Cases reported "Hypotension"

Filter by keywords:



Filtering documents. Please wait...

1/10. Primary percutaneous transluminal coronary angioplasty performed for acute myocardial infarction in a patient with idiopathic thrombocytopenic purpura.

    A 72-year-old female with idiopathic thrombocytopenic purpura (ITP) complained of severe chest pain. electrocardiography showed ST-segment depression and negative T wave in I, aVL and V4-6. Following a diagnosis of acute myocardial infarction (AMI), urgent coronary angiography revealed 99% organic stenosis with delayed flow in the proximal segment and 50% in the middle segment of the left anterior descending artery (LAD). Subsequently, percutaneous transluminal coronary angioplasty (PTCA) for the stenosis in the proximal LAD was performed. In the coronary care unit, her blood pressure dropped. Hematomas around the puncture sites were observed and the platelet count was 28,000/mm3. After transfusion, electrocardiography revealed ST-segment elevation in I, aVL and V1-6. Urgent recatheterization disclosed total occlusion in the middle segment of the LAD. Subsequently, PTCA was performed successfully. Then, intravenous immunoglobulin increased the platelet count and the bleeding tendency disappeared. A case of AMI with ITP is rare. The present case suggests that primary PTCA can be a useful therapeutic strategy, but careful attention must be paid to hemostasis and to managing the platelet count.
- - - - - - - - - -
ranking = 1
keywords = puncture
(Clic here for more details about this article)

2/10. intracranial hypotension with parkinsonism, ataxia, and bulbar weakness.

    OBJECTIVE: To describe a case of spontaneous intracranial hypotension with a previously unreported constellation of presenting features. DESIGN: Case report. SETTING: Tertiary care center. MAIN OUTCOME AND RESULTS: We describe a patient with intracranial hypotension who presented with a parkinsonian syndrome and later development of ataxia and prominent bulbar symptomatology. headache was not a feature of her initial presentation and was only reported after repeated questioning during later evaluations. magnetic resonance imaging of the patient's head revealed findings characteristic of intracranial hypotension. An [18F]fluoro-m-tyrosine positron emission tomographic scan showed normal striatal activity, suggesting intact presynaptic nigrostriatal function. Opening pressure on lumbar puncture was reduced at 40 mm H2O. A source of cerebrospinal fluid leakage was not identified on nuclear cisternography and the patient underwent lumbar epidural blood patching, which resulted in complete resolution of her signs and symptoms as well as in a marked improvement in her imaging findings. CONCLUSIONS: The clinical spectrum of intracranial hypotension can be broadened to include parkinsonism, cerebellar ataxia, and prominent bulbar dysfunction. As with more common manifestations of the disorder, these features may resolve after appropriate treatment.
- - - - - - - - - -
ranking = 1
keywords = puncture
(Clic here for more details about this article)

3/10. Bezold-Jarisch-like reflex during Brockenbrough's procedure for radiofrequency catheter ablation of focal left atrial fibrillation: report of two cases.

    Brockenbrough's puncture technique has been widely conducted in the electrophysiologic laboratory. We report here two cases exhibiting a rare complication of this procedure, which arose during the conduct of catheter ablation using radiofrequency energy delivered to the pulmonary vein for the treatment of focal left atrial fibrillation. These cases exhibited marked sinus bradycardia and profound hypotension, suggestive of a Bezold-Jarisch-like reflex, observed immediately after Brockenbrough's procedure but before radiofrequency application. ST elevation in the inferior leads was also observed in spite of normal coronary angiograms. This unanticipated transient complication was treated by intravenous administration of atropine, which had no influence on the ablation procedure or prognosis. This is speculated to be attributable to the elevation of vagal tone caused by the mechanical effects of transseptal puncture on the interatrial vagal network.
- - - - - - - - - -
ranking = 2
keywords = puncture
(Clic here for more details about this article)

4/10. Decreased bispectral index as an indicator of syncope before hypotension and bradycardia in two patients with needle phobia.

    We report two cases who exhibited a decrease in their bispectral index (BIS) score, associated with syncope during venipuncture in patients with suspected needle phobia. In case 1, the reduction in BIS score occurred during the development of hypotension and bradycardia and may well have been caused by cerebral hypoperfusion. In case 2, the patient lost consciousness with decreasing BIS score before hypotension and bradycardia; this patient's condition could not be completely explained by cerebral hypoperfusion as a result of a vasovagal reflex because the patient's blood pressure and heart rate remained normal during the syncopal episode.
- - - - - - - - - -
ranking = 1
keywords = puncture
(Clic here for more details about this article)

5/10. Nystagmus following acupuncture--a case report.

    A 50 year old woman experienced an episode of vertigo and nystagmus about 10 minutes after receiving her first treatment with acupuncture for shoulder pain. The nystagmus was confirmed by several health professionals. She had no previous history of nystagmus, and the symptom was not associated with feelings of faintness. Her blood pressure was 90/50 at the onset of symptoms but returned to normal while the symptoms continued. She recovered spontaneously after about five hours. Nystagmus after acupuncture has not been unequivocally reported before, though dizziness associated with hypotension is common. In this case the association may be coincidental, or a focal neurological response to needling; if the latter, then it should be regarded as an unavoidable idiosyncratic reaction.
- - - - - - - - - -
ranking = 6
keywords = puncture
(Clic here for more details about this article)

6/10. Hypotension and transient renal impairment induced by lumbar puncture.

