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Journal articles on the topic 'Haemorrhage'
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1
Boertjes, Emma, Stefanie Hillebrand, Janneke Elisabeth Bins, and Laurien Oswald. "Pulmonary haemorrhage in Weil’s disease." BMJ Case Reports 13, no. 1 (January 2020): e227570. http://dx.doi.org/10.1136/bcr-2018-227570.
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Leptospirosisis a zoonosis caused by spirochaetes from the species Leptospira. The more severe form of leptospirosis, known as Weil’s disease, is characterised by the triad of jaundice, renal impairment and haemorrhages. Pulmonary involvement occurs in 20%–70% of the patients, with severity ranging from non-productive cough to respiratory failure mainly due to pulmonary haemorrhage. Recognition of Weil’s disease in patients presenting with pulmonary symptoms can be difficult. This case illustrates a classic case of pulmonary haemorrhagic involvement in Weil’s disease.
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Blanco, Alicia, Roberto Chuit, Susana Meschengieser, Ana Kempfer, Cristina Farías, María Lazzari, and Adriana Woods. "Major haemorrhage related to surgery in patients with type 1 and possible type 1 von Willebrand disease." Thrombosis and Haemostasis 100, no. 05 (2008): 797–802. http://dx.doi.org/10.1160/th-07-12-0757.
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SummaryPatients with von Willebrand disease (VWD) frequently bleed under a challenge. The aim of our study was to identify predictive markers of perioperative major haemorrhage in type 1 (VWF:RCo = 15–30 IU dl-1) and possible type 1 (VWF:RCo = 31–49 IU dl-1)VWD patients. We recorded perioperative bleeding complications previous to diagnosis and laboratory parameters in 311 patients with 498 surgical procedures. The patients were grouped according to the absence (A) or presence (B) of perioperative major haemorrhages. Eighty-one patients (26%) and 87 surgical procedures (17.5%) presented major haemorrhages associated with surgeries. There was no difference between the percentage of type 1 and possible type 1 VWD patients who had major haemorrhages (32.6% and 24.8% respectively; p=ns). No difference in the prevalence of O blood group, age, gender, positive family history and laboratory test results (FVIII and VWF) was observed, independent of the haemorrhagic tendency. Bleeding after tooth extraction was the most frequent clinical feature observed in patients with perioperative major haemorrhages. The bleeding score and the number of bleeding sites (≥3) were not predictors of major haemorrhage associated with surgery. Caesarean section and adenotonsillectomy showed the highest frequency of major haemorrhages (24.6% and 22.3%, respectively). In conclusion, type 1 and possible type 1VWD patients showed similar incidence of perioperative major haemorrhages. Laboratory tests and positive family history did not prove to be effective at predicting major haemorrhages in patients that had either type 1 or possible type 1 VWD. The history of bleeding after tooth extraction could define risk factors of major haemorrhage.
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Abdulla, M. C. "Spontaneous soft tissue haemorrhage in systemic lupus erythematosus." Reumatismo 68, no. 4 (December 31, 2016): 199. http://dx.doi.org/10.4081/reumatismo.2016.952.
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Diversity in clinical presentations and complications of systemic lupus erythematosus (SLE) make the diagnosis and management challenging. The mechanisms of haemorrhagic manifestations in SLE have not been well elucidated. A 47-year-old woman with no comorbidities was admitted after suffering fatigue and low grade fever for six months. She had bilateral soft tissue haemorrhage over the forearm and intra retinal haemorrhages. She was assessed and diagnosed as having SLE based on positive antinuclear antibody, strongly positive anti double stranded DNA, thrombocytopenia and low C3 and C4 levels. We describe a case of spontaneous bilateral soft tissue haemorrhage in SLE and discuss the various mechanisms causing bleeding in lupus.
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Ibrahim, Umma A., Sagir G. Ahmed, Modu B. Kagu, and Usman A. Abjah. "Impact of intestinal helminths on the risks of gastrointestinal haemorrhage and iron deficiency among haemophilia patients in northern Nigeria." Journal of Haemophilia Practice 4, no. 1 (January 26, 2017): 58–64. http://dx.doi.org/10.17225/jhp00097.
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Abstract We predicted that haemophilia would create a prohaemorrhagic host-parasite relationship, which would make haemophiliacs very vulnerable to haemorrhagic effects of intestinal helminths in tropical countries like Nigeria. If our prediction is correct, the frequency and risks of gastrointestinal haemorrhage and iron deficiency will be higher among haemophiliacs infected by helminths in comparison with uninfected haemophiliacs. Frequency of gastrointestinal haemorrhages and iron deficiency among haemophiliacs with and without intestinal helminth infections were retrospectively obtained and analysed, and their relative risk determined by regression analysis. Haemophiliacs with intestinal helminths had significantly higher frequencies of gastrointestinal haemorrhage (73.3% vs. 18.5%, p<0.05) and iron deficiency (60% vs. 22.2%, p<0.05) in comparison with haemophiliacs without intestinal helminths. Haemophiliacs with intestinal helminths had significantly elevated relative risks (RR) of gastrointestinal haemorrhage (RR=3.4, CI95%: 2.4- 4.3, p=0.007) and iron deficiency (RR=2.5, CI95%: 1.7-3.3, p=0.009). These results showed that helminth infections were associated with increased risks of gastrointestinal haemorrhage and iron deficiency in haemophiliacs. This is thought to be due to a pro-haemorrhagic host-parasite relationship resulting from host haemostatic abnormality, coupled with the concurrent manipulation of the host haemostatic system by anticoagulants produced by some of the parasites. Haemophiliacs in tropical countries should be regularly screened and treated for intestinal helminths.
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Azeemuddin, Muhammad, Muhammad Awais, Fatima Mubarak, Abdul Rehman, and Noor Ul-Ain Baloch. "Prevalence of subarachnoid haemorrhage among patients with cranial venous sinus thrombosis in the presence and absence of venous infarcts." Neuroradiology Journal 31, no. 5 (June 12, 2018): 496–503. http://dx.doi.org/10.1177/1971400918783060.
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Introduction In patients with cranial venous sinus thrombosis, the occurrence of subarachnoid haemorrhage in association with haemorrhagic venous infarcts is a well described phenomenon. However, the presence of subarachnoid haemorrhage in patients with cranial venous sinus thrombosis in the absence of a haemorrhagic venous infarct is exceedingly rare. Methods We retrospectively reviewed charts and scans of all patients who had cranial venous sinus thrombosis confirmed by magnetic resonance venography at our hospital between September 2004 and May 2015. The presence of subarachnoid haemorrhage was ascertained on fluid-attenuated inversion recovery, susceptibility-weighted imaging and/or unenhanced computed tomography scans by a single experienced neuroradiologist. Statistical analysis was performed using the Statistical Package for Social Sciences version 20. Differences in the proportion of haemorrhagic venous infarcts among patients with subarachnoid haemorrhage versus those without subarachnoid haemorrhage were compared using the chi-square test. A P value of less than 0.05 was considered significant. Results A total of 138 patients who had cranial venous sinus thrombosis were included in the study. Seventy-three (52.9%) were women and the median age of subjects was 35 (interquartile range 22–47) years. Venous infarcts and haemorrhagic venous infarcts were noted in 20/138 (14.5%) and 62/138 (44.9%) cases, respectively. Subarachnoid haemorrhage was present in 15/138 (10.9%) cases and, in three cases, subarachnoid haemorrhage occurred in the absence of a venous infarct. Haemorrhagic venous infarcts were more prevalent ( P = 0.021) among patients with subarachnoid haemorrhage (11/15) than in those without subarachnoid haemorrhage (51/123). Conclusion In patients with cranial venous sinus thrombosis, subarachnoid haemorrhage can occur even in the absence of a haemorrhagic venous infarct. The recognition of cranial venous sinus thrombosis as the underlying cause of subarachnoid haemorrhage is important to avoid misdiagnosis and inappropriate management.
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Grysiewicz, Rebbeca, and Philip B. Gorelick. "Update on Amyloid-associated Intracerebral Haemorrhage." European Neurological Review 7, no. 1 (2012): 22. http://dx.doi.org/10.17925/enr.2012.07.01.22.
