominal wall injuries are reported to be less common than actually perceived by sports medicine practitioners. National Collegiate Athletic Association injury statistics for 2004-2005 cite a high of 0.71 abdominal muscle injuries per 1000 player-hours in wrestling competition to a low of 0.01 injuries per 1000 player-hours in autumn football practices. British professional soccer clubs reported an incidence of "torso" injuries of up to 7% of all injuries over the course of several seasons. Injury definition is most likely the explanation for this discrepancy. The abdominal wall muscles (rectus abdominis, external and internal obliques, and transverse abdominis) are injured by direct blows to the abdomen or by sudden or repetitive trunk movement, either rotation or flexion/extension. With the exception of the rare rectus sheath hematoma that does not self-tamponade, the treatment for these problems is nonoperative with symptoms guiding rehabilitation and return to play decisions.

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

    PubMed Central

    Xiang, Lan; Wei, Zhaolian; Cao, Yunxia

    2014-01-01

    Objective To evaluate the predictive value of the symptoms of an intrauterine hematoma (IUH) for adverse pregnancy outcomes. Methods A literature review was performed with the search terms, including intrauterine/subchorionic/retroplacental/subplacental hematoma/hemorrhage/bleeding/collection/fluid, covering the period from January, 1981 to January, 2014. We just focused on the pregnancy outcomes associated with different symptoms of an IUH. Results It is generally agreed that a retroplacental, posterior or subchorionic in the fundus of uterus, and/or persistent IUH is associated with adverse outcomes in the ongoing pregnancy. However, the prognosis value of both volume and gestational age at diagnosis of IUH still remains controversial. Some researchers argue that a large IUH is associated with an increased risk of adverse events during pregnancy while others refuted. It is believed by some that the earlier an IUH was detected, the higher the risk for adverse outcomes would be, while no or weak association were reported by other studies. The prognostic value of the simultaneous presence of vaginal bleeding on pregnancy outcome is also controversial. Conclusions Both the position relative to the placenta or uterus and duration of IUH have strong predictive value on the prognosis in the ongoing pregnancy. However, the prognostic values of the IUH volume, gestational age at diagnosis and the simultaneous presence of vaginal bleeding remain controversial up to now. Moreover, most of previous reports are small, uncontrolled studies with incomplete information. Prospective, large sample, cohorts studies which take all detailed symptoms of an IUH into consideration are needed when we evaluate its clinical significance in the prognosis of pregnancy. PMID:25369062

  19. Supratentorial extradural hematoma in children: An institutional clinical experience of 65 cases

    PubMed Central

    Nath, Pratap Chandra; Mishra, Sudhansu Sekhar; Das, Srikant; Deo, Rama Chandra

    2015-01-01

    Aim and Objective: To survey the epidemiology, management, and severity of extradural hematoma (EDH) in children. Materials and Methods: All patients of EDH (n = 65) in the age group of 0–16 years admitted to our department during the period of August 13 and July 14 were analyzed retrospectively from the hospital records. In all patients, age, sex, mode of injury, clinical presentation, site of EDH, management, duration of hospitalization, and outcome were evaluated. Observation and Results: Of 65 patients, males were 70.76% with a male to female ratio of 2.4:1, most of the victims (47.69%) were in the age group of 11–16 years. Mean duration of hospitalization was 4.32 days. The most common mode of injury was fall from height in 29 cases (44.61%) followed by road traffic accident (RTA) in 23 cases (35.35%). Temporoparietal EDH was the most common computed tomography finding present in 22 (33.84%) patients. 67.69% patients presented to casualty with minor head injury having Glasgow coma scale (GCS) between 14 and 15. Most common presenting feature was vomiting in 52 cases (80%) and next to it was altered sensorium. The mortality rate was 7.69% (n = 5). Conclusion: Extradural hematoma is a life-threatening entity encountered in pediatric head injury. Timely intervention and diagnosis decrease mortality to a great degree. Most of the mortality is encountered in patients who presented late at the neurosurgical unit with low GCS. PMID:26167211

  20. [Reduction cranioplasty for a case of intractable chronic subdural hematoma in infancy].

    PubMed

    Tsutsumi, K; Asano, T; Shigeno, T; Matsui, T; Ito, S; Nakaguti, H

    1994-01-01

    Although almost all infants suffering chronic subdural hematomas (CSDH) are successfully treated by established methods such as a subdural puncture, burr holes and shunting procedures, infantile CSDH with progressive craniocerebral disproportion requires a special therapeutical regimen. Clinical efforts such as reduction cranioplasty have been made as a treatment for these cases. This is a case report of a 9-month-old male infant with an intractable CSDH, bilateral and large, and subsequent brain atrophy caused by traumatic head injury. Excellent results were obtained by a modified reduction cranioplasty. In brief, the patient was supine-positioned with a 20-degree flexion of the head in an attempt to obtain a large operative field. Bicoronal skin incision was combined with an additional linear one on the midline (T-shaped incision). Bilateral frontoparietal craniotomy with periosteum was made to keep the midline bony bridge overlying the superior sagittal sinus (SSS). The resulting extensive dural opening allowed complete evacuation of the subdural hematoma. Thereafter, the anterior part, ca. 4cm in width, of the bony bridge was removed in order to make the remaining bone able to be manipulated and connected to the frontal bone. Prior to this stage, SSS close to the crista galli was ligated and cut with the falx to avoid postoperative kinking. The dura mater was sutured so as not to leave an excessive subdural space. The bone flaps were trimmed to complete a good-shaped reconstruction. Finally, the excessive scalp was removed because the original scalp was too large for the reconstructed skull.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8295704

  1. Volumetric electromagnetic phase-shift spectroscopy of brain edema and hematoma.

    PubMed

    Gonzalez, Cesar A; Valencia, Jose A; Mora, Alfredo; Gonzalez, Fernando; Velasco, Beatriz; Porras, Martin A; Salgado, Javier; Polo, Salvador M; Hevia-Montiel, Nidiyare; Cordero, Sergio; Rubinsky, Boris

    2013-01-01

    Motivated by the need of poor and rural Mexico, where the population has limited access to advanced medical technology and services, we have developed a new paradigm for medical diagnostic based on the technology of "Volumetric Electromagnetic Phase Shift Spectroscopy" (VEPS), as an inexpensive partial substitute to medical imaging. VEPS, can detect changes in tissue properties inside the body through non-contact, multi-frequency electromagnetic measurements from the exterior of the body, and thereby provide rapid and inexpensive diagnostics in a way that is amenable for use in economically disadvantaged parts of the world. We describe the technology and report results from a limited pilot study with 46 healthy volunteers and eight patients with CT radiology confirmed brain edema and brain hematoma. Data analysis with a non-parametric statistical Mann-Whitney U test, shows that in the frequency range of from 26 MHz to 39 MHz, VEPS can distinguish non-invasively and without contact, with a statistical significance of p<0.05, between healthy subjects and those with a medical conditions in the brain. In the frequency range of between 153 MHz to 166 MHz it can distinguish with a statistical significance of p<0.05 between subjects with brain edema and those with a hematoma in the brain. A classifier build from measurements in these two frequency ranges can provide instantaneous diagnostic of the medical condition of the brain of a patient, from a single set of measurements. While this is a small-scale pilot study, it illustrates the potential of VEPS to change the paradigm of medical diagnostic of brain injury through a VEPS classifier-based technology. Obviously substantially larger-scale studies are needed to verify and expand on the findings in this small pilot study.

  2. Volumetric Electromagnetic Phase-Shift Spectroscopy of Brain Edema and Hematoma

    PubMed Central

    Gonzalez, Cesar A.; Valencia, Jose A.; Mora, Alfredo; Gonzalez, Fernando; Velasco, Beatriz; Porras, Martin A.; Salgado, Javier; Polo, Salvador M.; Hevia-Montiel, Nidiyare; Cordero, Sergio; Rubinsky, Boris

    2013-01-01

    Motivated by the need of poor and rural Mexico, where the population has limited access to advanced medical technology and services, we have developed a new paradigm for medical diagnostic based on the technology of “Volumetric Electromagnetic Phase Shift Spectroscopy” (VEPS), as an inexpensive partial substitute to medical imaging. VEPS, can detect changes in tissue properties inside the body through non-contact, multi-frequency electromagnetic measurements from the exterior of the body, and thereby provide rapid and inexpensive diagnostics in a way that is amenable for use in economically disadvantaged parts of the world. We describe the technology and report results from a limited pilot study with 46 healthy volunteers and eight patients with CT radiology confirmed brain edema and brain hematoma. Data analysis with a non-parametric statistical Mann-Whitney U test, shows that in the frequency range of from 26 MHz to 39 MHz, VEPS can distinguish non-invasively and without contact, with a statistical significance of p<0.05, between healthy subjects and those with a medical conditions in the brain. In the frequency range of between 153 MHz to 166 MHz it can distinguish with a statistical significance of p<0.05 between subjects with brain edema and those with a hematoma in the brain. A classifier build from measurements in these two frequency ranges can provide instantaneous diagnostic of the medical condition of the brain of a patient, from a single set of measurements. While this is a small-scale pilot study, it illustrates the potential of VEPS to change the paradigm of medical diagnostic of brain injury through a VEPS classifier-based technology. Obviously substantially larger-scale studies are needed to verify and expand on the findings in this small pilot study. PMID:23691001

  3. Tratamiento Quirúrgico de los Meningiomas del Foramen Óptico, Técnicay Resultados de una Serie de 18 Pacientes

    PubMed Central

    Goldschmidt, Ezequiel; Ajler, Pablo; Campero, Álvaro; Landriel, Federico; Sposito, Maximiliano; Carrizo, Antonio

    2014-01-01

    Introducción: los meningiomas del foramen óptico producen un rápido deterioro de la función visual aún cuando su tamaño es pequeño, por eso su diagnóstico y manejo difiere del resto de los meningiomas clinoideos. El propósito de este estudio es presentar la técnica y los resultados de nuestro manejo quirúrgico de meningiomas foraminales (MF). Pacientes y Métodos: se llevó a cabo una revisión de las historias clínicas de 47 pacientes con meningiomas primarios intraorbitarios. Se realizaron 52 cirugías en los pacientes con MF. Se empleó una craneotomía fronto-orbitaria, seguida de una descompresión extradural del canal óptico, resección del componente intraorbitario y exploración intradural del nervio óptico. Resultados: de los 12 pacientes con MF que presentaban la visión conservada, la agudeza visual fue preservada en 7 casos, mejoró en 2, y empeoró en 3. En 18 pacientes, el principal síntoma fue exoftalmos y en 35 pacientes ceguera unilateral. Ocurrieron 6 recurrencias, 2 a 10 años después de la resección quirúrgica. Cinco de ellos fueron reoperados. Se indicó radioterapia después de la recurrencia en 3 pacientes. Conclusión: el manejo de los MF continúa siendo controvertido y frecuentemente se propone un tratamiento conservador. Basados en nuestros hallazgos de frecuente extensión intracraneal, proponemos realizar una resección total o subtotal del tumor, preservando el nervio óptico en pacientes con visión prequirúrgica conservada. PMID:25165616

  4. Cervical Epidural Hematoma after Chiropractic Spinal Manipulation Therapy in a Patient with an Undiagnosed Cervical Spinal Arteriovenous Malformation

    PubMed Central

    Huang, Meng; Barber, Sean M; Moisi, Marc; Powell, Suzanne; Rivera, Andreana; Rose, James

    2015-01-01

    Spinal epidural hematoma (SEH) occurring after chiropractic spinal manipulation therapy (CSMT) is a rare clinical phenomenon. Our case is unique because the patient had an undiagnosed cervical spinal arteriovenous malformation (AVM) discovered on pathological analysis of the evacuated hematoma. Although the spinal manipulation likely contributed to the rupture of the AVM, there was no radiographic evidence of the use of excessive force, which was seen in another reported case. As such, patients with a known AVM who have not undergone surgical intervention should be cautioned against symptomatic treatment with CSMT, even if performed properly. Regardless of etiology, SEH is a surgical emergency and its favorable neurological recovery correlates inversely with time to surgical evacuation. PMID:26430581

  5. Vital Life-Threatening Hematoma after Implant Insertion in the Anterior Mandible: A Case Report and Review of the Literature

    PubMed Central

    Schiegnitz, Eik; Moergel, Maximilian; Wagner, Wilfried

    2015-01-01

    Dental implant insertion is considered a safe and reliable surgical procedure and severe complications are seldom reported. However, we present a case of a 52-year-old patient who attended our Department of Oral and Maxillofacial Surgery, Johannes Gutenberg University Medical Center, Mainz, with spreading hematoma in the floor of the mouth and acute airway obstruction after insertion of a dental implant in the anterior mandible. The hematoma was removed and submentally drained by a silicon drainage. However, the progressive swelling of the tongue and the floor of the mouth necessitated a temporary tracheotomy for three days. The review of the literature summarizes guidelines for prevention and management of this life-threatening complication. PMID:26557390

  6. Non-surgical treatment of massive traumatic corpus callosum hematoma after blunt head injury: A case report.

    PubMed

    Elsayed, A; Elgamal, E; Elsayed, A A; Wasserberg, J; Kuncz, A

    2016-01-01

    Massive hematoma of the corpus callosum caused by blunt head trauma is an extremely rare lesion. Most frequent traumatic lesions involve the corpus callosum are diffuse axonal injuries. They might be associated with small hemorrhagic foci in the hemispheric and brain stem white matter, intraventricular hemorrhages, subarachnoid hemorrhages, traumatic lesions of the septum pellucidum and fornix. Many cases of corpus callosum injury present with permanent disconnection syndrome. We present a case of a 32-year-old female suffered blunt head trauma resulted in massive corpus callosum hematoma which was managed non-surgically. The patient initially had a reduced conscious level and symptoms of disconnection syndrome, and significant recovery was observed at 6 months follow up. PMID:27375150

  7. Non-surgical treatment of massive traumatic corpus callosum hematoma after blunt head injury: A case report.

    PubMed

    Elsayed, A; Elgamal, E; Elsayed, A A; Wasserberg, J; Kuncz, A

    2016-01-01

    Massive hematoma of the corpus callosum caused by blunt head trauma is an extremely rare lesion. Most frequent traumatic lesions involve the corpus callosum are diffuse axonal injuries. They might be associated with small hemorrhagic foci in the hemispheric and brain stem white matter, intraventricular hemorrhages, subarachnoid hemorrhages, traumatic lesions of the septum pellucidum and fornix. Many cases of corpus callosum injury present with permanent disconnection syndrome. We present a case of a 32-year-old female suffered blunt head trauma resulted in massive corpus callosum hematoma which was managed non-surgically. The patient initially had a reduced conscious level and symptoms of disconnection syndrome, and significant recovery was observed at 6 months follow up.

  8. Single burr hole evacuation for traumatic acute subdural hematoma of the posterior fossa in the emergency room.

    PubMed

    Motohashi, Osamu; Kameyama, Motonobu; Shimosegawa, Yasuko; Fujimori, Kiyoshi; Sugai, Kazuyuki; Onuma, Takehide

    2002-08-01

    A 57-year-old man and a 55-year-old man presented with acute subdural hematoma of the posterior cranial fossa due to trauma. Both were comatose preoperatively. Emergent single burr hole evacuation in the posterior cranial fossa was performed in the emergency room immediately after computed tomography. Neurological symptoms improved dramatically just after initiating the burr hole evacuation in both patients. A 57-year-old man became alert and could walk unassisted 1 month after surgery. The other could walk with assistance 4 months after surgery, although psychic disturbance resulting from cerebral contusion remained. Single burr hole evacuation in the emergency room is a useful treatment for acute subdural hematoma of the posterior cranial fossa because the procedure can be performed easily and rapidly, thus achieving reduction of intracranial pressure. Progressing neurological deterioration, reversibility of brainstem function by mannitol administration and the sign of brainstem compression and noncommunicating hydrocephalus are good indicators for this treatment.

  9. Iatrogenic spinal hematoma as a complication of lumbar puncture: What is the risk and best management plan?

    PubMed Central

    Brown, Merritt Weaver; Yilmaz, Tülin Serap; Kasper, Ekkehard M.

    2016-01-01

    Background: Lumbar puncture (LP) rarely results in complications such as spinal hematomas. However, it remains unclear if certain variables increase likelihood of these events, or if surgical intervention improves outcome. Methods: In addition to two clinical vignettes, we evaluated the post-1974 literature for cases of spinal hematoma and subsequent intervention. Based on our compilation of data, we evaluated outcome relative to numerous distinct variables. Results: Based on 35 LP-related spinal hematoma cases in the post-1974 literature and our encounters, we found 28.6% of patients presenting with preexisting coagulopathy had poor outcomes regardless of intervention, relative to 14.3% of patients without coagulopathy; a highly significant difference (P = 0.02). Once diagnosed, 21 patients were treated surgically and 14 nonsurgically. Of the 60% surgical patients, 57.1% had good outcomes, and 42.9% had poor outcomes within 12 months. Of 40% nonsurgical patients, 57.1% had good outcomes and 42.9% had poor outcomes. Results in these groups were not statistically different. Conclusions: We found a significant correlation between preexisting coagulopathy and poor neurological outcome irrespective of intervention. However, outcomes for these patients may be confounded by comorbidities including underlying conditions contributing to their coagulopathy. No significant correlation between type of surgical intervention and good outcome was found, possibly attributable to the paucity of details in existing case reports and the difficulty defining the degree of spinal cord compromise from a given lesion. Despite our findings, emergent neurosurgical intervention may be beneficial for the management of complications such as cauda equina syndrome secondary to intrathecal spinal hematoma. PMID:27625895

  10. Diagnosis and Management of Spontaneous Lumbar Venous Retroperitoneal Hematoma in Setting of Deep Venous Thrombosis: A Case Report and Algorithm

    PubMed Central

    Tseng, Joseph; Chapman, Todd; Scott, Ryan; Kalinkin, Olga

    2016-01-01

    Retroperitoneal hematoma is rare and benefits from a systematic approach to prevent morbidity and mortality. Management of such bleeds is based upon patient stability, the cause (spontaneous or posttraumatic), and source (arterial or venous). Herein, the authors describe a diagnostic and management algorithm for retroperitoneal hemorrhage with an example of a rare lumbar venous bleed under the complicated clinical setting of deep venous thrombosis. PMID:27795865

  11. Iatrogenic spinal hematoma as a complication of lumbar puncture: What is the risk and best management plan?

    PubMed Central

    Brown, Merritt Weaver; Yilmaz, Tülin Serap; Kasper, Ekkehard M.

    2016-01-01

    Background: Lumbar puncture (LP) rarely results in complications such as spinal hematomas. However, it remains unclear if certain variables increase likelihood of these events, or if surgical intervention improves outcome. Methods: In addition to two clinical vignettes, we evaluated the post-1974 literature for cases of spinal hematoma and subsequent intervention. Based on our compilation of data, we evaluated outcome relative to numerous distinct variables. Results: Based on 35 LP-related spinal hematoma cases in the post-1974 literature and our encounters, we found 28.6% of patients presenting with preexisting coagulopathy had poor outcomes regardless of intervention, relative to 14.3% of patients without coagulopathy; a highly significant difference (P = 0.02). Once diagnosed, 21 patients were treated surgically and 14 nonsurgically. Of the 60% surgical patients, 57.1% had good outcomes, and 42.9% had poor outcomes within 12 months. Of 40% nonsurgical patients, 57.1% had good outcomes and 42.9% had poor outcomes. Results in these groups were not statistically different. Conclusions: We found a significant correlation between preexisting coagulopathy and poor neurological outcome irrespective of intervention. However, outcomes for these patients may be confounded by comorbidities including underlying conditions contributing to their coagulopathy. No significant correlation between type of surgical intervention and good outcome was found, possibly attributable to the paucity of details in existing case reports and the difficulty defining the degree of spinal cord compromise from a given lesion. Despite our findings, emergent neurosurgical intervention may be beneficial for the management of complications such as cauda equina syndrome secondary to intrathecal spinal hematoma.

  12. Orbital hematoma caused by bleeding from orbital branch of the infraorbital artery after reconstruction of an orbital fracture.

    PubMed

    Hwang, Kun; Kim, Joo Ho; Kang, Young Hye

    2014-03-01

    We experienced and report on a case of retrobulbar hematoma caused by bleeding from the orbital branch of the infraorbital artery after a medial orbital wall reconstruction.A healthy 28-year-old man struck his left eye while playing baseball before admission. A computed tomographic scan revealed an approximately 13 × 12-mm-sized fracture of the left orbit medial wall. The medial orbit wall was reconstructed through a subciliary approach on the 18th day after the injury. Approximately 15 hours after the orbit wall reconstruction, the patient complained of pain in the left orbital area, headache, and vomiting. Upon an examination, swelling and ecchymosis were observed on the left eye. His visual acuity was 0.8 (oculus dexter [OD])/0.4 (oculus sinister [OS]) and the intraocular pressure was 18 (OD)/24 (OS) mm Hg by a Goldmann applanation tonometry. A computed tomographic scan showed an intraorbital hematoma and proptosis on the left side. In an emergency operation, a hematoma with a volume of approximately 2 to 3 mL was evacuated and an active bleeding point was noted on the orbital floor, which was thought to be the orbital branch of the infraorbital nerve. The bleeding point was cauterized. After the operation, his visual acuity was 1.0 (OD)/0.8 (OS) and the ocular pressure normalized to 16 (OD)/16 (OS) mm Hg by a Goldmann applanation tonometry.Close observation and meticulous hemostasis along the infraorbital groove may be needed in an orbital floor exploration to prevent postoperative orbital hematoma.

  13. Corticospinal Tract Compression by Hematoma in a Patient with Intracerebral Hemorrhage: A Diffusion Tensor Tractography and Functional MRI Study

    PubMed Central

    Jang, Sung-Ho; Lee, Mi Young; Ahn, Sang Ho; Kim, Joong Hwi; Jeong, Dong-Hoon; Choi, Byung Yeun; Lee, Dong Gyu

    2006-01-01

    The purpose of this study was to demonstrate corticospinal tract compression that was due to a hematoma by using diffusion tensor tractography (DTT) and functional MRI (fMRI) in a patient with an intracerebral hemorrhage (ICH). A 23-year-old right-handed woman presented with severe paralysis of her right extremities at the onset of a spontaneous ICH. Over the first three days from onset, the motor function of the affected upper and lower extremities rapidly recovered to the extent that she was able to overcome applied resistance to the affected limbs, and her limbs regained normal function 3 weeks after onset. The tract of the right hemisphere originated from the primary sensori-motor cortex (SM1) and it passed through the known corticospinal tract pathway. However, the tract of the left hemisphere was similar to that of the right hemisphere except that it was displaced to the antero-medial side by the hematoma at the cerebral peduncle. Only the contralateral SM1 area centered on the precentral knob was activated during affected (right) or unaffected (left) hand movements, respectively. In conclusion, fMRI and DTT demonstrated a corticospinal tract compression due to hematoma in this patient. We conclude that the combined use of these two modalities appears to improve the accuracy of investigating the state of the corticospinal tract. PMID:16502496

  14. Spontaneous calf hematoma in a patient with diabetic nephropathy receiving maintenance hemodialysis: A case report and review of the literature.

    PubMed

    Xiao, Li; Ling, Fengxia; Tan, Lihua; Li, Huabing; Hu, Chun; Luo, Ying; Tang, Dang; Liu, Fuyou; Kanwar, Yashpal S; Sun, Lin

    2015-10-01

    We report the outcome of a 52-year-old patient with diabetic nephropathy and receiving maintenance hemodialysis (HD) using low molecular weight heparin (LMWH) as an anticoagulant for 2 years. He presented right lower limb pain accompanied with difficulty in walking for 2 months, and had no history of bleeding tendency or trauma. Physical examination revealed marked swelling and tenderness on his right lower limb. By ultrasound and magnetic resonance imaging (MRI) diagnoses, the calf hematoma was diagnosed and identified with venous thrombosis. Following treatment with heparin-free HD, the swelling regressed and pain subsided, and a follow-up MRI showed complete dissolution of hematoma. However, similar symptoms recurred in the right upper limb after 2 months without any predisposition, he was just placed on HD with LMWH, and symptoms regressed following the aforementioned therapy. This suggests that HD patients, especially with diabetic nephropathy having extremity hematoma, should be watched for the development of spontaneous hemorrhage that can be differentially diagnosed by imaging tests, such as MRI, and can be effectively treated with heparin-free HD.

  15. Surgical treatment of poor grade middle cerebral artery aneurysms associated with large sylvian hematomas following prophylactic hinged craniectomy.

    PubMed

    Wang, Hai-Jun; Ye, You-Fan; Shen, Yin; Zhu, Rui; Yao, Dong-Xiao; Zhao, Hong-Yang

    2014-10-01

    The clinical characteristics of patients who presented in poor clinical grade due to ruptured middle cerebral artery aneurysms (MCAAs) associated with large sylvian hematomas (SylH) were analyzed and an ingenious designed prophylactic hinged craniectomy was introduced. Twenty-eight patients were graded into Hunt-Hess grades IV-V and emergency standard micro-neurosurgeries (aneurysm clipping, hematoma evacuation and prophylactic hinged craniectomy) were performed, and their clinical data were retrospectively analyzed. 46.43% of the patients reached encouraged favorable outcomes on discharge. The favorable outcome group and the poor outcome group significantly differed in terms of patients' anisocoria, Hunt-Hess grade before surgery, extent of the midline shift and time to the surgery after bleeding (P<0.05). There were no significant differences in age, sex, volume and location of the hematoma, size of aneurysm between the favorable and poor groups (P>0.05). However, ingenious designed prophylactic hinged craniectomy efficiently reduced the patients' intracranial pressure (ICP) after surgery. It was suggested that preoperative conditions such as Hunt-Hess grading, extent of the midline shift and the occurrence of cerebral hernia affect the prognosis of patients, but time to the surgery after bleeding and prophylactic hinged craniectomy are of significant importance for optimizing the prognosis of MCAA patients presenting with large SylH.

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

    PubMed

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

    2016-06-01

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

  17. Spontaneous spinal epidural hematoma management with minimally invasive surgery through tubular retractors: A case report and review of the literature.

    PubMed

    Fu, Chao-Feng; Zhuang, Yuan-Dong; Chen, Chun-Mei; Cai, Gang-Feng; Zhang, Hua-Bin; Zhao, Wei; Ahmada, Said Idrissa; Devi, Ramparsad Doorga; Kibria, Md Golam

    2016-06-01

    To report a minimally invasive paraspinal approach in the treatment of a case of spontaneous spinal epidural hematoma (SSEH). We additionally aim to review the relevant literature to enhance our knowledge of this disease. SSEH is an uncommon but potentially catastrophic disease. Currently, most appropriate management is emergence decompression laminectomy and hematoma evacuation. An 81-year-old woman was admitted to the neurology department with a chief complaint of bilateral numbness and weakness of the lower limbs and difficulty walking for 4 days with progressive weakness developed over the following 3 days accompanied with pain in the lower limbs and lower back. No history of trauma was reported. Magnetic resonance imaging of the thoracolumbar spine demonstrated an epidural hematoma extending from T-12 to L-5 with thecal sac and cauda equina displacement anterior. The patient was treated in our department with a minimally invasive approach. This operation method had been approved by Chinese Independent Ethics Committee. Three months following the operation, the patient had regained the ability to walk with the aid of a cane and myodynamia tests revealed normal results for the left lower limb and a 4/5 grade for the right limb. Importantly, no complications were exhibited from the surgical operation. The minimally invasive paraspinal approach through tubular retractors is demonstrated here as an effective alternative method for the treatment of SSEH. PMID:27367986

  18. Predicting Factors of Chronic Subdural Hematoma Following Surgical Clipping in Unruptured and Ruptured Intracranial Aneurysm

    PubMed Central

    Kwon, Min-Yong; Kim, Chang-Hyun

    2016-01-01

    Objective The aim of this study is to analyze the differences in the incidence, predicting factors, and clinical course of chronic subdural hematoma (CSDH) following surgical clipping between unruptured (UIA) and ruptured intracranial aneurysm (RIA). Methods We conducted a retrospective analysis of 752 patients (UIA : 368 and RIA : 384) who underwent surgical clipping during 8 years. The incidence and predicting factors of CSDH development in the UIA and RIA were compared according to medical records and radiological data. Results The incidence of postoperative CSDH was higher in the UIA (10.9%) than in the RIA (3.1%) (p=0.000). In multivariate analysis, a high Hounsfield (HF) unit (blood clots) for subdural fluid collection (SFC), persistence of SFC ≥5 mm and male sex in the UIA and A high HF unit for SFC and SFC ≥5 mm without progression to hydrocephalus in the RIA were identified as the independent predicting factors for CSDH development (p<0.05). Conclusion There were differences in the incidence and predicting factors for CSDH following surgical clipping between UIA and RIA. Blood clots in the subdural space and persistence of SFC ≥5 mm were predicting factors in both UIA and RIA. However, progression to hydrocephalus may have in part contributed to low CSDH development in the RIA. We suggest that cleaning of blood clots in the subdural space and efforts to minimize SFC ≥5 mm at the end of surgery is helpful to prevent CSDH following aneurysmal clipping.

  19. Craniotomy or Decompressive Craniectomy for Acute Subdural Hematomas: Surgical Selection and Clinical Outcome

    PubMed Central

    Kwon, Young Sub; Yang, Kook Hee

    2016-01-01

    Objective Craniotomy (CO) and decompressive craniectomy (DC) are two main surgical options for acute subdural hematomas (ASDH). However, optimal selection of surgical modality is unclear and decision may vary with surgeon's experience. To clarify this point, we analyzed preoperative findings and surgical outcome of patients with ASDH treated with CO or DC. Methods From January 2010 to December 2014, data for 46 patients with ASDH who underwent CO or DC were retrospectively reviewed. The demographic, clinical, imaging and clinical outcomes were analyzed and statistically compared. Results Twenty (43%) patients underwent CO and 26 (57%) patients received DC. In DC group, preoperative Glascow Coma Scale was lower (p=0.034), and more patient had non-reactive pupil (p=0.004). Computed tomography findings of DC group showed more frequent subarachnoid hemorrhage (p=0.003). Six month modified Rankin Scale showed favorable outcome in 60% of CO group and 23% of DC group (p=0.004). DC was done in patient with more unfavorable preoperative features (p=0.017). Patients with few unfavorable preoperative features (<6) had good outcome with CO (p<0.001). Conclusion In selective cases of few unfavorable clinical findings, CO may also be an effective surgical option for ASDH. Although DC remains to be standard of surgical modality for patients with poor clinical status, CO can be an alternative considering the possible complications of DC. PMID:27182498

  20. Diagnosis and management of acute aortic syndromes: dissection, intramural hematoma, and penetrating aortic ulcer.

    PubMed

    Bonaca, Marc P; O'Gara, Patrick T

    2014-01-01

    Acute aortic syndromes constitute a spectrum of conditions characterized by disruptions in the integrity of the aortic wall that may lead to potentially catastrophic outcomes. They include classic aortic dissection, intramural hematoma, and penetrating aortic ulcer. Although imaging studies are sensitive and specific, timely diagnosis can be delayed because of variability in presenting symptoms and the relatively low frequency with which acute aortic syndromes are seen in the emergency setting. Traditional classification systems, such as the Stanford system, facilitate early treatment decision-making through recognition of the high risk of death and major complications associated with involvement of the ascending aorta (type A). These patients are treated surgically unless intractable and severe co-morbidities are present. Outcomes with dissections that do not involve the ascending aorta (type B) depend on the presence of acute complications (e.g., malperfusion, early aneurysm formation, leakage), the patency and size of the false lumen, and patient co-morbidities. Patients with uncomplicated type B dissections are initially treated medically. Endovascular techniques have emerged as an alternative to surgery for the management of complicated type B dissections when intervention is necessary. Patients with acute aortic syndromes require aggressive medical care, risk stratification for additional complications and targeted genetic assessment as well as careful long-term monitoring to assess for evolving complications. The optimal care of patients with acute aortic syndrome requires the cooperation of members of an experienced multidisciplinary team both in the acute and chronic setting.

