Revascularization of an acutely ischemic limb may lead to the development of a reperfusion syndrome, characterized by acidosis, hyperkalemia, myoglobinuria, and disseminated intravascular coagulation. The authors evaluated the components of the femoral venous efflux after reperfusion of an acutely ischemic limb in both an experimental model and in a small ...

Purpura fulminans (PF) is a cutaneous manifestation of a dramatic and deadly syndrome of systemic disseminated intravascular coagulation (DIC). It is characterized by microvascular thrombosis in the dermis followed by perivascular haemorrhage. Since two other related syndromes involve the protein C (PC) system, we undertook a serial study to investigate ...

A native from Surinam (South America), known to have a chronic gonarthritis for 20 years, died from an acute disseminated histoplasmosis. His gonarthritis was retrospectively shown to have been due to histoplasmosis. Although histoplasmosis rarely presents as a monarthritis, unacquaintance with this entity may result in fatal acute dissemination of ...

We describe a case of severe septicaemia caused by Mycoplasma hominis in a 23 year old patient following childbirth. She developed disseminated intravascular coagulation and acute respiratory distress syndrome which have not hitherto been described in association with septicaemia due to this organism. Investigation and treatment leading to full recovery ...

In two cases of hemolytic uremic syndrome (HUS) the bacterial pathogenesis of the disease could be elucidated by lectin red cell agglutination tests. The possible role of anti-T and anti-Tk antibodies is discussed. Transfusions of fresh plasma had no adverse effects. The fatal outcome in one case was caused by ...

A previously healthy 19-year-old woman had a febrile illness with hypotension, progressive cyanosis, and an evolving petechial rash. Despite aggressive therapy in the face of shock and disseminated intravascular coagulation, the patient suffered a cardiac arrest and could not be resuscitated. Haemophilus influenzae type b was cultured from the blood ...

A previously fit 56 year old female presented with a rapidly progressive and fatal pneumococcal septicaemia with disseminated intravascular coagulation. Post-mortem studies confirmed a Waterhouse-Friderichsen syndrome and revealed an anatomically normal spleen; intracellular diplococci were seen within splenic macrophages providing evidence of normal splenic function. This appears to be only ...

Transient global amnesia has been associated with cerebral angiography performed with use of ionic agents. Nonionic contrast agents are associated with fewer complications, but complications do occur. The authors describe two patients who developed transient global amnesia after they underwent cerebral angiography with iopamidol. The precise pathophysiologic mechanism remains unclear, ...

The term lacuna or lacunar cavity defines the pathological lesion while the clinical pictures due to lacuna or lacunes are referred to as 'lacunar syndromes'. The lacunar syndromes include: (1) the typical lacunar syndromes or lacunar syndromes proper--pure motor hemiplegia, pure sensory stroke, ataxic hemiparesis including dysarthria and clumsy hand, ...

We evaluated 46 patients with right hemisphere strokes for unilateral spatial neglect (USN), anosognosia, hemiasomatognosia, extinction, constructional disturbance, motor impersistence and organic mental syndrome. High correlations were found among the incidences of USN, anosognosia, hemiasomatognosia, extinction, motor impersistence and constructional disturbance. USN, hemiasomatognosia, motor impersistence, constructional disturbance and anosognosia tended ...

Transient global amnesia has been reported to be precipitated by intense emotion in adult patients. Transient global amnesia is uncommon in the pediatric age group. We report the unusual occurrence of this syndrome, apparently precipitated on two occasions by emotion, in an adolescent who had earlier in life suffered a ...

The term "top of the basilar" has been used in reference to a group of signs and symptoms of midbrain, diencephalic, and posteroinferior hemispheric dysfunction. It has been attributed to ischemia in the territory of second- and third-order vessels that arise from the uppermost portion of the basilar artery. We ...

The risk of embolic stroke during sick sinus syndrome before cardiac pacemaker insertion is substantial, but stroke after pacemaker insertion has not been well studied. We observed 10 sick sinus syndrome patients who developed an ischemic stroke 4 days to 112 months after pacemaker insertion. Nine patients represented 6% of ...

