1/41. Postpartum haemolytic-uraemic syndrome.In a young woman a twin pregnancy and uneventful labour were complicated by the development of the postpartum haemolytic-uraemic syndrome. A number of unusual features of this syndrome were present, including early onset, accompanying hepatocellular necrosis, hepatic encephalopathy and bleeding diathesis. Early institution of heparin therapy combined with coagulation factor replacement was followed by cessation of haemorrhage and complete recovery from acute renal failure.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
2/41. basilar artery vasospasm in postpartum cerebral angiopathy.The reason cerebral edema in postpartum cerebral angiopathy (PPCA) occurs preferentially in the posterior brain is poorly understood. The authors present two patients with PPCA who showed vasospasm occurring earlier and more severely in the basilar artery than in the middle cerebral artery. Our patients demonstrate the difference in vascular change between the anterior and posterior cerebral vessels, explaining the susceptibility of the posterior brain to PPCA.- - - - - - - - - - ranking = 0.0056198838412573keywords = brain (Clic here for more details about this article) |
3/41. case reports: postpartum cerebral angiopathy in a patient with chronic migraine with aura.A 25-year-old woman with a history of chronic severe migraine with aura presented in an apoplectic state 1 week after the delivery of her third child. She developed a severe headache and within hours lapsed into a coma. A CT scan of the brain showed cerebral edema and an occipital hemorrhage. A four-vessel angiogram showed diffuse arterial narrowing of all the intracranial vessels with segmental narrowing of the suprasellar portion of the internal carotid arteries bilaterally. She had no risk factors for stroke or vasculitis. Her pregnancy and delivery were uneventful with no preeclampsia or eclampsia. Apart from ergometrine at the time of the delivery, no vasoconstrictor drugs were used. She recovered spontaneously. Serial CT scans of the brain demonstrated resolution of the edema and hemorrhage with the development of cortical and watershed infarcts. A repeat cerebral angiogram was normal. She was, therefore, diagnosed as having suffered from postpartum cerebral angiopathy, a form of reversible cerebral vasoconstriction, called the Call or Call-Fleming syndrome. The relationship between migraine and postpartum angiopathy in the development of reversible cerebral vasoconstriction is discussed.- - - - - - - - - - ranking = 0.0056198838412573keywords = brain (Clic here for more details about this article) |
4/41. rupture of subcapsular haematoma of the liver in a case of eclampsia.A case of rupture of subcapsular haematoma of the liver in a patient suffering from eclampsia is reported in which the patient survived. Peritoneal tap provided important diagnostic information. Surgical intervention with control of the liver haemorrhage provides the only chance of survival.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
5/41. Convexity meningioma presenting as postpartum eclampsia.A 37-year-old woman, Para 5( 0) presented with a 1 year history of recurrent convulsions and progressive weakness of the right side of the body. She had been treated for postpartum eclampsia in her last delivery but symptoms recurred 3 months later. Evaluation including computerized tomography scan of the brain suggested a parieto-temporal meningioma, which was completely excised at craniotomy. histology confirmed this to be a meningioma. The patient was well at 8 months of follow up. The growth of meningiomas may increase during pregnancy due to presence of receptors for progestational hormones in the tumour and the meningioma may become symptomatic in pregnancy, presenting as eclampsia. Close follow up of patients with eclampsia is necessary to identify neurological features that may lead to a diagnosis of meningioma. early diagnosis is essential if a good outcome is to be ensured.- - - - - - - - - - ranking = 0.0028099419206287keywords = brain (Clic here for more details about this article) |
6/41. brain abscess after esophageal dilatation for stenosis.The case is presented of a 28-year-old female with a brain abscess after esophageal dilatation for stricture, secondary to an acute necrotizing esophagitis. Other causes of brain abscess were excluded. To our knowledge this is the first documented case of brain abscess after dilatation for esophageal stricture in adult life. Some reports in the pediatric literature have been published previously.- - - - - - - - - - ranking = 0.008429825761886keywords = brain (Clic here for more details about this article) |
7/41. pregnancy outcome after operative correction of puerperal uterine inversion.uterine inversion is an uncommon but life-threatening obstetric emergency. A review of the approaches to correct uterine inversion is presented. In cases where time has elapsed between delivery and presentation, the inversion ring may have become too tight to allow manual reposition of the fundus. In such cases, it has to be divided by a vertical incision. In subsequent pregnancy, antenatal care should include placental localization and planning for an elective Caesarean Section. The outcome of future pregnancies may be complicated by placenta accreta and massive haemorrhage.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
8/41. Acute postpartum mental status change and coma caused by previously undiagnosed ornithine transcarbamylase deficiency.BACKGROUND: Acute postpartum mental status change usually represents postpartum blues or depression. Psychosis and coma are rare. This is a case report of a patient with previously undiagnosed ornithine transcarbamylase deficiency presenting as postpartum acute mental status change and coma. CASE: A 28-year-old multipara developed acute mental status change and coma 3 days after cesarean delivery. A metabolic profile and neurologic workup were unrevealing. An electroencephalogram revealed diffusely slow brain activity. She developed hyperammonemia and hyperglutaminemia and was diagnosed with ornithine transcarbamylase deficiency. Her newborn son was diagnosed with ornithine transcarbamylase deficiency on the previous day. Treatment with oral lactulose resulted in normalization of her ammonia level and resolution of her coma within 48 hours. She suffers no long-term sequelae. Dietary avoidance of protein was advised; outpatient treatment with sodium benzoate, sodium phenylacetate, and lactulose was initiated. A pedigree analysis is ongoing. CONCLUSION: ornithine transcarbamylase deficiency should be included in the differential diagnosis of acute postpartum coma. hyperammonemia, hyperglutaminemia, and orotic aciduria are diagnostic, facilitate early treatment, and mitigate the risk of permanent neurologic impairment or death.- - - - - - - - - - ranking = 0.0028099419206287keywords = brain (Clic here for more details about this article) |
9/41. Reversible posterior leukoencephalopathy syndrome in a postpartum woman without eclampsia.We report a patient who developed reversible posterior leukoencephalopathy syndrome (RPLS) in puerperium without preeclampsia-eclampsia or chronic hypertension. The woman suddenly complained of visual loss and headache 10 days after delivery caused by edematous lesions mainly distributed in the bilateral occipital lobe. Apparent diffusion coefficient map was useful for distinction of this vasogenic edema from cytotoxic edema due to brain infarction. Under the diagnosis of RPLS, we successfully treated her disease using a trinitroglycerin as an antihypertensive, a hyperosmolar agent, methylprednisolone, and a free radical scavenger. Postpartum women may have the risk of development of RPLS even without preeclampsia-eclampsia. Vascular endothelial dysfunction may trigger RPLS, in addition to acute and modest increase in systemic pressure.- - - - - - - - - - ranking = 0.0028099419206287keywords = brain (Clic here for more details about this article) |
10/41. Puerperal uterine inversion and shock.uterine inversion is an unusual and potentially life-threatening event occurring in the third stage of labour. It is associated with significant blood loss, and shock, which may be out of proportion to the haemorrhage, although this is questionable. When managed promptly and aggressively, uterine inversion can result in minimal maternal morbidity and mortality. A recent case is described, followed by a short review of the literature.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
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