scholarly journals Severe heat stroke complicated by multiple cerebral infarctions: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Ryo Kamidani ◽  
Hideshi Okada ◽  
Yuichiro Kitagawa ◽  
Keigo Kusuzawa ◽  
Masahiro Ichihashi ◽  
...  

Abstract Background Heat-related illnesses include symptoms such as heat syncope/cramps, heat exhaustion, and life-threatening heat stroke. Usually, a heat stroke causes cerebellar ataxia, cognitive impairment, dysphagia, and aphasia. We report a very rare case of a patient who developed severe heat stroke complicated by multiple cerebral infarctions. Case presentation An 80-year-old Asian woman was found lying unconscious at her house, with no air conditioner and closed windows; the highest outside temperature was 36.1 °C. She was brought to our hospital unconscious with a high bladder temperature (42.5 °C) and disseminated intravascular coagulation (DIC score 4). She was diagnosed with severe heat stroke and managed with rapid cooling, intravenous fluids therapy, antibiotic therapy, and anti-coagulation therapy for DIC. Anti-coagulation therapy consisted of treatment with recombinant thrombomodulin for 4 days (days 1–4) and recombinant antithrombin for 1 day (day 1). A head computed tomography (CT) and magnetic resonance imaging (MRI) examination were performed on day 3, because she was still unconscious. Diffuse-weighted imaging showed high-signal intensities, indicating multiple lesions. An intracranial magnetic resonance angiography showed normal results. Imaging indicated new multiple cerebellar infarctions complicated with DIC. A tracheotomy was performed on day 9 because her conscious condition had not improved. She was transferred to another hospital for subacute care on day 23. Conclusions Early management of heat stroke using anti-DIC, anti-bacterial, and fluid resuscitation therapy can help prevent complications such as intracranial hemorrhaging.

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 383
Author(s):  
Kojiro Omiya ◽  
Kazuhiro Hiramatsu ◽  
Yoshihisa Shibata ◽  
Masahide Fukaya ◽  
Masahiro Fujii ◽  
...  

Previous studies have shown that signal intensity variations in the gallbladder wall on magnetic resonance imaging (MRI) are associated with necrosis and fibrosis in the gallbladder of acute cholecystitis (AC). However, the association between MRI findings and operative outcomes remains unclear. We retrospectively identified 321 patients who underwent preoperative magnetic resonance cholangiopancreatography (MRCP) and early laparoscopic cholecystectomy (LC) for AC. Based on the gallbladder wall signal intensity on MRI, these patients were divided into high signal intensity (HSI), intermediate signal intensity (ISI), and low signal intensity (LSI) groups. Comparisons of bailout procedure rates (open conversion and laparoscopic subtotal cholecystectomy) and operating times were performed. The recorded bailout procedure rates were 6.8% (7/103 cases), 26.7% (31/116 cases), and 40.2% (41/102 cases), and the median operating times were 95, 110, and 138 minutes in the HSI, ISI, and LSI groups, respectively (both p < 0.001). During the multivariate analysis, the LSI of the gallbladder wall was an independent predictor of both the bailout procedure (odds ratio [OR] 5.30; 95% CI 2.11–13.30; p < 0.001) and prolonged surgery (≥144 min) (OR 6.10, 95% CI 2.74–13.60, p < 0.001). Preoperative MRCP/MRI assessment could be a novel method for predicting surgical difficulty during LC for AC.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
A. M. Zamarayeva ◽  
K. Gopalan ◽  
J. R. Corea ◽  
M. Z. Liu ◽  
K. Pang ◽  
...  

AbstractWe have developed a process for fabricating patient specific Magnetic Resonance Imaging (MRI) Radio-frequency (RF) receive coil arrays using additive manufacturing. Our process involves spray deposition of silver nanoparticle inks and dielectric materials onto 3D printed substrates to form high-quality resonant circuits. In this paper, we describe the material selection and characterization, process optimization, and design and testing of a prototype 4-channel neck array for carotid imaging. We show that sprayed polystyrene can form a low loss dielectric layer in a parallel plate capacitor. We also demonstrate that by using sprayed silver nanoparticle ink as conductive traces, our devices are still dominated by sample noise, rather than material losses. These results are critical for maintaining high Signal-to-Noise-Ratio (SNR) in clinical settings. Finally, our prototype patient specific coil array exhibits higher SNR (5 × in the periphery, 1.4 × in the center) than a commercially available array designed to fit the majority of subjects when tested on our custom neck phantom. 3D printed substrates ensure an optimum fit to complex body parts, improve diagnostic image quality, and enable reproducible placement on subjects.


