scholarly journals Case Report on Subarachnoid Hemorrhage

Author(s):  
Reshma Tighare ◽  
Ranjana Sharma

Introduction: Subarachnoid haemorrhage (SAH) is caused by intracranial bleeding into the cerebrospinal fluid-filled space between the arachnoid and pia mater membranes on the surface of the brain. Patient History: The 65-year-old female patient was hospitalised to AVBR hospital in neurosurgery ward on December 25, 2020 with the chief complaints of headache, vomiting and episodes of seizures since three days. The patients had episodes of seizures on 21/12/2020 and 24/12/2020. The day later she was admitted to the Intensive Care Unit.she underwent all routine investigations like blood tests, and CT scan. After a thorough examination, the final diagnosis was subarachnoid haemorrhage. Past History: Patient did not have any history of communicable disease, asthma, tuberculosis, or any hereditary disease. Patient was COVID – negative and did not have any significant surgical history. Pharmacology: Patient was treated with proton pump inhibitor, antiemetic, antiepileptic, calcium channel blocker, stool softener analgesic and antipyretic. Management: Inj. Levipril 500 mg, Inj.pan40-40mg, cap.nimodipine 60mg every four hourly, Inj.emset 4 mg, Inj. Neomol 100 ml, Syp. glycerol 30 ml, Syp. Zincovit 2tsp and Tablet Dolo 650mg. Nursing Management: Patient’s vital sign (including blood pressure) and neurological status were monitored with bed rest, pain management and assessment of risk of bleeding. Conclusion: Patient was hospitalised with a threeday history of headache, vomiting, and episodes of seizures actively managed; condition satisfactory.

Cephalalgia ◽  
1993 ◽  
Vol 13 (6) ◽  
pp. 427-430 ◽  
Author(s):  
Matthew Jackson ◽  
Graham Lennox ◽  
Timothy Jaspan ◽  
David Jefferson

Vasospasm is a rare cause of cerebrovascular disease except following subarachnoid haemorrhage. We describe a woman who developed an explosive-type sex headache, followed by a series of severe migrainous headaches associated with fully reversible segmental cerebral arterial narrowing and dilatation, resulting in widespread infarction in cerebral arterial border zones. This led to transient loss of consciousness and multiple focal cortical deficits including blindness. She had a past history of migraine and a family history of both migraine and sex headaches. Similar cases have been reported in the literature under a variety of rubrics. We suggest that this newly recognized clinico-radiological syndrome is a migraine variant.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Arti Khatri ◽  
Nidhi Mahajan ◽  
Niyaz Ahmed Khan ◽  
Natasha Gupta

Abstract Background Mixed cortico-medullary adrenal carcinoma (MCMAC) is an extremely rare entity with scarce literature on its cytomorphology. Case presentation A 2-year-old girl presented with abdominal pain for 3 days and a past history of fever with significant weight loss. On examination, a non-tender left hypochondrial firm mass and an enlarged left supraclavicular node were found. Twenty-four-hour urinary levels of VMA were marginally high. Contrast-enhanced computed tomography of the abdomen showed a suprarenal heterogeneous mass encasing major vessels. Aspiration cytology of both mass and node showed similar features comprising a predominant population of singly scattered large cells with moderate cytoplasm, eccentric nucleus and prominent nucleolus in a necrotic background. Tumour cells expressed Synaptophysin and Melan-A. In view of increasing respiratory distress, debulking surgery was performed, and histopathology of the specimen revealed the presence of both malignant medullary and cortical components supported by immunohistochemistry making a final diagnosis of MCMAC. The patient succumbed to death in the postoperative period. The cytology slides were reviewed and were seen to show a dual cell population. Conclusion Coexistent malignant cortical and medullary tumour of the adrenal gland is the first case reported in the paediatric age group in the literature with only three previous case reports in adults.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Ossama Mansour ◽  
Tamer Hassen ◽  
Sameh Fathy

Spontaneous pure acute bilateral subdural haematoma (ASDH) without intraparenchymal or subarachnoid haemorrhage caused by a ruptured cerebral aneurysm is extremely rare. It can follow rupture of different aneurysms specially located in anterior incisural space; the most frequently encountered location is the PcoA aneurysms as demonstrated in the present case. We present a case report of a PcoA aneurysm presenting as pure bilateral ASDH. A high level of suspicion for bleeding of arterial origin should be maintained in all cases of acute subdural haematoma without history of trauma. The neurological status on admission dictates the appropriate timing and methodology of the neuroradiological investigations.