Nine patients with brainstem infarct and two with brainstem haemorrhage presented with pure motor stroke, pure supranuclear facial palsy, sensorimotor stroke or ataxic hemiparesis. Despite the clinical similarity with hemispheric lacunes, brainstem infarcts causing lacunar syndromes probably have a greater tendency to progress. Small brainstem haemorrhages should also be considered ...

A 19-year-old woman with long-standing sensorineural deafness, bilateral cataracts and mild clumsiness, presented with acute focal edema in the left temperoparieto-occipital area which required surgical decompression as a life-saving measure. Investigation revealed a persistent lactic acidemia and evidence of many ragged red fibres in a skeletal muscle biopsy specimen, suggesting ...

Lacunar strokes result from occlusion of penetrating arteries in the deeper, subcortical parts of the cerebrum and brain stem. Approximately 19 percent of all strokes are of the lacunar variety with lacunar strokes representing the most common cerebrovascular complication of chronic hypertension. Four major clinical syndromes are pure motor hemiparesis, ...

Using a new method of express diagnosis, the authors proved that activation of the fibrinolytic system, which occurs after open-heart operations, can be the cause of excessive hypo coagulation and massive haemorrhage. Partial correction of hyperfibrinolysis, attained by adequate dosage of antifibrinolytic drugs and administered under the control of the ...

A severe multimodal neglect syndrome, mutism, oral apraxia and ideomotor apraxia for the right hand suddenly developed in a right-handed male following a right hemisphere (central) stroke. Neuropathologic examination showed an ischemic infarction involving the whole right insula, adjacent white matter, and the inner cortical surface of the right fronto-temporo-parietal ...

Coagulation studies were carried out in 14 children with haemolytic uraemic syndrome that followed acute dysentery. Stool cultures showed Shigella dysenteriae in 3 cases and were sterile in the remainder. Prolongation of the prothrombin time, activated partial thromboplastin time and thrombin time and raised levels of fibrinogen degradation products were ...

An in-depth discussion of Classic Heat Stroke (CHS) and Exertional Heat Stroke (EHS) Syndromes occurred during morning report at a large metropolitan teaching institution during a New Orleans heat wave. The opportunity arose to compare the syndromes via case reports of two patients admitted the same day to the same ...

Necropsy findings in adult salmon with subclinical "Hitra disease" (hemorrhagic syndrome) varied from negligible to hemorrhagic diathesis with generalized edema. By light microscopy, minute vessels were dilated, arterioles had mural necrosis, and thrombi were present. Occlusions consisted of fused erythrocytes and fibrin. Ultrastructurally, endothelial nuclei were pyknotic with condensed chromatin. ...

A standardized neurologic assessment scoring instrument was developed and tested for use in a multicenter trial of hypervolemic hemodilution in acute hemispheric stroke. Components of the neurologic examination pertinent to hemispheric stroke syndromes were emphasized. The scale was evaluated using 16 acute stroke patients for concurrent validity (Pearson coefficient r ...

An otherwise healthy 36-year-old man had abdominal pain, vomiting, sepsis, and disseminated intravascular coagulation (DIC). Negative exploratory laparotomy was shortly followed by death. Autopsy showed Haemophilus influenzae (type B) meningitis, multiple organ involvement with DIC, and bilateral adrenal hemorrhagic necrosis (Waterhouse-Friderichsen syndrome). This patient is the fourth reported adult with ...

A prospective study of Chinese patients aged 20-70 years reveals that at least 30.5% of all strokes are due to cerebral haemorrhage. Compared to previous studies in Caucasians, there is both a proportional and absolute increase in cerebral haemorrhage amongst all strokes, alert strokes, or those who presented with just ...

Disseminated epidermolytic acanthoma was observed during PUVA therapy in a patient with Sézary syndrome. The majority of the lesions resolved within 5 months after the cessation of therapy. This circumstantial evidence together with our knowledge of the effects of PUVA suggest that the skin lesions were revealed by topical photochemotherapy.