  1. Influence of Gender on Occurrence of Chronic Subdural Hematoma; Is It an Effect of Cranial Asymmetry?

    PubMed Central

    Oh, Jae-sang; Shim, Jai-Joon; Yoon, Seok-Mann

    2014-01-01

    Objective Chronic subdural hematoma (CSDH) is a condition mostly present in older people. Men are more commonly affected than women. Several theories about male predominance could not enough to explain the reason for male predominance on CSDH. The purpose of this study is to find out whether there were any differences in the anatomy of cranium, which may contribute the pathogenesis or risk factors of CSDH. Methods The study population was consisted of 87 patients with CSDH and 100 patients with transient ischemic attack (TIA) from 2006 to 2013. We classified into four groups; group A (CSDH male 47), group B (CSDH female 40), group C (TIA male 50), and group D (TIA female 50). We measured the size of the cranium in the computed tomography scans, retrospectively. We define the difference of cranium (Dc), which is difference between the right and left radiuses. Results The Dc was significantly higher in patients with CSDH (group A and B)(p=0.03). The mean Dc was 3.49 mm in CSDH group (group A and B) and 2.14 mm in TIA group (group C and D). The mean Dc of CSDH group was significantly larger than that of TIA group (by t-test, p<0.01). Conclusion Size and asymmetry of the cranium may be a risk factor of CSDH. Gender differences in the anatomy of cranium may contribute pathogenesis of CSDH. PMID:27169039

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

    PubMed

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

    2016-05-15

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

  3. Predicting Factors of Chronic Subdural Hematoma Following Surgical Clipping in Unruptured and Ruptured Intracranial Aneurysm

    PubMed Central

    Kwon, Min-Yong; Kim, Chang-Hyun

    2016-01-01

    Objective The aim of this study is to analyze the differences in the incidence, predicting factors, and clinical course of chronic subdural hematoma (CSDH) following surgical clipping between unruptured (UIA) and ruptured intracranial aneurysm (RIA). Methods We conducted a retrospective analysis of 752 patients (UIA : 368 and RIA : 384) who underwent surgical clipping during 8 years. The incidence and predicting factors of CSDH development in the UIA and RIA were compared according to medical records and radiological data. Results The incidence of postoperative CSDH was higher in the UIA (10.9%) than in the RIA (3.1%) (p=0.000). In multivariate analysis, a high Hounsfield (HF) unit (blood clots) for subdural fluid collection (SFC), persistence of SFC ≥5 mm and male sex in the UIA and A high HF unit for SFC and SFC ≥5 mm without progression to hydrocephalus in the RIA were identified as the independent predicting factors for CSDH development (p<0.05). Conclusion There were differences in the incidence and predicting factors for CSDH following surgical clipping between UIA and RIA. Blood clots in the subdural space and persistence of SFC ≥5 mm were predicting factors in both UIA and RIA. However, progression to hydrocephalus may have in part contributed to low CSDH development in the RIA. We suggest that cleaning of blood clots in the subdural space and efforts to minimize SFC ≥5 mm at the end of surgery is helpful to prevent CSDH following aneurysmal clipping. PMID:27651863

  4. Experimental studies on brain hematoma detection and oxygenation monitoring using PRM/NIR sensors

    NASA Astrophysics Data System (ADS)

    Zheng, Liu; Lee, Hyo Sang; Wilson, David A.; Hanley, Daniel F.; Lokos, Sandor; Kim, Jin

    1997-08-01

    Real time noninvasive head injury detection is needed in critical care facilities and triage site with limited resources. One tool missing right now is a small and fast noninvasive sensor which can help urgent care workers to (1) diagnose the location and severity of the injury, (2) to perform on site pre-hospital treatment if necessary, and (3) to make a decision on what kind of further medical action is needed. On the other hand, continuous monitoring of cerebral blood oxygenation is also needed in intensive care unit and in operation rooms. Pseudo-random modulation/near infrared sensor (PRM/NIR sensor) is developed to address these issues. It relies on advanced techniques in diode laser cw modulation and time resolved spectroscopy to perform fast and noninvasive brain tissue diagnostics. Phantom experiments have been conducted to study the feasibility of the sensor. Brain's optical properties are simulated with solutions of intralipid and ink. Hematomas are simulated with bags of paint and hemoglobin immersed in the solution of varies sizes, depths, and orientations. Effects of human skull and hair are studied experimentally. In animal experiment, the sensor was used to monitor the cerebral oxygenation change due to hypercapnia, hypoxia, and hyperventilation. Good correlations were found between NIR measurement parameters and physiological changes induced to the animals.

  5. Intraoperative Arachnoid Plasty Has Possibility to Prevent Chronic Subdural Hematoma after Surgery for Unruptured Cerebral Aneurysms

    PubMed Central

    YAGI, Kenji; IRIE, Shinsuke; INAGAKI, Toru; ISHII, Yosuke; SAITO, Osamu; LEE, Tejin; NAKAGAWA, Hiroshi; SAITO, Koji; NAGAHIRO, Shinji

    Some patients develop chronic subdural hematomas (CSDHs) after the clipping/coating of unruptured aneurysms. The risk factors are not well understood and while no preventive methods are currently available, arachnoid plasty (ARP) may intercept the development of postoperative CSDH. We investigated the risk factors for CSDH and the usefulness of ARP to prevent postoperative CSDH. Between January 2009 and June 2013, 393 patients underwent 416 aneurysm surgeries via the pterional approach at Kushiro Kojinkai Memorial Hospital. Of these, 394 aneurysms (371 patients) were included in this study. Using multivariate analysis we evaluated the relationship between the patient demographics and clinical characteristics, and the development of postoperative symptomatic CSDH. We also studied the effect of ARP performed during aneurysm surgery. We found that symptomatic CSDH developed after 20 (5.1%) of the 394 operations; it was addressed by burr hole surgery and evacuation/irrigation. Male gender, advanced age, and oral anticoagulant therapy were significant risk factors for CSDH. Additive ARP, performed in the course of 132 surgeries (33.5%) was found to be a significant negative risk factor. The incidence of CSDH was significantly lower in patients who had undergone ARP than in patients who had not undergone it (0.8% vs. 7.3%, p < 0.01). We first report that ARP is useful for the prevention of CSDH in patients treated by aneurysm surgery. PMID:26041629

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

    PubMed

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

    2016-02-01

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

  7. Unilateral oculomotor nerve palsy as an initial presentation of bilateral chronic subdural hematoma: case report.

    PubMed

    Matsuda, Ryosuke; Hironaka, Yasuo; Kawai, Hisashi; Park, Young-Su; Taoka, Toshiaki; Nakase, Hiroyuki

    2013-01-01

    Isolated oculomotor nerve palsy is well known as a symptom of microvascular infarction and intracranial aneurysm, but unilateral oculomotor nerve palsy as an initial manifestation of chronic subdural hematoma (CSDH) is a rare clinical condition. We report a rare case of an 84-year-old woman with bilateral CSDH who presented with unilateral oculomotor nerve palsy as the initial symptom. The patient, who had a medical history of minor head injury 3 weeks prior, presented with left ptosis, diplopia, and vomiting. She had taken an antiplatelet drug for lacunar cerebral infarction. Computed tomography (CT) of the head showed bilateral CSDH with a slight midline shift to the left side. She underwent an urgent evacuation through bilateral frontal burr holes. Magnetic resonance angiography (MRA) after evacuation revealed no intracranial aneurysms, but constructive interference in steady-state (CISS) magnetic resonance imaging (MRI) revealed that the left posterior cerebral artery (PCA) ran much more anteriorly and inferiorly compared with the right PCA and the left oculomotor nerve passed very closely between the left PCA and the left superior cerebellar artery (SCA). There is the possibility that the strong compression to the left uncus, the left PCA, and the left SCA due to the bilateral CSDH resulted in left oculomotor nerve palsy with an initial manifestation without unconsciousness. Unilateral oculomotor nerve palsy as an initial presentation caused by bilateral CSDH without unconsciousness is a rare clinical condition, but this situation is very important as a differential diagnosis of unilateral oculomotor nerve palsy.

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

    PubMed Central

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

    2012-01-01

    Abstract Approximately 1,700,000 people sustain a traumatic brain injury (TBI) each year and motor vehicle crashes (MVCs) are a leading cause of hospitalization from TBI. Acute subdural hematoma (SDH) is a common intracranial injury that occurs in MVCs associated with high mortality and morbidity rates. In this study, SDH volume and midline shift have been analyzed in order to better understand occupant injury by correlating them to crash and occupant parameters. Fifty-seven head computed tomography (CT) scans were selected from the Crash Injury Research Engineering Network (CIREN) with Abbreviated Injury Scale (AIS) level 3+ SDH. Semi-automated methods were used to isolate the intracranial volume. SDH and additional occupant intracranial injuries were segmented across axial CT images, providing a total SDH injury volume. SDH volume was correlated to crash parameters and occupant characteristics. Results show a positive correlation between SDH volume and crash severity in near-side and frontal crashes. Additionally, the location of the resulting hemorrhage varied by crash type. Those with greater SDH volumes had significantly lower Glasgow Coma Scale (GCS) scores at the crash site in near-side crashes. Age and fracture type were found to be significant contributors to SDH volume. This study is a volumetric analysis of real world brain injuries and known MVC impacts. The results of this study demonstrate a relationship among SDH volume, crash mechanics, and occupant characteristics that provide a better understanding of the injury mechanisms of MVC-associated TBI. PMID:22928543

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

    PubMed Central

    KARIBE, Hiroshi; KAMEYAMA, Motonobu; HAYASHI, Toshiaki; NARISAWA, Ayumi; TOMINAGA, Teiji

    2016-01-01

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

  10. [Chronic subdural hematoma (CSH) complicated by bilateral occipital lobe infarction: two case reports].

    PubMed

    Kudo, Kanae; Naraoka, Masato; Shimamura, Norihito; Ohkuma, Hiroki

    2013-04-01

    Chronic subdural hematoma (CSH) is a common disease that is treated with burr hole drainage by neurosurgeons. The outcome of CSH is mostly favorable. We treated 2 cases with bilateral occipital lobe infarction due to CSH. A 57-year-old woman was ambulatory when she visited a clinic for evaluation of headache. One hour after the CT was taken, she developed acute impairment of consciousness, so that she was referred to our hospital. The second patient was a 73-year-old woman with a history of depression who was involved in a traffic accident 5 weeks before admission to our hospital. She was at first admitted to a psychiatric hospital for evaluation of gait disturbance. Three weeks after she was admitted to the psychiatric hospital, she fell into a coma. She was referred to our hospital. Their brain CT on admission revealed compressed ambient and interpeduncular cistern and bilateral CSH. Although burr hole drainage surgery was performed, the 2 patients developed severe sequelae due to occipital lobe infarction caused by central transtentorial herniation.

  11. [A multi-factorial approach in the vital prognosis of spontaneous intracerebral hematoma].

    PubMed

    Senant, J; Samson, M; Proust, B; Szeibert, J; Onnient, Y

    1988-01-01

    The prognostic assessment of a patient with intra-cerebral hemorrhage (IH) requires simultaneous appraisal of several parameters. We have attempted this with a multivariate method: discriminant analysis. We studied retrospectively 142 patients with non-operated IH, not due to vascular malformation, distributed two months after the initial event in two groups: 92 living patients and 50 dead. Discriminant analysis of 21 parameters from the initial examination and CT scan, selected five factors which best separate the two groups, since 89% of the patients were well classified. These five parameters (age, consciousness impairment, temperature, volume of the hematoma and ventricular hemorrhage) combined, give a prognostic score which gives for each patient his probability of survival or death. The validity of the proposed model was controlled on a test-sample of 66 patients from another department. The possibility of giving a trustworthy spontaneous prognosis on the first day can enable the evaluation of the possible benefit from surgery, which we illustrated with a group of 23 operated patients. PMID:3047834

  12. Tranexamic Acid for Recurring Subdural Hematomas Following Surgical Evacuation: A Clinical Case Series.

    PubMed

    Stary, Joel M; Hutchins, Leslie; Vega, Rafael A

    2016-09-01

    Background Chronic subdural hematomas (SDHs) are commonly encountered in neurosurgery. Optimal management of SDHs remains a significant challenge. Current treatment options generally include supportive care or surgical intervention. A significant proportion of patients have surgery; however, the reoperation rate is considered high. There are also cases in which additional surgical procedures would carry significant morbidity, and as a result, there is a need for nonsurgical medical therapies. We describe the use of tranexamic acid (TXA) as a nonsurgical option for the treatment of recurrent SDHs following surgery. Methods Patients were identified as candidates for potential TXA therapy and followed prospectively. The decision to administer TXA was made on the basis of history, presentation, and prognosis after further surgical intervention. Data collected included patient imaging, treatment administered, and both radiologic and clinical outcomes. Results Three patients underwent surgical evacuation of a chronic SDH (two via burr hole washout and one via craniotomy). All patients had recurrence identified on subsequent imaging. Two patients had poorer predicted outcomes if additional surgical intervention was necessary, and one refused additional surgical intervention. TXA was administered, in the same dosing and scheduled course, to all patients. Complete resolution was observed on imaging, and in the case of the patient who was symptomatic, clinical improvement was also noted. Conclusion TXA may be considered for the treatment of recurrent SDHs following surgical evacuation in patients for whom additional surgery would add significant morbidity. PMID:27300772

  13. Microdialysis as Clinical Evaluation of Therapeutic Hypothermia in Rat Subdural Hematoma Model.

    PubMed

    Yokobori, Shoji; Spurlock, Markus S; Lee, Stephanie W; Gajavelli, Shyam; Bullock, Ross M

    2016-01-01

    Cerebral microdialysis (MD) is a fine laboratory technique which has been established for studying physiological, pharmacological, and pathological changes in the experimental studies of traumatic brain injury (TBI). This technique has also been well translated and widely applied to clinical bedside monitoring to provide pathophysiological analysis in severe TBI patients. The MD technique is thus well suited for straightforward translation from basic science to clinical application.In this chapter, we describe our evaluation of MD method in acute subdural hematoma (ASDH) rat model. With 100 kDa cut-off microdialysis membrane, we could measure several biomarkers such as ubiquitin carboxy hydrolase L1 (UCH-L1), a neuronal marker and glial fibrillary acidic protein (GFAP), and a glial marker in extracellular fluid. In this experiment, we could detect that the peak of extracellular UCH-L1 in the early hypothermia group was significantly lower than in the normothermia group. Also, in the late phase of reperfusion (>2.5 h after decompression), extracellular GFAP in the early hypothermia group was lower than in the normothermia. These data thus suggested that early, preoperatively induced hypothermia could mediate the reduction of neuronal and glial damage in the reperfusion phase of ischemia/reperfusion brain injury.Microdialysis allows for the direct measurement of extracellular molecules in an attempt to characterize metabolic derangements before they become clinically relevant. Advancements in technology have allowed for the bedside assay of multiple markers of ischemia and metabolic dysfunction, and the applications for traumatic brain injury have been well established. As clinicians become more comfortable with these tools their widespread use and potential for clinical impact with continue to rise. PMID:27604731

  14. Aortic Branch Artery Pseudoaneurysms Associated with Intramural Hematoma: When and How to Do Endovascular Embolization

    SciTech Connect

    Ferro, Carlo; Rossi, Umberto G. Seitun, Sara; Scarano, Flavio; Passerone, Giancarlo; Williams, David M.

    2013-04-15

    To describe when and how to perform endovascular embolization of aortic branch artery pseudoaneurysms associated with type A and type B intramural hematoma (IMH) involving the descending thoracic and abdominal aorta (DeBakey I and III) that increased significantly in size during follow-up. Sixty-one patients (39 men; mean {+-} standard deviation age 66.1 {+-} 11.2 years) with acute IMH undergoing at least two multidetector computed tomographic examinations during follow-up for 12 months or longer were enrolled. Overall, 48 patients (31 men, age 65.9 {+-} 11.5) had type A and type B IMH involving the descending thoracic and abdominal aorta (DeBakey I and III). Among the 48 patients, 26 (54 %; 17 men, aged 64.3 {+-} 11.4 years) had 71 aortic branch artery pseudoaneurysms. Overall, during a mean follow-up of 22.1 {+-} 9.5 months (range 12-42 months), 31 (44 %) pseudoaneurysms disappeared; 22 (31 %) decreased in size; two (3 %) remained stable; and 16 (22 %) increased in size. Among the 16 pseudoaneurysms with increasing size, five of these (three intercostal arteries, one combined intercostobronchial/intercostal arteries, one renal artery), present in five symptomatic patients, had a significant increase in size (thickness >10 mm; width and length >20 mm). These five patients underwent endovascular embolization with coils and/or Amplatzer Vascular Plug. In all patients, complete thrombosis and exclusion of aortic pseudoaneurysm and relief of back pain were achieved. Aortic branch artery pseudoaneurysms associated with type A and type B IMH involving the descending thoracic and abdominal aorta (DeBakey I and III) may be considered relatively benign lesions. However, a small number may grow in size or extend longitudinally with clinical symptoms during follow-up, and in these cases, endovascular embolization can be an effective and safe procedure.

  15. Factors Associated with Hemispheric Hypodensity after Subdural Hematoma following Abusive Head Trauma in Children

    PubMed Central

    Recker, Matthew J.; Lee, Philip S.; Bell, Michael J.; Tyler-Kabara, Elizabeth C.

    2014-01-01

    Abstract Abusive head trauma (AHT) is a unique form of pediatric TBI with increased mortality and neurologic sequelae. Hemispheric hypodensity (HH) in association with subdural blood after AHT has been described. Though risk factors for HH are not understood, we hypothesized that risk factors could be identified. We retrospectively enrolled children under 5 years with TBI secondary to AHT (child advocacy diagnosis) who had undergone initial and interval brain imaging. Records were interrogated for prearrival and in-hospital physiologic and radiographic findings. HH was determined by a blinded observer. Twenty-four children were enrolled and 13 developed HH. HH was not significantly associated with age, initial Glascow Coma Scale, or mortality. Pediatric Intensity Level of Therapy (PILOT) scores (p=0.01) and daily maximal intracranial pressure (ICPmax; p=0.037) were higher in HH. Hypoxia, hypotension, cardiopulmonary arrest, need for blood transfusion, and daily blood glucoses tended to be greater in HH. Whereas all children with HH had acute subdural hematoma (SBH), many children without HH also had subdural blood; the presence of skull fracture was more likely in the children who did not develop HH (p=0.04), but no other intracranial radiographic pattern of injury was associated with HH. Surgical intervention did not appear to protect against development of HH. A variety of insults associated with ischemia, including intracranial hypertension, ICP-directed therapies, hypoxia, hypotension, and cardiac arrest, occurred in the children who developed HH. Given the morbidity and mortality of this condition, larger studies to identify mechanisms leading to the development of HH and mitigating clinical approaches are warranted. PMID:24693985

  16. Prognosis of patients in coma after acute subdural hematoma due to ruptured intracranial aneurysm.

    PubMed

    Torné, Ramon; Rodríguez-Hernández, Ana; Romero-Chala, Fabián; Arikan, Fuat; Vilalta, Jordi; Sahuquillo, Juan

    2016-04-01

    Acute subdural hematomas (aSDH) secondary to intracranial aneurysm rupture are rare. Most patients present with coma and their functional prognosis has been classically considered to be very poor. Previous studies mixed good-grade and poor-grade patients and reported variable outcomes. We reviewed our experience by focusing on patients in coma only and hypothesized that aSDH might worsen initial mortality but not long-term functional outcome. Between 2005 and 2013, 440 subarachnoid hemorrhage (SAH) patients were admitted to our center. Nineteen (4.3%) were found to have an associated aSDH and 13 (2.9%) of these presented with coma. Their prospectively collected clinical and outcome data were reviewed and compared with that of 104 SAH patients without aSDH who presented with coma during the same period. Median aSDH thickness was 10mm. Four patients presented with an associated aneurysmal cortical laceration and only one had good recovery. Overall, we observed good long-term outcomes in both SAH patients in coma with aSDH and those without aSDH (38.5% versus 26.4%). Associated aSDH does not appear to indicate a poorer long-term functional prognosis in SAH patients presenting with coma. Anisocoria and brain herniation are observed in patients with aSDH thicknesses that are smaller than those observed in trauma patients. Despite a high initial mortality, early surgery to remove the aSDH results in a good outcome in over 60% of survivors. Aneurysmal cortical laceration appears to be an independent entity which shows a poorer prognosis than other types of aneurysmal aSDH.

  17. Risk Factors in Chronic Subdural Hematoma: Comparison of Irrigation with Artificial Cerebrospinal Fluid and Normal Saline in a Cohort Analysis

    PubMed Central

    Adachi, Akihiko; Higuchi, Yoshinori; Fujikawa, Atsushi; Machida, Toshio; Sueyoshi, Shigeo; Harigaya, Kenichi; Ono, Junichi; Saeki, Naokatsu

    2014-01-01

    Background Chronic subdural hematoma (CSDH) is known to have a substantial recurrence rate. Artificial cerebrospinal fluid (ACF) is an effective irrigation solution in general open craniotomy and endoneurosurgery, but no evidence of its use in burr-hole surgery exists. Objective To identify the potential of ACF irrigation to prevent CSDH recurrence. More specifically, to investigate the perioperative and intraoperative prognostic factors, and to identify controllable ones. Methods To examine various prognostic factors, 120 consecutive patients with unilateral CSDH treated with burr-hole drainage between September 2007 and March 2013 were analyzed. Intraoperative irrigation was performed with one of two irrigation solutions: normal saline (NS; n = 60) or ACF (n = 60). All patients were followed-up for at least 6 months postoperatively. We also examined the morphological alternations of the hematoma outer membranes after incubation with different solutions. Results Eleven patients (9.2%) had recurrence. Nine patients (15%) required additional surgery in the NS group, whereas only 2 patients (3.3%) in the ACF group required additional surgery. Among preoperative and intraoperative data, age (<80 years old, P = .044), thrombocyte (>22.0, P = .037), laterality (right, P = .03), and irrigation solution (ACF, P = .027) were related to smaller recurrence rates by log-rank tests. Only the type of irrigation solution used significantly correlated with recurrence in favor of ACF in both Cox proportional hazards (relative hazard: 0.20, 95% confidence interval (CI): 0.04–0.99; P = .049) and logistic regression models (odds ratio, 0.17, 95% CI: 0.03–0.92; P = .04) using these factors. Histological examinations of the hematoma membranes showed that the membranes incubated with NS were loose and infiltrated by inflammatory cells compared with those incubated with ACF. Conclusion Irrigation with ACF decreased the rate of CSDH recurrence. PMID

  18. Histopathological study of the outer membrane of the dura mater in chronic sub dural hematoma: Its clinical and radiological correlation

    PubMed Central

    Bokka, Sriharsha; Trivedi, Adarsh

    2016-01-01

    Background: A chronic subdural hematoma is an old clot of blood on the surface of the brain between dura and arachnoid membranes. These liquefied clots most often occur in patients aged 60 and older with brain atrophy. When the brain shrinks inside the skull over time, minor head trauma can cause tearing of blood vessels over the brain surface, resulting in a slow accumulation of blood over several days to weeks. Aim of the Study: To evaluate the role of membrane in hematoma evaluation and to correlate its histopathology with clinic-radiological aspects of the condition and overall prognosis of patients. Material and Methods: The study incorporated all cases of chronic SDH admitted to the Neurosurgery department of JLN Hospital and Research Centre, Bhilai, between November 2011 and November 2013. All such cases were analyzed clinically, radiologically like site, size, thickness in computed tomography, the attenuation value, midline shift and histopathological features were recorded. Criteria for Inclusion: All cases of chronic subdural haematoma irrespective of age and sex were incorporated into the study. Criteria for Exclusion: All cases of acute subdural haematoma and cases of chronic sub dural hematoma which were managed conservatively irrespective of age and sex were excluded from the study Results: In our series of cases, the most common histopathological type of membrane was the inflammatory membrane (Type II) seen in 42.30% of cases followed by hemorrhagic inflammatory membrane (Type III) seen in 34.62% of cases while scar inflammatory type of membrane (Type IV) was seen in 23.08% of cases. No case with noninflammatory type (Type I) was encountered. PMID:26889276

  19. Design of a prospective, dose-escalation study evaluating the Safety of Pioglitazone for Hematoma Resolution in Intracerebral Hemorrhage (SHRINC).

    PubMed

    Gonzales, Nicole R; Shah, Jharna; Sangha, Navdeep; Sosa, Lenis; Martinez, Rebecca; Shen, Loren; Kasam, Mallikarjunarao; Morales, Miriam M; Hossain, M Monir; Barreto, Andrew D; Savitz, Sean I; Lopez, George; Misra, Vivek; Wu, Tzu-Ching; El Khoury, Ramy; Sarraj, Amrou; Sahota, Preeti; Hicks, William; Acosta, Indrani; Sline, M Rick; Rahbar, Mohammad H; Zhao, Xiurong; Aronowski, Jaroslaw; Grotta, James C

    2013-07-01

    RATIONALE : Preclinical work demonstrates that the transcription factor peroxisome proliferator-activated receptor gamma plays an important role in augmenting phagocytosis while modulating oxidative stress and inflammation. We propose that targeted stimulation of phagocytosis to promote efficient removal of the hematoma without harming surrounding brain cells may be a therapeutic option for intracerebral hemorrhage. AIMS : The primary objective is to assess the safety of the peroxisome proliferator-activated receptor gamma agonist, pioglitazone, in increasing doses for three-days followed by a maintenance dose, when administered to patients with spontaneous intracerebral hemorrhage within 24 h of symptom onset compared with standard care. We will determine the maximum tolerated dose of pioglitazone. STUDY DESIGN : This is a prospective, randomized, blinded, placebo-controlled, dose-escalation safety trial in which patients with spontaneous intracerebral hemorrhage are randomly allocated to placebo or treatment. The Continual Reassessment Method for dose finding is used to determine the maximum tolerated dose of pioglitazone. Hematoma and edema resolution is evaluated with serial magnetic resonance imaging (MRI) at specified time points. Functional outcome will be evaluated at three- and six-months. OUTCOMES : The primary safety outcome is mortality at discharge. Secondary safety outcomes include mortality at three-months and six-months, symptomatic cerebral edema, clinically significant congestive heart failure, edema, hypoglycemia, anemia, and hepatotoxicity. Radiographic outcomes will explore the time frame for resolution of 25%, 50%, and 75% of the hematoma. Clinical outcomes are measured by the National Institutes of Health Stroke Scale (NIHSS), the Barthel Index, modified Rankin Scale, Stroke Impact Scale-16, and EuroQol at three- and six-months.

  20. Fast Virtual Stenting with Active Contour Models in Intracranical Aneurysm.

    PubMed

    Zhong, Jingru; Long, Yunling; Yan, Huagang; Meng, Qianqian; Zhao, Jing; Zhang, Ying; Yang, Xinjian; Li, Haiyun

    2016-02-15

    Intracranial stents are becoming increasingly a useful option in the treatment of intracranial aneurysms (IAs). Image simulation of the releasing stent configuration together with computational fluid dynamics (CFD) simulation prior to intervention will help surgeons optimize intervention scheme. This paper proposed a fast virtual stenting of IAs based on active contour model (ACM) which was able to virtually release stents within any patient-specific shaped vessel and aneurysm models built on real medical image data. In this method, an initial stent mesh was generated along the centerline of the parent artery without the need for registration between the stent contour and the vessel. Additionally, the diameter of the initial stent volumetric mesh was set to the maximum inscribed sphere diameter of the parent artery to improve the stenting accuracy and save computational cost. At last, a novel criterion for terminating virtual stent expanding that was based on the collision detection of the axis aligned bounding boxes was applied, making the stent expansion free of edge effect. The experiment results of the virtual stenting and the corresponding CFD simulations exhibited the efficacy and accuracy of the ACM based method, which are valuable to intervention scheme selection and therapy plan confirmation.

  1. Fast Virtual Stenting with Active Contour Models in Intracranical Aneurysm

    PubMed Central

    Zhong, Jingru; Long, Yunling; Yan, Huagang; Meng, Qianqian; Zhao, Jing; Zhang, Ying; Yang, Xinjian; Li, Haiyun

    2016-01-01

    Intracranial stents are becoming increasingly a useful option in the treatment of intracranial aneurysms (IAs). Image simulation of the releasing stent configuration together with computational fluid dynamics (CFD) simulation prior to intervention will help surgeons optimize intervention scheme. This paper proposed a fast virtual stenting of IAs based on active contour model (ACM) which was able to virtually release stents within any patient-specific shaped vessel and aneurysm models built on real medical image data. In this method, an initial stent mesh was generated along the centerline of the parent artery without the need for registration between the stent contour and the vessel. Additionally, the diameter of the initial stent volumetric mesh was set to the maximum inscribed sphere diameter of the parent artery to improve the stenting accuracy and save computational cost. At last, a novel criterion for terminating virtual stent expanding that was based on the collision detection of the axis aligned bounding boxes was applied, making the stent expansion free of edge effect. The experiment results of the virtual stenting and the corresponding CFD simulations exhibited the efficacy and accuracy of the ACM based method, which are valuable to intervention scheme selection and therapy plan confirmation. PMID:26876026

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

    PubMed Central

    Jeon, Dae Geun; Kim, Seok-Kon; Kim, Juri

    2014-01-01

    A 26-year-old male undergoing thoracotomy and bleeding control received a preoperative thoracic epidural for postoperative analgesia. On the fifth postoperative day, paralysis of both lower limbs occurred and urgent magnetic resonance imaging showed massive anterior epidural hematoma. During laminectomy and decompression, platelet dysfunction was diagnosed and preoperative non-steroidal anti-inflammatory drugs medications were supposed to the cause of platelet dysfunction. After infusion of ten units of platelet concentrate, coagulopathy was improved. We should be more careful to drugs with antiplatelet effect when using regional analgesia. PMID:24729848

  3. [Evaluation on Ability to Detect the Intracranial Hematoma with Different Density Using C-Arm Cone-beam Computed Tomography Based on Animal Model].

    PubMed

    Zhou, Mi; Zeng, Yongming; Yu, Renqiang; Zhou, Yang; Xu, Rui; Sun, Jingkun; Gao, Zhimei

    2016-02-01

    This study aims to evaluate the ability of C-arm cone-beam CT to detect intracranial hematomas in canine models. Twenty one healthy canines were divided into seven groups and each group had three animals. Autologous blood and contrast agent (3 mL) were slowly injected into the left/right frontal lobes of each animal. Canines in the first group, the control group, were only injected with autologous blood without contrast agent. Each animal in all the 7 groups was scanned with C-arm cone-beam CT and multislice computed tomography (MSCT) after 5 minutes. The attenuation values and their standard deviations of the hematoma and uniformed brain tissues were measured to calculate the image noise, signal to noise ratio (SNR) and contrast to noise ratio (CNR). A scale with scores 1-3 was used to rate the quality of the reconstructed image of different hematoma as a subjective evaluation, and all the experimental data were processed with statistical treatment. The results revealed that when the density of hematoma was less than 65 HU, hematomata were not very clear on C-arm CT images, and when the density of hematoma was more than 65 HU, hematomata showed clearly on both C-arm CT and MSCT images and the scores of them were close. The coherence between the two physicians was very reliable. The same results were obtained with C-arm cone-beam CT and MSCT grades in measuring SD value, SNR, and CNR. The reasonable choice of density detection range of intracranial hematoma with C-arm cone-beam CT could be effectively applied to monitoring the intracranial hemorrhage during interventional diagnosis and treatment.

