Adult ; Aneurysm, Dissecting ; complications ; diagnosis ; Aortic Aneurysm ; complications ; diagnosis ; Diagnostic Errors ; Female ; Humans ; Myocardial Infarction ; complications ; diagnosis

Adult ; Aortic Aneurysm ; etiology ; Aortic Coarctation ; complications ; diagnosis ; Female ; Humans

Carney complex is an autosomal dominant disease that displays such characteristic features as cardiac and cutaneous myxomas and spotty pigmentation of the skin. We report here on a case of Carney complex that was accompanied by increased myxoid fibroadenomas in the breast and multiple intracranial aneurysms.
Adult ; Breast Neoplasms/*complications/diagnosis ; Female ; Fibroadenoma/*complications/diagnosis ; Humans ; Intracranial Aneurysm/*complications ; Magnetic Resonance Imaging ; Pigmentation Disorders/*complications ; Syndrome

Telangiectatic osteosarcoma is a rare and special variant of osteogenic sarcoma with distinct radiologic, gross and microscopic features. This tumor is predominantly lytic, destructive tumor without sclerosis on roentgenogram, and is soft and cystic on gross examination. Histologically aneurysmally dilated spaces lined or traversed by stromal cells producing osteoid are noted. This report concerns a case of telangiectatic osteosarcoma occurring in a 7 years old boy. He presented with pathologic fracture of the right distal tibia, followed by a purely lytic lesion on X-ray examination. This lesion recurred five times during a span of one year. Microscopic features of the biopsy specimen was difficult to differentiate from aneurysmal bone cyst because of prominant blood-filled cyst formation. It was finally identified as osteosarcoma from the below-knee amputation specimen through the close examination for anaplastic osteoid-producing stromal cells in the septa that separate the blood cysts.
Aneurysm/complications/diagnosis ; Child ; Diagnosis, Differential ; Humans ; Male ; Neoplasm Recurrence, Local ; Osteosarcoma/complications/*pathology ; Tibia

To evaluate the risk of definitive intracranial microsurgical aneurysm obliteration as a function of the timing of the operative intervention, we retrospectively reviewed 167 consecutive patients in the department of Neurosurgery of Busan Paik's Hospital, Inje medical college, from January 1980 to December 1983. The patients who were operated upon within the first 3 days of their most recent subarachnoid hemorrhage formed the early group;the patients operated upon after the 3 days were considered to have undergone the late surgery. On the base of their clinical outcome the patients were allocated to one of five outcome categories(excellent, good, fair, poor, death) both at the time of their hospital discharge and at their most recent clinical revaluation. The 83% favorable outcome estimated from early operation and 72% from late operation. The mortality was estimated 5% from early operation and estimated 11% from late operation. The optimal timing of surgery for ruptured intracranial aneurysms is currently unknown, but early operation is an effective and reliable method to reduce the occurrence of rebleeding, vasospasm, ischemic complication and medical complication etc. Recently, there has been a resurgence of interest in early operation and increasing numbers of surgeons have been adopting this modality, but prompt, accuate diagnosis and early referral to specialized centers is the only way in which significant advances in reducing the overall morbidity and mortality for majority of patients can be achieved.
Aneurysm ; Aneurysm, Ruptured ; Busan ; Diagnosis ; Humans ; Intracranial Aneurysm* ; Microsurgery ; Mortality ; Neurosurgery ; Postoperative Complications ; Referral and Consultation ; Retrospective Studies ; Subarachnoid Hemorrhage

INTRODUCTIONAtherosclerotic coronary artery thrombosis is the most common cause of acute myocardial infarction.

CLINICAL PICTUREA 30-year-old lady presented with acute peripartum massive anterior ST segment myocardial infarction and cardiogenic shock. This was due to acute Stanford type A aortic dissection with the intimal flap occluding the left coronary ostium. The initial diagnosis was not apparent. Echocardiography confirmed the diagnosis.

TREATMENT AND OUTCOMEShe underwent emergency surgical repair (Bentall procedure). Pathology confirmed underlying idiopathic cystic medial degeneration.

CONCLUSIONA high index of clinical suspicion is required in acute myocardial infarction presenting without traditional cardiovascular risk factors.

Acute Disease ; Adult ; Aneurysm, Dissecting ; complications ; diagnosis ; surgery ; Aortic Aneurysm ; complications ; diagnosis ; surgery ; Echocardiography ; Electrocardiography ; Female ; Humans ; Myocardial Infarction ; etiology ; physiopathology ; Pregnancy ; Pregnancy Complications, Cardiovascular ; Shock, Cardiogenic ; etiology

Adult ; Aneurysm, Dissecting ; diagnosis ; physiopathology ; Aneurysm, False ; Coronary Aneurysm ; diagnosis ; physiopathology ; Coronary Vessels ; pathology ; physiopathology ; Humans ; Male ; Myocardial Infarction ; diagnosis ; physiopathology ; Thoracic Injuries ; complications ; physiopathology ; Young Adult

Chest trauma can lead to various cardiac complications ranging from simple arrhythmias to myocardial rupture. An acute myocardial infarction (AMI) is a rare complication that can occur after chest trauma. We report a case of 66-year-old male who suffered a blunt chest trauma from a traffic accident resulting in an AMI. The coronary angiography revealed an eccentric 50% narrowing of the ostium of left anterior descending artery (LAD) by a dissection flap with calcification. Intravascular ultrasonography (IVUS) revealed eccentric calcified plaque (minimal luminal diameter [MLD]=3.5 mm) with a dissection flap. Intervention was not performed considering the MLD and calcified flap, and he has been conservatively managed with aspirin and losartan for 2 years. The follow-up coronary angiography showed an insignificant luminal narrowing of the proximal LAD from the ostium without evidence of a dissection. An early coronary evaluation including an IVUS study should be considered for managing patients who complain of ongoing, deep-seated chest pain with elevated cardiac enzyme levels and an abnormal electrocardiogram (ECG) after a blunt chest trauma. Based on this case, some limited cases of traumatic coronary artery dissections can be healed with conservative management and result in a good prognosis.
Aged ; Aneurysm, Dissecting/diagnosis/*etiology ; Coronary Aneurysm/diagnosis/*etiology ; Coronary Angiography ; Human ; Male ; Myocardial Infarction/diagnosis/*etiology ; Radiography, Thoracic ; Thoracic Injuries/*complications ; Ultrasonography, Interventional ; Wounds, Nonpenetrating/*complications

Adult ; Aortic Aneurysm, Thoracic ; complications ; diagnosis ; Hoarseness ; diagnosis ; etiology ; Humans ; Male

During cerebral vasospasm (CVS) due to ruptured aneurysm the retinal arteries were photographed and evaluated with angiographic studies at various stages to study any correlation between them. Among 60 cases with angiographic CVS, ophthalmoscopic retinal artery spasm (RAS) was detected in 29 cases. Photographic demonstration of the RAS was possible in 7 cases. In general, in a series of cases, the degree of RAS seems to correspond to the severity of CVS.
Carotid Artery Diseases/complications ; Human ; Intracranial Aneurysm/complications ; Ischemic Attack, Transient/complications* ; Ophthalmoscopy* ; Retinal Artery* ; Retinal Diseases/diagnosis