1/4. rupture of a large ophthalmic segment saccular aneurysm associated with closed head injury: case report.OBJECTIVE AND IMPORTANCE: Although each year approximately 30,000 to 50,000 cases of subarachnoid hemorrhage in the united states are caused by the rupture of intracranial saccular aneurysms, there is little information in the literature documenting the association of aneurysmal rupture with closed head injury. CLINICAL PRESENTATION: A 61-year-old woman presented after a motor vehicle accident with multiple injuries, including a severe closed head injury. Computed tomography revealed a diffuse basal subarachnoid hemorrhage. angiography revealed the source as a large aneurysm arising from the ophthalmic segment of the left carotid artery. INTERVENTION: After the patient was stabilized for her multiple injuries, she underwent craniotomy and clipping of the aneurysm. She recovered without developing new neurological deficits. CONCLUSION: Although the association of head trauma and aneurysmal subarachnoid hemorrhage is rare, the presence of significant basal subarachnoid blood on a computed tomographic scan should alert the physician to the possibility of a ruptured aneurysm.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/4. Findings of negligence followed communication lapses in BC aneurysm case.Negligence is sometimes established on the basis of lapses in communication and patient care management that, in hindsight, could have been avoided. A recent BC court case concerned a patient who died because of a ruptured aneurysm. A Supreme Court judge found that some of the physicians involved had failed in their duty to diagnose the patient's condition properly, or failed to communicate to one another significant signs of the patient's illness, and failed to refer him in time to the medical specialists who could have diagnosed and treated his condition promptly.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/4. The complexity of caring for patients with ruptured cerebral aneurysm: case studies.Ruptured intracerebral aneurysm causes instantaneous neurologic chaos and is associated with high morbidity ad mortality. The event initiates a cascade of physiologic and structural changes that manifest themselves in a variety of clinical symptoms. The critical care team of nurses, physicians, and therapists must rapidly identify the cause; understand the pathology; and use advanced assessment techniques, medications, and interventions to stabilize the patient and to counter the horrendous effects of the injury. Interventions that include endovascular aneurysm coiling and cerebral angioplasty are providing new options for isolating the aneurysm and countering the effects of vasospasm. Through an integrated team approach, recovery from ruptured aneurysm will be maximized.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/4. Segmental mediolytic arteritis [correction of arteries]: a case report with review of the literature.Segmental mediolytic arteritis is a very rare vascular disease which causes sudden intraabdominal hemorrhage. The disease is characterized by degeneration of the arterial media, followed by aneurysmal dilatation and rupture of the involved artery. Up to now, only 13 cases have been reported, and this unique disease is not fully recognized among general pathologists and physicians. Here, we present a case of segmental mediolytic arteritis involving the propria hepatic artery, which resulted in intraabdominal hemorrhage, and consequently hypovolemic circulatory disturbance. Histologically, the rupture focus showed degeneration and desquamation of the intima and media with fibrin-like material covering the exposed adventitia. Inflammatory infiltrates were only noted in the rupture focus as a secondary reactive change. Other than the rupture focus, there were two foci showing similar findings. This disease has rarely been reported and is seldom recognized as a cause of arterial rupture. In cases of sudden intraabdominal hemorrhage, segmental mediolytic arteritis should be considered as a possible cause in addition to atherosclerotic and mycotic aneurysm, traumatic injury and vasculitis syndromes.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |