1/7. Acute lead poisoning: Five cases resulting from self-injection of lead and opium.Five cases of acute lead poisoning resulted from the self-injection of lead and opium pills which were crushed, heated and suspended in water. Two of the five patients died of illnesses in which hepatic failure and reversible acute tubular necrosis were prominent features. One of these two had a severe neuropathy, with flaccid quadriplegia and respiratory paralysis. The other three patients had relatively minor symptoms but unequivocal biochemical evidence of lead toxicity. autopsy changes included hepatic degeneration with inclusion bodies, regenerating renal tubular epithelium and wasting of skeletal muscle. Hepatic lead content was extremely high in one case. chelation therapy in the other fatal case resulted in a fall in blood lead to within normal limits and a clinical improvement, which was terminated by massive haemorrhage from a ruptured innominate artery.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
2/7. Subarachnoid haemorrhage with "Ecstasy" abuse in a young adult.Abuse of the drugs like amphetamine, cocaine and "Ecstasy" may be complicated by intracerebral, subdural or subarachnoid haemorrhage. Contrary to historical opinion, drug-related intracranial haemorrhage (ICH) is frequently related to an underlying vascular malformation. We report the case of an 18-year-old man with a history of Ecstasy abuse preceding the onset of severe occipital headache. Cerebral computed tomography revealed right-sided subarachnoid haemorrhage and cerebral angiography showed right-sided middle cerebral artery aneurysm of 1 cm diameter. The patient was treated surgically with aneurysm clipping. Three weeks after onset of intracranial haemorrhage, neurological examination demonstrated normal findings. A history of severe headache immediately after using amphetamine, Ecstasy, or cocaine should alert doctors to the possibility of intracerebral haemorrhage. Arteriography should be part of the evaluation of most young patients with stroke or non-traumatic ICH.- - - - - - - - - - ranking = 9keywords = haemorrhage (Clic here for more details about this article) |
3/7. Intracerebral haemorrhage and vasculitis secondary to amphetamine use.We report a case of amphetamine-related intracranial haemorrhage and vasculitis, responding to immunosuppressants. Angiograms obtained before and after therapy are shown; the importance of immunosuppressive therapy is discussed.- - - - - - - - - - ranking = 5keywords = haemorrhage (Clic here for more details about this article) |
4/7. Self-regulation of chronic arthritic pain and long-term analgesic dependence in a haemophiliac.Haemophilia is characterized by recurrent internal bleeding episodes, with repeated haemorrhages into the joint areas eventually resulting in a chronic condition similar to osteoarthritis. A 31-year-old haemophiliac, with a nine-year history of narcotic analgesic dependence secondary to chronic arthritis pain, learned self-regulation techniques consisting of progressive muscle relaxation exercises, meditative breathing, and guided imagery. Long-term follow-up evidenced clinically significant decreases in arthritic pain intensity and analgesic intake subsequent to self-regulation training.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
5/7. Intracerebral haemorrhage due to amphetamine abuse: report of two cases with underlying arteriovenous malformations.Amphetamine abuse may be complicated by intracerebral, subdural or subarachnoid haemorrhage. The causative mechanism is probably a combination of vasculitis and induced hypertension. Most cases of intracerebral haemorrhage are subcortical. Only one case of amphetamine-induced intracerebral haematoma where there was also an underlying arteriovenous malformation has been previously reported. We report two cases of intracerebral haematoma due to amphetamine abuse whether an underlying AVM was found at the time of surgery. This possibility should be considered in cases of amphetamine-induced intracerebral haemorrhage.- - - - - - - - - - ranking = 7keywords = haemorrhage (Clic here for more details about this article) |
6/7. Intracerebral haemorrhage in a young adult: consider amphetamine abuse.We present the case of a young female who suffered a massive intracerebral bleed following the ingestion of a small quantity of amphetamine (speed). physicians should be aware that amphetamine abuse can lead to cerebrovascular events in young adults.- - - - - - - - - - ranking = 4keywords = haemorrhage (Clic here for more details about this article) |
7/7. Pharmacologic management of movement disorder after midbrain haemorrhage.movement disorders following midbrain haemorrhage are infrequently encountered in rehabilitation, and are uncommonly corrected by pharmacologic means. This report describes a 20 year-old male with a prior history of cocaine abuse who presented with a 4 day history of dysarthria and blurred vision following methamphetamine abuse. physical examination demonstrated hypertension, left facial hemispasm, bilateral upward gaze paresis and ataxic gait. magnetic resonance imaging/magnetic resonance angiography (MRI/MRA) showed multifocal parenchymal haematomas in the mesencephalic tegmentum, subcortical left front region and right anterior thalamus consistent with cavernous angiomas. The patient was transferred to rehabilitation on hospital day 5. The following day, he developed choreoathetoid movements, dystonia, and aphasia, secondary to an extension of the midbrain haemorrhage. Cogentin was initiated with slight improvement in choreoathetoid movements. The patient began intensive multidisciplinary rehabilitation therapy but after 18 days of therapy, the patient remained totally dependent in activities of daily living (ADLs), transfers, mobility and was unable to communicate in any manner. A trial of Sinemet was initiated, with resultant steady improvement in functional ability over the next month. By discharge, the patient was independent in ADLs and ambulation. By 9 months post discharge follow-up, the patient was fully independent with normal cognition, and had self tapered all medications without ill effect. dopamine agonist trials of appropriate duration appear indicated in cases of movement disorder (paucity or excess) following midbrain lesions.- - - - - - - - - - ranking = 6keywords = haemorrhage (Clic here for more details about this article) |