Journal articles: 'Spontaneous intracranial bleeding'

1

Zapletal, Ondrej, Jan Blatny, Roman Kotlin, and Jan E. Dyr. "Severe Spontaneous Intracranial Bleeding in 11 Months Old Boy with Congenital Afibrinogenemia with Novel Mutation - Deletion aα 6477A in Fibrinogen Gene." Blood 124, no. 21 (December 6, 2014): 5070. http://dx.doi.org/10.1182/blood.v124.21.5070.5070.

Full text

Abstract:

Abstract Congenital afibrinogenemia is very rare inherited bleeding disorder, caused by absence of fibrinogen in plasma. Serious spontaneous bleeding including intracranial haemorrhage may occur at any age. We present a case report of a boy with afibrinogenemia caused by novel mutation – homozygous deletion Aα 6477A. Diagnosis was set after bleeding post cleft lip and palate plastic surgery. Spontaneous intracranial haematoma in occipital region occurred when the boy was 11 month old. Replacement therapy with plasma derived fibrinogen concentrate successfully covered neurosurgical evacuation of hematoma. The patient was then commenced on regular prophylaxis with fibrinogen concentrate two times a week. No further bleeding episodes occurred until present time. Spontaneous intracranial bleeding in patients with inherited bleeding disorders is often life threatening. Immediate replacement therapy is crucial, together with diagnostics and surgery, when necessary. Prophylactic substitution therapy after a severe bleeding episode is recommended. Disclosures No relevant conflicts of interest to declare.

APA, Harvard, Vancouver, ISO, and other styles

2

Quinones-Hinojosa, Alfredo, Mittul Gulati, Vineeta Singh, and Michael T. Lawton. "Spontaneous intracerebral hemorrhage due to coagulation disorders." Neurosurgical Focus 15, no. 4 (October 2003): 1–17. http://dx.doi.org/10.3171/foc.2003.15.4.3.

Full text

Abstract:

Although intracranial hemorrhage accounts for approximately 10 to 15% of all cases of stroke, it is associated with a high mortality rate. Bleeding disorders account for a small but significant risk factor associated with intracranial hemorrhage. In conditions such as hemophilia and acute leukemia associated with thrombocytopenia, massive intracranial hemorrhage is often the cause of death. The authors present a comprehensive review of both the physiology of hemostasis and the pathophysiology underlying spontaneous ICH due to coagulation disorders. These disorders are divided into acquired conditions, including iatrogenic and neoplastic coagulopathies, and congenital problems, including hemophilia and rarer diseases. The authors also discuss clinical features, diagnosis, and management of intracranial hemorrhage resulting from these bleeding disorders.

APA, Harvard, Vancouver, ISO, and other styles

3

Boŝnjak, Róman, Christopher Derham, Mara Popović, and Janez Ravnik. "Spontaneous intracranial meningioma bleeding: clinicopathological features and outcome." Journal of Neurosurgery 103, no. 3 (September 2005): 473–84. http://dx.doi.org/10.3171/jns.2005.103.3.0473.

Full text

APA, Harvard, Vancouver, ISO, and other styles

4

Hou, Kun, Xiaobo Zhu, Yang Sun, Xianfeng Gao, Jinchuan Zhao, Yang Zhang, and Guichen Li. "Transient Acute Hydrocephalus After Spontaneous Intracranial Bleeding in Adults." World Neurosurgery 100 (April 2017): 38–43. http://dx.doi.org/10.1016/j.wneu.2016.12.103.

Full text

APA, Harvard, Vancouver, ISO, and other styles

5

Ataoglu, Emel, Nilgun S. Duru, Tiraje Celkan, Mahmut Civilibal, Selda C. Yavuz, Murat Elevli, and Semih Ayta. "Spontaneous intracranial bleeding in a neonate with congenital afibrinogenemia." Blood Coagulation & Fibrinolysis 21, no. 6 (September 2010): 592–94. http://dx.doi.org/10.1097/mbc.0b013e32833a06e2.

Full text

APA, Harvard, Vancouver, ISO, and other styles

6

Utami, Sri, Muhamad Yunus, and Deviani Utami. "Gambaran Pengetahuan Bidan dan Perawat Tentang VKDB di Puskesmas Prabumulih Sumatera Selatan." ARTERI : Jurnal Ilmu Kesehatan 2, no. 1 (April 1, 2021): 23–29. http://dx.doi.org/10.37148/arteri.v2i1.142.

Full text

Abstract:

Intracranial hemorrhage is a dangerous bleeding in infants. The impact of intracranial bleeding is in the form of death and sequelae, such as hydrocephalus, cerebral atrophy, encephalopathy, and epilepsy which will interfere with growth and development. One of the causes of intracranial bleeding is bleeding due to Vitamin K deficiency (VKDB). Meanwhile, intracranial bleeding due to vitamin K deficiency can be prevented by giving vitamin K1 to newborns. This study aimed to know the description of the level of knowledge of health workers about spontaneous intracranial bleeding caused by vitamin K deficiency bleeding at the Prabumulih Health Center, South Sumatra in 2020. The type of research used in this research is descriptive with a cross sectional design. The samples used in this study were nurses and midwives who worked at the Prabumulih Health Center in South Sumatra who had met the criteria in this study. The result showed that the frequency of sufficient knowledge of respondents was found as many as 31 people with a percentage of 46.3%. In conclusion Midwives at the Prabumulih health center in South Sumatra have a sufficient level of knowledge about intracranial bleeding due to vitamin K deficiency. It is hoped that this study can provide information to the public about the knowledge of intracranial bleeding due to vitamin K deficiency, so that the incidence of intracranial bleeding due to vitamin K deficiency and infant mortality can be reduced.

APA, Harvard, Vancouver, ISO, and other styles

7

Calderon-Miranda, Willem Guillermo, Nidia Escobar Hernandez, Luis Rafael Moscote Salazar, and Amit Agrawal. "Acute spontaneous subdural hematomaas unusual complication after tooth extraction." Romanian Neurosurgery 30, no. 3 (September 1, 2016): 397–401. http://dx.doi.org/10.1515/romneu-2016-0061.

Full text

Abstract:

Abstract Background: Intracranial bleeding has been reported in the literature associated with tooth extraction. Coagulation disorders are often associated with complications after dental extraction. In this case report, we describe a case of spontaneously intracranial subdural hematoma possible after tooth extraction. Case description: The patient was a 26-y-old female without any underlying diseases. A computerized tomography scan showed a subdural hematoma 48 hours after the dental extraction. She was managed with a burr hole, good postoperative evolution and discharged to home. Conclusion: Although rare, the presence of headache with signs of alarm after the extraction of a tooth, we must discard intracranial abnormalities. To the best of our knowledge this is the first report in the literature of a spontaneously intracranial subdural hematoma possible after tooth extraction.

APA, Harvard, Vancouver, ISO, and other styles

8

Swary, Angela Dinaria Kemala, Mia Ratwita Andarsini, and Arifoel Hajat. "Characteristic of Hemophilia A Patients in Initial Diagnosis in Dr. Soetomo General Hospital Surabaya." Biomolecular and Health Science Journal 2, no. 1 (June 30, 2019): 9. http://dx.doi.org/10.20473/bhsj.v2i1.12888.

Full text

Abstract:

Introduction: This research is conducted to describe the characteristic of Hemophilia A patients.Methods: Cross-sectional study conducted in 55 patients with Hemophilia A. The variables were age, bleeding episode, factor VIII level, and bleeding site. The data presented descriptively.Results: The largest group was 2-10 years old (52,73%). The most common bleeding episode occured in the patients was moderate level (60,0%). The most common patient’s factor VIII level was moderate level (52,7%). The patient’s bleeding most likely took place in muscle or known as hematoma (41,8%). While the less likely bleeding were intracranial and nose bleeding.Conclusion: 2-10 years old patient are the largest group because of hemophilia A mostly diagnosed in childhood, where children are actively moved so that the spontaneous bleeding or abnormal bleeding can be seen easily. Parents needs to be aware if there were abnormal or spontaneous bleeding which takes place in muscle or known as hematoma with moderate episode of bleeding which meant that the occurrence of spontaneous bleeding is periodically happened or in prolonged bleeding accompanied by minor trauma or invasive action.

APA, Harvard, Vancouver, ISO, and other styles

9

Vazzana, Natale, Luca Scarti, Chiara Beltrame, Antonella Picchi, Gianni Taccetti, and Alberto Fortini. "Acquired Factor XI Inhibitor Presenting as Spontaneous Bilateral Subdural Hematoma in an Elderly Patient." Case Reports in Hematology 2014 (2014): 1–4. http://dx.doi.org/10.1155/2014/626831.

Full text

Abstract:

Development of autoantibodies against coagulation factors is an uncommon bleeding disorder associated with cancer, autoimmune conditions, pregnancy, or no apparent disease. Spontaneous FVIII inhibitors are the most frequently encountered; those against FXI have been only anecdotally reported. We report a case of acquired FXI inhibitor presenting as fatal intracranial spontaneous bleeding in an elderly patient with history of cancer and previous transfusions. Few cases of acquired FXI inhibitor have been reported in association with connective tissue disease, cancer, or surgery. Bleeding includes mucocutaneous bleeding, postsurgical hemorrhage, or life-threatening events. Treatment consists of arresting the bleeding and inhibitor eradication. High degree of suspicion is essential to promptly diagnose and treat this uncommon condition.

