Cases reported "Embolism"

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1/13. Disseminated intravascular meconium in a newborn with meconium peritonitis.

    A 3-day-old premature infant with meconium peritonitis, periventricular leukomalacia, and pulmonary hypertension died with respiratory insufficiency. An autopsy disclosed intravascular squamous cells in the lungs, brain, liver, pancreas, and kidneys. Numerous pulmonary capillaries and arterioles were occluded by squamous cells, accounting for pulmonary hypertension. brain parenchyma surrounding occluded cerebral vessels showed infarct and gliosis. A mediastinal lymph node filled with squamous cells alluded to the mechanism by which these cells from the peritoneal cavity likely entered the bloodstream--namely, via diaphragmatic pores connecting with lymphatics. Thus, disseminated intravascular meconium rarely may complicate meconium peritonitis and have devastating consequences.
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keywords = arteriole
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2/13. Embolic central retinal artery occlusion detected by orbital color Doppler imaging.

    OBJECTIVE: To describe the detection of emboli to the retrobulbar circulation using orbital color Doppler imaging in patients with central retinal artery occlusions (CRAO) without visible retinal emboli. DESIGN: Noncomparative, retrospective, observational case series. patients AND methods: Twenty-nine patients with CRAO, without funduscopic evidence of embolic material within the retinal arterioles, underwent neuroophthalmic examination and evaluation with orbital color Doppler imaging. MAIN OUTCOME MEASURES: The detection of retrobulbar plaques using orbital color Doppler imaging. RESULTS: Nine of 29 (31%) patients with CRAO demonstrated hyperechoic retrobulbar plaques. All nine patients had visual acuity of counting fingers or worse at presentation. Six of the nine patients (67%) had a history of hypertension, and seven (78%) had coronary artery disease as vascular risk factors for arterial occlusive disease. Two of the nine patients (22%) subsequently died from cardiac-related events. CONCLUSIONS: This study demonstrates that orbital color Doppler imaging is an important diagnostic procedure for establishing embolism as the cause of CRAO when no emboli are visible in the retinal circulation. This noninvasive technology enables prompt differentiation of embolic disease from arterial occlusion caused by intrinsic atherosclerosis, vasospasm, or vasculitis from giant cell arteritis. Recognition of emboli has important management implications for these patients.
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ranking = 1
keywords = arteriole
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3/13. Quadrantic venous-stasis retinopathy secondary to an embolic branch retinal artery obstruction.

    Venous-stasis retinopathy is a term used to describe the posterior segment findings of the ocular ischemic syndrome. These include midperipheral blot retinal hemorrhages, dilated retinal veins, attenuated arterioles, peripheral retinal microaneurysms, macular edema, as well as retinal and optic disc neovascularization. The authors recently evaluated a 71-year-old woman who presented with an asymptomatic calcific embolus in her right infero-temporal branch retinal artery. Classic venous-stasis retinopathy that was limited to the territory of the obstructed arteriole was present concurrently. This case appears to demonstrate that chronic retinal hypoperfusion and resultant venous-stasis retinopathy can be produced by not only high-grade, fixed stenosis but also by embolic disease.
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keywords = arteriole
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4/13. spinal cord infarction following intraaortic balloon support.

    infarction of the lumbar and sacral spinal cord was demonstrated at autopsy of a 72-year-old man in whom acute paraplegia developed following coronary artery bypass grafting and atrial septal defect repair with intraoperative insertion of an intraaortic balloon. autopsy findings showed that infarcts of the spinal cord and other key organs were caused by critical occlusion of small arterioles by cholesterol emboli. These emboli apparently arose as a result of the fragmentation of atheromatous plaques within the aorta during use of the intraaortic balloon pump with subsequent embolization and occlusion of small blood vessels.
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keywords = arteriole
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5/13. Symmetrical peripheral gangrene in disseminated tuberculosis.

    We report the case of a 66-year-old man who developed a symmetrical peripheral gangrene (SPG) on both feet during disseminated miliary tuberculosis. mycobacterium tuberculosis was not only isolated from sputum, gastric juice, and urine, but also from a blood culture. Since a disseminated intravascular coagulopathy was very likely to be excluded, it is possible that the SPG was due to embolization of arterioles by the tubercle bacilli. The literature of SPG is reviewed and the different possible pathogenic mechanisms of SPG, such as hypoxemia, vasoconstriction, primary endothelial damage, and vascular obstruction, are discussed. SPG is another cutaneous manifestation of disseminated tuberculosis.
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ranking = 1
keywords = arteriole
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6/13. talc emboli and macular ischemia in intravenous drug abuse.

    A patient with decreased visual acuity had small, glistening white particles that were scattered over both posterior poles. Monochromatic fundus photography revealed ghost vessels and intraluminal particulate matter in small retinal vessels. fluorescein angiography demonstrated nonperfusion of small arterioles and macular capillaries. The patient admitted to multiple intravenous injections of crushed methylphenidate (Ritalin) hydrochloride tablets, which contain talc 18 months prior to examination. To our knowledge, visual loss and irreversible macular ischemia from talc emboli have not been previously documented.
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ranking = 1
keywords = arteriole
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7/13. Cutaneous crystal cholesterol emboli.

    One case of cutaneous cholesterol emboli is described. In patients affected with severe arteriosclerosis of the abdominal aorta, cholesterol crystals may become detached from an atheromatous plaque and result in micro emboli ensuing skin lesions (livedo reticularis, nodules, purple toes, ulcerations, distal gangrene) on the lower extremities. Histopathologic study is required for diagnosis: the lumens of the arterioles were extensively occluded by macrophagic granuloma which surrounded cholesterol crystals.
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ranking = 1
keywords = arteriole
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8/13. Occlusion of the central retinal artery after retrobulbar corticosteroid injection.

    Occlusion of the central retinal artery with loss of all vision occurred in a 38-year-old white woman given a retrobulbar injection of betamethasone acetate and betamethasone disodium phosphate (Celestone Soluspan) for the treatment of a retrobulbar neuritis. ophthalmoscopy revealed embolic, whitish material within several of the small retinal arterioles and capillaries. This, together with the absence of any signs of retrobulbar hemorrhage, suggested that the corticosteroid material was accidentally injected into a branch of the central retinal artery and subsequently passed into the main vessel.
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ranking = 1
keywords = arteriole
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9/13. Embolic ischemic optic neuropathy.

    On examining the postmortem enucleated eyes of a 68-year-old man, we found the left eye had focal infarction 3 mm behind the lamina cribrosa caused by thromboembolic compromise of three discrete pial and pial-derived arterioles. The optic nerve had been destroyed focally, whereas the retinal and choroidal tissue supplied by a similarly occluded vessel had been preserved. We diagnosed nonarteritis ischemic optic neuropathy.
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ranking = 1
keywords = arteriole
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10/13. blindness secondary to steroid injections into the nasal turbinates.

    Two cases of inadvertent intra-arterial injection into the anterior turbinates for treatment of allergic rhinitis resulted in retrograde flow of methylprednisolone acetate in the ophthalmic artery. Both patients demonstrated embolization of the retinal circulation, and one of the choroidal circulation as well. Visual outcome was favorable, although one patient showed a permanent paracentral scotoma. Fundus photographs clearly showed intra-arterial obstruction of arterioles that cleared within several days. Precautions can be taken for the prevention of this complication.
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ranking = 1
keywords = arteriole
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