scholarly journals A Case of Sudden Death: Subarachnoid Hemorrhage, Pheochromocytoma, Berry Aneurysm

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Ana B. Arevalo ◽  
Jacxelyn Moran ◽  
Stephen Zink ◽  
Binny Khandakar
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Pulseless Electrical Activity ◽  
Young Female ◽  
Aneurysm Rupture ◽  
Medical Emergency ◽  
Uncontrolled Hypertension ◽  
Past Medical History ◽  
Common Cause ◽  
History Of ◽  
The Right

Subarachnoid hemorrhage is a medical emergency. Berry aneurysm rupture is the second most common cause following trauma. Diagnosis is often challenging. Neurogenic heart syndrome often complicates subarachnoid hemorrhage. A concomitant pheochromocytoma can be deadly causing sudden cardiac arrhythmia. Here, we describe a case of subarachnoid hemorrhage with concomitant incidental pheochromocytoma in a relatively young female who died suddenly, diagnosed during autopsy. A 57-year-old Hispanic woman with past medical history of asthma, prediabetes, and uncontrolled hypertension collapsed unexpectedly. She initially had ventricular tachycardia, followed by pulseless electrical activity and finally asystole without response to resuscitation. In the emergency department she was on epinephrine, calcium, naloxone, and tPA with suspected thrombotic stroke. Despite measures, she was pronounced dead. Autopsy revealed subarachnoid hemorrhage due to a ruptured berry aneurysm. Additionally, pheochromocytoma was detected in the right adrenal gland. Subarachnoid hemorrhage has a grave prognosis by itself. This case describes the uncommon detection of pheochromocytoma in the setting of subarachnoid hemorrhage.

scholarly journals October 2021 Critical Care Case of the Month: Unexpected Post-Operative Shock

2021 ◽  
Vol 23 (4) ◽  
pp. 93-97
Author(s):  
Sharanyah Srinivasan ◽  
◽  
Sooraj Kumar ◽  
Benjamin Jarrett ◽  
Janet Campion
Keyword(s):  
Lower Extremity ◽  
Pulseless Electrical Activity ◽  
Spontaneous Circulation ◽  
Intravenous Drug Use ◽  
Past Medical History ◽  
Incision And Drainage ◽  
Lower Extremity Wound ◽  
History Of ◽  
The Right ◽  
Operative Assessment

No abstract available. Article truncated after 150 words. History of Present Illness: A 55-year-old man with a past medical history significant for endocarditis secondary to intravenous drug use, osteomyelitis of the right lower extremity was admitted for ankle debridement. Pre-operative assessment revealed no acute illness complaints and no significant findings on physical examination except for the ongoing right lower extremity wound. He did well during the approximate one-hour “incision and drainage of the right lower extremity wound”, but became severely hypotensive just after the removal of the tourniquet placed on his right lower extremity. Soon thereafter he experienced pulseless electrical activity (PEA) cardiac arrest and was intubated with return of spontaneous circulation being achieved rapidly after the addition of vasopressors. He remained intubated and on pressors when transferred to the intensive care unit for further management. PMH, PSH, SH, and FH: • S/P Right lower extremity incision and drainage for suspected osteomyelitis as above • Distant history of endocarditis related …

Subarachnoid hemorrhage in a case of segmental arterial mediolysis with coexisting intracranial and intraabdominal aneurysms

2012 ◽  
Vol 116 (5) ◽  
pp. 948-951 ◽  
Author(s):  
Ryosuke Matsuda ◽  
Yasuo Hironaka ◽  
Yasuhiro Takeshima ◽  
Young-Su Park ◽  
Hiroyuki Nakase
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Distal Portion ◽  
Dissecting Aneurysm ◽  
Arterial System ◽  
Left Vertebral Artery ◽  
Retroperitoneal Hemorrhage ◽  
Segmental Arterial Mediolysis ◽  
History Of ◽  
The Right ◽  
Distal Anterior Cerebral Artery

The authors report the rare case of a 58-year-old man with segmental arterial mediolysis (SAM) with associated intracranial and intraabdominal aneurysms, who suffered subarachnoid hemorrhage (SAH) due to rupture of an intracranial aneurysm. This disease primarily involves the intraabdominal arterial system, resulting in intraabdominal and retroperitoneal hemorrhage in most cases. The patient presented with severe headache and vomiting. The CT scans of the head revealed SAH. Cerebral angiography revealed 3 aneurysms: 1 in the right distal anterior cerebral artery (ACA), 1 in the distal portion of the A1 segment of the right ACA, and 1 in the left vertebral artery. The patient had a history of multiple intraabdominal aneurysms involving the splenic, gastroepiploic, gastroduodenal, and bilateral renal arteries. He underwent a right frontotemporal craniotomy and fibrin coating of the dissecting aneurysm in the distal portion of the A1 segment of the right ACA, which was the cause of the hemorrhage. Follow-up revealed no significant changes in the residual intracranial and intraabdominal aneurysms. An SAH due to SAM with associated multiple intraabdominal aneurysms is extremely rare. The authors describe their particular case and review the literature pertaining to SAM with associated intracranial and intraabdominal aneurysms.

scholarly journals Long term follow-up in a patient with papillary glioneuronal tumor

2004 ◽  
Vol 62 (3b) ◽  
pp. 869-872 ◽  
Author(s):  
Guilherme Borges ◽  
Leonardo Bonilha ◽  
Ana Silvia Menezes ◽  
Luciano de Souza Queiroz ◽  
Edmur Franco Carelli ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Young Female ◽  
Cystic Mass ◽  
Glioneuronal Tumor ◽  
Surgical Specimen ◽  
Papillary Glioneuronal Tumor ◽  
Parietal Lobes ◽  
Long Term Follow Up ◽  
History Of ◽  
The Right

We report a case of a young female patient with a rare and recently described form of brain tumor. This patient had a history of headache, hemiparesis and motor simple partial seizures. Her investigation revealed a brain tumor involving the left frontal and parietal lobes. The radiological images showed a cystic mass with multiple nodular masses and a rim of contrast enhancement extending from the right parietal cortex to the ipsilateral ventricle and corpus callosum. The patient underwent gross resection of the lesion and the histological analysis of the surgical specimen revealed a pseudopapillary structure formed by delicate vessels intermixed with a fibrillary pattern and bordered by intense astrocytic reaction with Rosenthal fibers. These features correspond to the recently described mixed neuronal-glial neoplasm, the papillary glioneuronal tumor. The patient has been followed for five years since the surgical treatment, without evidence of tumor recurrence, confirming the indolent behavior of this type of tumor.

Cerebral mycotic aneurysm of fungal origin

1978 ◽  
Vol 49 (1) ◽  
pp. 0107-0110 ◽  
Author(s):  
Gulshan K. Ahuja ◽  
Neeraj Jain ◽  
Malini Vijayaraghavan ◽  
Subimal Roy
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Mycotic Aneurysm ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Content Type ◽  
History Of ◽  
The Right ◽  
Internal Carotid Arteries ◽  
Fine Print

✓ A young man who had a long history of sinusitis developed subarachnoid hemorrhage and died. Autopsy showed a mycotic aneurysm of fungal origin at the junction of the right posterior cerebral and internal carotid arteries. Four of five reported cases of fungal aneurysm were due to Aspergillus infection.

scholarly journals Subacute idiopathic pericarditis with a large pericardial effusion in a young adult seven months post COVID-19 (SARS-Cov-2) infection

2021 ◽  
Vol 10 (1) ◽  
pp. 340-342
Author(s):  
Ashan T Hatharasinghe ◽  
Andrey E Manov
Keyword(s):  
Pericardial Effusion ◽  
Time Frame ◽  
Young Female ◽  
Past Medical History ◽  
Active Infection ◽  
Pericardial Window ◽  
Large Pericardial Effusion ◽  
The World ◽  
History Of ◽  
Short Time

The number of COVID-19 (SARS-Cov-2) cases has risen substantially throughout the world, and consequently we are finding there are several extrapulmonary manifestations associated with this disease. Viral pericarditis and pericardial effusion have been reported several times in COVID-19 patients, however the majority of these cases occurred during active infection or within a relatively short time frame afterwards. The following case is a young female with only a past medical history of COVID-19 pneumonia, seven months prior, presenting with abdominal pain and progressively worsening dyspnea. She was subsequently found to have a large pericardial effusion without tamponade, but requiring a pericardial window. Gross pathology showed fibrinous pericarditis. It is suspected her symptoms and pericardial effusion resulted from a subacute idiopathic pericarditis likely as post-viral complication of COVID-19.

scholarly journals Localized Aortic Dissection in a Patient with Polycystic Kidney Disease: A Case Report

2021 ◽  
Vol 6 (04) ◽  
pp. 285-287
Author(s):  
Sarah A. Alkuraydis ◽  
Abdulaziz S. Allihimy ◽  
Osama Smettei ◽  
Rami M Abazid
Keyword(s):  
Chest Pain ◽  
Aortic Dissection ◽  
Acute Chest Pain ◽  
Uncontrolled Hypertension ◽  
Polycystic Kidney ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
The Right ◽  
Multiple Cysts

Aortic dissection (AD) is the most frequent life-threatening aortic disorder. It is commonly associated with hypertension; however, aortic dissection occasionally represents a complication of more complex syndromes. In this article we aim to report. A 40-year-old male patient, with a known case of ADPKD and a strong family history of ADPKD. He presented to the emergency department with prolonged sharp retrosternal chest pain radiating to the back and uncontrolled hypertension. Computed tomography angiography showed a localized dissection flap at the aortic root and multiple cysts in the right kidney. AD is a life-threatening condition and should be suspected in patients presenting with acute chest pain with history of ADPKD.