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Cerebral congophilic or amyloid angiopathy (CAA) is a clinicopathological entity that is considered a common cause of primary non-traumatic brain haemorrhage in the elderly. CAA is frequently associated with Alzheimer’s disease (AD) and has become a primary focus of scientific inquiry. The spectrum of intracerebral haemorrhage (ICH) that may occur in CAA includes: cerebral lobar haemorrhages, deep haemorrhages, purely subarachnoid and subdural haemorrhages and cerebral microbleeds. CAA is also associated with microinfarcts, leukoencephalopathy and superficial siderosis. This brief article will provide an update on the advances in our understanding of CAA-associated ICH with a focus on the following topics: neuropathology and mechanism of CAA-related haemorrhage; epidemiology, including genetic and other possible risk factors; clinical presentation; diagnosis, including newer imaging modalities; and prospects for prevention and treatment.
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Patwary, ZP, MAR Faruk, and MM Ali. "Clinical and Histopathological Study of Important Air-Breathing Fishes." Progressive Agriculture 19, no. 1 (November 23, 2013): 69–78. http://dx.doi.org/10.3329/pa.v19i1.17109.
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A study was conducted to know the health and disease problems of three important air-breathing fishes viz. Shing (Heteropneustes fossilis), Magur (Clarias batrachus) and Thai Koi (Anabas testudineus) through clinical and histopathological technique from June 2007 to March 2008 collected from selected farms and from local markets. Generally, during December and January, acute pathologies were recorded. Clinical signs of Shing included haemorrhage, extended belly and ulceration. Histopathologically, partly missing and splitted epidermis and dermis, necrotic, vacuoled and ruptured myotomes of muscle with fungal granuloma were observed. Major gill pathologies included partly missing and highly hypertrophied, haemorrhagic gill lamellae, presence of monogenetic trematode and pyknotic cells. In liver, haemorrhagic areas, necrotic, vacuoled, hyperplasid hepatocytes, cell debris, pyknotic nuclei and plenty of inflammatory cells were evident. Haemorrhages, vacuolation, necrosis, missing and ruptured kidney tubules and pyknotic nuclei were the major pathologies of kidney. Clinically, dark red lesion, haemorrhage, necrosis and ulcer in body surface were seen in Magur. Histopathologically observed pathologies in Magur were almost similar to that of Shing. Clinical signs of Thai Koi included discoloration, loss of scales and fins, abnormal caudal fin, haemorrhage in gill and ulcer. Marked histopathology in the skin and muscle were observed such as totally lost epidermis, dermis separated from muscle, severely ruptured, degenerated and missing of myotomes in many places. In gills, hypertrophy, hyperplasia, telangiectasis, clubbing, haemorrhage and massive necrosis in both primary and secondary gill lamellae were found. Pathologies observed in liver and kidney were most alike to that of Shing. In the months of February and March, all the investigated organs of the three fish species were at a healing stage.DOI: http://dx.doi.org/10.3329/pa.v19i1.17109 Progress. Agric. 19(1): 69 - 78, 2008
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Klopfleisch, R., B. Kohn, S. Plog, C. Weingart, K. Nöckler, A. Mayer-Scholl, and A. D. Gruber. "An Emerging Pulmonary Haemorrhagic Syndrome in Dogs: Similar to the Human Leptospiral Pulmonary Haemorrhagic Syndrome?" Veterinary Medicine International 2010 (2010): 1–7. http://dx.doi.org/10.4061/2010/928541.
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Severe pulmonary haemorrhage is a rare necropsy finding in dogs but the leptospiral pulmonary haemorrhagic syndrome (LPHS) is a well recognized disease in humans. Here we report a pulmonary haemorrhagic syndrome in dogs that closely resembles the human disease. All 15 dogs had massive, pulmonary haemorrhage affecting all lung lobes while haemorrhage in other organs was minimal. Histologically, pulmonary lesions were characterized by acute, alveolar haemorrhage without identifiable vascular lesions. Seven dogs had mild alveolar wall necrosis with hyaline membranes and minimal intraalveolar fibrin. In addition, eight dogs had acute renal tubular necrosis. Six dogs had a clinical diagnosis of leptospirosis based on renal and hepatic failure, positive microscopic agglutination test (MAT) and/or positive blood/urineLeptospira-specific PCR.Leptospiracould not be cultured post mortem from the lungs or kidneys. However,Leptospira-specific PCR was positive in lung, liver or kidneys of three dogs. In summary, a novel pulmonary haemorrhagic syndrome was identified in dogs but the mechanism of the massive pulmonary erythrocyte extravasation remains elusive. The lack of a consistent post mortem identification ofLeptospiraspp. in dogs with pulmonary haemorrhage raise questions as to whether additional factors besidesLeptospiramay cause this as yet unrecognized entity in dogs.
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Pertiwi, Kartika, Allard van der Wal, Dara Pabittei, Claire Mackaaij, Marinus van Leeuwen, Xiaofei Li, and Onno de Boer. "Neutrophil Extracellular Traps Participate in All Different Types of Thrombotic and Haemorrhagic Complications of Coronary Atherosclerosis." Thrombosis and Haemostasis 118, no. 06 (April 19, 2018): 1078–87. http://dx.doi.org/10.1055/s-0038-1641749.
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AbstractAcute coronary syndromes can be initiated by either atherosclerotic fibrous cap ruptures, superficial plaque erosions or intraplaque haemorrhages (IPHs). Since neutrophil extracellular traps (NETs) display pro-inflammatory and pro-thrombotic properties, we investigated the presence, extent and distribution of neutrophils and NETs in different types of plaque complications in relation to the age of overlying thrombus mass or haemorrhage. Sixty-four paraffin-embedded coronary plaque segments of 30 acute myocardial infarction patients were retrieved from the autopsy archives, which contained 44 complicated plaques (17 IPHs, 9 erosions and 18 ruptures) and 20 intact plaques. Complicated plaques were further categorized according to the histological age of thrombus or haemorrhage. Immunohistochemistry was performed to visualize neutrophils (anti-myeloperoxidase, anti-elastase and anti-CD177) and NETs (anti-citrullinated histone-3 and anti-peptidyl-arginine-deiminase-4). The results were scored semi-quantitatively. Neutrophils and NETs were abundantly present in all types of complicated, but not in intact, plaques (p < 0.05). They were found in thrombus, haemorrhages and at the thrombus–plaque interface, with no significant differences in extent between ruptures, erosions and IPHs. Interestingly, adjacent perivascular tissue of complicated, but not of intact plaques, also contained high numbers of neutrophils and NETs (p < 0.05). In thrombus and haemorrhage of different age, neutrophils and NETs were more frequently present in non-organized (fresh) thrombi and in on-going IPHs. In conclusion, netosis is a prominent pro-thrombotic participant in all distinct types of atherothrombosis, which may facilitate the progression of thrombotic or haemorrhagic complications and thus the onset of ensuing clinical coronary ischemic syndromes.
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Belenje, Akash, Rupali Bose, and Subhadra Jalali. "Rare case of Terson’s syndrome and viral retinitis due to dengue haemorrhagic fever in an infant." BMJ Case Reports 14, no. 5 (May 2021): e242274. http://dx.doi.org/10.1136/bcr-2021-242274.
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Dengue haemorrhagic fever with consequent thrombocytopaenia can lead to intracranial haemorrhage and Terson’s syndrome that can lead to visual problems. Simultaneously, the dengue virus can cause typical viral retinitis like picture in the eye. Early funduscopy and vision assessment is desirable in all dengue patients. In our case, an infant with dengue haemorrhagic fever and intracranial haemorrhage developed not only simultaneous bilateral vitreous and subinternal limiting membrane haemorrhage due to Terson’s syndrome from the indirect effect of thrombocytopaenia but also typical chorioretinitis possibly due to the direct effect of the virus on the retina. The vitreoretinal surgical outcome was satisfactory in this case.
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Behrouz, Réza. "Prognostic factors in pontine haemorrhage: A systematic review." European Stroke Journal 3, no. 2 (January 8, 2018): 101–9. http://dx.doi.org/10.1177/2396987317752729.
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Background Pontine haemorrhage comprises approximately 10% of intracerebral haemorrhages. There is a common presumption that pontine haemorrhage is inherently associated with poor outcome. Purpose The aim of the review was to identify chief predictors of prognosis in (pontine haemorrhage) through systematic review of published literature. Methods A query of PubMed/MEDLINE was conducted in search of studies in English language since, 1980 focusing specifically on outcome in pontine haemorrhage. References for each publication were reviewed for additional studies not detected by the PubMed/MEDLINE probe. Surgical outcome studies were excluded from the review. Findings The query identified 7867 titles, after removal of duplicates and irrelevant studies, 20 titles were included in the review. In a total of 1437 pontine haemorrhage patients included in the 20 studies, the overall rate for early all-cause mortality was 48.1%. Level of consciousness on admission and haemorrhage size were the most consistent predictors of mortality in patients with pontine haemorrhage. Haemorrhage localisation within the pons was also a prognostic factor, but not consistently. Age and intraventricular extension were not found to be powerful prognostic predictors. Discussion/Conclusion Based on this review, level of consciousness on admission and haemorrhage size were the most influential prognostic factors in pontine haemorrhage, whereas age, haemorrhage localisation, and intraventricular haemorrhage did not consistently predict prognosis.
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Dong, Wei-Hua, and Zhi Chen. "Leptospirosis with pulmonary haemorrhage and multiple organ failure: a case report and literature review." Journal of International Medical Research 49, no. 5 (May 2021): 030006052110196. http://dx.doi.org/10.1177/03000605211019665.
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Pulmonary haemorrhage is an important complication of leptospirosis. We herein report an uncommon case of severe pulmonary haemorrhage and multiple organ failure caused by leptospirosis in a 49-year-old man who was previously healthy. He was a farm worker who was admitted to the hospital because of haemoptysis. He had worked in a paddy field 4 days prior to admission. Chest computed tomography revealed pulmonary haemorrhage, which rapidly deteriorated into haemorrhagic shock and multiple organ failure. Based on the patient’s possible history of contact with contaminated water and the DNA sequence of Leptospira detected in his bronchoalveolar lavage fluid, the patient was diagnosed with pulmonary haemorrhagic leptospirosis. Despite the administration of a fluid bolus, norepinephrine, broad-spectrum antibiotics, and haemostatics, and even with administration of a blood transfusion and extracorporeal life support, the pulmonary haemorrhage could not be controlled effectively. The patient eventually died of haemorrhagic shock. Leptospirosis can be a life-threatening disease despite aggressive treatment, even with extracorporeal life support. Next-generation sequencing can provide important diagnostic clues for patients with atypical leptospirotic symptoms.
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Zentler-Munro, P. L., E. R. Howard, J. Karani, and R. Williams. "Variceal haemorrhage in hereditary haemorrhagic telangiectasia." Gut 30, no. 9 (September 1, 1989): 1293–97. http://dx.doi.org/10.1136/gut.30.9.1293.
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Gilligan, Amanda K., Romesh Markus, Stephen J. Read, Velandai Srikanth, Gregory Fitt, Brian R. Chambers, and Geoffrey A. Donnan. "Early CT Changes Do Not Predict Parenchymal Haemorrhage Following Streptokinase Therapy In Acute Stroke." Stroke 32, suppl_1 (January 2001): 370–71. http://dx.doi.org/10.1161/str.32.suppl_1.370-d.
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P173 Aims Recent thrombolytic trials in acute stroke, and acute treatment in the USA, exclude patients with early CT changes of infarction affecting greater than one third of the middle cerebral artery (MCA) territory because of a possible increased risk of parenchymal haemorrhage. We reviewed CT scans of patients recruited into the Australian Streptokinase Trial to determine whether such changes or other factors were predictive in this group of patients. Methodology Acute CT scans were classified by three neurology research fellows according to ECASS criteria in 264 patients. Where consensus was not reached, a panel of ECASS trained physicians reviewed the scans. Haemorrhage on second CT were classified into haemorrhagic infarction or parenchymal haemorrhage. Results CT s showed no acute changes in 36%, minor ischaemic changes (<1/3 MCA territory) in 29%, and major ischaemic changes (>1/3 MCA territory) in 35%. Major early ischaemic changes were predictive of haemorrhagic infarction (p=0.037) and stroke death (p= <0.001). Major changes were not predictive of parenchymal haemorrhage (O.R.=0.70 95% C.I.= 0.30 - 1.66). Parenchymal haemorrhage was not more likely with any early CT changes or delays in time to therapy but was predictive of death and severe disability. Systolic blood pressure prior to treatment was significantly higher in patient s with secondary parenchymal haemorrhage(p = 0.03). Discussion Early CT changes were predictive of poor outcome but not predictive of parenchymal haemorrhage. The risk of parenchymal haemorrage was increased with moderately increased systolic blood pressure. Excluding patients with high risk of parenchymal haemorrhage, may improve the safety and overall efficacy of thrombolytic therapy. The findings of this study do not support the exclusion of patients on CT criteria.
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Alexander, R. J., R. Kukreja, and G. R. Ford. "Secondary post-tonsillectomy haemorrhage and informed consent." Journal of Laryngology & Otology 118, no. 12 (December 2004): 937–40. http://dx.doi.org/10.1258/0022215042790619.
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This is a prospective incidence study of 250 secondary post-tonsillectomy haemorrhages from a population of 2706 tonsillectomies performed over a seven-year period, which aims to ascertain the incidence and character of post-tonsillectomy secondary haemorrhage. Out of 250 post-tonsillectomy secondary bleeds (9.2 per cent of total; 95 per cent CI = 8.2 per cent – 10.4 per cent), 39 patients had a severe bleed (1.4 per cent; 95 per cent CI = 1.2 per cent – 2.1 per cent). The incidence of secondary tonsillectomy haemorrhage increased with age, peaking at 30–34 years in both men and women (p < 0.001), with no statistically significant difference between the two sexes (p = 0.23). The incidence of serious haemorrhage increases in the older age categories (p = 0.005) but is not influenced by gender (p = 0.50). The majority of secondary tonsillectomy haemorrhages presented between the fourth and seventh day post-operation (69.8 per cent). These results now provide the basis for informed consent for a tonsillectomy in our department.
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McBride, Devin W., Derek Nowrangi, Harpreet Kaur, Guangyong Wu, Lei Huang, Tim Lekic, Jiping Tang, and John H. Zhang. "A composite neurobehavioral test to evaluate acute functional deficits after cerebellar haemorrhage in rats." Journal of Cerebral Blood Flow & Metabolism 38, no. 3 (March 20, 2017): 433–46. http://dx.doi.org/10.1177/0271678x17696509.
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Cerebellar haemorrhage accounts for 5–10% of all intracerebral haemorrhages and leads to severe, long-lasting functional deficits. Currently, there is limited research on this stroke subtype, which may be due to the lack of a suitable composite neuroscoring system specific for cerebellar injury in rodents. The purpose of this study is to develop a comprehensive composite neuroscore test for cerebellar injury using a rat model of cerebellar haemorrhage. Sixty male Sprague-Dawley rats were subjected to either sham surgery or cerebellar haemorrhage. Twenty-four hours post-injury, neurological behaviour was evaluated using 17 cost-effective and easy-to-perform tests, and a composite neuroscore was developed. The composite neuroscore was then used to assess functional recovery over seven days after cerebellar haemorrhage. Differences in the composite neuroscore deficits for the mild and moderate cerebellar haemorrhage models were observed for up to five days post-ictus. Until now, a composite neuroscore for cerebellar injury was not available for rodent studies. Herein, using mild and moderate cerebellar haemorrhage rat models a composite neuroscore for cerebellar injury was developed and used to assess functional deficits after cerebellar haemorrhage. This composite neuroscore may also be useful for other cerebellar injury models.
