Ischaemia in the Heart Due to Atherosclerotic Mechanisms, Flow Anomalies and Vascular Spasm

Author(s):  
Daniel J. Schneck ◽  
Roy B. Davis
Keyword(s):  
2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P34-P35 ◽  
Author(s):  
Michael S Morris

Objective 1) Better recognize pathophysiology of postoperative tonsillectomy hemorrhage. 2) Be able to better differentiate the different types of post-tonsillectomy hemorrhage based upon understanding the vascular physiology and adjust management accordingly. Methods Post-tonsillectomy complications in children and adults were reviewed. 7 cases of hemorrhage, including 5 deaths, were carefully reviewed. Patients ranged between 2–40 years of age. This represents the largest series of post-tonsillectomy deaths reported to date. All postoperative deaths were due to bleeding and cardiopulmonary arrest. Post-mortem analysis was undertaken on those patients. CT angiography was reviewed in one surviving patient and the utility of this type of scanning is discussed. Results Post-tonsillectomy bleeding is one of the most worrisome otolaryngology concerns. Patients with bleeding on postoperative days 2–3 reported episodic bleeding stopping spontaneously. In these patients, the episode of unobserved bleeding signaled a vascular spasm with a likehood of recurrence. When the bleeding recurred it was massive and occured in a uncontrolled setting, leading to a poor outcome. Vascular trauma and spasm is likely. Conclusions Postoperative tonsillectomy bleeding is better managed by differentiating those patients with early stage bleeding on postoperative days 2–3. Direct examination of the operative field is imperative. Ancillary testing including CT angiograpy is helpful in the evaluation.


Author(s):  
Maya Yabumoto ◽  
Murtaza Bharmal ◽  
Morton Kern
Keyword(s):  

PEDIATRICS ◽  
1966 ◽  
Vol 38 (3) ◽  
pp. 444-447
Author(s):  
Yutaka Kikkawa ◽  
Ira Greifer ◽  
Jay Bernstein ◽  
Chester M. Edelmann

Focal scarring has been observed in two patients in a second biopsy of the same kidney. It has been attributed to the trauma of the initial puncture, especially to the late effects of vascular spasm and disruption in a zone surrounding the needle track. To prevent confusion in histologic interpretation, the contralateral kidney should be used for a second biopsy.


Author(s):  
Andrew Davenport ◽  
Todd W. Costantini ◽  
Raul Coimbra ◽  
Marc M. Sedwitz ◽  
A. Brent Eastman ◽  
...  
Keyword(s):  

The Lancet ◽  
1982 ◽  
Vol 320 (8292) ◽  
pp. 268-269 ◽  
Author(s):  
E. Van Den Berg ◽  
K.-D. Rumpf ◽  
H. Fröhlich ◽  
G. Walterbusch ◽  
H. Müller-Vahl ◽  
...  

Author(s):  
Gaurav Chauhan ◽  
Vivek Singh ◽  
R. V. Phadke ◽  
Sapna Yadav ◽  
Abhishek Gupta

Postpartum cerebral angiopathy (PCA) is a rare cause of stroke in the puerperium. It usually presents with episodes of headache, seizures and neurological deficits in early post-partum period in normotensive females. CT, MRI and catheter angiography may demonstrate segmental vasoconstriction that often resolves spontaneously. PPA is generally regarded as a benign, non-relapsing and reversible disease process. We present a clinico-radiological correlative case of isolated corpus callosal hematoma in a post-partum normotensive female with evidence of intracranial vascular spasm and luminal irregularity on CT and catheter angiography. Follow up MR angiography showed resolution of the vasospasm and luminal irregularity. Patient was managed conservatively and showed resolution of the symptoms in follow up visit on 8th week. 


1999 ◽  
Vol 127 (2) ◽  
pp. 505-513
Author(s):  
P Dorigo ◽  
I Maragno ◽  
G Santostasi ◽  
D Fraccarollo

1949 ◽  
Vol 89 (6) ◽  
pp. 583-596 ◽  
Author(s):  
Philip D. McMaster ◽  
Heinz Kruse

Pronounced vascular changes occurring in the ears and claws of mice during anaphylactic shock are described. Practically at once after a foreign serum (pig, horse, or rabbit) enters the blood stream of sensitized animals both the arterial and venous vessels undergo marked, local or generalized constriction in the organs mentioned. Usually spasm of the vessel walls occurs simultaneously in the arteries and veins, but it may appear first in the arteries, or occasionally in the veins. When venous spasm precedes arterial spasm, the true capillaries become distended with cells; if the reverse order holds, the ears appear bloodless. There is no active constriction or dilatation of capillaries; the capillary behavior follows passively the changes in the large vessels. Peripheral vascular spasm occurs while the carotid blood pressure is high, but a few minutes later, while this still holds true, the ear vessels begin to relax and the circulation is resumed. Shortly afterwards the blood pressure falls to levels far below normal, but the vessels remain open. If the circulation of one ear is obstructed while anaphylactic shock is produced, no vascular spasm occurs in it. Release of the obstruction during the animal's recovery results in belated constriction of the blood vessels of this ear although by now the vessels in the other ear are dilated and the general systolic blood pressure is very low. The vascular reactions in the ears appear to be uninfluenced by the blood pressure in the large vessels, and they are not a response to nervous stimuli. They are local in origin. The vascular changes are often not clearly perceptible in the gross but are plainly to be seen under a low power of the microscope. They occur in some sensitized mice exhibiting no manifest signs of shock, differing only in degree from the changes taking place when shock is severe or fatal.


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