APA, Harvard, Vancouver, ISO, and other styles

10

Henriques, José Gilberto de Brito, Geraldo Pianetti Filho, Karina Santos Wandeck Henriques, Luiz Fernando Fonseca, Renato Pacheco de Melo, Márcia Cristina da Silva, and José Augusto Malheiros. "Spontaneous acute subdural hematoma contralateral to an arachnoid cyst." Arquivos de Neuro-Psiquiatria 65, no. 4a (December 2007): 1034–36. http://dx.doi.org/10.1590/s0004-282x2007000600025.

Full text

Abstract:

Arachnoid cysts (AC) are extra-cerebral cerebrospinal fluid collections of unknown origin. They correspond to 1% of all intracranial nontraumatic space-occupying lesions and appear more frequently in the middle fossa (50%). More than 25% of these cysts are incidental findings and the majority of patients are asymptomatic. Seizures, intracranial hypertension signs, neurological deficits, macrocrania, developmental delay and bulging of the skull are the main signs and symptoms of the lesion. AC rupture and bleeding are rare, usually occurring in young adults and associated with trauma. The risk of hemorrhage does not exceed 0.04% / year. We describe the case of a ten-year-old boy who presented with acute signs of intracranial hypertension secondary to a spontaneous acute subdural hematoma, contralateral to an AC of the middle fossa. Three factors were significant in this case: signs and symptoms occurred spontaneously; the presence of an acute subdural hematoma exclusively contralateral to the AC; successful outcome of the conservative treatment.

APA, Harvard, Vancouver, ISO, and other styles

11

Jokovic, M. B., D. V. Radulovic, G. M. Tasic, B. M. Djurovic, V. T. Jovanovic, I. M. Nikolic, E. E. Slavik, and M. Lj Rakic. "Treatment of patients with spontaneous intracranial hematomas." Acta chirurgica Iugoslavica 55, no. 2 (2008): 119–22. http://dx.doi.org/10.2298/aci0802119j.

Full text

Abstract:

Spontaneous intracerebral haemorrhage is a common cause of stroke especially in the young. The term "spontaneous intracerebral haemorrhage" refers to bleeding without coincident trauma. About 80% of this haemorrhage occur supratentorial in the basal nuclei and they are associated with hypertension. Etiological factors range from congenital vascular malformations (aneurysmas, AVM, cavernomas) to acquired and degenerative vascular and brain conditions. In primary intracerebral hemorrhage arterial hypertension and consequent vascular changes are the major etiological factors. In secondary- nonhypertensive hemorrhage cause may be associated with aneurysms, AVM, tumors, coagulation disorders. Contemporary diagnosis imaging (CT, MRI) and neurological evaluation, allow early diagnosis and effective medical and/or surgical therapy in a majority patients. Without treatment, the risk of mortality and morbidity is high. Medical management involves normalization of blood pressure, reduction of intracranial pressure, control of brain edema and prevention of seizures. In design for operative treatment must be include age of the patient, hematoma size and location, clinical condition, the level of consciousness and patient outcome. The role of surgery remains controversial.

APA, Harvard, Vancouver, ISO, and other styles

12

Schievink, Wouter I., Philip Wasserstein, and M. Marcel Maya. "Intraspinal hemorrhage in spontaneous intracranial hypotension: link to superficial siderosis? Report of 2 cases." Journal of Neurosurgery: Spine 24, no. 3 (March 2016): 454–56. http://dx.doi.org/10.3171/2015.6.spine15428.

Full text

Abstract:

Spontaneous intracranial hypotension due to a spinal CSF leak has become a well-recognized cause of headaches, but such spinal CSF leaks also are found in approximately half of patients with superficial siderosis of the CNS. It has been hypothesized that friable vessels at the site of the spinal CSF leak are the likely source of chronic bleeding in these patients, but such an intraspinal hemorrhage has never been visualized. The authors report on 2 patients with spontaneous intracranial hypotension and intraspinal hemorrhage, offering support for this hypothesis. A 33-year-old man and a 62-year-old woman with spontaneous intracranial hypotension were found to have a hemorrhage within the ventral spinal CSF collection and within the thecal sac, respectively. Treatment consisted of microsurgical repair of a ventral dural tear in the first patient and epidural blood patching in the second patient. The authors suggest that spontaneous intracranial hypotension should be included in the differential diagnosis of spontaneous intraspinal hemorrhage, and that the intraspinal hemorrhage can account for the finding of superficial siderosis when the CSF leak remains untreated.

APA, Harvard, Vancouver, ISO, and other styles

13

Amoroso, Rosina, and Rolando Gagliardi. "Indications, time and types of urgent and elective neurosurgical approach in intracranial spontaneous haemorrhage." Reviews in Health Care 2, no. 1S (June 10, 2011): 55. http://dx.doi.org/10.7175/rhc.6221s55-67.

Full text

Abstract:

Up to now, the possibility of neurosurgical approach remains one of the main key points in acute management of non traumatic intracranial haemorrhage. The aims of neurosurgical evacuation are represented by stopping bleeding, reducing haematoma enlargement, endocranial hypertension and mass effect, and improving cerebral perfusion. In the acute phase of intracranial bleeding, neurosurgeons are called to take critical decisions about the indication or exclusion of surgical approach and this kind of choices can be very difficult. Only a minority of patients suffering from intraparenchimal bleeding undergo urgent surgical evacuation. This decision is based on the presence or the absence of mass effect, occlusion of liquoral flow associated to impairment of vigilance, sites of hematoma surgically accessible and good performance status. In patients suffering for subarachnoid haemorrhage, mainly due to rupture of aneurisms or artero-venous malformations, the percentage of surgery increases together with the possibility of the elective approach.

APA, Harvard, Vancouver, ISO, and other styles

14

Amoroso, Rosina, and Rolando Gagliardi. "Indications, time and types of urgent and elective neurosurgical approach in intracranial spontaneous haemorrhage." Reviews in Health Care 2, no. 1S (June 10, 2011): 55–67. http://dx.doi.org/10.7175/rhc.v2i1s.62.

Full text

Abstract:

Up to now, the possibility of neurosurgical approach remains one of the main key points in acute management of non traumatic intracranial haemorrhage. The aims of neurosurgical evacuation are represented by stopping bleeding, reducing haematoma enlargement, endocranial hypertension and mass effect, and improving cerebral perfusion. In the acute phase of intracranial bleeding, neurosurgeons are called to take critical decisions about the indication or exclusion of surgical approach and this kind of choices can be very difficult. Only a minority of patients suffering from intraparenchimal bleeding undergo urgent surgical evacuation. This decision is based on the presence or the absence of mass effect, occlusion of liquoral flow associated to impairment of vigilance, sites of hematoma surgically accessible and good performance status. In patients suffering for subarachnoid haemorrhage, mainly due to rupture of aneurisms or artero-venous malformations, the percentage of surgery increases together with the possibility of the elective approach.

APA, Harvard, Vancouver, ISO, and other styles

15

Nozar, A., D. Philippe, P. Fabrice, M. Silvia, and T. Marc. "Acute Pure Spontaneous Subdural Haematoma from Ruptured Intracranial Aneurysms." Interventional Neuroradiology 8, no. 4 (December 2002): 393–98. http://dx.doi.org/10.1177/159101990200800408.

Full text

Abstract:

Acute subdural haematoma (ASDH) is rarely caused by an aneurysmal rupture. We report four cases of pure acute subdural haematomas caused by ruptured intracranial aneurysms. Aneurysms were localized in the posterior communicating artery in two cases, in the anterior communicating artery in one case and in the middle cerebral artery in one other case. Possible mechanisms for this type of aneurysmal bleeding are discussed. A good prognosis for these patients can be expected with rapid evacuation of the haematoma (in case of high intracranial pressure and midline structure shift), and treatment of the aneurysm (surgical clipping or endovascular treatment). Our report demonstrates the utility of angiography in the evaluation of nontraumatic acute subdural haematomas. Angiography has to be performed before haematoma evacuation or just after if the patient requires urgent surgery in case of intracranial hypertension. Aneurysms may require surgical clipping or endovascular treatment.

APA, Harvard, Vancouver, ISO, and other styles

16

Gutenberg, Angelika, Bettina Lange, Bastian Gunawan, Joerg Larsen, Wolfgang Brück, Veit Rohde, and Raphaela Verheggen. "Spontaneous adrenal hemorrhage: a little-known complication of intracranial tumor surgery." Journal of Neurosurgery 106, no. 6 (June 2007): 1086–88. http://dx.doi.org/10.3171/jns.2007.106.6.1086.