  4. [Evaluation on Ability to Detect the Intracranial Hematoma with Different Density Using C-Arm Cone-beam Computed Tomography Based on Animal Model].

    PubMed

    Zhou, Mi; Zeng, Yongming; Yu, Renqiang; Zhou, Yang; Xu, Rui; Sun, Jingkun; Gao, Zhimei

    2016-02-01

    This study aims to evaluate the ability of C-arm cone-beam CT to detect intracranial hematomas in canine models. Twenty one healthy canines were divided into seven groups and each group had three animals. Autologous blood and contrast agent (3 mL) were slowly injected into the left/right frontal lobes of each animal. Canines in the first group, the control group, were only injected with autologous blood without contrast agent. Each animal in all the 7 groups was scanned with C-arm cone-beam CT and multislice computed tomography (MSCT) after 5 minutes. The attenuation values and their standard deviations of the hematoma and uniformed brain tissues were measured to calculate the image noise, signal to noise ratio (SNR) and contrast to noise ratio (CNR). A scale with scores 1-3 was used to rate the quality of the reconstructed image of different hematoma as a subjective evaluation, and all the experimental data were processed with statistical treatment. The results revealed that when the density of hematoma was less than 65 HU, hematomata were not very clear on C-arm CT images, and when the density of hematoma was more than 65 HU, hematomata showed clearly on both C-arm CT and MSCT images and the scores of them were close. The coherence between the two physicians was very reliable. The same results were obtained with C-arm cone-beam CT and MSCT grades in measuring SD value, SNR, and CNR. The reasonable choice of density detection range of intracranial hematoma with C-arm cone-beam CT could be effectively applied to monitoring the intracranial hemorrhage during interventional diagnosis and treatment. PMID:27382751

  5. Chronic expanding hematoma with a significantly high fluorodeoxyglucose uptake on 18F-fluorodeoxyglucose positron emission tomography, mimicking a malignant soft tissue tumor: a case report

    PubMed Central

    2014-01-01

    Introduction Chronic expanding hematoma is a rare persistent hematoma that can sometimes be misdiagnosed as a malignant tumor due to its clinical and radiological features. Case presentation A 42-year-old Japanese man with a large mass in his leg, suggestive of malignancy, presented to our hospital. He had been aware of the leg swelling for the last eight years. A magnetic resonance imaging scan demonstrated a large mass with two components. One was a large, well-defined cystic mass (13×9cm) showing high intensity on T1- and T2-weighted images, and the other was a solid mass (3.5×2.5cm, adjacent to the large mass) with high intensity on T1-weighted images. Two-[18F]fluoro-2 deoxy-D glucose positron emission tomography images revealed increased uptake with a maximum standardized uptake value of 15.8 in the solid mass. As these findings were considered suggestive of hematoma associated with a malignant lesion, an open biopsy was performed. A pathological examination demonstrated a hematoma with xanthogranuloma, and no malignant cells were evident. Therefore, we resected the tumor including both components, and the histological diagnosis was chronic expanding hematoma. Clinical diagnosis based on 2-[18F]fluoro-2 deoxy-D glucose uptake is sometimes limited by the fact that 2-[18F]fluoro-2 deoxy-D glucose is taken up by not only malignant tumor cells but also macrophages and tissues with granulation or inflammation. Conclusions Significantly increased standardized uptake value in the peripheral rim of the lesion on 2-[18F]fluoro-2 deoxy-D glucose positron emission tomography imaging, mimicking a soft tissue sarcoma, should be recognized as a potential diagnostic pitfall in cases of chronic expanding hematoma. PMID:25335527

  6. Hematoma in Retzius' space following US-guided prostate biopsy: evidence of the diagnostic accuracy using transrectal end-fire probe in the anterior prostate gland.

    PubMed

    Dell'atti, Lucio

    2014-03-01

    We report a rare case of hematoma in Retzius' space in a 62-year-old man who underwent transrectal prostate biopsy using an endocavitary, end-fire, convex probe. Clinical symptoms resolved spontaneously after catheter placement and appropriate antibiotic therapy. Transrectal ultrasound 1 month later showed partial resolution of the hematoma. Based on the analysis of this unusual complication, we demonstrate the effectiveness of transrectal biopsy as compared to transperineal biopsy in detecting cancer of the anterior prostate. We have also analyzed the various factors that may be the reason why core biopsy harvested in this "hidden" area may be inadequate.

  7. Dengue hemorrhagic fever presenting with hemorrhagic pancreatitis and an intramural hematoma of the duodenal wall: a case report and review of the literature.

    PubMed

    Lee, Chun-Yuan; Tsai, Hung-Chin; Lee, Susan Shin-jung; Lin, Chun-Ku; Huang, Jer-Shyung; Chen, Yao-Shen

    2013-05-01

    Dengue fever may present with atypical manifestations. Here we report a 47 year-old male presenting with fever and sore throat for 2 days, followed by epigastric pain and tarry stool for 4 days. The esophagogastroduodenoscopy revealed multiple ulcers with a nodular margin in the duodenal bulb and second portion of the duodenum. A MRI of the abdomen revealed hemorrhagic pancreatitis, with a large intramural hematoma in the second portion of duodenum. The final diagnosis was dengue hemorrhagic fever, grade II, complicated with hemorrhagic pancreatitis and an intramural hematoma of the duodenal wall. Physicians should be aware of the atypical abdominal presentations of dengue fever.

  8. Subintimal TRAnscatheter Withdrawal (STRAW) of hematomas compressing the distal true lumen: a novel technique to facilitate distal reentry during recanalization of chronic total occlusion (CTO).

    PubMed

    Smith, Elliot J; Di Mario, Carlo; Spratt, James C; Hanratty, Colm G; de Silva, Ranil; Lindsay, Alistair C; Grantham, J Aaron

    2015-01-01

    The development of a large hematoma impairing visualization of the distal true lumen is a recognized complication of antegrade recanalization of chronic total occlusions, often forcing the operator to abort the procedure or switch to a retrograde approach. We describe a novel technique utilizing an over-the-wire balloon inflated in the proximal occluded vessel to block inflow and allow aspiration of the blood from the subintimal space. This decompressed the true lumen, restored distal visualization, and allowed successful reentry using a dedicated technology. Utilization of this novel technique may rescue antegrade recanalization attempts complicated by large subintimal hematomas.

  9. A New Modified Twist Drill Craniostomy Using a Novel Device to Evacuate Chronic Subdural Hematoma

    PubMed Central

    Wang, Qing-Feng; Cheng, Cheng; You, Chao

    2016-01-01

    Abstract Compared with burr hole craniostomy (BHC), twist drill craniostomy (TDC) is increasingly popular because of its minimal invasiveness in evacuating chronic subdural hematoma (CSDH). However, the TDC technique varies and is continually developing; moreover, no consensus yet exists regarding the optimal protocol, and the efficacy and safety of TDC is still controversial, especially with respect to a specific method. This article introduces a new modified TDC technique using a novel device, the YL-1 puncture needle, and evaluates its efficacy and advantages compared with BHC. A retrospective study involving 121 patients with CSDH who underwent surgery at a single center was conducted, involving 68 patients undergoing modified TDC (TDC group) and 53 patients treated by BHC (BHC group). The neurological outcome was studied to evaluate the surgery efficacy, and the radiological outcome was assessed as a supplement to the surgery efficacy. In addition, complications, recurrence, and reoperation, as well as pneumocrania, operation duration, and length of stay, were studied to evaluate the advantages of the modified TDC compared with BHC. Independent sample t tests or rank-sum tests were used to compare the outcomes between the 2 groups. The neurological and radiological outcomes did not differ significantly between the TDC and BHC groups (P = 0.852 and P = 0.232, respectively), while the rates of complication and pneumocrania in patients who underwent the modified TDC were significantly lower than that in those who underwent BHC (P = 0.021 and P < 0.001, respectively). The recurrence and reoperation rates in patients from the 2 groups were similar (P = 0.566 and P = 0.715, respectively). The operation duration and length of hospital stay of the patients who underwent the modified TDC were significantly shorter than those of the patients who underwent BHC (both P < 0.001). Modified TDC with a YL-1 puncture needle is a minimally invasive

  10. Memory impairment caused by cerebral hematoma in the left medial temporal lobe due to ruptured posterior cerebral artery aneurysm

    PubMed Central

    2014-01-01

    Background Cognitive disorders, such as memory disturbances, are often observed following a subarachnoid hemorrhage. We present a very rare case where rupture of a posterior cerebral artery aneurysm caused restricted damage to the hippocampus unilaterally, and caused memory disturbances. Case presentation A 56-year-old, right-handed man, with a formal education history of 16 years and company employees was admitted to our hospital because of a consciousness disturbance. He was diagnosed as having a subarachnoid hemorrhage due to a left posterior cerebral artery dissecting aneurysm, and coil embolization was performed. Subsequently, he had neither motor paresis nor sensory disturbances, but he showed disorientation, and both retrograde and anterograde amnesia. Although immediate recall and remote memory were almost intact, his recent memory was moderately impaired. Both verbal and non-verbal memories were impaired. Brain computed tomography (CT) and magnetic resonance imaging (MRI) revealed a cerebral hematoma in the left temporal lobe involving the hippocampus and parahippocampal gyrus, and single-photon emission computed tomography (SPECT) demonstrated low perfusion areas in the left medial temporal lobe. Conclusions We suggest that the memory impairment was caused by local tissue destruction of Papez’s circuit in the dominant hemisphere due to the cerebral hematoma. PMID:24602130

  11. Neuroprotective effect of suppression of astrocytic activation by arundic acid on brain injuries in rats with acute subdural hematomas.

    PubMed

    Wajima, Daisuke; Nakagawa, Ichiro; Nakase, Hiroyuki; Yonezawa, Taiji

    2013-06-26

    Acute subdural hematoma (ASDH) can cause massive ischemic cerebral blood flow (CBF) underneath the hematoma, but early surgical evacuation of the mass reduces mortality. The aim of this study was to evaluate whether arundic acid improves the secondary ischemic damage induced by ASDH. Our results confirmed that arundic acid decreases the expression of S100 protein produced by activated astrocytes around ischemic lesions due to cytotoxic edema after ASDH as well as reducing infarction volumes and numbers of apoptotic cells around the ischemic lesions. In this study, we also evaluate the relationship of brain edema and the expression of Aquaporin 4 (AQP4) in an ASDH model. The expression of AQP4 was decreased in the acute phase after ASDH. Cytotoxic edema, assumed to be the main cause of ASDH, could also cause ischemic lesions around the edema area. Arundic acid decreased the infarction volume and number of apoptotic cells via suppression of S100 protein expression in ischemic lesions without changing the expression of AQP4.

  12. Does hypernatremia cause subdural hematoma in children?: two case reports and a meta-analysis of the literature.

    PubMed

    Ali, Syed Adnaan; Jaspan, Timothy; Marenah, Christine; Vyas, Harish

    2012-06-01

    Hypernatremia has been causally linked with subdural hematoma (SDH), but more recently this has been called into question. Conversely, there is a well-established link between SDH and injury. We wish to examine the evidence base that hypernatremia in infants and young children causes SDH.We present 2 cases of children with severe hypernatremia whose intracranial contents were assessed by imaging in the first case and postmortem examination in the second. Neither demonstrated SDH. The first case was important as the hypernatremia was iatrogenic occurring in a controlled hospital environment.We also searched the literature from 1950 to 2007, collecting data on all reported cases of hypernatremia in children younger than 7 years whose intracranial contents were examined by imaging, surgery, and/or postmortem examination. Of 124 cases reported in 31 articles, 112 cases developed hypernatremia in the community, and 12 in the hospital. Subdural hematoma was demonstrated in 7 cases, all of which had developed hypernatremia in the community under circumstances that would make it difficult to exclude nonaccidental injury. None of the 12 cases that developed hypernatremia in a controlled hospital environment had SDH.The evidence base supporting the hypothesis that hypernatremia causes SDH is poor, depending on isolated reports with uncertain histories.

  13. Mechanical Recanalization following i.v. Thrombolysis: A Retrospective Analysis regarding Secondary Hemorrhagic Infarctions and Parenchymal Hematomas.

    PubMed

    Höltje, J; Bonk, F; Anstadt, A; Terborg, C; Pohlmann, C; Urban, P P; Brüning, R

    2015-01-01

    Introduction. In acute stroke by occlusion of the proximal medial cerebral artery (MCA) or the distal internal carotid artery, intravenous thrombolysis is an established treatment. Another option is mechanical recanalization. It remains unclear if the combination of both methods poses an additional bleeding risk. The aim of this retrospective analysis is to determine the proportion of hemorrhagic infarctions and parenchymal hematomas. Methods. Inclusion criteria were an occlusion of the carotid T or proximal MCA treated with full dose thrombolysis and mechanical recanalization. 31 patients were selected. Devices used were Trevo, Penumbra Aspiration system, Penumbra 3D Retriever, and Revive. The initial control by computed tomography was carried out with a mean delay to intervention of 10.9 hours (SD: 8.5 hours). Results. A slight hemorrhagic infarction (HI1) was observed in 2/31 patients, and a more severe HI2 occurred in two cases. A smaller parenchymal hematoma (PH1) was not seen and a space-occupying PH2 was seen in 2/31 cases. There was no significant difference in the probability of intracranial bleeding after successful (thrombolysis in cerebral infarctions 2b and 3) or unsuccessful recanalization. Conclusion. The proportion of intracranial bleeding using mechanical recanalization following intravenous thrombolysis appears comparable with reports using thrombolysis alone. PMID:26640710

  14. Non-traumatic subdural hematoma secondary to septic brain embolism: A rare cause of unexpected death in a drug addict suffering from undiagnosed bacterial endocarditis.

    PubMed

    Geisenberger, D; Huppertz, L M; Büchsel, M; Kramer, L; Pollak, S; Grosse Perdekamp, M

    2015-12-01

    Acute subdural hematomas are mostly due to blunt traumatization of the head. In rare instances, subdural bleeding occurs without evidence of a previous trauma following spontaneous hemorrhage, e.g. from a ruptured aneurysm or an intracerebral hematoma perforating the brain surface and the arachnoid. The paper presents the morphological, microbiological and toxicological findings in a 38-year-old drug addict who was found by his partner in a dazed state. When brought to a hospital, he underwent trepanation to empty a right-sided subdural hematoma, but he died already 4h after admission. Autopsy revealed previously undiagnosed infective endocarditis of the aortic valve as well as multiple infarctions of brain, spleen and kidneys obviously caused by septic emboli. The subdural hematoma originated from a subcortical brain hemorrhage which had perforated into the subdural space. Microbiological investigation of the polypous vegetations adhering to the aortic valve revealed colonization by Streptococcus mitis and Klebsiella oxytoca. According to the toxicological analysis, no psychotropic substances had contributed to the lethal outcome. The case reported underlines that all deaths of drug addicts should be subjected to complete forensic autopsy, as apart from intoxications also natural and traumatic causes of death have to be taken into consideration.

  15. Non-traumatic subdural hematoma secondary to septic brain embolism: A rare cause of unexpected death in a drug addict suffering from undiagnosed bacterial endocarditis.

    PubMed

    Geisenberger, D; Huppertz, L M; Büchsel, M; Kramer, L; Pollak, S; Grosse Perdekamp, M

    2015-12-01

    Acute subdural hematomas are mostly due to blunt traumatization of the head. In rare instances, subdural bleeding occurs without evidence of a previous trauma following spontaneous hemorrhage, e.g. from a ruptured aneurysm or an intracerebral hematoma perforating the brain surface and the arachnoid. The paper presents the morphological, microbiological and toxicological findings in a 38-year-old drug addict who was found by his partner in a dazed state. When brought to a hospital, he underwent trepanation to empty a right-sided subdural hematoma, but he died already 4h after admission. Autopsy revealed previously undiagnosed infective endocarditis of the aortic valve as well as multiple infarctions of brain, spleen and kidneys obviously caused by septic emboli. The subdural hematoma originated from a subcortical brain hemorrhage which had perforated into the subdural space. Microbiological investigation of the polypous vegetations adhering to the aortic valve revealed colonization by Streptococcus mitis and Klebsiella oxytoca. According to the toxicological analysis, no psychotropic substances had contributed to the lethal outcome. The case reported underlines that all deaths of drug addicts should be subjected to complete forensic autopsy, as apart from intoxications also natural and traumatic causes of death have to be taken into consideration. PMID:26296471

  16. Large subcapsular hematoma following ureteroscopic laser lithotripsy of renal calculi in a spina bifida patient: lessons we learn

    PubMed Central

    Vaidyanathan, Subramanian; Samsudin, Azi; Singh, Gurpreet; Hughes, Peter L; Soni, Bakul M; Selmi, Fahed

    2016-01-01

    Introduction Paraplegic patients are at greater risk of developing complications following ureteroscopic lithotripsy because of urine infection associated with neuropathic bladder, difficulties in access due to altered anatomy of urinary bladder and urethra, spinal curvature, spasticity, and contractures. We report the occurrence of large subcapsular hematoma following ureteroscopy and discuss lessons we learn from this case. Case report A 48-year-old male patient with spina bifida underwent ureteroscopy with laser lithotripsy and ureteric stenting for left ureteric stone and staghorn calculus with hydronephrosis; laser lithotripsy was repeated after 3 months; both procedures were performed by a senior urologist and did not result in any complications. Ureteroscopic laser lithotripsy was performed 5 months later by a urological trainee; it was difficult to negotiate the scope as vision became poor because of bleeding (as a result of the procedure). Postoperatively, hematuria persisted; temperature was 39°C. Cefuroxime was given intravenously followed by gentamicin for 5 days; hematuria subsided gradually; he was discharged home. Ten days later, this patient developed temperature, the urine culture grew Pseudomonas aeruginosa, and ciprofloxacin was given orally. Computed tomography (CT) of the urinary tract, performed 4 weeks after ureteroscopy, revealed a 9×7 cm subcapsular collection on the left kidney compressing underlying parenchyma. Percutaneous drainage was not feasible because of severe curvature of spine. Isotope renogram revealed deterioration in left renal function from 30% to 17%. Follow-up CT revealed reduction in the size of subcapsular hematoma, no hydronephrosis, and several residual calculi. Conclusion Risk of subcapsular hematoma following ureteroscopic lithotripsy can be reduced by avoiding prolonged endoscopy and performing ureteroscopy under low pressure. When a paraplegic patient develops features of infection after ureteroscopy, renal

  17. Large subcapsular hematoma following ureteroscopic laser lithotripsy of renal calculi in a spina bifida patient: lessons we learn

    PubMed Central

    Vaidyanathan, Subramanian; Samsudin, Azi; Singh, Gurpreet; Hughes, Peter L; Soni, Bakul M; Selmi, Fahed

    2016-01-01

    Introduction Paraplegic patients are at greater risk of developing complications following ureteroscopic lithotripsy because of urine infection associated with neuropathic bladder, difficulties in access due to altered anatomy of urinary bladder and urethra, spinal curvature, spasticity, and contractures. We report the occurrence of large subcapsular hematoma following ureteroscopy and discuss lessons we learn from this case. Case report A 48-year-old male patient with spina bifida underwent ureteroscopy with laser lithotripsy and ureteric stenting for left ureteric stone and staghorn calculus with hydronephrosis; laser lithotripsy was repeated after 3 months; both procedures were performed by a senior urologist and did not result in any complications. Ureteroscopic laser lithotripsy was performed 5 months later by a urological trainee; it was difficult to negotiate the scope as vision became poor because of bleeding (as a result of the procedure). Postoperatively, hematuria persisted; temperature was 39°C. Cefuroxime was given intravenously followed by gentamicin for 5 days; hematuria subsided gradually; he was discharged home. Ten days later, this patient developed temperature, the urine culture grew Pseudomonas aeruginosa, and ciprofloxacin was given orally. Computed tomography (CT) of the urinary tract, performed 4 weeks after ureteroscopy, revealed a 9×7 cm subcapsular collection on the left kidney compressing underlying parenchyma. Percutaneous drainage was not feasible because of severe curvature of spine. Isotope renogram revealed deterioration in left renal function from 30% to 17%. Follow-up CT revealed reduction in the size of subcapsular hematoma, no hydronephrosis, and several residual calculi. Conclusion Risk of subcapsular hematoma following ureteroscopic lithotripsy can be reduced by avoiding prolonged endoscopy and performing ureteroscopy under low pressure. When a paraplegic patient develops features of infection after ureteroscopy, renal

  18. Age determination of vessel wall hematoma in spontaneous cervical artery dissection: A multi-sequence 3T Cardiovascular Magnetic resonance study

    PubMed Central

    2011-01-01

    Background Previously proposed classifications for carotid plaque and cerebral parenchymal hemorrhages are used to estimate the age of hematoma according to its signal intensities on T1w and T2w MR images. Using these classifications, we systematically investigated the value of cardiovascular magnetic resonance (CMR) in determining the age of vessel wall hematoma (VWH) in patients with spontaneous cervical artery dissection (sCAD). Methods 35 consecutive patients (mean age 43.6 ± 9.8 years) with sCAD received a cervical multi-sequence 3T CMR with fat-saturated black-blood T1w-, T2w- and TOF images. Age of sCAD was defined as time between onset of symptoms (stroke, TIA or Horner's syndrome) and the CMR scan. VWH were categorized into hyperacute, acute, early subacute, late subacute and chronic based on their signal intensities on T1w- and T2w images. Results The mean age of sCAD was 2.0, 5.8, 15.7 and 58.7 days in patients with acute, early subacute, late subacute and chronic VWH as classified by CMR (p < 0.001 for trend). Agreement was moderate between VWH types in our study and the previously proposed time scheme of signal evolution for cerebral hemorrhage, Cohen's kappa 0.43 (p < 0.001). There was a strong agreement of CMR VWH classification compared to the time scheme which was proposed for carotid intraplaque hematomas with Cohen's kappa of 0.74 (p < 0.001). Conclusions Signal intensities of VWH in sCAD vary over time and multi-sequence CMR can help to determine the age of an arterial dissection. Furthermore, findings of this study suggest that the time course of carotid hematomas differs from that of cerebral hematomas. PMID:22122756

  19. Inter-hemispheric scissure, a rare location for a traumatic subdural hematoma, case report and review of the literature.

    PubMed

    Rapanà, A; Lamaida, E; Pizza, V; Lepore, P; Caputi, F; Graziussi, G

    1997-05-01

    Subdural interhemispheric hematomas (ISH), though not really rare, are quite an uncommon complication of head traumas. This condition is more frequent in childhood, where it is generally considered as a part of a more complex syndrome, called 'Shaken Children Syndrome', usually pointing out child abuse. Although a head injury is very often considered the cause (in about 80-90% of the cases), possible predisposing factors such as coagulopathies, alcohol abuse or anticoagulant therapy can also be considered. Furthermore, as the rupture of an intracranial aneurysm has also occasionally pinpointed as a possible cause, this event should be kept in mind in order to be able to address exactly both the diagnostic and therapeutical procedures. A new conservatively managed case is thereby described. A review of the literature with particular attention drawn to the diagnosis and the different therapeutical possibilities is also elaborated. PMID:9213057

  20. [Features of memantine action profile in cholinergic deficit and intracerebral posttraumatic hematoma (hemorrhagic stroke) models in rats].

    PubMed

    Garibova, T L; Voronina, T A; Litvinova, S A; Kuznetsova, A L; Kul'chikov, A E; Alesenko, A V

    2008-01-01

    Memantine, a low-affinity non-competitive antagonist of glutamatergic NMDA-subtype receptors, was used at a daily dose of 1 mg/kg over 10 days for the treatment of rats with cholinergic deficit induced by the chronic administration of scopolamine (1 mg/kg, 20 days). The drug prevented violation of the learning of conditioned active and passive avoidance reflexes and produced no significant effect on the emotional state of animals in elevated plus maze (EPM) test. In animals with intracerebral posttraumatic hematoma (hemorrhagic stroke), memantine (2 mg/kg, for 3 days after operation) completely prevented the loss of animals, reduced the neurological deficit, improved conditioned passive avoidance reflex performance, and decreased emotional stress in the EPM test.

  1. Spontaneous Subcapsular Renal Hematoma: Strange Case in an Anticoagulated Patient with HWMH after Aortic and Iliac Endovascular Stenting Procedure.

    PubMed

    Greco, Michele; Butticè, Salvatore; Benedetto, Filippo; Spinelli, Francesco; Traxer, Olivier; Tefik, Tzevat; Pappalardo, Rosa; Magno, Carlo

    2016-01-01

    Spontaneous subcapsular renal hematoma is a rare condition in clinical practice. It is caused by renal cysts, benign and malignant renal tumors, vascular lesions, and antiplatelet or anticoagulant therapy. In this paper we report an unusual case of rupture of a renal cyst of a 66-year-old male patient during an aortic and iliac endovascular procedure for a massive calcified atheroma above the iliac bifurcation. We suspected that the bolus of high weight molecular heparin given during the procedure caused the rupture of the cyst. According to the literature, this is the first case of renal cyst rupture during an endovascular aortic procedure after administering a high weight molecular heparin bolus. PMID:27579210

  2. Spontaneous Subcapsular Renal Hematoma: Strange Case in an Anticoagulated Patient with HWMH after Aortic and Iliac Endovascular Stenting Procedure

    PubMed Central

    Greco, Michele; Benedetto, Filippo; Spinelli, Francesco; Traxer, Olivier; Tefik, Tzevat; Pappalardo, Rosa

    2016-01-01

    Spontaneous subcapsular renal hematoma is a rare condition in clinical practice. It is caused by renal cysts, benign and malignant renal tumors, vascular lesions, and antiplatelet or anticoagulant therapy. In this paper we report an unusual case of rupture of a renal cyst of a 66-year-old male patient during an aortic and iliac endovascular procedure for a massive calcified atheroma above the iliac bifurcation. We suspected that the bolus of high weight molecular heparin given during the procedure caused the rupture of the cyst. According to the literature, this is the first case of renal cyst rupture during an endovascular aortic procedure after administering a high weight molecular heparin bolus. PMID:27579210

  3. Cerebral Infarction following Acute Subdural Hematoma in Infants and Young Children: Predictors and Significance of FLAIR Vessel Hyperintensity

    PubMed Central

    MOMOSE, Hiroaki; SORIMACHI, Takatoshi; AOKI, Rie; ATSUMI, Hideki; MATSUMAE, Mitsunori

    A phenomenon of cerebral infarction following acute subdural hematoma (ASDH) in infants and young children, termed cerebral infarction following ASDH (CIASDH), has been well recognized, though both its mechanisms and risk factors have been poorly understood. The purpose of the present study was to investigate the predictors for CIASDH in a population of ASDH, and to evaluate the imaging studies to presume the mechanisms of CIASDH. We retrospectively examined consecutive children 6 years of age or younger, who were diagnosed with ASDH and were admitted to our hospital between 2000 and 2014. In 57 consecutive children with ASDH, 12 (21.1%) developed CIASDH. The multivariate analysis revealed five predictors for CIASDH: presence of seizure, consciousness disturbance at admission, absence of skull fracture, hematoma thickness ≥ 5 mm on computed tomography (CT), and midline shift ≥ 3 mm on CT (p < 0.05). In three of six patients (50%) undergoing magnetic resonance (MR) imaging/fluid-attenuated inversion recovery (FLAIR) within 5 days of admission, serpentine hyperintensities in the subarachnoid space (FLAIR vessel hyperintensities) were demonstrated. MR angiography showed neither occlusion nor stenosis of the cerebral arteries. Single photon emission CT performed at admission in one patient showed a cerebral blood flow reduction in the ASDH side. All the children with CIASDH showed unfavorable outcomes at discharge. Children showing multiple predictors at admission should be carefully observed for development of CIASDH. Evaluation of the imaging studies suggested that a blood flow disturbance in the level of peripheral arteries to microcirculation was one candidate for possible mechanisms to induce the CIASDH. PMID:26041626

  4. Recovery process and prognosis of aphasic patients with left putaminal hemorrhage: relationship between hematoma type and language modalities.

    PubMed

    Komiya, Keiji; Sakai, Yasujiro; Horikoshi, Toru; Naganuma, Hirofumi

    2013-02-01

    To elucidate the precise recovery process and prognosis of language functions in aphasic patients with left putaminal hemorrhage, we investigated 48 aphasic patients classified into 4 groups according to the location and extent of hematoma. The hematoma extended to the corona radiata in all patients, extracapsular in type I (12 cases), to the anterior limb in type II (10 cases), to the posterior limb in type III (12 cases), and to both limbs in type IV (14 cases). The Standard Language Test for Aphasia was performed at 1 month, 3 months, and 6 months after the attack. The type II, III, and IV patients were divided into 2 groups, with and without ventricular rupture of the hemorrhage. At 3 and 6 months after the attack, the type I, II, and III patients showed significant improvement (P < .05) in all language modalities compared with the type IV patients. Most improvement in language modalities occurred in the first 3 months. The evaluation of patients with ventricular rupture after 6 months revealed poor recovery (P < .05) in oral commands, visual commands, confrontation naming, sentence repetition, narratives, verbal fluency, and writing in type II and III patients. In type IV patients, this evaluation showed poor recovery (P < .05) only in oral and written naming (kanji words). No significant difference in prognostic outcome was observed between the surgical treatment group and the nonsurgical treatment group. The classification of hemorrhage may be useful in predicting the outcome of aphasia with putaminal hemorrhage and in guiding clinicians in providing effective instructions to patients and their relatives. PMID:21903420

  5. Impact of Time Interval between Trauma Onset and Burr Hole Surgery on Recurrence of Late Subacute or Chronic Subdural Hematoma

    PubMed Central

    Kim, Dae-in; Kim, Jae-hoon; Kang, Hee-in; Moon, Byung-gwan; Kim, Joo-seung

    2016-01-01

    Objective Although subdural hematoma (SDH) is commonly treatable by burr hole surgery in the late subacute or chronic stage, there is no clear consensus regarding appropriate management and exact predictive factors for postoperative recurrence also remain unclear. The aim of this study was to evaluate risk factors associated with recurrence of SDH that requires burr hole surgery in the late subacute or chronic stage. We also identified the appropriate timing of surgery for reducing the recurrence. Methods We retrospectively reviewed 274 patients with SDH in the late subacute or chronic stage treated with burr hole surgery in our hospital between January 2007 and December 2014. Excluding patients with acute intracranial complications or unknown time of trauma onset left 216 patients included in the study. Results Of 216 patients with SDH in the late subacute or chronic stage, recurrence was observed in 36 patients (16.7%). The timing of the operation in patients with late subacute stage (15–28 days) resulted in a significant decrease in recurrence (RR, 0.33; 95% CI, 0.17–0.65; p=0.001) compared to chronic stage (>28 days). Otherwise, no significant risk factors were associated with recurrences including comorbidities and surgical details. Conclusion The results indicated that time from trauma onset to burr hole surgery may be important for decreasing the risk of recurrence. Therefore, unless patients can be treated conservatively without surgery, prompt surgical management is recommended in patients diagnosed as having late subacute or chronic subdural hematoma treatable by burr hole surgery, even when neurological deficits are unclear.