2016 ◽  
Vol 49 (5) ◽  
pp. 288-294 ◽  
Author(s):  
Antonello Giardino ◽  
Frank H. Miller ◽  
Bobby Kalb ◽  
Miguel Ramalho ◽  
Diego R. Martin ◽  
...  

Abstract Objective: To determine common imaging findings of hepatic epithelioid hemangioendothelioma on magnetic resonance images. Materials and Methods: A search was made of three institutional databases between January 2000 and August 2012. Seven patients (mean age, 47 years; range, 21-66 years; 6 women) with pathology-confirmed diagnosis of hepatic epithelioid hemangioendothelioma who had undergone magnetic resonance imaging were identified. None of the patients had received any treatment for hepatic epithelioid hemangioendothelioma at the time of the initial magnetic resonance imaging examination. Results: Hepatic epithelioid hemangioendothelioma tumors appeared as focal masses in 7/7 patients, greater than 5 in number, with a coalescing lesion in 1/5, and peripheral localization in 6/7. Capsular retraction was present in 4/7, and was associated with peripherally located lesions. Early ring enhancement was appreciated in the majority of lesions in 7/7 patients. Centripetal progressive enhancement was shown in 5/7 patients on venous phase that exhibited a distinctive thick inner border of low signal on venous phase images, and a central core of delayed enhancement. Small lesions did not show this. Conclusion: The combination of multifocal round-configuration lesions that are predominantly peripheral and exhibit early peripheral ring enhancement and late appearance of an inner thick border of low signal and central core of high signal may represent an important feature for hepatic epithelioid hemangioendothelioma.


1987 ◽  
Vol 66 (6) ◽  
pp. 830-834 ◽  
Author(s):  
John L. Doppman ◽  
Giovanni Di Chiro ◽  
Andrew J. Dwyer ◽  
Joseph L. Frank ◽  
Edward H. Oldfield

✓ Magnetic resonance imaging (MRI) was performed on 12 patients with spinal arteriovenous malformations (AVM's). Six lesions were intramedullary, five were dural, and one was in a posterior extramedullary location. Serpentine filling defects similar to the classic myelographic findings were demonstrated within the high-signal cerebrospinal fluid on T2-weighted coronal scans. The intramedullary nidus was identified by MRI as an area of low-signal intensity within the cord in all six intramedullary AVM's. Neither the dural nor the posterior extramedullary lesions showed intramedullary components. It is concluded that MRI may noninvasively provide the initial diagnosis of a spinal AVM and distinguish intramedullary from dural and extramedullary lesions.


2017 ◽  
Vol 26 (1) ◽  
pp. 93-97 ◽  
Author(s):  
Hyun-Jin Son ◽  
In Kyu Yu ◽  
Seong Min Kim

Lymphoplasmacyte-rich meningioma (LPRM) is an extremely rare variant of meningioma, and a small percentage of LPRM may be associated with IgG4-related disease. To date, the coexistence of 2 rare meningioma variants consisting of LPRM and angiomatous meningioma within one neoplasm has not been reported in the literature. A 56-year-old woman presented with episodes of frequent and severe epistaxis that began 4 months ago. Initial magnetic resonance imaging showed localized, heterogeneous, and intermediate to high signal lesion at the odontoid process and clivus. In subsequent magnetic resonance images, the mass grew to the posterior nasopharyngeal wall, and compression to the medulla, and a suspicious enhancement of both distal vertebral arteries became evident even though there was 3 times of partial resection over 17 years. The tumor showed regional and temporal heterogeneity, and atypical features such as mitoses and a high proliferative index were also identified in the area of angiomatous meningioma in addition to LPRM with an increased deposition of IgG4-positive plasma cells within the neoplasm.


