• Title/Summary/Keyword: Acute hemorrhage

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A Fatal Intracerebral Hemorrhage Complicated by Compartment Syndrome of the Upper Arm (상지 구획 증후군 이후 발생한 치명적인 뇌출혈)

  • Han, In-Bo;Chung, Young-Sun;Shin, Dong Eun;Huh, Ryoong;Chung, Sang-Sup;Ahn, Jung-Yong
    • Journal of Trauma and Injury
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    • v.19 no.2
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    • pp.178-182
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    • 2006
  • Compartment syndrome has a wide spectrum from muscle pain to a life- threatening condition, such as acute renal failure and disseminated intravascular coagulation (DIC). Intracerebral hemorrhage (ICH) due to compartment syndrome has not been reported. We report a patient who presented with ICH leading to death. A 25-year-old female with no significant past history developed extensive compartment syndrome followed by rhabdomyolysis, acute renal failure, DIC, and ICH. Although the patient underwent a fasciotomy and hemodialysis and received aggressive resuscitation with massive transfusions of blood and intravenous fluids, she died. This case stresses the importance of early diagnosis and prompt treatment of compartment syndrome to prevent devastating complications.

Association of Carotid Intraplaque Hemorrhage and Territorial Acute Infarction in Patients with Acute Neurological Symptoms Using Carotid Magnetization-Prepared Rapid Acquisition with Gradient-Echo

  • Park, Jung Soo;Kwak, Hyo Sung;Lee, Jong Myong;Koh, Eun Jeong;Chung, Gyung Ho;Hwang, Seung Bae
    • Journal of Korean Neurosurgical Society
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    • v.57 no.2
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    • pp.94-99
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    • 2015
  • Objective : The purpose of our study was to assess prevalence of carotid intraplaque hemorrhage (IPH) and associations between territorial acute infarction and IPH on magnetization-prepared rapid acquisition with gradient-echo (MPRAGE) in patients with acute neurologic symptoms. Methods : 83 patients with suspected acute neurologic symptoms were evaluated with both brain diffusion weighted imaging (DWI) and carotid MPRAGE sequences. Carotid plaque with high signal intensity on MPRAGE of >200% that of adjacent muscle was categorized as IPH. We analyzed the prevalence of IPH and its correlation with territorial acute infarction. Results : Of 166 arteries, 39 had a carotid artery plaque. Of these arteries, 26 had carotid artery stenosis less than 50%. In all carotid arteries, MR-depicted IPH was found in 7.2% (12/166). High-signal intensity on DWI was found in 17.5% (29/166). Combined lesion with ipsilateral high-signal intensity on DWI and IPH on carotid MPRAGE sequence was found in 6 lesions (6/166, 3.6%). Of patients with carotid artery plaque, MR-predicted IPH was found in 30.8% (12/39) and match lesions with high-signal intensity on DWI and MPRAGE was found in 15.4% (6/39). MR-predicted IPH was significantly higher prevalence in high-grade stenosis group (p=0.010). Relative risk between carotid MPRAGE-positive signal and ipsilateral high-signal intensity on DWI in arteries with carotid artery plaques was 6.8 (p=0.010). Conclusion : Carotid MPRAGE-positive signal in patients was associated with an increased risk of territorial acute infarction as detected objectively by brain DWI. The relative risk of stroke was increased in high-grade stenosis categories.

A rare case of childhood-onset systemic lupus erythematosus associated end-stage renal disease with cerebral abscess and hemorrhage

  • Jee Hyun Kim;Jae Il Shin; Ji Hong Kim;Keum Hwa Lee
    • Childhood Kidney Diseases
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    • v.28 no.1
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    • pp.44-50
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    • 2024
  • Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease that affects multiple organs. More than half of the patients with SLE have kidney involvement, and up to 10% of patients with lupus nephritis develop end-stage renal disease (ESRD). Central nervous system (CNS) involvement in SLE occurs in 21% to 95% of patients. Severe neurological manifestations such as seizures, cerebrovascular disease, meningitis, and cerebrovascular accidents can develop in childhood-onset SLE, but cerebral infections, such as brain abscess and hemorrhage, are seldom reported in lupus nephritis, even in adults. Here, we report a rare case of childhood-onset SLE with ESRD, cerebral abscess, and hemorrhage. A 9-year-old girl diagnosed with lupus nephritis was administered high-dose steroids and immunosuppressant therapy to treat acute kidney injury (AKI) and massive proteinuria. The AKI deteriorated, and after 3 months, she developed ESRD. She received hemodialysis three times a week along with daily peritoneal dialysis to control edema. She developed seizures, and imaging showed a brain abscess. This was complicated by spontaneous cerebral hemorrhage, and she became unstable. She died shortly after the hemorrhage was discovered. In conclusion, CNS complications should always be considered in clinical practice because they increase mortality, especially in those with risk factors for infection.

Pathologic Studies on Cottonseed Meal Poisoning in Chicken (가계(家鷄)의 면실박중독(綿實粕中毒)에 관(關)한 병리학적(病理學的) 연구(硏究))

  • Lee, Jae Houn
    • Korean Journal of Veterinary Research
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    • v.7 no.2
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    • pp.46-50
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    • 1967
  • The pathologic studies on the cottonseed meal poisoning in chicken were performed by feeding a diet containing 50 per cent cottonseed meal. The results obtained are summarized as follows: The specific effect of cottonseed meal on chicken was apparently limited to the parenchymatous tissue and blood vessels, where its major pathologic manifestations were degenerative changes in acute cases fed for a period of 7 days, while necrosis of portal and central veins of liver and consequent perivascular hemorrhage and coagulative necrosis of liver and intra-glomerular hemorrhage were characteristic lesions in chronic cases fed for a period 20, 40 and 60 days. In addition, specific cottonseed pigment cells were observed in small number in villus of small intestine in acute cases and in large number in villus, liver and spleen in chronic cases.

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Acute Spontaneous Subdural Hematoma due to Rupture of a Tiny Cortical Arteriovenous Malformation

  • Choi, Hyuk Jin;Lee, Jae Il;Nam, Kyoung Hyup;Ko, Jun Kyeung
    • Journal of Korean Neurosurgical Society
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    • v.58 no.6
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    • pp.547-549
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    • 2015
  • Acute subdural hematoma (SDH) of arterial origin is rare, especially SDH associated with an arteriovenous malformation (AVM) is extremely rare. The authors report a case of acute spontaneous SDH due to rupture of a tiny cortical AVM. A 51-year-old male presented with sudden onset headache and mentality deterioration without a history of trauma. Brain CT revealed a large volume acute SDH compressing the right cerebral hemisphere with subfalcine and tentorial herniation. Emergency decompressive craniectomy was performed to remove the hematoma and during surgery a small (5 mm sized) conglomerated aciniform mass with two surrounding enlarged vessels was identified on the parietal cortex. After warm saline irrigation of the mass, active bleeding developed from a one of the vessel. The bleeding was stopped by coagulation and the vessels were removed. Histopathological examination confirmed the lesion as an AVM. We concluded that a small cortical AVM existed at this area, and that the cortical AVM had caused the acute SDH. Follow up conventional angiography confirmed the absence of remnant AVM or any other vascular abnormality. This report demonstrates rupture of a cortical AVM is worth considering when a patient presents with non-traumatic SDH without intracerebral hemorrhage or subarachnoid hemorrhage.

Detection of Cyanide and Arsenic from Oral Tissues of Acute Poisoned Rabbits (급성중독가토의 치아 및 악골에서의 청산 및 비소검출에 관한 실험적 연구)

  • 임동원;김종열
    • Journal of Oral Medicine and Pain
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    • v.8 no.1
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    • pp.83-96
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    • 1983
  • The purpose of this study was detection of the poison from the acute cyanide and aresenic poisoned rabbits, The author administered KCN and $AS_2O_3$ to rabbits and caused acute poisoning, then analysed the teeth, dental pulp and jaws of the rabbits chemicotoxicologically and observed the specimen histopathologically. 1. In subcutaneausly injected group of KCN, a large amount of cyanide was detected in blood and lung and a small amount of cyanide was detected in teeth and dental pulp, but was not detected in jaws. 2. In orally administered group of KCN a large amount of cyanide was detected in blood, lung and dental pulp and a small amount of cyanide was detected in teeth and jaws. 3. In orally administered group of $AS_2O_3$, arsenic was detected markedly in teeth and jaws, but was detected a little in dental pulp. 4. In orally administered and heat-treated group of KCN, the author could detected cyanide in teeth, dental pulp and jaws. 5. In suvcutanelusly injected group of KCN, orally administered group of KCN and orally dministered group of $AS_2O_3$, histopathologic findings showed the congestion and hemorrhage in dental pulp. 6. In orally administerd group of $AS_2O_3$, the congestion and hemorrhage in buccal mucosa were found and the basal cell degeneration and fibrosis were found in palatal mucosa.

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Predicting Factors Affecting Clinical Outcomes for Saccular Aneurysms of Posterior Inferior Cerebellar Artery with Subarachnoid Hemorrhage

  • Hong, Young-Ho;Kim, Chang-Hyun;Che, Gil-Sung;Lee, Sang-Hoon;Ghang, Chang-Gu;Choi, Yu-Seok
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.327-331
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    • 2011
  • Objective : The aim of this study is to investigate the clinical outcomes of surgery and coiling and analyze the predicting factors affecting the clinical outcomes of ruptured posterior inferior cerebellar artery (PICA) aneurysms. Methods : During the last 15 years, 20 consecutive patients with ruptured PICA aneurysms were treated and these patients were included in this study. The Fisher's exact test was used for the statistical significance of Glasgow Outcome Scale (GOS) according to initial Hunt-Hess (H-H) grade, treatment modalities, and the presence of acute hydrocephalus. Results : Eleven (55%) and nine (45%) patients were treated with surgical clipping and endovascular treatment, respectively. Among 20 patients, thirteen (65.0%) patients had good outcomes (GOS 4 or 5). There was the statistical significance between initial poor H-H grade, the presence of acute hydrocephalus and poor GOS. Conclusion : In our study, we suggest that initial H-H grade and the presence of acute hydrocephalus may affect the clinical outcome rather than treatment modalities in the ruptured PICA aneurysms.

Efficacy and General Pharmacology of Recombinant Human Erythropoietin(DA-3285) (Recombinant Human Erythropoietin(DA-3285)의 효력 및 일반약리작용)

  • 김동환;안병옥;손문호;신명수;이성희;김원배;양중익
    • Biomolecules & Therapeutics
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    • v.4 no.1
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    • pp.68-77
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    • 1996
  • Efficacy and general pharmacology of recombinant human erythropoietin (rHu-EPO), were investigated. Efficacy studies were conducted in normal, cisplatin- and acute hemorrhage-induced anemic rats. Normal and anemic animals were treated intravenously with rHu-EPO for 5 days and the changes in the numbers of red blood cells (RBC), hemoglobin (Hb), hematocrit (Hct) and reticulocytes (Ret) were examined. In normal rats, rHu-EPO significantly increased RBC, Hb, Hct and Ret at doses of 50∼ 1250 IU/kg/day. Cisplatin-induced anemic rats showed significant increase of RBC, Hb, Hct and Ret in a dose-dependent manner after administration of rHu-EPO (50∼200 lU/kg/day). And in acute hemorrhage-induced anemic rats, rHu-EPO(4∼100 Iu/kg/day) accelerated recovery of anemia with significant increase in Ret. These changes disappeared gradually after cessation of the treatment. The general pharmacological effects of rHu-EPO were investigated in mice, rats, guinea-pigs, rabbits and cats. rHu-EPO had no influences on central nervous, cardiovascular, gastrointestinal and blood coagulation system. It also had no influence on the contraction of phrenic nerve-diaphragm preparation. rHu-EPO produced significant increase of urine volume at a dose of 7000 IU/kg. These results suggest that rHu-EPO might be useful for the therapy of anemia without serious side effect.

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Multiple, Sequential, Remote Intracranial Hematomas Following Cranioplasty

  • Moon, Hong-Joo;Park, Ju-No;Kim, Sang-Dae;Lim, Dong-Jun;Park, Jung-Yul
    • Journal of Korean Neurosurgical Society
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    • v.42 no.3
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    • pp.228-231
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    • 2007
  • The intracranial hemorrhage in regions remote from the site of initial operations is unusual but may present as fatal surgical complication. We report a rare case of multiple, sequential, remote intracranial hematomas after cranioplasty in a patient who did not have any prior risk factors. A 51-years-old man was transferred to the hospital after a head trauma. The brain computed tomography (CT) revealed acute subdural hemorrhage on the right hemisphere with prominent midline shifting. After performing decompressive craniectomy and hematoma removal, the patient recovered without any complications. However, the patient showed neurological deterioration immediately after cranioplasty, which was done three months after the first surgery. There was extensive hemorrhage in the posterior fossa remote from the site of the initial operation site. The brain CT taken soon after removing this hematoma evacuation displayed large epidural hematoma on the left hemisphere. This case represents posterior fossa hemorrhage after supratentorial procedure and sequential delayed hematoma on the contralateral supratentorial region thus seems very rare surgical complications. Despite several possible pathogenetic mechanisms for such remote hematomas, there are usually no clear cut relationships with each case as in our patient. However, for the successful outcome, prompt evaluation and intensive management seem mandatory.

The Motility of Esophagus in Acute Hemorrhage (급성실혈시의 식도운동)

  • Park, Soon-Il;Shin, Dong-Hoon
    • The Korean Journal of Physiology
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    • v.6 no.2
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    • pp.39-48
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    • 1972
  • Two polyethylene tubes were inserted into the esophagus of anesthetized rabbit in order to record the fluctuation of the intraluminal pressure through the orifices located near the tips of the tubes. The orifice of the first tube was 10 cm apart from the incisor of the rabbit and the orifice of the second tube was 5 cm below that of the first one. The tubes were filled with saline solution running at various rates ranging from 1.5 ml/min. to 4.2 ml/min. The tubes were connected to the pressure transducers and the electrical signals were recorded by the physiograph. When the peristaltic wave approached to the orifice a rise in the pressure was recorded, returning to the base line when the portion of the orifice was quiescent. The frequency of the peristaltic motion and the velocity of the wave were studied in connection with the flow rate of saline solution through the tubes and in the case of massive acute hemorrhage. The results obtained were as follows: 1. There was reflux of fluid induced during the procedure of the experiment. This outwrad flow through the pharynx seemed to elicite swallowing reflexes. Accordingly, the frequency of peristalsis of the esophagus was largely dependent on the flow rate of the fluid through the inserted tubes. By the flow rate of 1.5 ml/min., 2.5 ml/min., or 4.2 ml/min., the frequencies of the peristalsis were revealed to be $8.6{\pm}3.6/10min.,\;14.5{\pm}4.8/10min.\;or\;21.1{\pm}6.3/10min.,$ respectively. The velocity of peristalsis also coincided with the enhanced motility of the esophagus, showing $6.6{\pm}1.5\;cm/sec.,\;8.9{\pm}3.9\;cm/sec.,\;or\;12.4{\pm}4.6\;cm/sec.,$ respectively. 2. By acute hemorrhage, amounting to 2% of the body weight, the frequency of the peristalsis increased to twofold of the control and the propagation velocity also increased by 52 percent. 3. Retransfusion of the shed blood resulted in divergent responses. In some cases there were noticable ameliorations of the effects brought by acute hemorrhage, and in the others there were still increasing tendenies of the motility after the transfusion. 4. Some speculation was made about the possibility of a kind of relationship between the irreversibility of the hemorrhagic shock and the absence of responses by transfusion. 5. The peristalsis persisted even after complete disconnection at the midportion of the esophagus, reaffirming the view of a central regulation of the spatiotemporally coordinated motility, peristalsis.

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