OC3.04.1 CLINICAL PRESENTATION AND NATURAL HISTORY OF PORTAL CAVERNOMA (PC) IN 60 PATIENTS WITH AND WITHOUT LIVER CIRRHOSIS

Abstract Purpose of the Review Non-cirrhotic portal hypertension (NCPH) includes a heterogeneous group of conditions. The aim of this paper is to make an overview on the denominations, diagnostical features and management of porto-sinusoidal vascular disease (PSVD) and chronic portal vein thrombosis (PVT) being the main causes of NCPH in the Western world. Recent Findings The management of NCPH consists in the treatment of associated diseases and of portal hypertension (PH). PH due to PSVD or PVT is managed similarly to PH due to cirrhosis. TIPS placement and liver transplantation are considerable options in patients with refractory variceal bleeding/ascites and with progressive liver failure. Anticoagulation is a cornerstone both in the treatment of thrombosis in PSVD and in the prevention of thrombosis recurrence in patients with portal cavernoma. Summary Physicians should be aware of the existence of PSVD and chronic PVT and actively search them in particular settings. To now, the management of portal hypertension-related complications in NCPH is the same of those of cirrhosis. Large cooperative studies on the natural history of NCPH are necessary to better define its management.

Download Full-text

Clinical Presentation and Natural History of Mesothelioma: Abdominal

Malignant Mesothelioma ◽

10.1007/0-387-28274-2_25 ◽

2006 ◽

pp. 391-401 ◽

Cited By ~ 4

Author(s):

Claire F. Verschraegen ◽

Charles R. Key ◽

Raffit Hassan

Keyword(s):

Natural History ◽

Clinical Presentation ◽

History Of

Download Full-text

Clinical Presentation and Natural History of Osteoarthritis

Advances in MRI of the Knee for Osteoarthritis ◽

10.1142/9789814271714_0002 ◽

2010 ◽

pp. 27-67

Author(s):

Ehsan Saadat ◽

Radu I. Bolbos ◽

Michael D. Ries

Keyword(s):

Natural History ◽

Clinical Presentation ◽

History Of

Download Full-text

Spontaneous thrombosis of internal carotid artery: a natural history of giant carotid cavernous aneurysms

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2009000200020 ◽

2009 ◽

Vol 67 (2a) ◽

pp. 278-283 ◽

Cited By ~ 12

Author(s):

Lucas Perez de Vasconcellos ◽

Juan Antônio Castro Flores ◽

Mário Luiz Marques Conti ◽

José Carlos Esteves Veiga ◽

Carmen Lúcia Penteado Lancellotti

Keyword(s):

Carotid Artery ◽

Natural History ◽

Internal Carotid Artery ◽

Collateral Circulation ◽

Internal Carotid ◽

Clinical Presentation ◽

Spontaneous Thrombosis ◽

Related Factors ◽

Trigeminal Neuropathy ◽

History Of

OBJECTIVE: To describe five cases of giant carotid cavernous aneurysms which evolved with spontaneous thrombosis of internal carotid artery (STICA), with emphasis at epidemiology, clinical presentation, natural history, related factors and neurological outcome. METHOD: There were 711 consecutives patients with 802 aneurysms with and without surgical treatment during a period of 19 years. We selected 35 patients with 40 carotid cavernous aneurysms (5%) of which 20 (50%) were giant aneurysms. Among those cases, 5 patients evolved with STICA (25%). Symptoms and findings at presentation were recorded and compared with those at outcome. RESULTS: Clinical presentation was commonly related to atherosclerotic factors such as elevated blood pressure (80%), diabetes mellitus (40%) and dislipidemy (40%). All patients presented with hemicranial headache, ophthalmparesy and retro bulbar pain, and after STICA all presented improvement of symptoms. After STICA, 4 patients had regression of deficit, 2 partial and 2 complete. Four patients had sensorial trigeminal neuropathy in V1 and V2 territories, also showing improvement of symptoms after STICA. CONCLUSION: STICA is a common outcome in giant carotid cavernous aneurysms, and is related with significant improvement of symptoms; however, it may be catastrophic for those patients without efficient collateral circulation.

Download Full-text