scholarly journals Scalp congenital hemangioma with associated high-output cardiac failure in a premature infant: Case report and review of literature

2016 ◽  
Vol 23 (1) ◽  
pp. 102-106 ◽  
Author(s):  
Sumedh S Shah ◽  
Brian M Snelling ◽  
Samir Sur ◽  
Alexandra R Ramnath ◽  
Emmalee S Bandstra ◽  
...  
Keyword(s):  
Premature Infant ◽  
Cardiac Failure ◽  
Neonatal Intensive Care ◽  
Vascular Malformations ◽  
Arterial Embolization ◽  
Venous Drainage ◽  
Occipital Artery ◽  
Sagittal Sinus ◽  
Doppler Ultrasound Imaging ◽  
High Output

Introduction Scalp congenital hemangiomas (CHs) are rare vascular malformations among infants; they can be associated with an array of complications, including cardiac and cosmetic issues. Here, we report the endovascular treatment of a premature infant with a suspected large right parietal scalp hemangioma and associated high-output cardiac failure. Case description A two-day-old female premature infant (29 weeks gestational age; 1330 g birth weight) was referred by the neonatologists to our department for consultation and potential treatment of a large right parietal CH causing abrupt hypotension and high-output cardiac failure. Doppler ultrasound imaging at bedside revealed areas of arterial-venous shunting from the scalp and the presence of a superior sagittal sinus waveform, consistent with intracranial venous drainage. To alleviate cardiac dysfunction secondary to this lesion, trans-arterial embolization via n-butyl cyanoacrylate (nBCA) glue and deployment of detachable coils was performed via umbilical artery to occlude the right superficial temporal and occipital artery branches supplying the CH. Following treatment, the infant continued to require ventilator management, vasopressor support, and correction of coagulopathy, but by post-operative day two, her condition improved remarkably and the mass size began decreasing. The patient was discharged after a relatively uncomplicated subsequent 2½-month course in the neonatal intensive care unit. Conclusion Endovascular therapy proved effective and safe in treating cardiac failure associated with scalp CH, despite potential complications associated with neuro-interventional surgery in premature infants. Appropriate consideration in this patient population should be given to factors including blood loss, contrast use, radiation exposure, operative time, and possible intra-/post-operative complications.

Intraosseous Arteriovenous Malformations Mimicking Malignant Disease

1988 ◽  
Vol 29 (1) ◽  
pp. 109-114 ◽  
Author(s):  
S. J. Savader ◽  
B. L. Savader ◽  
R. R. Otero
Keyword(s):  
Surgical Treatment ◽  
Cardiac Failure ◽  
Arteriovenous Malformations ◽  
Malignant Disease ◽  
Vascular System ◽  
Arterial Embolization ◽  
Initial Work ◽  
Work Up ◽  
High Output

Primary (congenital) intraosseous arteriovenous malformations are rare, accounting for less than one per cent of all primary intraosseous lesions. They are quite variable in their gross and microscopic presentation, yet all can be traced to anomalous development of the primitive vascular system. They may be totally asymptomatic, cosmetically disfiguring, painful, or on rare occasions, cause high-output cardiac failure. Surgical treatment is often unrewarding with recurrence not uncommon. Intra-arterial embolization has shown promising results. We present three cases of primary intraosseous arteriovenous malformations which on initial work-up mimicked malignant disease. Arteriography proved diagnostic in all three cases.

scholarly journals Hereditary Hemorrhagic Telangiectasia Presenting as High Output Cardiac Failure during Pregnancy

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Tareq Goussous ◽  
Alex Haynes ◽  
Katherine Najarian ◽  
Marcos Daccarett ◽  
Shukri David
Keyword(s):  
Cardiac Failure ◽  
Hereditary Hemorrhagic Telangiectasia ◽  
Preterm Labor ◽  
Vascular Malformations ◽  
Rare Complication ◽  
Pregnant Patient ◽  
Non Invasive ◽  
Hepatic Involvement ◽  
History Of ◽  
High Output

