首页 > 最新文献

Journal of clinical case reports最新文献

英文 中文
Pericarditis: Uncommon Onset of Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis Induced by Methimazol 心包炎:甲巯咪唑诱导的抗中性粒细胞细胞质抗体相关血管炎的罕见发作
Pub Date : 2018-05-08 DOI: 10.1530/ENDOABS.56.P994
M. Jemel, H. Sayadi, I. Khochtali
Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) is a group of small vessel vasculitides characterized by necrotizing inflammation, with few or no immune deposits associated with myeloperoxidase (MPO) ANCA or proteinase 3 (PR3) ANCA. It includes microscopic polyangiitis, granulomatosis with polyangiitis (Wegner’s), eosinophilic granulomatosis with polyangiitis (Churg-Strauss) and single-organ AAV (for renal example, renal-limited AAV) [1]. Even the etiology of this vasculitis is still unclear several factors have been reported to be associated with AAV with more consideration of drug-associated ANCAassociated vasculitis [2]. Antithyroid drugs (ATDs) which are generally well tolerated can be associated with minor side effect, but serious and potentially life-threatening complications can occurred in very rare cases with such AAV [3]. To date Propylthiouracil (PTU) is more likely to be associated with AAV than Carbimazole (CBZ) or his active metabolite Methimazole (MMI) [4]. Skin lesions and kidney involvement are the most common clinical features reported in this field. Here we present the first case report of a 25-yr-old woman who developed AAV initially presenting with pericarditis after 1 year of MMI use.
抗中性粒细胞胞浆抗体(ANCA)相关血管炎(AAV)是一组以坏死性炎症为特征的小血管血管炎,很少或没有与髓过氧化物酶(MPO)ANCA或蛋白酶3(PR3)ANCA相关的免疫沉积。它包括显微镜下多血管炎、肉芽肿伴多血管炎(Wegner's)、嗜酸性肉芽肿伴多发血管炎(Churg Strauss)和单器官AAV(例如肾局限性AAV)[1]。即使这种血管炎的病因仍不清楚,据报道,有几个因素与AAV有关,更多地考虑了药物相关的ANCA相关血管炎[2]。通常耐受性良好的抗甲状腺药物(ATD)可能会产生轻微副作用,但在极少数AAV病例中可能会出现严重且可能危及生命的并发症[3]。到目前为止,丙基硫氧嘧啶(PTU)比氨甲唑(CBZ)或其活性代谢产物甲硫唑(MMI)更有可能与AAV相关[4]。皮肤病变和肾脏受累是该领域报道的最常见的临床特征。在这里,我们提出了第一个病例报告,一名25岁的女性在使用MMI一年后出现AAV,最初表现为心包炎。
{"title":"Pericarditis: Uncommon Onset of Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis Induced by Methimazol","authors":"M. Jemel, H. Sayadi, I. Khochtali","doi":"10.1530/ENDOABS.56.P994","DOIUrl":"https://doi.org/10.1530/ENDOABS.56.P994","url":null,"abstract":"Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) is a group of small vessel vasculitides characterized by necrotizing inflammation, with few or no immune deposits associated with myeloperoxidase (MPO) ANCA or proteinase 3 (PR3) ANCA. It includes microscopic polyangiitis, granulomatosis with polyangiitis (Wegner’s), eosinophilic granulomatosis with polyangiitis (Churg-Strauss) and single-organ AAV (for renal example, renal-limited AAV) [1]. Even the etiology of this vasculitis is still unclear several factors have been reported to be associated with AAV with more consideration of drug-associated ANCAassociated vasculitis [2]. Antithyroid drugs (ATDs) which are generally well tolerated can be associated with minor side effect, but serious and potentially life-threatening complications can occurred in very rare cases with such AAV [3]. To date Propylthiouracil (PTU) is more likely to be associated with AAV than Carbimazole (CBZ) or his active metabolite Methimazole (MMI) [4]. Skin lesions and kidney involvement are the most common clinical features reported in this field. Here we present the first case report of a 25-yr-old woman who developed AAV initially presenting with pericarditis after 1 year of MMI use.","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":"4 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46939376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Klebsiella Meningitis as the Initial Presentation of Macroprolactinoma: A Case Report 以克雷伯氏脑膜炎为首发表现的大泌乳素瘤一例报告
Pub Date : 2018-05-07 DOI: 10.4172/2165-7920.10001111
Y. Elamir, W. Grist
Introduction: Gram negative bacterial meningitis is a rare initial presentation of a macroprolactinoma. Meningitis in these cases is likely caused by a defect in the sellar floor from surgical manipulation or treatment with a dopamine agonist causing rapid shrinkage of a tumor. Patients generally have headaches as the predominant symptom. Our case is an illustration of where meningitis is caused by a transsphenoidal surgery and where meningitis is the presenting symptom to diagnosing a macroprolactinoma.Case presentation: The patient is a 20-year old African female with history of transsphenoidal surgery over one year ago, who presents with headache associated with subjective fevers, nausea, and vomiting. The patient states that she had similar headaches for the past 2 years but not to this severity. She reports that when she was in her country one year ago she had an unknown surgery through her nose that helped the headaches for a short period of time. She recalls having increasingly irregular periods over the past year and milky discharge from her breasts.Results: Physical exam was significant for nuchal rigidity. CT scan showed large sellar mass and MRI was consistent with likely pituitary adenoma. The patient’s presentation was suspicious for meningitis, so a lumbar puncture was performed, and CSF analysis was consistent with bacterial meningitis. The patient was started on broad spectrum antibiotics until CSF cultures returned showing Klebsiella pneumoniae sensitive to ceftriaxone. Further testing showed very high prolactin levels. Endocrinology was consulted and agreed the tumor was a pituitary macroadenoma, most likely a prolactinoma due to her laboratory findings and symptoms of menstrual irregularity and galactorrhea. The patient was treated with Cabergoline 0.5 mg two times per week.Conclusion: Bacterial meningitis, especially when caused by gram negative organisms is a rare presentation of a pituitary macroprolactinoma. Thorough history taking, and prompt diagnostic evaluation is crucial, especially when medical records cannot be obtained. Treatment of both conditions quickly and simultaneously is important. The case also illustrates that how treating a prolactinoma can result in complications such as meningitis not just immediately after surgery but in any stage of treatment.
简介:革兰氏阴性细菌性脑膜炎是一种罕见的大泌乳素腺瘤。这些病例中的脑膜炎可能是由手术操作或多巴胺激动剂治疗引起的鞍底缺陷引起的,从而导致肿瘤快速缩小。患者通常以头痛为主要症状。我们的病例说明了脑膜炎是由经蝶窦手术引起的,脑膜炎是诊断大泌乳素腺瘤的主要症状。病例介绍:患者是一名20岁的非洲女性,一年多前有经蝶窦手术史,表现为头痛,伴有主观发烧、恶心和呕吐。患者表示,在过去的两年里,她也有类似的头痛,但没有严重到这种程度。她报告说,一年前她在自己的国家时,做了一次不知名的鼻子手术,在短时间内缓解了头痛。她回忆说,在过去的一年里,月经越来越不规律,乳房排出乳白色分泌物。结果:体格检查对颈部强直有显著意义。CT扫描显示鞍区有较大肿块,MRI与可能的垂体腺瘤一致。患者的表现可疑为脑膜炎,因此进行了腰椎穿刺,脑脊液分析与细菌性脑膜炎一致。患者开始服用广谱抗生素,直到CSF培养物显示肺炎克雷伯菌对头孢曲松敏感。进一步的测试显示泌乳素水平非常高。咨询了内分泌科,认为肿瘤是垂体大腺瘤,很可能是泌乳素瘤,因为她的实验室检查结果以及月经不规律和溢乳的症状。患者接受卡麦角林0.5 mg治疗,每周两次。结论:细菌性脑膜炎,尤其是由革兰氏阴性菌引起的细菌性脑膜炎是垂体大泌乳素腺瘤的罕见表现。彻底的病史采集和及时的诊断评估至关重要,尤其是在无法获得医疗记录的情况下。快速同时治疗这两种情况很重要。该病例还表明,治疗泌乳素瘤不仅会在手术后立即,而且在任何治疗阶段都会导致脑膜炎等并发症。
{"title":"Klebsiella Meningitis as the Initial Presentation of Macroprolactinoma: A Case Report","authors":"Y. Elamir, W. Grist","doi":"10.4172/2165-7920.10001111","DOIUrl":"https://doi.org/10.4172/2165-7920.10001111","url":null,"abstract":"Introduction: Gram negative bacterial meningitis is a rare initial presentation of a macroprolactinoma. Meningitis in these cases is likely caused by a defect in the sellar floor from surgical manipulation or treatment with a dopamine agonist causing rapid shrinkage of a tumor. Patients generally have headaches as the predominant symptom. Our case is an illustration of where meningitis is caused by a transsphenoidal surgery and where meningitis is the presenting symptom to diagnosing a macroprolactinoma.Case presentation: The patient is a 20-year old African female with history of transsphenoidal surgery over one year ago, who presents with headache associated with subjective fevers, nausea, and vomiting. The patient states that she had similar headaches for the past 2 years but not to this severity. She reports that when she was in her country one year ago she had an unknown surgery through her nose that helped the headaches for a short period of time. She recalls having increasingly irregular periods over the past year and milky discharge from her breasts.Results: Physical exam was significant for nuchal rigidity. CT scan showed large sellar mass and MRI was consistent with likely pituitary adenoma. The patient’s presentation was suspicious for meningitis, so a lumbar puncture was performed, and CSF analysis was consistent with bacterial meningitis. The patient was started on broad spectrum antibiotics until CSF cultures returned showing Klebsiella pneumoniae sensitive to ceftriaxone. Further testing showed very high prolactin levels. Endocrinology was