Kasabach-Merritt syndrome with consumption coagulopathy occurred in a 5-week-old female infant with a hemangioma on her back. Disseminated intravascular coagulopathy was improved by an exchange transfusion. Administration of steroid and radiation therapy was attempted as a treatment for the hemangioma and thrombocytopenia; however, it was unsuccessful. Complete recovery was obtained ...

The role of the athletic trainer for competitive swimmers must include a knowledge of stroke mechanics, adaptations to the musculoskeletal systems, and preventative exercises to reduce the incidence of injury. Maintaining competitive training while the swimmer recuperates from injury is important, especially in the overuse syndromes that are common in ...

Disseminated intravascular coagulation (DIC) is not uncommon in the obstetric patient, but DIC of sufficient severity to be of clinical importance is unusual. Treatment of DIC is directed primarily at its cause. Replacement of depleted blood components with packed red blood cells, fresh frozen plasma, cryoprecipitate, and platelets is sometimes ...

A 10-month-old boy who presented with strabismus and symptoms of intracranial hypertension was found to have a pineoblastoma and a unilateral ocular retinoblastoma. Despite enucleation of the eye, subtotal removal of the pineoblastoma, and craniospinal axis irradiation, the patient died 6 months later from disseminated intracranial neoplasm. As there was ...

An unusual case of multifocused postpartum thrombotic microangiopathy was encountered in a woman with pregnancy-induced hypertension, which presented clinical features different from those generally seen in postpartum hemolytic uremic syndrome or thrombotic thrombocytopenic purpura. These changes included acute disseminated intravascular coagulation, severe elevations of liver enzymes, severe renal dysfunction, and ...

In 35 cases out of 37 (88%) microthrombi have been found in CNS. They appeared much more frequently than it could be expected on the basis of the clinical picture of DIC syndrome or changes in the coagulation system. Microthrombi occurred prevalently in white substance of the frontal and occipital ...

This report concerns an unusual case of thrombosis and hemorrhage in the choroid plexus caused by disseminated intravascular coagulation (DIC). The case is of special interest because it occurred in a patient with Down's syndrome. Nevertheless, there is no causal relation between Down's syndrome and the choroid plexus lesion except ...

A 50-year-old woman was admitted as an acute medical emergency and was diagnosed as having toxic shock syndrome. Thirty-six hours after admission she went into hepato-renal failure and had disseminated intravascular coagulation. She developed severe laryngeal oedema, a complication which has not been reported previously, and was intubated with great ...

The localization of intrarenal cross-linked fibrin was examined by the effect of monochloroacetic acid treatment on the kidney sections. In acute glomerulonephritis or in mild diffuse or focal proliferative type of nephritis, cross-linked fibrin was observed mainly within glomerular capillary walls. Extension of cross-linked fibrin deposit over the mesangium or ...

Extensive gangrene of both lower extremities necessitating bilateral above-the-knee amputations complicated the adult respiratory distress syndrome (ARDS) caused by Escherichia coli pneumonia and septicemia in a 52-yr-old man. Concurrent with the evolution of tissue necrosis, peripheral blood leukocyte and platelet counts fell, and pulmonary vascular resistance increased. Adequacy of the ...

Two cases of disseminated systemic zygomycosis caused by Cunninghamella bertholletiae in compromised persons were studied. The underlying disease in one patient was hematopoietic dysplasia (preleukemic syndrome) and in the other, postnecrotic hepatic cirrhosis. A definitive diagnosis of zygomycosis caused by C bertholletiae is achieved only by isolation and identification of ...

Of six cats with eosinophilic enteritis, two had lesions confined to the intestinal tract, and four had varied disseminated eosinophilic infiltration of other organs. The lesions in these cats are similar to those of the hypereosinophilic syndrome in man. A feline hypereosinophilic syndrome is proposed, consisting of eosinophilic enteritis, disseminated ...

