Cases reported "Hematoma"

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1/14. Spontaneous intramural atrial hematoma presenting as a left atrial mass.

    We describe an unusual case of spontaneously occurring intramural atrial hematoma with no communication with either atrium. The diagnosis of left atrial mass was made from transthoracic echocardiography. Subsequent examination with transesophageal echocardiography confirmed a large mass essentially filling the whole left atrium but failed to provide an etiologic diagnosis, which was eventually made at surgery.
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2/14. Reversed portal vein pulsatility on Doppler ultrasound secondary to an iatrogenic mediastinal haematoma.

    The Doppler ultrasound pattern of reversed pulsatile flow (RPF) of the portal vein (PV) is strongly associated with high atrial pressure. Tricuspid regurgitation is considered to be the main cause of RPF in patients with chronic heart disease, but the precise pathomechanism of this PV flow pattern has not yet been resolved. We describe for the first time a RPF of the PV in a young patient with a mediastinal haematoma after inadvertent puncture of the subclavian artery. In this patient, transcutaneous echocardiography demonstrated normal valves without any tricuspid regurgitation as well as normal diameters of the cardiac cavities. The RPF of the PV in this patient resolved spontaneously within 7 days. An increased hepatic outflow resistance with transmission of hepatic artery pulsations across arterioportal communications seems the most likely pathomechanism to explain our finding.
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3/14. Management of complications associated with an excision of a lipoma from the ankle.

    This case study demonstrates the following: close proximity of lipoma to underlined skin can compromise circulation; the size of the lipoma and the resulting redundant skin after the incision can lead to fluid development and impede the healing process; and a patient who is noncompliant and stands or walks excessively after the excision of a lipoma can cause buildup of a hematoma, which can compromise the incision site. Lipomas associated with the foot or ankle are rarely symptomatic. When they do cause pain and are surgically treated, possible complications because of their size and location must be considered. Finally, these complications could have been avoided if the redundant skin had been excised and a Penrose drain inserted to eliminate excess fluid buildup. Also, better communication should have been maintained with the patient during the entire postoperative course.
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4/14. Cervical epidural hematoma in children: a rare clinical entity. Case report and review of the literature.

    Pediatric spinal epidural hematoma is a very rare clinicopathological entity. In the vast majority of cases, spinal epidural hematomas have a nonspecific clinical presentation; this, along with their rapid progression, makes their early diagnosis and prompt surgical evacuation critical. magnetic resonance imaging is the neuroimaging modality of choice, whereas hemilaminectomy or laminectomy is the indicated surgical intervention. The outcome is good when hematoma evacuation is performed before the onset of complete sensorimotor paralysis. In this communication, the authors describe a 12-year-old girl with a traumatic acute cervical epidural hematoma. This lesion was successfully evacuated through a hemilaminectomy, and the patient had an excellent outcome. The pertinent literature is reviewed in terms of the incidence, origin, management, and prognosis of this rare and potentially disastrous clinical entity.
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5/14. Bilateral intrapulmonary hematomas.

    A 67-yr-old man, known to have chronic obstructive lung disease, developed bilateral localized pulmonary densities on chest radiographs after cardiopulmonary resuscitation. An autopsy disclosed bilateral intrapulmonary hematomas without communication with bronchi, pulmonary arteries, or pleural cavities. We suggest blunt pulmonary injury is the most probable cause of the hematomas and discuss its pathogenic mechanism. Intrapulmonary hematomas should be considered in the differential diagnosis of pulmonary densities developing after a vigorous resuscitation.
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6/14. Calcified chronic subdural hematoma with intracerebral rupture forming a subcortical hematoma. A case report.

    We report a calcified chronic subdural hematoma which ruptured intracerebrally forming an acute subcortical hematoma in the frontal lobe in a 59-year-old woman with long-standing liver cirrhosis. Both hematoma cavities communicated each other through a small defect within the inner membrane of the subdural hematoma. The content of both hematomas was identical and was of a clay-like clot. The inner membrane around this communication consisted of thick, very vascular granulation tissue with many hemosiderin deposits and was tightly adherent to the cortex. We speculated that a fresh bleeding into the granulation tissue resulted in formation of a subcortical hematoma through a rupture of the inner membrane. disseminated intravascular coagulation likely played an important role in this unusual condition.
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7/14. Unusual complications of renal cyst puncture.

    The authors present a case of subcapsular hematoma with compromise of renal function and a case of arteriovenous communication as two infrequent complications of renal cyst puncture.
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8/14. Pathophysiology of positional vertigo of the malignant paroxysmal type.

    It is well known that paroxysmal positional vertigo is induced by change of head position and subsides immediately when the head is returned to the original position. There are two types of paroxysmal positional vertigo. One is what DIX and HALLPIKE (1952) call the benign type which is thought to be caused by otolith lesions. Another is a malignant type, in contrast to the former and is related to a lesion in the central nervous system. Otologists are usually familiar with the former, but the latter is not known among neurologists and neurosurgeons. We experienced 37 cases of the malignant type and found that this type of paroxysmal vertigo is induced by various diseases. Furthermore, we believe that the mechanism of this paroxysmal vertigo is the lack of inhibitory function of the vestibular cerebellum, and not abrupt malfunction of communication of the cerebrospinal fluid in the ventricular system. We also believe that this symptom is a very useful sign for diagnosing lesions of the cerebellar vermis.
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9/14. False aneurysm and pseudo-false aneurysm of the left ventricle: etiology, pathology, diagnosis, and operative management.

    Four patients are presented in whom either a false aneurysm or a "pseudo-false" aneurysm of the left ventricle developed following a myocardial infarction. False aneurysms of the left ventricle are unusual and are distinctly different from the more common true aneurysms. A false aneurysm is the result of a contained hematoma dissecting, into a transmural infarct. It communicates with the left ventricle through a small orifice. Previous descriptions of false aneurysms have stressed that their wall consists of pericardium and mural thrombus and lack identifiable epicardial or myocardial elements. Two pseudo-false aneurysms are described. They communicated with the left ventricle through a small orifice but their wall contained myocardial tissue. False aneurysms have a tendency to rupture and therefore their presence alone is an indication for operation. One of the pseudo-false aneurysms discussed ruptured into the right ventricle. The operation for false aneurysm may be simpler than that for true aneurysm since it might be possible to close the small communication into the left ventricle without resecting the entire aneurysm wall.
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10/14. Case report. aortic aneurysm presenting as psoas enlargement.

    We present a case of abdominal aortic aneurysm in which erosion and bleeding into the psoas muscle caused enlargement of that structure but remained confined within it until needle biopsy produced communication with the extraperitoneal space. This confirms the observation that separate compartmentalization of retrofascial and extraperitoneal spaces normally maintains.
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