High-output cardiac failure secondary to hepatic involvement is a rare complication of hereditary hemorrhagic telangiectasia (HHT). Here we report a 43-year-old woman who presented at 29 weeks gestation of her second pregnancy with complications of right-sided heart failure and preterm labor. After delivery via cesarean section, the patient was found to have intrahepatic arteriovenous malformations through non-invasive imaging. Subsequently, a family history of vascular malformations and epistaxis was elucidated and a diagnosis of HHT was made. This case is presented, along with a review of the literature and discussion of hepatic involvement in HHT with particular focus on the pregnant patient.

scholarly journals High output cardiac failure in 3 patients with hereditary hemorrhagic telangiectasia and hepatic vascular malformations, evaluation of treatment

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Lilian B. Olsen ◽  
Anette D. Kjeldsen ◽  
Mikael K. Poulsen ◽  
Jens Kjeldsen ◽  
Annette D. Fialla
Keyword(s):  
Liver Transplantation ◽  
Orthotopic Liver Transplantation ◽  
Cardiac Failure ◽  
Hereditary Hemorrhagic Telangiectasia ◽  
Arteriovenous Malformations ◽  
Vascular Malformations ◽  
Symptom Relief ◽  
Case Series ◽  
Hospital Treatment ◽  
High Output

Abstract Background This report addresses how patients with hereditary hemorrhagic telangiectasia (HHT) and high output cardiac failure (HOCF) due to hepatic vascular malformations, should be evaluated and could be treated. HHT is a genetic disorder, leading to vascular abnormalities with potentially serious clinical implications. In the liver, arteriovenous malformations occur in more than 70% of patients, but only about 8% present clinical symptoms such as HOCF with pulmonary hypertension and less commonly portal hypertension, biliary ischemia and hepatic encephalopathy. Results Three female patients with HHT type 2 and HOCF caused by severe arteriovenous malformations in the liver are presented in this case series. The patients were seen at the HHT-Centre at Odense University Hospital. Treatment with either orthotopic liver transplantation (one patient) or bevacizumab (two patients) was initiated. All patients experienced marked symptom relief and objective improvement. New York Heart Association—class were improved, ascites, peripheral edema and hence diuretic treatment was markedly reduced or discontinued in all three patients. Bevacizumab also resulted in notable effects on epistaxis and anemia. Conclusion Our findings substantiate the importance of identification of symptomatic arteriovenous malformations in the liver in patients with HHT. Bevacizumab may possibly, as suggested in this case series and supported by previous case studies, postpone the time to orthotopic liver transplantation or even make it unnecessary. Bevacizumab represents a promising new treatment option, which should be investigated further in clinical trials.

Management of dural arteriovenous malformations of the anterior cranial fossa

1990 ◽  
Vol 72 (5) ◽  
pp. 692-697 ◽  
Author(s):  
Neil A. Martin ◽  
Wesley A. King ◽  
Charles B. Wilson ◽  
Stephen Nutik ◽  
L. Phillip Carter ◽  
...  
Keyword(s):  
Arteriovenous Malformations ◽  
Vascular Malformations ◽  
Venous Drainage ◽  
Anterior Cranial Fossa ◽  
Venous Aneurysm ◽  
Content Type ◽  
Cortical Vein ◽  
Sagittal Sinus ◽  
Feeding Vessels ◽  
Cranial Fossa

✓ Eight patients with dural arteriovenous malformations (AVM's) of the anterior cranial fossa are presented, and the pertinent literature is reviewed. Unlike cases of dural AVM's in other locations, sudden massive intracerebral hemorrhage was the most frequent reason for presentation. Other symptoms included tinnitus, retro-orbital headache, and a generalized seizure. The malformations were supplied consistently by the anterior ethmoidal artery, usually in combination with other less prominent feeding vessels. The lesion's venous drainage was through the superior sagittal sinus via a cortical vein; in addition, in two cases a subfrontal vein drained the AVM. A venous aneurysm was encountered near the site of anastomosis with the dural feeder in most cases, and was found in all patients who presented with hemorrhage. The AVM was obliterated surgically in six patients, with favorable results achieved in five. One patient died postoperatively from a pulmonary complication. Because of their anatomy and proclivity for hemorrhage, these vascular malformations represent a unique group of dural AVM's. Surgical management of anterior fossa dural AVM's carries low morbidity, and is indicated when the lesions have caused hemorrhage or when there is an associated venous aneurysm.