Full text

Abstract:

✓ Nontraumatic adrenal hemorrhage in adults is uncommon and unexpected in the context of intracranial surgery. The authors report on a patient in whom hemodynamically relevant retroperitoneal bleeding developed within hours after an otherwise uneventful operation for a falcine meningioma. In this brief report they seek to draw attention to this rare but life-threatening complication, because rapid diagnosis can be life-saving.

APA, Harvard, Vancouver, ISO, and other styles

17

Arauz, Antonio, Hernán M. Patiño-Rodríguez, Mónica Chavarría-Medina, Mayra Becerril, José G. Merino, and Marco Zenteno. "Embolic stroke secondary to spontaneous thrombosis of unruptured intracranial aneurysm: Report of three cases." Interventional Neuroradiology 22, no. 2 (December 7, 2015): 196–200. http://dx.doi.org/10.1177/1591019915618169.

Full text

Abstract:

Intracranial aneurysms uncommonly present with ischemic stroke. Parent artery occlusion due to local extension of the luminal thrombus, aneurysms ejecting emboli to distal arteries, or increased mass effect have been described as possible pathogenic mechanisms. Guidelines for the management of these patients are absent. We present the clinical outcome and radiological characteristics of three patients with spontaneous thrombosis of intracranial aneurysms as a cause of ischemic stroke. This information is relevant given the possible benign history in terms of stroke recurrence and risk of bleeding.

APA, Harvard, Vancouver, ISO, and other styles

18

Wei, Huijun, Jin Shang, CarolAnn Keohane, Min Wang, Qiu Li, Weihua Ni, Kim O’Neill, and Madhu Chintala. "A novel approach to assess the spontaneous gastrointestinal bleeding risk of antithrombotic agents using Apc min/+ mice." Thrombosis and Haemostasis 111, no. 06 (2014): 1121–32. http://dx.doi.org/10.1160/th13-11-0926.

Full text

Abstract:

SummaryAssessment of the bleeding risk of antithrombotic agents is usually performed in healthy animals with some form of vascular injury to peripheral organs to induce bleeding. However, bleeding observed in patients with currently marketed antithrombotic drugs is typically spontaneous in nature such as intracranial haemorrhage (ICH) and gastrointestinal (GI) bleeding, which happens most frequently on top of preexisting pathologies such as GI ulcerations and polyps. Apc min/+ mice are reported to develop multiple adenomas through the entire intestinal tract and display progressive anaemia. In this study, we evaluated the potential utility of Apc min/+ mice as a model for assessing spontaneous GI bleeding with antithrombotic agents. Apc min/+ mice exhibited progressive blood loss starting at the age of nine weeks. Despite the increase in bleeding, Apc min/+ mice were in a hypercoagulable state and displayed an age-dependent increase in thrombin generation and circulating fibrinogen as well as a significant decrease in clotting times. We evaluated the effect of warfarin, dabigatran etexilate, apixaban and clopidogrel in this model by administering them in diet or in the drinking water to mice for 1–4 weeks. All of these marketed drugs significantly increased GI bleeding in Apc min/+ mice, but not in wild-type mice. Although different exposure profiles of these antithrombotic agents make it challenging to compare the bleeding risk of compounds, our results indicate that the Apc min/+ mouse may be a sensitive preclinical model for assessing the spontaneous GI bleeding risk of novel antithrombotic agents.

APA, Harvard, Vancouver, ISO, and other styles

19

Adhikari, Anju, Mohammad Muhsin Chisti, Sanjog Bastola, and Ojbindra KC. "Rare case of catastrophic antiphospholipid syndrome with spontaneous intracranial haemorrhage." BMJ Case Reports 12, no. 3 (March 2019): e227171. http://dx.doi.org/10.1136/bcr-2018-227171.

Full text

Abstract:

Catastrophic antiphospholipid syndrome (CAPS) is a rare but severe form of antiphospholipid syndrome (APS). The syndrome manifests itself as a rapidly progressive multiorgan failure that is believed to be caused by widespread micro-thrombosis. Seldom does bleeding comanifest with thrombosis. We present a patient with APS who presented with nausea, vomiting and fatigue, and rapidly progressed into multiorgan failure before being diagnosed with CAPS. The clinical course was complicated by an atraumatic intracranial haemorrhage which demanded discontinuation of anticoagulation. The patient was treated with high dose steroid, intravenous immunoglobulin, followed by weekly rituximab infusion. Although the trigger for CAPS was not obvious during her hospital stay, she was diagnosed with acute cytomegalovirus (CMV) infection soon after discharge. In this case report, we explore the differential diagnoses of CAPS, investigate the possibility of CMV infection as a potential trigger, present the therapeutic challenges of anticoagulation and discuss the emerging use of rituximab.

APA, Harvard, Vancouver, ISO, and other styles

20

Merhemic, Zulejha, Lidija Lincender, Emir Guso, Emina Bicakcic, Edin Avdagic, and Majda M. Thurnher. "Computed tomography angiography in the diagnosis of arteriovenous malformations." Journal of Health Sciences 8, no. 1 (April 3, 2018): 73–77. http://dx.doi.org/10.17532/jhsci.2017.521.

Full text

Abstract:

Introduction: The most common cause of intracranial bleeding in younger patients and children are vascular anomalies. Digital subtractions angiography presents a gold standard in diagnostics of aneurisms and vascular malformations. Our aim is to present our experience in using computed tomography angiography in diagnosing arteriovenous malformations. Methods: We included 150 patients with acute non-traumatic intracranial hemorrhage diagnosed by non-contrast CT examination, after which they were subjected to CT angiography of the cerebral vessels, and then underwent maximum intense projection and volume rendering reconstruction. Results: Out of 150 patients with non-traumatic intracranial hemorrhage, in 121 (81%) a diagnosis of aneurysm was rendered, while in 8 (5%) arteriovenous malformation was found. In 29 (14%) patients cause of bleeding was not identified. Patients with arteriovenous malformations, were age 17-77 years, with mean age 42.75 years. Five (62.5%) of them were female patients and three (37.5%) were male. Conclusion: Spontaneous non-traumatic intracranial hemorrhage is a significant cause of morbidity and mortality. Computed tomography angiography is sufficiently specific and sensitive in diagnosis of arteriovenous malformations in our experience.

APA, Harvard, Vancouver, ISO, and other styles

21

Mercado, Marta Ruiz, Silvia Verdesoto Cozzarelli, Cristina Calderón-Cabrera, Ramiro Núñez Vázquez, Reyes Jiménez Bárcenas, Rosario Pérez Garrido, Jose Antonio Pérez-Simón, and Francisco Javier Rodríguez Martorell. "Factor XIII Deficiency As Underlying Cause Of Unexplained Bleeding." Blood 122, no. 21 (November 15, 2013): 4776. http://dx.doi.org/10.1182/blood.v122.21.4776.4776.

Full text

Abstract:

Introduction Factor XIII deficiency (FXIII) is an uncommon coagulation disorder. Congenital FXIII deficiency, generally due to mutations in F13A1 gene, presents with early life- threating hemorrhages in homozygotes. Acquired deficiency, a more rare state, has been associated with certain drugs and inhibitors against FXIII. Materials and methods We retrospectively analyzed 47 patients (male:female 1:1.3). Study criteria were unexplained hemorrhage, mainly after surgery, or spontaneous intracranial bleeding at perinatal period and no relevant findings in conventional haemostasia assays, from 01/01/2010 to 15/07/2013. FXIII measure was performed by a functional method. Results 20 out of 47 patients (42.5%) other abnormalities that might contribute to bleeding were detected: 13 had primary haemostasis disorders and 7 had low levels of a coagulation factor different from FXIII. In 10 patients, FXIII deficiency was observed: 4 congenital and 6 acquired. In all acquired deficiencies, the presence of an inhibitor was discarded. Patients with congenital FXIII deficiency, had mucocutaneous bleeding in 75% of cases and hemorrhage after surgery in 50%. However, there was no intracranial hemorrhage. In acquired deficiency (median FXIII 44.5 U/dl at first diagnostic work up), mucocutaneous bleeding appeared in 40% patients and postoperative and intracranial hemorrhage in 100%. In 8/ 10 patients FXIII concentrate was administered, achieving bleeding control in 7. In 3 cases of congenital deficiency, prophylactic substitutive therapy was started enabling a cessation of new bleeding episodes, except for a posttraumatic muscle hematoma; median FXIII levels reached 6.8 U/ dL. 2 patients with acquired deficiency died of non-hemorrhagic complications, 3 patients developed spontaneous remission of the deficiency in a median time of 2 months and 1 is still receiving substitutive therapy. Conclusions In congenital deficiency, maintenance of FXIII through levels in the range of 5-10% is enough to avoid bleeding manifestations. The acquired deficiencies have at least the same frequency as congenital, develop hemorrhage episodes at higher levels of factor and respond to therapy in a thrifty way. For those reasons, tests for FXIII are essential for diagnosis in high index clinical suspicious cases, such as unexplained bleeding. Disclosures: No relevant conflicts of interest to declare.

APA, Harvard, Vancouver, ISO, and other styles

22

Nagarajan, Vaishnavi Divya, Asha Shenoi, Lucy Burgess, and Vlad C. Radulescu. "Spontaneous pyohaemothorax in a teenager with von Willebrand disease: a case report and review of literature." BMJ Case Reports 14, no. 8 (August 2021): e241613. http://dx.doi.org/10.1136/bcr-2021-241613.

Full text

Abstract:

An 18-year-old man with a history of type 3 von Willebrand disease (VWD) presented with a spontaneous pyohaemothorax. Type 3 VWD may present with both mucocutaneous and deep-seated bleeds, such as visceral haemorrhages, intracranial bleeds and haemarthrosis. There have been very few cases described in children of spontaneous pyohaemothorax. Management of this patient was challenging due to risks of bleeding following surgical drainage, requiring constant replacement with von Willebrand factor concentrate, while monitoring factor VIII levels to balance the risks of thrombosis.

APA, Harvard, Vancouver, ISO, and other styles

23

Makkiyah, Feda, and Rahma Nida Nurrahmah. "A CASE REPORT OF ACUTE NONTRAUMATIC SPONTANEOUS SUBDURAL HAEMATOMA DUE TO PSEUDOANEURYSM OF MIDDLE MENINGEAL ARTERY." MNJ (Malang Neurology Journal) 7, no. 1 (January 1, 2021): 66–69. http://dx.doi.org/10.21776/ub.mnj.2021.007.01.13.

Full text

Abstract:

Acute subdural bleeding is blood collection in subdural space, usually caused by laceration of the bridging vein that runs from cortex to meningeal layer. On the other hand, the acute epidural hematoma is a collection of blood above the dura mater, usually caused by tearing of the middle meningeal artery. Subdural hematoma acute more likely happen in elderly than young adult. This case report discusses acute spontaneous subdural hematoma that was caused by a pseudoaneurysm of the middle meningeal artery. Seventeen years old boy came with symptoms of high intracranial pressure because of massive subdural bleeding. He was undergone craniotomy. After the clot removal operation, Digital Subtraction Angiography revealed vascular blush and pseudoaneurysm of the middle meningeal artery. Onyx embolization was delivered to proximal to a distal branch of the middle meningeal artery. The patient recovered in good condition, and no rebleeding in two years. Conclusion. Acute spontaneous subdural bleeding even though it is quite rare, but the chance of fatal rebleeding is high. As a result, one still has to look for the source of bleeding and manage comprehensively with embolization.

APA, Harvard, Vancouver, ISO, and other styles

24

Ge, YuanHong, QingJia Lai, and XueJun Xu. "Letter to the Editor Regarding “Transient Acute Hydrocephalus After Spontaneous Intracranial Bleeding in Adults”." World Neurosurgery 140 (August 2020): 418. http://dx.doi.org/10.1016/j.wneu.2020.04.034.

Full text

APA, Harvard, Vancouver, ISO, and other styles

25

Grote, Ernst, and Werner Hassler. "The Critical First Minutes after Subarachnoid Hemorrhage." Neurosurgery 22, no. 4 (April 1, 1988): 654–61. http://dx.doi.org/10.1227/00006123-198804000-00006.

Full text

Abstract:

Abstract Six patients were observed during recurrent subarachnoid hemorrhage (SAH). Three each had an open skull and intact dura mater and demonstrated an extreme increase in intracranial pressure (ICP) that developed within 1 minute and then declined over several minutes. Three other patients were investigated with transcranial Doppler sonography before, during, and after recurrent bleeding, and their hemodynamics were studied. There is conclusive evidence that acute spontaneous SAH is often followed by an intracranial circulatory arrest lasting for several minutes and caused by a peak of ICP in the range of mean arterial levels. The mechanisms involved are discussed. There are strong indications that this temporary intracranial circulatory arrest promotes hemostasis, but may constitute a severe ischemic event.

APA, Harvard, Vancouver, ISO, and other styles

26

Bal, Muhlis, Yavuz Atar, Ziya Salturk, Ahmet Hakan Ateş, Serkan Yağcı, and Gökçen Coşkun Bal. "Lingual Haematoma due to Tenecteplase in a Patient with Acute Myocardial Infarction." Case Reports in Otolaryngology 2013 (2013): 1–3. http://dx.doi.org/10.1155/2013/239796.

Full text

Abstract:

The use of intravenous thrombolytic agents has revolutionised the treatment of acute myocardial infarction. However, the improvement in mortality rate achieved with these drugs is tempered by the risk of serious bleeding complications, including intracranial haemorrhage. Tenecteplase is a genetically engineered mutant tissue plasminogen activator. Haemorrhagic complications of tissue plasminogen activator (tPA) are well known. Compared to other tPAs, tenecteplase use leads to lower rates of bleeding complications. Here, we report a case of unusual site of spontaneous bleeding, intralingual haematoma during tenecteplase therapy following acute myocardial infarction, which caused significant upper airway obstruction and required tracheotomy to maintain the patient’s airway. Clinical dilemmas related to securing the airway or reversing the effects of tissue plasminogen activator are discussed.

APA, Harvard, Vancouver, ISO, and other styles

27

Schievink, Wouter I., M. Marcel Maya, Brian K. Pikul, and Charles Louy. "Spontaneous spinal cerebrospinal fluid leaks as the cause of subdural hematomas in elderly patients on anticoagulation." Journal of Neurosurgery 112, no. 2 (February 2010): 295–99. http://dx.doi.org/10.3171/2008.10.jns08428.

Full text

Abstract:

Subdural hematoma is a relatively common complication of long-term anticoagulation, particularly in the elderly. The combination of anticoagulation and cerebral cortical atrophy is believed to be sufficient to explain the subdural bleeding. The authors report a series of elderly patients who were on a regimen of anticoagulation and developed chronic subdural hematomas (SDHs) due to a spontaneous spinal CSF leak. They reviewed the medical records and imaging studies of a consecutive group of patients with spontaneous intracranial hypotension who were evaluated at Cedars-Sinai Medical Center. Among 141 patients with spontaneous spinal CSF leaks and spontaneous intracranial hypotension, 3 (2%) were taking anticoagulants at the time of onset of symptoms. The mean age of the 3 patients (1 woman and 2 men) was 74 years (range 68–86 years). All 3 patients had chronic SDHs measuring between 12 and 23 mm in maximal diameter. The SDHs resolved after treatment of the underlying spontaneous spinal CSF leak, and there was no need for hematoma evacuation. Epidural blood patches were used in 2 patients, and percutaneous placement of a fibrin sealant was used in 1 patient. The presence of an underlying spontaneous spinal CSF leak should be considered in patients with chronic SDHs, even among the elderly taking anticoagulants.

APA, Harvard, Vancouver, ISO, and other styles

28

Corral, Javier, Juan Antonio Iniesta, Rocio González-Conejero, Marino Villalón, and Vicente Vicente. "Polymorphisms of clotting factors modify the risk for primary intracranial hemorrhage." Blood 97, no. 10 (May 15, 2001): 2979–82. http://dx.doi.org/10.1182/blood.v97.10.2979.

Full text

Abstract:

Abstract Intracranial hemorrhage is the third most frequent cause of cerebrovascular disease, but few genetic risk factors have been associated with its development. Recently, it has been reported that some polymorphisms that affect clotting factors increase the risk for thrombosis. However, reports have analyzed the effect of polymorphisms influencing the hemostatic state in bleeding disorders insufficiently. A case-control study was conducted of 201 patients with spontaneous intracranial hemorrhage and 201 control subjects matched for age, race, sex, and selected risk factors (hypertension, smoking, and alcohol consumption). Genomic polymerase chain reaction was used to analyze the prevalence of 4 polymorphisms: factor V Leiden, prothrombin 20210A, factor VII−323 Del/Ins of a decanucleotide, and factor XIII V34L. Subjects with factor V Leiden had decreased risk for spontaneous intracranial hemorrhage (odds ratio, 0.19; 95% confidence interval, 0.03-0.95). The frequency of the prothrombin 20210A/G genotype was also lower among patients than controls (1.5% vs 3%, respectively). Moreover, carriers of the −323 Ins allele of factor VII had a 1.54-fold risk for intracranial hemorrhage (95% CI, 1.03-2.72). Finally, no significant differences were observed in the prevalence of factor XIII V34L polymorphism between patients and controls. Therefore, new genetic factors affecting the risk for spontaneous intracranial hemorrhage were identified. These data, together with the relevance of these polymorphisms in thrombotic diseases, support the idea that a polymorphism may play opposite roles in thrombosis and hemorrhage, suggesting an explanation for the high frequency of these polymorphisms in the general population.

APA, Harvard, Vancouver, ISO, and other styles

29

Cohen, Erin L., Samantha E. Millikan, Perry C. Morocco, and Jill L. O. de Jong. "Hemorrhagic Shock after Neonatal Circumcision: Severe Congenital Factor XIII Deficiency." Case Reports in Pediatrics 2021 (May 3, 2021): 1–6. http://dx.doi.org/10.1155/2021/5550199.

Full text

Abstract:

A Caucasian male infant born full term via normal spontaneous vaginal delivery was given vitamin K after birth, circumcised on day of life (DOL) 1, and discharged from the nursery on DOL 2. At the time of circumcision, oozing from the surgical site was noted and initially resolved with silver nitrate. Over the next two days, he presented to local emergency rooms multiple times for recurrent bleeding, eventually developing hemorrhagic shock resulting in admission to the neonatal intensive care unit. After extensive work up, he was ultimately diagnosed with severe congenital factor XIII deficiency. Congenital factor XIII deficiency is a rare bleeding disorder characterized by normal prothrombin time (PT) and activated partial thromboplastin time (aPTT) coagulation labs on routine screening, and has a high risk of complications, such as spontaneous intracranial hemorrhage. Although uncommon, when caring for a child with bleeding, physicians must have a high index of suspicion to make this diagnosis in order to initiate proper treatment and start prophylaxis given the risk of morbidity and mortality in untreated patients.

APA, Harvard, Vancouver, ISO, and other styles

30

Parameswaran, R., J. P. Dickinson, S. De Lord, D. M. Keeling, and B. T. Colvin. "Spontaneous intracranial bleeding in two patients with congenital afibrinogenaemia and the role of replacement therapy." Haemophilia 6, no. 6 (November 2000): 705–8. http://dx.doi.org/10.1046/j.1365-2516.2000.00448.x.

Full text

APA, Harvard, Vancouver, ISO, and other styles

31

Tascu, A., C. Pascal, S. M. Florea, and St M. Iencean. "Spontaneous intracranial hemorrhage in children – ruptured lobar arteriovenous malformations: report of two cases." Romanian Neurosurgery 22, no. 1 (March 1, 2015): 86–93. http://dx.doi.org/10.1515/romneu-2015-0010.

Full text

Abstract:

Abstract Brain arteriovenous malformations (AVMs) are lesions thought to be primarily congenital in origin, consisting of fistulous connections of abnormal arteries and veins, without normal intervening capillary beds and no cerebral parenchyma between vessels. In the pediatric population, AVMs represent the most common cause of spontaneous intracranial hemorrhage (ICH), with a high recurrent bleeding risk. The aim of this paper is to report 2 cases of ruptured lobar AVMs in children, presenting with spontaneous ICH. Due to the patients’ neurological status, the only imaging examination performed preoperatively was a CT scan, showing intraparenchymal hemorrhage. Thus, there was no MRI/angiographic examination to prove the existence of a brain AVM prior to the surgical interventions. Also, the cerebral angiography performed after the surgery showed, in both patients, no signs of residual vascular malformations. Therefore, the diagnosis of AVM was certified by macroscopic and microscopic pathological findings, with no brain imaging suggestive of a vascular malformation.

APA, Harvard, Vancouver, ISO, and other styles

32

Mačiukaitienė, Jomantė, Diana Bilskienė, Arimantas Tamašauskas, and Adomas Bunevičius. "Prothrombin Complex Concentrate for Warfarin-Associated Intracranial Bleeding in Neurosurgical Patients: A Single-Center Experience." Medicina 54, no. 2 (April 25, 2018): 22. http://dx.doi.org/10.3390/medicina54020022.

Full text

Abstract:

Objective: The number of patients presenting with warfarin-associated intracranial bleeding and needing neurosurgical intervention is growing. Prothrombin complex concentrate (PCC) is commonly used for anti-coagulation reversal before emergent surgery. We present our experience with PCC use in patients presenting with coagulopathy and needing urgent craniotomy. Methods: We retrospectively identified all patients presenting with intracranial bleeding and coagulopathy due to warfarin use, requiring urgent neurosurgical procedures, from January, 2014 (implementation of 4-PCC therapy) until December, 2016. For coagulation reversal, all patients received 4-PCC (Octaplex) and vitamin K. Results: Thirty-five consecutive patients (17 men; median age 72 years) were administered 4-PCC before emergent neurosurgical procedures. The majority of patients presented with traumatic subdural hematoma (62%) and spontaneous intracerebral hemorrhage (32%). All patients were taking warfarin. Median international normalized ratio (INR) on admission was 2.94 (range: 1.20 to 8.60). Median 4-PCC dose was 2000 I.U. (range: 500 I.U. to 3000 I.U.). There was a statically significant decrease in INR (p < 0.01), PT (p < 0.01), and PTT (p = 0.02) after 4-PCC administration. Postoperative INR values were ≤3.00 in all patients, and seven (20%) patients had normal INR values. There were no 4-PCC related complications. Four (11%) patients developed subdural/epidural hematoma and 20 (57%) patients died. Mortality was associated with lower Glasgow coma scale (GCS) score. Conclusions: The 4-PCC facilitates INR reversal and surgery in patients presenting with warfarin-associated coagulopathy and intracranial bleeding requiring urgent neurosurgical intervention.

APA, Harvard, Vancouver, ISO, and other styles

33

Mohammad, Nur, Jalal Uddin Mohammad Rumi, Sadia Jabeen Khan, Kalim Uddin, and Patoary Mohammed Faruque. "Diagnostic Validity of 3D-Computed Tomographic Angiography in Spontaneous Subarachnoid Haemorrhage." Journal of National Institute of Neurosciences Bangladesh 5, no. 1 (July 12, 2019): 47–52. http://dx.doi.org/10.3329/jninb.v5i1.42169.

Full text

Abstract:

Background: Diagnostic validity of different tests for the detection of spontaneous subarachnoid haemorrhage is an important issue. Objectives: The purpose of the present study was to validate 3D-Computed tomographic angiography in spontaneous subarachnoid haemorrhage. Methodology: This cross-sectional study was carried out in the Department of Neurosurgery and Cath Lab of DMCH in collaboration with private diagnostic centre from September 2013 to February 2015 for a period of six (06) months. Adult patients diagnosed as a case of spontaneous SAH based on clinical features and confirmed by plain CT evidence of subarachnoid blood were included as study population. Patients having current history of trauma, poor clinical grade and agitated patient, patient with renal insufficiency, known allergy to iodinated contrast agent and patients who were not willing participate in the study were excluded from this study. Then both CT angiography and DSA were performed to detect cause of bleeding and to make a treatment planning. In this study DSA was considered as reference standard for evaluation of CTA. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of CTA were calculated per patient basis and per aneurysmal basis. Result: A total number of 37 patients presented with spontaneous subarachnoid haemorrhage were recruited for this study. The mean age of patients was 58.53±7.54 years. Sensitivity and specificity in depicting intracranial aneurysms were, 93.75% and 100% respectively on a per-patient basis. Positive predictive value and negative predictive value of CTA are 100% and 71.43% respectively. CTA had shown 94.59% accuracy in detection of intracranial aneurysm. Sensitivity and specificity in depicting intracranial aneurysms were 94.74% and 100% respectively on a per-aneurysm basis. Positive predictive value and negative predictive value of CTA are 100% and 71.43% respectively. CTA had shown 95.35% accuracy in detection of intracranial aneurysm. Conclusion: In conclusion CTA has high detection capacity of aneurysm among spontaneous subarachnoid haemorrhage patients. Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 47-52

APA, Harvard, Vancouver, ISO, and other styles

34

Naderi, Majid, Peyman Eshghi, Mehran Karimi, Shaban Alizadeh, and Akbar Dorgalaleh. "Prophylactic Program in fxiii Deficient Patients From Iran." Blood 120, no. 21 (November 16, 2012): 3376. http://dx.doi.org/10.1182/blood.v120.21.3376.3376.

Full text

Abstract:

Abstract Abstract 3376 Background: Prophylaxis is the management strategy in FXIII deficient patients. Life-long prophylactic therapy by 10–20 U/kg FXIII (every 4–6 weeks) is recommended in patients with severe FXIII deficiency to prevent life-threatening spontaneous bleeding. In this study we evaluated of the efficacy and safety of prophylaxis program in a large study group consisting of 182 FXIII deficient Iranian patients. Material and methods: A total of 182 FXIII deficient patients (98 male and 84 female, mean age 26 years old) from south and south-east Iran were selected as a study group. Continual prophylaxis was done in all patients for periods of 6–168 months (mean 66.6 months). The patients received Fibrogamin-P (Dade Behring, Marburg, Germany) 10–20 U/kg every 4–6 weeks and before availability of this concentrate in Iran the prophylaxis was done by FFP 15–20 ml/kg every 20–30 days. All of patients were followed up for any bleeding diathesis and adverse effects during the prophylaxis period. Results: A total of 189 bleeding episodes including epistaxis, gum bleeding, bleeding after dental extraction, hemarthrosis, hematoma, hematuria, wound bleeding, menorrhagia and abortion were detected in 182 patients after prophylaxis program. Life-threatening intracranial bleeding was found in 34 patients before starting prophylaxis; however, there were no reports after prophylaxis. The bleeding episodes and bleeding score were significantly decreased after prophylaxis in compare to before starting prophylaxis (P<0.05) Discussion: The prophylaxis of FXIII deficiency by FXIII concentrate is seems clinical significance in prevention of spontaneous and life-threatening bleeding and also abortion in affected women. Also it is recommended to start prophylaxis in patients as soon as possible for prevention of life-threatening bleeding episodes. Disclosures: No relevant conflicts of interest to declare.

