How often is haemosiderin not visible on routine MRI following traumatic intracerebral haemorrhage?

Intracerebral haemorrhage may be visible indefinitely on MRI, due to persistence of haemosiderin in macrophages around the lesion, but it is not clear whether all haemorrhages produce haemosiderin or, if not, what proportion cannot be identified as former haemorrhages on routine MRI. We performed routine MRI (spin-echo T2- and proton-density weighted images) in 116 survivors of moderate to severe head injury, 1–5 years after injury. We reviewed the images blindly and correlated them with CT in the acute stage, to determine how many haemorrhages from the acute stage were identifiable by virtue of haemosiderin deposition on late MRI. Of 106 haemorrhages in 78 patients on CT at the time of injury, 96 (90 %) were visible as haemosiderin on late MRI. Of the old haemorrhages without haemosiderin, seven of ten were in patients where another haemorrhage with haemosiderin was still visible elsewhere in the brain. No patient or haemorrhage features explained the formation or absence of haemosiderin. Thus about 10 % of definite haematomas show no trace of haemosiderin on routine spin-echo MRI. Radiologists should be alerted to supplement routine spin-echo with gradient-echo sequences if there is a reason to suspect, or specifically exclude, prior haemorrhage. Received: 20 April 1999/Accepted: 1 July 1999     

Haemorrhagic shock from solid tumours of the adrenal gland: a case of bleeding primary adrenal lymphoma

Suprarenal or adrenal gland haemorrhage is an uncommon but potentially lethal condition if unrecognised. Adrenal masses rarely present with haemorrhage, but they remain an important differential aetiology for adrenal bleeding. We present a novel case of primary adrenal lymphoma with adrenal haemorrhage in a middle-aged woman who presented with right-sided abdominal pain and class 1 haemorrhagic shock. She was found to have spontaneous unilateral adrenal gland haemorrhage in the absence of any underlying previous pathology. Presenting features, diagnosis and subsequent oncological management are reported.     

不同的生长抑素制剂与垂体后叶素治疗肝硬化性消化管静脉曲张破裂出血的疗效比较(附55例疗效分析)

目的 比较不同的生长抑素制剂(施他宁、善宁)与垂体后叶素治疗肝硬化食管、胃底静脉曲张破裂出血的疗效.方法 将55例出血患者随机分为3组,16例予施他宁治疗,剂量为首次250μg静注,再以6000μg/24h持续静滴;16例予善宁治疗,剂量为首次0.1mg静注,再以0.6mg/24h持续静滴;23例予垂体后叶素48U/8h持续静滴,3组均连用3天.结果 施他宁组、善宁组、垂体后叶素组平均止血时间分别为(15±10)、(21±6)、(38±28)小时,3组间比较均有显著性差异(P＜0.05).施他宁组与善宁组的疗效均优于垂体后叶素组.结论 施他宁、善宁治疗肝硬化食管、胃底静脉曲张破裂出血的疗效较垂体后叶素好.     

大块脑梗塞中出血性梗塞的病理特点

报告２４例大块脑梗塞的脑局解病例，对其中１６例ＨＩ的病理特点及发生机制进行探讨。结果证实：ＨＩ占本组大块脑梗塞的发生率为７１．４％，脑血栓ＨＩ的发生率为６０％。ＨＩ多发生在梗塞灶的边缘区及皮质区，以小静脉和毛细血管出血为主。ＨＩ的发生与梗塞的体积及动脉血压增高有关。其发生机制可能是周边区或皮质区侧枝循环建立和脑水肿导致静脉回流障碍，血液淤滞所致。本文还证实溶栓治疗与其它治疗比较并未见出血扩大。     

Retroperitoneal haemorrhage from the superior glutaeal artery: A late complication of total hip arthroplasty

Summary A patient with rheumatoid arthritis was admitted with a sudden onset of abdominal pain owing to a retroperitoneal haemorrhage from a false aneurysm of the superior gluteal artery. This aneurysm probably developed as a result of a migrating total hip prosthesis     

Ligation vs. bipolar diathermy for haemostasis in tonsillectomy—a comparative study

The use of diathermy for haemostasis in Tonsillectomy remains controversial. A thorough scan of English literature comparing the ligation with diathermy has been presented. The reasoning of using Bipolar instead of Unipolar is explained. A prospective randomized study of 376 tonsillectomy is being presented. This is the first study in India where Bipolar instead of Unipolar diathermy is being used. No significant difference was found in P.O. Hg. rates when either diathermy or ligatures were used. Diathermy is significantly faster method of securing haemostasis resulting in shorter operative a & anesthetic time, thus saving on cost. Long term follow-up has shown better results with diathermy & is associated with less pharyngitis, hyper-trophied nodes & resulis in more smooth tonsillar fossae.     

Blutungen in der Frühschwangerschaft: Ein Hinweis auf kindliche Mißbildungen?

Zusammenfassung Die Frage, ob es nach Blutungen in der Frühschwangerschaft gehäuft zu kindlichen Mißbildungen kommt, wird in der Literatur unterschiedlich beantwortet. In der vorliegenden Arbeit werden die vielfältigen methodischen Schwierigkeiten aufgezeigt, die zu einer falschen Beurteilung führen können. Diese Fehlermöglichkeiten können mit der Technik des Paarvergleichs weitgehend ausgeschaltet werden. An Hand eines prospektiv gesammelten Materials von insgesamt 5257 Fällen kann gezeigt werden, daß sich bei 68 schweren Mißbildungsfällen und 136 paarweise zugeordneten gesunden Kindern statistisch keine Unterschiede der Blutungshäufigkeit in der Frühschwangerschaft sichern ließen. Ein unterschiedliches zeitliches Blutungsmuster läßt sich gleichfalls nicht nachweisen.Arbeit im Rahmen des Schwerpunktprogramms Schwangerschaftsverlauf und Kindesentwicklung der Deutschen Forschungsgemeinschaft (auszugsweise als Vortrag gebracht auf 4th International Conference on Birth Defects, September 1973 in Wien).     

Utility of radiofrequency ablation for haemorrhagic lingual lymphangioma

Lymphangiomas of the mouth and tongue pose considerable therapeutic problems. Their complete exeresis is not feasible, and they can be a major functional impediment and cause face and jaw deformities. A risk of secondary growth is classically described after surgical reduction. Invasion of lingual mucosa, often papillomatous, results in accidental biting, recurrent bleeding and pain. Here, we report on 7 cases of children with haemorrhagic mucosal lingual lymphangiomas, one with noteworthy drop in the haemoglobin, treated by surface radiofrequency reduction. With a short follow-up (3-13 months), a functional improvement was observed in every case, as a complete disappearance of bleeding in 5/7 cases, and a moderate local relapse in 2/7 cases. This technique did not induce progressive regrowth. It provides a new therapeutic tool for the treatment of lingual microcystic lymphangioma.