Case 3: Premature Infant with Anemia and High-Output Cardiac Failure

NeoReviews ◽  
2018 ◽  
Vol 19 (11) ◽  
pp. e690-e693
Author(s):  
Scott A. Weiner ◽  
Gil Talmon ◽  
Marina Peniakov ◽  
Clari Felszer-Fisch
Keyword(s):  
Premature Infant ◽  
Cardiac Failure ◽  
High Output

scholarly journals Dural Arteriovenous Fistula within Superior Sagittal Sinus Wall with Direct Cortical Venous Drainage: A Systematic Literature Review

2021 ◽  
Author(s):  
Rajendra Chavan ◽  
Shreya Sethi ◽  
Harsha Sahu ◽  
Neeraj Rao ◽  
Shivani Agarwal
Keyword(s):  
Literature Review ◽  
Treatment Option ◽  
Systematic Literature Review ◽  
Superior Sagittal Sinus ◽  
English Literature ◽  
Venous Drainage ◽  
Sagittal Sinus ◽  
Complete Obliteration ◽  
Cortical Venous Drainage ◽  
Special Subgroup

AbstractDural arteriovenous fistulas (DAVFs) located within superior sagittal sinus (SSS) wall with direct cortical venous drainage are rare. They are also known as variant DAVF (vDAVF) and form a special subgroup of DAVFs. Their chance of presenting with aggressive features is high compared with transverse sigmoid sinus fistula. They drain directly into cortical veins (Borden type 3, Cognard type III and IV). A systematic English literature review of SSS vDAVF was made. Systematic literature review revealed a total of 31 published cases. These were commonly seen in male population, (24 males, 77.41%, 24/31). Average age of patients was 54 years. A total of 24 patients (77.41%, 24/31) had aggressive clinical presentations with 13 patients (41.93%, 13/31) having intracranial hemorrhages (ICH). Two patients had rebleeding (15.38%, 2/13). Middle portion of SSS was commonly involved (15 cases, 75%). A total of 25 (96.15%, 25/26) cases had patent SSS. Most of the fistulas were idiopathic (65.38%, 17/26), with trauma being a frequent etiological factor (26.92%, 7/26). Venous ectasia was seen in 19 patients (59.37%, 19/32). Middle meningeal arterial (MMA) supply was seen in all patients (100%, 26/26), with bilateral MMA supply in 21 cases (80.76%), and unilateral in 5 cases (19.23%). Twenty patients (62.50%, 20/32) received only endovascular treatment (EVT), while four patients had EVT followed by surgery (12.5%, 4/32). Transarterial route via MMA was the preferred treatment option (79.16%). Complete obliteration of fistulas was noted in all cases (100%, 30/30). No immediate complication was noted after EVT. As much as 92.30% patients showed good recovery. Thus, SSS vDAVF forms a special subgroup of DAVF, with aggressive presentation, and warrants urgent treatment. EVT is effective treatment option and can produce complete obliteration.

scholarly journals Using a behavior analytics approach to change nursing care of extremely premature infants: A pilot study

2018 ◽  
Vol 9 (5) ◽  
pp. 14
Author(s):  
Jenn Gonya ◽  
Jessica Niski ◽  
Nicole Cistone
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pilot Study ◽  
Neonatal Intensive Care Unit ◽  
Premature Infant ◽  
Premature Infants ◽  
Nursing Care ◽  
Neonatal Intensive Care ◽  
Extremely Premature Infant

The neonatal intensive care unit (NICU) is, inherently, a trauma environment for the extremely premature infant. This trauma is often exacerbated by nurse caregiving practices that can be modified and still remain effective. Our study explored how behavior analytics could be used to implement an intervention known as Care by Cues and how the intervention might, ultimately, impact infant physiologic stability.

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