APA, Harvard, Vancouver, ISO, and other styles

35

Afroz, Farhana, Hasna Fahmima Haque, Samira Rahat Afroze, Muhammad Abdur Rahim, Aparna Rahman, Md Mostarshid Billah, Razib Bhadra Rony, Jamal Uddin Ahmed, Md Delwar Hossain, and KM Shaheen Ahmed. "Subarachnoid Haemorrhage Complicating Resistant Idiopathic Thrombocytopenic Purpura: A Case Report." BIRDEM Medical Journal 4, no. 2 (November 10, 2014): 105–7. http://dx.doi.org/10.3329/birdem.v4i2.33199.

Full text

Abstract:

Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disease where low platelet counts predisposeto various bleeding tendencies; intracranial haemorrhageis one of them. It is a rare and devastating complication of ITP, mostly presenting as intracerebral (ICH) or subarachnoid haemorrhage (SAH). Here, we report a 32-year-old splenectomized chronic ITP patient on corticosteroid and azathioprine, in whom spontaneous SAH developed. In this case, conservative management resulted in clinicoradiological improvement and showed eventual favourable out-come.Birdem Med J 2014; 4(2): 105-107

APA, Harvard, Vancouver, ISO, and other styles

36

Shah, Vijay B., Niraj Bansal, and Kirti Mehta. "The study of disease pattern of various clinical classes of hemophilia in South Gujarat area, India." International Journal of Contemporary Pediatrics 6, no. 3 (April 30, 2019): 1168. http://dx.doi.org/10.18203/2349-3291.ijcp20192006.

Full text

Abstract:

Background: Haemophilia is one of the most severe bleeding disorder. Seventy-five per cent of the global haemophiliacs live in developing countries, where probably only one in five cases is diagnosed, and there is little or no care available. Haemophilia as a disease and its management has a large impact on the community, including social integration and economics. Inability to be an active part of society and high cost of the medical care make this disease an important problem for all haemophilic patients.Methodology: a cross-sectional study, conducted over a period of one and half year. Institutional Ethics Committee permission was taken before starting the study. Information was gathered through personal interview of the patient’s guardian with the help of predesigned questionnaires. Special emphasis was given to past history of bleeding. For each specific symptom/ specific site a detailed history and relevant details was taken and number of episodes of each symptom or number of episodes of involvement of a specific site was written.Observations: Out of 75 patients of haemophilia; 8 (10.7%) were Mild haemophilic, 17 (22.7%) were moderate haemophilic; and 50 (66.7%) were severe haemophilic. Most common site for spontaneous bleeding was muscle where 121 (25%) episodes of bleeding were reported, followed by knee joint 97(20%), and Ankle 79 (16.3%). The commonest site for traumatic bleeding was muscle where 201 (24.7%) episodes of bleeding were reported, followed by knee joint 175 (21.5%), Ankle 143 (17.6%) and Elbow joint 83 (10.2%). Site with highest duration of bleeding was intracranial for 6 days.Conclusion: Frequency of traumatic dental and nasal bleeds was significantly higher in mild class as compared to moderate and severe classes. In severe category Knee, ankle, elbow and muscle were the commonest site where traumatic bleeding. There was no significant difference in bleeding frequencies at various sites in moderate and severe cases, whether spontaneous or traumatic bleed.

APA, Harvard, Vancouver, ISO, and other styles

37

Luchian, Mihaela, and Adriana Săceleanu. "Haemorrhagic Cerebrovascular Accident (CVA) Etiology and Case Report." Acta Medica Transilvanica 25, no. 4 (December 1, 2020): 16–18. http://dx.doi.org/10.2478/amtsb-2020-0061.

Full text

Abstract:

Abstract A haemorrhagic cerebrovascular accident refers to a spontaneous bleeding in the cerebral parenchyma, located either supratentorial or infratentorial, that occurs in the absence of a surgical or traumatic cause. The incidence is estimated at 12-15 new cases per 100.000 inhabitants per year. Intracranial haemorrhage is the third most frequent cause of stroke, the vast majority being represented by primary/hypertensive (spontaneous) intracerebral haemorrhage, ruptured saccular aneurysm, a vascular malformation or haemorrhage associated with the use of anticoagulants or thrombolytic agents. A cerebral tomography computer examination is the examination of choice in diagnosis of haemorrhagic CVAs. The treatment can be either therapeutic or surgical, depending on the case, with the consideration that an immediate medical treatment is mandatory for the best odds of recovery.(1)

APA, Harvard, Vancouver, ISO, and other styles

38

Abdelmalik, Peter, and Wendy Ziai. "Spontaneous Intraventricular Hemorrhage: When Should Intraventricular tPA Be Considered?" Seminars in Respiratory and Critical Care Medicine 38, no. 06 (December 2017): 745–59. http://dx.doi.org/10.1055/s-0037-1607991.

Full text

Abstract:

AbstractSpontaneous intracerebral hemorrhage (ICH) is the most common cause of intraventricular hemorrhage (IVH) in adults. Complicating approximately 40% of ICH cases, IVH adds to the morbidity and mortality of this often fatal form of stroke. It is also a severity factor that complicates subarachnoid hemorrhage and traumatic brain injury, along with other less common causes of intracranial bleeding. Medical and surgical interventions to date have focused on limiting ICH and IVH expansion, controlling intracranial pressure, and relieving obstructive hydrocephalus. The placement of an external ventricular drain (EVD) can achieve the latter two goals but has not demonstrated improvement in clinical outcomes beyond mortality reduction. More recently, intraventricular fibrinolysis, utilizing the EVD, has gained interest as a safe and potentially effective method to maintain catheter patency and facilitate hematoma removal. A recent phase III clinical trial evaluating the efficacy of intraventricular alteplase versus intraventricular saline showed a mortality benefit, but failed to meet the primary endpoint of significant functional improvement. However, planned subgroup analysis focusing on patients with IVH volume > 20 mL, and those with IVH removal > 85% suggest that significant functional benefits may be attainable with this therapy. The practice of intraventricular fibrinolysis for spontaneous IVH is not the standard of care; however, based on 20 years of experience, it meets thresholds as a safe intervention, and in those patients with a high burden of intraventricular blood, aggressive clearance may lead to improved quality of life in survivors of this morbid syndrome.

APA, Harvard, Vancouver, ISO, and other styles

39

Parreira, Johnathan de Sousa, Adelmo Ferreira, Adriano Torres Antonucci, Natally Marques Santiago, Roberto Parente Neto, Bruno de Azevedo Oliveira, Luiz Henrique Garcia Lopes, and Pedro Garcia Lopes. "Intratumoral hemorrhage and deadly upward transtentorial herniation after endoscopic third ventriculostomy in the management of posterior fossa tumor-related hydrocephalus – Case report and literature review." Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 33, no. 02 (June 2014): 142–46. http://dx.doi.org/10.1055/s-0038-1626263.

Full text

Abstract:

AbstractThe management of hydrocephalus associated with posterior fossa tumors in children has always been controversial. Studies show that 71%-90% of children with posterior fossa tumors already presented hydrocephalus on admission. Of these cases, 10%-62% will have persistent hydrocephalus after surgical treatment of the tumor. The shunt, although it is an important alternative for preoperative treatment in these cases is not without complications. Among the numerous complications identified by the literature, we highlight the most rare, intratumoral hemorrhage, upward transtentorial herniation and dissemination of neoplastic cells by the peritoneum. Medulloblastoma is considered the most common malignant pediatric tumor, comprising 15%-20% of all intracranial tumors in childhood. In addition, 5%-6% of primary or recurrent medulloblastomas may be associated with spontaneous bleeding and rapid deterioration. The bleeding presents with tumor swelling, extending to the ventricular system through the tumor capsule, increased intracranial pressure and upward transtentorial herniation. Tumoral hemorrhage associated with ventricular drainage for treatment of hydrocephalus in patients with medulloblastoma represents an extremely rare phenomenon. The endoscopy third-ventriculostomy (ETV) is known to be very useful in the treatment of intracranial hypertension preoperatively and prevent persistent postoperative hydrocephalus in cases associated with posterior fossa tumors, with efficacy superior to traditional ventricular shunts. We describe a case of intratumoral hemorrhage and upward transtentorial herniation associated with endoscopic third-ventriculostomy (ETV).

APA, Harvard, Vancouver, ISO, and other styles

40

Zakaria, Zaitun, Chandrasekaran Kaliaperumal, Darach Crimmins, and John Caird. "Neurosurgical management in children with bleeding diathesis: auditing neurological outcome." Journal of Neurosurgery: Pediatrics 21, no. 1 (January 2018): 38–43. http://dx.doi.org/10.3171/2017.6.peds16574.

