1/26. Severe arteriosclerosis in the kidney of a cocaine addict.cocaine abuse has been associated with sudden cardiac death with coronary artery thrombosis with or without underlying vessel disease. Additional vascular beds thus far implicated in cocaine-associated arteriopathy include thoracic and abdominal aorta, and pulmonary, cerebral, and placental vessels; abnormalities include vasospasm, thrombosis, and accelerated atherosclerosis. We report the case of an adult male cocaine user with severe arteriosclerosis of renal vessels, and suggest that cocaine may also affect the renal vasculature.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/26. Lethal injuries occurring during illegal break-ins.Individuals who undertake criminal activity are often at risk of injury for a variety of reasons. Two cases are reported where individuals who were engaged in illegal breaking and entering activities sustained stab wounds from broken window glass and died of exsanguination. The cases both involved young males who were under the influence of alcohol and/or drugs and who sustained relatively minor tissue damage that had fatal consequences due to a variety of coincident factors. Critical location of wound sites over major vessels resulted in rapid bleeding that was enhanced by vasodilator effects of alcohol and stimulant effects of amphetamines. In addition, adrenergic effects of being engaged in illegal activities, and the subsequent pain from the wounds, may also have contributed to accelerated heart rate and blood loss. Failure to appreciate the potential effects of such wounds, which may initially have appeared relatively minor based on their small size, added to an impaired ability to apply first aid or seek appropriate medical assistance, may also have been due to the combined effects of drugs, alcohol, and concerns regarding the illegal nature of the underlying activity. Such a scenario constitutes a specific subgroup of offender injury that could be termed the break, enter, and die syndrome.- - - - - - - - - - ranking = 0.33333333333333keywords = vessel (Clic here for more details about this article) |
3/26. Subarachnoid and intracerebral hemorrhage associated with necrotizing angiitis due to methamphetamine abuse--an autopsy case.The authors report an autopsy case of methamphetamine-related intracranial hemorrhage and vasculitis. A 22-year-old female was comatose after an intravenous injection of an unknown dose of methamphetamine. Computed tomographic scans demonstrated massive subarachnoid hemorrhage and hematoma in the corpus callosum. cerebral angiography revealed nonfilling of bilateral intracranial carotid arteries and extravasation of contrast medium from the right pericallosal artery which was visualized retrogradely via the vertebral artery. Postmortem studies found cerebral edema, subarachnoid, intraventricular, and intracerebral hemorrhage, and intracranial vasculitis, but no aneurysm or arteriovenous malformation. necrosis of vessel walls with destruction of the smooth muscle layer, but no leukocytotic infiltration of the vessel walls were observed in all major cerebral arteries. The hemorrhage probably resulted from medial necrosis in the large intracerebral vessels, and a sudden drug-induced rise in blood pressure.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/26. Cerebral vasculitis associated with cocaine abuse.BACKGROUND: Earlier reports of cocaine-associated cerebral vasculitis have been based primarily on angiographic findings without pathological verification. CASE DESCRIPTION: We present a case of acute encephalopathy following intravenous and intranasal administration of cocaine. brain biopsy revealed vascular changes involving primarily small arteries. Findings included lymphocytic infiltration, endothelial thickening, and deposition of proteinaceous amorphous material within and around vessel walls. CONCLUSIONS: These abnormalities are consistent with pathological features of arteritis previously reported in association with amphetamine and multiple-drug abuse. Vasospasm-induced changes are an alternative explanation for the vascular picture seen in this case. The patient made modest improvement with high-dose intravenous steroids.- - - - - - - - - - ranking = 0.33333333333333keywords = vessel (Clic here for more details about this article) |
5/26. Vascular lesions in intestinal ischemia induced by cocaine-alcohol abuse: report of a fatal case due to overdose.Intestinal ischemia induced by cocaine abuse is a rare condition. To this date, only three cases have been described. The diagnosis of bowel ischemia should be suspected whenever a cocaine addict has severe abdominal pain. A pathological examination of the resected bowel segment was performed in one case, and the diagnosis was confirmed microscopically. However, the existence of pathologic alterations of the intestinal vessels was not confirmed. Why the intestinal injury is segmental and whether it is related to the dose ingested, the administration route, or the combination of cocaine with alcohol, caffeine, or marijuana remain unclear. The authors report one fatal case associated with cocaine-alcohol overdose. The postmortem examination demonstrated the existence of segmental intestinal ischemia. Microscopic study failed to demonstrate thrombosis in the mesenteric vessels; however, we found an unusual lesion affecting the arterioles located in the intestinal submucosa of the hemorrhagic areas.- - - - - - - - - - ranking = 0.66666666666667keywords = vessel (Clic here for more details about this article) |