consulted and agreed the tumor was a pituitary macroadenoma, most likely a prolactinoma due to her laboratory findings and symptoms of menstrual irregularity and galactorrhea. The patient was treated with Cabergoline 0.5 mg two times per week.Conclusion: Bacterial meningitis, especially when caused by gram negative organisms is a rare presentation of a pituitary macroprolactinoma. Thorough history taking, and prompt diagnostic evaluation is crucial, especially when medical records cannot be obtained. Treatment of both conditions quickly and simultaneously is important. The case also illustrates that how treating a prolactinoma can result in complications such as meningitis not just immediately after surgery but in any stage of treatment.","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7920.10001111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43475325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Full Term Abdominal Pregnancy with Healthy Newborn: A Case Report 足月腹部妊娠伴健康新生儿1例
Pub Date : 2018-05-07 DOI: 10.4172/2165-7920.10001110
H. Jalal
We report a case of full term abdominal pregnancy with healthy newborn. This is a rare variety of ectopics pregnancies whose evolution to the end remains exceptional. It is unique to developing countries with a high incidence of genital infections and poor pregnancy monitoring. It is associated with significant perinatal mortality because of fetal malformations and maternal morbidity related to hemorrhagic, infectious and occlusive risk. Ultrasound is almost unavoidable for positive diagnosis supplemented by magnetic resonance imaging detecting fetal malformations and allowing a better analysis of placental relations with the abdominal organs; decisive elements to optimize the care of the parturient.
我们报告一例足月腹部妊娠与健康的新生儿。这是一种罕见的异位妊娠,其进化到最后仍然是例外的。它是发展中国家所特有的,这些国家生殖器感染发生率高,妊娠监测差。由于胎儿畸形和与出血、感染和闭塞风险相关的产妇发病率,它与显著的围产期死亡率有关。对于阳性诊断,超声几乎是不可避免的,辅以磁共振成像检测胎儿畸形,可以更好地分析胎盘与腹部器官的关系;优化产妇护理的决定性因素。
{"title":"Full Term Abdominal Pregnancy with Healthy Newborn: A Case Report","authors":"H. Jalal","doi":"10.4172/2165-7920.10001110","DOIUrl":"https://doi.org/10.4172/2165-7920.10001110","url":null,"abstract":"We report a case of full term abdominal pregnancy with healthy newborn. This is a rare variety of ectopics pregnancies whose evolution to the end remains exceptional. It is unique to developing countries with a high incidence of genital infections and poor pregnancy monitoring. It is associated with significant perinatal mortality because of fetal malformations and maternal morbidity related to hemorrhagic, infectious and occlusive risk. Ultrasound is almost unavoidable for positive diagnosis supplemented by magnetic resonance imaging detecting fetal malformations and allowing a better analysis of placental relations with the abdominal organs; decisive elements to optimize the care of the parturient.","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7920.10001110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42671268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Metastatic Liposarcoma: A Case of Partial Remission with Eribulin in Late Treatment Lines 转移性脂肪肉瘤:在晚期治疗中使用艾力布林部分缓解1例
Pub Date : 2018-05-07 DOI: 10.4172/2165-7920.10001109
V. Grünwald, P. Ivanyi
Liposarcoma, a type of soft tissue sarcoma, represents a therapeutic challenge, in particular in the metastatic setting. This case describes a patient with retroperitoneal liposarcoma that was first treated by surgery and, upon manifestation of metastatic disease, with a series of chemotherapy regimens comprising doxorubicin (line 1), doxorubicin plus ifosfamide (line 2), trabectedin (lines 3 and 4) and dacarbazine (line 5). While transient partial remission was achieved in the first three lines, rapid disease progression was observed in subsequent therapies. After failure of the previous chemotherapy regimens, eribulin was administered (line 6), and partial remission was achieved within five months. However, the occurrence of grade 3 polyneuropathy led to temporary discontinuation of therapy. Overall, metastatic liposarcoma was controlled for twelve months with eribulin treatment in a heavily pre-treated patient. This case underscores the efficacy of eribulin in treatment-refractory advanced/metastatic liposarcoma.
脂肪肉瘤是一种软组织肉瘤,是一种治疗挑战,尤其是在转移性环境中。该病例描述了一名腹膜后脂肪肉瘤患者,该患者首先通过手术治疗,并在出现转移性疾病时,采用一系列化疗方案,包括阿霉素(第1行)、阿霉素加异环磷酰胺(第2行)、曲贝替丁(第3行和第4行)和达卡巴嗪(第5行)。虽然前三条线获得了短暂的部分缓解,但在随后的治疗中观察到疾病进展迅速。在之前的化疗方案失败后,给药埃里布林(第6行),并在五个月内获得部分缓解。然而,3级多发性神经病的发生导致暂时停止治疗。总的来说,转移性脂肪肉瘤在一名重度预治疗的患者中通过埃里布林治疗控制了12个月。该病例强调了埃里布林治疗难治性晚期/转移性脂肪肉瘤的疗效。
{"title":"Metastatic Liposarcoma: A Case of Partial Remission with Eribulin in Late Treatment Lines","authors":"V. Grünwald, P. Ivanyi","doi":"10.4172/2165-7920.10001109","DOIUrl":"https://doi.org/10.4172/2165-7920.10001109","url":null,"abstract":"Liposarcoma, a type of soft tissue sarcoma, represents a therapeutic challenge, in particular in the metastatic setting. This case describes a patient with retroperitoneal liposarcoma that was first treated by surgery and, upon manifestation of metastatic disease, with a series of chemotherapy regimens comprising doxorubicin (line 1), doxorubicin plus ifosfamide (line 2), trabectedin (lines 3 and 4) and dacarbazine (line 5). While transient partial remission was achieved in the first three lines, rapid disease progression was observed in subsequent therapies. After failure of the previous chemotherapy regimens, eribulin was administered (line 6), and partial remission was achieved within five months. However, the occurrence of grade 3 polyneuropathy led to temporary discontinuation of therapy. Overall, metastatic liposarcoma was controlled for twelve months with eribulin treatment in a heavily pre-treated patient. This case underscores the efficacy of eribulin in treatment-refractory advanced/metastatic liposarcoma.","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7920.10001109","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45240223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Double Duodenal Perforation: A Case Report 双十二指肠穿孔1例
Pub Date : 2018-04-30 DOI: 10.4172/2165-7920.10001107
H. Gupta
Duodenal perforation is a common cause of acute abdomen which is complication of peptic ulcer disease. The pathogenesis is considered complex and involves imbalance between defensive mechanisms of intestinal mucosa and aggravating factors to which a person is exposed.
十二指肠穿孔是消化性溃疡并发急腹症的常见原因。发病机制被认为是复杂的,涉及肠黏膜防御机制与人体暴露的加重因素之间的不平衡。
{"title":"Double Duodenal Perforation: A Case Report","authors":"H. Gupta","doi":"10.4172/2165-7920.10001107","DOIUrl":"https://doi.org/10.4172/2165-7920.10001107","url":null,"abstract":"Duodenal perforation is a common cause of acute abdomen which is complication of peptic ulcer disease. The pathogenesis is considered complex and involves imbalance between defensive mechanisms of intestinal mucosa and aggravating factors to which a person is exposed.","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":"2018 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7920.10001107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45851338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Drug Induced Aseptic Meningitis due to IV Immunoglobulins 静脉注射免疫球蛋白引起的药物诱导无菌性脑膜炎
Pub Date : 2018-04-27 DOI: 10.4172/2165-7920.10001108
P. Thaneeru
Drug induced aseptic meningitis (DIAM) is an uncommon condition that can mimic infectious process. DIAM constitutes a diagnostic and management challenge. We report a case of a 23-year-old female presenting with aseptic meningitis, two days after commencing a course of intravenous immunoglobulins (IVIG) treatment.