Full text

Abstract:

OBJECTIVEThe aim of this study was to assess the outcome of neurosurgical treatment in children with bleeding diathesis and also to evaluate the current management plan applied in the authors’ service.METHODSThe authors retrospectively analyzed all cases in which neurosurgical procedures were performed in pediatric patients presenting with intracranial hematoma due to an underlying bleeding tendency over a 5-year period at their institution. They evaluated the patients’ neurological symptoms from the initial referral, hematological abnormalities, surgical treatment, neurological outcome, and scores on the Pediatric Glasgow Outcome Scale–Extended (GOS-E Peds) obtained 1 year after the last operation.RESULTSFive patients with a bleeding diathesis who underwent surgery for intracranial hematoma were identified; the diagnosis was hemophilia A in 3 cases, idiopathic thrombocytopenic purpura in 1 case, and severe aplastic anemia in 1 case. Intracerebral hematoma (ICH) (n = 4) and acute subdural hematoma (n = 1) were confirmed on radiological investigations. In 2 of the 4 patients with ICH, the diagnosis of bleeding diathesis was made for the first time on presentation. Four patients (all male) were younger than 2 years; the patient with severe aplastic anemia and spontaneous ICH was 15 years old and female. The duration of symptoms varied from 24 hours to 5 days. Neurological examination at 1 year’s follow-up showed complete recovery (GOS-E Peds score of 1) in 3 cases and mild weakness (GOS-E Peds score of 2) in 2 cases.CONCLUSIONSNeurosurgical management of patients with bleeding diathesis should be carried out in a tertiary-care setting with multidisciplinary team management, including members with expertise in neuroimaging and hematology, in addition to neurosurgery. Early diagnosis and prompt treatment of a bleeding diathesis is crucial for full neurological recovery.

APA, Harvard, Vancouver, ISO, and other styles

41

Abu Hishmeh, M., P. Srivastava, Q. Lougheide, M. Srinivasan, and S. Murthy. "Massive Spontaneous Hemothorax as a Complication of Apixaban Treatment." Case Reports in Pulmonology 2018 (October 16, 2018): 1–4. http://dx.doi.org/10.1155/2018/8735036.

Full text

Abstract:

Introduction. Hemothorax is usually related to chest or iatrogenic trauma from procedures such as central lines and thoracentesis. Spontaneous hemothorax is defined as pleural fluid hematocrit greater than 50% of serum hematocrit in absence of natural or iatrogenic trauma affecting the lung or pleural space. Coagulopathy secondary to anticoagulant use has been associated with spontaneous hemothorax. We present a case of spontaneous hemothorax in a patient taking apixaban for venous thromboembolism disease. To our knowledge, this is the first case report of apixaban as a cause of spontaneous hemothorax. Case Presentation. A 56-year-old woman with end-stage renal disease (ESRD) was diagnosed with upper extremity deep vein thrombosis (DVT) one month prior to presentation and was started on apixaban presented with dyspnea and left-sided pleuritic chest pain for two weeks. She was found to have left-sided large pleural effusion which was diagnosed as hemothorax. Other etiologies for spontaneous hemothorax were excluded and drainage by 12-French pigtail catheter achieved total resolution of hemothorax in three days. Discussion. Apixaban is a DOAC used to prevent stroke or thromboembolic events in patients with nonvalvular atrial fibrillation and to prevent recurrent venous thromboembolic disease. Events such as gastrointestinal, intracranial, and soft tissue bleeding have been well-documented. However, bleeding manifestation as hemothorax is seldom reported. Our patient presented with isolated left-sided large pleural effusion which was diagnosed as spontaneous hemothorax. 12-Fr pigtail catheter drainage was effective in the management of our patient and provided total resolution in three days. Conclusion. Spontaneous hemothorax is a rare complication of anticoagulant therapy and might not exhibit the usual radiological signs of traumatic hemothorax. Health care providers should have high index of suspicion for spontaneous hemothorax when evaluating new pleural effusion in patients receiving DOACs therapy. Drainage by small bore pigtail catheter might be as effective as larger chest tubes.

APA, Harvard, Vancouver, ISO, and other styles

42

Ismy, Jufitriani. "DUA KASUS ACQUIRED PROTHROMBIN COMPLEX DEFICIENCY DENGAN PERDARAHAN INTRAKRANIAL : LAPORAN KASUS." Jurnal Kedokteran Syiah Kuala 17, no. 3 (December 1, 2017): 174–78. http://dx.doi.org/10.24815/jks.v17i3.9068.

Full text

Abstract:

Abstrak. Acquired Prothrombin Complex Deficiency (APCD) merupakan perdarahan spontan yang disebabkan oleh penurunan aktivitas faktor koagulasi yang tergantung vitamin K (faktor II, VII, IX dan X), sedangkan aktivitas faktor koagulasi lain, kadar fibrinogen dan jumlah trombosit masih dalam batas normal. Insiden tertinggi APCD pada anak usia 3 – 8 minggu. Dilaporkan 2 kasus APCD di RS Zainoel Abidin Banda Aceh dengan hasil CT-Scan tampak adanya perdarahan Subaracnoid haemorhagic, Subdural haemorhagic, Intracranial Haemorhagic dan Edema cerebri. Pasien mengalami penyembuhan tanpa dilakukan intervensi bedah.Kata kunci : Acquired Prothrombin Complex Deficiency , vitamin K, Perdarahan Subaracnoid haemorhagic, Subdural haemorhagic, Intracranial Haemorhagic AbstractAcquired Prothrombin Complex Deficiency (APCD) is a spontaneous haemorrhage caused by decreased vitamin K-dependent coagulation factor activity (factor II, VII, IX and X), while other coagulation factor activity, fibrinogen levels and platelet counts are within normal limits. Highest incidence of APCD at age 3 - 8 weeks. Reported 2 cases of APCD in RS Zainoel Abidin Banda Aceh with CT-Scan result seen bleeding Subaracnoid haemorhagic, Subdural haemorhagic, Intracranial Haemorhagic and Edema cerebri. The patient is healed without surgical intervention.Key words : Acquired Prothrombin Complex Deficiency, child, vitamin K, Subaracnoid haemorhagic, Subdural haemorhagic, Intracranial Haemorhagic

APA, Harvard, Vancouver, ISO, and other styles

43

Doherty, John Anthony, Christopher Paul Millward, and Zaid Sarsam. "Spontaneous and recurrent subdural haematoma in a patient with May-Hegglin anomaly." BMJ Case Reports 14, no. 5 (May 2021): e243134. http://dx.doi.org/10.1136/bcr-2021-243134.

Full text

Abstract:

Both acute and chronic subdural haematomas typically occur following trauma. Non-traumatic causes are less common, but aetiologies include arteriovenous malformation, intracranial aneurysm rupture, tumour-associated haemorrhage and coagulopathies. May-Hegglin anomaly is an example of a coagulopathy, which is caused by a mutation in the gene encoding non-muscle myosin heavy chain 9 (MYH9) and therefore falls into a group of diseases referred to as MYH9-related diseases (MYH9-RD). The symptomology of MYH9-RD is often mild, and patients tend to experience epistaxis, gingival bleeding and bruising. Life-threatening haemorrhage rarely occurs. In this short report, we describe a patient with known May-Hegglin anomaly who presented with a potentially life-threatening, spontaneous subdural haematoma requiring surgery on two occasions. This is only the second such report in the literature, and the first of spontaneous and recurrent haemorrhage in association with May-Hegglin anomaly.

APA, Harvard, Vancouver, ISO, and other styles

44

White, J. Bradley, David G. Piepgras, Bernd W. Scheithauer, and Joseph E. Parisi. "Rate of spontaneous hemorrhage in histologically proven cases of pilocytic astrocytoma." Journal of Neurosurgery 108, no. 2 (February 2008): 223–26. http://dx.doi.org/10.3171/jns/2008/108/2/0223.

Full text

Abstract:

Object Spontaneous intracerebral hemorrhage is an uncommon but recognized initial presenting sign of both primary and metastatic brain tumors. The rate of tumor-related intracranial hemorrhage is variably reported from < 1 to 14.6%. Hemorrhage in primary gliomas occurs in 3.7–7.2% of gliomas, mainly in glioblastoma muliforme and oligodendroglioma with low-grade astrocytomas accounting for < 1%. Hemorrhage associated with pilocytic astrocytomas (PAs) is only sporadically reported. The authors report on a series of patients in whom PAs presenting as hemorrhages prompted them to examine the incidence of bleeding in these tumors. Methods Cases involving a confirmed tissue diagnosis of PA from 1994–2005 were reviewed retrospectively. The authors included only patients with evidence of hemorrhage on computed tomography and/or magnetic resonance imaging seen prior to biopsy or resection and in the absence of trauma or other vascular pathological entities. Results In 138 patients with histologically proven PAs, the mean age at diagnosis was 23 years. In 11 patients (8%; 5 male and 6 female) there was evidence of hemorrhage at presentation. There were no locations more susceptible to hemorrhage than any other, although no bleeding occurred within the cerebellum. All but 1 patient was treated with a gross-total resection. Conclusions Hemorrhage in association with PAs likely results from the frequently observed abnormal vasculature in these tumors, occurs with a greater frequency than previously thought, and should be considered in the differential diagnosis of spontaneous intracerebral hemorrhage.

