Hematoma In Association Research Articles

Traumatic cervical spine subarachnoid hemorrhage with hematoma and cord compression presenting as Brown-Séqüard syndrome: illustrative case.

Spinal hematomas are a rare entity with broad etiologies, which stem from idiopathic, tumor-related, and vascular malformation etiologies. Less common causes include traumatic blunt nonpenetrating spinal hematomas with very few cases being reported. In the present manuscript presents a case report and review of the literature of a rare traumatic entity of a cervical subarachnoid hematoma in association with Brown-Séquard syndrome in a patient on anticoagulants. Searches were performed on PubMed and Embase for specific terms related. A well-documented case of an 83-year-old female taking anticoagulants with traumatic cervical subarachnoid hematoma presenting as Brown-Séquard syndrome was reported. Six similar cases were identified, scrutinized, and analyzed in the literature review. Traumatic blunt nonpenetrating cervical spine subarachnoid hematomas are a rare entity that can happen more specifically in anticoagulant users and in patients with arthritic changes and stenosis of the spinal canal. Rapid neurological deterioration and severe disability warrant early aggressive surgical treatment. This report has the intention to record this case in the medical literature for registry purposes.

A rare complication of chronic subdural hematoma surgery; Subgaleal cerebrospinal fluid leakage. Case Report

Gonderilme tarihi: 25.04.2013 Kabul tarihi: 27.08.2013 Abstract Chronic subdural hematoma is predominantly a disease of the elderly and is rare in children. We report here a rare case of chronic subdural hematoma associated with arachnoid cyst in a 9-year-old child due to ball struck to his head while he was playing football. No altered mental state or focal neurological deficits were observed. The hematoma drainage was performed with one burr-hole. One week later, the patient was admitted to our clinic with complaint of scalp swelling. Physical examination revealed subcutaneous fluctuation beginning from the vertex. The authors reported a case of sports related chronic subdural hematoma in association with arachnoid cyst and a rare complication of subdural hematoma during postoperative period.

Spontaneous Intramural Esophageal Hematoma in Association With Idiopathic Thrombocytopenic Purpura: A Cause of Non-Cardiac Chest Pain

An 81-year-old man presented to the Emergency Department with severe acute onset epigastric and retrosternal chest discomfort with dysphagia coincident with the consumption of a small meal. His medical history was notable for chronic idiopathic thrombocytopenic purpura (ITP) as well as a remote history of a prior cardiac arrest with pacemaker/defibrillator implantation. There was no significant premorbid history of upper gastrointestinal or general constitutional symptomatology. Physical examination was unremarkable aside from audible heart sounds in the epigastrum and moderate epigastric tenderness to palpation.

Spinal Subdural Haematoma in association with anticoagulant therapy, an unusual presentation: a case report and review of literature

A case of spontaneous, atraumatic subdural haematoma involving thoracic region in a 78-year-old woman on an anticoagulant therapy (Warfarin) for atrial fibrillation presented. This patient initially presented with sudden onset headache and giddiness (signs of increased intracranial pressure) followed by an acute onset neuro-deficit in lower limb. After appropriate investigations she was treated with an emergency surgical decompression of involved spinal segment. Post-operatively the patients had complete neurological recovery.

Rectus sheath haematoma following exercise testing: a case report

IntroductionExercise testing is a safe diagnostic procedure which is widely used in the evaluation of patients suspected of having coronary heart disease or for the assessment of the prognosis in patients with established disease. Its complications are mainly cardiac disorders. Here, we report a rectus sheath haematoma as a complication of this procedure in a patient with acute coronary syndrome. To our knowledge, this is the first case report of rectus sheath haematoma in association with exercise testing.Case presentationA 72-year-old Caucasian woman was admitted for acute coronary syndrome. She received conservative treatment including low molecular weight heparin and anti-platelet agents. On the fifth day of her hospital stay, she underwent an exercise test, where no ischaemic response occurred. Several hours later, she experienced pain in the left side of her abdomen. Subsequent investigations revealed a rectus sheath haematoma. The patient underwent surgical haematoma evacuation. A few days later, re-operation was performed for recurrent bleeding in the abdominal wall. The patient had several characteristics known to increase the risk of bleeding during treatment for acute coronary syndrome.ConclusionAwareness of this possible consequence of exercise testing is important for preventing and treating it correctly. For prevention, an assessment of the bleeding risk of the individual patient is necessary before the test, and excessive anticoagulation must be avoided.