  6. Impact of Time Interval between Trauma Onset and Burr Hole Surgery on Recurrence of Late Subacute or Chronic Subdural Hematoma

    PubMed Central

    Kim, Dae-in; Kim, Jae-hoon; Kang, Hee-in; Moon, Byung-gwan; Kim, Joo-seung

    2016-01-01

    Objective Although subdural hematoma (SDH) is commonly treatable by burr hole surgery in the late subacute or chronic stage, there is no clear consensus regarding appropriate management and exact predictive factors for postoperative recurrence also remain unclear. The aim of this study was to evaluate risk factors associated with recurrence of SDH that requires burr hole surgery in the late subacute or chronic stage. We also identified the appropriate timing of surgery for reducing the recurrence. Methods We retrospectively reviewed 274 patients with SDH in the late subacute or chronic stage treated with burr hole surgery in our hospital between January 2007 and December 2014. Excluding patients with acute intracranial complications or unknown time of trauma onset left 216 patients included in the study. Results Of 216 patients with SDH in the late subacute or chronic stage, recurrence was observed in 36 patients (16.7%). The timing of the operation in patients with late subacute stage (15–28 days) resulted in a significant decrease in recurrence (RR, 0.33; 95% CI, 0.17–0.65; p=0.001) compared to chronic stage (>28 days). Otherwise, no significant risk factors were associated with recurrences including comorbidities and surgical details. Conclusion The results indicated that time from trauma onset to burr hole surgery may be important for decreasing the risk of recurrence. Therefore, unless patients can be treated conservatively without surgery, prompt surgical management is recommended in patients diagnosed as having late subacute or chronic subdural hematoma treatable by burr hole surgery, even when neurological deficits are unclear. PMID:27651869

  7. Recovery process and prognosis of aphasic patients with left putaminal hemorrhage: relationship between hematoma type and language modalities.

    PubMed

    Komiya, Keiji; Sakai, Yasujiro; Horikoshi, Toru; Naganuma, Hirofumi

    2013-02-01

    To elucidate the precise recovery process and prognosis of language functions in aphasic patients with left putaminal hemorrhage, we investigated 48 aphasic patients classified into 4 groups according to the location and extent of hematoma. The hematoma extended to the corona radiata in all patients, extracapsular in type I (12 cases), to the anterior limb in type II (10 cases), to the posterior limb in type III (12 cases), and to both limbs in type IV (14 cases). The Standard Language Test for Aphasia was performed at 1 month, 3 months, and 6 months after the attack. The type II, III, and IV patients were divided into 2 groups, with and without ventricular rupture of the hemorrhage. At 3 and 6 months after the attack, the type I, II, and III patients showed significant improvement (P < .05) in all language modalities compared with the type IV patients. Most improvement in language modalities occurred in the first 3 months. The evaluation of patients with ventricular rupture after 6 months revealed poor recovery (P < .05) in oral commands, visual commands, confrontation naming, sentence repetition, narratives, verbal fluency, and writing in type II and III patients. In type IV patients, this evaluation showed poor recovery (P < .05) only in oral and written naming (kanji words). No significant difference in prognostic outcome was observed between the surgical treatment group and the nonsurgical treatment group. The classification of hemorrhage may be useful in predicting the outcome of aphasia with putaminal hemorrhage and in guiding clinicians in providing effective instructions to patients and their relatives.

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

    PubMed

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

    2009-05-01

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

  9. [Treatment of Non-Traumatic Spinal Epidural Hematoma:A Report of Five Cases and a Systematic Review of the Literature].

    PubMed

    Terada, Yukinori; Toda, Hiroki; Hashikata, Hirokuni; Yamamoto, Yu; Nagai, Yasunori; Yoshimoto, Naoya; Goto, Masanori; Nishida, Namiko; Iwasaki, Koichi

    2016-08-01

    Objective:Non-traumatic spinal epidural hematoma(SEH)is relatively rare. We report five cases of SEH, review the relevant literature, and discuss the current treatment strategies for non-traumatic SEH in Japan. Methods:Clinical data of cases with non-traumatic SEH treated at our institute from 2008 to 2015 were retrospectively analyzed. In addition, we identified the relevant literature using the Japan Medical Abstracts Society databases for peer-reviewed articles published from Jan 1, 1995 to Aug 31, 2015. The search terms "spinal", "epidural hematoma", and "non-traumatic OR spontaneous" were used. Treatment strategies were summarized according to the treatment criteria. Results:Five patients(1 man and 4 women;age, 59-86 years;mean age, 74 years)were treated for SEH. Hematomas were located in the cervical(n=1), cervicothoracic(n=2), thoracic(n=1), and thoracolumbar(n=1)regions. All patients suffered sudden neck and/or back pain followed by subsequent neurological deterioration. Four patients were under antithrombotic treatment, and underwent laminectomy and drainage of the hematoma due to severe and progressive neurological deficits. All patients demonstrated significant neurological recovery. Seventy-seven articles from domestic institutes and hospitals were identified. Their criteria for conservative and surgical treatments differed based on the time from the onset and severity. Conclusion:Five cases of non-traumatic SEH were treated successfully. Patients with moderate to severe neurological deficit need timely surgical management, while non-surgical treatment may be indicated in mild deficits. To standardize the optimal treatment for non-traumatic SEH, an appropriate assessment system incorporating the time from onset and severity of neurological impairment should be established. PMID:27506844

  10. Retroperitoneal hematoma: an unexpected complication during intervention on an occluded superficial femoral artery via a retrograde popliteal artery approach.

    PubMed

    Akkus, Nuri I; Beedupalli, Jagan; Varma, Jai

    2013-01-01

    Peripheral arterial disease involvement of the superficial femoral artery (SFA) is common. Different endovascular techniques are used successfully for revascularization of this artery. A retrograde approach to chronic total occlusion (CTO) of the SFA through the ipsilateral popliteal artery has been used occasionally if an antegrade approach is not feasible or has failed. Some of the known complications encountered during this approach are arteriovenous fistula formation at the access site, occlusion of the popliteal artery if closure devices are used, and bleeding. There are no reports of perforation or bleeding of the SFA or the external iliac artery (EIA) during a popliteal approach, probably due to lack of flow in the occluded segment of the SFA. We report a case in which a retroperitoneal hematoma occurred due to retrograde blood flow through the established true channel in the proximal SFA and subsequently to the dissection plane with a wire tip perforation in the EIA, which was treated by stopping retrograde filling with prolonged balloon inflation in the distal SFA before the CTO. PMID:23890758

  11. Spontaneous large renal pelvis hematoma in ureteropelvic junction obstruction presenting as an acute abdomen: Rare case report.

    PubMed

    Sawant, Ajit; Kasat, Gaurav; Pawar, Prakash; Tamhankar, Ashwin

    2016-01-01

    Patients with ureteropelvic junction (UPJ) obstruction can present with flank pain or hematuria. We present 20-year-old male presenting with acute pain in lumbar and right fossa with tenderness and guarding, this case was clinically mimicking general surgical emergency. On computed tomography with urography and angiography, there was 15 cm × 11 cm × 10 cm size non-enhancing hyperdense lesion (average Hounsfield units - +64) in right renal pelvis suggestive of hematoma. Patient's diethylenetriaminepentaacetic acid diuretic renography was suggestive of right kidney glomerular function rate of 48.4 ml/min with the relative function of 43%, Peak to half peak was not achieved. The patient was managed by retrograde ureteropyelography and double J stenting. After 1 month, clot size decreased to 4 cm × 3 cm × 2 cm. The patient had undergone open reduction Anderson hynes dismembered pyeloplasty with the removal of pelvis clot after 6 weeks. We report the first case of UPJ obstruction presenting as an acute abdomen and spontaneous hematuria with large pelvis clot without rupture of the renal pelvis. PMID:27141202

  12. Epidemiological characteristics of 778 patients who underwent surgical drainage of chronic subdural hematomas in Brasília, Brazil

    PubMed Central

    2013-01-01

    Background Chronic subdural hematomas (CSDHs) are common in neurosurgical practice. There are no publications that report large series of the epidemiological characteristics of this pathology in Brazil. The purpose is to describe a large series of surgical cases and analyze the epidemiological and clinical characteristics. Methods We retrospectively analyzed patients with CSDH admitted into Neurosurgical Services at the Hospital de Base do Distrito Federal, Brasília, Brazil from 2006 to 2011. Age, sex, clinical feature, etiology, surgical procedure, side, clinical outcome, and recurrence were reviewed. Statistical tests were used to analyze data, and P < 0.05 was considered statistically significant. Results The series included 778 patients. There were 643 (82.6%) male patients with a mean age of 64.3 ± 15.9 (range, 14–93) years. The principal symptom was headache (58.9%). The most frequent origin was a fall (282 cases, 36.2%), but the origin remained unclear in 281 (36.1%) patients. Mild head injury occurred in 540 (69.4%) cases. Burr holes with drainage were used as the surgical procedure in 96.5% patients, and 687 (88.3%) patients had a positive outcome. Mortality was 0%. Recurrence was observed in 42 cases. Conclusions The occurrence of CSDHs is more common in elderly men. Treatment with burr holes and drainage is a simple and safe method for treatment. In our experience, CSDH presents decreased morbidity and mortality. PMID:23452673

  13. Surgical management of complicated intra-mural duodenal hematoma: A case-report and review of literature

    PubMed Central

    Elmoghazy, Walid; Noaman, Islam; Mahfouz, Ahmed-Emad; Elaffandi, Ahmed; Khalaf, Hatem

    2015-01-01

    Introduction Intramural duodenal hematoma (IDH) is a rare pathological entity that occurs as a complication of trauma, pancreatitis, peptic ulcer disease or endoscopic biopsy procedures. In this report, we present a case of IDH related to a duodenal diverticulum that was complicated by intra-abdominal bleeding and peritonitis. Presentation of case We report a 31-year old male who presented with pancreatitis that was complicated with IDH, as diagnosed using endoscopy and CT scan of the abdomen. The condition was related to a duodenal diverticulum as appears on imaging. The patient was treated conservatively over a course of 1 week when he started to have intra-abdominal bleeding and developed peritonitis. The patient was successfully treated with laparotomy, drainage of intra-abdominal abscess, evacuation of IDH and repair of duodenal perforation. We discuss this case in the context of the current indications of surgery in cases of IDH. Conclusion Despite shift towards conservative management of IDH cases over last few decades, these cases should be handled carefully as they might develop life-threatening complications. PMID:26595897

  14. Subdural hematoma in a patient taking imatinib for GIST: a case report and discussion of risk with other chemotherapeutics.

    PubMed

    Theodotou, Christian B; Shah, Ashish H; Ivan, Michael E; Komotar, Ricardo J

    2016-03-01

    Although anticancer drugs have existed for over 50 years, targeted drugs have only recently been marketed, and their side effects may not be completely understood. The patient is a 56-year-old woman with a gastrointestinal stromal tumor who presented with headache, nausea, and vomiting lasting 2 weeks. An MRI to rule out brain metastasis found a large right-hemispheric subdural hematoma without metastases. She denied trauma, seizures, or alcohol abuse. Laboratory test results were normal. Eight months prior, she had begun a dose escalation of imatinib, which became the suspected cause of her hemorrhage. The literature was reviewed for reports of intracranial hemorrhage with targeted chemotherapeutics excluding metastases, anticoagulation, and trauma. Multiple events have been documented but only one for imatinib with gastrointestinal stromal tumor. Imatinib is believed to cause platelet dysfunction (missed by standard testing), leading to intracranial hemorrhage. Intracranial hemorrhage risk may be under-reported and neurosurgical consultation for immediate treatment and oncology for reinitiation of chemotherapy are recommended. PMID:26628484

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

    PubMed

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

    2016-01-01

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

  16. Interthalamic hematoma secondary to cerebrovascular atherosclerosis in an aged grizzly bear (Ursus arctos horribilis) with primary cardiac schwannoma.

    PubMed

    Miller, Andrew David; McDonough, Sean

    2008-12-01

    A 38-year-old intact female Grizzly bear (Ursus arctos horribilis) was evaluated for progressive seizure activity, pale mucous membranes, deficient pupillary light and menace responses, and irregular shallow respiration. Because of poor response to treatment, the animal was euthanized. Gross examination revealed abundant hemorrhage in both lateral ventricles; a large, encapsulated mass within the rostral interthalamic region; and a well-demarcated, round white mass in the apex of the right ventricle. Histologic examination of the interthalamic mass revealed a resolving hematoma composed of stratified layers of fibrin and white blood cells that was surrounded by a thick fibrous capsule. Most meningeal and intraparenchymal blood vessels had multifocal degeneration, fragmentation, and fraying of the internal elastic lamina with prominent intimal proliferations and plaques. The plaques were formed by small numbers of lipid-laden macrophages (foam cells) that were intermixed with occasional lymphocytes and plasma cells. The cardiac mass was composed of pallisading and interlacing spindle cells with parallel nuclei and abundant, pale eosinophilic cytoplasm consistent with a schwannoma.

  17. Interthalamic hematoma secondary to cerebrovascular atherosclerosis in an aged grizzly bear (Ursus arctos horribilis) with primary cardiac schwannoma.

    PubMed

    Miller, Andrew David; McDonough, Sean

    2008-12-01

    A 38-year-old intact female Grizzly bear (Ursus arctos horribilis) was evaluated for progressive seizure activity, pale mucous membranes, deficient pupillary light and menace responses, and irregular shallow respiration. Because of poor response to treatment, the animal was euthanized. Gross examination revealed abundant hemorrhage in both lateral ventricles; a large, encapsulated mass within the rostral interthalamic region; and a well-demarcated, round white mass in the apex of the right ventricle. Histologic examination of the interthalamic mass revealed a resolving hematoma composed of stratified layers of fibrin and white blood cells that was surrounded by a thick fibrous capsule. Most meningeal and intraparenchymal blood vessels had multifocal degeneration, fragmentation, and fraying of the internal elastic lamina with prominent intimal proliferations and plaques. The plaques were formed by small numbers of lipid-laden macrophages (foam cells) that were intermixed with occasional lymphocytes and plasma cells. The cardiac mass was composed of pallisading and interlacing spindle cells with parallel nuclei and abundant, pale eosinophilic cytoplasm consistent with a schwannoma. PMID:19110714

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

    PubMed

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

    2016-07-01

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

  19. The Optimal Surgical Approach for Treatment of Chronic Subdural Hematoma: Questionnaire Assessment of Practice in Iran and Review of Literature.

    PubMed

    Javadi, Seyed Amir Hossein; Naderi, Fereshteh; Javadi, Amir Mohammad

    2015-10-01

    Chronic subdural hematoma (CSDH) is a curable entity frequently encountered by neurosurgeons. The present study was conducted to explore expert opinion and common practice in Iran. Besides, a Review of randomized clinical trials in literature was performed. A questionnaire including six questions discussing major aspects of practice on CSDH, with multiple choices was designed. A pilot study was performed for reliability analysis of the questionnaire. A total of 100 neurosurgeons were selected randomly from the members of Iranian Association of Neurological Surgeons. Frequency of answers to each item, differences in response rates and correlation of various categories were analyzed using Chi-square statistics. The mean duration of experience was 15.4 ± 5 years, with a range of 10 to 37 years. The most common initial procedure of choice was burr-hole drainage (64%). At recurrent cases, surgical approach was changed to craniotomy at one-third of those treated initially with burr-hole drainage. The participants believed that surgical technique was predictive of outcome and recurrence. Burr-hole without drainage was used by less expert neurosurgeons (mean 12.5 ± 6), however, burr-hole drainage was the dominant technique at more than 15 years of experience and craniectomy was used only by participants with more than 30 years of experience (10%). Irrigation was used by most of the neurosurgeons (87.5%) in combination with drainage and burr-hole. The majority of participants used flat position at the postoperative period. At the current study, the pattern of management for CSDH was similar to other reports at literature suggesting the burr-hole drainage and irrigation as optimal treatment. Individualized decision-making could be made at challenging cases. PMID:26615373

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

    PubMed

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

    2009-05-01

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

  1. Tiger hide appearance: Impaction and prolapse of brain parenchyma through burr holes after evacuation of bilateral chronic subdural hematoma: A rare case report.

    PubMed

    Jaiswal, Manish; Gandhi, Ashok; Purohit, Devendra; Mittal, R S

    2016-01-01

    Burr hole evacuation of chronic subdural hematoma (SDH) with or without drainage system is the most common surgical method among various techniques. There are various complications of burr hole drainage evacuation of chronic SDH, but there is no case report regarding impaction and prolapse of brain parenchyma through burr hole as a complication. Herewith, we are reporting a case of bilateral chronic SDH with prolapse of brain parenchyma through burr holes. Magnetic resonance imaging (MRI) of brain showed a characteristic look and we named it "Tiger hide appearance". We failed to find such characteristic appearance in MRI brain on reviewing the available literature. PMID:27366284

  2. Can Herbal Medicine Cause Hematoma Enlargement of Hypertensive Intracerebral Hemorrhage within 24 hrs Time Window? A Retrospective Study of 256 Cases from a Single Center in China

    PubMed Central

    Xu, Yafa; Guo, Jianwen; Liu, Xian; Li, Juehui; Wang, Jing; Hou, Lingbo

    2015-01-01

    A retrospective review was performed of consecutive patients presenting with HICH within 24 hours of ictus presenting between March 2008 and March 2013 who were diagnosed as having HICH by CT scan. Of the 256 patients who matched study inclusion standard, 43 patients hematoma was enlarged (16.8%). The number of the patients who did not take PBC or RBC herbal medicine, took the PBC herbal medicine, and took RBS herbal medicine was 19 (44.2%), 2 (4.7%), and 22 (51.2%) in hematoma enlargement group and 78 (36.6%), 26 (12.2%), and 109 (51.2%) in nonhematoma enlargement group, individually. There was no significant difference between two groups (P = 0.671). PBC and RBS herbal medicine did not increase the incidence of hematoma expansion of ICH within 24 hours after onset of symptom. PMID:25788965

  3. The Effect of Minimally Invasive Hematoma Aspiration on the JNK Signal Transduction Pathway after Experimental Intracerebral Hemorrhage in Rats

    PubMed Central

    Pei, Haitao; Jiang, Tao; Liu, Guofang; Li, Zhaoxing; Luo, Kai; An, Jingjiao; Li, Guangcheng; Guo, Yunliang

    2016-01-01

    Objective: To explore the effect of minimally invasive hematoma aspiration (MIHA) on the c-Jun NH2-terminal kinase (JNK) signal transduction pathway after intracerebral hemorrhage (ICH). Methods: In this experiment, 300 adult male Wistar rats were randomly and averagely divided into sham-operated group, ICH group and MIHA group. In each group, 60 rats were used in the detection of indexes in this experiment, while the other 40 rats were used to replace rats which reached the exclusion criteria (accidental death or operation failure). In ICH group and MIHA group, ICH was induced by injection of 70 µL of autologous arterial blood into rat brain, while only the rats in MIHA group were treated by MIHA 6 h after ICH. Rats in sham-operated group were injected nothing into brains, and they were not treated either, like rats in ICH group. In each group, six rats were randomly selected to observe their Bederson’s scales persistently (6, 24, 48, 72, 96, 120 h after ICH). According to the time they were sacrificed, the remaining rats in each group were divided into 3 subgroups (24, 72, 120 h). The change of brain water content (BWC) was measured by the wet weight to dry weight ratio method. The morphology of neurons in cortex was observed by the hematoxylin–eosin (HE) staining. The expressions of phospho-c-Jun NH2-terminal kinase (pJNK) and JNK in peri-hematomal brain tissue were determined by the immunohistochemistry (IHC) and Western blotting (WB). Results: At all time points, compared with the ICH groups, the expression of pJNK decreased obviously in MIHA groups (p < 0.05), while their Bederson’s scales and BWC declined, and neuron injury in the cortex was relieved. The expression level of JNK was not altered at different groups. The data obtained by IHC and WB indicated a high-level of consistency, which provided a certain dependability of the test results. Conclusion: The JNK signal transduction pathway could be activated after intracerebral hemorrhage, with the

  4. Effects of diclofenac sodium on the hippocampus of rats with acute subdural hematoma: histological, stereological, and molecular approach.

    PubMed

    Türkmen, A P; Kaplan, S; Aksoy, A; Altunkaynak, Bz; Yurt, Kk; Elibol, E; Çokluk, C; Onger, Me

    2016-01-01

    This study was aimed at evaluating the potential effects of acute subdural hematoma (ASDH) and diclofenac sodium (DS) therapy following ASDH on the rat hippocampus. Twenty-four male Sprague Dawley rats were used and divided into four groups. 0.1 ml of non-heparinized autologous blood from the tail vein of the animals in the non-treatment group (NTG) and treatment group (TG) was injected into the subdural space. The TG received intramuscular diclofenac sodium at a 15 mg/kg dose daily from the postoperative second hour to the seventh day after the operation. The control group (CG) and sham group (SG) were used for control and sham operations, respectively. On the postoperative eighth day, all animals were sacrificed, and the hippocampi of all animals were stereologically and histologically evaluated. Also blood samples of the animals were biochemically analyzed. As a result of the study, the mean number of neurons in CA1, CA2, and CA3 regions of the hippocampus and the total number of neurons were decreased in the hippocampus samples of the NTG and especially the TG subjects. When comparing the second blood samples, there was no difference between the levels of adrenaline and serotonin among the groups. However, after the operation, noradrenalin levels in the treatment group were found to be higher than those of the sham and control groups (p < 0.05). In the NTG and TG, histopathological findings were observed such as Nissl condensation as well as completely dead and indistinguishable neurons with abnormally shaped, shrunken cytoplasm and nuclei. Also necrotic areas on the specimens of the TG were seen. In immunohistochemical sections, c-FOS positivity was decreased in the NTG and especially the TG. Otherwise, PGC-1 positive cells were increased in the NTG and especially the TG. In this study, it was shown for the first time by means of stereological techniques that using DS after ASDH caused a decrease in the number of hippocampal neurons (CA1, CA2, and CA3

  5. Ligamentum flavum hematomas: Why does it mostly occur in old Asian males? Interesting point of reported cases: Review and case report

    PubMed Central

    Ozdemir, Bulent; Kanat, Ayhan; Batcik, Osman Ersegun; Gucer, Hasan; Yolas, Coskun

    2016-01-01

    Hematoma of the ligamentum flavum (LF) is a rare cause of neural compression and sciatica. Currently, the etiology and epidemiological characteristics of ligamentum flavum hematoma (LFH) are unknown and epidemiological investigations using rewieving of reported cases have not been performed. We report the case of a 63-year-old man with a LFH compressing the spinal canal at the left L2–L3 level, rewieved relevant literature. In Medline research, wefound a total of 50 reported cases with LFHs, and the interesting point of these cases were analyzed. Many of cases were old males. Interestingly, 39 of the 50 cases were reported from Asian countries. The ages of 42 patients could be verified. The youngest age was 45 years, oldest age was 81 years, and mean age was 66.07 years. Thirty-three out of these 42 patients (78.53%) were older than 60 years. An important aspect of the present review is to bring attention for occurrence in older Asian males. With an increasing number of elderly people in the general population, there is a need to investigate risk factors such as sexual gender, age, and geographic location for LFH. PMID:27041879

  6. Perinephric Hematoma and Hemorrhagic Shock as a Rare Presentation for an Acutely Obstructive Ureteral Stone with Forniceal Rupture: A Case Report

    PubMed Central

    Zynger, Debra L.; Box, Geoffrey N.; Shah, Ketul K.

    2016-01-01

    Abstract Background: Spontaneous perinephric hematoma (SPH) secondary to a forniceal rupture as the first presenting sign for an obstructive ureteral stone in a patient without history of urolithiasis has not been described previously. Case presentation: We report a 70-year-old Caucasian male patient who presented to our emergency room with fever, altered mental status, and left flank pain. He had a temperature of 103.3°F, tachycardia, but stable blood pressure. He had left flank tenderness. A computed tomography scan of the abdomen/pelvis with intravenous contrast revealed an intracapsular hematoma (13.3 × 10.0 × 6.4 cm) with an active bleeding and a 1.1 cm left proximal ureteral stone. The patient became quickly hemodynamically unstable and was taken for emergent exploratory laparotomy and left nephrectomy. An active bleeding was encountered secondary to a (2.4 × 2.0 cm) lateral capsular defect in the kidney. Conclusion: Hemorrhagic/septic shock as a presenting sign for an obstructive ureteral stone may require an emergent nephrectomy in a hemodynamically unstable patient. PMID:27579423

  7. Blood glutamate grabbing does not reduce the hematoma in an intracerebral hemorrhage model but it is a safe excitotoxic treatment modality.

    PubMed

    da Silva-Candal, Andrés; Vieites-Prado, Alba; Gutiérrez-Fernández, María; Rey, Ramón I; Argibay, Bárbara; Mirelman, David; Sobrino, Tomás; Rodríguez-Frutos, Berta; Castillo, José; Campos, Francisco

    2015-07-01

    Recent studies have shown that blood glutamate grabbing is an effective strategy to reduce the excitotoxic effect of extracellular glutamate released during ischemic brain injury. The purpose of the study was to investigate the effect of two of the most efficient blood glutamate grabbers (oxaloacetate and recombinant glutamate oxaloacetate transaminase 1: rGOT1) in a rat model of intracerebral hemorrhage (ICH). Intracerebral hemorrhage was produced by injecting collagenase into the basal ganglia. Three treatment groups were developed: a control group treated with saline, a group treated with oxaloacetate, and a final group treated with human rGOT1. Treatments were given 1 hour after hemorrhage. Hematoma volume (analyzed by magnetic resonance imaging (MRI)), neurologic deficit, and blood glutamate and GOT levels were quantified over a period of 14 days after surgery. The results observed showed that the treatments used induced a significant reduction of blood glutamate levels; however, they did not reduce the hematoma, nor did they improve the neurologic deficit. In the present experimental study, we have shown that this novel therapeutic strategy is not effective in case of ICH pathology. More importantly, these findings suggest that blood glutamate grabbers are a safe treatment modality that can be given in cases of suspected ischemic stroke without previous neuroimaging.

  8. [Comparative assessment of MR-semiotics of acutest intracerebral hematomas in low- and extra high-field frequency magnetic resonance tomography].

    PubMed

    Skvortsova, V I; Burenchev, D V; Tvorogova, T V; Guseva, O I; Prokhorov, A V; Smirnov, A M; Kupriianov, D A; Pirogov, Iu A

    2009-01-01

    An objective of the study was to compare sensitivity of low- and extra high-field frequency magnetic resonance (MR) tomography of acutest intracerebral hematomas (ICH) and to assess differences between symptoms in obtained images. A study was conducted using experimental ICH in rats (n=6). Hematomas were formed by two injections of autologic blood into the brain. MR-devices "Bio Spec 70/30" with magnetic field strength of 7 T and "Ellipse-150" with magnetic field strength of 0,15 T were used in the study. MR-tomography was carried out 3-5 h after the injections. Both MR-devices revealed the presence of pathological lesion in all animals. Extra highfield frequency MR-tomography showed the specific signs of ICH caused by the paramagnetic effect of deoxyhemoglobin in T2 and T2*-weighted images (WI) and low frequency MR-tomography - in T2*-WI only. The comparable sensitivity of low- and extra high-field frequency MR-devices in acutest ICH was established.

  9. Chronic subdural hematoma

    MedlinePlus

    Ling GSF. Traumatic brain injury and spinal cord injury. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 406. Stippler M. Trauma of ...

  10. Skin blister formation together with patterned intradermal hematoma: a special type of tire mark injury in victims run over by a wheel.

    PubMed

    Pircher, R; Epting, T; Schmidt, U; Geisenberger, D; Pollak, S; Kramer, L

    2015-04-01

    A traffic accident victim run over by a vehicle may show a patterned skin hematoma reflecting the grooves of the tire's profile. Apart from this well-known type of imprint mark, the affected skin can also be blistered provided that the wheel exerts high pressure on the body for a prolonged period of time. The macro- and micromorphological findings as well as the protein composition of the blister fluid were investigated on the basis of a relevant autopsy case. Analogous to blisters associated with hanging marks, the transudation of serous fluid with consecutive detachment of the epidermis is interpreted as a pressure-related effect which cannot be regarded as a sign of vitality.

  11. Spontaneous Rectus Sheath Hematoma in Pregnancy Complicated by the Development of Transfusion Related Acute Lung Injury: A Case Report and Review of the Literature

    PubMed Central

    Gibbs, Jennifer; Bridges, Firas; Trivedi, Kiran; Vullo, John

    2016-01-01

    Background Rectus sheath hematoma (RSH) represents a rare, but serious cause of abdominal pain. Case Here we discuss the case of a healthy multigravida female who presented at 28 weeks gestation with spontaneous RSH. Conservative management with multiple blood transfusions led to the development of transfusion related acute lung injury (TRALI) and intensive care unit admission. She was managed with noninvasive ventilatory support, gradually improved, and was weaned of ventilation. After hospital discharge, she progressed to full term and delivered a viable male infant vaginally at 37 weeks gestation. Conclusion Review of the literature demonstrates 13 cases of RSH in pregnancy, including our own. No other cases were complicated by transfusion related morbidity. RSH and TRALI are rare, but life threatening entities that can complicate pregnancy. PMID:27651980

  12. In Vivo Imaging of Twist Drill Drainage for Subdural Hematoma: A Clinical Feasibility Study on Electrical Impedance Tomography for Measuring Intracranial Bleeding in Humans

    PubMed Central

    Xu, Canhua; Yang, Bin; Li, Jianbo; Fu, Feng; Fei, Zhou; Dong, Xiuzhen

    2013-01-01

    Intracranial bleeding is one of the most severe medical emergencies in neurosurgery. Early detection or diagnosis would largely reduce the rate of disability and mortality, and improve the prognosis of the patients. Electrical Impedance Tomography (EIT) can non-invasively image the internal resistivity distribution within a human body using a ring of external electrodes, and is thus a promising technique to promptly detect the occurrence of intracranial bleedings because blood differs from other brain tissues in resistivity. However, so far there is no experimental study that has determined whether the intracranial resistivity changes in humans could be repeatedly detected and imaged by EIT. Hence, we for the first time attempt to clinically validate this by in vivo imaging the influx and efflux of irrigating fluid (5% dextrose in water, D5W) during the twist-drill drainage operation for the patients with subdural hematoma (SDH). In this study, six patients (four male, two female) with subacute or chronic SDH received the surgical operation in order to evacuate the hematoma around subdural region, and EIT measurements were performed simultaneously on each patient’s head. The results showed that the resistivity significantly increased on the corresponding position of EIT images during the influx of D5W and gradually decreased back to baseline during the efflux. In the quantitative analysis, the average resistivity values demonstrated the similar results and had highly linear correlation (R2 = 0.93±0.06) with the injected D5W volumes, as well as the area of the resistivity gain(R2 = 0.94±0.05). In conclusion, it was clinically validated that intracranial resistivity changes in humans were detectable and quantifiable by the EIT method. After further technical improvements, EIT has the great potential of being a routine neuroimaging tool for early detection of intracranial bleedings. PMID:23372808

  13. Technetium-99m methylene diphosphonate uptake in the brachialis muscle hematoma in a patient with prostate cancer and coagulation disorder mimicking bone metastasis evaluated by single-photon emission tomography-computed tomography/computed tomography.

    PubMed

    Kamaleshwaran, Koramadai Karuppusamy; Mohanan, Vyshakh; Madhavan, Devdas; Shinto, Ajit Sugunan

    2013-10-01

    We report a case of 79-year-old male with prostate cancer and coagulation disorder presented with left shoulder pain. He underwent bone scintigraphy to rule out metastasis, which showed intense foci of tracer activity in the left axilla. Hybrid single-photon emission tomography-computed tomography (SPECT/CT) of the shoulder region localized tracer uptake to the left brachialis muscle hematoma.

  14. Technetium-99m methylene diphosphonate uptake in the brachialis muscle hematoma in a patient with prostate cancer and coagulation disorder mimicking bone metastasis evaluated by single-photon emission tomography-computed tomography/computed tomography

    PubMed Central

    Kamaleshwaran, Koramadai Karuppusamy; Mohanan, Vyshakh; Madhavan, Devdas; Shinto, Ajit Sugunan

    2013-01-01

    We report a case of 79-year-old male with prostate cancer and coagulation disorder presented with left shoulder pain. He underwent bone scintigraphy to rule out metastasis, which showed intense foci of tracer activity in the left axilla. Hybrid single-photon emission tomography-computed tomography (SPECT/CT) of the shoulder region localized tracer uptake to the left brachialis muscle hematoma. PMID:24379534

  15. The efficacy of dexamethasone on reduction in the reoperation rate of chronic subdural hematoma – the DRESH study: straightforward study protocol for a randomized controlled trial

    PubMed Central

    2014-01-01

    Background Chronic subdural hematoma (cSDH) is a common neurosurgical disease. It is often considered to be a rather benign entity. In spite of well established surgical procedures cSDH is complicated by a recurrence rate up to 30%. Since glucocorticoids have been used for treatment of cSDH in 1962 their role is still discussed controversially in lack of evident data. On the basis of the ascertained inflammation cycle in cSDH dexamethasone will be an ideal substance for a short lasting, concomitant treatment protocol. Objective: to test the efficacy of dexamethasone on reduction inthe reoperation rate of cSDH. Methods/Design The study is designed as a double-blind randomized placebo-controlled trial 820 patients who are operated for cSDH and from the age of 25 years are included after obtaining informed consent. They are randomized for administration of dexamethasone (16-16-12-12-8-4 mg/d) or placebo (maltodextrin) during the first 48 hours after surgery. The type I error is 5% and the type II error is 20%. The primary endpoint is the reoperation within 12 weeks postoperative. Discussion This study tests whether dexamethasone administered over 6 days is a safe and potent agent in relapse prevention for evacuated cSDH. Trial registration EudraCT 201100354442 PMID:24393328

  16. [Neuroprotector effect of human recombinant erythropoietin sorbed on polymer nanoparticles studied on model of intracerebral post-traumatic hematoma (hemorrhagic stroke)].

    PubMed

    Balaban'ian, V Iu; Solev, I N; Elizarova, O S; Garibova, T L; Litvinova, S A; Voronina, T A

    2011-01-01

    The neuroprotective activity of recombinant human erythropoietin (r-HuEpo) sorbed on poly(butyl)cyanoacrilate nanoparticles (EPO-PBCA) and on polylactic-co-glycolic acid nanoparticles (EPO-PLGA) has been studied on Wistar rats with intracerebral post-traumatic hematoma (model of hemorrhagic stroke) (IPH-HS) in comparison to native r-HuEpo. It is established that EPO-PBCA produced a protective effect in rats after IPH-HS that was manifested by a decrease in the number of animals with neurological disorders such as circus movement, paresis, and paralysis of hind limbs; the drug also improved coordination (rotating rod test), reduced the number of lost animals, and decreased the loss weight among survived rats. In addition, EPO-PBCA optimized the research behavior of rats with IPH-HS in the open field test and prevented amnesia of passive avoidance reflex (PAR), which was caused by the IPH-HS. These effects were manifested during a two-week observation period. EPO-PLGA has a similar but much less pronounced effect on the major disorders caused by IPH-HS. The efficiency of native r-HuEpo as a neuropotective agent was insignificant and only manifested by decrease in the number of lost animals with IPH-HS.

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

    PubMed Central

    Župan, Željko; Sotošek Tokmadžić, Vlatka; Matanić-Manestar, Marinka; Šustić, Alan; Antončić, Igor; Dunatov, Siniša; Pavlović, Ivan; Antulov, Ronald

    2012-01-01

    The aim of this study is to report the first case of simultaneous appearance of cerebral venous thrombosis (CVT) and bilateral subdural hematomas (SDHs) following epidural analgesia for labor and delivery and to point out the difficulty of establishing such a diagnosis in the presence of postpartum headache. A 26-year old primigravida with a history of epilepsy received epidural analgesia for delivery. Three days after the uneventful spontaneous vaginal delivery she complained about the headache. Patient responded very well to the pain medication and oral hydration, and the headache was relieved. Ten days after the delivery, the headache reoccurred, and an epidural blood patch was performed that successfully relieved her symptom. Stronger progressive headache with nausea reappeared two days later and the parturient was readmitted to hospital. Urgent neuroimaging examinations detected CVT of right the transverse sinus, ipsilateral cortical veins, and partially occluded superior sagittal sinus, as well as bilateral subacute/chronic SDHs. The treatment of the patient with low molecular weight heparin and antiaggregation therapy was effective. In this case, the diagnosis was delayed because of atypical clinical presentation and potentially confounding events (epidural analgesia and assumption that it was a case of PDPH). It is important to carefully observe patients in such conditions and promptly conduct suitable diagnostic tests. Otherwise, unrecognized intracranial complications and delay of appropriate therapy could be life-threatening. PMID:22911532

  18. [A Case of Ruptured Internal Carotid-Posterior Communicating Artery Aneurysm Associated with Acute Subdural Hematoma, Extending from the Interhemispheric Space to the Posterior Fossa].

    PubMed

    Otsuka, Hiroaki; Fukuda, Yuhtaka; Yoshimura, Shouta; Somagawa, Chika; Hiu, Takeshi; Ono, Tomonori; Ushijima, Ryujirou; Toda, Keisuke; Tsutsumi, Keisuke

    2016-06-01

    A 69-year-old woman was admitted to our hospital because of a sudden severe headache without a history of head trauma. CT and MRI revealed an acute subdural hematoma (ASDH) extending from the right interhemispheric space to the posterior fossa bilaterally, with a small amount of subarachnoid hemorrhage that was predominantly localized to the left side of the basal cistern. CT angiogram demonstrated a long protruding ruptured aneurysm at the junction of the right internal carotid and posterior communicating arteries (IC/PC AN) with a posteroinferior projection, associated with a small bleb located near the tentorial edge close to the ipsilateral posterior clinoid process, for which she received clipping surgery. Though rare, IC/PC AN could cause pure or nearly pure ASDH in the above-mentioned distribution. Therefore, in patients with such ASDH, especially without a history of head injury or precise information regarding the situation at the time of onset, urgent imaging evaluation and early intervention are essential to prevent devastating re-rupture events. PMID:27270151

  19. Preguntas y respuestas acerca del Estudio del

    Cancer.gov

    El Estudio del Tamoxifeno y Raloxifeno (STAR, por sus siglas en ingls) es un estudio clnico (un estudio de investigacin conducido con voluntarios) diseado para ver cómo el medicamento raloxifeno (Evista) se compara con el medicamento tamoxifeno (Nolvadex)

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

    PubMed Central

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

    2015-01-01

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

  1. Correlation of the Beta-Trace Protein and Inflammatory Cytokines with Magnetic Resonance Imaging in Chronic Subdural Hematomas : A Prospective Study

    PubMed Central

    Park, Ki-Su; Park, Seong-Hyun; Hwang, Sung-Kyoo; Kim, Chaekyung

    2015-01-01

    Objective Magnetic resonance imaging (MRI) of chronic subdural hematoma (CSDH) detects various patterns, which can be attributed to many factors. The purpose of this study was to measure the level of interleukin-6 (IL-6), interleukin-8 (IL-8), and highly specific protein [beta-trace protein (βTP)] for cerebrospinal fluid (CSF) in CSDHs, and correlate the levels of these markers with the MRI findings. Methods Thirty one patients, treated surgically for CSDH, were divided on the basis of MRI findings into hyperintense and non-hyperintense groups. The concentrations of IL-6, IL-8, and βTP in the subdural fluid and serum were measured. The βTP was considered to indicate an admixture of CSF to the subdural fluid if βTP in the subdural fluid (βTPSF)/βTP in the serum (βTPSER)>2. Results The mean concentrations of IL-6 and IL-8 of the hyperintense group (n=17) of T1-WI MRI were 3975.1±1040.8 pg/mL and 6873.2±6365.4 pg/mL, whereas them of the non-hyperintense group (n=14) were 2173.5±1042.1 pg/mL and 2851.2±6267.5 pg/mL (p<0.001 and p=0.004). The mean concentrations of βTPSF and the ratio of βTPSF/βTPSER of the hyperintense group (n=13) of T2-WI MRI were 7.3±2.9 mg/L and 12.6±5.4, whereas them of the non-hyperintense group (n=18) were 4.3±2.3 mg/L and 7.5±3.9 (p=0.011 and p=0.011). Conclusion The hyperintense group on T1-WI MRI of CSDHs exhibited higher concentrations of IL-6 and IL-8 than non-hyperintense group. And, the hyperintese group on T2-WI MRI exhibited higher concentrations of βTPSF and the ratio of βTPSF/βTPSER than non-hyperintense group. These findings appear to be associated with rebleeding and CSF admixture in the CSDHs. PMID:25932289

  2. Core Outcomes and Common Data Elements in Chronic Subdural Hematoma: A Systematic Review of the Literature Focusing on Baseline and Peri-Operative Care Data Elements.

    PubMed

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

    2016-09-01

    Chronic subdural hematoma (CSDH) is an increasingly common subtype of head injury, especially in the elderly population. The optimization of treatment strategies has been hampered by the collection of heterogeneous outcome measures and data elements, precluding cross-study comparisons. This study aimed to quantify the heterogeneity of data elements in the pre-operative, operative, and post-operative phases of care, and build the basis for the development of a set of common data elements (CDEs) for CSDH. This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was registered with the PROSPERO register of systematic reviews (CRD42014007266). All full-text English studies with more than 10 patients (prospective) or more than 100 patients (retrospective) published after 1990 examining clinical outcomes in CSDH were eligible for inclusion. One hundred two eligible studies were found. Only 40 studies (39.2%) reported the main presenting symptom/feature and 24 (23.5%) reported additional symptoms/features. Admitting neurological/functional status was classified by the Glasgow Coma Scale (25 studies; 24.5%), the Markwalder Score (26 studies; 25.5%) and the modified Rankin Scale (three studies; 2.9%). Fifty-four studies (52.9%) made some mention of patient comorbidities and 58 studies (56.9%) reported the proportion or excluded patients on anticoagulant medication. Eighteen studies (17.6%) reported baseline coagulation status. Sixty-four studies (62.7%) stratified or assessed severity based on radiological findings, although the methods used varied widely. There was variable reporting of surgical technique and post-operative care; 32 studies (31.4%) made no mention of whether the operations were performed under general or local anesthetic. This study, a part of the Core Outcomes and Common Data Elements in CSDH (CODE-CSDH) project, confirms and quantifies the heterogeneity of data elements collected and

  3. Estudio del CH interestelar

    NASA Astrophysics Data System (ADS)

    Olano, C.; Lemarchand, G.; Sanz, A. J.; Bava, J. A.

    El objetivo principal de este proyecto consiste en el estudio de la distribución y abundancia del CH en nubes interestelares a través de la observación de las líneas hiperfinas del CH en 3,3 GHz. El CH es una molécula de amplia distribución en el espacio interestelar y una de las pocas especies que han sido observadas tanto con técnicas de radio como ópticas. Desde el punto de vista tecnológico se ha desarrollado un cabezal de receptor que permitirá la realización de observaciones polarimétricas en la frecuencia de 3,3 GHz, con una temperatura del sistema de 60 K y un ancho de banda de 140 MHz, y que será instalado en el foco primario de la antena parabólica del IAR. El cabezal del receptor es capaz de detectar señales polarizadas, separando las componentes de polarización circular derecha e izquierda. Para tal fin el cabezal consta de dos ramas receptoras que amplificarán la señal y la trasladarán a una frecuencia más baja (frecuencia intermedia), permitiendo de esa forma un mejor transporte de la señal a la sala de control para su posterior procesamiento. El receptor además de tener características polarimétricas, podrá ser usado en el continuo y en la línea, utilizando las ventajas observacionales y de procesamiento de señal que actualmente posee el IAR.

  4. [Subarachnoid hematoma and spinal anesthesia].

    PubMed

    Dupeyrat, A; Dequiré, P M; Mérouani, A; Moullier, P; Eid, G

    1990-01-01

    Two cases of spinal subarachnoid haematoma occurring after spinal anaesthesia are reported. In the first case, lumbar puncture was attempted three times in a 81-year-old man; spinal anaesthesia trial was than abandoned, and the patient given a general anaesthetic. He was given prophylactic calcium heparinate soon after surgery. On the fourth day, the patient became paraparetic. Radioculography revealed a blockage between T10 and L3. Laminectomy was performed to remove the haematoma, but the patient recovered motor activity only very partially. The second case was a 67-year-old man, in whom spinal anaesthesia was easily carried out. He was also given prophylactic calcium heparinate soon after surgery. On the fourth postoperative day, pulmonary embolism was suspected. Heparin treatment was then started. Twelve hours later, lumbar and bilateral buttock pain occurred, which later spread to the neck. On the eighth day, the patient had neck stiffness and two seizures. Emergency laminectomy was carried out, which revealed a subarachnoid haematoma spreading to a level higher than T6 and below L1, with no flow of cerebrospinal fluid, and a non pulsatile spinal cord. Surgery was stopped. The patient died on the following day. Both these cases are similar to those previously reported and point out the role played by anticoagulants. Because early diagnosis of spinal cord compression is difficult, the prognosis is poor, especially in case of paraplegia. PMID:2278424

  5. Neonatal posterior fossa subdural hematoma.

    PubMed

    Coker, S; Beltran, R; Fine, M

    1987-07-01

    Hemorrhage into the posterior fossa is a rare neurosurgical emergency in neonates. CT scanning is diagnostic. Blood layering under the apex of the tentorium cerebelli, however, may resemble a dilated vascular structure, and the rigidity of the pressured tentorium may prevent upward transmission of increased intracranial pressure, resulting in a soft fontanelle.

  6. [Diagnosis of duodenal wall hematoma].

    PubMed

    Zapf, S; Düber, C; Kuhn, F P; Lauff, V

    1988-01-01

    Blunt trauma to the epigastrium is becoming an increasingly important cause of injury and may result in retroperitoneal haematoma involving the head of the pancreas as well as the descending duodenum. Ultrasound seems to be of great advantage in the diagnosis of the effects and complications of blunt abdominal trauma such as obstruction of the biliary tree, the gastric outlet and the inferior vena cava. Direct involvement of the descending duodenum seems to be relatively uncommon, intramural haematoma of the duodenum is described only rarely in the literature. Three additional cases of intramural haematoma of the duodenum are reported with particular reference to the recent literature.

  7. The Del Rio ataxite, Texas

    NASA Technical Reports Server (NTRS)

    Henderson, E. P.; King, E. A.

    1977-01-01

    Basic data are presented on the Del Rio, Nordheim, and Monahans ataxites found in Texas. Results are reported for bulk-chemistry analysis, metallographic observations, and electron-microprobe analysis of the Del Rio meteorite. It is shown that Del Rio is distinctly different from the other two ataxites in terms of nickel, phosphorous, and carbon content, and is composed of at least three coarse grains in different crystallographic orientations. All the kamacite in Del Rio is found to have transformation structures that are probable shock products, and minor inclusions of daubreelite, schreibersite, and troilite are observed. It is concluded that Del Rio was apparently mildly shocked prior to its fall.

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

    PubMed Central

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

    2016-01-01

    Object In traumatic brain injury (TBI) patients, hypothermia therapy has not shown efficacy in multicenter clinical trials. With the post-hoc data from the latest clinical trial (NABIS:H II), we hypothesized that hypothermia may be beneficial in the rat acute subdural hematoma (ASDH) model by blunting the effects of ischemic/ reperfusional (I/R) injury. The major aim of our study was to test the efficacy of temperature management in reducing brain damage after ASDH. Methods Rats were induced with ASDH and placed into (1) Normothermia group (37°C) (2) Early hypothermia group; head and body temperature reduced to 33°C at 30 minutes prior to craniotomy (3) Late hypothermia group; temperature was lowered to 33°C at 30 minutes after decompression (4) Sham group; no ASDH and underwent only craniotomy with normothermia. To assess of neuronal and glial cell damage, we analyzed microdialysate (MD ; using 100kD probe) concentrations of: glial fibrillary acidic protein (GFAP) and ubiquitin carboxyl-terminal hydrolase-L1 (UCH-L1). Fluoro-Jade B (FJB) positive neurons and injury volume with 2,3,5-triphenyltetrazolium chloride (TTC) staining were also measured. Results In the early phase of reperfusion (30min- 2.5 hrs after decompression), extracellular UCH-L1 in the early hypothermia group was significantly lower than in the normothermia. (Early; 4.9±1.0 ng/dl, Late; 35.2±12.1 ng/dl, Normo; 50.20± 28.3 ng/dl, Sham; 3.1±1.3 ng/dl, Early vs Normo; p < 0.01, Sham vs Normo; p < 0.01, analyzed with ANOVA followed by a post-hoc Bonferroni’s test ). In the late phase of reperfusion (> 2.5hrs after decompression), extracellular GFAP in the early hypothermia group was also lower than in the normothermia and late hypothermia groups (Early; 5.5±2.9 ng/dl, Late; 7.4±3.4 ng/dl, Normo; 15.3±8.4 ng/dl, Sham; 3.3±1.0 ng/dl, Normo vs Sham; p < 0.01). The number of FJB positive cells in early hypothermia group was significantly smaller than in normothermia group (Normo vs Early: 774

  9. Nevado del Huila, Columbia

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Nevado del Huila Volcano in Colombia is actually a volcanic chain running north to south, capped by a glacier. With peaks ranging in height from 2,600 to 5,780 meters (8,530 to 18,960 feet), Nevado del Huila is a stratovolcano composed of alternating layers of hardened lava, solidified ash, and volcanic rocks. Its first recorded eruption occurred in the mid-sixteenth century. The long-dormant volcano erupted again in mid-April 2007. A few months before the eruption, the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) on NASA's Terra satellite captured this image of Nevado del Huila, on February 23, 2007. In this image, the bright white area just east of the central summit is ice. Immediately west of the summit are bare rocks, appearing as blue-gray. West of those rocks, white reappears, but this patch of white results from clouds hovering in the nearby valley. In the east, the colors turn to brown (indicating bare rock) and bright green (indicating vegetation). ASTER photographed Nevado del Huila near the end of a long phase of quietude. On April 17, 2007, local authorities recorded seismic activity associated with rock fracturing on the volcano's central summit, according to the ReliefWeb Website. Activity intensified the following day with an eruption and mudflows, forcing thousands of nearby residents to evacuate. As the Associated Press reported, the eruption caused avalanches and floods that wiped away both houses and bridges. It marked the volcano's first recorded eruption since the Spanish colonized the area five centuries earlier. NASA image created by Jesse Allen, using data provided courtesy of the NASA/GSFC/MITI/ERSDAC/JAROS, and U.S./Japan ASTER Science Team.

  10. Atlas del Genoma del Cáncer: Antecedentes

    Cancer.gov

    El Atlas del Genoma del Cáncer es una iniciativa de los Institutos Nacionales de la Salud (NIH) para crear mapas multidimensionales completos de los cambios genómicos clave en los tipos y subtipos principales de cáncer.

  11. Yeast DEL assay detects clastogens.

    PubMed

    Kirpnick, Zhanna; Homiski, Michael; Rubitski, Elizabeth; Repnevskaya, Marina; Howlett, Niall; Aubrecht, Jiri; Schiestl, Robert H

    2005-04-01

    Chromosomal rearrangements, including DNA deletions are involved in carcinogenesis. The deletion (DEL) assay scoring for DNA deletions in the yeast Saccharomyces cerevisiae is able to detect a wide range of carcinogens. Among approximately 60 compounds of known carcinogenic activity, the DEL assay detected 86% correctly whereas the Ames Salmonella assay detected only 30% correctly [R.J. Brennan, R.H. Schiestl, Detecting carcinogens with the yeast DEL assay, Methods Mol. Biol. 262 (2004) 111-124]. Since the DEL assay is highly inducible by DNA double strand breaks, this study examined the utility of the DEL assay for detecting clastogens. Ten model compounds, with varied mechanisms of genotoxicity, were examined for their effect on the frequency of DNA deletions with the DEL assay. The compounds tested were: actinomycin D, camptothecin, methotrexate and 5-fluorodeoxyuridine, which are anticancer agents, noscapine and furosemide are therapeutics, acridine, methyl acrylate and resorcinol are industrial chemicals and diazinon is an insecticide. The in vitro micronucleus assay (IVMN) in CHO cells, a commonly used tool for detection of clastogens, was performed on the same compounds and the results of the two assays were compared. The results of our study show that there is 70% concordance in the presence of metabolic activation (rat liver S9) and 80% concordance in the absence of metabolic activation between the DEL assay and the standard in vitro micronucleus assay. The lack of cytotoxicity observed for four of the ten compounds examined indicates limited diffusion of lipophilic compounds across the yeast cell wall. Thus, the development of a more permeable yeast tester strain is expected to greatly improve concordance of the DEL assay with the IVMN assay. The yeast DEL assay is inexpensive, amenable to automation and requires less expertise to perform than the IVMN. Thus, it has a strong potential as a robust, fast and economical screen for detecting clastogens in

  12. Case Study: del Amo Bioventing

    EPA Science Inventory

    The attached presentation discusses the fundamentals of bioventing in the vadose zone. The basics of bioventing are presented. The experience to date with the del Amo Superfund Site is presented as a case study.

  13. El libro del Relogio del Palacio de las Horas

    NASA Astrophysics Data System (ADS)

    Morales, J. D.

    2009-08-01

    This paper resume the investigation entitled ``El libro del Relogio del Palacio de las Horas''. That consist in an edition of the original text of the book of the Clock of the Palace of the Hours from the Books of the knowledge of Astronomy of Alfonso X (Manuscript 156, Complutense University). And a description of the astronomical functionality of the Clock of the Palace of the Hours. It includes a geometric description of the positional astronomy on which the operation of the Palace is based.

  14. Vacunas contra los virus del papiloma humano

    Cancer.gov

    Una hoja informativa acerca de las vacunas contra los virus del papiloma humano (VPH) para prevenir infecciones con ciertos tipos de VPH, los cuales son la causa principal del cáncer de cuello del útero o cérvix.

  15. [Acute posterior multifocal placoid pigment epitheliopathy. A rare cause of ischaemic stroke].

    PubMed

    del Saz-Saucedo, Pablo; Alfaya-Muñoz, Laura Blanca; Recio-Bermejo, Marta; Lara-Medina, Francisco Javier; García-Chiclano, Amalia; Ortega-León, Teresa; Rueda-Medina, Ignacio; Domínguez-Fernández, María José; Madrid-Muñiz, Carmen; Franco-Huerta, María

    2013-06-01

    Introduccion. La epiteliopatia pigmentaria placoide multifocal posterior aguda (EPPMPA) es una enfermedad inflamatoria rara, generalmente de etiologia indeterminada, de la coriocapilar, el epitelio pigmentario y la retina externa. Afecta predominantemente a pacientes jovenes y en algunos casos puede involucrar al sistema nervioso central en forma de ictus o de meningoencefalitis. Presentamos el caso clinico de una mujer joven con EPPMPA complicada con ictus e hipertension intracraneal. Caso clinico. Mujer de 16 anos que comienza con cefalea intensa sugestiva de hipertension intracraneal, asi como con un deficit agudo hemisferico izquierdo. La resonancia magnetica craneal ponia de manifiesto lesiones embolicas o vasculiticas en diferentes territorios. No se evidenciaron datos de meningoencefalitis en el estudio del liquido cefalorraquideo, pero si de hipertension intracraneal asociada. La presencia de lesiones muy especificas en el polo ocular posterior permitio el diagnostico de EPPMPA complicada con ictus isquemico, probablemente por mecanismo vasculitico. Un amplio estudio etiologico fue negativo para identificar un factor desencadenante claro del proceso. Se inicio tratamiento corticoideo con buena evolucion clinica y radiologica. Conclusiones. La EPPMPA es una entidad rara que generalmente entrana buen pronostico; sin embargo, en algunos casos puede complicarse con afectacion del sistema nervioso central, y el ictus isquemico secundario a vasculitis es la complicacion mas grave. Ante un paciente joven con ictus que presente sintomatologia visual y lesiones coriorretinianas, debe considerarse la EPPMPA en su diagnostico etiologico.

  16. 33 CFR 80.1118 - Marina Del Rey, CA.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Marina Del Rey, CA. 80.1118... NAVIGATION RULES COLREGS DEMARCATION LINES Pacific Coast § 80.1118 Marina Del Rey, CA. (a) A line drawn from Marina Del Rey Breakwater South Light 1 to Marina Del Rey Light 4. (b) A line drawn from Marina Del...

  17. 33 CFR 80.1118 - Marina Del Rey, CA.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Marina Del Rey, CA. 80.1118... NAVIGATION RULES COLREGS DEMARCATION LINES Pacific Coast § 80.1118 Marina Del Rey, CA. (a) A line drawn from Marina Del Rey Breakwater South Light 1 to Marina Del Rey Light 4. (b) A line drawn from Marina Del...

  18. 33 CFR 80.1118 - Marina Del Rey, CA.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Marina Del Rey, CA. 80.1118... NAVIGATION RULES COLREGS DEMARCATION LINES Pacific Coast § 80.1118 Marina Del Rey, CA. (a) A line drawn from Marina Del Rey Breakwater South Light 1 to Marina Del Rey Light 4. (b) A line drawn from Marina Del...

  19. 33 CFR 80.1118 - Marina Del Rey, CA.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Marina Del Rey, CA. 80.1118... NAVIGATION RULES COLREGS DEMARCATION LINES Pacific Coast § 80.1118 Marina Del Rey, CA. (a) A line drawn from Marina Del Rey Breakwater South Light 1 to Marina Del Rey Light 4. (b) A line drawn from Marina Del...

  20. Tierra del Fuego, Argentina, South America

    NASA Technical Reports Server (NTRS)

    1991-01-01

    The Mitre Peninsula is the easternmost tip of Tierra del Fuego, Argentina, (54.5S, 65.5W). Early winter snow can be seen on this south tip of the Andes Mountains. These same mountains continue underwater to Antarctica. The Strait of Magellan, separating the South American mainland from Tierra del Fuego is off the scene to the north and west, but the Strait of LeMaire, separating Tierra del Fuego from the Isla de los Estados can be seen.

  1. Control del cáncer y salud mundial: noticia del Instituto Nacional del Cáncer (NCI)

    Cancer.gov

    En combinación con una reunión de alto nivel de las Naciones Unidas sobre enfermedades no transmisibles en países en vías de desarrollo, el doctor Harold Varmus, director del NCI, y el doctor Ted L. Trimble, del NCI, han publicado un comentario en Science

  2. Líneas Vitales: Programas y servicios del NCI

    Cancer.gov

    Artículos y videos sobre los programas y servicios del Instituto Nacional del Cáncer de la serie educativa Líneas Vitales del NCI, la cual está dirigida especialmente a poblaciones multiculturales.

  3. Optimal management of hemophilic arthropathy and hematomas

    PubMed Central

    Lobet, Sébastien; Hermans, Cedric; Lambert, Catherine

    2014-01-01

    Hemophilia is a hematological disorder characterized by a partial or complete deficiency of clotting factor VIII or IX. Its bleeding complications primarily affect the musculoskeletal system. Hemarthrosis is a major hemophilia-related complication, responsible for a particularly debilitating chronic arthropathy, in the long term. In addition to clotting factor concentrates, usually prescribed by the hematologist, managing acute hemarthrosis and chronic arthropathy requires a close collaboration between the orthopedic surgeon and physiotherapist. This collaboration, comprising a coagulation and musculoskeletal specialist, is key to effectively preventing hemarthrosis, managing acute joint bleeding episodes, assessing joint function, and actively treating chronic arthropathy. This paper reviews, from a practical point of view, the pathophysiology, clinical manifestations, and treatment of hemarthrosis and chronic hemophilia-induced arthropathy for hematologists, orthopedic surgeons, and physiotherapists. PMID:25378964

  4. Instantánea del linfoma

    Cancer.gov

    Información sobre las tendencias de incidencia, mortalidad y financiamiento del NCI sobre el linfoma; así como ejemplos de actividades del NCI y adelantos en la investigación de este tipo de cáncer.

  5. Instantánea del melanoma

    Cancer.gov

    Información sobre las tendencias de incidencia, mortalidad y financiamiento del NCI sobre el melanoma; así como ejemplos de actividades del NCI y adelantos en la investigación de este tipo de cáncer.

  6. Instantánea del sarcoma

    Cancer.gov

    Información sobre las tendencias de incidencia, mortalidad y financiamiento del NCI sobre el sarcoma; así como ejemplos de actividades del NCI y adelantos en la investigación de este tipo de cáncer.

  7. Instantánea del mieloma

    Cancer.gov

    Información sobre las tendencias de incidencia, mortalidad y financiamiento del NCI sobre el mieloma; así como ejemplos de actividades del NCI y adelantos en la investigación de este tipo de cáncer.

  8. Produccion Gaseosa del Cometa Halley: Erupciones Y Fotodisociacion del Radical OH

    NASA Astrophysics Data System (ADS)

    Silva, A. M.; Mirabel, I. F.

    1990-11-01

    RESUMEN:En este trabajo informamos la detecci6n de 20 erupciones en la li'nea de =18cm (1667MHz) del radical OH en el Cometa Halley.Las observaciones incluyen todos los monitoreos existentes y se extienden desde 120 dias antes del perihelio hasta 90 dias despues.Se detectan bruscos crecimientos en el flujo medido,hasta un factor 1O,seguidos por decaimientos lentos asociados con la fotodisociaci6n del OH. Se obtuvieron valores para el tiempo de vida fotoquimico del OH y del H2O basandose en el modelo desarrollado previamente por Silva(1988). Esos tiempos de vida estan de acuerdo con predicciones teoricas y con las observaciones en el Ultravioleta, y los resultados, los que son fuertemente dependientes de la velocidad heliocentrica del Coineta (variando hasta un factor 6), han sido calculados para varios rangos de velocidad entre +28 y -28 km/seg. Key wo'L :

  9. Gonadal dysgenesis in del (18p) syndrome

    SciTech Connect

    Telvi, L.; Ion, A.; Fouquet, F.

    1995-07-17

    We report on a girl with syndromal gonadal dysgenesis and a de novo del (18p). Genetic factors controlling gonadal development are located not only on the X chromosome, but also on autosomes. The present case suggests that one of these genes is situated on 18p. We conclude that patients with del (18p) syndrome should be evaluated for gonadal dysgenesis. 16 refs., 3 figs.