药物性无菌性脑膜炎(DIAM)是一种罕见的疾病,可以模拟感染过程。DIAM对诊断和管理构成挑战。我们报告一例23岁的女性表现为无菌性脑膜炎,两天后开始静脉注射免疫球蛋白(IVIG)治疗。
{"title":"Drug Induced Aseptic Meningitis due to IV Immunoglobulins","authors":"P. Thaneeru","doi":"10.4172/2165-7920.10001108","DOIUrl":"https://doi.org/10.4172/2165-7920.10001108","url":null,"abstract":"Drug induced aseptic meningitis (DIAM) is an uncommon condition that can mimic infectious process. DIAM constitutes a diagnostic and management challenge. We report a case of a 23-year-old female presenting with aseptic meningitis, two days after commencing a course of intravenous immunoglobulins (IVIG) treatment.","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":" ","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7920.10001108","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43575397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Emergency Lumbar Puncture for Suspected Meningitis after Dabigatran Reversal with Idarucizumab: A Case Report 依达鲁珠单抗逆转达比加群后疑似脑膜炎的紧急腰椎穿刺:1例报告
Pub Date : 2018-04-24 DOI: 10.4172/2165-7920.10001103
S. Agosti, L. Casalino, A. Daffonchio, L. Arena, L. Celli, E. Rota
Idarucizumab is a monoclonal antibody which has been shown to be effective for rapid, durable, and safe reversal of the anticoagulant effect of dabigatran. We will describe herein the third case reported so far on the use of idarucizumab in a patient on dabigatran for nonvalvular atrial fibrillation and an indication for emergency lumbar puncture for suspected meningitis.
Idarucizumab是一种单克隆抗体,已被证明对快速、持久和安全逆转达比加群的抗凝作用有效。我们将在本文中描述迄今为止报道的第三例在达比加群治疗非瓣膜性心房颤动的患者中使用依达鲁珠单抗的病例,以及疑似脑膜炎的紧急腰椎穿刺指征。
{"title":"Emergency Lumbar Puncture for Suspected Meningitis after Dabigatran Reversal with Idarucizumab: A Case Report","authors":"S. Agosti, L. Casalino, A. Daffonchio, L. Arena, L. Celli, E. Rota","doi":"10.4172/2165-7920.10001103","DOIUrl":"https://doi.org/10.4172/2165-7920.10001103","url":null,"abstract":"Idarucizumab is a monoclonal antibody which has been shown to be effective for rapid, durable, and safe reversal of the anticoagulant effect of dabigatran. We will describe herein the third case reported so far on the use of idarucizumab in a patient on dabigatran for nonvalvular atrial fibrillation and an indication for emergency lumbar puncture for suspected meningitis.","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":"8 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7920.10001103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42268077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Cushing Reflex and Importance during Treatment of Cerebrovascular Diseases via Endovascular Route 库欣反射及其在血管内途径治疗脑血管疾病中的重要性
Pub Date : 2018-04-24 DOI: 10.4172/2165-7920.10001104
A. Yektaş, Bedih Balkan, Abdülcelil Gezmiş, Tolga Ae, B. Kara, H. H. Selçuk
Aim: Assessment of the Cushing reflex developing during mechanical thrombectomy in a case presenting with acute ischemic stroke.Case: A 59-year-old male patient had CT angio tests due to speaking disorder and right lateral weakness developing 5 hours earlier. Acute infarctus was observed in the left MCA irrigation area with M1 segment occlusion observed in the left MCA. The decision was made to treat the patient with mechanical thrombectomy and he was transferred to the interventional neuroradiology unit. Under general anesthesia during navigation of the thromboaspiration catheter to the clot localization as the procedure was technically advancing routinely, with sudden development of bradycardia and hypertension the neuroradiology team was warned, and 1 mg IV atropine was administered for bradycardia.Simultaneously contrast material injection through the guide catheter showed the MCA M1 segment had ruptured and extravasation had developed.Conclusion: The Cushing reflex is a situation characterized by bradycardia and hypertension in cerebrovascular events causing sudden intracranial pressure increases. The most common situations observed during treatment of cerebrovascular diseases via the endovascular route is intracranial hemorrhage linked to arterial rupture. Prevention of the mortality and morbidity linked to hemorrhagic complications developing during endovascular treatment is based on early awareness and rapid treatment. Additionally, as extravasation is commonly not observed radiologically, the anesthesia team should be on the alert for the Cushing reflex and when variations of hemodynamic parameters in accordance with the Cushing response are observed, informing the operation team immediately has vital importance.
目的:评估急性缺血性脑卒中患者机械血栓切除术中库欣反射的发展。病例:一名59岁男性患者,因说话障碍和5小时前出现右侧无力而进行了CT血管检查。左MCA冲洗区观察到急性梗死,左MCA观察到M1段闭塞。决定用机械血栓切除术治疗患者,并将其转移到介入神经放射学部门。在全身麻醉下,在将血栓抽吸导管引导至血栓定位的过程中,由于程序在技术上的常规推进,随着心动过缓和高血压的突然发展,神经放射学团队收到警告,并对心动过缓给予1 mg静脉注射阿托品。同时,通过引导导管注射造影剂显示MCA M1节段破裂,出现外渗。结论:库欣反射是一种以脑血管事件中的心动过缓和高血压为特征,导致颅内压突然升高的情况。在通过血管内途径治疗脑血管疾病期间观察到的最常见情况是与动脉破裂相关的颅内出血。预防血管内治疗过程中出现的出血性并发症的死亡率和发病率是基于早期意识和快速治疗。此外,由于通常不会在放射学上观察到外渗,麻醉团队应警惕库欣反射,当观察到与库欣反应一致的血液动力学参数变化时,立即通知手术团队至关重要。
{"title":"Cushing Reflex and Importance during Treatment of Cerebrovascular Diseases via Endovascular Route","authors":"A. Yektaş, Bedih Balkan, Abdülcelil Gezmiş, Tolga Ae, B. Kara, H. H. Selçuk","doi":"10.4172/2165-7920.10001104","DOIUrl":"https://doi.org/10.4172/2165-7920.10001104","url":null,"abstract":"Aim: Assessment of the Cushing reflex developing during mechanical thrombectomy in a case presenting with acute ischemic stroke.Case: A 59-year-old male patient had CT angio tests due to speaking disorder and right lateral weakness developing 5 hours earlier. Acute infarctus was observed in the left MCA irrigation area with M1 segment occlusion observed in the left MCA. The decision was made to treat the patient with mechanical thrombectomy and he was transferred to the interventional neuroradiology unit. Under general anesthesia during navigation of the thromboaspiration catheter to the clot localization as the procedure was technically advancing routinely, with sudden development of bradycardia and hypertension the neuroradiology team was warned, and 1 mg IV atropine was administered for bradycardia.Simultaneously contrast material injection through the guide catheter showed the MCA M1 segment had ruptured and extravasation had developed.Conclusion: The Cushing reflex is a situation characterized by bradycardia and hypertension in cerebrovascular events causing sudden intracranial pressure increases. The most common situations observed during treatment of cerebrovascular diseases via the endovascular route is intracranial hemorrhage linked to arterial rupture. Prevention of the mortality and morbidity linked to hemorrhagic complications developing during endovascular treatment is based on early awareness and rapid treatment. Additionally, as extravasation is commonly not observed radiologically, the anesthesia team should be on the alert for the Cushing reflex and when variations of hemodynamic parameters in accordance with the Cushing response are observed, informing the operation team immediately has vital importance.","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":"8 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7920.10001104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42033009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Case Report on Dressler’s Syndrome Dressler的案例报告™患有综合征
Pub Date : 2018-04-24 DOI: 10.4172/2165-7920.10001106
J. Ek, Lisa Koshy, A. Kuriakose
Introduction: Dressler’s syndrome (delayed pericarditis) is considered as a secondary form of pericarditis resulting in the inflammation of the sac surrounding heart (pericardium). Case Presentation: A 56-year-old male was admitted to the cardiology department due to left sided chest pain associated with breathlessness, palpitation and sweating. patient had a past history of CAD-AWMI, moderate left ventricular(LV) dysfunction (diagnosed 2 months back). Percutaneous transluminal coronary angioplasty (PTCA) with stent to CAD done 2 months back. ECHO shows mild to moderate pericardial effusion, mild pulmonary arterial hypertension(PAH), moderate mitral regurgitation (MR), moderate LV dysfunction. Conclusion: This reveals that the patient is diagnosed with Dressler’s syndrome, a rare disease in the age of reperfusion therapy.
简介:德雷斯勒综合征(延迟性心包炎)被认为是心包炎的一种继发形式,可导致心脏周围囊(心包)的炎症。病例介绍:一名56岁男性因左侧胸痛伴呼吸困难、心悸和出汗入院。患者既往有CAD-AWMI病史,中度左心室(LV)功能障碍(2个月前诊断)。2个月前进行的经皮冠状动脉腔内成形术(PTCA)支架治疗冠心病。ECHO显示轻度至中度心包积液、轻度肺动脉高压(PAH)、中度二尖瓣反流(MR)、中度左心室功能障碍。结论:这表明患者被诊断为德雷斯勒综合征,这是再灌注治疗年龄段的一种罕见疾病。
{"title":"Case Report on Dressler’s Syndrome","authors":"J. Ek, Lisa Koshy, A. Kuriakose","doi":"10.4172/2165-7920.10001106","DOIUrl":"https://doi.org/10.4172/2165-7920.10001106","url":null,"abstract":"Introduction: Dressler’s syndrome (delayed pericarditis) is considered as a secondary form of pericarditis resulting in the inflammation of the sac surrounding heart (pericardium). \u0000Case Presentation: A 56-year-old male was admitted to the cardiology department due to left sided chest pain associated with breathlessness, palpitation and sweating. patient had a past history of CAD-AWMI, moderate left ventricular(LV) dysfunction (diagnosed 2 months back). Percutaneous transluminal coronary angioplasty (PTCA) with stent to CAD done 2 months back. ECHO shows mild to moderate pericardial effusion, mild pulmonary arterial hypertension(PAH), moderate mitral regurgitation (MR), moderate LV dysfunction. \u0000Conclusion: This reveals that the patient is diagnosed with Dressler’s syndrome, a rare disease in the age of reperfusion therapy.","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":"8 1","pages":"1-1"},"PeriodicalIF":0.0,"publicationDate":"2018-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7920.10001106","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43894708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Isolated Intracranial Rosai-Dorfman Disease: A Case Report of F ollow- Up MRI Showing Dynamic Changes of the Lesion 孤立性颅内Rosai-Dorfman病:MRI随访显示病灶动态变化1例
Pub Date : 2018-04-24 DOI: 10.4172/2165-7920.10001099
Jie-ming Jiang, D. Han, Yuanming Jiang, Zhen-Guang Zhang, Fenglin Xue, B. He
Rosai-dorfman disease (RDD) is a histiocytic proliferative disorder and considered to be extremely rare in the CNS. In this paper, we reported a patient confirmed as isolated intracranial RDD in a 58-year-old woman. MRI imaging without contrast enhancement two years ago found nothing at the onset of the symptoms. Follow-up CT and MRI imaging one year later showed dynamic changes of the lesion from scratch. This report suggests that the symptoms of RRD are earlier than imaging findings. Moreover, we made a systematic literature review on the disease to better understand it.
Rosai-dorfman病(RDD)是一种组织细胞增殖性疾病,在中枢神经系统极为罕见。在本文中,我们报告了一例确诊为孤立性颅内RDD的58岁女性患者。两年前没有增强对比的核磁共振成像没有发现任何症状。1年后随访CT和MRI显示病灶从头开始发生动态变化。本报告提示RRD的症状早于影像学发现。此外,我们对该疾病进行了系统的文献综述,以更好地了解它。
{"title":"Isolated Intracranial Rosai-Dorfman Disease: A Case Report of F ollow- Up MRI Showing Dynamic Changes of the Lesion","authors":"Jie-ming Jiang, D. Han, Yuanming Jiang, Zhen-Guang Zhang, Fenglin Xue, B. He","doi":"10.4172/2165-7920.10001099","DOIUrl":"https://doi.org/10.4172/2165-7920.10001099","url":null,"abstract":"Rosai-dorfman disease (RDD) is a histiocytic proliferative disorder and considered to be extremely rare in the CNS. In this paper, we reported a patient confirmed as isolated intracranial RDD in a 58-year-old woman. MRI imaging without contrast enhancement two years ago found nothing at the onset of the symptoms. Follow-up CT and MRI imaging one year later showed dynamic changes of the lesion from scratch. This report suggests that the symptoms of RRD are earlier than imaging findings. Moreover, we made a systematic literature review on the disease to better understand it.","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7920.10001099","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44452227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of clinical case reports
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1