1/20. Stress-related primary intracerebral hemorrhage: autopsy clues to underlying mechanism.BACKGROUND: research into the causes of small-vessel stroke has been hindered by technical constraints. Cases of intracerebral hemorrhage occurring in unusual clinical contexts suggest a causal role for sudden increases in blood pressure and/or cerebral blood flow. CASE DESCRIPTION: We describe a fatal primary thalamic/brain stem hemorrhage occurring in the context of sudden emotional upset. At autopsy, the brain harbored several perforating artery fibrinoid lesions adjacent to and remote from the hematoma as well as old lacunar infarcts and healed destructive small-vessel lesions. CONCLUSIONS: We postulate that the emotional upset caused a sudden rise in blood pressure/cerebral blood flow, mediating small-vessel fibrinoid necrosis and rupture. This or a related mechanism may underlie many small-vessel strokes.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/20. Cardiac rupture during exercise stress echocardiography: a case report.Stress echocardiography is widely used in the evaluation of coronary artery disease. dobutamine stress echocardiography has been the preferred method, but many centers have adopted exercise stress echocardiography, which can visualize myocardial motion during physiologic stress testing. The complications of this method in the post-myocardial infarction period are the same as those identified in conventional exercise testing. We report a case of myocardial rupture in the postinfarction period during exercise stress echocardiography.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
3/20. Two-stage operation for treatment of a large dissecting popliteal cyst after failed total knee arthroplasty.A symptomatic popliteal cyst after total knee arthroplasty (TKA) is rare, occurring most frequently as a result of intra-articular knee pathology. We present a case of a large dissecting popliteal cyst 7 years after TKA with symptoms of severe calf pain and functional disability. The symptomatic cyst was excised completely in a first-stage operation, and the severely worn TKA was corrected by a second-stage surgical procedure. The patient in this report was pain free and had satisfactory range of knee motion 5 years after the index revision TKA, without recurrence of effusion or popliteal cyst formation.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
4/20. Tendon lengthening repair and early mobilization in treatment of neglected bilateral simultaneous traumatic rupture of the quadriceps tendon.Bilateral simultaneous traumatic rupture of the quadriceps tendon is a rare injury that is most frequently seen in elderly patients with predisposing diseases such as gout, hyperparathyroidism and diabetes. Delay in diagnosis is not uncommon. One of the main problems in treatment is loss of motion, especially flexion, after surgical repair. We report a case that was diagnosed 5 months after the trauma and was treated by Scuderi's tendon lengthening technique. Range-of-motion exercises were started early without using the generally recommended 4-6 weeks of immobilization in plaster cylinder or knee brace. Five years of follow-up showed full range of motion in both knees with sound tendons. Stable fixation makes starting early motion and accelerated rehabilitation feasible and thus the most common complication, loss of motion, is prevented.- - - - - - - - - - ranking = 2.5keywords = motion (Clic here for more details about this article) |
5/20. Echocardiographic findings of ventricular septal rupture in acute myocardial infarction.Echocardiograms were recorded both before and after the clinical appearance of an autopsy-confirmed interventricular septal rupture in a patient with an acute myocardial infarction. The major findings were related to the upper portion of the interventricular septum. Before rupture, this portion of the septum was relatively akinetic with a slight anterior motion during systole, whereas after rupture there was a marked increase in the amplitude of septal motion with abrupt posterior motion occurring with the onset of ventricular diastole.- - - - - - - - - - ranking = 1.5keywords = motion (Clic here for more details about this article) |
6/20. Echocardiographic manifestations of postinfarction ventricular septal rupture.The echocardiographic features of three patients with postinfarction ventricular spectal rupture are described. All patients showed a decreased or paradoxical motion on the ventricular septum, and two of the patients demonstrated an unusual motion of the tricuspid valve. There were no abnormalities in mitral valve motion. The echocardiogram can be helpful in the diagnosis of postinfarction ventricular septal rupture and can assist in distinguishing this condition from acute disruption of the mitral valve complex.- - - - - - - - - - ranking = 1.5keywords = motion (Clic here for more details about this article) |
7/20. Echocardiographic manifestations of aortic cusp rupture in a myxomatous aortic valve.A 16-year-old pregnant black girl who had spontaneous perforation of the aortic valve associated with myxomatous aortic valvular degeneration is presented. The echocardiogram revealed chaotic systolic motion of one of the aortic cusps, diastolic aortic valvular fluttering, and abnormal diastolic echoes in the left ventricular outflow tract. The report illustrates that the echocardiographic features associated with valvular vegetations are not specific for infectious endocarditis.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
8/20. 'Bald trochanter' spontaneous rupture of the conjoined tendons of the gluteus medius and minimus presenting as a trochanteric bursitis.A 66-yr-old white woman presented with progressive complaints of right lateral hip and thigh pain associated with a disabling limp without an antecedent history of trauma. physical examination revealed localized pain over the right greater trochanter to palpation. A full pain-free range of motion of the right hip was associated with weakness in the hip abductors. The patient ambulated with a compensated right Trendelenburg gait. Subsequent magnetic resonance imaging demonstrated a trochanteric bursitis and an effusion of the hip and a full-thickness tear of the gluteus medius muscle, with both a disruption and retraction of the tendon of an atretic gluteus minimus muscle. Conjoined tendon pathology of both the gluteus medius and minimus as, revealed by magnetic resonance examination, is probably more frequent than heretofore commonly recognized. In patients presenting with "intractable" complaints of a trochanteric bursitis and an ambulatory limp due to weakness in the hip abductors, imaging studies calling attention to a possible tendon rupture may be diagnostic.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
9/20. Spontaneous rupture of the extensor pollicis longus tendon in a professional skier.Spontaneous rupture of the extensor pollicis longus (EPL) tendon is uncommon in sports activities. We report a rare case of a professional downhill skier presenting with a rupture of the EPL tendon. Repetitive motion of the wrist joint appeared to cause the rupture. The patient was treated successfully with tendon transfer of the extensor indicis proprius.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
10/20. Arthroscopic surgery for degenerative rupture of the ligamentum teres femoris.We performed arthroscopic debridement for degenerative rupture of the ligamentum teres femoris in a patient and obtained good results. A 78-year-old woman suddenly developed intense load-bearing pain from the left lumbar to gluteal region, and giving way, without a definitive cause. At presentation, the range of motion of the left hip joint for external rotation was 0 degrees, showing restricted motion. When passive internal rotation was applied at 90 degrees of flexion, intense pain in the left gluteal region was induced. At the initial radiographic examination, there were no abnormal findings in the left hip joint. However, arthroscopic findings showed degeneration in the articular cartilage and labrum but no tear. In addition, degenerative rupture of the ligamentum teres femoris was observed and it was entrapped in the posterior joint space. Using a bipolar radiofrequency scalpel, the entrapped stump of the ligamentum teres was vaporized and excised. The restriction in external rotation of the hip joint observable even under anesthesia was resolved immediately after surgery. Two years after surgery, the patient had regained her preoperative walking ability with the aid of a T cane, and radiographic examination showed no coxarthrosis changes. This case indicates that coxalgia caused by degenerative rupture of the ligamentum teres femoris is also a good indication for arthroscopic debridement.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
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