  10. Intertextual Sexual Politics: Illness and Desire in Enrique Gomez Carrillo's "Del amor", "del dolor y del vicio" and Aurora Caceres's "La rosa muerta"

    ERIC Educational Resources Information Center

    LaGreca, Nancy

    2012-01-01

    This study explores the intertextuality between Aurora Caceres's "La rosa muerta" (1914) and the novel "Del amor, del dolor y del vicio" (1898) by her ex-husband, Enrique Gomez Carrillo. Caceres strategically mentions Gomez Carrillo's novel in "La rosa muerta" to invite a reading of her work in dialogue with his. Both narratives follow the sexual…

  11. Visiting the Gödel universe.

    PubMed

    Grave, Frank; Buser, Michael

    2008-01-01

    Visualization of general relativity illustrates aspects of Einstein's insights into the curved nature of space and time to the expert as well as the layperson. One of the most interesting models which came up with Einstein's theory was developed by Kurt Gödel in 1949. The Gödel universe is a valid solution of Einstein's field equations, making it a possible physical description of our universe. It offers remarkable features like the existence of an optical horizon beyond which time travel is possible. Although we know that our universe is not a Gödel universe, it is interesting to visualize physical aspects of a world model resulting from a theory which is highly confirmed in scientific history. Standard techniques to adopt an egocentric point of view in a relativistic world model have shortcomings with respect to the time needed to render an image as well as difficulties in applying a direct illumination model. In this paper we want to face both issues to reduce the gap between common visualization standards and relativistic visualization. We will introduce two techniques to speed up recalculation of images by means of preprocessing and lookup tables and to increase image quality through a special optimization applicable to the Gödel universe. The first technique allows the physicist to understand the different effects of general relativity faster and better by generating images from existing datasets interactively. By using the intrinsic symmetries of Gödel's spacetime which are expressed by the Killing vector field, we are able to reduce the necessary calculations to simple cases using the second technique. This even makes it feasible to account for a direct illumination model during the rendering process. Although the presented methods are applied to Gödel's universe, they can also be extended to other manifolds, for example light propagation in moving dielectric media. Therefore, other areas of research can benefit from these generic improvements. PMID

  12. Calidad de Imagen del Telescopio UNAM212

    NASA Astrophysics Data System (ADS)

    Cobos, F. J.; Teiada de Vargas, C.

    1987-05-01

    El telescopio UNAM2l2, del Observatorio Astronómico Nacional, situado en la Sierra de San Pedro Mártir (Baja California, México), cumplira en un futuro muy cercano siete años de uso para fines de investigación astronómica. Aunque en este tiempo no se ha efectuado un estudio sistemático acerca de su comportamiento óptico y de los factores que influyen en la calidad de las imágenes, se han realizado pruebas diversas, estudios parciales y reuniones especificas, cuyos resultados no siempre se han difundido ampliamente y generalmente no se han presentado por escrito. Es por ello que hemos creido necesario intentar una recopilación de la información existente para poder con ella establecer un diagnóstjco que, aunque no sea definitivo, sirva de base para futuros trabajos tendientes a optimizar el comportamiento óptico del telescopio. Es evidente que un buen número de las conclusiones que se presentan son resultado del trabajo de muchas personas ó de esfuerzos colectivos. Asimismo, hemos tratado de localizar información bibliográfica que pueda ser de utilidad. Nuestro objetivo primordial ha consistido en centrarnos en la óptica del telescopio y su calidad, pero también se han considerado otros aspectos que puedan afectar las imágenes obtenidas tales como: celda del primario, `seeing' local y externo, flexiones posibles en la estructura mecánica del telescopio, etc.

  13. Visiting the Gödel universe.

    PubMed

    Grave, Frank; Buser, Michael

    2008-01-01

    Visualization of general relativity illustrates aspects of Einstein's insights into the curved nature of space and time to the expert as well as the layperson. One of the most interesting models which came up with Einstein's theory was developed by Kurt Gödel in 1949. The Gödel universe is a valid solution of Einstein's field equations, making it a possible physical description of our universe. It offers remarkable features like the existence of an optical horizon beyond which time travel is possible. Although we know that our universe is not a Gödel universe, it is interesting to visualize physical aspects of a world model resulting from a theory which is highly confirmed in scientific history. Standard techniques to adopt an egocentric point of view in a relativistic world model have shortcomings with respect to the time needed to render an image as well as difficulties in applying a direct illumination model. In this paper we want to face both issues to reduce the gap between common visualization standards and relativistic visualization. We will introduce two techniques to speed up recalculation of images by means of preprocessing and lookup tables and to increase image quality through a special optimization applicable to the Gödel universe. The first technique allows the physicist to understand the different effects of general relativity faster and better by generating images from existing datasets interactively. By using the intrinsic symmetries of Gödel's spacetime which are expressed by the Killing vector field, we are able to reduce the necessary calculations to simple cases using the second technique. This even makes it feasible to account for a direct illumination model during the rendering process. Although the presented methods are applied to Gödel's universe, they can also be extended to other manifolds, for example light propagation in moving dielectric media. Therefore, other areas of research can benefit from these generic improvements.

  14. Radio-Observaciones del OH EN la Coma del Cometa Halley Desde EL Hemisferio Sur

    NASA Astrophysics Data System (ADS)

    Silva, A. M.; Bajaja, E.; Morras, R.; Cersosimo, J. C.; Martin, M. C.; Arnal, E. M.; Poppel, W. G. L.; Colomb, F. R.; Mazzaro, J.; Olalde, J. C.; Boriakoff, V.; Mirabel, I. F.

    1987-05-01

    Se utilizó una antena de 30 metros del Instituto Argentino de Radioastronomía para observaciones diarias Cf ebrero a abril de 1986) de la transición en 1667 MHz ( λ = 18 cm) del OH en la coma del cometa Halley. De las observaciones realizadas se concluye: 1) El número promedio de moléculas de OH en la coma durante 37 días de observación fue de (8.9±3.5)x1034 moléculas, lo que implica una tasa de producción promedio de OH de 1.8x1029 moléculas seg-1 y consecuentemente una pérdida de masa promedio de 17±6 toneladas seg-1 . Este valor está de acuerdo con las mediciones realizadas por las sondas Vega y Giotto. 2) El monitoreo desde el lAR revela la existencia de variaciones bruscas en los flujos de absorción del OH. Estas variaciones son consistentes con los modelos que representan la producción gaseosa a partir de ejecciones y/o desprendimientos discretos de materia congelada del núcleo. 3) Las variaciones en la densidad de flujo son consistentes con las estimaciones de los tiem- pos de vida medios del H2O y del OH en presencia del campo de radiación solar. 4) Se encuentra una correlación entre la intensidad del flujo absorbido y anisotropías en Ia dinamica de la coma.

  15. [Revista de Gastroenterologia del Peru: 25 years].

    PubMed

    Celestino Fernández, Alvaro

    2005-01-01

    In this article is described in a very summarized form the history of the Revista de Gastroenterología del Perú (RGP) that dates from the same origins of the Sociedad de Gastroenterología del Perú, when based in October 30 of 1952 already glimpse the presence of the RGP as the official organ for the publication for studies of doctors of the society or foreign guests. We spent 29 years, and this idea becomes reality; and today the RGP turns to their XXV anniversary. The RGP, to locate itself as the Peruvian medical publication best reputation.

  16. Manual del McVCO 1999

    USGS Publications Warehouse

    McChesney, P.J.

    1999-01-01

    El McVCO es un generador de frecuencias basado en un microcontrolador que reemplaza al oscilador controlado por voltaje (VCO) utilizado en telemetría analógica de datos sísmicas. Acepta señales de baja potencia desde un sismómetro y produce una señal subportadora modulada en frecuencia adecuada para enlaces telefónicos o vía radio a un lugar remoto de recolección de datos. La frecuencia de la subportadora y la ganancia pueden ser seleccionadas mediante un interruptor. Tiene la opción de poder operar con dos canales para la observación con ganancia alta y baja. El McVCO fue diseñado con el propósito de mejorar la telemetría analógica de las señales dentro de la Pacific Northwest Seismograph Network (PNSN) (Red Sismográfica del Noroeste del Pacífico). Su desarrollo recibió el respaldo del Programa de Geofísica de la Universidad de Washington y del "Volcano Hazards and Earthquake Hazards programs of the United States Geological Survey (USGS) (Programa de Investigaciones de Riesgos Volcánicos y Programa de Investigaciones de Riesgos Sísmicos de los EEUU). Cientos de instrumentos se han construido e instalado. Además de utilizarlo el PNSN, el McVCO es usado por el Observatorio Vulcanológico de Alaska para monitorear los volcanes aleutianos y por el USGS Volcano Disaster Assistance Program (Programa de Ayuda en las Catástrofes Volcánicas del USGS) para responder a crisis volcánicas en otros países. Este manual cubre el funcionamiento del McVCO, es una referencia técnica para aquellos que necesitan saber con más detalle cómo funciona el McVCO, y cubre una serie de temas que requieren un trato explícito o que derivan del despliegue del instrumento.

  17. 33 CFR 80.1118 - Marina Del Rey, CA.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Marina Del Rey, CA. 80.1118 Section 80.1118 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY INTERNATIONAL NAVIGATION RULES COLREGS DEMARCATION LINES Pacific Coast § 80.1118 Marina Del Rey, CA. (a) A line drawn from Marina Del Rey Breakwater South Light...

  18. Vigilando la Calidad del Agua de los Grandes Rios de la Nacion: El Programa NASQAN del Rio Grande (Rio Bravo del Norte)

    USGS Publications Warehouse

    Lurry, Dee L.; Reutter, David C.; Wells, Frank C.; Rivera, M.C.; Munoz, A.

    1998-01-01

    La Oficina del Estudio Geologico de los Estados Unidos (U.S. Geological Survey, 0 USGS) ha monitoreado la calidad del agua de la cuenca del Rio Grande (Rio Bravo del Norte) desde 1995 como parte de la rediseiiada Red Nacional para Contabilizar la Calidad del Agua de los Rios (National Stream Quality Accounting Network, o NASOAN) (Hooper and others, 1997). EI programa NASOAN fue diseiiado para caracterizar las concentraciones y el transporte de sedimento y constituyentes quimicos seleccionados, encontrados en los grandes rios de los Estados Unidos - incluyendo el Misisipi, el Colorado y el Columbia, ademas del Rio Grande. En estas cuatro cuencas, el USGS opera actualmente (1998) una red de 40 puntos de muestreo pertenecientes a NASOAN, con un enfasis en cuantificar el flujo en masa (la cantidad de material que pasa por la estacion, expresado en toneladas por dial para cada constituyente. Aplicacando un enfoque consistente, basado en la cuantificacion de flujos en la cuenca del Rio Grande, el programa NASOAN esta generando la informacion necesaria para identificar fuentes regionales de diversos contaminantes, incluyendo sustancias qui micas agricolas y trazas elementos en la cuenca. EI efecto de las grandes reservas en el Rio Grande se puede observar segun los flujos de constituyentes discurren a 10 largo del rio. EI analisis de los flujos de constituyentes a escala de la cuenca proveera los medios para evaluar la influencia de la actividad humana sobre las condiciones de calidad del agua del Rio Grande.

  19. Hopeful (protein InDel) monsters?

    PubMed

    Tóth-Petróczy, Agnes; Tawfik, Dan S

    2014-06-10

    In this issue of Structure, Arpino and colleagues describe in atomic detail how a protein stomachs a deletion within a helix, an event that rarely occurs in nature or in the lab. Can insertions and deletions (InDels) trigger dramatic structural transitions?

  20. Near Infrared Photometry of Nova Del 2013

    NASA Astrophysics Data System (ADS)

    Cass, A. C.; Carlon, R. L.; Corgan, D. T.; Dykhoff, D. A.; Gehrz, R. D.; Shenoy, D. P.

    2013-09-01

    We continued to follow Nova Del 2013 during the period from 31.15 August 2013 UT through 25.18 September 2013 UT using an As:Si bolometer mounted on the 0.76-m infrared telescope of the University of Minnesota's O'Brien Observatory (Marine on St. Croix, Minnesota, USA). Vega (alpha Lyrae) is used as the standard star.

  1. del and Gödel-type universes in Brans-Dicke theory

    NASA Astrophysics Data System (ADS)

    Agudelo, J. A.; Nascimento, J. R.; Petrov, A. Yu.; Porfírio, P. J.; Santos, A. F.

    2016-11-01

    In this paper, conditions for existence of Gödel and Gödel-type solutions in Brans-Dicke (BD) scalar-tensor theory and their main features are studied. The consistency of equations of motion, causality violation and existence of CTCs (closed time-like curves) are investigated. The role which cosmological constant and Mach principle play to achieve the consistency of this model is studied.

  2. The Punta del Cobre Formation, Punta del Cobre Candelaria area, northern Chile

    NASA Astrophysics Data System (ADS)

    Marschik, Robert; Fontboté, Lluís.

    2001-09-01

    The Punta del Cobre Formation hosts the iron oxide-rich Cu-Au(-Zn-Ag) deposits of the Punta del Cobre belt, Chile. Hydrothermal alteration associated with mineralization and/or contact metamorphism caused by the Coastal Batholith exposed in the west resulted in new mineral assemblages and significant changes in the geochemical composition of its rocks. This paper presents a redefinition of the Punta del Cobre Formation and discusses its geologic context. The Punta del Cobre Formation is subdivided, from bottom to top, into: (1) the 'Geraldo-Negro Member', composed mainly of massive andesitic volcanic rocks (>300 m) and locally dacitic rocks (up to 200 m) that overlie the latter, and (2) the 'Algarrobos Member' (up to >800 m) comprising mainly volcaniclastic rocks, basalt andesitic and basaltic flows, and volcanic breccias. The Punta del Cobre Formation is overlain by the Chañarcillo Group, the lowest part of which is represented by alternating carbonate and volcaniclastic beds of the Abundancia Formation, which pass vertically and laterally into limestones of the Nantoco Formation. The contact between the Punta del Cobre Formation and the overlying Abundancia Formation is transitional and defined by the first continuous bed of massive limestone or its metamorphosed equivalent. A pre-upper Valanginian age for the Punta del Cobre Formation is suggested by ammonites of Berriasian age found in the upper part of the Algarrobos Member and Late Valanginian-Early Hauterivian fauna in the overlying Abundancia Formation. Despite the intense alteration, immobile element compositions of the volcanic rocks of the Punta del Cobre Formation enable the recognition of a calc-alkaline suite with a trend to more primitive, less differentiated magmas towards the top of the stratigraphic sequence, reflecting initial stages of basin development. The transgressive nature of the sedimentary part of the Punta del Cobre Formation marks the onset of increased subsidence that eventually

  3. Del Norte means north to recycling

    SciTech Connect

    Aquino, J.T.

    1998-06-01

    Del Norte Regional Recycling and Transfer Station is owned by the city of Oxnard, California and operated by BLT Enterprises, Inc. The Del Norte facility--located in southwestern Ventura County about an hour northwest of Los Angeles--processes polyethylene terephthalate (PET) and high-density polyethylene (HDPE) plastic containers, aluminum, steel, glass, old corrugated containers (OCC), newspapers, computer printout paper, white and colored ledger paper, coated book, supermix paper, telephone books, and old magazines. According to the company, there has been virtually no community opposition to the site. The facility has few neighbors, and those are agricultural. To keep the community relationship strong, the facility`s design and location all but eliminated odor and noise complaints. The building was designed against the prevailing wind pattern, and BLT processes odorous material fast. A misting system installed for dust suppression also can be used with a solution for odor control should the need arise.

  4. Procesamiento Digital de Imagenes del Cometa Halley

    NASA Astrophysics Data System (ADS)

    Ferrin, L.; Fuenmayor, F.; Naranjo, O.; Bulka, P.; Mendoza, C.

    1987-05-01

    Se reportan observaciones fotográficas del cometa Halley, obtenidas con los telescopios Schmidt de 1-m del CIDA, y de 35 cms de la ULA. Se hicieron exposiciones desde 2 segundos a 30 minutos y se utilizaron emulsiones IIa-O, 103a-F, y 103a-D, guladas manualmente 0 automaticámente. Las imágenes fueron digitalizadas con el microdensitómetro PDS, y procesadas con el sistema HACIENDA del CCIBM. Se experimentó con la Transformada de Fourier en dos dimensiones, y con la aplicación de filtros de paso alto y bajo. Se encontró que el metodo de "autocorrelación" es el mejor para separar "la vegetación" de "la montaña". Se aplicaron diversas técnicas a fin de cubrir ambos extremos: a) enfatizar detalles débiles en la cola, y b) penetrar en las regiones más intensas de la coma. Se lograron ambos objetivos. Detalles en la cola permitieron determinar velocidades de propagación de unos 50 a 90 kms/ seg. Se pudieron detectar no menos de tres perturbaciones en "Y", y una en 5? Co de Cisne). Se cree que las primeras están asociadas a eventos de desconexión. Se puede separar la cola de gas de la de polvo. Las fotos de color permiten enfatizar diferentes regiones espectrales con mayor claridad aún. El "balance" del color puede ser hecho con la computadora.

  5. del, Einstein, Mach, Gamow, and Lanczos: Gödel's remarkable excursion into cosmology

    NASA Astrophysics Data System (ADS)

    Rindler, Wolfgang

    2009-06-01

    This article is an expanded version of a talk given at the International Symposium Celebrating the 100th Birthday of Kurt Gödel (Vienna, 2006). It seeks to trace the path which led this preeminent mathematical logician to discover one of the famous results of General Relativity, the rotating Gödel Universe. This universe has some remarkable properties, which gave the philosophers plenty to worry about. It allows a person to travel into his own past, with all the ensuing causal paradoxes; it allows no unique temporal ordering of events; and though Gödel's Universe is rigid and infinite, the Foucault pendulum planes everywhere in it rotate in unison, a clear affront to adherents of Mach's Principle. We also discuss some lesser known precursors in the field, who just missed discovering Gödel's universe. While the article gives all the necessary derivations in simplified form (for example, of the metric and its geodesics), much of it should be accessible to the general reader, who can simply skip most of the mathematics. [Reprinted, with permission, from Kurt Gödel and the Foundations of Mathematics: Horizons of Truth, edited by Matthias Baaz, Christos H. Papadimitriou, Dana S. Scott, Hilary Putnam, and Charles L. Harper, Jr. (Cambridge U. P., New York, 2009).

  6. Visualization of the Gödel universe

    NASA Astrophysics Data System (ADS)

    Buser, M.; Kajari, E.; Schleich, W. P.

    2013-01-01

    The standard model of modern cosmology, which is based on the Friedmann-Lemaître-Robertson-Walker metric, allows the definition of an absolute time. However, there exist (cosmological) models consistent with the theory of general relativity for which such a definition cannot be given since they offer the possibility for time travel. The simplest of these models is the cosmological solution discovered by Kurt Gödel, which describes a homogeneous, rotating universe. Disregarding the paradoxes that come along with the abolishment of causality in such space-times, we are interested in the purely academic question of how an observer would visually perceive the time travel of an object in Gödel's universe. For this purpose, we employ the technique of ray tracing, a standard tool in computer graphics, and visualize various scenarios to bring out the optical effects experienced by an observer located in this universe. In this way, we provide a new perspective on the space-time structure of Gödel's model.

  7. Morphology, geology and geochemistry of the "Salar del Gran Bajo del Gualicho" (Rio Negro, Argentina)

    USGS Publications Warehouse

    Angelucci, A.; Barbieri, M.; Brodtkorb, A.; Ciccacci, S.; Civitelli, G.; De Barrio, R.; Di, Filippo M.; Fredi, P.; Friedman, I.; Lombardi, S.; Schalamuk, A.I.; Toro, B.

    1996-01-01

    A multidisciplinary study of the Gran Bajo del Gualicho area (Rio Negro - Argentina) was carried out; the aim was to delineate its geological and geomorphological evolution and to estabilish the genesis of salts filling the depression. Climatic conditions were analized first to individuate their role in the present morphogenetic processes; moreover the main morphological features of present landscape were examined as well as the stratigraphy of the outcropping formations, and of the Gran Bajo del Gualicho Formation in particular. Finally, a possible geomorphological evolution of the studied area was traced. Geophysical analyses allowed to estabilish that the paleosurface shaped on the crystalline basement is strongly uneven and shows evidence of the strong tectonic phases it underwent. The result of isotope analyses confirmed that the salt deposits on the Gran Bajo del Gualicho bottom were produced by fresh water evaporation, while strontium isotope ratio suggested that such waters were responsible for solubilization of more ancient evaporitic deposits.

  8. Kurt Gödels Brünner Verwandte

    NASA Astrophysics Data System (ADS)

    Müller, Dora

    2007-11-01

    The author of this memoir Dora Müller (born 1920) belongs - as well as Kurt Gödel-to the German minority playing an important role in the past life of Brno. The marriage of his son included her among the Gödels collaterals. She was chemist, but also pianist, historician, participant of antinacist movement and iniciator of Czech-German understanding after war. Following her personal experiences, remembrances of Gödels relatives and documental materials, she evokes the atmosphere of broader family milieu of Kurt Gödel.

  9. [First case described of isolated, complete and fluctuating cranial nerve III palsy heralding multiple myeloma].

    PubMed

    León-Ruiz, Moisés; Benito-León, Julián; Sierra-Hidalgo, Fernando; García-Soldevilla, Miguel Ángel; Izquierdo-Esteban, Laura; Tejeiro-Martínez, José; Cabrera-Valdivia, Francisco; García-Albea Ristol, Esteban

    2015-02-01

    Introduccion. El mieloma multiple es la neoplasia de celulas plasmaticas mas frecuente. Al ser incurable, el tratamiento persigue obtener el mayor tiempo de supervivencia libre de clinica. Constituye una causa extremadamente rara de afectacion de los nervios craneales y es producido habitualmente por un plasmocitoma intracraneal. Presentamos un caso de mieloma multiple, que asociaba un plasmocitoma intracraneal y que comenzo clinicamente con paralisis aislada, completa y fluctuante del III nervio craneal. Caso clinico. Mujer de 63 años que acudio a urgencias por presentar un cuadro clinico oscilante, consistente en diplopia binocular horizontal y, posteriormente, cefalea. La exploracion neurooftalmologica revelo una paralisis completa del III nervio craneal derecho. Se solicito una tomografia axial computarizada craneal urgente, que revelo multiples lesiones osteoliticas diploicas, asociando una de ellas componente de partes blandas en la hendidura esfenoidal derecha. La paciente fue ingresada, y se le diagnostico posteriormente un mieloma multiple IgA-kappa. Tras recibir induccion quimioterapica y ser sometida a un trasplante autologo de progenitores hematopoyeticos, alcanzo la remision completa. Conclusiones. El mieloma multiple es un trastorno raro de los nervios craneales, una causa muy infrecuente de paralisis aislada y completa del III nervio craneal y menos aun fluctuante, y no se ha encontrado ningun caso publicado con este inicio clinico. Tener en cuenta las posibles manifestaciones neurooftalmologicas del mieloma multiple puede contribuir a un diagnostico precoz y a una incidencia positiva sobre el curso de esta enfermedad.

  10. An evening at "La Clinica del Pueblo".

    PubMed

    Shefsky, M L

    1986-01-01

    This article describes a typical evening at the Clinica del Pueblo in the Hispanic neighborhood of Adams-Morgan in Washington, D.c. The Clinical del Pueblo began operating in 1983 in response to the urgen medical needs of Central American refugees arriving in the Washington D.c. area. The refugees bring with them severe trauma, fear, and health problems caused by the civil was and exacerbated by inadequate or non-existant health services. Approximately 80,000 Salvadoran refugees live in the area. They do not receive adequate health care for 3 reasons. 1) Because the US goverment is unwilling to recognize them as true refugees, they live with the constant threat of deportatin back to the violence from which they have fled. 2) Refugees lack the ability to pay for private care. 3) Langauage and culture create frightening barriers to health care for the refugees. For those who do seek care, these barriers can lead to the inadequate or incomplete diagnoses and poor compliance and follow-up. Plenty International and the Central American Refugee Center responded to these problems by organizing a free clinic to provide not only medical care but also a training course for volunteers. The director of the clinic organizes the course, the classes are taught by a variety of people including the clinic's volunteer physicians, nurses, and public health educators as well as graduates of previus training courses and people from the wider community. The services of the clinic reach only a small portion of the population in need. However, the fact that free medical services are now available to some Central American refugees make the Clinica del Pueblo an important program.

  11. Huave de San Mateo del Mar, Oaxaca (Huave of San Mateo del Mar, Oaxaca).

    ERIC Educational Resources Information Center

    Mexico Coll. (Mexico City)

    This document is one of 17 volumes on indigenous Mexican languages and is the result of a project undertaken by the Archivo de Lenguas Indigenas de Mexico. This volume contains information on Huave, an indigenous language of Mexico spoken in San Mateo del Mar, in the state of Oaxaca. The objective of collecting such a representative sampling of…

  12. Near Infrared Photometry of Nova Del 2013

    NASA Astrophysics Data System (ADS)

    Cass, C. A.; Carlon, L. R.; Corgan, T. D.; Dykhoff, A. D.; Gehrz, D. R.; Shenoy, P. D.

    2013-08-01

    Subjects: Infra-Red, Nova We report RIJHKLM photometry of Nova Del 2013 taken on August 28.13 UT using an As:Si bolometer mounted on the 0.76-m infrared telescope of the University of Minnesota's O'Brien Observatory (Marine on St. Croix, Minnesota, USA). Vega (alpha Lyrae) was used as the standard star. On this date we find: R = 5.6 +/- 0.1, I = 5.2 +/- 0.1, J = 4.5 +/- 0.1, H = 4.7 +/- 0.1, K = 4.7 +/- 0.1, L = 3.3 +/- 0.2, M = +1.8 +/- 0.3.

  13. 33 CFR 110.65 - Indian River Bay, Del.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Indian River Bay, Del. 110.65 Section 110.65 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY ANCHORAGES ANCHORAGE REGULATIONS Special Anchorage Areas § 110.65 Indian River Bay, Del. Beginning at a point...

  14. 33 CFR 110.65 - Indian River Bay, Del.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Indian River Bay, Del. 110.65 Section 110.65 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY ANCHORAGES ANCHORAGE REGULATIONS Special Anchorage Areas § 110.65 Indian River Bay, Del. Beginning at a point...

  15. 33 CFR 110.65 - Indian River Bay, Del.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Indian River Bay, Del. 110.65 Section 110.65 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY ANCHORAGES ANCHORAGE REGULATIONS Special Anchorage Areas § 110.65 Indian River Bay, Del. Beginning at a point...

  16. Instantánea del cáncer colorrectal

    Cancer.gov

    Información sobre las tendencias de incidencia, mortalidad y financiamiento del NCI sobre el cáncer colorrectal; así como ejemplos de actividades del NCI y adelantos en la investigación de este tipo de cáncer.

  17. Pastoral del Nino: Bringing the Abundant Life to Paraguayan Children

    ERIC Educational Resources Information Center

    Austin, Ann Berghout; Aquino, Cyle; Burro, Elizabeth

    2007-01-01

    Pastoral del Nino is transforming children's lives in rural Paraguay. Part of Pastoral Social (Catholic Social Services), Pastoral del Nino's primary focus is to bring "vida en abundancia" (the abundant life) to families by ensuring that mothers survive childbirth and children reach their first birthdays. In addition, the organization promotes…

  18. 33 CFR 110.65 - Indian River Bay, Del.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Indian River Bay, Del. 110.65... ANCHORAGE REGULATIONS Special Anchorage Areas § 110.65 Indian River Bay, Del. Beginning at a point bearing... State highway bridge across Indian River Inlet; thence 174°, 600 feet; thence 264°, 800 feet; thence...

  19. 33 CFR 110.111 - Marina del Rey Harbor, Calif.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Marina del Rey Harbor, Calif. 110.111 Section 110.111 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY ANCHORAGES ANCHORAGE REGULATIONS Special Anchorage Areas § 110.111 Marina del Rey Harbor, Calif. An area...

  20. Instantánea del sarcoma de Kaposi

    Cancer.gov

    Información sobre las tendencias de incidencia, mortalidad y financiamiento del NCI sobre el sarcoma de Kaposi; así como ejemplos de actividades del NCI y adelantos en la investigación de este tipo de cáncer.

  1. [Strengths and future of the Revista Médica del Instituto Mexicano del Seguro Social].

    PubMed

    Fajardo-Dolci, Germán

    2014-01-01

    The journals of medicine arose as a communication tool more than 200 years ago. At the beginning, their nature was local; later, their aim was to spread medical information along the nation; and, finally, they sought to reach the world distribution. The Revista Médica del Instituto Mexicano del Seguro Social was published for the first time 52 years ago, and it has walked its way from local to international distribution. This journal has 23 000 subscribers, it is included in Medline and it reached a 0.112 SCImago Journal Rank in 2012. Its website receives around 200 000 visits monthly and 45 % are foreign visits. In the future, the peer review system is going to be strengthened, and the journal is going to offer audio, video, and applications to reinforce interactive participation between authors, readers in order to reach modernity and draw young new attention.

  2. Illuminating water and life: Emilio Del Giudice.

    PubMed

    Ho, Mae-Wan

    2015-01-01

    The quantum electrodynamics theory of water put forward by Del Giudice and colleagues provides a useful foundation for a new science of water for life. The interaction of light with liquid water generates quantum coherent domains in which the water molecules oscillate between the ground state and an excited state close to the ionizing potential of water. This produces a plasma of almost free electrons favoring redox reactions, the basis of energy metabolism in living organisms. Coherent domains stabilized by surfaces, such as membranes and macromolecules, provide the excited interfacial water that enables photosynthesis to take place, on which most of life on Earth depends. Excited water is the source of superconducting protons for rapid intercommunication within the body. Coherent domains can also trap electromagnetic frequencies from the environment to orchestrate and activate specific biochemical reactions through resonance, a mechanism for the most precise regulation of gene function.

  3. Illuminating water and life: Emilio Del Giudice.

    PubMed

    Ho, Mae-Wan

    2015-01-01

    The quantum electrodynamics theory of water put forward by Del Giudice and colleagues provides a useful foundation for a new science of water for life. The interaction of light with liquid water generates quantum coherent domains in which the water molecules oscillate between the ground state and an excited state close to the ionizing potential of water. This produces a plasma of almost free electrons favoring redox reactions, the basis of energy metabolism in living organisms. Coherent domains stabilized by surfaces, such as membranes and macromolecules, provide the excited interfacial water that enables photosynthesis to take place, on which most of life on Earth depends. Excited water is the source of superconducting protons for rapid intercommunication within the body. Coherent domains can also trap electromagnetic frequencies from the environment to orchestrate and activate specific biochemical reactions through resonance, a mechanism for the most precise regulation of gene function. PMID:26098522

  4. Características del viento en estrellas Be derivadas del perfil Hα

    NASA Astrophysics Data System (ADS)

    Rohrmann, R.; Cidale, L.

    El estudio teórico de perfiles Hα y su variabilidad en estrellas Be ha sido frecuentemente desarrollado en base a modelos de envolturas circunestelares inhomogéneas, donde la geometría del material es responsable de la forma del perfil dependiendo de la dirección de observación. Nosotros damos una interpretación alternativa y proponemos que la mayoría de las propiedades de esta línea tienen origen en la base de un viento estelar y de una estructura cromosférica anexa a la fotósfera. Encontramos que típicos perfiles Hα en Be, como son los llamados pole-on y winebottle, pueden ser reproducidos cualitativamente sin recurrir a la existencia de una envoltura asimétrica. Analizamos como la línea Hα permite identificar la posible estructura del viento en la región donde éste se inicia.

  5. Estudio teórico del CO2. Orbitales de valencia y del ``core''

    NASA Astrophysics Data System (ADS)

    Olalla Gutiérrez, E.

    Hemos calculado las intensidades de las transiciones E1 a los miembros de las series de Rydberg con origen en los orbitales ``no enlazantes'' del dióxido de carbono, especie de conocida relevancia atmosférica. Se han computado, asimismo, los continuos de fotoionización correspondientes a los distintos canales de ionización, representándolos como densidad espectral de fuerza de oscilador frente a la energía del fotón incidente; mostramos los resultados df/dE para la fotoionización total de esta especie en el intervalo 15-60 eV. Todos los cálculos se han llevado a cabo mediante la formulación Molecular del Método de los Orbitales de Defecto Cuántico, MQDO [1,2]. La calidad de los resultados que presentamos se ha evaluado en base a la comparación con los datos, tanto experimentales como teóricos, disponibles en la bibliografía. El acuerdo encontrado es altamente satisfactorio

  6. [La Medicina del Lavoro: 100 volumes].

    PubMed

    Zocchetti, C

    2009-01-01

    With these pages La Medicina del Lavoro starts its 100th volume, so we have yet another historical occasion to celebrate the oldest occupational health journal in the world that is still publishing. Over the last few years we have had many occasions to celebrate, for example several anniversaries of the Journal (the 80th volume in 1989, 90 years in 1992, 100 years in 2001); the centenary of the foundation of the Clinica del Lavoro "Luigi Devoto" of Milan in 2001; the celebration of the 300 years' anniversary of the publication of De Morbis Artificum Diatriba by Bernardino Ramazzini, and we obviously hope to continue for many years to come in this positive outlook. One hundred volumes makes for a very large collection, with the highs and lows ofthe Journal's history (here we mean the variations in number of pages and physical size of the Journal). It is thanks to the Editors-in-chief(there have been very few so we can cite them all: Luigi Devoto, 1901-1936; Luigi Preti, 1936-1941; Enrico Vigliani, 1943-1992; e Vito Foà, 1992 to the present); the contributors who in various ways and with varying degrees of commitment but always with an exceptional personal participation, that it has been possible to reach 100 volumes, starting with C. Moreschi who, along with Luigi Devoto, was the first and sole editor at the Journal's foundation; up to the present extended and impressive editorial board; the printers (from the first. Tipografia Cooperativa, Via dei Molini in Pavia, to the latest: Casa Editrice Mattioli in Fidenza); the sponsors, including the most evident who, via advertising (rather limited as a matter offact), directly gave information about themselves, but also those who have often been or are behind the scenes, ensuring fundamental support which is not visible; content. articles, news, events, reports, ideas, opinions, photographs, tables, numbers... etc, which are really impossible to sum up. But the true collection which, for obvious reasons, cannot be

  7. 394delTT: a Nordic cystic fibrosis mutation.

    PubMed

    Schwartz, M; Anvret, M; Claustres, M; Eiken, H G; Eiklid, K; Schaedel, C; Stolpe, L; Tranebjaerg, L

    1994-02-01

    In a systematic screening for mutations in the gene encoding the cystic fibrosis transmembrane regulator among Danish cystic fibrosis (CF) patients, we identified a mutation in exon 3 (394delTT); this mutation was found to be relatively common in Denmark. We therefore screened for 394delTT in Sweden and Norway, where it turned out to be the second most frequent mutation, accounting for 4% of all CF mutations. It also occurs with a high frequency in Finland, but has not been found in larger surveys of mutations in the CFTR gene. Thus, 394delTT seems to be a specific Nordic CF mutation.

  8. Living Legacy: A Conversation with Carolina Gomez del Valle.

    ERIC Educational Resources Information Center

    Montessori Life, 1993

    1993-01-01

    Carolina Gomez del Valle has been involved in training other Montessorians in Mexico, Chile, Nicaragua, Peru, and Taiwan. This interview explores her experiences with Montessori education and describes how she has woven her religious training and Montessori philosophy together. (PAM)

  9. Centro para la Salud Mundial (CGH) del NCI

    Cancer.gov

    El Centro para la Salud Mundial (CGH) del NCI coordina actividades de investigación y trabaja con socios nacionales e internacionales para comprender y enfrentar la carga que representa el cáncer a nivel mundial.

  10. Del Pueblo: A School That's "Customade" for Learning

    ERIC Educational Resources Information Center

    Cooper, Terry Touff

    1975-01-01

    The contributions made by Hispanic people to the development of the United States were emphasized through the use of a model bilingual/bicultural program produced by the Del Pueblo Elementary School in Denver, Colorado. (Author/RK)

  11. Estudio del sistema simbiótico AR Pavonis

    NASA Astrophysics Data System (ADS)

    Quiroga, C.; Brandi, E.; Ferrer, O.; García, L.; Barbá, R.

    Se presenta un estudio espectroscópico y polarimétrico de la binaria eclipsante AR Pavonis a partir de observaciones obtenidas con el telescopio de 2.15 m. del CASLEO (San Juan). El estudio de la naturaleza del sistema se realizó a través del análisis de algunos espectros reunidos entre los años 1990 y 1995 y de datos polarimétricos correspondientes al intervalo 1995 y 1997. El análisis espectroscópico indica que AR Pav está compuesta por una gigante roja M3.7 y una componente caliente compacta, con una temperatura mayor a 90000 K y una luminosidad del orden de 500Lsolar. A lo largo del período orbital, las variaciones observadas en flujo y en velocidades radiales, reflejan que las emisiones permitidas se forman en una región que rodea la componente caliente. El estudio de la polarización lineal de AR Pav indica que además de una componente interestelar, existe una componente intrínseca del sistema que varía temporalmente y con la longitud de onda de la luz polarizada. El distinto comportamiento del grado de polarización y del ángulo de posición observado en fases diferentes, sugiere que distintos mecanismos pueden estar actuando, dependiendo de la región de scattering observado a lo largo de la línea de la visual.

  12. Se evitaron casi 800 000 muertes por descenso del tabaquismo

    Cancer.gov

    Programas y estrategias de control del tabaco del siglo XX fueron responsables de la prevención de más de 795 000 muertes por cáncer de pulmón en Estados Unidos de 1975 al 2000. Si todo el tabaquismo en este país hubiera cesado después de la publicación d

  13. 65. Photographer unknown March 1931 DEL NORTE COUNTY, SECTION B, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    65. Photographer unknown March 1931 DEL NORTE COUNTY, SECTION B, HIGHWAY 1, 1-DN-1-B #66A, STA. 166.0+00 WIDENED ROADBED BEFORE COVERING LOG CRIB, 3-31. BACK READS: WIDENING ROAD BED WITH LOGS, APPROX 30 SQUARE & 60 LONG ON DN-1 SEC B STA 156+. Stamped office copy, - Redwood National & State Parks Roads, California coast from Crescent City to Trinidad, Crescent City, Del Norte County, CA

  14. V339 Del (Nova Del 2013) is a weak non-super-soft X-ray source

    NASA Astrophysics Data System (ADS)

    Page, K. L.; Beardmore, A. P.

    2013-09-01

    V339 Del (Nova Del 2013) is currently being monitored approximately daily by Swift-XRT. X-ray analysis has been complicated due to optical loading caused by photons from the very bright optical source. (For a discussion of optical loading in the XRT, see our help page.) At early times, the data were collected mainly in Windowed Timing mode to mitigate this issue, and no X-ray source was detected (ATel #5283, #5305, #5318).

  15. Eruption hematoma as a possible oral sign of infantile scurvy.

    PubMed

    Adewumi, Abi O; Ashoor, Isa F; Soares, Flavio M; Guelmann, Marcio; Novak, Donald A

    2010-01-01

    Scurvy, vitamin C deficiency, is uncommon in industrialized societies today. Although supplementation of food with vitamin C has diminished its incidence, scurvy continues to occur in specific economically and nutritionally disadvantaged populations. The purpose of this report was to describe the case of infantile scurvy in a 20-month-old male with multisystem involvement including significant oral manifestations. Following an extensive initial evaluation, the multidisciplinary approach to diagnosis and management is discussed. This case demonstrates the need for heightened awareness of severe and multiplefood allergies in children and highlights disease conditions caused by nutritional deficiencies in this population.

  16. Alloimmunization of patients by blood units harboring distinct DEL variants.

    PubMed

    St-Louis, Maryse; Lebrun, André; Goldman, Mindy; Lavoie, Marianne

    2013-01-01

    The alloimmunization potential of many RHD variants is unknown, and it can be explored by lookback and traceback studies. Hema-Quebec (HQ) investigated the RHD status of 3980 D- repeat blood donors. Thirteen were found to be RHD positive: 4 RHD*1p, and 1 RHD*487delACAG, which show a Dphenotype;and 1 RHD*885T and 7 RHD*(93-94insT) causing a DEL phenotype when C antigen is present. Look back studies were done to verify the alloimmunization potential of these eight DEL donors. Coincidentally, Canadian Blood Services (CBS)performed a trace back study by investigating the RHD status of donors after aD- recipient developed anti-Dafter transfusion of two D- red blood cell (RBC) units. Donor genotyping was done either manually (HQ) or using the Progenika Bloodchip platform(CBS). Donations were traced through computer records. Letters were sent to hospital blood bank physicians to verify the presence of anti-Din recipients and to donors to request repeat samples.A total of 118 RBC units were transfused, 82 to D- recipients.Anti-D was found in three patients transfused with RHD*(93-94insT) DEL red blood cells. One donor presenting the same DEL variant was involved in the trace back study. Even without strong evidence clearly demonstrating the alloimmunization potential of DEL variants, whenever HQ or CBS identifies a donor harboring a DEL phenotype, his or her D status will be changed from DtoD+ to protect against the potential alloimmunization risk. PMID:24689683

  17. May Gödel's Ideas Be Addressed Philosophically?

    NASA Astrophysics Data System (ADS)

    Dokulil, Miloš

    2007-11-01

    del emphasised philosophy as an important tool in science. Much less is known about his religious background. We should bear in mind that our evaluational perspective differs very much from the one in which Gödel lived. He was personally sure that there must be another existence after death-an afterlife (''of unlimited life span''). As a ''Baptized Lutheran'' he did not include ''Trinity'' in his creed. He was also certain that mind is separate from matter. This text tries to include Libet's ''readiness potential'' into the debate concerning the specificity of the mind. Neither Gödel's identification of materialism with mechanism nor his vision of the ''spirit'' are a viable solution of the problem.

  18. Estudio multifrecuencia del medio interestelar cercano a HD 192281

    NASA Astrophysics Data System (ADS)

    Arnal, E. M.; Cappa, C.; Cichowolski, S.; Pineault, S.; St-Louis, N.

    Una de las causas que modifica la estructura y dinámica del medio interestelar es la acción que los vientos de las estrellas de gran masa ejercen sobre el mismo. En este trabajo, mediante el uso de datos interferométricos obtenidos en la banda de radio en la transición de 21-cm del Hidrógeno neutro y de imágenes de la emisión de continuo en las bandas de 408 y 1420 MHz, de imágenes HIRES del satélite IRAS en 60 y 100 micrones, y de observaciones de continuo obtenidas con radiotelescopios de disco simple en 2695, 4850 y 8350 MHz se ha realizado un estudio multifrecuencia de los efectos que los vientos estelares de HD 192281, una estrella de tipo espectral O5 Vn((f))p, han tenido sobre el medio interestelar que rodea a la misma.

  19. Photometric study of the binary system NN Del

    NASA Astrophysics Data System (ADS)

    Gómez-Forrellad, J. M.; Sánchez-Bajo, F.; Corbera-Subirana, M.; GarcÍa-Melendo, E.; Vidal-Sainz, J.

    We present the results of the differential V light curve analysis of NN Del. We show that NN Del is an EA eclipsing binary system with a period of 99.27 days and a highly eccentric orbit. Photometric solutions obtained using the Russell and the Wilson-Devinney models seem to indicate that both components are very similar in radii and luminosities (assuming a F5 spectral type). Constraints imposed on the V luminosity of the system by the HIPPARCOS data suggest that the components of the system could be subgiants instead of main sequence stars.

  20. Outcome following haematopoietic cell transplantation in patients with myelodysplasia and del (5q) karyotypes.

    PubMed

    Stewart, B; Verdugo, M; Guthrie, K A; Appelbaum, F; Deeg, H J

    2003-12-01

    The deletion (5q) karyotype [del (5q)] in patients with myelodysplastic syndrome (MDS) is considered a good risk feature, while the impact of del (5q) combined with other karyotypic abnormalities [del (5q)+] is less well defined. We analysed the outcome of haematopoietic cell transplants (HCT) in patients with MDS with del (5q) or del (5q)+. Fifty-seven patients, aged 6-72 years, with MDS and del (5q) abnormalities received HCT from related (n = 32) or unrelated (n = 25) donors. By French-American-British (FAB) criteria, 27 patients had refractory anaemia (RA), 10 RA with excess blasts (RAEB), eight RAEB in transformation (RAEB-T) and 12 acute myeloid leukaemia evolving from MDS (tAML). Non-relapse mortality at 1-year post-transplantation was 30% for del (5q) and 38% for del (5q)+ patients. Relapse occurred in one of 20 del (5q) patients and 15 of 37 del (5q)+ patients (P = 0.001). After adjusting for del (5q) status, blast count (<5%) was the only factor significantly associated with relapse-free survival. Patients with del (5q), either as a '5q- syndrome' or with MDS in general, had better outcomes than did patients with del (5q)+. The indication for transplantation in patients with del (5q) was generally severe cytopenias, compared with disease progression to a more advanced FAB stage in patients with del (5q)+. Conceivably, outcome for patients with del (5q)+ would be improved with transplantation earlier in the disease course. PMID:14632779

  1. Síntesis: Resultados iniciales del Estudio Nacional de Ex

    Cancer.gov

    El 4 de noviembre de 2010, el Estudio Nacional de Exámenes de Pulmóndio a conocer resultados iniciales que indican que hubo 20% menos muertes por cáncer de pulmón entre los participantes del estudio evaluados con tomografía computarizada espiral de baja d

  2. Cosmogenic Radionuclides in the Campo Del Cielo Iron Meteorite

    NASA Technical Reports Server (NTRS)

    Liberman, R. G.; FernandezNiello, J. O.; Reedy, R. C.; Fifield, L. K.; diTada, M. L.

    2001-01-01

    Cosmogenic Be-10, Al-26, Cl-36, Ca-41, and Ni-59 were measured in the Campo del Cielo iron meteorite. Our results led us to conclude that the pre-atmospheric radius might have been approximately 2 m. Comparisons with other big bodies are also presented. Additional information is contained in the original extended abstract.

  3. 75 FR 21220 - Del Norte Resource Advisory Committee (RAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-23

    ... agency #0;statements of organization and functions are examples of documents #0;appearing in this section...; ] DEPARTMENT OF AGRICULTURE Forest Service Del Norte Resource Advisory Committee (RAC) AGENCY: Forest Service... Rivers National Forest, 1330 Bayshore Way, Eureka, CA 95503 (707) 441-3673; e-mail...

  4. Design, aerodynamics and autonomy of the DelFly.

    PubMed

    de Croon, G C H E; Groen, M A; De Wagter, C; Remes, B; Ruijsink, R; van Oudheusden, B W

    2012-06-01

    One of the major challenges in robotics is to develop a fly-like robot that can autonomously fly around in unknown environments. In this paper, we discuss the current state of the DelFly project, in which we follow a top-down approach to ever smaller and more autonomous ornithopters. The presented findings concerning the design, aerodynamics and autonomy of the DelFly illustrate some of the properties of the top-down approach, which allows the identification and resolution of issues that also play a role at smaller scales. A parametric variation of the wing stiffener layout produced a 5% more power-efficient wing. An experimental aerodynamic investigation revealed that this could be associated with an improved stiffness of the wing, while further providing evidence of the vortex development during the flap cycle. The presented experiments resulted in an improvement in the generated lift, allowing the inclusion of a yaw rate gyro, pressure sensor and microcontroller onboard the DelFly. The autonomy of the DelFly is expanded by achieving (1) an improved turning logic to obtain better vision-based obstacle avoidance performance in environments with varying texture and (2) successful onboard height control based on the pressure sensor. PMID:22617112

  5. Design, aerodynamics and autonomy of the DelFly.

    PubMed

    de Croon, G C H E; Groen, M A; De Wagter, C; Remes, B; Ruijsink, R; van Oudheusden, B W

    2012-06-01

    One of the major challenges in robotics is to develop a fly-like robot that can autonomously fly around in unknown environments. In this paper, we discuss the current state of the DelFly project, in which we follow a top-down approach to ever smaller and more autonomous ornithopters. The presented findings concerning the design, aerodynamics and autonomy of the DelFly illustrate some of the properties of the top-down approach, which allows the identification and resolution of issues that also play a role at smaller scales. A parametric variation of the wing stiffener layout produced a 5% more power-efficient wing. An experimental aerodynamic investigation revealed that this could be associated with an improved stiffness of the wing, while further providing evidence of the vortex development during the flap cycle. The presented experiments resulted in an improvement in the generated lift, allowing the inclusion of a yaw rate gyro, pressure sensor and microcontroller onboard the DelFly. The autonomy of the DelFly is expanded by achieving (1) an improved turning logic to obtain better vision-based obstacle avoidance performance in environments with varying texture and (2) successful onboard height control based on the pressure sensor.

  6. Faculty Activity Analysis in the Universidad Tecnica Del Estado Campuses.

    ERIC Educational Resources Information Center

    Karadima, Oscar

    An analysis of academic activities of college faculty at the eight campuses of Chile's Universidad Tecnica del Estado was conducted. Activities were grouped into seven categories: direct teaching, indirect teaching, research, community services, faculty development, academic administration, and other activities. Following the narrative…

  7. 78 FR 50025 - Del Norte County Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-16

    ...The Del Norte County Resource Advisory Committee (RAC) will meet in Crescent City, California on the dates listed below. The Committee is authorized under the Secure Rural Schools and Community Self-Determination Act (Act) (Pub. L. 112-141) and operates in compliance with the Federal Advisory Committee Act (FACA) (Pub. L. 92- 463). The purpose of the Committee is to improve collaborative......

  8. Interdisciplinary Unit: La Isla del Encanto (The Enchanted Island).

    ERIC Educational Resources Information Center

    Ford-Guerrera, Rebecca

    This document presents a series of 14 lesson plans in an interdisciplinary Spanish unit on "La isla del encanto/The Enchanted Island." The materials were prepared for students in grades 5 or 6 who have had basic Spanish instruction in previous grades. The students should also be familiar with basic concepts in English such as math computation, map…

  9. Cirugía de los trastornos del comportamiento: el estado del arte

    PubMed Central

    Yampolsky, Claudio; Bendersky, Damián

    2014-01-01

    Introducción: La cirugía de los trastornos del comportamiento (CTC) se está convirtiendo en un tratamiento más común desde el desarrollo de la neuromodulación. Métodos: Este artículo es una revisión no sistemática de la historia, indicaciones actuales, técnicas y blancos quirúrgicos de la CTC. Dividimos su historia en 3 eras: la primera comienza en los inicios de la psicocirugía y termina con el desarrollo de las tícnicas estereotácticas, cuando comienza la segunda era. Ésta se caracteriza por la realización de lesiones estereotácticas. Nos encontramos transitando la tercera era, que comienza cuando la estimulación cerebral profunda (ECP) comienza a ser usada en CTC. Resultados: A pesar de los errores graves cometidos en el pasado, hoy en día, la CTC está renaciendo. Los trastornos psiquiátricos que se más frecuentemente se tratan con cirugía son: depresión refractaria, trastorno obsesivo-compulsivo y síndrome de Tourette. Además, algunos pacientes con agresividad fueron tratados quirúrgicamente. Hay varios blancos estereotácticos descriptos para estos trastornos. La estimulación vagal puede ser usada también para depresión. Conclusión: Los resultados de la ECP en estos trastornos parecen alentadores. Sin embargo, se necesitan más estudios randomizados para establecer la efectividad de la CTC. Debe tenerse en cuenta que una apropiada selección de pacientes nos ayudará a realizar un procedimiento más seguro así como también a lograr mejores resultados quirúrgicos, conduciendo a la CTC a ser más aceptada por psiquiatras, pacientes y sus familias. Se necesita mayor investigación en varios temas como: fisiopatología de los trastornos del comportamiento, indicaciones de CTC y nuevos blancos quirúrgicos. PMID:25165612

  10. Extensión del Formalismo de Orbitales de Defecto Cuántico al tratamiento del efecto Stark (SQDO).

    NASA Astrophysics Data System (ADS)

    Menéndez, J. M.; Martín, I.; Velasco, A. M.

    El estudio experimental de las interacciones de átomos Rydberg altamente excitados con campos eléctricos ha experimentado un creciente interés durante las dos últimas décadas debido, en gran medida, al desarrollo de nuevas técnicas para crear y estudiar átomos Rydberg en el laboratorio. Acompañando a estas nuevas técnicas experimentales, es necesario el desarrollo de modelos teóricos que nos permitan contrastar sus medidas y conocer mejor los fundamentos de los mismos. Desde el punto de vista teórico el conocimiento del desdoblamiento de los niveles energéticos de un átomo en función de la magnitud del campo eléctrico aplicado (lo que se conoce como mapa Stark) es el mejor punto de partida para la descripción del sistema y un prerrequisito fundamental para el cálculo de distintas propiedades atómicas en presencia del campo eléctrico tales como intensidades de transición, umbrales de ionización de campo eléctrico, tiempos de vida, posición y anchura de cruces evitados, etc. En este trabajo presentamos la adaptación del método de orbitales de defecto cuántico [1,2,3] al tratamiento del efecto Stark (SQDO) [4] y su aplicación al cálculo de los desdoblamientos energéticos y fuerzas de oscilador de estados Rydberg en los átomos de Li, Na y K. El propósito de este estudio es, por un lado, desarrollar métodos fiables para la determinación de propiedades atómicas en presencia de campos eléctricos y, por otro, mostrar la fiabilidad de las funciones de onda QDO en la descripción del efecto Stark en sistemas atómicos.

  11. Analisis del contenido curricular de los Documentos Normativos del Programa de Ciencias en el area de biologia para la escuela superior del sistema de educacion publica de Puerto Rico: 1993-2012

    NASA Astrophysics Data System (ADS)

    Davila Montanez, Melissa

    Esta investigacion de naturaleza cualitativa se ocupo de realizar un analisis de contenido documental de los Documentos Normativos del Programa de Ciencias en el area de biologia de la escuela superior del sistema de educacion publica de Puerto Rico del periodo 1993-2012. Los documentos analizados fueron: Guia Curricular, 1995; Marco Curricular, 2003; Estandares de Excelencia, 1996, 2000 y Estandares de Contenido y Expectativas de Grado, 2007. Se indago si hubo cambios en significados en los Componentes Estructurales: Naturaleza de la ciencia, Paradigmas para la ensenanza de la ciencia, Funcion del curriculo formal, Mision de la ensenanza de la ciencia; Contenidos, destrezas y competencias, Estrategias de ensenanza y Evaluacion/Assessment del aprendizaje. El analisis sugiere que no hubo cambios sustanciales en los significados de los Componentes Estructurales. Los documentos estudiados muestran mayormente caracteristicas similares, aunque los documentos mas recientes eran mas descriptivos, explicativos y especificos.

  12. Genomic Copy Number Variations in the Myelodysplastic Syndrome and Acute Myeloid Leukemia Patients with del(5q) and/or -7/del(7q).

    PubMed

    Zhang, Rui; Kim, Young-Mi; Wang, Xianfu; Li, Yan; Lu, Xianglan; Sternenberger, Andrea R; Li, Shibo; Lee, Ji-Yun

    2015-01-01

    The most common chromosomal abnormalities in myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) are -5/del(5q) and -7/del(7q). When -5/del(5q) and -7/del(7q) coexist in patients, a poor prognosis is typically associated. Given that -5/del(5q) and/or -7/del(7q) often are accompanied with additional recurrent chromosomal alterations, genetic change(s) on the accompanying chromosome(s) other than chromosomes 5 and 7 may be important factor(s) affecting leukemogenesis and disease prognosis. Using an integrated analysis of karyotype, FISH and array CGH results in this study, we evaluated the smallest region of overlap (SRO) of chromosomes 5 and 7 as well as copy number alterations (CNAs) on the other chromosomes. Moreover, the relationship between the CNAs and del(5q) and -7/del(7q) was investigated by categorizing the cases into three groups based on the abnormalities of chromosomes 5 and 7 [group I: cases only with del(5q), group II: cases only with -7/del(7q) and group III: concurrent del(5q) and del(7q) cases]. The overlapping SRO of chromosome 5 from groups I and III was 5q31.1-33.1 and of chromosome 7 from groups II and III was 7q31.31-q36.1. A total of 318 CNAs were observed; ~ 78.3% of them were identified on chromosomes other than chromosomes 5 and 7, which were defined as 'other CNAs'. Group III was a distinctive group carrying the most high number (HN) CNAs, cryptic CNAs and 'other CNAs'. The loss of TP53 was highly associated with del(5q). The loss of ETV6 was specifically associated with group III. These CNAs or genes may play a secondary role in disease progression and should be further evaluated for their clinical significance and influence on therapeutic approaches in patients with MDS/AML carrying del(5q) and/or -7/del(7q) in large-scale, patient population study. PMID:26392809

  13. [Endovascular treatment of critical basilar stenosis with a Solitaire® stent device: a first experience in our centre].

    PubMed

    Mulero, Patricia; Cortijo-García, Elisa; Ruiz-Piñero, Marina; Pérez-Fernández, Santiago; Arenillas-Lara, Juan F; Martínez-Galdámez, Mario

    2014-08-01

    Introduccion. Aunque la arterioesclerosis intracraneal es una causa importante de ictus, la actitud terapeutica no esta claramente establecida. En este sentido, el estudio SAMMPRIS comparo el tratamiento medico intensivo con la angioplastia y colocacion de stent, con resultados favorables al tratamiento farmacologico. Estos resultados podrian, en parte, deberse al dispositivo utilizado (stent Wingspan ®). Caso clinico. Varon de 71 años con una estenosis grave de la arteria basilar, en quien se repetian episodios de focalidad neurologica transitoria a pesar del tratamiento con doble antiagregacion y estatinas. En estas circunstancias se decidio realizar una arteriografia terapeutica con angioplastia y colocacion de un stent Solitaire ® para optimizar resultados y se logro una estenosis residual del 40%. La evolucion fue favorable y los controles posteriores muestran una minima progresion. Conclusion. Segun nuestro conocimiento, este es el primer caso publicado de tratamiento de una estenosis critica de la arteria basilar mediante la colocacion de un stent Solitaire ®.

  14. The first century of the "clinica del lavoro" in Milan.

    PubMed

    Bertazzi, Pier Alberto; Foà, Vito

    2005-01-01

    The Clinica del Lavoro was created in Milan at the beginning of the 20th century by Luigi Devotto, who deemed it essential for physicians and health researchers to get involved in the life and health problems of working populations. The main roles of the Clinica del Lavoro were to educate medical students and train physicians; study actual workplaces, examine health and safety hazards and their noxious effects; and create initiatives and services to protect and promote workers' health. Important scientific contributions were made in several fields, including chemical carcinogenesis, effects of mineral and biologicalfibers, mechanism of action of silica dust, methods for the detection and measurements of toxic substances in both the work environment and workers' biological media.

  15. New records of fishes at Isla del Coco, Costa Rica

    USGS Publications Warehouse

    Garrison, V.H.

    1996-01-01

    Isla del Coco lies at 5 degrees 32'N latitude, 87 degrees 04'W longitude and is the sole peak of the Cocos Ridge exposed above sea level. This isolated island formed approximately 2 million years ago. It rises 575 m above the surface of the sea and covers 46 km2 (Castillo et aI., 1988). Five hundred km to the NNE is Costa Rica; 630 km SSW are the Galapagos Islands; 650 km to the E is Isla Malpelo, Colombia; and approximately 8,000 km W lie the Line Islands. Costa Rica claimed Isla del Coco in 1832 and declared it a National Park in 1978. The area of the park was increased to include the adjacent waters 5 km offshore in 1984 and 25 km offshore in 1991.

  16. Biological and behavioral determinants of fertility in Tierra del Fuego.

    PubMed

    Pascual, J; García-Moro, C E; Hernández, M

    2005-05-01

    The reproductive history of 182 women in postreproductive life or near menopause from the Chilean part of Tierra del Fuego was traced back by means of familial interviews. These postmenopausal women represent the population since almost the beginning of the settlement, and their reproductive years were spent on the island. Path analysis was applied to analyze fertility determinants of these women and to propose a complex model of interconnections among factors. The reproductive history of these women is characterized by a long fertile span, a short childbearing period, and low fertility. Age at menarche is relatively late, and the age of the women at first birth is mainly determined by their late age at marriage. The use of contraception is related to both spacing and stopping behaviors. The late age of women at marriage, the rhythm of conception, and practices of contraception are proposed as the main determinants of fertility in Tierra del Fuego.

  17. A model of Nevado del Ruiz Volcano, Colombia

    NASA Astrophysics Data System (ADS)

    Williams, Stanley N.; Meyer, Hansjürgen

    A workshop was held at the Observatorio Vulcanologico de Colombia in Manizales, Colombia, March 28 to April 1, 1988, to review the accumulated data on the disastrous November 13, 1985, eruption and related activity of Nevado del Ruiz volcano (Figure 1). Approximately 30 scientists from eight countries presented data, developed a preliminary model, and addressed the future problems of Ruiz. The volcano (see Figure 2) erupted just prior to the meeting, covering the meeting site with 1-2 mm of ash.The workshop was convened by Stanley N. Williams (Louisiana State University, Baton Rouge) and Hansjürgen Meyer (Universidad del Valle, Cali, Colombia). A special volume of the Journal of Volcanology and Geothermal Research is planned for the papers and letters presented at the workshop, with some additional contributions. Publication is expected in mid-1989.

  18. Solar adaptive optics at the Observatorio del Teide, Tenerife

    NASA Astrophysics Data System (ADS)

    Soltau, Dirk; Berkefeld, Thomas; Schmidt, Dirk; von der Lühe, Oskar

    2013-10-01

    Observing the Sun with high angular resolution is difficult because the turbulence in the atmosphere is strongest during day time. In this paper we describe the principles of solar adaptive optics exemplified by the two German solar telescopes VTT and GREGOR at the Observatorio del Teide. With theses systems we obtain near diffraction limited images of the Sun. Ways to overcome the limits of conventional AO by applying multiconjugate adaptive optics (MCAO) are shown.

  19. 2. COURSE OF THE LATERAL THROUGH DEL NORTHWEST MAR PARK. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. COURSE OF THE LATERAL THROUGH DEL NORTHWEST MAR PARK. - Highline Canal, Sand Creek Lateral, Beginning at intersection of Peoria Street & Highline Canal in Arapahoe County (City of Aurora), Sand Creek lateral Extends 15 miles Northerly through Araphoe County, City & County of Denver, & Adams County to its end point, approximately 1/4 mile Southest of intersectioin of D Street & Ninth Avenue in Adams County (Rocky Mountain Arsenal, Commerce City Vicinity), Commerce City, Adams County, CO

  20. 3. 1939 DROP STRUCTURE IN DEL MAR PARK SURMOUNTED BY ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    3. 1939 DROP STRUCTURE IN DEL MAR PARK SURMOUNTED BY RECENT PEDESTRIAN BRIDGE. - Highline Canal, Sand Creek Lateral, Beginning at intersection of Peoria Street & Highline Canal in Arapahoe County (City of Aurora), Sand Creek lateral Extends 15 miles Northerly through Araphoe County, City & County of Denver, & Adams County to its end point, approximately 1/4 mile Southest of intersectioin of D Street & Ninth Avenue in Adams County (Rocky Mountain Arsenal, Commerce City Vicinity), Commerce City, Adams County, CO

  1. Determinacion de Caracteristicas Opticas del Telescopio OAN150

    NASA Astrophysics Data System (ADS)

    Galan, M. J.; Cobos, F. J.

