Cases reported "Vascular Diseases"

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1/25. Spontaneous cerebral haemorrhage without hypertension in non-mosaic 45X Turner's syndrome.

    Cerebral haemorrhage without hypertension, arteriosclerosis or clotting defect has not been reported in patients with Turner's syndrome before. In a 51 year old female patient with non-mosaic Turner's syndrome, acute aphasia and right-sided hemiplegia occurred, due to left-sided basal ganglia haemorrhage. The history for hypertension was negative, blood pressure was normal throughout hospitalisation as well as during 24 h monitoring, and all tests for secondary hypertension were negative. There was no indication of arteriosclerosis or a clotting defect. Since there were hypermobile joints, hyperextensible skin and ectatic ascending aorta and brachiocephalic trunk on angiography, a general connective tissue defect was assumed, making arteries more vulnerable to physiologically increased blood pressure and rupture of intracerebral arteries with consecutive bleeding.
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2/25. Intraoesophageal rupture of a thoracic aortic aneurysm.

    The intraoesophageal rupture of a large thoracic aortic aneurysm is reported in a 49 year old man. He had been hypertensive for some years while the aneurysm increased in size. Although a graft was successfully inserted to repair the leak, infection from the oesophagus with candida albicans, subsequently led to secondary haemorrhage and death 17 days later. A plea is made for the earlier referral of patients with aneurysm prior to rupture, as the operative mortality rises markedly after rupture has occurred and in this case the situation was virtually irreparable.
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keywords = haemorrhage
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3/25. Vascular amyloidosis causing spontaneous mediastinal haemorrhage with haemothorax.

    Bleeding diathesis is a recognised complication of amyloid disease. Localised and generalised bleeding manifestations are usually associated with intravascular coagulopathy related to isolated or multiple coagulation factor deficiencies. Recently, there have been reports of haemorrhage due to amyloid deposition in blood vessel walls and in the perivascular region leading to increased fragility and poor haemostasis. We report a case of spontaneous mediastinal haemorrhage due to amyloid involvement of vascular tissue in the absence of coagulopathy.
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4/25. Local vascular complications after knee replacement: a review with illustrative case reports.

    The incidence of vascular complications after knee replacement is between 0.03% and 0.2%. These complications include acute ischaemia, thrombosis, haemorrhage, fistula and aneurysm formation. Vascular complications can be avoided by careful pre-operative selection. If doubt exists, a vascular opinion should be obtained before knee replacement. In the event of a vascular complication occurring, serious morbidity can be avoided by prompt diagnosis, investigation and specialist treatment.
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keywords = haemorrhage
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5/25. Cilio-retinal arterial circulation in central retinal vein occlusion.

    The hypothesis that an occlusion of the central retinal artery is an essential prerequisite for haemorrhage formation after central retinal vein obstruction has been investigated by examining the fundus changes in patients with a cilio-retinal arterial circulation; the findings are at variance with the 'combined occlusion hypothesis'. Comparisons were made between the pathological features in two retinal capillary beds with independent sources of arterial supply--namely, the central retinal and cilio-retinal arteries--but with an obstructed venous drainage channel common to both--namely, the central retinal vein. The importance of intraluminal pressure changes (as distinct from perfusion changes) in the causation of haemorrhages and oedema after venous occlusion is stressed, and the role of arterial disease in the pathogenesis of venous occlusions is distinguished from its role in determining the sequelae of such occlusions.
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keywords = haemorrhage
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6/25. Congenital fibromuscular dysplasia involving multivessels in an infant with fatal outcome.

    We report the unusual case of a 2-month-old boy with systemic fibromuscular dysplasia (FMD). He presented with congenital renovascular hypertension due to stenosis of the right renal artery, and later developed renal infarction on the contralateral side resulting in renal failure. The boy subsequently died of intracranial haemorrhage at the age of 14 months. During the course, hemiconvulsion caused by a moyamoya disease-like vascular lesion was noted. Stenotic lesions of both the abdominal aorta and its branches were also revealed by angiography. Post-mortem examination confirmed that the coronary, splenic and mesenteric arteries were also affected and their histological findings were compatible with FMD. To our knowledge, this is the first congenital case of FMD demonstrating a rapidly progressive course resulting in a fatal outcome. In this case, multivessels in both intracranial and extracranial arteries were involved. CONCLUSION: Our case suggests that the nature of fibromuscular dysplasia is congenital in origin and its aetiology, at least in some cases, is a systemic abnormality of vascular development.
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keywords = haemorrhage
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7/25. Autologous salvaged blood transfusion in spontaneous hemopneumothorax.

    Spontaneous hemopneumothorax (SHP) is a rare clinical entity, and an emergent operation due to continuous bleeding or hypovolemic shock is at times necessary. Although allogeneic blood transfusions are urgently required for significant blood loss, autologous blood transfusions can also be considered in patients with SHP. We herein report two cases of successful autologous blood transfusions using blood in the pleural space, decreasing or obviating the need for allogeneic blood transfusion.
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ranking = 0.57153445148942
keywords = blood loss
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8/25. Percutaneous dilatational tracheostomy complicated by delayed life-threatening haemorrhage.

    Percutaneous dilatational tracheostomy has become increasingly popular as an alternative to formal surgical tracheostomy. We report a case of profuse, life-threatening haemorrhage which occurred after percutaneous dilatational tracheostomy.
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keywords = haemorrhage
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9/25. Severe hypertension during postpartum haemorrhage after i.v. administration of prostaglandin E2.

    Severe hypertension with arterial spasm was observed after i.v. administration of prostaglandin E2 (PGE2) during uterine exploration under general anaesthesia for control of postpartum haemorrhage. This hypertension was exceptional because PGE2 is known to cause a decrease in systemic arterial pressure. Different hypotheses for this paradoxical hypertensive crisis after PGE2 administration are discussed.
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ranking = 0.83333333333333
keywords = haemorrhage
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10/25. A rare cause of intra-abdominal haemorrhage: spontaneous rupture of the splenic vein.

    Spontaneous rupture of the splenic vein is rare, and is associated with high mortality. Few cases have been documented, associated with pregnancy, with hepatic cirrhosis and diseases predisposing to portal hypertension. We report a rare case with no evident symptoms or signs of liver deficiency, which was manifested with sudden massive intraperitoneal haemorrhage. An urgent laparotomy was performed and a tear of the splenic vein which was massively bleeding was found. The patient underwent urgent splenectomy and a biopsy of the liver was taken. The patient had an uneventful postoperative course. The histological examination documented the presence of micro-nodular liver cirrhosis. rupture of the splenic vein is a rare condition, which should be considered in the differential diagnosis of intra-abdominal haemorrhage in a cirrhotic patient and in pregnant women. Control of haemorrhage and ligation of the splenic vein with urgent splenectomy is the appropriate treatment.
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keywords = haemorrhage
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