The Natural History of Cerebral Aneurysms

2017 ◽  
Author(s):  
David Hasan
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Cerebral Aneurysms ◽  
Aneurysm Rupture ◽  
Morbidity And Mortality ◽  
Neurological Dysfunction ◽  
Contributing Factors ◽  
Intracellular Adhesion Molecule ◽  
History Of ◽  
Very High

Subarachnoid hemorrhage (SAH) secondary to rupture of cerebral aneurysms represents a relatively small fraction of strokes (5%) but morbidity and mortality associated with aneurysm rupture remain very high despite advances in the treatment of aneurysmal SAH. Cerebral vasospasm (CV) is the leading cause of delayed morbidity and mortality following aneurysmal subarachnoid hemorrhage, as well as delayed neurological dysfunction 1 to 2 weeks after rupture. Endothelial dysfunction is one of the primary contributing factors to CV following aneurysmal SAH, and this is associated with alterations in intracellular adhesion molecule-1 (ICAM-1), matrix metalloproteinases (MM), and the blood-brain barrier[p63].

Cardiac Tamponade - A Hypothyroidism Associated Emergency: A Report of 2 Cases

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Tripathi S ◽  
◽  
Sharma JB ◽  
Vijayvergia P ◽  
Khichar S ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Young Female ◽  
Medical Emergency ◽  
Myxedema Coma ◽  
First Case ◽  
History Of ◽  
Medical Emergencies ◽  
Recurrent Pericardial Effusion

Pericardial effusion in commonly seen in-patient with hypothyroidism but effusion large enough to cause cardiac tamponade is not a common presenting feature whereas myxedema coma is a commonly defined medical emergency in-patient with hypothyroidism. We report 2 cases of hypothyroid associated medical emergencies. First case is a young female with history of recurrent pericardial effusion presenting to the emergency department with cardiac tamponade and later on diagnosed as having hypothyroidism. The second patient is a known case of hypothyroidism non-compliant to thyroid supplement and presented with lethargy, fatigue, decreased talking and breathlessness who was later diagnosed as having myxedema coma and impending cardiac tamponade. Both the patient required percutaneous pericardiocentesis and improved with medical management.

WED 142 ‘anti-hu syndrome’ – a case of paraneoplastic sensory neuropathy with encephalitis

2018 ◽  
Vol 89 (10) ◽  
pp. A16.3-A16
Author(s):  
Gupta Srishti ◽  
Jaiswal Amit ◽  
Knopp Michael
Keyword(s):  
Sensory Neuropathy ◽  
Middle Lobe ◽  
Past Medical History ◽  
Small Cell Lung ◽  
Mri Brain ◽  
Brain Scan ◽  
History Of ◽  
Right Middle Lobe ◽  
T2 Hyperintensity ◽  
The Right

A 75-year-old female was referred to the neurology outpatients department with a 6 month history of progressive amnesia and cognitive decline as well as symptoms/signs suggestive of a sensory neuropathy. Past medical history included TIA, cervical spondylosis and recent investigation for hyponatraemia which had been attributed to SIADH. She had been a smoker with a 50+pack year history and consumed minimal alcohol. An MRI brain scan demonstrated bilateral hippocampal T2 hyperintensity. A lumbar puncture demonstrated normal CSF constituents and negative viral PCRs. Full autoimmune and paraneoplastic screening was undertaken which was all normal except for a positive anti-Hu antibody. A CT-TAP highlighted a mass lesion in the right middle lobe of the lung and biopsy confirmed small cell lung cancer (T1aN2M0). A diagnosis of anti-Hu antibody related paraneoplastic syndrome was made and an initial treatment course of IV Methylprednisolone was administered. The patient’s cancer was treated with chemotherapy and adjuvant radiotherapy. Despite a good response with regard to her tumour and hyponatraemia, the patient did not improve significantly cognitively. This case highlights the need for awareness of the combination of symptoms/signs of the described ‘anti-Hu syndrome’ with paraneoplastic sensory neuropathy and/or encephalomyelitis.

Salbutamol misuse or abuse with fatal outcome: A case-report

2010 ◽  
Vol 30 (11) ◽  
pp. 1869-1871 ◽  
Author(s):  
Alexandra Boucher ◽  
Christine Payen ◽  
Christelle Garayt ◽  
Hervé Ibanez ◽  
Anne Dieny ◽  
...  
Keyword(s):  
Right Ventricle ◽  
Adrenergic Receptors ◽  
Fatal Outcome ◽  
Lung Edema ◽  
Acute Dyspnea ◽  
Past Medical History ◽  
History Of ◽  
The Right ◽  
Acting Agonist ◽  
Sudden Collapse

Salbutamol is a short-acting agonist of the β2 adrenergic receptors sometimes misused or abused, which can result in various cardiovascular adverse effects. We report one case of fatal salbutamol misuse or abuse in a 36-year-old poorly controlled female asthmatic patient with a past medical history of alcoholism and a recent smoking cessation. She died shortly after hospital admission following acute dyspnea and sudden collapse at home. Toxicological analyses evidenced salbutamol overdose, and necropsy showed acute lung edema and marked dysplasia of the right ventricle and revealed the patient was pregnant. The involvement of an initial disorder of the ventricular rhythm leading to cardiac failure is suggested by the presence of several combined pro-arrhythmogenic factors, such as arrhythmogenic right ventricle dysplasia, hypoxemia related to bronchospasm and salbutamol overdose.

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