Cases reported "Edema"

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1/68. Diffuse acute cellulitis with severe neurological sequelae. A clinical case.

    The incidence of head and neck odontogenic infections considerably diminished in the last decades due to appropriate antibiotic therapy. Herein we describe a case of acute diffuse facial cellulitis following tooth extraction in a patient with no apparent risk factor. During the acute process, injury was caused to the hypoglossal, vagal, glossopharyngeal and recurrent nerves of both sides. For this reason the patient currently has a nasogastric line for enteral feedings and a tracheotomy tube, which significantly affects his quality of life.
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ranking = 1
keywords = neck
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2/68. Internal jugular phlebectasia--an unusual cause of neck swelling.

    We describe a 7-year-old child who presented with a soft fluctuant swelling on the neck which became more prominent during the Valsalva manoeuvre. He underwent adeno-tonsillectomy based on a mistaken diagnosis of ballooning of the pharynx secondary to enlarged adenoids and tonsils obstructing the nasopharyngeal and oropharyngeal airways. Investigations revealed the swelling to be a markedly dilated internal jugular vein. We discuss the diagnostic features and mode of treatment of this condition so as to avoid unnecessary and dangerous surgical intervention.
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ranking = 5
keywords = neck
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3/68. granular cell tumor of the hypopharynx treated by endoscopic CO(2) laser excision: report of two cases.

    BACKGROUND: granular cell tumor (GCT), or Abrikossoff's tumor, is an unusual lesion probably arising from schwann cells. It is frequently found in the head and neck region, where the tongue is the most commonly affected site. Involvement of the hypopharynx is exceedingly rare because, to the best of our knowledge, only four cases have been reported in the literature. methods: We describe hypopharyngeal GCT in two women aged 29 and 52 years, respectively. RESULTS: In the first patient, preoperative diagnostic examination, including endoscopy, CT, and MRI scan, was suggestive of a benign lesion arising from the posterior wall of the hypopharynx. In the second patient, a previous biopsy of the postcricoid area performed elsewhere suggested a diagnosis of well-differentiated squamous cell carcinoma, and CT scan staged the lesion as T1 N0. In both cases, treatment included surgical excision under microlaryngoscopy with CO(2) laser. The histopathologic study of the specimens, supported by immunohistochemical techniques, determined the lesions to be a GCT. The postoperative course was uneventful, and the patients were discharged 12 and 2 days after surgery, respectively. Both patients were asymptomatic without evidence of recurrence when last seen 2 years and 4 months after surgery, respectively. CONCLUSIONS: GCT should be included in the differential diagnosis of submucosal hypopharyngeal lesions. endoscopy and radiologic imaging do not display any typical finding suggestive of the diagnosis, which can be based only on histologic findings. Resection of the tumor, when technically feasible, should be performed under microlaryngoscopy with the CO(2) laser, which makes it possible to work in a bloodless field with minimal thermal damage and reduction of scarring and postoperative edema.
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ranking = 1
keywords = neck
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4/68. Complicated emergent endovascular repair of a life-threatening bilateral internal jugular vein occlusion.

    A 62-year-old woman had painful facial swelling that progressed to extensive periorbital and perioral edema with loss of vision, hearing, and consciousness. Her past surgical history was significant for right radical neck dissection including internal jugular vein (IJV) resection, laryngectomy, partial esophagectomy, tracheoesophageal fistula repair, and tracheostomy for squamous cell carcinoma of the oropharynx. In addition, the patient had received radiation therapy to the neck. A venogram revealed occlusion of the left IJV. A guidewire from the femoral vein was passed through the occluded segment; however, attempts to introduce an angioplasty balloon failed. A percutaneous basilic vein approach allowed passage of a dilator sheath over a guidewire, thereby enabling Wallstent deployment across the IJV occlusion. A second Wallstent was inserted across a stenosis in the brachiocephalic vein; however, this second stent reoccluded the IJV. Surgical removal of the second Wallstent was required through a segmental claviculectomy and venotomy. Patency was restored in the IJV and the brachiocephalic vein with the return of baseline neurologic function. This case demonstrates a complicated emergent endovascular repair of a life-threatening IJV occlusion that required surgical salvage.
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ranking = 2
keywords = neck
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5/68. Penetrating neck injury: case report and evaluation of management.