    1987-05-01

    En el Observatorio de Calar Alto, en Almería, España, está ubicado un telescopio de 15O-cms de diámetro -construído por REOSC- perteneciente al Observatorio Astronómico Nacional, con sede en Madrid, España. La infraestructura técnica del OAN ha sido tradicionalmente débil y actualmente se está haciendo un esfuerzo por fortalecerla. Existe una información muy limitada del telescopio en general; de su óptica en particular se conocían los valores de los parámetros principales pero sin saber si éstos corresponden a valores teóricos ó de construcción. Por ello se consideró necesario iniciar una investigación para conocer en detalle los valores reales de las componentes ópticas del telescopio, obteniéndose algunos resultados de interés. El primario del telescopio OANl5O es aproximadamente F/3 y el siste ma en su conjunto es F/8.2, con su sistema corrector de campo. En términos generales, la imagen es satisfactoria en todo el campo y, sin sistema corrector, la imagen axial también es buena. En un futuro muy cercano se piensa diseñar instrumentación adicional para este telescopio. Conocer con mayor precisión sus características puede ser de gran utilidad para tal fin, pues se efectúan los cálculos considerando conjuntamente al telescopio y al instrumento.

  2. Field Measurements of Respiratory Del13CO2 and Photodegradation

    NASA Astrophysics Data System (ADS)

    van Asperen, H.; Sabbatini, S.; Nicolini, G.; Warneke, T.; Papale, D.; Notholt, J.

    2014-12-01

    Carbon decomposition dynamics have been studied in a variety of ecosystems and its variation can mostly be explained in terms of environmental variables (e.g. temperature and precipitation). However, carbon dynamics in arid, water limited regions have shown to be very different and are still largely unknown. Several studies have indicated the importance of photodegradation, the direct breakdown of organic matter by sunlight, in these arid regions. A FTIR (Fourier Transform Infrared Spectrometer) was set up to continuously measure concentrations of CO2, CH4, N2O, CO as well as del13C in CO2. The FTIR was connected to 2 different flux measurement systems: a Flux Gradient system and 2 flux chambers, providing a continuous data set of gas concentrations and biosphere-atmosphere gas fluxes at different heights and scales. Field measurements showed photodegradation induced carbon fluxes. Also, respiratory del13CO2 was determined by use of Keeling plots, and was determined to vary between -25‰ and -21‰. A clear diurnal pattern in respiratory del13CO2 was found, suggesting either different (dominant) respiratory processes between day and night or the effect of diffusive fractionation.

  3. Modeling Visibility in the EL Paso del Norte Region

    NASA Astrophysics Data System (ADS)

    Fitzgerald, R. M.; Medina, R.; DuBois, D. W.; Novlan, D.

    2013-12-01

    Poor visibility is a subject of growing public concern throughout the U.S, and an active area of research. Its societal impacts in air quality, aviation transport and traffic are significant. Aerosols play a fundamental role in the attenuation of solar radiation, and also affect visibility. The scattering and extinction coefficients of aerosol particles in the Paso del Norte Region have been calculated using the T- matrix model in conjunction with a laser particle counter. Inter-comparison of the model's results of the scattering and absorption coefficients against the corresponding data from a Photoacustic Extinctiometer instrument (which measures in-situ absorption and scattering coefficients of aerosol particles) shows excellent agreement. In addition, the volume-weighted method is used to determine the composite index of refraction which is representative of the aerosols for the Paso del Norte Airshed to obtain information of the type of aerosol particles present in the Airshed. The Single Scattering Albedo has also been retrieved using our methodology to obtain further insight into the type of aerosols present on a given day. Finally, the Koschmieder equation has been used to calculate the visual range or visibility, and was correlated with the PM2.5 and PM10 particle concentration present in the Airshed. Our methodology will allow a better understanding of the size and type of aerosol particles that are most detrimental to the visibility for the Paso del Norte Region.

  4. Los plaguicidas y la contaminacion del medio ambiente Venezolano

    USGS Publications Warehouse

    Stickel, L.F.; Stickel, W.H.

    1972-01-01

    RESUMEN DE RECOMENDACIONES Recomendaciones para el Programa de Investigacion: 1. Establecer un sistema de muestreo biologico para detectar los niveles tendencias de los productos quimicos toxicos en un peque?o numero de si tios representativos. 2. Mantener continua vigilancia de la contaminacion ambiental, mediante la seleccion acertadamente dirigida de las zonas afectadas y de las fuentes de contaminacion. 3. Realizar estudios acerca de las poblaciones de animales silvestres, y del exito de los procesos reproductivos de las especies o grupos clayes de animales que se consideran mas gravemente afectados. 4. Preparar recomendaciones para una accion gubernamental de proteccion al hombre, a la fauna silvestre y al medio ambiente. Recomendaciones para la Accion Administrativa: 1. Establecer limites a la tolerancia de los residuos de plaguicidas en los alimentos. Constituye una medida clave para disminuir la contaminacion ambiental. 2. Establecer normas de calidad del agua para las corrientes, represas, la gos y otros cuerpos. Es la segunda medida clave para reducir la contaminacion del ambiente 3. Exigir un tratamiento adecuado de los efluentes industriales, especialmente antes de que se construyan las nuevas plantas. 4. Exigir a los agricultores que en el uso de plaguicidas sigan los consejos tecnicos autorizados y negar a los vendedores el derecho a recomendar productos por su cuenta. 5. Tomar medidas para recoger y eliminar los recipientes y sobrantes de los plaguicidas.

  5. Estudio multifrecuencia del medio interestelar cercano a HD 192281

    NASA Astrophysics Data System (ADS)

    Arnal, E. M.; Cappa, C. E.; Cichowolski, S.; Pineault, S.; St-Louis, N.

    Una de las causas que modifica la estructura y dinámica del medio interestelar es la acción que los vientos de las estrellas de gran masa ejercen sobre el mismo. En este trabajo, mediante el uso de datos interferométricos obtenidos en la banda de radio en la transición de λ˜21-cm del hidrógeno neutro y de imágenes de la emisión de continuo en las bandas de 408 y 1420 MHz, de imágenes HIRES del satélite IRAS en 60 y 100μm, y de observaciones de continuo obtenidas con radiotelescopios de disco simple en 2695, 4850 y 8350 MHz se ha realizado un estudio multifrecuencia de los efectos que los vientos estelares de HD 192281, una estrella de tipo espectral O5,Vn((f))p, han tenido sobre el medio interestelar que rodea a la misma.

  6. Estrategia innovadora enfocada en parejas del mismo sexo para disminuir la infección del VIH en hombres Latinos

    PubMed Central

    Martinez, Omar; Wu, Elwin; Sandfort, Theo; Shultz, Andrew Z.; Capote, Jonathan; Chávez, Silvia; Moya, Eva; Dodge, Brian; Morales, Gabriel; Porras, Antonio; Ovejero, Hugo

    2014-01-01

    Resumen El VIH es un problema de salud importante dentro de la comunidad latina de los Estados Unidos. Gracias a los esfuerzos de prevención, los niveles de contagio entre los latinos se han mantenido estables por más de una década. Sin embargo, esta población sigue siendo afectada a niveles muy altos, en particular entre hombres que tienen sexo con hombres (HSH), de origen latino y que hablan principalmente el idioma español. Existen varios factores que contribuyen a la transmisión del VIH entre esta población, como son: el uso de drogas; la violencia dentro de la pareja; la presencia de infecciones de transmisión sexual; relaciones sexuales sin protección, dentro y fuera de la pareja; el evadir la búsqueda de recursos (prueba y tratamiento adecuado) por temor a ser discriminado o por su estatus migratorio; la escasez de recursos económicos o estado de pobreza y los patrones relacionados a la migración. En particular, Investigaciones Epidemiológicas de Comportamientos han determinado: cómo algunas dinámicas en parejas están directamente asociadas a los comportamientos sexuales de riesgos. En consecuencia, es necesaria mayor investigación para identificar esas dinámicas, y a su vez, realizar intervenciones dirigidas a la reducción de conductas de riesgo enfocadas en parejas de hombres del mismo sexo. En este escrito, se describe la importancia del uso de las relaciones de pareja como estrategia en la reducción de la trasmisión del VIH/SIDA en HSH de origen latino y que hablan principalmente el idioma español en los Estados Unidos. PMID:25580466

  7. Nova Del 2013 (V339 Del) is now a bright super-soft X-ray source

    NASA Astrophysics Data System (ADS)

    Osborne, Julian P.; Page, Kim; Beardmore, Andrew; Woodward, Chick; Schwarz, Greg; Bode, Mike; Ness, Jan-Uwe; Shore, Steve; Starrfield, Sumner; Wagner, Mark; Walter, Fred

    2013-10-01

    Regular Swift XRT monitoring of nova Del 2013 since our report in ATEL #5470 has revealed a decrease in the high absorbing column affecting the optically thin harder X-ray emission above 1 keV; spectral fits suggest N_H ~ 5x10^22 cm^-2 around day 45 and N_H ~ 1.8x10^22 around day 65 after discovery on Aug 14, 2013.

  8. The 2012 Reactivation of Nevado del Ruiz Volcano, Colombia

    NASA Astrophysics Data System (ADS)

    Ordoñez, M.; Lopez, C.; Cortes, G. P.; Londoño, J.; Battaglia, M.

    2012-12-01

    Nevado Del Ruiz volcano is most known for its tragic November 13, 1985 explosive event, when a small eruption produced an enormous lahar that buried and destroyed the town of Armero in Tolima, causing an estimated 25,000 deaths. Similar but less deadly incidents occurred in 1595 and 1845, again where a small explosive eruption was followed by a large lahar. Other minor explosive events occurred in 1805, 1828-9, and 1989. The Armero tragedy was a major factor in the establishment of a volcano monitoring program in Colombia. The network monitoring Nevado del Ruiz volcano has dramatically improved since the 1985 eruption and now includes geodetic, geophysical, geochemical and visual monitoring. The activity of Nevado Del Ruiz between 1985 and 1991 saw significant increases in seismicity and significant gas emissions with the main eruptive events of November 13, 1985 and September 1st, 1989. The volcano became seismically active again in 1995 and 2002, whit an increase in seismicity, without any gas emission or eruption. In October 2010 the volcano entered in a new phase of unrest with increased seismicity (HB events), deformation and gas emissions, likely associated with a new magma intrusion. In February, 2012 the volcano had a new and significant increase in seismicity (VT-LP), followed in May and June 2012 by small phreatic and phreato-magmatic eruption. This eruptive activity is still ongoing. Deformation measurements at Nevado Del Ruiz volcano have been carried out since just after the tragic eruption of the 13th of November 1985. In 2007 seven new electronic tilt meters were set up to monitor the deformation. Significant uplift was measured from August 2007 to October 2010, for a total cumulative value of more than 500 microradians. From the end of 2011 to July 2012, moderate changes of uplift were detected for a total of 70 microradians. The analysis of these deformation data shows a pattern of surface displacement associated with an intrusion of new magma

  9. Comportamiento del Helio en estrellas químicamente peculiares

    NASA Astrophysics Data System (ADS)

    Malaroda, S. M.; López García, Z.; Leone, F.; Catalano, F.

    Las estrellas químicamente peculiares (CP) se caracterizan por tener deficiencias y sobreabundancias de algunos elementos químicos de hasta 106 veces la abundancia solar. Además presentan variaciones en las líneas espectrales. Se piensa que ello se debe a que los campos magnéticos presentes en este tipo de estrellas son principalmente dipolares, con un eje de simetría diferente del eje de rotación. La distribución de los elementos sobreabundantes y deficientes no es homogénea sobre la superficie estelar y las variaciones observadas serían una consecuencia directa de la rotación estelar. Entre los elementos con abundancia anómala se encuentra el Helio, cuyas líneas tienen intensidades que no son consistentes con una abundancia normal, que no puede ser determinada del modo usual, o sea, considerando una atmósfera con composición solar. Con el fin de determinar la abundancia de este elemento, se inició un estudio de estrellas anómalas de Helio, Hew y He strong. Además se determinarán las abundancias de otros elementos anómalos como ser el Si, Cr, Mg, Mn y Fe. Las mismas se determinan del modo tradicional, o sea: a) medida de los anchos equivalentes de las líneas de los distintos elementos analizados; b) adopción de la temperatura efectiva, gravedad y abundancia del Helio; c) cálculo del modelo de atmósfera d) comparación con las observaciones y reinicio de un proceso iterativo hasta lograr un acuerdo entre todos los parámetros analizados. Las observaciones se llevaron a cabo en el Complejo Astronómico El Leoncito. Se observaron setenta y ocho estrellas anómalas de Helio. En este momento se está procediendo a calcular las abundancias correspondientes a los distintos elementos químicos. Para ello se hace uso de los modelos de Kurucz, ATLAS9. Los cálculos NLTE de las líneas de Helio se llevan a cabo con el programa MULTI y se compararán con los realizados con el programa WIDTH9 de Kurucz (LTE), con el objeto de resaltar la importancia de

  10. Perk Ablation Ameliorates Myelination in S63del-Charcot–Marie–Tooth 1B Neuropathy

    PubMed Central

    Musner, Nicolò; Sidoli, Mariapaola; Zambroni, Desireè; Del Carro, Ubaldo; Ungaro, Daniela; D’Antonio, Maurizio; Feltri, Maria L.

    2016-01-01

    In peripheral nerves, P0 glycoprotein accounts for more than 20% of myelin protein content. P0 is synthesized by Schwann cells, processed in the endoplasmic reticulum (ER) and enters the secretory pathway. However, the mutant P0 with S63 deleted (P0S63del) accumulates in the ER lumen and induces a demyelinating neuropathy in Charcot–Marie–Tooth disease type 1B (CMT1B)–S63del mice. Accumulation of P0S63del in the ER triggers a persistent unfolded protein response. Protein kinase RNA-like endoplasmic reticulum kinase (PERK) is an ER stress sensor that phosphorylates eukaryotic initiation factor 2 alpha (eIF2alpha) in order to attenuate protein synthesis. We have shown that increasing phosphophorylated-eIF2alpha (P-eIF2alpha) is a potent therapeutic strategy, improving myelination and motor function in S63del mice. Here, we explore the converse experiment: Perk haploinsufficiency reduces P-eIF2alpha in S63del nerves as expected, but surprisingly, ameliorates, rather than worsens S63del neuropathy. Motor performance and myelin abnormalities improved in S63del//Perk+/− compared with S63del mice. These data suggest that mechanisms other than protein translation might be involved in CMT1B/S63del neuropathy. In addition, Perk deficiency in other cells may contribute to demyelination in a non–Schwann-cell autonomous manner. PMID:27095827

  11. Screening for 185delAG in the Ashkenazim.

    PubMed Central

    Richards, C S; Ward, P A; Roa, B B; Friedman, L C; Boyd, A A; Kuenzli, G; Dunn, J K; Plon, S E

    1997-01-01

    A study was initiated to assess interest, educational effectiveness, and implications of genetic testing for the common BRCA1 mutation, 185delAG, in the Ashkenazim. Of 333 individuals who attended group sessions, 309 (92%) participated in the study. Participants were categorized as having negative family history (67%), positive family history (defined, by a relaxed criterion, as one first-degree relative or two second-degree relatives with breast [premenopausal] or ovarian cancer) (22%), positive personal history (7%), and both positive personal history and positive family history (4%). Group education was effective, as shown by the improvement in participant scores from pre- to posteducation tests. For the 289 individuals (94%) who requested testing, the major reasons included concern for their own risk, concern for the risk of their children, and desire to learn about surveillance options. The most common reason given by participants who declined testing was concern about health insurance. Six participants found to be heterozygous for the 185delAG mutation received results and were offered genetic counseling. Participants had consented for additional testing without receiving results and were screened for the 6174delT mutation in BRCA2, and seven were found to be positive. All identified carriers reported at least one first- or second-degree relative with a history of breast or ovarian cancer, although they did not all meet our study criteria for positive family history. Given these outcomes, we conclude that screening for breast and ovarian cancer susceptibility is most appropriate for individuals with a positive personal or positive family cancer history. We propose a guideline for future studies designed to identify individuals who may benefit from genetic testing for inherited breast and ovarian cancer. Images Figure 1 PMID:9150156

  12. Non-seasonality of births in Tierra del Fuego (Chile).

    PubMed

    Pascual, J; García-Moro, C; Hernández, M

    2000-01-01

    Tierra del Fuego is situated at the southern tip of the American continent, which conditions its environmental and climatic characteristics. The colonizing population arrived, at the end of the 19th century, from other Chilean regions (particularly from Chiloé) and diverse European countries, especially Britain and Croatia, but also Germany, Spain and Italy. In the present study, the existence of a seasonal pattern in 5430 births registered in the Chilean population of Tierra del Fuego from 1890 to 1995 was analysed. The analysis showed no seasonal distribution of births in the periods 1890-1920 and from 1946 to the present day, a phenomenon rarely reported in the literature. The absence of seasonality in birth distribution could be related to the great diversity in the origins of the population's families, the constant renovation of this and the declining importance of the administrative capital of the province of Tierra del Fuego, Porvenir, in favour of Punta Arenas, capital of the Magellanic region. In the period of maximum development of the capital of the province, a seasonal pattern was detected with a peak in April and a trough in October, which corresponds with a maximum of conceptions in July and, in general, during the early southern winter and a decline in births from late spring to mid-summer, with a trough in January. This birth distribution is interpreted as a subordination of activity and social life to the annual sheep cycle. In addition to temporal trends, the influence on the observed patterns of environmental parameters, father's occupation, seasonality of marriage and the origin of the parents were analysed.

  13. Gynandromorphs in mosquitoes (Diptera: Culicidae) from Valle del Cauca, Colombia.

    PubMed

    Barreto, Mauricio; Burbano, María E; Barreto, Pablo

    2008-01-01

    Gynandromorphs of Culex nigripalpus Theobald (2), Cx. pedroi Sirivanakarn and Belkin (1) and Aedes albopictus (Skuse) (2) are described. Two individuals of the latter species were reared in the laboratory, while the remaining three specimens were wild-caught with different traps in rural areas in Valle del Cauca department, southwestern Colombia. All of the individuals were mounted on microscopic slides with Canada balsam. From each mosquito, main morphological characteristics are described and illustrated. Due to the paucity of information about this subject, these findings as well as other relevant cases are discussed.

  14. Optical photometry and spectroscopy of Nova Del 2013

    NASA Astrophysics Data System (ADS)

    Tomov, T.; Ilkiewicz, K.; Swierczynski, E.; Belcheva, M.; Dimitrov, D.

    2013-08-01

    We report optical BV photometry and spectroscopy of Nova Del 2013, carried out between August 14.88 UT and August 15.08 UT. Using a 60 cm Cassegrain telescope at the Nicolaus Copernicus University Observatory (Torun, Poland) we estimated the V brightness of the Nova to be 6.31+/-0.02 mag and 6.18+/-0.03 mag on Aug. 14.94 UT and Aug. 15.02 UT respectively. HD 194113 (F2, V=8.00 mag) was used as a comparison star.

  15. Albedo polarimétrico de asteroides del grupo Hungaria

    NASA Astrophysics Data System (ADS)

    Gil-Hutton, R.; Benavidez, P.

    La región del cinturón de asteroides en donde se encuentra el grupo de los Hungarias (a= 1.79 a 1.98 UA, i=15 a 40 grados) es la única zona donde es común encontrar objetos de tipo taxonómico E, caracterizados por altos albedos, colores relativamente neutros y espectros sin detalles. Este tipo de asteroides está relacionado espectralmente con ciertos meteoritos (aubritas) que indican la existencia de episodios de gran calentamiento que ocurrieron durante la formación del Sistema Solar. Como el espectro de los asteroides de tipo E es idéntico a los de tipo M y P, la única forma de clasificar un asteroide en alguno de estos tres tipos taxonómicos es mediante el albedo. En este trabajo se presentan resultados preliminares sobre la determinación polarimétrica de albedos para objetos de este grupo utilizando el polarímetro CASPROF de CASLEO.

  16. 66. Photographer unknown March 1920'S DEL NORTE COUNTY, SECTION B, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    66. Photographer unknown March 1920'S DEL NORTE COUNTY, SECTION B, HIGHWAY 1. 1-DN 1-B #9, CORDUROY DETOUR INTO CRESCENT CITY, 2-2 (3?). Stamped office copy. - Redwood National & State Parks Roads, California coast from Crescent City to Trinidad, Crescent City, Del Norte County, CA

  17. Content Analysis Schedule for Bilingual Education Programs: Del Valle Bilingual Education Program.

    ERIC Educational Resources Information Center

    Ehrlich, Roselin; Shore, Marietta Saravia

    This content analysis schedule for the Del Valle Bilingual Education Program of Del Valle, Texas, presents information on the history, funding, and scope of the project. Included are sociolinguistic process variables such as the native and dominant languages of students and their interaction. Information is provided on staff selection and the…

  18. Instantánea del cáncer de páncreas

    Cancer.gov

    Información sobre las tendencias de incidencia, mortalidad y financiamiento del NCI sobre el cáncer de páncreas; así como ejemplos de actividades del NCI y adelantos en la investigación de este tipo de cáncer.

  19. Instantánea del cáncer de pulmón

    Cancer.gov

    Información sobre las tendencias de incidencia, mortalidad y financiamiento del NCI sobre el cáncer de pulmón; así como ejemplos de actividades del NCI y adelantos en la investigación de este tipo de cáncer.

  20. Instantánea del cáncer de seno (mama)

    Cancer.gov

    Información sobre las tendencias de incidencia, mortalidad y financiamiento del NCI sobre el cáncer de seno (mama); así como ejemplos de actividades del NCI y adelantos en la investigación de este tipo de cáncer.

  1. Elaphopsocoides, a new genus of Psocidae (Psocodea: ´Psocoptera´) from Valle del Cauca, Colombia.

    PubMed

    Román-P, Cristian; García Aldrete, Alfonso N; Obando, Ranulfo González

    2014-10-14

    Two new species of Elaphopsocoides n. gen. from Valle del Cauca, Colombia, are here described and illustrated. The new genus is related to Elaphopsocus Roesler, but differs from it mostly in the hypandrial projections and in phallosome structure. The female subgenital plate has a distinct, median, posterior projection. The types are deposited in the Entomology Museum, Universidad del Valle (MUSENUV), Santiago de Cali, Colombia.

  2. Instantánea del cáncer de tiroides

    Cancer.gov

    Información sobre las tendencias de incidencia, mortalidad y financiamiento del NCI sobre el cáncer de tiroides; así como ejemplos de actividades del NCI y adelantos en la investigación de este tipo de cáncer.

  3. Instantánea del cáncer de cuello uterino

    Cancer.gov

    Información sobre las tendencias de incidencia, mortalidad y financiamiento del NCI sobre el cáncer de cuello uterino; así como ejemplos de actividades del NCI y adelantos en la investigación de este tipo de cáncer.

  4. Instantánea del cáncer de próstata

    Cancer.gov

    Información sobre las tendencias de incidencia, mortalidad y financiamiento del NCI sobre el cáncer de próstata; así como ejemplos de actividades del NCI y adelantos en la investigación de este tipo de cáncer.

  5. Instantánea del cáncer de estómago

    Cancer.gov

    Información sobre las tendencias de incidencia, mortalidad y financiamiento del NCI sobre el cáncer de estómago; así como ejemplos de actividades del NCI y adelantos en la investigación de este tipo de cáncer.

  6. 62. R.L.T., photographer November 1, 1934 DEL NORTE COUNTY, SECTION ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    62. R.L.T., photographer November 1, 1934 DEL NORTE COUNTY, SECTION D, HIGHWAY 1. REDWOOD CLEARING ON EXISTING LINE, 1-DN-71-A #26, R.L.T. 11-1-34. Stamped office copy. - Redwood National & State Parks Roads, California coast from Crescent City to Trinidad, Crescent City, Del Norte County, CA

  7. Primer registro para Peru del genero Nielsonia Young, 1977 (Hemiptera: Cicadellidae: Cicadellinae: Cicadellini)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    En este articulo se reporta por primera vez para el Peru una especies del genero Nielsonia Young, 1977, de material procedente del Departamento de Tumbes. El genero ha sido reportada anteriormente de Ecuador, como unico registro para Sudamerica, y America Central. El unico especimen hembra encontra...

  8. Instantánea del cáncer de esófago

    Cancer.gov

    Información sobre las tendencias de incidencia, mortalidad y financiamiento del NCI sobre el cáncer de esófago; así como ejemplos de actividades del NCI y adelantos en la investigación de este tipo de cáncer.

  9. [Recommendations to improve the scientific communication process in the Revista Médica del IMSS].

    PubMed

    Álvarez, Ivón

    2016-01-01

    In order to improve the position of the Revista Médica del Instituto Mexicano del Seguro Social among the different journals, in this editorial we enumerate a series of recommendations to ameliorate the practices of the different actors who participate in the scientific communication process of this journal.

  10. Instantánea del cáncer de ovario

    Cancer.gov

    Información sobre las tendencias de incidencia, mortalidad y financiamiento del NCI sobre el cáncer de ovario; así como ejemplos de actividades del NCI y adelantos en la investigación de este tipo de cáncer.

  11. 60. C.J.T., photographer December 23, 1955 KLAMATH RIVER BRIDGE, DEL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    60. C.J.T., photographer December 23, 1955 KLAMATH RIVER BRIDGE, DEL NORTE COUNTY, SECTION A, HIGHWAY 1. DN-1-A #538, KLAMATH RIVER BR. FROM SO. END, 12/23/55, C.J.T. - Redwood National & State Parks Roads, California coast from Crescent City to Trinidad, Crescent City, Del Norte County, CA

  12. 63. G.F.H., photographer July 30, 1932 DEL NORTE COUNTY, SECTION ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    63. G.F.H., photographer July 30, 1932 DEL NORTE COUNTY, SECTION A, HIGHWAY 1. 1-DN A #124, STA. 164=00 SHOWING DRAINAGE CONDITIONS, G.F.H., 7-30-32. - Redwood National & State Parks Roads, California coast from Crescent City to Trinidad, Crescent City, Del Norte County, CA

  13. Instantánea del cáncer de endometrio

    Cancer.gov

    Información sobre las tendencias de incidencia, mortalidad y financiamiento del NCI sobre el cáncer de endometrio; así como ejemplos de actividades del NCI y adelantos en la investigación de este tipo de cáncer.

  14. [Recommendations to improve the scientific communication process in the Revista Médica del IMSS].

    PubMed

    Álvarez, Ivón

    2016-01-01

    In order to improve the position of the Revista Médica del Instituto Mexicano del Seguro Social among the different journals, in this editorial we enumerate a series of recommendations to ameliorate the practices of the different actors who participate in the scientific communication process of this journal. PMID:26820191

  15. Instantánea del cáncer de vejiga

    Cancer.gov

    Información sobre las tendencias de incidencia, mortalidad y financiamiento del NCI sobre el cáncer de vejiga; así como ejemplos de actividades del NCI y adelantos en la investigación de este tipo de cáncer.

  16. Instantánea del cáncer de riñón

    Cancer.gov

    Información sobre las tendencias de incidencia, mortalidad y financiamiento del NCI sobre el cáncer de riñón; así como ejemplos de actividades del NCI y adelantos en la investigación de este tipo de cáncer.

  17. 33 CFR 162.40 - Inland waterway from Delaware River to Chesapeake Bay, Del. and Md. (Chesapeake and Delaware Canal).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... section in 33 CFR part 207. ... River to Chesapeake Bay, Del. and Md. (Chesapeake and Delaware Canal). 162.40 Section 162.40 Navigation... Bay, Del. and Md. (Chesapeake and Delaware Canal). (a) Applicability. The regulations in this...

  18. Efecto del Programa de Entrenamiento “Manejo del Dolor” en la Documentación de Enfermería en el Expediente Electrónico

    PubMed Central

    Monsiváis, María Guadalupe Moreno; Guzmán, Ma. Guadalupe Interial; Flores, Paz Francisco Sauceda; Arreola, Leticia Vázquez

    2012-01-01

    Resumen En el presente trabajo se muestra la importancia de entrenar al personal de enfermería para mejorar la documentación en el expediente electrónico. Se eligió el manejo del dolor por ser un área prioritaria; una alta proporción de pacientes en período post operatorio cursa con dolor, por lo tanto, la documentación debe ser útil para la toma de decisiones clínicas. Se implementó un programa de entrenamiento denominado “Manejo del Dolor” dirigido al personal de enfermería. Se utilizó la tecnología de la información como herramienta para fortalecer el conocimiento con base en la revisión sistemática de la literatura; el personal de enfermería participante seleccionó la mejor evidencia; posteriormente se trabajó en la transferencia de este conocimiento a la práctica a través del diseño de un protocolo para el manejo del dolor. Se concluye que el conocimiento del manejo del dolor es fundamental para que enfermería documente con mayor precisión sus intervenciones. PMID:24199106

  19. Disruption of cytokeratin-8 interaction with F508del-CFTR corrects its functional defect

    PubMed Central

    Colas, Julien; Faure, Grazyna; Saussereau, Emilie; Trudel, Stéphanie; Rabeh, Wael M.; Bitam, Sara; Guerrera, Ida Chiara; Fritsch, Janine; Sermet-Gaudelus, Isabelle; Davezac, Noëlie; Brouillard, Franck; Lukacs, Gergely L.; Herrmann, Harald; Ollero, Mario; Edelman, Aleksander

    2012-01-01

    We have previously reported an increased expression of cytokeratins 8/18 (K8/K18) in cells expressing the F508del mutation of cystic fibrosis transmembrane conductance regulator (CFTR). This is associated with increased colocalization of CFTR and K18 in the vicinity of the endoplasmic reticulum, although this is reversed by treating cells with curcumin, resulting in the rescue of F508del-CFTR. In the present work, we hypothesized that (i) the K8/K18 network may interact physically with CFTR, and that (ii) this interaction may modify CFTR function. CFTR was immunoprecipitated from HeLa cells transfected with either wild-type (WT) CFTR or F508del-CFTR. Precipitates were subjected to 2D-gel electrophoresis and differential spots identified by mass spectrometry. K8 and K18 were found significantly increased in F508del-CFTR precipitates. Using surface plasmon resonance, we demonstrate that K8, but not K18, binds directly and preferentially to the F508del over the WT human NBD1 (nucleotide-binding domain-1). In vivo K8 interaction with F508del-CFTR was confirmed by proximity ligation assay in HeLa cells and in primary cultures of human respiratory epithelial cells. Ablation of K8 expression by siRNA in F508del-expressing HeLa cells led to the recovery of CFTR-dependent iodide efflux. Moreover, F508del-expressing mice topically treated with K8-siRNA showed restored nasal potential difference, equivalent to that of WT mice. These results show that disruption of F508del-CFTR and K8 interaction leads to the correction of the F508del-CFTR processing defect, suggesting a novel potential therapeutic target in CF. PMID:22038833

  20. Instantánea de los cánceres de cerebro y del sistema nervioso central

    Cancer.gov

    Información sobre las tendencias de incidencia, mortalidad y financiamiento del NCI sobre los cánceres de cerebro y del sistema nervioso central; así como ejemplos de actividades del NCI y adelantos en la investigación de estos tipos de cáncer.