1/3. Pleural effusions appearing in the rehabilitation ward after ventriculoperitoneal shunts: a report of two adult cases and a review of the literature.This study presents two adult patients who experienced pleural effusion during hospitalization for stroke rehabilitation therapy after ventriculoperitoneal shunt placement for normal pressure hydrocephalus associated with aneurysmal subarachnoid haemorrhage. The pleural effusion appeared without migration of the catheter into the thoracic cavity. Because of respiratory insufficiency, which prevented progress in their rehabilitation programme, thoracentesis was repeated for recurrent pleural effusions, the composition of which differed significantly from that of cerebrospinal fluid. Both cases had past histories of laparostomies; therefore, the distal end of the catheter was placed in the right anterior subphrenic recess. One was able to resolve the pleural effusion and rehabilitate the patients by replacing the ventriculoperitoneal shunt with a vetriculoatrial shunt. In the literature, there have been only 23 reports of pleural effusion associated with a ventriculoperitoneal shunt. Among those reports, four involved pleural effusion without migration of the distal catheter; however, all of those cases were in children. Thus, this study reports the first adult cases of pleural effusion without migration of the catheter into the pleural cavity and discusses a putative mechanism.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
2/3. 'Expanding cerebral lacunae' in a hypertensive patient with normal pressure hydrocephalus.A hypertensive patient who had been treated successfully for normal pressure hydrocephalus (NPH), died from a left thalamic haemorrhage. Neuropathological examination showed recent and old thalamic haematomas and numerous parenchymal cavities or 'cerebral lacunae'. Two lacunae bulged into the lateral ventricles, and had all the characteristics of so called 'expanding lacunae'. They were surrounded by a single layer of epithelial-like cells, contained a normal, patent, arteriole, and presented as space occupying lesions. Only two similar cases have been reported previously. The complexity of the neuropathological features of 'cerebral lacunae' is emphasized and the relationships between cerebral hypertensive disease, NPH, and expanding lacunae are discussed.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
3/3. herpes zoster ophthalmicus with contralateral hemiplegia and normal pressure hydrocephalus.A case of herpes zoster ophthalmicus complicated by contralateral hemiplegia and normal pressure hydrocephalus is presented. The hydrocephalus is considered to be caused by recurrent haemorrhage from extensive cerebral arteritis.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |