phenylephrine-hydrochloride and Cerebral-Hemorrhage

Topics: Birth Injuries; Brachial Plexus; Cerebral Hemorrhage; Eye Injuries; Female; Humans; Infant, Newborn; Nose; Prognosis; Respiratory Paralysis; Skull Fractures; Spinal Cord Injuries

During the period 1991-2007, autopsy was undertaken in 13 fetuses with warfarin embryopathy. Pregnancy data and radiographic babygrams were available in each instance. Gestational age ranged from 17 to 37 weeks. Eleven of the fetuses had the characteristic nasal hypoplasia, but only three had radiological epiphyseal stippling. Cerebral hemorrhage was a major feature of autopsy in 8 of the fetuses, and it is evident that bleeding is a significant factor in the pathogenesis of warfarin embryopathy. A wide variety of additional visceral manifestations which were observed at autopsy have been tabulated. There was no obvious correlation between maternal or gestational age and the presence and severity of any specific embryopathic feature. No information was available concerning the dose and timing of warfarin administration in this series.

Topics: Abnormalities, Drug-Induced; Adolescent; Adult; Anticoagulants; Autopsy; Cerebral Hemorrhage; Chondrodysplasia Punctata; Female; Fetal Development; Heart Valve Diseases; Humans; Hyperplasia; Nose; Pregnancy; Retrospective Studies; Warfarin; Young Adult

A case of septic cavernous sinus thrombosis in 41 year old men is described. One week prior to hospitalisation he had an influenza infection. During influenza nose furunculus, labial herpes and viral left otitis media with facial nerve paresis occurred. Patient manipulated furunculus nasi. On admission to hospital he complained of severe hedeache, left ear pain and left visual loss. He had left orbital cellulitis with immobile eyeball, the left part of the face, neck and throat were swollen. Lumbar puncture showed cerebrospinal fluid containing protein 156 mg/dl, glucose 94 mg/dl, and 5888 polymorphonuclear cells. Cranial CT scan showed left exophatlmos with periorbital swelling, left ethmoid sinusitis, and probable thrombosis of cerebral vessels. Involvement of the right eye appeared after two days. He was treated with high dose of antibiotics, steroids and anticoagulants. After four days in the control cranial CT scan two focus of intracerebral hemorrhage were found in the frontal lobe. We excluded anticoagulants from the therapy. The patients improved slowly and he was discharged after 22 days of hospitalisation with the left abducent and facial nerve paresis.

Topics: Adult; Cavernous Sinus Thrombosis; Cerebral Hemorrhage; Facial Paralysis; Female; Furunculosis; Herpes Simplex; Humans; Lip; Nose; Otitis Media; Tomography, X-Ray Computed

Intracranial bleeding damages the surrounding tissue in a complex fashion that involves contamination by blood-borne products and loss of ionic homeostasis. We used electrophysiological techniques to examine the functional changes in the developing intracerebral bleed and in surrounding regions using an in vivo swine model. Intracerebral hemorrhage (ICH) was induced by collagenase injection into the primary somatosensory cortex (SI). Somatic evoked potential (SEP) elicited by electrical stimulation of the contralateral snout as well as changes in DC-coupled potential were monitored in the SI from the time of collagenase injection in order to measure the effects of ICH. The SEP decreased in amplitude within minutes of the intracerebral injection. Its short-latency component was abolished within the first hour after collagenase injection without any sign of recovery for the duration of the experiment. As the SEP started decreasing in amplitude, we observed spontaneous, recurring episodes of cortical spreading depression (SD) as early as 20 min post-injection. The timing of SDs in SI is consistent with our interpretation that SDs were initially generated at multiple sites adjacent to the lesion core and propagated into the surrounding area. With time, SD became less frequent near the injection site, shifting to more distant electrodes in the surrounding area. Our results indicate that ICH leads to the reduction in SEP amplitude and induces spontaneous episodes of SD. Loss of ionic homeostasis is most likely the physiological basis for the SEP change and for the induction of SD. Recurring SD spontaneously generated in experimental ICH needs further study in humans with ICH.

Topics: Animals; Brain Mapping; Cerebral Hemorrhage; Collagenases; Cortical Spreading Depression; Disease Models, Animal; Electric Stimulation; Electrodes, Implanted; Evoked Potentials, Somatosensory; Microelectrodes; Nose; Recurrence

A 75-year-old woman with a previous repair of a cribiform plate fracture was nasotracheally intubated following a suicide attempt. Twenty-one days later she was readmitted to the hospital with a massive pneumocephalus, followed by a terminal intracranial hemorrhage. Nasotracheal intubation as a contributing factor in the development of pneumocephalus is previously unreported.

Topics: Aged; Cerebral Hemorrhage; Drug Overdose; Female; Humans; Intubation, Intratracheal; Nose; Pneumocephalus; Poisoning; Suicide, Attempted; Temazepam; Tomography, X-Ray Computed

Topics: Brain Injuries; Cerebral Hemorrhage; Craniocerebral Trauma; Fracture Fixation; Hearing Disorders; Humans; Intracranial Pressure; Nose; Skull Fractures