6/26. biopsy-proven cerebral vasculitis associated with cocaine abuse.We report cerebral vasculitis in 2 cocaine users who developed symptoms (transient blindness and persistent headache) while smoking "crack," followed by progressive widespread cerebral dysfunction with focal signs over the next few weeks. One patient had smoked crack exclusively, and the other also used cocaine intravenously. Sedimentation rates were elevated and hiv titers negative. Arteriography was normal in 1 patient and in the other showed multiple large-vessel occlusions without beading. brain biopsy showed vasculitis involving small vessels in both patients. Multinucleated cells were present in the neuropil, but there were no granulomas or evidence of infection. One patient improved significantly with corticosteroid treatment, and made a good recovery. The other died despite corticosteroid and cyclophosphamide treatment.- - - - - - - - - - ranking = 0.66666666666667keywords = vessel (Clic here for more details about this article) |
7/26. A fatal attraction: cocaine related subarachnoid hemorrhage.An alarming number of people use cocaine, a drug surrounded with myths and misconceptions. cocaine use is associated with many medical and psychiatric problems. It is now believed cocaine use may lead to subarachnoid hemorrhage. cocaine stimulates the release of various neurotransmitters in the brain as well as blocks their uptake, causing a temporary surge in systolic blood pressure. The constant assault on the vessels from continuous cocaine use weakens them causing hemorrhage or possibly creates an aneurysm. This article explains how cocaine affects the blood vessels and neurotransmitters of the brain, reviews two case histories in which cocaine may have contributed to aneurysmal formation and subarachnoid hemorrhage and discusses nursing implications of cocaine related subarachnoid hemorrhage.- - - - - - - - - - ranking = 0.66666666666667keywords = vessel (Clic here for more details about this article) |
8/26. Intracerebral hemorrhage following intravenous administration of epinephrine.We report a case of intracerebral hemorrhage (ICH) in a young man following intravenous self-administration of epinephrine. Arteriography evidenced normal intracranial vessels, and namely excluded the presence of vascular malformations which could have been implicated in the pathogenesis of ICH. We believe that the main pathogenetic agent in this case was the sudden rise in arterial blood pressure. This report aims at underlying the severe implications of non-medical use of sympathomimetic drugs.- - - - - - - - - - ranking = 0.33333333333333keywords = vessel (Clic here for more details about this article) |
9/26. Left-sided endocarditis due to pseudomonas aeruginosa. A report of 10 cases and review of the literature.Ten confirmed cases of left-sided endocarditis due to pseudomonas aeruginosa were reported in detail and the English literature was reviewed. In recent years, venous access (usually illicit) has been the major predisposing factor to this infection and abuse of pentazocine and tripelennamine has been particularly associated with endocarditis due to this organism. This infection involves previously damaged as well as normal valves. The development of congestive heart failure did not adversely affect the prognosis of this infection. However, the development of azotemia was associated with a greater likelihood of a fatal outcome. In the current series, deaths were due to uncontrolled infection. This often occurred despite inhibitory and bactericidal activity in serum generally considered adequate for treatment of endocarditis. Medical treatment alone rarely produced cure of infection. Our experience with a high frequency of major vessel embolization (4/10) and the improved survival after medical/surgical treatment suggests that prompt valve replacement combined with high doses of an aminoglycoside plus carbenicillin or ticarcillin provide the best opportunity for successful outcome in patients with left-sided endocarditis due to P. aeruginosa.- - - - - - - - - - ranking = 0.33333333333333keywords = vessel (Clic here for more details about this article) |
10/26. Legal issues associated with PCP abuse--the role of the forensic expert.These cases illustrate some of the complex issues associated with PCP-related litigation. The concept that malice is implied when an experienced drug user commits a crime while under the influence of the drug is not held in most states, at the present time. The authors have now reviewed in detail four cases of unexpected death following the use of neck holds in PCP-intoxicated individuals. In all of the cases, multiple carotid compression holds had been attempted, according to the history. skin abrasions, hemorrhage into the soft tissues of the neck, and fractures of the hyoid bone and thyroid cartilage provide structural evidence of the application of substantial force to the neck. On autopsy, there has been no evidence of lethal injuries to the bronchial tree, brain, or heart. Drugs related to PCP are known to alter the carotid sinus reflex. Mechanical stimulation of the carotid sinus in the neck normally results in a slowing of heart rate and a decrease in blood pressure. carotid sinus stimulation, coupled with the effects of PCP on blood vessels, might result in a marked fall in the blood pressure that could lead, ultimately, to death. Individuals intoxicated with PCP may be at a higher risk to complications of carotid compression neck holds. Hence, additional cases would be expected to become medicolegal issues.- - - - - - - - - - ranking = 0.33333333333333keywords = vessel (Clic here for more details about this article) |
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