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Smith, I., and A. Wilde. "Secondary tonsillectomy haemorrhage and non-steroidal anti-inflammatory drugs." Journal of Laryngology & Otology 113, no. 1 (January 1999): 28–30. http://dx.doi.org/10.1017/s0022215100143087.
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AbstractModern non-steroidal anti-inflammatory drugs (NSAIDs), are now widely accepted analgesics for posttonsillectomy patients, but their effect on secondary haemorrhage has not been fully evaluated.This study attempts to evalute the influence of NSAIDs on the secondary haemorrhage rate, and also whether mode of dissection is an important factor.The records of 557 consecutive patients undergoing tonsillectomy were studied to determine if there was a relationship between the secondary haemorrhage rate and discharge prescription of NSAIDs.There was an overall secondary haemorrhage rate of 5.2 per cent (29) and a significantly increased secondary haemorrhage rate in those taking regular NSAIDs, 11 per cent, compared to those not taking NSAIDs, 1.47 per cent, ().There was a higher rate of secondary haemorrhages with bipolar dissection than with standard dissection for both those taking and not taking NSAIDs (13 per cent vs seven per cent and 2.75 per cent vs 0.87 per cent) however this was not statistically significant ( and ). Both bipolar dissection and standard dissection individually showed very significant increases in secondary haemorrhage rate when on regular NSAIDs ( and ).Although NSAIDs are very good analgesics, they may cause an increased secondary haemorrhage rate, and should be prescribed at discharge prescription with caution.
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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.
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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)
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Svensson, Edith H., Kasim Abul-Kasim, Gunnar Engström, and Martin Söderholm. "Risk factors for intracerebral haemorrhage – Results from a prospective population-based study." European Stroke Journal 5, no. 3 (June 12, 2020): 278–85. http://dx.doi.org/10.1177/2396987320932069.
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Introduction While the relationship between hypertension and incident intracerebral haemorrhage is well established, other risk factors are less clear. This study examined risk factors for primary intracerebral haemorrhage, separately for lobar and non-lobar intracerebral haemorrhage. Patients and methods Incidence of intracerebral haemorrhage was studied among 28,416 individuals from the population-based Malmö Diet and Cancer cohort. Intracerebral haemorrhage cases were ascertained using the Swedish Hospital Discharge Register and the Stroke Register of Malmö, validated by review of hospital records and images, and classified by location by a neuroradiologist. Multivariable Cox regression was used. Results Three hundred and thirty-three intracerebral haemorrhages occurred, mean follow-up time was 18.4 years. Systolic blood pressure (hazard ratio per 10 mmHg 1.19 [95% confidence interval 1.13–1.26], diastolic blood pressure (hazard ratio 1.42 [1.27–1.59]), oral anticoagulants (hazard ratio 4.26 [2.17–8.38]), smoking (hazard ratio 1.45 [1.14–1.87]), living alone (hazard ratio 1.32 [1.04–1.69]) and low apolipoprotein B (hazard ratio per 10 mg/dL: 0.94 [0.90–0.99]) were significantly associated with incident intracerebral haemorrhage after multivariable adjustment. Systolic blood pressure, smoking and oral anticoagulants were associated with lobar intracerebral haemorrhage. Systolic blood pressure, diastolic blood pressure, living alone and diabetes were associated with non-lobar intracerebral haemorrhage. Diabetes and diastolic blood pressure showed significantly different relationships with lobar and non-lobar intracerebral haemorrhage. Alcohol, apolipoprotein A1, body mass index, waist circumference, physical activity and education were not independently associated with intracerebral haemorrhage. Discussion and conclusions: Blood pressure, smoking, low apolipoprotein B, oral anticoagulants and living alone were associated with intracerebral haemorrhage. Diabetes was associated with non-lobar intracerebral haemorrhage only. Further research is required on differences between lobar and non-lobar intracerebral haemorrhage.
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Üstün Özek, Sibel, and Canan Emir. "The clinical, laboratory and prognostic characteristics of haemorrhagic stroke cases related to COVID-19 infection." Medical Science and Discovery 8, no. 11 (November 23, 2021): 636–41. http://dx.doi.org/10.36472/msd.v8i11.622.
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Objective: Although ischemic and thrombotic vascular processes are more widely reported in COVID-19, the ratio of haemorrhagic cerebrovascular disease is lower. However, it needs to be evaluated because the mortality rate is higher in haemorrhages, and they may appear iatrogenically.
Material and Methods: Patients observed at the Prof. Dr. Cemil Taşçıoğlu City Hospital between March 11th, 2020, and March 11th, 2021, were included in the study. Cases diagnosed as consecutive full intracerebral haemorrhage and concomitant with COVID-19 were observed during the study period. This study is a cross-sectional, retrospective, and observational study.
Results: Within the 1-year period, 11 patients (7 men and 4 women) with a mean age of 64.45±18.68 years related to COVID-19 were recorded. Risk factors were high blood pressure at a frequency of 64%, diabetes mellitus at 45%, and the use of antiaggregants/anticoagulants at 36%. The ratio of male patients was 64% (n=7). The location of haemorrhage was intraparenchymal in 91% (n=10), and subdural in 9% (n=1). The mortality rate was 64%.
Conclusion: Neurologic findings that develop, especially in noncooperating and prone patients in wards and intensive care units, must be observed carefully. Caution must be exercised in prophylactic antiaggregant and anticoagulant treatment, especially in high-risk patients. Intracranial haemorrhages are important due to high mortality.
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Joy, AK, Annada Sankar Mohes, Th Bidyarani, L. Dorendrojit Singh, and Aten Jongky. "A Rare Case of Bilateral Spontaneous Intracerebral Haemorrhage Presenting With Left Hemiplegia: A Case Report." Indian Journal of Physical Medicine and Rehabilitation 26, no. 4 (2015): 109–10. http://dx.doi.org/10.5005/ijopmr-26-4-109.
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Abstract Haemorrhage is responsible for around 11% of stroke syndrome. Haemorrhage usually occurs at a single site. However, it can be at multiple sites in some specific conditions i.e. coagulopathy, vascular malformation, malignancy etc. A 56-year-old male with left sided hemiplegia was admitted in the rehabilitation ward of RIMS, Imphal. He was hypertensive and was on irregular medication for that. He was also an alcoholic and chronic smoker for last 20 years. Patient was conscious and clinical examination revealed left 7th and 12th cranial nerve involvement with left hemiplegia. Non-contrast CT scan of brain revealed right thalamus and left basal ganglia haemorrhages. Thorough history and investigations did not reveal any aetiology for bilateral haemorrhage. Patient was treated with conservative management and improvement was noticed in serial follow-ups. There are very few case reports about bilateral spontaneous intracerebral haemorrhage associated with other diseases like migraine, Japanese encephalitis etc. Cause of bilateral haemorrhage in our case is doubtful.
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Noorlaila, Baharuddin, Embong Zunaina, and Mohd-Noor Raja-Azmi. "Successful Resolution of Preretinal Haemorrhage with Intravitreal Ranibizumab." Case Reports in Ophthalmological Medicine 2016 (2016): 1–7. http://dx.doi.org/10.1155/2016/4164198.
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We would like to report two cases of preretinal haemorrhage from two different aetiology courses of bleeding being treated with intravitreal ranibizumab and its outcome. Our first case was a 39-year-old man with a diagnosis of severe aplastic anaemia that presented with bilateral premacular haemorrhages in both eyes. His right eye vision was 6/45 and it was counting finger in the left eye. He was treated with intravitreal ranibizumab once to the right eye and twice to the left eye. Right eye showed complete resolution of premacular haemorrhage and minimal residual premacular haemorrhage in the left eye at 3 months after initial presentation. Our second case was a 32-year-old healthy teacher that presented with preretinal haemorrhage at superotemporal region extending to macular area in left eye secondary to valsalva retinopathy. Her left vision was counting finger. She was treated with single intravitreal ranibizumab to the left eye. There was significant reduction of premacular haemorrhage and her left eye vision improved to 6/6 at 10 weeks after injection. Both cases had favourable outcome with intravitreal ranibizumab and can be considered as nonsurgical treatment option in treating premacular haemorrhage.
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Blackney, Dean. "Prehospital administration of calcium in trauma." Journal of Paramedic Practice 14, no. 7 (July 2, 2022): 279–86. http://dx.doi.org/10.12968/jpar.2022.14.7.279.
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Background Calcium depletion in haemorrhagic shock is associated with pathophysiology detrimental to survival. Aim The purpose of this systematic literature review was to determine whether paramedic administration of calcium for haemorrhagic shock could reduce trauma morbidity and mortality. Method The MEDLINE and CINAHL databases were searched for publications relevant to hypocalcaemia management in traumatic haemorrhage. Findings Fourteen peer-reviewed articles met the inclusion criteria. These examined incidence, morbidity, mortality and treatment options for hypocalcaemia associated with traumatic haemorrhage. Paramedicine can play a key role in managing hypocalcaemia early and determining the effect this has on improving patient outcomes from severe trauma. Conclusion The findings in this review link hypocalcaemia to poor yet potentially modifiable outcomes in trauma. Ambulance services should consider empiric treatment with calcium when shocked patients are expected to receive blood transfusion for traumatic haemorrhage.
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Zhang, W., X.-X. Ma, Y.-M. Ji, X.-S. Kang, and C.-F. Li. "Haemorrhage Detection in Brain Metastases of Lung Cancer Patients using Magnetic Resonance Imaging." Journal of International Medical Research 37, no. 4 (August 2009): 1139–44. http://dx.doi.org/10.1177/147323000903700418.
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Magnetic resonance susceptibility-weighted imaging (SWI) is a new, highly-sensitive technique used to detect haemorrhage. This study evaluated the ability of magnetic resonance imaging (MRI) to detect haemorrhage in 45 lung cancer patients with brain metastases and compared the results with T2*-weighted imaging (T2*WI) and contrast-enhanced T1-weighted imaging (CE-T1WI). Eighty-nine haemorrhagic brain metastases were identified in 31 patients using SWI, 68 were identified in 23 patients using T2*WI and 46 were identified in 14 patients using CE-T1WI. Most micro-bleeds could only be identified by SWI. It was concluded that haemorrhage is a frequent occurrence in brain metastases originating from lung cancer and that haemorrhage can be detected using SWI in a majority of brain metastases patients.
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Mahendran, Suresh, Manoj Kumar, and Mark Preece. "Post-tonsillectomy bleed: a delayed diagnosis of duodenal ulceration." Journal of Laryngology & Otology 115, no. 2 (February 2001): 143–44. http://dx.doi.org/10.1258/0022215011907550.
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Post-operative haemorrhage is one of the commonest complications of tonsillectomy. We report a case of a 36-year-old lady who presented with three haemorrhagic episodes following tonsillectomy. Although initially treated as secondary tonsillar haemorrhage, the actual cause of the bleeding was later identified to be a duodenal ulcer. The case is presented with a review of the literature.
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Szeto, L. D., and C. T. Hung. "Haemorrhage of a Thyroid Cyst as an Unusual Complication of Intubation." Anaesthesia and Intensive Care 30, no. 2 (April 2002): 230–33. http://dx.doi.org/10.1177/0310057x0203000220.
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A case is presented of haemorrhage into a thyroid cyst after endotracheal intubation for an elective nasal operation in a healthy young man. The haemorrhagic cyst compressed the trachea and the patient was taken to the intensive care unit with the endotracheal tube left in situ. Hemithyroidectomy was performed uneventfully two days later. Causes of haemorrhage into thyroid cysts are reviewed.
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Leen, Edward J., T. Martin Feeley, Mary Paula Colgan, M. Kevin O'Malley, Dermot J. Moore, Dermot O'Brien Hourihane, and Gregor D. Shanik. "“Haemorrhagic” carotid plaque does not contain haemorrhage." European Journal of Vascular Surgery 4, no. 2 (April 1990): 123–28. http://dx.doi.org/10.1016/s0950-821x(05)80425-6.
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Ramsay, D. A., J. L. Penswick, and D. M. Robertson. "Fatal Streptokinase-Induced Intracerebral Haemorrhage in Cerebral Amyloid Angiopathy." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 17, no. 3 (August 1990): 336–41. http://dx.doi.org/10.1017/s0317167100030705.
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ABSTRACT:A fatal intracerebral haemorrhage (ICH) associated with streptokinase (SK) treatment of an acute myocardial infarction is described. Autopsy examination showed a lobar ICH and severe cerebral amyloid angiopathy (CAA). The close temporal relationship between SK administration and intracranial haemorrhage, the absence of pretreatment risk factors for ICH, and the presence of CAA suggests that these are related phenomena. Accordingly: 1. There may be a synergistic relationship between CAA and intracranial haemorrhage induced by fibrinolytic agents; 2. Thrombolytic agents may induce more frequent than expected intracranial haemorrhage in conditions associated with a high incidence of CAA, notably old age and Alzheimer's disease; 3. A regional defect in haemostasis other than vessel fragility may contribute to the intracranial haemorrhagic predisposition of CAA; 4. Autopsy examination of cases of ICH is an essential part of the audit of clinical trials of fibrinolytic agents.
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Cuevas, Pedro, Luis Antonio Outeiriño, Carlos Azanza, Javier Angulo, and Guillermo Giménez-Gallego. "Case Report: Resolution of submacular haemorrhage secondary to exudative age-related macular degeneration after a single intravitreal dobesilate injection." F1000Research 2 (December 9, 2013): 271. http://dx.doi.org/10.12688/f1000research.2-271.v1.
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Introduction: Submacular haemorrhage is not an unusual cause of acute central vision loss, particularly in older people. It may be caused by a number of conditions, most common of which is exudative age-related madular degeneration. In patients affected by this type of macular degeneration, choroidal neovascularization extends into the subretinal space, producing substantial bleeding in approximately 17% of cases, resulting in large haemorrhages in the subretinal space that detach the neurosensory retina from the supporting retinal pigment epithelial (RPE) layer. This leads to substantial vision loss because of a relatively fast process of extensive photoreceptor atrophy in the overlying neuroretina and formation of macular scarsCase presentation: We describe a patient with submacular haemorrhage secondary to exudative age-related macular degeneration, treated with intravitreal injection of dobesilate. Two months later, visual acuity in the treated eye reached 0.50 with a significant improvement of the distortion and an anatomical resolution of the haemorrhage, as confirmed by optical coherence tomography.Conclusions: Submacular haemorrhage secondary to exudative age-related macular degeneration can be successfully treated with intravitreal dobesilate. To our knowledge, this is the first case reporting a resolution of submacular haemorrhage after a single dobesilate injection.
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FAHMY, J. A., V. KNUDSEN, and S. RY ANDERSEN. "INTRAOCULAR HAEMORRHAGE FOLLOWING SUBARACHNOID HAEMORRHAGE." Acta Ophthalmologica 47, no. 3 (May 27, 2009): 550–59. http://dx.doi.org/10.1111/j.1755-3768.1969.tb08140.x.
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Thomas, Raji, and Swapna Patil. "Brainstem Haemorrhage due to Autonomic Dysreflexia in a Person with C6 Tetraplegia." Indian Journal of Physical Medicine and Rehabilitation 26, no. 4 (2015): 114–16. http://dx.doi.org/10.5005/ijopmr-26-4-114.
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Abstract Autonomic dysreflexia is an important clinical complication occurring in patients with high levels of spinal cord injury. If untreated, the acute rise in blood pressure can cause end organ damage, including intracerebral haemorrhage. Though unusual, it can be fatal with large haemorrhages causing brain herniation syndromes. Here we report the case of a patient with C6 complete tetraplegia patient who developed brainstem haemorrhage during an episode of autonomic dysreflexia. The pathophysiology and treatment methods of this condition are discussed, highlighting the importance of preventive measures to avoid the same.
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Kilgert, K., and G. Pfanner. "Obstetric bleeding complications." Hämostaseologie 26, S 02 (2006): S56—S63. http://dx.doi.org/10.1055/s-0037-1617083.
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SummaryThe instability of the gestational and puerperal equilibrium of haemostasis is affected by a shift of primary and plasmatic haemostasis in a procoagulatory direction, whereas the regulation mechanism of the fibrinolytic system can easily cause disproportional peri- and postpartal reaction leading to massive haemorrhage. Peripartal injuries or an atonic uterus can lead to massive haemorrhage and cause a classic haemorrhagic coagulopathy. Complications like amniotic fluid embolism, puerperal sepsis, eclampsia or HELLP syndrom can lead through DIC to rapidly developing and possibly fulminant hyperfibrinolysis.This article depicts different forms of haemorrhage in the peripartal situation, their particular pathologies and specific possibilities for management. A case study demonstrates the diagnostic and therapeutic options in the case of eclampsia with early abruption of placenta.
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Krishnan, Kailash, Siti F. Mukhtar, James Lingard, Aimee Houlton, Elizabeth Walker, Tanya Jones, Nikola Sprigg, et al. "Performance characteristics of methods for quantifying spontaneous intracerebral haemorrhage: data from the Efficacy of Nitric Oxide in Stroke (ENOS) trial." Journal of Neurology, Neurosurgery & Psychiatry 86, no. 11 (January 9, 2015): 1258–66. http://dx.doi.org/10.1136/jnnp-2014-309845.
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BackgroundPoor prognosis after intracerebral haemorrhage (ICH) is related to haemorrhage characteristics. Along with developing therapeutic interventions, we sought to understand the performance of haemorrhage descriptors in large clinical trials.MethodsClinical and neuroimaging data were obtained for 548 participants with ICH from the Efficacy of Nitric Oxide in Stroke (ENOS) trial. Independent observers performed visual categorisation of the largest diameter, measured volume using ABC/2, modified ABC/2, semiautomated segmentation (SAS), fully automatic measurement methods; shape, density and intraventricular haemorrhage were also assessed. Intraobserver and interobserver reliability were determined for these measures.ResultsICH volume was significantly different among standard ABC/2, modified ABC/2 and SAS: (mean) 12.8 (SD 16.3), 8.9 (9.2), 12.8 (13.1) cm3, respectively (p<0.0001). There was excellent agreement for haemorrhage volume (n=193): ABC/2 intraobserver intraclass correlation coefficient (ICC) 0.96–0.97, interobserver ICC 0.88; modified ABC/2 intraobserver ICC 0.95–0.97, interobserver ICC 0.91; SAS intraobserver ICC 0.95–0.99, interobserver ICC 0.93; largest diameter: (visual) interadjudicator ICC 0.82, (visual vs measured) adjudicator vs observer ICC 0.71; shape intraobserver ICC 0.88 interobserver ICC 0.75; density intraobserver ICC 0.86, interobserver ICC 0.73. Graeb score (mean 3.53) and modified Graeb (5.22) scores were highly correlated. Using modified ABC/2, ICH volume was underestimated in regular (by 2.2-2.5 cm3, p<0.0001) and irregular-shaped haemorrhages (by 4.8-4.9 cm3, p<0.0001). Fully automated measurement of haemorrhage volume was possible in only 5% of cases.ConclusionsFormal measurement of haemorrhage characteristics and visual estimates are reproducible. The standard ABC/2 method is superior to the modified ABC/2 method for quantifying ICH volume.Clinical trial registrationISRCTN9941422.
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Kamiguti, A. S., F. P. Rugman, R. D. G. Theakston, F. O. S. Franca, H. Ishii, and C. R. M. Hay. "The Role of Venom Haemorrhagin in Spontaneous Bleeding in Bothrops jararaca Envenoming." Thrombosis and Haemostasis 67, no. 04 (1992): 484–88. http://dx.doi.org/10.1055/s-0038-1648475.
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SummaryThirty-eight patients bitten by Bothrops jararaca were investigated. Twenty-six had signs of local or systemic haemorrhage. Twenty-two of these had incoagulable blood, and these patients were found to have low fibrinogen levels (mean 0.17 ± 0.03 g/1), thrombocytopenia, very high thrombin-antithrombin III complex (850 ± 184 pg/1) and D-dimer (170 ± 44 μg/ml) antigen levels. Serum venom haemorrhagin levels were significantly higher in patients with clinical signs of haemorrhage (36.4 ± 6.4 ng/ml) than those without (11.7 ± 3.7 ng/ml; p <0.002). Twelve out of 13 patients with thrombocytopenia were bleeding. High levels of thrombomodulin (22.3 ± 1.5 ng/ml) and haemorrhagin (35.7 ± 7.7 ng/ml) were detected in these 12 patients, suggesting vascular endothelial damage. Haemorrhagin levels also correlated inversely with platelet count in these patients. It was concluded that thrombocytopenia is one of the main causes of bleeding inB. jararaca victims, possibly as a result of venom haemorrhagin activity.
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Sancho Saldaña, A., Á. Lambea Gil, B. Sánchez Marín, and J. Gazulla. "Convexity subarachnoid haemorrhage secondary to hereditary haemorrhagic telangiectasia." Neurología (English Edition) 35, no. 6 (July 2020): 432–33. http://dx.doi.org/10.1016/j.nrleng.2018.04.003.
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Cripps, N. P. J., and A. S. Ward. "Distant haemorrhagic effects in intra-arterial Tissue Plasminogen Activator — The effect of a bolus dose." Journal of The Royal Naval Medical Service 80, no. 2 (1994): 66–70. http://dx.doi.org/10.1136/jrnms-80-66.
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AbstractDetails are reported of four patients who developed serious distant haemorrhagic complications while undergoing peripheral arterial thrombolysis with intra-arterial tissue plasminogen activator (t-PA). The thrombolytic regime comprised a 20 mg bolus of t-PA followed by a continuous infusion of 1 mg/hr.Four additional cases of haemorrhage at the catheter entry site were also encountered in a group of 23 patients exposed to the bolus-infusion t-PA regimen. The high haemorrhage rate (31%) is a significant disadvantage of this thrombolytic protocol.
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Wijemanne, A., I. Watt-Coote, and S. Austin. "Glanzmann thrombasthenia in pregnancy: Optimising maternal and fetal outcomes." Obstetric Medicine 9, no. 4 (August 19, 2016): 169–70. http://dx.doi.org/10.1177/1753495x16655021.
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Glanzmann thrombasthenia is a rare autosomal recessive haemorrhagic disorder. The risks of miscarriage, antepartum and postpartum haemorrhage, and neonatal complications are all increased in individuals presenting with the disease in pregnancy. Some individuals may develop antibodies to platelet glycoproteins; the presence of these antibodies is a rare cause of neonatal alloimmune thrombocytopenia and potential intracranial haemorrhage. Multidisciplinary care is paramount for ensuring optimal fetal and maternal outcomes in such cases. We report a case of neonatal alloimmune thrombocytopenia secondary to maternal Glanzmann thrombasthenia in pregnancy.
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Tsui, Kl, Hh Yau, and Cw Kam. "Case Report: Life Threatening Bleeding following Maxillofacial Injury." Hong Kong Journal of Emergency Medicine 9, no. 1 (January 2002): 42–45. http://dx.doi.org/10.1177/102490790200900107.
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Maxillofacial injury is commonly seen in the practice of emergency medicine. Major maxillofacial injury itself can be life threatening. Apart from the danger of potential airway compromise, severe haemorrhage from branches of carotid artery causing haemorrhagic shock can occur. Blind techniques, such as packing or ligation of external carotid artery are the usual methods employed to stop the bleeding. However blind techniques carry a significant failure rate. A patient with severe maxillofacial injury and torrential haemorrhage is reported. The bleeding could not be controlled by oral and nasal packing. Emergency selective carotid angiography was performed to identify the source of bleeding and embolization of the bleeding branches successfully arrested the haemorrhage. Interventional radiology could be as effective, if not superior, as an operation in controlling bleeding in selective cases.
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Shrestha, Dinuj, Upama Sharma, Janam Shrestha, Gopi Nepal, Bishal Shrestha, Pranaya Shrestha, Samir Acharya, et al. "Surgical Management among Patients with Spontaneous Supratentorial Intracerebral Haemorrhage Admitted in a Tertiary Care Centre: A Descriptive Cross-sectional Study." Journal of Nepal Medical Association 60, no. 252 (August 1, 2022): 697–701. http://dx.doi.org/10.31729/jnma.7178.