2022 ◽  
Author(s):  
Naoko Ogura ◽  
Mieko Inagaki ◽  
Ritsuko Yasuda ◽  
Shigeki Yoshida ◽  
Tetsuo Maeda

A fibroepithelial stromal polyp is a benign soft tissue tumour that can occur in the vagina, vulva and uterine cervix. Magnetic resonance imaging (MRI) findings have been reported in patients with vulvar fibroepithelial stromal polyps, not in those with vaginal polyps. We present MRI findings of vaginal fibroepithelial stromal polyp in a postmenopausal female. A 1 to 2 cm firm vaginal mass arising from the left side of the vaginal wall with hypointense signal changes on T1W MRI was identified. A well-defined vaginal mass (1 cm diameter) was detected with inhomogeneous signal intensity on T2W images. However, a major portion had high signal intensity on diffusion-weighted images. A benign vaginal lesion with oedematous changes or myxoid degeneration was suspected. Vaginal resection was performed, and fibroepithelial stromal polyp was pathologically diagnosed. MRI may be a useful non-invasive modality for preoperatively diagnosing vaginal fibroepithelial stromal polyps.


2015 ◽  
Vol 22 (05) ◽  
pp. 546-553
Author(s):  
Sajid Ali Mustafvi ◽  
Nadeem Yousaf ◽  
Zainab Amjad ◽  
Tahir Ahamd Munir ◽  
Syed Shoiab Shah ◽  
...  

Objective: To study the adaptive strategies from harmful effect of heat waveon an urban, educated, well to do subjects for a period of May to July 2014.Data Source:250 selected young students of RIHS. Design of Study: Descriptive Study. Setting: RawalInstitute of Health Sciences, Islamabad. Period: March – July 2014. Method: A questionnairewas circulated among the students of Rawal Institute of Health Sciences Islamabad regardingeffects of heat and measures taken to combat its effects. Results: A total of 250 urban studentswith mean age of 19.77±1.10 years were inducted in the study, having resources to face theextreme heat. A significant number of female non boarder students (p=0.000), wearing cottonclothes (p=0.000) having fair skin (p=0.000) and using air condition at homes (p=0.000) werenot acclimatized to heat waves still have headache and anxiety. A great percent of students didnot complaint of headache, heat exhaustion, heat cramp or syncope, except mild sweating,effect on studies. A great percentage (>65%) of students complained of malaise, nauseavomiting. Male students showed increase thirst than female, while anxiety state was noticedmore in female than male students. Conclusion: The use of cotton clothing, daily bathing,increased water intake and use of air conditioner minimized the severe adverse effects likeheat exhaustion, heat syncope, and heat stroke, although the minor effects like skin tanning,disturbed sleep, anxiety and adverse effects on studies cannot be avoided in heat wave season.


2017 ◽  
Vol 65 (5) ◽  
pp. 1146 ◽  
Author(s):  
RaviK Jakkani ◽  
VijayK Agarwal ◽  
Suryanarayana Anasuri ◽  
Sriharish Vankayalapati ◽  
Rahul Koduri ◽  
...  

2020 ◽  
Vol 9 (11) ◽  
pp. 205846012097054
Author(s):  
Georgia Hyde ◽  
Andrew Fry ◽  
Ashok Raghavan ◽  
Elspeth Whitby

Background Less invasive techniques for fetal post-mortems are increasingly used to correlate with parental wishes. With the use of post-mortem magnetic resonance imaging (MRI), normal appearance of the organs must be established. Purpose To investigate the after death appearance of the fetal meconium throughout gestation using the hyperintense appearance of meconium on T1 weighted MRI. Material and Methods This was a retrospective study that took place in a tertiary referral centre radiology department. Sixty-two fetal body post-mortem MRI scans (January 2014 to May 2018) between 12 and 41 weeks gestation were reviewed. Signal intensity of meconium at the rectum, sigmoid colon, splenic flexure and hepatic flexure was evaluated and correlated with gestational age. Interrater reliability was calculated. Results Meconium did not consistently have high signal intensity on T1 scans and was not always obvious. Rectal meconium had the highest intensity, and the more proximal the bowel the lower the intensity. The meconium had higher intensity at earlier gestations. Interrater reliability for rectal meconium gradings was excellent. Conclusion This study provides the first published primary research on the appearance of fetal meconium on post-mortem MRI. Overall, results were variable and suggest an alteration of bowel contents after death, but further investigation is needed to effectively inform practice.


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