    INTRODUCTION: Raised intracranial pressure (ICP) may induce hypertension through sympathetic mechanisms. methods: Case report. RESULTS: A 55-year-old man was admitted with a symptomatic intracerebral mass and new refractory arterial hypertension. Several antihypertensive medications were necessary to control his blood pressure. A lumbar puncture was performed for diagnostic purposes and raised opening pressure (42 cm H2O) denoted raised ICP. After cerebrospinal fluid extraction, the closing pressure dropped to normal level. Shortly after the lumbar puncture, a sudden and pronounced drop in blood pressure was noted. Over the next day, the patient's serum creatinine rose from 0.9 to 1.9 mg/dL. blood pressure normalized after discontinuation of all antihypertensive drugs and administration of intravenous fluids. Renal function also completely recovered within 2 days. The patient remained spontaneously normotensive thereafter. CONCLUSION: Sudden hypotension may occur after lumbar puncture in patients with raised ICP receiving treatment for arterial hypertension.
- - - - - - - - - -
ranking = 7
keywords = puncture
(Clic here for more details about this article)

7/10. Non-invasive circulatory evaluation and electro-acupuncture & TES treatment of diseases difficult to treat in Western medicine.

    Even in the presence of normal blood pressure (B.P.) in both arms in some individuals, abnormal B.P. and circulatory disturbances can be found in the brain and lower extremities. The author discovered the following five types of abnormal B.P. in the brain in the presence or absence of normal B.P. in the arms: unilateral cephalic hypertension; bilateral cephalic hypertension; unilateral cephalic hypotension; bilateral cephalic hypotension; mixed cephalic hypertension and hypotension. When the B.P. of the head exceeds about 160 mm Hg, patients experience sensation of increased pressure buildup in the head to moderate headache. When it exceeds over 220 mm Hg, most of them experience severe headache in that side of the head. When the B.P. is very low (less than 30 mm Hg in both sides), majority of the subjects experience sleep disturbance pattern, mainly insomnia and some develop excessive sleepiness; difficulty in concentration and easy forgetfulness of recent events; various degrees of irritability. They are often associated with injury of neck-shoulder area with the presence of spastic muscles in the area. relaxation of the spastic muscles by acupuncture, TES or soft laser beam from He-Ne (7 approximately 15m Watts) often change the abnormal cephalic B.P. toward normal. Among individuals with cephalic hypotension some of them develop eye problems. Blind patients with macular degeneration and retinitis pigmentosa often have severe cephalic hypotension and reduced blood flow. Improvement of B.P. and blood flow induced by safe and effective electrical stimulation resulted in significant improvement in vision. In some patients, abnormal B.P. and blood flow of the brain are dependent on the position of the head and neck which can be classified as "Cephalo-cervical Position Dependent Dysfunction syndrome" which interferes with the function of some of the internal organs. In many psychiatric patients with schizophrenia or severe depression, cephalic B.P. and blood flow are often reduced significantly with additional abnormal function of pancreas, thyroid gland or liver. These abnormalities can explain some of the abnormal behavior, particularly when hypoglycemia, decrease in serotonin level and decreased circulation in the brain coexist.(ABSTRACT TRUNCATED AT 400 WORDS)
- - - - - - - - - -
ranking = 5
keywords = puncture
(Clic here for more details about this article)

8/10. Primary intracranial hypotension and bilateral isodense subdural hematomas.

    A 39-year-old woman with headache and an organic mental syndrome was found to have primary intracranial hypotension (PIH). Bilateral isodense subdural hematomas were discovered in association with an absence of detectable CSF pressure on two lumbar punctures. This case study emphasizes that PIH is not an entirely benign condition and that intracranial hemorrhage may accompany persistent intracranial hypotension.
- - - - - - - - - -
ranking = 1
keywords = puncture
(Clic here for more details about this article)

9/10. recurrence of spontaneous intracranial hypotension with subdural hematomas.

    A 59-year-old man developed postural headache associated with a low CSF pressure. A CT scan revealed no abnormal findings and the orthostatic symptoms resolved without treatment 6 weeks after onset. He was diagnosed as having spontaneous intracranial hypotension (SIH) and remained symptom-free until he experienced recurrence of postural headache 9 months later. A lumbar puncture demonstrated low CSF pressure, and a CT scan revealed slit-like ventricles with narrowing of the sulci, Sylvian fissures, and infratentorial cisterns, in addition to bilateral subdural masses. After draining the hematomas, his symptoms resolved completely, and a follow-up CT scan was normal. We hypothesize that recurrent SIH in this case was due to small recurrent tears of a root sleeve. This case emphasizes the importance of follow-up of SIH for at least 9 months after resolution of symptoms.
- - - - - - - - - -
ranking = 1
keywords = puncture
(Clic here for more details about this article)

10/10. MRI meningeal enhancement with intracranial hypotension caused by lumbar puncture.

    A 12-year-old girl with recent history of pseudotumor cerebri developed severe postural headache due to intracranial hypotension after lumbar puncture. Meningeal enhancement and thickening were demonstrated on magnetic resonance imaging. Repeated imaging 3 months later disclosed no abnormalities. This is the first report of a child with evident meningeal enhancement on magnetic resonance imaging related to lumbar puncture.
- - - - - - - - - -
ranking = 6
keywords = puncture
(Clic here for more details about this article)
| Next ->


Leave a message about 'Hypotension'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.