Acute Management of Intracranial Hemorrhage in Patients Receiving Thrombolytic Therapy: Case Reports

Neurosurgery ◽  
1990 ◽  
Vol 26 (5) ◽  
pp. 867-869 ◽  
Author(s):  
Scott M. Eleff ◽  
Cecil Borel ◽  
William R. Bell ◽  
Donlin M. Long
Keyword(s):  
Early Diagnosis ◽  
Thrombolytic Therapy ◽  
Intracranial Hemorrhage ◽  
Antithrombotic Therapy ◽  
Perioperative Management ◽  
Case Reports ◽  
Acute Management ◽  
Anticoagulant Treatment ◽  
Life Threatening ◽  
Uncommon Complication

Abstract Intracranial hemorrhage is an uncommon complication of antithrombotic therapy. We present two patients who suffered life-threatening intracranial bleeding as a complication of thrombolytic/anticoagulant treatment. Early diagnosis and treatment appear to be crucial factors for survival. We suggest an approach to perioperative management for intracranial hemorrhage resulting from antithrombotic therapy.

scholarly journals Subcutaneous emphysema: how can we prevent and treat it?

2021 ◽  
Vol 31 (3) ◽  
pp. 24-28
Author(s):  
Elisa Siqueira-Mendes ◽  
◽  
Pamella Santana-Nunes ◽  
F BritodeMelo-Silva ◽  
SC Sartoretto-Lorenzi ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Subcutaneous Emphysema ◽  
Clinical Case ◽  
Case Reports ◽  
Third Molar ◽  
Compressed Air ◽  
Local Infection ◽  
Secondary Complications ◽  
Fascial Spaces ◽  
Uncommon Complication

Subcutaneous emphysema is described as an uncommon complication resulting from the passage of compressed air to the fascial planes and is associated, in dentistry, with restorative, endodontic treatments, periodontal surgery and extractions, the latter with a higher incidence. Early diagnosis, appropriate approach and ordering of imaging tests prevent secondary complications, such as local infection and progression to deep cervical and thoracic fascial spaces. Thus, the present clinical case reports the transoperative occurrence of subcutaneous emphysema during extraction of the lower third molar, its indicated treatment and how we can avoid this type of complication

scholarly journals Nasogastric Tube Syndrome; Severe Complication Associated with Nasointestinal ileus Tube: A Case Report and Literature Review

2020 ◽  
Author(s):  
Kenkichiro Taira ◽  
Kazunori Fujiwara ◽  
Fukuhara Takahiro ◽  
Satoshi Koyama ◽  
Tsuyoshi Morisaki ◽  
...  
Keyword(s):  
Case Report ◽  
Early Diagnosis ◽  
Literature Review ◽  
Nasogastric Tube ◽  
Early Recognition ◽  
Proper Treatment ◽  
Proper Management ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Uncommon Complication

Abstract BackgroundNasogastric tube syndrome induced by nasointestinal ileus tube is uncommon complication and potentially life-threatening complication. The early detection and proper treatment for NGTS is necessary.Case presentaionWe describe a case of a 78-year-old patient with this syndrome induced by nasointestinal ileus tube. The symptom of this syndrome was improved by immediate proper management. Immediate removal of tube and early recognition of symptom are the first step in treatment for this syndrome, in addition to initiation of steroids, proton pomp inhibitor and antibiotic therapy. The cause of NGTS is supposed to be a continuous pressure on hypopharynx and cervical esophagus.ConclusionsNasogastric tube syndrome should be considered in patients not only with nasogastric tube but also nasointestinal ileus tube. Early diagnosis and proper management for NGTS are important

scholarly journals Multidisciplinary management of the pregnant patient in haemorrhagic shock secondary to an undiagnosed ruptured liver adenoma

2020 ◽  
Vol 13 (2) ◽  
pp. e231995
Author(s):  
Brittany Sanford ◽  
Catherine Hoeppner ◽  
Tammy Ju ◽  
Brian K Theisen ◽  
Anna BuAbbud ◽  
...  
Keyword(s):  
General Surgery ◽  
Case Reports ◽  
Hepatocellular Adenoma ◽  
Multidisciplinary Care ◽  
Exploratory Laparotomy ◽  
Pregnant Patient ◽  
Haemorrhagic Shock ◽  
Liver Adenoma ◽  
Life Threatening ◽  
Temporary Closure

Management of a ruptured hepatocellular adenoma during pregnancy is a rare and potentially life-threatening entity. Few case reports have described management of the pregnant patient who presents in haemorrhagic shock secondary to a ruptured liver adenoma. A 30-year-old primigravid woman at 31 weeks pregnant presented with abdominal pain and fetal bradycardia. After stat caesarean delivery of the infant, she had continued hemoperitoneum and was in shock secondary to an undiagnosed ruptured liver mass. General surgery was consulted intraoperatively and performed an exploratory laparotomy, packing and temporary closure. She was subsequently taken to interventional radiology (IR) for angioembolisation of the left hepatic artery. After stabilisation, she underwent formal abdominal closure. Management of a ruptured hepatocellular adenoma in pregnancy requires urgent multidisciplinary care including obstetrics gynaecology, general surgery and IR.