Anomalous Renal Effects of Tin Protoporphyrin in a Murine Model of Sickle Cell Disease

In human and murine models of sickle cell disease (SCD), heme oxygenase-1 (HO-1) is induced in the kidney, an organ commonly involved in SCD. The present study assessed the role of HO-1 by using a competitive inhibitor of HO activity, tin protoporphyrin (SnPP), in protocols affording a composite, clinically relevant analysis of the kidney in SCD under unstressed and stressed conditions. Whereas short-term administration of SnPP exerted comparable renal hemodynamic effects in wild-type and sickle mice, chronic administration of SnPP exerted divergent effects: SnPP provoked tubulointerstitial inflammation and up-regulation of injury-related genes in wild-type mice, whereas in sickle mice SnPP reduced expression of injury-related genes and vascular congestion without provoking tubulointerstitial inflammation. SnPP also protected against the heightened sensitivity to renal ischemia observed in sickle mice, preventing ischemia-induced worsening of renal injury in sickle mice above that observed in wild-type mice. Effective and comparable inhibition of HO activity by SnPP in wild-type and sickle mice was confirmed. These findings suggest that induction of HO-1, at least as assessed by this approach, may contribute to renal injury in this murine model of SCD and uncover an experimental maneuver that protects the kidney in murine SCD.

Spinal Chronic Subdural Hematoma in Association With Anticoagulant Therapy

A case of spinal chronic subdural hematoma (SCSDH) in association with anticoagulant therapy was treated surgically. To clarify the etiopathogenesis, clinical presentation, and surgical outcomes of SCSDH. Intracranial chronic subdural hematoma is a well-recognized complication of anticoagulant therapy. However, SCSDH is very rare and its etiopathogenesis is uncertain. A 72-year-old man with SCSDH who had received anticoagulant therapy for atrial fibrillation complained of bilateral lower extremity pain, cramps, and gait disturbance. The patient underwent an operation for evacuation of the hematoma. Lower-extremity pain, cramps, and gait disturbance improved, and the patient was discharged 10 days after surgery. SCSDH should be included in the differential diagnosis of progressive spinal cord and nerve root compression in patients receiving anticoagulant therapy. Prompt diagnosis and early surgical decompression lead to a good outcome.

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

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

External hydrocephalus: a probable cause for subdural hematoma in infancy

Subdural hemorrhage is common in infancy, particularly in the first year of life. The most common cause is nonaccidental (child abuse), with accidental in second place. We present three healthy infants, ages 4, 5, and 7 months that, during an evaluation for macrocephaly, were found to have frontal subdural hematoma in association with prominent extracerebral cerebrospinal fluid spaces (external hydrocephalus). There was no history of trauma or risk factors for child abuse. Skull surveys and ophthalmologic examinations were normal. All infants were neurologically intact and achieved normal developmental milestones in one-year follow-up. We suggest that some infants with external hydrocephalus may be at risk for development of subdural hematoma with minimal or no trauma, most likely secondary to stretching of the bridging veins in the unusually widened subarachnoid spaces. Child abuse, although it should always be kept in mind and should be excluded, may not be the most common cause in this specific context. Ravid S, Maytal J. External hydrocephalus: A probable cause for subdural hematoma in infancy.

Spontaneous spinal epidural haematoma in association with Kasabach-Merritt syndrome

The authors report a case of spontaneous spinal epidural haematoma causing paraplegia secondary to thrombocytopaenia and consumptive coagulopathy from Kasabach-Merritt syndrome. The patient had long-standing multiple subcutaneous and visceral haemangiomas from childhood and developed lumbago and subsequent paraplegia. Evacuation of a spinal epidural haematoma was performed, however, the patient's neurological symptoms did not improve significantly. This case describes the potential risk of bleeding in the spinal column in patients with Kasabach-Merritt syndrome. Prompt diagnosis and management are crucial for an optimal outcome.

Does regional anesthesia improve outcome after surgery?

The benefits and complications associated with regional anesthesia are assessed on the basis of a review of the recent literature. Benefits are separately considered as: (1) effects on hospital discharge; (2) effects on pulmonary function; (3) cardiac benefits; (4) effects on ambulation; (5) effects on metabolic stress responses; and (6) the preemptive effect. Complications reviewed are those of recent interest, and include epidural hematoma in association with anticoagulant therapy, and neural toxicity in association with high-dose local anesthetic.

Nontraumatic Acute Subdural Hematoma

A case of an acute subdural hematoma in association with a hypertensive intracerebral hemorrhage is presented. Scene examination, medical history, and autopsy findings support the conclusion that the subdural hemorrhage was the result of natural disease. Although the majority of acute subdural hematomas occurring in cases of sudden unexpected death involve trauma of some type, they can occur as a result of natural processes, or as a spontaneous phenomenon associated with cortical artery rupture. The literature describing nontraumatic causes of subdural hemorrhage is reviewed.

