11/37. Cerebellar haemorrhage after supratentorial aneurysm surgery with lumbar drainage.Haemorrhage within the posterior fossa (PF) after supratentorial surgery is a very rare and exceedingly dangerous complication. Only 28 cases were found in the literature. Up to now, no pathogenetic factor has decisively proven to be the cause of this phenomenon. We present clinical details of a patient operated on for aneurysm of the anterior communicating artery. Lumbar drainage was used during surgery, with the loss of a large amount of cerebrospinal fluid (200 ml). Other causes in our case which may have led to cerebellar shift or a critical increase in transmural venous pressure with subsequent vascular disruption and haemorrhage were extreme head rotation during lengthy surgery and blood pressure peaks in the early postoperative period. Repeated computed tomography (CT) allowed immediate diagnosis of this complication and control of its conservative management. After postponed ventriculoperitoneal shunt, the patient recovered completely.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
12/37. Novel use of nebulised adrenaline in the treatment of secondary oropharyngeal haemorrhage.We report the use of nebulised adrenaline in the treatment of secondary oropharyngeal haemorrhage. Cases involving two adults and one child are presented to illustrate the usefulness of this technique in helping to achieve haemostasis without the need for a general anaesthetic. The mechanisms of the haemostatic action of adrenaline are also explored. We believe that in selected cases nebulised adrenaline is both safe, effective and easily tolerated and represents a useful additional tool in the treatment of oropharyngeal haemorrhage.- - - - - - - - - - ranking = 1.2keywords = haemorrhage (Clic here for more details about this article) |
13/37. Spinal subdural haematoma mimicking tethered cord after posterior fossa open surgery.We report the MRI findings in a girl aged 3 years and 10 months who developed a spinal subdural haematoma after posterior fossa open surgery for cerebellar malignant rhabdoid tumour. Emergency surgery was performed immediately because of increased intracranial pressure. Control MRI 48 h after surgery showed a spinal subdural haematoma without clinical signs of paresis or bladder dysfunction. Spinal subdural haematoma is rare, and only few cases have been reported, especially in children. This report suggests that "silent" (without clinical symptoms) postoperative spinal acute subdural haemorrhage can occur after posterior fossa surgery.- - - - - - - - - - ranking = 0.2keywords = haemorrhage (Clic here for more details about this article) |
14/37. A case of uterine artery pseudoaneurysms.uterine artery pseudoaneurysms is a rare cause of haemorrhage but is potentially life-threatening and can occur after common gynaecological operations such as a Caesarean section or a hysterectomy. A 33-year-old woman who developed secondary postpartum haemorrhage after a Caesarean section was diagnosed to have uterine artery pseudoaneurysms on ultrasound scan. She was treated with bilateral uterine artery embolisation via selective catherisation of uterine arteries. Good outcome with the aneurysms remaining obliterated was obtained. Angiographic embolisation is a safe and effective method of treating postpartum haemorrhage in haemodynamically stable patients and should be an option before resorting to surgery in appropriately selected cases.- - - - - - - - - - ranking = 0.6keywords = haemorrhage (Clic here for more details about this article) |
15/37. Unusual presentation of factor xiii deficiency.factor xiii deficiency is a rare inherited bleeding disorder that is often difficult to diagnose. The standard screening tests are normal in these patients and their bleeding phenotype may be variable. We report the case of a 3-year-old girl who presented with an intracranial haemorrhage. Several confounding factors, such as the suspicion of an arteriovenous malformation and the development of a deep venous thrombosis, led to a delay in the diagnosis of factor xiii deficiency. Subsequently, her brother was also found to have severe factor xiii deficiency. This case highlights the importance of a detailed history and of screening families in which index cases have been identified. It should also remind physicians that bleeding disorders may have unusual presentations and should be sought when investigating unexplained bleeding.- - - - - - - - - - ranking = 0.2keywords = haemorrhage (Clic here for more details about this article) |
16/37. Desmopressin is not always effective in mild haemophilia A patients undergoing urological surgery: the need of standardized protocols.Desmopressin may be an efficient haemostatic treatment for mild A haemophiliacs because its infusion raises plasma factor viii level. We report the use of desmopressin in five mild haemophilia A patients undergoing urological surgery. They all received a preoperative infusion (0.3 microg kg(-1), i.v.) 1 h before incision followed by repeated injections at 12- or 24-h intervals according to the severity of the procedure. Nevertheless, four patients presented a postoperative bleeding requiring again surgery performed for 3 of them under clotting factor concentrate instead of desmopressin. The occurrence of haemorrhage was not always correlated with particularly low plasma factor viii level. Surgical management of urological procedures with desmopressin in mild haemophilia A patients requires standardized protocols.- - - - - - - - - - ranking = 0.2keywords = haemorrhage (Clic here for more details about this article) |
17/37. Complete recovery after 2 h of cardiopulmonary resuscitation following high-dose prostaglandin treatment for atonic uterine haemorrhage.We report the case of a 31-year-old woman who delivered twins by Caesarean section in whom atonic uterine haemorrhage developed 6 h postoperatively. During conservative treatment with the high-dose prostaglandin analogs sulprostone (PGE(2)) and dinoprost (PGF(2alpha)), acute pulmonary oedema and cardiac decompensation developed and, subsequently, the patient suffered cardiopulmonary arrest. After a 2h-period of cardiopulmonary resuscitation (CPR), it was possible to restore and stabilize circulation under the highest dose of catecholamines. Despite 2h of CPR, the patient was discharged from hospital 3 months later without any major physical or neurocognitive deficit.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
18/37. Unusual haemorrhage complication after carotid endarterectomy.An unusual case of haemorrhage complication after carotid endarterectomy caused by vein patch perforation is presented.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
19/37. Recombinant activated factor VII for exsanguinating haemorrhage post bilateral lung transplantation for extra-corporeal lung support-dependent respiratory failure.Following three weeks of extracorporeal lung support for acute respiratory distress syndrome, a 15-year-old male underwent bilateral lung transplantation. This procedure was complicated by massive postoperative haemorrhage. The administration of recombinant activated Factor VII was associated with improved haemostasis. However, development of cardiac tamponade soon after injection required emergency exploration and evacuation of a large mediastinal clot.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
20/37. Retrobulbar haemorrhage associated with chronic Gingko biloba ingestion.Retrobulbar haemorrhage is a rare and potentially sight threatening complication after peribulbar local anaesthetic injection for cataract surgery. A case is reported of a woman who developed this complication and was subsequently found to have been taking Gingko biloba extract tablets which may have predisposed her to developing the haemorrhage.- - - - - - - - - - ranking = 1.2keywords = haemorrhage (Clic here for more details about this article) |
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