Peaked “T” Waves with Tranylcypromine (Parnate) Overdose

1982 ◽  
Vol 11 (2) ◽  
pp. 155-160 ◽  
Author(s):  
Timothy E. Quill
Keyword(s):  
Monoamine Oxidase ◽  
Intracranial Hemorrhage ◽  
Case Reports ◽  
Monoamine Oxidase Inhibitors ◽  
Toxic Effects ◽  
Recent Case ◽  
Clinical Use ◽  
Ecg Changes ◽  
T Waves

A case of tranylcypromine (Parnate) overdose is presented in which the main toxic effects were headache, obtundation, hypertension, and diffusely peaked T-waves on ECG. The latter effect, which occurred in the absence of hyperkalemia, has not been previously associated with monoamine oxidase inhibitors (MAOI). Recent case reports of tranylcypromine toxicity are briefly reviewed, confirming the potential for hypertension, hypotension, shock, hyperpyrexia, intracranial hemorrhage, agitation, hyperkinesis, coma and death in association with overdosage, or concommitant ingestion of sympathomimetic substances or other drugs. These ECG changes add to the worrisome list of potential toxicities in an era in which MAOI are finding increased clinical use.

scholarly journals Valproate semisodium-induced encephalopathy: diet and polypharmacy interactions

2012 ◽  
Vol 36 (4) ◽  
pp. 137-139 ◽  
Author(s):  
Nuno Rodrigues Silva ◽  
Ângela Venâncio
Keyword(s):  
Case Reports ◽  
Adult Population ◽  
Paediatric Population ◽  
Valproate Semisodium ◽  
Bipolar I Disorder ◽  
Life Threatening ◽  
Life Threatening Complication

SummaryDespite extensive use of valproate in neurology and psychiatry, valproate-induced encephalopathy is a rarely reported complication. Although initially reported in the paediatric population, case reports are growing in the adult population.Clinicians need to be aware of this potentially life-threatening complication. We report a case in a 37-year-old woman with bipolar I disorder with previously uncomplicated valproate use, who developed encephalopathy when valproate was restarted a few years later. The patient has provided consent for publication.

HIV/AIDS and traditional healers: a blessing in disguise

2010 ◽  
Vol 50 (3) ◽  
pp. 154-155
Author(s):  
B L Meel
Keyword(s):  
Case Reports ◽  
Health Care Systems ◽  
Traditional Healers ◽  
Immunodeficiency Virus ◽  
Herbal Decoction ◽  
Care Systems ◽  
Life Threatening ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
Hiv Aids

Traditional healers contribute significantly to the level of health-care systems in Africa. They could play an important role in the prevention and care of patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in the community. The traditional healing system deals with psychosocial stress associated with HIV/AIDS as well as herbal medications. Sometimes, herbal medicine causes serious life-threatening complications. Two case reports are presented in this article. The first is a 48-year-old woman with HIV who was made to drink a large volume of a herbal decoction to stimulate vomiting in the belief that cleansing the bowel would rid the system of the disease. The second is a 25-year-old young man who had a herbal enema, which resulted in gangrene of the large bowel. The case histories, mechanism of action and causes of death are discussed.

HYDRAMNIOS AS AN AID TO THE EARLY DIAGNOSIS OF CONGENITAL OBSTRUCTION OF THE ALIMENTARY TRACT: A STUDY OF THE MATERNAL AND FETAL FACTORS

PEDIATRICS ◽  
1958 ◽  
Vol 21 (6) ◽  
pp. 903-909
Author(s):  
James R. Lloyd ◽  
H. William Clatworthy
Keyword(s):  
Early Diagnosis ◽  
Alimentary Tract ◽  
Case Reports ◽  
Perinatal Period ◽  
University Hospital ◽  
Diagnostic Significance ◽  
Children's Hospital ◽  
Obstructive Disease ◽  
Children’S Hospital ◽  
The University