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Introduction: Spontaneous intracerebral haemorrhage is the second most common form of stroke and the most deadly one. An understanding of changing trends in the epidemiology of intracerebral haemorrhage prevalence, its risk factors, current practice in management, case fatality, and long-term outcome is essential to measure the effectiveness of stroke prevention and various treatment efforts. The objective of this study was to find out the prevalence of surgical management among patients with spontaneous supratentorial intracerebral haemorrhage in a tertiary centre. Methods: A descriptive cross-sectional study was conducted in the Department of Neurosurgery from January 2017 to December 2019. Ethical approval was obtained from the Institutional Review Committee (Reference number: 06/2020/IRC-ANIAS). A convenience sampling method was used. Data of the patients were retrieved from online medical records. Point estimate and 95% Confidence Interval were calculated. Results: Among 221 patients with spontaneous supratentorial intracerebral haemorrhage, 115 (52.04%) (45.45-58.63, 95% Confidence Interval) underwent surgical management. In-hospital mortality was seen in 23 (20%) and survivors at 3 months were 78 (67.82%) patients. Conclusions: The prevalence of surgical management among spontaneous supratentorial intracerebral haemorrhages was higher than in other studies done in a similar setting.
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Karagül, Duygu. "Additive effect of dabigatran and high-dose aspirin in the development of haemorrhagic pleural effusion in a patient with tuberculous pleuritis." Malawi Medical Journal 32, no. 3 (October 30, 2020): 176–79. http://dx.doi.org/10.4314/mmj.v32i3.11.
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Tuberculous pleuritis can rarely cause haemorrhagic pleural effusion. Dabigatran etexilate can have an additive effect on increasing the risk of haemorrhage. Aspirin cannot cause major haemorrhage, but in the elderly it can cause gastrointestinal bleeding via ulceration of the gastrointestinal mucosa. We report here the case of a 77-year-old male who presented to the hospital with a 2-month history of progressive dyspnoea. He had been taking dabigatran etexilate (220 mg) and high-dose acetylsalicylic acid (aspirin; 300 mg) daily for chronic atrial fibrillation. A chest X-ray revealed a moderately sized right pleural effusion confirmed by a computed tomography scan, which also showed bronchiectasis of both lungs. Dabigatran was discontinued and aspirin was decreased to the minimal therapeutic dose of 100 mg before thoracentesis was performed. Lymphocyte-predominant (50%) haemorrhagic fluid of 500 ml was drained, positive for acid-fast bacilli smear and polymerase chain reaction of Mycobacterium tuberculosis. A chest tube was placed and an additional 1250 ml of haemorrhagic exudate drained out. We treated the patient with a routine regimen of antituberculous medication and the infection resolved without complications other than the bronchiectasis present before treatment. We think that the combination of dabigatran etexilate and high doses of aspirin increased the risk of pleural haemorrhage in this patient with tuberculous pleuritis
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You, Yijie, Yunlian Niu, Fengbing Sun, Jian Zhang, Sheng Huang, Peiyuan Ding, and Xuhui Wang. "Impact of COVID-19 pandemic on haemorrhagic stroke admissions: a systematic review and meta-analysis." BMJ Open 11, no. 12 (December 2021): e050559. http://dx.doi.org/10.1136/bmjopen-2021-050559.
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Background and purposeCOVID-19 pandemic, a global health crisis, is disrupting the present medical environment. This systematic review and meta-analysis aimed to evaluate the impact of the COVID-19 pandemic on stroke hospitalisations, especially haemorrhagic stroke.MethodsThe EMBASE, PubMed, Web of Science, Elsevier, Medline, Cochrane Library and Google Scholar electronic databases were searched for all relevant studies. Two researchers independently screened the studies, extracted data and assessed the quality of the included studies. Odds ratio (OR), total events, OR and 95% CI were considered as the effect size. A fixed-effects model was used to pool the study-specific estimate. The present study was performed by using Review Manager (V.5.3.0) software. We assessed the risk of bias using the Newcastle–Ottawa Scale.ResultsA total of 17 studies with 14 445 cases were included. Overall, the number of stroke admissions is lower in the pandemic period versus the control period (6252 vs 8193). The difference of haemorrhagic stroke is significant, with 1233 of 6252 cases in the pandemic group and 1621 of 8193 cases in the control group. Intracerebral haemorrhage is present in 461 of 1948 cases in the pandemic group and 618 of 2734 cases in the control group. As for subarachnoid haemorrhage, the difference between the two groups is significant, with 70 of 985 cases in the pandemic group and 202 of 1493 cases in the control group.ConclusionsThe number of stroke admissions is lower in the pandemic period compared with the control period. There is a higher rate of haemorrhagic stroke in the pandemic period. Subgroup analysis identifies a significant increase in the occurrence of intracerebral haemorrhage in the pandemic period. Due to limited data and the impact of a single article, the impact of COVID-19 pandemic on subarachnoid haemorrhage is unclear.
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Ploen, Robert, Markus Zorn, Li Sun, Wei Zhou, and Roland Veltkamp. "Anticoagulation with dabigatran does not increase secondary intracerebral haemorrhage after thrombolysis in experimental cerebral ischaemia." Thrombosis and Haemostasis 110, no. 07 (2013): 153–61. http://dx.doi.org/10.1160/th12-12-0942.
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SummaryDabigatran etexilate (DE) has recently been introduced for stroke prevention in atrial fibrillation, but management of acute ischaemic stroke during therapy with DE is a challenge. Thrombolysis is contrain-dicated because of a presumed increased risk of intracerebral haemorrhagic complications. We studied in different ischaemia models whether DE increases secondary haemorrhage after thrombolysis. C57BL/6 mice were anticoagulated with high-dose DE or warfarin. After 2 hour (h) or 3 h transient filament MCAO, rt-PA was injected. At 24 h after MCAO, secondary haemorrhage was quantified using a macroscopic haemorrhage score and haemoglobin spectrophotometry. Post-ischaemic blood-brain-barrier (BBB) damage was assessed using Evans blue. To increase the validity of findings, the duration of anticoagulation was prolonged in mice (5 x DE over 2 days), and the effect of DE after thrombolysis was also examined in thromboembolic MCAO in rats. Pretreatment with warfarin resulted in significantly more secondary haemorrhage (mean haemorrhage score 2.6 ± 0.2) compared to non-anticoagulated animals (1.7 ± 0.3) and DE (9 mg/kg, 1.6 ± 0.3) in 2 h ischaemia. Also after a 3 h period of ischaemia, haemorrhage was more severe in animals anticoagulated with warfarin compared to 9 mg/kg DE and non-anticoagulated control. Prolonged or enteral dabigatran pretreatment led to identical results. Also, thrombolysis after thromboembolic MCAO in rats did not induce more severe bleeding in DE-treated animals. Mice pretreated with warfarin had higher BBB permeability and increased activation of matrix-metalloproteinase 9. In conclusion, DE does not increase the risk of secondary haemorrhage after thrombolysis in various rodent models of ischaemia and reperfusion. The implications of this finding for stroke patients have to be determined in the clinical setting.
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Giragani, Suresh, Santhosh Kumar Pavunesan, and Anandh Balasubramaniam. "Targeted endovascular treatment of haemorrhagic posterior fossa proliferative angiopathy." Interventional Neuroradiology 24, no. 4 (March 19, 2018): 440–43. http://dx.doi.org/10.1177/1591019918761640.
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Cerebral proliferative angiopathy (CPA) is a rare vascular abnormality and separate from “classical” brain arteriovenous malformations. Haemorrhage due to proliferative angiopathy is rarely reported. We describe the clinical features, imaging findings and targeted endovascular management for a 12-year-old boy having proliferative angiopathy of the posterior fossa presenting with haemorrhage. Targeted endovascular embolisation in CPA is not previously described in the literature. The optimal treatment options for haemorrhagic CPA are debatable, and we wish to highlight the role of targeted treatment for culprit focal lesion demonstrable on imaging.
