1/186. Epileptic falling spells after epidural haematoma in adult Down's syndrome.A 35-year-old man with Down's syndrome showed epileptic falling spells. He had suffered from a traumatic right-sided epidural haematoma 3 years before. It had been neurosurgically treated, but MRI taken 5 days later had revealed a small contracoup contusion at the left temporal lobe. His falling spell was a brief tonic seizure without disturbance of consciousness. Background activities of EEG consisted of slow alpha waves interspersed with sporadic theta waves and the amplitude at the left temporal area was lower than the opposite one. Interictal EEG showed sharp waves or sharp and slow wave complexes predominantly at the right temporo-centro-parietal area as well as diffuse, though predominantly at frontal areas, bursts of slow waves with high amplitude. The EEG suggested focal epileptic activities evolving into secondary generalization. SPECT of the brain showed the hypoperfusion at the left temporal area and at the right posterotemporo-parietal area, where the hypoperfusion was somewhat reduced after the improvement of seizures. seizures were well controlled with phenytoin combined with phenobarbital. The incidence of epilepsy in the Down's syndrome has been reported to increase after the middle age in association with the development of Alzheimer's neuropathology. When those people would sustain head injuries, it was necessary to follow carefully using SPECT and EEG.- - - - - - - - - - ranking = 1keywords = haematoma, brain (Clic here for more details about this article) |
2/186. Abrupt exacerbation of acute subdural hematoma mimicking benign acute epidural hematoma on computed tomography--case report.A 75-year-old male was hit by a car, when riding a bicycle. The diagnosis of acute epidural hematoma was made based on computed tomography (CT) findings of lentiform hematoma in the left temporal region. On admission he had only moderate occipitalgia and amnesia of the accident, so conservative therapy was administered. Thirty-three hours later, he suddenly developed severe headache, vomiting, and anisocoria just after a positional change. CT revealed typical acute subdural hematoma (ASDH), which was confirmed by emergent decompressive craniectomy. He was vegetative postoperatively and died of pneumonia one month later. Emergent surgical exploration is recommended for this type of ASDH even if the symptoms are mild due to aged atrophic brain.- - - - - - - - - - ranking = 7.0575831157056E-6keywords = brain (Clic here for more details about this article) |
3/186. Epidural haematoma after removal of an epidural catheter in a patient receiving high-dose enoxaparin.A patient developed an epidural haematoma 6 days after removal of an epidural catheter resulting in paraplegia and death. Insertion and removal of the epidural catheter during anticoagulation with prophylactic unfractionated heparin and subsequent administration of high-dose enoxaparin (Clexane), which commenced 3 days after catheter removal, were implicated.- - - - - - - - - - ranking = 0.99999294241688keywords = haematoma (Clic here for more details about this article) |
4/186. Spinal haematoma following epidural anaesthesia in a patient with eclampsia.A patient with a twin pregnancy required a Caesarean section for severe pre-eclampsia. Her platelet count was 71 x 10(9).l-1. Epidural anaesthesia was performed after platelet transfusion. A spinal epidural haematoma was diagnosed postoperatively. A generalised tonic-clonic seizure sparing the lower limbs enabled early diagnosis to be made. The patient recovered with no permanent neurological damage after laminectomy and clot removal. The risks and benefits of regional techniques require careful consideration, and postoperative monitoring for recovery of neural blockade is essential.- - - - - - - - - - ranking = 0.99999294241688keywords = haematoma (Clic here for more details about this article) |
5/186. spinal cord injury following an attempted thoracic epidural.Unsuccessful attempts were made to insert a thoracic epidural in an anaesthetised patient. Signs of spinal cord damage were observed the following day. magnetic resonance imaging demonstrated a haematoma anterior to the spinal cord. Surgical exploration revealed an intradural haematoma and a needle puncture of the cord. The patient suffered a permanent paraparesis.- - - - - - - - - - ranking = 0.39999717696675keywords = haematoma (Clic here for more details about this article) |
6/186. Spontaneous epidural haematoma associated with radiation-induced malignant fibrous histiocytoma.We report a case of spontaneous epidural haemorrhage associated with metastatic radiation-induced malignant fibrous histiocytoma of the dural meninges in a patient who had been previously treated for nasopharyngeal carcinoma with radiotherapy.- - - - - - - - - - ranking = 0.80103231059879keywords = haematoma, haemorrhage (Clic here for more details about this article) |
7/186. Rapid spontaneous resolution of an acute extradural haematoma: case report.A case of acute extradural haematoma with spontaneous resolution within 6 h of the head injury is presented. The literature is reviewed.- - - - - - - - - - ranking = 0.99999294241688keywords = haematoma (Clic here for more details about this article) |
8/186. Occipital condyle fracture with peripheral neurological deficit.A 24-year-old woman sustained a type III Anderson and Montesano fracture in a road traffic accident. Acute respiratory stridor, multiple cranial nerve palsies and right upper limb neurological deficits associated with a C1 to T2 extradural haematoma were unique features of this case. The patient made a full and uncomplicated recovery with conservative management.- - - - - - - - - - ranking = 0.19999858848338keywords = haematoma (Clic here for more details about this article) |
9/186. The shaking trauma in infants - kinetic chains.The findings in three children who died as a consequence of shaking and those in another child who survived are presented. In the three fatal cases, a combination of anatomical lesions were identified at autopsy which appear to indicate the sites where kinetic energy related to the shaking episodes had been applied thus enabling the sequence of events resulting in the fatal head injury to be elucidated. Such patterns of injuries involved the upper limb, the shoulder, the brachial nerve plexus and the muscles close to the scapula; hemorrhages were present at the insertions of the sternocleidomastoid muscles due to hyperextension trauma (the so-called periosteal sign) and in the transition zone between the cervical and thoracic spine and extradural hematomas. Characteristic lesions due to traction were also found in the legs. All three children with lethal shaking trauma died from a subdural hematoma only a few hours after the event. The surviving child had persistant hypoxic damage of the brain following on massive cerebral edema. All the children showed a discrepancy between the lack of identifiable external lesions and severe internal ones.- - - - - - - - - - ranking = 5.4710040157027E-5keywords = cerebral, brain (Clic here for more details about this article) |
10/186. Concomitant post-traumatic craniocervical junction epidural hematoma and pontomedullary junction infarction: clinical, neurophysiologic, and neuroradiologic features.STUDY DESIGN: A case report. OBJECTIVES: To report and discuss a case of post-traumatic epidural hematoma of the craniocervical junction with concomitant brain stem infarction. SUMMARY OF BACKGROUND DATA: Post-traumatic epidural hematoma of the cervical spine and brain stem post-traumatic infarction are very rare disorders. Post-traumatic epidural hematoma is usually located dorsally in the epidural space. methods: The clinical, neuroradiologic, and neurophysiologic findings in one patient with post-traumatic epidural hematoma located ventrally at the cervicomedullary junction and associated with medial infarction at the pontomedullary junction are reported. RESULTS: The main clinical finding in this patient was bilateral corticospinal and corticobulbar tract involvement. A magnetic resonance image showed displacement and flattening of the medulla oblongata and of the most cranial portion of cervical cord, which were caused by the epidural hematoma associated with an ischemic lesion of the pontomedullary junction. Results of central motor conduction studies indicated that the abnormality of the central motor pathways was localized at brain stem level, and that there was normal conduction from the cervicomedullary junction to spinal cord. CONCLUSION: This is the first reported case of spinal epidural hematoma located ventrally in the cervical spine at the cervicomedullary junction level and concomitant infarction at the pontomedullary junction resulting from whiplash injury.- - - - - - - - - - ranking = 2.1172749347117E-5keywords = brain (Clic here for more details about this article) |
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