ALTHOUGH the association between hydramnios and congenital anomalies of the alimentary tract of the fetus has been recognized for more than 75 years, little emphasis has been placed upon this prenatal maternal abnormality as an aid to the earlier diagnosis of obstructive disease in the newborn. With the exception of isolated case reports which were summarized by Taussig in 1927 and the more recent observations of Mengert and Bourland, Castanier et al., and Clatworthy and Lloyd, the diagnostic significance of this relationship has not received proper recognition. Fortunately, today, the majority of anatomic abnormalities of the alimentary tract which are encountered in the neonate can be surgically corrected, if the diagnosis can be established and the treatment instituted before the infant has deteriorated irreversibly. A more general appreciation of the importance of hydramnios as a diagnostic sign of obstructive disease by physicians responsible for the care of the infant during the perinatal period should improve infant salvage. Recent surveys of our experience at the Columbus Children's Hospital with neonates having obstructing lesions of the esophagus or intestine attracted our attention to the fact that many of these infants were delivered of mothers who suffered from acute or chronic hydramnios. In an effort to determine the significance of the interrelationship between hydramnios in the mother and congenital obstruction of the alimentary tract in the fetus, a study was undertaken which included not only a survey of all infants admitted to the Children's Hospital with alimentary tract obstruction but also an analysis of a series of obstetric cases at the University Hospital in women with pregnancy complicated by hydramnios.

Ischemic stroke as a presenting manifestation of polycythemia vera: a narrative review

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Marco Burattini ◽  
Lorenzo Falsetti ◽  
Eleonora Potente ◽  
Claudia Rinaldi ◽  
Marco Bartolini ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Early Diagnosis ◽  
Polycythemia Vera ◽  
Case Reports ◽  
Previous History ◽  
Recurrence Risk ◽  
Narrative Review ◽  
Stroke Recurrence ◽  
Increased Risk

Abstract Polycythemia vera (PV) is a myeloproliferative disorder associated with an increased risk of cerebrovascular diseases. In this narrative review, we aimed to analyze the relationships between acute ischemic stroke and PV. We conducted a PubMed/Medline and Web of Sciences Database search using MeSH major terms. We found 75 articles and finally considered 12 case reports and 11 cohort studies. The ischemic stroke resulted as the first manifestation of PV in up to 16.2% of cases; the cumulative rate of cerebrovascular events was up to 5.5 per 100 persons per year and stroke accounted for 8.8% of all PV-related deaths; age, mutations, and a previous history of thrombosis were the main risk factors. The best approach to reduce stroke recurrence risk is unclear, even if some evidence suggests a potential role of lowering hematocrit below 45%. Ischemic stroke represents one of the most common PV manifestations but, despite their relationship, patients with both diseases have a very heterogeneous clinical course and management. PV-related strokes often remain underdiagnosed, especially for the low prevalence of PV. An early diagnosis could lead to prompt treatment with phlebotomy, cytoreduction, and low-dose aspirin to decrease the risk of recurrences. Clinicians should be aware of PV as a risk factor for stroke when approaching the differential diagnosis of cryptogenic strokes. An early diagnosis could positively influence patients’ management and clinical outcomes. Further studies are required to evaluate the role of PV treatments in the prevention of cerebrovascular disease.

POTT’S PUFFY TUMOR: A CASE REPORT

2020 ◽  
Vol 18 (Suppl.1) ◽  
pp. 93-96
Author(s):  
V. Stoyanov ◽  
D. Petkov ◽  
P. Bozdukova
Keyword(s):  
Case Report ◽  
Early Diagnosis ◽  
Rare Complication ◽  
Frontal Bone ◽  
Frontal Sinusitis ◽  
Subperiosteal Abscess ◽  
Prompt Treatment ◽  
Pott’S Puffy Tumor ◽  
Intracranial Complications ◽  
Life Threatening

Pott’s puffy tumor (PPT) is a rare complication of sinusitis characterized by osteomyelitis of the frontal bone with subperiosteal abscess presenting as frontal swelling. It was first described by Sir Percival Pott in 1768 in relation to frontal head trauma. Later, it was established that this entity is more common in relation to frontal sinusitis (1). In this article we report a case of PPT in a 17-year-old boy. CT scan confirmed subperiosteal abscess. At surgery, the subperiosteal abscess was drained and sequestrectomy of the affected frontal bone was done. Broad-spectrum antibiotics were given for 4 weeks. The patient recovered without residual problems and has remained well. PPT is now relatively uncommon and early diagnosis and prompt treatment is necessary to avoid further intracranial complications, which can be life-threatening.

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