    Greater urban violence has resulted in an increased incidence of penetrating neck trauma. Penetrating neck wounds can present difficult diagnostic and therapeutic dilemmas. The evaluation and management of such injuries, however, remains controversial. There is no universally accepted specific approach to the management of patients with penetrating neck injuries, with some surgeons advocating mandatory neck exploration whilst others believe in selective surgical intervention. We believe that an equal willingness for both conservative and surgical intervention as dictated by serial bedside evaluation with adequate radiological and endoscopic support can provide the clinician a safe and effective means of managing a potentially complex and lethal problem.
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ranking = 8
keywords = neck
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6/68. Transient osteoporosis of the hip during pregnancy.

    We report the clinical features of and MRI findings in transient osteoporosis of the hip during pregnancy. The study population consisted of 4 patients with a mean age of 33 years. The mean gestational age at onset was 31 weeks (range: 27 to 35 weeks). The main symptoms consisted of a weight-bearing pain in the hip and gait disturbance. The pain occurred suddenly and was of unknown cause and became severe within 2 to 3 weeks. X-ray examinations showed diffuse osteoporosis in the femoral head and neck. Moreover in 3 patients, similar lesions were also found in the lumbar spine or the knee. MRI obtained from 3 patients revealed a mottled low-signal lesion extending from the femoral head and neck on T1-weighted images and a high-signal lesion in the bone marrow suggesting edema on T2-weighted images. Mild elevation of C- reactive protein was shown in 2 patients. Conservative treatments with the limitation of weight bearing and bed rest were performed for all patients, and nonsteroidal anti-inflammatory drugs were given to 3 patients. The hip pain began to decline from 8 to 14 weeks after the onset, and completely disappeared from 14 to 24 weeks. X-ray examinations showed that osteoporotic lesions tended to improve at 10 to 14 weeks, on MRI, a high-signal lesion suggesting bone marrow edema resolved together with relief of the pain. No recurrence was found in any patients at mean follow-up of 70.8 months.
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ranking = 2
keywords = neck
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7/68. Histological findings of bone marrow edema pattern on MRI in osteonecrosis of the femoral head.

    Sequential magnetic resonance imaging (MRI) was performed on a 38-year-old woman with systemic lupus erythematosus who had received corticosteroid and had developed non-traumatic osteonecrosis of the femoral head. The initial MR finding was a band lesion on the T1-weighted image, which had been present before the onset of symptoms. At the onset of symptoms, a diffuse bone marrow edema pattern, with a low signal intensity on T1 and high signal intensity on T2-weighted images, was noted around the band lesion, extending to the femoral neck. Histopathologically, this region was found to consist of serous exudate, focal interstitial hemorrhage, and mild fibrosis, without any evidence of extension of osteonecrosis. It should be noted that extension of a low signal intensity area on MRI after the onset of hip pain may not be the result of the extension of osteonecrosis, but may represent concomitant edema due to collapse.
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ranking = 1
keywords = neck
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8/68. Schneckenbecken dysplasia, radiology, and histology.

    To our knowledge this is the first report of Schneckenbecken dysplasia with the development of hydrops early in the second trimester. The radiological findings showed the typical hypoplastic iliac bones with medial extension and very flattened, on lateral view, oval-shaped vertebral bodies and short long bones. The histology showed hypercellular and hypervascular cartilage with chondrocytes with centrally located nucleus. The absence of the lacunar space as described before was also observed in some chondrocytes in our case. This male fetus was the product of consanguineous parents of Mediterranean origin compatible with autosomal recessive inheritance.
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ranking = 5
keywords = neck
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9/68. Traumatic pseudoaneurysm of the thyrocervical trunk.

    A case of a pseudoaneurysm of the thyrocervical trunk after a pocketknife stab wound to zone I of the neck is reported. The patient was evaluated and treated in an emergency department with irrigation of the wound, bandage, and oral antibiotics. A large pseudoaneurysm slowly developed over the next 2 months. When the patient arrived at our hospital, he was immediately admitted and arteriograms were obtained. Arteriograms revealed an active leak of blood into a pseudoaneurysm from the thyrocervical trunk. Surgical treatment consisted of proximal and distal ligation of the thyrocervical trunk. This is the first case of a pseudoaneurysm developing only from the thyrocervical trunk due to a stab wound to zone I of the neck. This case and its complication serve to illustrate and emphasize the rationale for routinely imaging the great vessels after all penetrating trauma to zone I of the neck.
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ranking = 3
keywords = neck
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10/68. Fusiform aneurysm of the internal jugular vein: an unusual cause of neck swelling.

    Aneurysmal anomalies of the internal jugular vein are very uncommon. We report two cases of internal jugular vein aneurysm and discuss the clinical pattern, pathology, aetiology and management.
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ranking = 4
keywords = neck
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