• Title/Summary/Keyword: Hemorrhagic

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외상환자의 전산화 단층촬영소견에서 나타난 달무리 소견의 임상적 유용성 (The Clinical Usefulness of Halo Sign on CT Image of Trauma Patients)

  • 이승용;손유동;안희철;강구현;최정태;안무업;서정열
    • Journal of Trauma and Injury
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    • 제20권2호
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    • pp.144-148
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    • 2007
  • Purpose: The management of hemorrhagic shock is critical for trauma patients. To assess hemorrhagic shock, the clinician commonly uses a change in positional blood pressure, the shock index, an estimate of the diameter of inferior vena cava based on sonography, and an evaluation of hypoperfusion complex shown on a CT scan. To add the finding for the hypoperfusion complex, the 'halo sign' was introduced recently. To our knowledge, this 'halo sign' has not been evaluated for its clinical usefulness, so we designed this study to evaluate its usefulness and to find the useful CT signs for hypoperfusion complex. Methods: The study was done from January 2007 to May 2007. All medical records and CT images of 124 patients with trauma were reviewed, of which 103 patients were included. Exclusion criteria was as follows: 1) age < 15 year old and 2) head trauma score of AIS ${\geq}$ 5. Results: The value of kappa, to assess the inter-observer agreement, was 0.51 (p < 0.001). The variables of the halo-sign-positive group were statistically different from those of the halo-sign-negative group. The rate of transfusion for the halo-sign-positive group was about 10 times higher than that of the halo-sign-negative group and the rate of mortality was about 6 times higher. Conclusion: In the setting of trauma, early abdominal CT can show diffuse abnormalities due to hypoperfusion complex. Recognition of these signs is important in order to prevent an unwanted outcome in hemorrhagic shock. We conclude that the halo sign is a useful one for hypoperfusion complex and that it is useful for assessing the degree of hemorrhagic shock.

금궤요략${\cdot}$경계토뉵하혈흉만어혈병맥증병치 제십육(第十六)에 대(對)한 연구(硏究) (Study on the 'Diagnosis and Treatment of Terror and Palpitation due to Fright and the Several Hemorrhagic Diseases' in Synopsis of Golden Chamber)

  • 윤주헌;박금숙;권미자;임동국;정헌영
    • 동의생리병리학회지
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    • 제22권1호
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    • pp.13-24
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    • 2008
  • This Chapter mentioned Terror and Palpitation due to Fright(驚悸) and Hemorrhagic disease(血證). Terror and Palpitation due to FrightAcctually Terror(驚) is different from Palpitation(悸). Terror(驚) is one of the seven emotions. But in this case, It refer to the Palpitation and the uneasiness of mind due to one's hearing a strange sound of seeing a strange. Tremulous Pulse can be appear. So Terror(驚) is caused by Exopathic Factors(外因) and belongs to Excess syndrome(實證). Palpitaion(悸) is the sensation of plamus, palpitation and unrest not because of being frightened. It is usurally caused by the deficiency of Ki(氣) and blood(血). So Deep, Thready and weak pulse can be appear. So Palpitaion(悸) is caused by Endopathic Factors and belongs to Deficiency Syndrome. In this Chapter, Terror and Palpitation due to Fright(驚悸) treat with the Kyeji-ke-jakyak-ka-chokchil-moryu-yongkol-kuyuk-tang(桂枝去芍藥加蜀漆牡蠣龍骨救逆湯) and Banha-mahwang-hwan(半夏麻黃丸). There are two type in Hemorrhagic disease(血證). One is bleeding(出血) and another is blood stasis(瘀血). The contents which relate with the Hemorrhagic disease(血證) are Hematemisis(吐血), Rhinorrhagia, Hemafecia(下血). In hemorrhage pathological mechanisms, there are two mechanisms. One is that Fire and Heat(火熱) pressure blood. Another is that cold and deficiency(虛寒) disable Ki(氣) from keeping blood flowing within vessels. Blood stasis(瘀血) can be called Extravasated Blood(惡血), Coagulated Blood, Blood retention(蓄血,積血), Dead Blood(死血) and Emaciation due to Blood disorder(乾血). It refer to a morbid state of unsmooth circulation and blood stagnancy often resulting from Ki(氣) stagnation, Ki(氣) deficiency and accumulation of pathogenic coldness. The symptom of Blood stasis are 'Fullness sensation in the chest, Lip Flaccidity, Cyonotic Tongue and Dryness of Mouth'. And the man who have Blood stasis, want to rinse his mouth with the water, but he can't drink the water because there isn't interior Heat of Excess Type. The symptom of Cyonotic Tongue(舌靑) had influence on diagnosing Blood stasis(瘀血) in offspring.