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Sue-Ling, H. M., M. E. Foster, M. H. Wheeler, and M. J. McMahon. "Spontaneous Rupture of Phaeochromocytoma Mimicking Leaking Aortic Aneurysm." Journal of the Royal Society of Medicine 82, no. 1 (January 1989): 53–54. http://dx.doi.org/10.1177/014107688908200125.
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Phaeochromocytomas are vascular tumours, and small areas of haemorrhage are commonly found in tumours which have been removed electively1. We report two cases of spontaneous haemorrhagic rupture of phaeochromocytoma presenting as abdominal emergencies.
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Patel, A., N. Foden, and A. Rachmanidou. "Is weekend surgery a risk factor for post-tonsillectomy haemorrhage?" Journal of Laryngology & Otology 130, no. 8 (June 13, 2016): 763–67. http://dx.doi.org/10.1017/s0022215116008161.
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AbstractBackground:Tonsillectomy is a common, low-risk procedure. Post-tonsillectomy haemorrhage remains the most serious complication. Recent nationwide studies in the UK have identified an increased morbidity and mortality for both high-risk and low-risk elective general surgery performed at the weekend.Methods:Data for tonsillectomies performed at a district general hospital over a three-year period were retrospectively reviewed. The same group of surgeons performed elective tonsillectomies on both weekends and weekdays. All patients who developed a post-tonsillectomy haemorrhage were identified and the day of original operation was noted.Results:Between 2010 and 2013, 2208 (94.00 per cent) elective tonsillectomies were performed on a weekday and 141 (6.00 per cent) were performed on the weekend. Post-tonsillectomy haemorrhages occurred in 104 patients (4.71 per cent) who underwent their procedure on a weekday and in 10 patients (7.09 per cent) who had their surgery at the weekend (p = 0.20).Conclusion:There is no difference in the rate of post-tonsillectomy haemorrhage for procedures performed on a weekday or weekend.
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Ahmad, M. U., A. N. Wardak, T. Hampton, M. R. S. Siddiqui, and I. Street. "Coblation versus cold dissection in paediatric tonsillectomy: a systematic review and meta-analysis." Journal of Laryngology & Otology 134, no. 3 (March 2020): 197–204. http://dx.doi.org/10.1017/s0022215120000377.
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AbstractBackgroundCold dissection is the most commonly used tonsillectomy technique, with low post-operative haemorrhage rates. Coblation is an alternative technique that may cause less pain, but could have higher post-operative haemorrhage rates.ObjectiveThis study evaluated the peri-operative outcomes in paediatric tonsillectomy patients by comparing coblation and cold dissection techniques.MethodsA systematic review was conducted of all comparative studies of paediatric coblation and cold dissection tonsillectomy, up to December 2018. Any studies with adults were excluded. Outcomes such as pain, operative time, and intra-operative, primary and secondary haemorrhages were recorded.ResultsSeven studies contributed to the summative outcome. Coblation tonsillectomy appeared to result in less pain, less intra-operative blood loss (p < 0.01) and a shorter operative time (p < 0.01). There was no significant difference between the two groups for post-operative haemorrhage (p > 0.05).ConclusionThe coblation tonsillectomy technique may offer better peri-operative outcomes when compared to cold dissection, and should therefore be offered in paediatric cases, before cold dissection tonsillectomy.
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Souter, Michael. "Critical care of subarachnoid haemorrhage." Journal of Neuroanaesthesiology and Critical Care 04, no. 04 (February 2017): S49—S55. http://dx.doi.org/10.4103/jnacc-jnacc-75.16.
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AbstractSubarachnoid haemorrhage (SAH) is a consistent presentation of haemorrhagic stroke of significance to clinicians in neurocritical care, inducing consequent effects on non-neurological systems, while at the same time, rendering the brain vulnerable to secondary physiological insult modifying neurological outcome, despite control of the original point of haemorrhage. Coordinated treatment depends on comprehensive evaluation of both cerebral and systemic physiology, identifying and treating impaired function. The presence of a dedicated neurocritical care team can benefit outcome. Protocols of care have evolved to meet evidence-based challenges, discarding potentially deleterious components of hypervolaemia and haemodilution, while maintaining pressure-guided perfusion. Treatment targets have also evolved with a shift in focus away from SAH-associated vasospasm, towards actual ischaemic outcome – illustrated by lack of effectiveness of pharmaceutical treatments of vasospasm. Clinicians must consequently review pathophysiological mechanisms of injury and devise new treatment opportunities.
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Downs, M. O., D. N. Aron, E. A. Mahaffey, and C. W. Dewey. "Acute Traumatic Intracranial Haemorrhage in Dogs and Cats." Veterinary and Comparative Orthopaedics and Traumatology 06, no. 03 (1993): 153–59. http://dx.doi.org/10.1055/s-0038-1633114.
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SummaryTwenty-three records of dogs and cats having experienced severe craniocerebral trauma were reviewed. Case selection was restricted to those patients whose brains were examined at necropsy and/or surgery. Records of 14 dogs and nine cats were evaluated for the presence or absence of intracranial haemorrhage. The majority of patients were victims of automobile trauma (n = 16), the remainder being victims of household accidents (n = 4), malicious human behavior (n = 2), and injury inflicted by another animal (n = 1). Six of the 23 (27%) were conscious upon admission. One patient was unconscious upon admission, but regained consciousness following medical therapy. Evidence of intracranial haemorrhage was found in 100% (14/14) of the canine and 89% (8/9) of the feline cases. Four dogs and four cats exhibited two forms of intracranial haemorrhage. One cat exhibited three forms of intracranial haemorrhage. The distribution of intracranial haemorrhage was as follows: two epidural, 10 subdural, 10 subarachnoid and 10 intraparenchymal. Histopathology was available for 10 of the 23 cases. Surgical confirmation of the subdural haematomas, as typical subdural haematomas (focal intradural mass lesions), was available for four cases. Gross pathology of one other of the 10 subdural hematomas described a focal, 2 × 3 cm mass lesion. The remaining five subdural haematomas were of a more diffuse nature (more typical of subarachnoid haemorrhage), but three of these five were described as massive accumulations of blood. Four patients underwent emergency craniotomy/craniectomy; two of these patients made rapid and full recoveries, one died on the operating table, and one was euthanatized at the operation because of uncontrollable brain swelling. Ninety-three percent of the canine and 75% of the feline cases had haemorrhagic lesions that would have been potentially accessible via a lateral craniotomy/craniectomy. The results of this investigation suggest that acute intracranial haemorrhage may be a relatively frequent occurrence, following severe brain injury in dogs and cats. Prospective studies are needed to better define the incidence, anatomical distribution, and potential clinical significance of acute traumatic intracranial haemorrhage in dogs and cats. Comparative aspects of acute traumatic intracranial haemorrhage in people and small animals (dogs and cats) are discussed.Twenty-three records of dogs (n = 14) and cats (n = 9) with severe craniocerebral trauma were evaluated for the presence or absence of intracranial haemorrhage. Evidence of intracranial haemorrhage was found in 96% (14 dogs, 8 cats) of the cases reviewed. Comparative aspects of acute traumatic intracranial haemorrhage in people and small animals (dogs and cats) are discussed.
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El Sayad, Mohamed, and Hussein Noureddine. "Recent Advances of Hemorrhage Management in Severe Trauma." Emergency Medicine International 2014 (2014): 1–5. http://dx.doi.org/10.1155/2014/638956.
Full textAbstract:
Trauma is one of the most common causes of mortality worldwide with a substantial percentage of deaths resulting secondary to haemorrhages, which are preventable and treatable when adequately managed. This paper offers a review of the current literature on how to successfully resuscitate patients with major haemorrhage.
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Kumar, Ranjan, Manish Kumar Choudhary, and Shorav Bhatnagar. "Adrenal Myelolipoma with Haemorrhage." Annals of Pathology and Laboratory Medicine 7, no. 5 (May 28, 2020): C59–61. http://dx.doi.org/10.21276/apalm.2669.
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