Author(s):  
Yidong Gao ◽  
Man Qu ◽  
Chao Song ◽  
Lufeng Yin ◽  
Min Zhang

AbstractCerebral vasculitis is a long-standing but flourishing and fadeless research topic. Infections are a frequent cause of cerebral vasculitis, vital to diagnose due to involvement of specific anti-infection treatments. A 65-year-old man visited the hospital for his neurological symptoms without obvious inducements. After admission, radiological examination and comprehensive conventional microbiological tests (CMTs) revealed suspected intracranial infectious vasculitis. Metagenomic next-generation sequencing (mNGS) and reverse transcription-polymerase chain reaction further confirmed that his cerebral vasculitis was caused by Talaromyces marneffei (T. marneffei) and Aspergillus niger (A. niger) co-infection. The patient’s final diagnosis changed from initial herpetic encephalitis, due to the past history of cephalosome and facial herpes and non-significant antiviral therapeutic effects, to fungal cerebral vasculitis. The patient was discharged after use of targeted antifungal therapies on day 18 of his admission, and his associated symptoms disappeared completely at follow-up 3 weeks later. We first illustrated the presence of uncommon cerebral vasculitis caused by T. marneffei and A. niger in a human immunodeficiency virus-positive patient. In clinically suspected patients with infectious cerebral vasculitis, mNGS should be performed to detect potential pathogens if CMTs may not provide useful pathogenic clues, highlighting the importance of mNGS in the diagnosis and treatment of infectious diseases.


2002 ◽  
Vol 91 (2) ◽  
pp. 423-427 ◽  
Author(s):  
John G. Seamon ◽  
John D. Guerry ◽  
Gregory P. Marsh ◽  
Michael C. Tracy

Research suggests that individuals may differ in their susceptibility to false memory in the Deese/Roediger and McDermott procedure. Prior studies of differences have focused on the effects of age, personality, personal past history of abuse, and neurological status on false memory susceptibility. This study examined whether sex might also differentially influence false memory. After listening to a series of word lists designed to elicit false recall of nonstudied associates, 50 male and 50 female college students free recalled the lists. Analysis showed no sex difference in accurate recall, false recall, or unrelated intrusions. A robust false memory effect was observed, but sex did not differentiate performance.


2014 ◽  
pp. 140-152
Author(s):  
Manh Hoan Nguyen ◽  
Ngoc Thanh Cao

Background and Objective: HIV infection is also a cause of postpartum depression, however, in Vietnam, there has not yet the prevalence of postpartum depression in HIV infected women. The objective is to determine prevalence and related factors of postpartum depression in HIV infected women. Materials and Methods: From November 30th, 2012 to March 30th, 2014, a prospective cohort study is done at Dong Nai and Binh Duong province. The sample includes135 HIV infected women and 405 non infected women (ratio 1/3) who accepted to participate to the research. We used “Edinburgh Postnatal Depression Scale (EPDS) as a screening test when women hospitalized for delivery and 1 week, 6weeks postpartum. Mother who score EPDS ≥ 13 are likely to be suffering from depression. We exclude women who have EPDS ≥ 13 since just hospitalize. Data are collected by a structural questionaire. Results: At 6 weeks postpartum, prevalence of depression in HIV infected women is 61%, in the HIV non infected women is 8.7% (p < 0.001). There are statistical significant differences (p<0.05) between two groups for some factors: education, profession, income, past history of depression, child’s health, breast feeding. Logistical regression analysis determine these factors are related with depression: late diagnosis of HIV infection, child infected of HIV, feeling guilty of HIV infected and feeling guilty with their family. Multivariate regression analysis showed 4 factors are related with depression: HIV infection, living in the province, child’s health, past history of depression. Conclusion: Prevalence of postpartum depression in HIV infected women is 61.2%; risk of depression of postnatal HIV infected women is 6.4 times the risk of postnatal HIV non infected women, RR=6.4 (95% CI:4.3 – 9.4). Domestic women have lower risk than immigrant women from other province, RR=0.72 (95% CI:0.5 – 0.9). Past history of depression is a risk factor with RR=1.7 (95% CI:1.02 – 0.9. Women whose child is weak or die, RR=1.7(95% CI:0.9 – 3.1). Keywords: Postpartum depression, HIV-positive postpartum women


Author(s):  
Bahram Mashhoon

A postulate of locality permeates through the special and general theories of relativity. First, Lorentz invariance is extended in a pointwise manner to actual, namely, accelerated observers in Minkowski spacetime. This hypothesis of locality is then employed crucially in Einstein’s local principle of equivalence to render observers pointwise inertial in a gravitational field. Field measurements are intrinsically nonlocal, however. To go beyond the locality postulate in Minkowski spacetime, the past history of the accelerated observer must be taken into account in accordance with the Bohr-Rosenfeld principle. The observer in general carries the memory of its past acceleration. The deep connection between inertia and gravitation suggests that gravity could be nonlocal as well and in nonlocal gravity the fading gravitational memory of past events must then be taken into account. Along this line of thought, a classical nonlocal generalization of Einstein’s theory of gravitation has recently been developed. In this nonlocal gravity (NLG) theory, the gravitational field is local, but satisfies a partial integro-differential field equation. A significant observational consequence of this theory is that the nonlocal aspect of gravity appears to simulate dark matter. The implications of NLG are explored in this book for gravitational lensing, gravitational radiation, the gravitational physics of the Solar System and the internal dynamics of nearby galaxies as well as clusters of galaxies. This approach is extended to nonlocal Newtonian cosmology, where the attraction of gravity fades with the expansion of the universe. Thus far only some of the consequences of NLG have been compared with observation.


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
B Kewlani ◽  
I Hussain ◽  
J Greenfield

Abstract The hallmark symptom of spontaneous intracranial hypotension (SIH) is orthostatic headaches which manifests secondary to cerebrospinal fluid (CSF) hypovolaemia. Well-recognised aetiologies include trauma which includes procedures such as lumbar punctures and spinal surgery. More recently, structural defects such as bony osteophytes and calcified or herniated discs have been attributed to mechanically compromising dural integrity consequently resulting in CSF leak and symptom manifestation. A thorough literature review noted only a handful of such cases. We report the case of a thirty-two-year-old Asian female who presented with a one-month history of new-onset progressively worsening orthostatic headaches. Workup included MRI of the thoracic spine which revealed an epidural collection of CSF consequently prompting a dynamic CT-myelogram of the spine which not only helped to confirm severe cerebral hypotension but also suggested the underlying cause as being a dorsally projecting osteophyte-complex at level T2-3. Conservative and medical management including bed rest, analgesia, mechanical compression, and epidural blood patches failed to alleviate symptoms and a permanent surgical cure was eventually sought. The surgery involved T2-T3 laminectomy and osteophytectomy and at a 3-month follow-up, complete resolution of symptoms was noted.


2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S163-S164
Author(s):  
K G Manjee ◽  
W G Watkin

Abstract Introduction/Objective Cervical biopsy is performed following an abnormal pap smear or positive HPV testing in an attempt to uncover clinically significant lesions [HSIL/invasive carcinoma (HSIL+)]. An excisional procedure is considered if biopsy confirms HSIL+. When preceded by pap smear of LSIL, ASCUS, NILM/HPV+ or persistent HPV, continued surveillance is recommended for biopsies showing no SIL or LSIL. In our laboratory, cervical biopsies are routinely sectioned at 3 levels. Deeper levels are often ordered when initial sections are non-diagnostic. p16 immunohistochemistry, with or without deeper levels, is often ordered to confirm HSIL, or to differentiate HSIL from mimics. In this study, we examine whether and in what clinical situations does obtaining additional levels uncover clinically significant lesions. Methods 430 cervical biopsies between January-May 2018, with recent cytology of LSIL, ASCUS or NILM/HPV+ were identified in the pathology database. HPV status (if known), final biopsy diagnosis and past history of LSIL/HSIL were recorded. For each biopsy, orders for additional levels and/or p16 immunohistochemistry were recorded resulting in 4 categories: C1-no additional levels or p16, C2-deeper only, C3-deeper+p16 and C4-p16 only. Final diagnoses were divided into HSIL+, LSIL and no SIL. Results There was no significant difference in prior history of LSIL/HSIL and HPV status between all categories. Biopsy results were as follows: HSIL+: 11/222 (5%) C1; 1/78 (1%) C2; 7/43 (16%) C3; 15/87 (17%) C4 LSIL: 91/222 (41%) C1; 7/78 (9%) C2; 16/43 (37%) C3; 35/87 (40%) C4 No SIL: 120/222 (54%) C1; 70/78 (90%) C2; 20/43 (46%) C3; 37/87 (42%) C4 The average number of additional levels in C2 and C3 was 3.8 and 1.8, respectively. Conclusion Deeper levels alone did not enhance the detection of HSIL+. Almost all LSIL/HSIL were detected when initial levels were diagnostic or suspicious and supported by p16 immunohistochemistry. 3 levels are adequate to detect clinically significant lesions.


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