1/35. Retinal venous macroaneurysm associated with premacular hemorrhage.To report an unusual association of a retinal venous macroaneurysm with premacular hemorrhage in a 50-year-old man, using a case report method. The patient exhibited a dense premacular hemorrhage in the left eye. fluorescein angiography demonstrated that the source of bleeding was an isolated retinal venous macroaneurysm. The anterior surface of the hematoma was opened with an argon green laser, resulting in rapid clearing of the premacular hemorrhage and improvement in vision. Treatment of the retina surrounding the macroaneurysm to prevent recurrence of bleeding was ineffective to achieve occlusion of the lesion. No recurrent hemorrhage occurred during the observation period. Retinal venous macroaneurysm, a quite rare condition, may be complicated by premacular hemorrhage. argon green laser may be useful in treating such hemorrhage. Hemorrhagic detachment of the internal limiting membrane or subhyaloid hemorrhage in the macula may occur after retinal vessel rupture with physical exertion (Valsalva retinopathy) or in retinal vascular diseases, such as proliferative diabetic retinopathy, and retinal arterial macroaneurysm. Arterial macroaneurysms are a common, well-described retinal vascular disorder. In contrast to retinal arterial macroaneurysms, retinal venous macroaneurysms are quite rare. In this article we describe a patient who presented with premacular hemorrhage that was caused by a retinal venous macroaneurysm. The hematoma and the macroaneurysm were treated with argon green laser.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/35. Polyarthritis nodosa with mesenteric aneurysms demonstrated by angiography: report of a case and successful treatment of the patient with prednisolone and cyclophosphamide.polyarteritis nodosa is a necrotizing angitis that predominantly affects small and medium-sized arteries. The prognosis of untreated polyarteritis nodosa is very poor. Since symptoms are diverse and no serologic test is specific for polyarteritis nodosa, the diagnosis is difficult and often delayed. We describe a patient with polyarteritis nodosa who had gastrointestinal involvement with multiple aneurysms of the inferior mesenteric artery; only abdominal angiography provided a conclusive diagnosis. Alleviation of symptoms and regression of aneurysms were observed after combination therapy of an immunosuppressive agent, cyclophosphamide, and prednisolone. We emphasize the importance of early diagnosis by angiography and aggressive therapy in patients in whom physical signs indicating definite polyarteritis nodosa are not present.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/35. Leber's miliary aneurysms associated with telangiectasia of the nasal mucosa.A 20-year-old woman, treated with cryopexy and xenon- and argon-laser photocoagulation for Leber's miliary aneurysms in her right eye, suffered from repeated epistaxis. She underwent an endoscopy that showed an unusual number of telangiectatic veins. Laboratory results and routine physical and neurologic examinations showed normal values. Dematologic examination revealed no signs of hereditary hemorrhagic telangiectasis (Osler's disease). Nevertheless, it seems reasonable to assume that the combination of microvascular disturbances in one eye and in the nasal mucous membrane is not a coincidental finding.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/35. facial nerve palsy secondary to internal carotid artery dissection.We report facial palsy as the sole cranial neuropathy complicating an ipsilateral internal carotid artery dissection. A previously healthy 44-year-old man developed retro-orbital and temporal headache with associated nausea while engaged in modest physical exercise. On the following morning he noticed a left ptosis and miotic pupil. One week later he woke with a left facial weakness. On the same day he had a 90-minute episode of expressive dysphasia. magnetic resonance imaging and angiography demonstrated left internal carotid artery dissection. The temporal association between our patient's facial nerve palsy and typical features of spontaneous internal carotid artery dissection suggests a common aetiology. We suggest that involvement of the VII cranial nerve in isolation followed disruption of an anomalous nutrient artery. The delay in clinical manifestation may imply extension of the dissection.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/35. ehlers-danlos syndrome type IV and multiple aortic aneurysms--a case report.Beside atherosclerosis, aortic aneurysms can be part of the clinical spectrum of many systemic diseases, including infectious, inflammatory, genetic and, less often, congenital disorders. A 48-year-old white man presented with multiple large aneurysms of the aorta and its main branches. Medical history was unremarkable except for the presence of a softened abdominal mass since he was 28 years old. On the physical examination, an arterial murmur was heard over the left carotid artery and a palpable mass was noted in the whole right side of the abdomen. No skin or joint abnormalities were noted. aortography, computed tomography, and magnetic resonance angiography showed multiple large aneurysms of the descending thoracic and abdominal aorta. Aneurysms of the innominate, left subclavian, and carotid arteries were also seen. This case resembles those previously reported, in which multiple aortic aneurysms were associated with abnormalities of the type III procollagen gene (COL3A1). Although the classic stigmas of the ehlers-danlos syndrome type IV were lacking, this genetic disease may be the cause of the multiple aneurysms in this patient.- - - - - - - - - - ranking = 12.618921042899keywords = physical examination, physical (Clic here for more details about this article) |
6/35. Embolisation of a traumatic aneurysm of the posterior circumflex humeral artery in a volleyball player.Repetitive minor vascular injuries caused by physical activity in athletes may lead to ischaemia of the upper extremities. In volleyball players in particular, traumatic aneurysm of the posterior circumflex humeral artery has been reported to be a cause of ischaemia of the arm and hand. Such an aneurysm is described here; it was treated successfully with endovascular embolisation.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/35. Venous aneurysms of the wrist.We describe 2 cases of primary atraumatic venous aneurysm affecting the wrist. Both aneurysms were in branches of the cephalic vein in close proximity to the radial artery. The definitive treatment for these venous aneurysms was surgical excision. There was no recurrence after 9 years in case 1 and after 11 years in case 2. Modern diagnostic modalities were used, including physical examination, Doppler ultrasonography, aspiration, magnetic resonance imaging, and venography. The pathologic analysis was consistent with those venous aneurysms reported in other parts of the body. The hand surgeon should be aware of this rare condition when formulating a differential diagnosis for soft tissue masses of the wrist.- - - - - - - - - - ranking = 12.618921042899keywords = physical examination, physical (Clic here for more details about this article) |
8/35. An asymmetric ballooning of the neck: Jugular vein aneurysm.The differential diagnosis and treatment of a 2-year-old boy with a left-sided cystic neck bulge enlarged in size while straining, coughing, and crying is presented. Contemporary diagnostic tools were of little value, whereas its location, variability in size, and consistency at physical examination played a major impact. Simple excision of the venous aneurysm was sufficient in its treatment.- - - - - - - - - - ranking = 12.618921042899keywords = physical examination, physical (Clic here for more details about this article) |
9/35. False aneurysm of the brachial artery complicating closed fracture of the humerus. A case report.A 66-year-old, obese, mentally retarded man sustained a closed spiral fracture of the humerus accompanied by development of a large false aneurysm arising from a small rent in the distal third of the brachial artery. Because of the patient's body habitus, mental deficiency, and paucity of objective physical findings, the arterial injury was not suspected until expensive pressure necrosis necessitated shoulder disarticulation as a lifesaving measure. Although false aneurysms are known to complicate penetrating trauma and various surgical procedures using metallic implants, the lesion has not been previously reported with closed long bone fractures. The authors wish to alert others to occurrence of the occult arterial injury in association with a relatively common extremity fracture. The need to exercise special awareness and suspicion of subtle injuries in patients whose age, mental status, or associated trauma render communication of symptoms impossible, cannot be overemphasized.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
10/35. Horner's syndrome resulting from agenesis of the internal carotid artery: report of a third case.INTRODUCTION: Only two previous reports of agenesis of the internal carotid artery with a coexistent Horner's syndrome are to be found in the medical literature. CASE REPORT: We report a case of a male child seen initially for what was presumed to be a traumatic superficial temporal artery aneurysm. MRA incidentally revealed ipsilateral agenesis of the internal carotid artery. This child's physical exam included ipsilateral Horner's syndrome. CONCLUSION: This case report illustrates that agenesis of the internal carotid artery does indeed cause Horner's syndrome in some cases. The clinician who diagnoses a patient with Horner's syndrome should remember that agenesis of the internal carotid artery may be the cause as this entity can be associated in itself with other pathologies of the central nervous system.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
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