Fracture of the spine, spinal epidural haematoma and spondylitis

We report the case of a patient suffering from spinal epidural haematoma and thoracic spinal fracture, and from ankylosing spondylitis. Fourteen cases of spinal epidural haematoma in association with ankylosing spondylitis have been reported in the literature, 12 of them at a cervical level. Spinal epidural haematoma found in patients suffering from ankylosing spondylitis share the same clinical picture as other haematomas, the notion of time being the main feature. Serious neurological complications caused the death of five patients. The case we report is singular for its thoracic localization and two attacks of total paralysis both followed by spontaneous and complete recovery. Today, MRI is the best method to reach a clear and reliable diagnosis. Widespread use of MRI will certainly increase the number of diagnoses made. Our patient underwent operation including osteosynthesis using Cotrel-Dubousset instrumentation. This enabled him to resume his professional activities only 30 days after his accident.

Case report: Acute subdural haematoma — an unusual presentation of a meningioma

Acute subdural haemorrhage is usually the result of a head injury, but when it occurs without a history of trauma, an underlying cause must be suspected. An unusual case is described of an acute subdural haematoma in association with a parasagittal meningioma. This is a rare but serious complication of a meningioma and outcome depends upon prompt removal of the tumour.

Extracerebral hematoma in association with dural substitute

Extracerebral hematoma in association with dural substitute

Intracranial Hemorrhage With Vasculitis in Rheumatoid Arthritis

To the Editor.— Edwards has described two patients with intracranial hemorrhage occurring with cerebral arteritis ( Arch Neurol 34:549-555, 1977). One of these cases was a subarachnoid hemorrhage secondary to amphetamine-induced necrotizing angitis. The second was an intracerebral hematoma in association with intracranial arteritis and anticoagulant therapy in a patient with ulcerative colitis. They pointed out that intracranial hemorrhage with cerebral vasculitis is not well recognized. We published a case in the context of CNS vasculitis in rheumatoid disease, 1 itself a rare entity in the literature. The hemorrhagic aspect of the vasculitis was not considered a remarkable feature in that report. In our case, four separate areas of the brain were involved by hemorrhage at at least two different times. The symmetry is remarkable. A review of the eight cases of CNS vasculitis in rheumatoid arthritis 1-7 shows that in only one of these did hemorrhage occur. 5 In this instance (case

Perirenal hematoma in association with renal infarction in sickle-cell trait.

Massive renal infarction with perirenal hematoma formation occurring in sickle-cell trait has not been previously reported. Various renal complications in patients with sickle-cell trait have been described by Harrow (5), Kay (6), and Vix (13), but no cases of extensive renal infarction were included. The present report describes infarction of the kidney and demonstrates the radiographic features of perirenal hematoma in the sickle-cell trait. The association of sickle-cell hemoglobinopathy and hematuria was first reported by Goodwin in 1950. Since then hematuria and renal papillary necrosis have been described in hemoglobin SA, SC, and SD disease (5, 6, 13). Gunnells and Grim (4), reporting hematuria in AD hemoglobinopathy, emphasized that hemoglobinopathies must be considered in cases of “essential” or “unexplained” hematuria. Case Report A 33-year-old Negro laborer was hospitalized with right upper quadrant abdominal pain of twelve hours duration. During the preceding two years the patient had experienced five similar episodes of pain which usually lasted twenty-four hours and had been treated with aspirin by the patient. There was no family history of sickle-cell anemia. On physical examination right costovertebral and right upper quadrant tenderness were present, and there was a questionable right upper quadrant mass. The bowel sounds were active. Hematuria was present. Radiographic studies on admission suggested a mass in the right upper quadrant and a bone infarct in the left femoral head (Fig. 1). Intravenous urography the same day demonstrated a nonfunctioning right kidney. Retrograde pyelography the next morning showed extensive hydronephrosis on the right (Fig. 2) and a renal arteriogram the same afternoon, approximately forty to forty-four hours after the initial symptoms, showed two patent right renal arteries. The small peripheral vessels were irregular, however, with markedly attenuated distal segments (Fig. 3). A nephrogram density was visualized within the large nonopacified mass in the right upper quadrant. The mass was considered to represent a perirenal hematoma secondary to either trauma or cortical infarct with subsequent capsular rupture. The patient denied any flank trauma, but in view of the bone infarct it was suggested that sickling might be responsible for a renal cortical infarct. A sickle test was positive, and hemoglobin electrophoresis revealed hemoglobin A—61.8 per cent, hemoglobin S—36 per cent, hemoglobin A 2—1 per cent, hemoglobin F—1.2 per cent. At surgery stenosis of the ureteropelvic junction was found, explaining the marked hydronephrosis. A large perirenal hematoma surrounding the kidney was evacuated and a right nephrectomy performed. Pathological examination revealed chronic and active pyelonephritis as well as sickled cells in the glomerular capillaries.