The limulus lysate assay was utilized as a diagnostic adjunct in the evaluation of three cases of disseminated gonorrhea in women. Although not a specific test for Neisseria gonorrhoeae, the limulus lysate assay, when used with properly diluted endocervical samples, gave results that correlated with conventional diagnostic techniques. If the ...

A patient with transient global amnesia (TGA) had a glioma in the dominant hippocampus. Neuroradiologic studies showed local mass effect on the posterior choroidal artery on that side. This finding suggests that unilateral involvement is sufficient to cause the syndrome despite the widely held view that bilateral lesions are essential.

We believe there is a significant association between migraine and the prolapse mitral valve syndrome. Propranolol is the drug of choice in these patients for the treatment and prevention of migraine. Increased platelet aggregability may be the common pathophysiologic mechanism as relates to emboli from the valve and possibly in ...

Disseminated intravascular coagulation (DIC) is being recognized with increased frequency and not only are newer diagnostic modalities becoming available for this syndrome, but newer, some controversial, methods of management are also being recognized and may prove to increase survival in DIC. In addition, several syndromes classically considered separate, definitive disease ...

Coagulation studies were performed on 13 children with clinical diagnoses of Reye syndrome. Four had abnormalities so severe that transfusion of coagulation factors and platelets were required prior to percutaneous liver biopsy. In one of these, abnormalities frequently found in association with acute hepatic failure were present. Disseminated intravascular coagulation ...

A 14-year-old boy, who had the physical and neurological characteristics of cerebral gigantism (Sotos syndrome), developed hepatocarcinoma. This tumor is rare in children and has never, to our knowledge, been recorded in a patient with cerebral gigantism. An autopsy was performed, the first we are aware of in a patient ...

In a 3-year-old boy disseminated histoplasmosis was recognized from a liver biopsy. The patient died shortly afterwards and had foci of the disease in liver, spleen, and kidneys. Large numbers of yeast cells of Histoplasma capsulatum were found within histiocytes in other organs including the eye. This rare finding is ...

Transient global amnesia is generally regarded as a benign syndrome of probable vascular etiology. We describe a man who experienced a single episode of transient global amnesia and subsequently developed a progressive dominant hemispheric syndrome. Neuroradiologic investigations and the patient's subsequent death strongly suggest that his disease was due to ...

A 78 year old, right handed man developed the syndrome of alexia without agraphia due to a right occipital thrombotic stroke. The cerebral dominance test strongly suggests that his right hemisphere is dominant. This is believed to be the first case of alexia without agraphia secondary to a right occipital ...

A 53-year-old female patient with ovarian dermatoid cyst and lung tuberculosis had been treated with rifampicin. During repeated rifampicin treatment she developed an acute haemolytic syndrome with haemorrhagic diathesis. Laboratory findings showed that it was caused by disseminated intravascular coagulation. Death ensued despite intensive administration of heparin and Trasylol. It ...

'Pure motor hemiplegia' is a common stroke syndrome defined by Fisher as paralysis of face, arm, and leg on one side, unaccompanied by sensory signs, visual field defect, aphasia, or apractognosia. It occurs almost exclusively in hypertensive patients and carried a good prognosis. We report a case of a normotensive ...

Disturbances in the blood coagulation mechanism are seen by the obstetrician and gynecologist as rare complications of abruptio placentae, retained dead fetus syndrome, amniotic fluid embolism, toxemia, saline amnioinfusion, and septic abortion. Two cases of disseminated intravascular coagulation complicating gynecologic malignancy are presented. Laboratory studies showed thrombocytopenia, hypofibrinogenemia, and increased ...

In a 47-year-old healthy male, the syndrome of overwhelming pneumococcal sepsis, associated with diffuse intravascular clotting, appeared 25 years after a post-traumatic splenectomy. Although no other disease was present, the course was fulminant and the outcome fatal. Splenectomy for any condition and in all ages, augments the risk to severe ...