Combining Non-Contrast CT Signs With Onset-to-Imaging Time to Predict the Evolution of Intracerebral Hemorrhage

  • Lei Song;Xiaoming Qiu;Cun Zhang;Hang Zhou;Wenmin Guo;Yu Ye;Rujia Wang;Hui Xiong;Ji Zhang;Dongfang Tang;Liwei Zou;Longsheng Wang;Yongqiang Yu;Tingting Guo
    • Korean Journal of Radiology
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    • 제25권2호
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    • pp.166-178
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    • 2024
  • Objective: This study aimed to determine the predictive performance of non-contrast CT (NCCT) signs for hemorrhagic growth after intracerebral hemorrhage (ICH) when stratified by onset-to-imaging time (OIT). Materials and Methods: 1488 supratentorial ICH within 6 h of onset were consecutively recruited from six centers between January 2018 and August 2022. NCCT signs were classified according to density (hypodensities, swirl sign, black hole sign, blend sign, fluid level, and heterogeneous density) and shape (island sign, satellite sign, and irregular shape) features. Multivariable logistic regression was used to evaluate the association between NCCT signs and three types of hemorrhagic growth: hematoma expansion (HE), intraventricular hemorrhage growth (IVHG), and revised HE (RHE). The performance of the NCCT signs was evaluated using the positive predictive value (PPV) stratified by OIT. Results: Multivariable analysis showed that hypodensities were an independent predictor of HE (adjusted odds ratio [95% confidence interval] of 7.99 [4.87-13.40]), IVHG (3.64 [2.15-6.24]), and RHE (7.90 [4.93-12.90]). Similarly, OIT (for a 1-h increase) was an independent inverse predictor of HE (0.59 [0.52-0.66]), IVHG (0.72 [0.64-0.81]), and RHE (0.61 [0.54-0.67]). Blend and island signs were independently associated with HE and RHE (10.60 [7.36-15.30] and 10.10 [7.10-14.60], respectively, for the blend sign and 2.75 [1.64-4.67] and 2.62 [1.60-4.30], respectively, for the island sign). Hypodensities demonstrated low PPVs of 0.41 (110/269) or lower for IVHG when stratified by OIT. When OIT was ≤ 2 h, the PPVs of hypodensities, blend sign, and island sign for RHE were 0.80 (215/269), 0.90 (142/157), and 0.83 (103/124), respectively. Conclusion: Hypodensities, blend sign, and island sign were the best NCCT predictors of RHE when OIT was ≤ 2 h. NCCT signs may assist in earlier recognition of the risk of hemorrhagic growth and guide early intervention to prevent neurological deterioration resulting from hemorrhagic growth.

Growing Hemorrhagic Choroidal Fissure Cyst

  • Karatas, Ayse;Gelal, Fazil;Gurkan, Gokhan;Feran, Hamit
    • Journal of Korean Neurosurgical Society
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    • 제59권2호
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    • pp.168-171
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    • 2016
  • Choroidal fissure cysts are often incidentally discovered. They are usually asymptomatic. The authors report a case of growing and hemorrhagic choroidal fissure cyst which was treated surgically. A 22-year-old female presented with headache. Cranial MRI showed a left-sided choroidal fissure cyst. Follow-up MRI showed that the size of the cyst had increased gradually. Twenty months later, the patient was admitted to our emergency department with severe headache. MRI and CT showed an intracystic hematoma. Although such cysts usually have a benign course without symptoms and progression, they may rarely present with intracystic hemorrhage, enlargement of the cyst and increasing symptomatology.

Hemorrhagic Rupture of Arachnoid Cyst into the Intradural Space

  • Choi, Sun-Ju;Lee, Hui Joong;Hahm, Myong Hun
    • Investigative Magnetic Resonance Imaging
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    • 제21권3호
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    • pp.183-186
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    • 2017
  • A 7-year-old boy, diagnosed with an arachnoid cyst and subdural effusion on initial MRI, was admitted with left limb weakness and no history of head trauma. A subsequent follow-up MRI showed different stages of hematoma within multilayered enhancing membranes and in the arachnoid cyst, which was separated by the cerebrospinal fluid cleft. Craniotomy and fenestration of the cyst wall and hematoma removal were performed. The patient was diagnosed as a having a hemorrhagic rupture of an arachnoid cyst into the intradural space, probably via some one-way valve-like defect, based on the MRI and surgical findings. The MRI features and possible mechanism of this rare disease are discussed within the literature review.

뇌 CT에서 출혈로 오인된 소뇌의 허상: 증례보고 (Unusual Brain Computed Tomography Artifact in Cerebellum Mimicking Hemorrhage: A Case Report)

  • 이지훈;엄기성;김태영
    • Journal of Trauma and Injury
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    • 제28권3호
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    • pp.195-197
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    • 2015
  • Artifacts can seriously degrade the quality of computed tomography (CT) images, sometimes to the point of making them diagnostically unusable. Here, we report an unusual CT artifact that could have resulted in the misdiagnosis of a hyperdense hemorrhagic lesion in a 55-year-old man. The author recommend that when hemorrhagic lesion in posterior fossa is suggested on CT, the physician should carefully consider all patient-related clinical data prior to considering surgical intervention or a biopsy. Cranial magnetic resonance imaging (MRI) can help in preventing the misdiagnosis as hemorrhage of CT scan.

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