APA, Harvard, Vancouver, ISO, and other styles

45

Kitsuta, Yoichi, Noriyuki Suzuki, Mitsugi Sugiyama, and Isao Yamamoto. "Changes in Level of Consciousness and Association with Hyperglycemia as Tool for Predicting and Preventing Re-bleeding after Spontaneous Subarachnoid Hemorrhage." Prehospital and Disaster Medicine 21, no. 3 (June 2006): 190–95. http://dx.doi.org/10.1017/s1049023x00003666.

Full text

Abstract:

AbstractIntroduction:It is crucial to predict and prevent re-bleeding from ruptured intracranial aneurysms in patients with subarachnoid hemorrhage (SAH). During the prehospital period and on arrival to the hospital, blood glucose and serum potassium levels, as well as changes in levels of consciousness were assessed in patients in the acute stage of spontaneous subarachnoid hemorrhage. These assessments were analyzed as possible risk factors for re-bleeding and as potential contributors to the prevention of re-bleeding, both in prehospital care and after hospital admission.Methods:Upon the arrival of 202 patients with spontaneous subarachnoid hemorrhage, the following indications were examined retrospectively: (1) presence/absence of re-bleeding; (2) time interval between the onset of SAH and re-bleeding; (3) level of consciousness using the Glasgow Coma Scale (GCS) score before and on arrival; (4) amount and distribution of subarachnoid blood using Fisher's Computerized Tomography Classification; (5) blood pressure; (6) blood glucose concentration; and (7) serum potassium concentration. The patients were hospitalized in the Yokohama City University Critical Care and Emergency Center (Yokohama, Japan) between January 1991 and December 2000. The re-bleeding rate was analyzed using the chi-square ([X]2 test, and the averages and standard deviations of hematological data were compared using the Mann-Whitney U-test. The level of statistical significance was set at p <0.05.Results:The overall re-bleeding rate was 20.8%. Among 119 patients with a GCS score of 3–7 before arrival, 42 (35.3%) had re-bleeding, but none of the 83 patients with a GCS score of 8–15 before arrival had re-bleeding. Of 105 patients with a GCS score of 13–15 on arrival, 14 (51.8%) of 27 patients whose consciousness level was a GCS score of 3–7 before arrival experienced re-bleeding. The re-bleeding rate of this group was high. Moreover, this rebleeding group had a significantly higher blood glucose concentration than did the patients whose GCS score was 13–15 both before and on arrival. Between the patients with or without re-bleeding, there was no significant difference in the blood pressure on arrival or in distribution according to Fisher's Computerized Tomography ClassificationConclusion:Since the re-bleeding rate is high in patients who have hyperglycemia and a history of a level of consciousness as low as a GCS score of 3–7, a detailed assessment of level of consciousness and blood glucose tests performed on arrival provide important information that will contribute to predicting and preventing re-bleeding. This may be extended to the prehospital phase, because blood glucose tests are simple and safe when performed by paramedics.

APA, Harvard, Vancouver, ISO, and other styles

46

Hou, Kun, and Guichen Li. "In Reply to the Letter to the Editor Regarding “Transient Acute Hydrocephalus After Spontaneous Intracranial Bleeding in Adults”." World Neurosurgery 140 (August 2020): 419–20. http://dx.doi.org/10.1016/j.wneu.2020.05.051.

Full text

APA, Harvard, Vancouver, ISO, and other styles

47

Kader, Sebnem, Mehmet Mutlu, Filiz Akturk Acar, Yakup Aslan, and Aysenur Bahadir. "Homozygous congenital factor VII deficiency with a novel mutation, associated with severe spontaneous intracranial bleeding in a neonate." Blood Coagulation & Fibrinolysis 29, no. 5 (July 2018): 476–80. http://dx.doi.org/10.1097/mbc.0000000000000748.

Full text

APA, Harvard, Vancouver, ISO, and other styles

48

Lovejoy, Amy E., Tom C. Reynolds, Jennifer E. Visich, Michael D. Butine, Guy Young, Melissa A. Belvedere, Rachelle C. Blain, Susan M. Pederson, Laura M. Ishak, and Diane J. Nugent. "Safety and pharmacokinetics of recombinant factor XIII-A2 administration in patients with congenital factor XIII deficiency." Blood 108, no. 1 (July 1, 2006): 57–62. http://dx.doi.org/10.1182/blood-2005-02-0788.

Full text

Abstract:

Congenital factor XIII (FXIII) deficiency is associated with a tendency for severe bleeding, a risk for spontaneous abortion, and a high rate of spontaneous intracranial hemorrhage. This phase 1 escalating-dose study was developed to evaluate the safety and pharmacokinetics of a single administration of human recombinant FXIII-A2 (rFXIII-A2) homodimer in adults with congenital FXIII deficiency. Pharmacokinetics and activity of rXIII and changes in endogenous B subunit levels were assessed. Recombinant FXIII-A2 homodimer were complexed with endogenous FXIII-B subunits to form an FXIII-A2B2 heterotetramer with a half-life of 8.5 days, similar to that of endogenous FXIII. The median dose response was a 2.4% increase in FXIII activity based on unit per kilogram rFXIII administered. After the administration of rFXIII-A2, clot solubility normalized as measured by clot lysis in urea. Clot strength and resistance to fibrinolysis, as assessed by thromboelastography, also improved. Safety reviews were conducted before each dose escalation; no serious adverse events, including bleeding or thrombosis, were noted during the study. In addition, there was no evidence of the generation of specific antibodies to rFXIII or yeast proteins. Recombinant FXIII appears to be a safe and potentially effective alternative for FXIII replacement in patients with FXIII deficiency. (Blood. 2006;108:57-62)

APA, Harvard, Vancouver, ISO, and other styles

49

Golubovic, Jagos, Djula Djilvesi, Tomislav Cigic, Vladimir Papic, Bojan Jelaca, and Petar Vulekovic. "Rare case of dural arteriovenous fistula presenting by spontaneous acute subdural hematoma: A case report and review of literature." Vojnosanitetski pregled 77, no. 2 (2020): 237–39. http://dx.doi.org/10.2298/vsp160522111g.

Full text

Abstract:

Introduction. Dural arteriovenous fistulas represent pathological acquired bonds between the meningeal blood vessels (arteries) and drainage veins associated to them. These fistulas can vary in clinical presentations, from being asymptomatic to causing serious neurological deficits, depending mostly on the localization and size. Only one fourth of dural fistulas present themselves with intracranial bleeding. This hemorrhage is most frequently localized in subarachnoid space, occasionally intracerebrally, and seldom beneath the dura mater, ie subdurally. Case report. We presented a rare case of a patient with spontaneous acute subdural hematoma. After the initial treatment and consequent imaging methods, a diagnosis of a dural arteriovenous fistula was established. After the craniotomy for hematoma evacuation, the patient underwent an uneventful endovascular treatment. Despite the rarity of non-traumatic acute subdural hematoma caused by dural arteriovenous fistula, one should not overlook the possible pathogenesis and etiology in patients with spontaneous acute subdural hematoma. Even with the absence of the symptoms and signs of subdural bleeding, dural arteriovenous fistula, as a cause of it, should not be immediately ruled out. Conclusion. Despite the rarity of non-traumatic acute subdural hematoma being caused by dural arteriovenous fistulas, one should not immediately overlook the possible pathogenesis and etiology. Cautious approach is needed when treating such diseases even in the absence of typical symptoms.

APA, Harvard, Vancouver, ISO, and other styles

50

Yu, Jinlu, Lei Shi, Xianli Lv, Zhongxue Wu, and Hongfa Yang. "Intracranial non-galenic pial arteriovenous fistula: A review of the literature." Interventional Neuroradiology 22, no. 5 (July 9, 2016): 557–68. http://dx.doi.org/10.1177/1591019916653934.

Full text

Abstract:

An intracranial non-galenic pial arteriovenous fistula (NGPAVF) is a direct connection between the intracranial artery and vein without a nidus. NGPAVFs are clinically rare, and the current understanding of NGPAVFs is limited. This study searched PubMed for the currently available literature, and a review of the relevant publications revealed that NGPAVFs require aggressive treatment, spontaneous occlusion is uncommon, and the prognosis following conservative treatment is poor. NGPAVFs can be divided into congenital and traumatic (including iatrogenic) types. Clinically, NGPAVFs are characterized by congestive heart failure, epilepsy, hemorrhage, mass effects, and nerve function deficits. For the imaging examination of NGPAVFs, digital subtraction angiography (DSA) is still the gold standard for diagnosis, although magnetic resonance DSA (MRDSA) and 4D computed tomography angiography (CTA) can also provide hemodynamic data in a non-invasive manner. Current treatments for NGPAVFs include surgical resection and endovascular embolization, both of which can yield clinical improvements. However, potential postoperative complications should be addressed, such as fatal bleeding due to rupture and deep vein thrombosis. Some studies recommend postoperative anticoagulation to reduce postoperative thrombotic complications.

APA, Harvard, Vancouver, ISO, and other styles

Journal articles on the topic 'Spontaneous intracranial bleeding'

Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles