1/24. Management of penetrating injury to the petrous internal carotid artery: case report.We report the management of a penetrating foreign body injury to the neck with a length of fencing wire traversing the internal carotid artery within the petrous temporal bone and entering the middle cranial fossa. Discussion points include methods of haemorrhage control, as well as ligation versus repair or bypass as the definitive treatment.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
2/24. Subarachnoid haemorrhage with "Ecstasy" abuse in a young adult.Abuse of the drugs like amphetamine, cocaine and "Ecstasy" may be complicated by intracerebral, subdural or subarachnoid haemorrhage. Contrary to historical opinion, drug-related intracranial haemorrhage (ICH) is frequently related to an underlying vascular malformation. We report the case of an 18-year-old man with a history of Ecstasy abuse preceding the onset of severe occipital headache. Cerebral computed tomography revealed right-sided subarachnoid haemorrhage and cerebral angiography showed right-sided middle cerebral artery aneurysm of 1 cm diameter. The patient was treated surgically with aneurysm clipping. Three weeks after onset of intracranial haemorrhage, neurological examination demonstrated normal findings. A history of severe headache immediately after using amphetamine, Ecstasy, or cocaine should alert doctors to the possibility of intracerebral haemorrhage. Arteriography should be part of the evaluation of most young patients with stroke or non-traumatic ICH.- - - - - - - - - - ranking = 9keywords = haemorrhage (Clic here for more details about this article) |
3/24. Deterioration of pre-existing hemiparesis brought about by subsequent ipsilateral lacunar infarction.Mechanisms of post-stroke recovery are still poorly understood. Recent evidence suggests that cortical reorganisation in the unaffected hemisphere plays an important role. A 59 year old man developed a small lacunar infarct in the left corona radiata, which then caused marked deterioration in a pre-existing left hemiparesis that had resulted from an earlier right putaminal haemorrhage. Functional magnetic resonance imaging showed that the paretic left hand grip activated the ipsilateral left motor areas, but not the right hemispheric motor areas. This suggests that partial recovery of the left hemiparesis had been brought about by cortical reorganisation of the left hemisphere and intensification of the uncrossed corticospinal tract. The subsequent small infarct may have damaged the uncrossed tract, thereby causing the pre-existing hemiparesis to deteriorate even further.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
4/24. Haemorrhagic brain injury: a care study.Mark was only 20 years old when an unfortunate sequence of events dramatically altered his life. In July 1989 he sustained two subarachnoid haemorrhages within a fortnight, first from a left anterior communicating artery aneurysm and then from a right middle cerebral artery aneurysm. Both aneurysm were successfully clipped but Mark remained hemiplegic with severe physical and behavioural problems, including incontinence, sexual disinhibition, aggression and uninhibited spitting. In November 1989, he was transferred to a neuro-rehabilitation unit and his management there will be described, showing how his complex problems were managed within enforced environmental limitations.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
5/24. Risus sardonicus after thalamic haemorrhage.We describe an uncommon movement disorder after stroke. A 70-year-old man was admitted for a right thalamic haemorrhage and 1 week later developed bilateral contractions of the face. Electromyographic study revealed a bilateral facial dystonia. The association of this bilateral facial dystonia and vertical gaze palsy produced the aspect of a "risus sardonicus."- - - - - - - - - - ranking = 5keywords = haemorrhage (Clic here for more details about this article) |
6/24. Dissociated perceptual-sensory and exploratory-motor neglect.A patient with a right sided parietal lobe infarction manifested left sided sensory extinction in the visual, auditory, and tactile modalities but had only mild exploratory-motor neglect. In contrast, another patient with a right frontal haemorrhage demonstrated only left sided exploratory-motor hemispatial neglect. Tasks that combined perceptual and exploratory features elicited varying degrees of neglect in each patient. These two cases with dissociated neglect behaviour lend further evidence for behavioural specialisation within components of a cortical network for directed attention: sensory-representational aspects mediated primarily by the parietal component, motor-exploratory primarily by the frontal component. These cases also highlight the need to include and distinguish among several different measures of neglect in the clinical investigation of patients with hemispatial inattention.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
7/24. Multiple subcortical haemorrhages following lumbar metrizamide myelography.The case is presented of a patient showing multiple subcortical haemorrhages after lumbar metrizamide myelography. This complication after intrathecally administered metrizamide contrast medium appears not to have been reported before. Several different possible explanations are proposed for the phenomena observed in this case.- - - - - - - - - - ranking = 5keywords = haemorrhage (Clic here for more details about this article) |
8/24. Lacunar syndromes due to brainstem infarct and haemorrhage.Nine patients with brainstem infarct and two with brainstem haemorrhage presented with pure motor stroke, pure supranuclear facial palsy, sensorimotor stroke or ataxic hemiparesis. Despite the clinical similarity with hemispheric lacunes, brainstem infarcts causing lacunar syndromes probably have a greater tendency to progress. Small brainstem haemorrhages should also be considered as a cause of lacunar syndromes and the difficulty in differentiating them from small infarcts without CT is emphasised.- - - - - - - - - - ranking = 6keywords = haemorrhage (Clic here for more details about this article) |
9/24. Acute spinal subdural haematoma.A 55-year-old female was brought to our out-patient clinic with an initially ascending, acute hemiplegia. The following descending myelography and CT scan disclosed a mass lesion at C6-D4. The acute spinal subarachnoidal haemorrhage found at operation, its genesis, diagnosis, treatment and rehabilitation are discussed.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
10/24. Mirror-writing and reversed repetition of digits in a right-handed patient with left basal ganglia haematoma.A 57 year old right-handed Chinese man sustained a left basal ganglia haemorrhage resulting in speech disorder and right hemiplegia. He mirror-wrote with his left hand and during speech recovery repeated digits in reverse sequence. The abnormal right to left directionality possibly reflected release of right basal ganglia from left-sided control.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
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