The carotid stump is a known source of cerebral embolisms. Direct ultrasound sonographic visualization of a thrombus in the common carotid stump after development of a cerebral infarction is rare. We report a case of a 69-year-old man who presented with acute ipsilateral ischemic stroke with occlusion of the left common carotid artery, forming a stump proximal to the carotid bifurcation. Carotid duplex sonography revealed a mobile thrombus in the stump. An ipsilateral microembolic signal was observed by transcranial Doppler imaging.
Aged ; Carotid Artery, Common ; Cerebral Infarction ; Embolism ; Humans ; Intracranial Embolism ; Stroke ; Thromboembolism ; Thrombosis ; Ultrasonography, Doppler

Thromboembolic events are rare among systemic complications of inflammatory bowel disease; however, they are a significant cause of mortality when they occur. Several reports have considered thromboembolic events in patients with ulcerative colitis presenting with venous or arterial thromboembolism, such as cerebral thrombosis, deep vein thrombosis, pulmonary thromboembolism, portal vein thrombosis, or mesenteric vein thrombosis. However, increased coagulability related to Crohn's disease is extremely rare compared with that of ulcerative colitis. We report a case of a 42-year-old man with complicated portal hypertension that occurred due to extensive portal vein and mesenteric vein thrombosis. He had a monozygotic twin brother who was also in remission with Crohn's disease. The patient showed protein C and protein S deficiencies; however, he recovered with early anticoagulation therapy.
Colitis, Ulcerative ; Crohn Disease ; Humans ; Hypertension, Portal ; Intracranial Thrombosis ; Mesenteric Veins ; Portal Vein ; Protein C ; Protein S ; Pulmonary Embolism ; Siblings ; Thromboembolism ; Thrombosis ; Twins, Monozygotic ; Venous Thromboembolism ; Venous Thrombosis

Seventeen years old man was diagnosed as left calf varicous vein and deep vein thrombosis on the same area. Three years later the patient visited for the exasperated swelling but had no sufficient warfarin therapy. At the age of 24, the patient had abrupt onset of left hemiplegia. Risk factor was monitored and patent foramen ovale and protein S deficiency were diagnosed. Simultaneously pulmonary embolism was detected and inferior vena cava filter was inserted. Nine months later from stroke, the patient had several times neurolysis on left lower extremity for spasticity. But after three days from last neurolysis we detected aggravation of lower extremity and left upper extremity swelling. He continued anticoagulation therapy. We reported a young patient with cerebral infarction by the mechanism of paradoxical embolism and upper extremity deep vein thrombosis in the lack of anticoagulation medication.
Cerebral Infarction ; Embolism, Paradoxical ; Foramen Ovale, Patent ; Hemiplegia ; Humans ; Intracranial Embolism* ; Lower Extremity ; Muscle Spasticity ; Protein S Deficiency ; Pulmonary Embolism ; Risk Factors ; Stroke ; Upper Extremity ; Upper Extremity Deep Vein Thrombosis ; Veins ; Vena Cava Filters ; Venous Thrombosis ; Warfarin

Cerebral venous thrombosis is an uncommon cause of cerebral infarction. A 31-year-old man complained of headache, weakness, and numbness of the left leg a day before being admitted to the hospital. After admission, brain computed tomography and brain magnetic resonance imaging revealed superior sagittal sinus thrombosis with cerebral infarction in the right hemisphere. He had no significant medical history. On the fourth hospital day, he suddenly collapsed and died. Medicolegal autopsy was performed 3 days later; medical malpractice was suspected. External examination revealed a few conjunctival petechiae. Internal examination revealed thrombi in the superior sagittal sinus and superficial cortical veins. Thrombi were noted in the pulmonary trunk and both pulmonary arteries. Upon dissection of the left leg, we found thrombi in the posterior tibial vein. A microscopic examination revealed vasculitis of the same cortical veins, and we therefore assumed that vasculitis of the cortical veins gave rise to thrombosis. In typical autopsy practice, an examination of the dura mater is often overlooked, but careful examination of this region should be performed in cases of cerebral infarction in young adults, such as this one.
Adult ; Autopsy ; Brain ; Cerebral Infarction ; Dura Mater ; Headache ; Humans ; Hypesthesia ; Intracranial Thrombosis ; Leg ; Magnetic Resonance Imaging ; Malpractice ; Pulmonary Artery ; Pulmonary Embolism* ; Purpura ; Superior Sagittal Sinus ; Thrombosis ; Vasculitis ; Veins ; Venous Thrombosis* ; Young Adult

Adolescent ; Humans ; Male ; Pulmonary Embolism ; etiology ; Sinus Thrombosis, Intracranial ; complications ; diagnosis

Adult ; Aged ; Arthritis, Rheumatoid ; complications ; Female ; Humans ; Intracranial Thrombosis ; complications ; Male ; Middle Aged ; Pulmonary Embolism ; complications ; Venous Thrombosis ; complications

Anti-thrombin III deficiency is known as a disease of autosomal dominant trait and relatively common, but in Korea, exact incidence and mortality is not known, In general, Anti-thrombin III deficiency is expressed to venous thromboembolism like deep vein thrombosis or pulmonary embolism. But, arterial embolism is very rare. We experienced a case of Antithrombin III deficiency expressed as myocardial infarction of inferior wall by huge thrombosis in the mid and distal right coronary artery.
Antithrombin III Deficiency ; Coronary Vessels ; Embolism ; Incidence ; Korea ; Mortality ; Myocardial Infarction* ; Pulmonary Embolism ; Thrombosis ; Venous Thromboembolism ; Venous Thrombosis

Clinical observation was done on 302 cases of cerebrovascular accidents admitted at Sung-Sim hospital, Chung-Ang University from January, 1968 to August, 1976. 1) Of 302 cases of cerebrovascular accidents, the incidence of cerebral hemorrhage was 28.8, cerebral thrombosis 47,7 Subarachnoid hemorrhage 20.2% and cerebral embolism 3.3%. 2) The peak age incidence was in the fifth decade in cerebral hemorrhage, subarachnoid hemorrhage, whereas in cerebral thrombosis, it was in the sixth decade. 3) The most frequent predisposing factor in cerebral hemorrhage and subarachnoid hemorrhage were physical activity and emotional stress, whereas in thrombosis and embolism, it was rest. 4) Among disease preceding the onset of cerebrovascular accidents, hypertension were presented 65.4% in cerebral hemorrhage, 63.6% in cerebral thrombosis, 56.6% in subarachnoid hemorrhage and valvular heart disease was presented 40.0% in cerebral embolism. 5) Serum cholesterol level over 200mg% was seen in 33.0% of cerebrovascular accidents. 6) Leukocytosis was seen 58.6% of cerebrovascular accidents which was predominantly found in the hemorrhagic group. 7) The pressure of cerebrospinal fluid was elevated in 61.7% of cerebrovascular accidents, predominantliny the hemorrhagic group. 8) The peak duration of admission was present in 51.7% of cerebrovascular accidents within 7 days and mortality rate during hospitalization was 38.0% in cerebral hemorrhage, 10.4% in cerebral thrombosis and 27.8% in subarachnoid hemorrhage. 9)The mortality rate during hospitalization was 35.3% in all cerebrlavascular accidents within 24 hours.
Causality ; Cerebral Hemorrhage ; Cerebrospinal Fluid ; Cholesterol ; Embolism and Thrombosis ; Heart Valve Diseases ; Hospitalization ; Hypertension ; Incidence ; Intracranial Embolism ; Intracranial Thrombosis ; Leukocytosis ; Mortality ; Motor Activity ; Stress, Psychological ; Stroke ; Subarachnoid Hemorrhage

Antiphospholipid syndrome is characterized by arterial or venous thrombosis and the production of antiphospholipid antibodies. Antiphospholipid syndrome may present primarily or secondary to systemic lupus erythematosus. The clinical features include multiple thrombosis, cerebral diseases, abortion in female, thrombocytopenia and so on. The treatment is based on anticoagulants, steroids, immunosuppressive agents and antiplatelet drugs. We report a case of a 29- year-old man who was admitted to Ewha Womans University Mok-dong Hospital with a generalized peritonitis. On emergency exploratory laparotomy, segmental infarction of the terminal ileum and the right colon was revealed and a right colon and ileal resection was performed. During the postoperative period, the patient was finally diagnosed having antiphospholipid syndrome with systemic lupus erythematosus. He also had ischemic heart disease due to coronary artery thrombosis and pulmonary embolism due to deep vein thrombosis of the lower extremities. He eventually expired following a restorative ileocolostomy owing to anastomotic leakage and sepsis.
Anastomotic Leak ; Antibodies, Antiphospholipid ; Anticoagulants ; Antiphospholipid Syndrome* ; Colon ; Coronary Vessels ; Emergencies ; Female ; Humans ; Ileum ; Immunosuppressive Agents ; Infarction* ; Intracranial Thrombosis ; Laparotomy ; Lower Extremity ; Lupus Erythematosus, Systemic* ; Myocardial Ischemia ; Peritonitis ; Platelet Aggregation Inhibitors ; Postoperative Period ; Pulmonary Embolism ; Sepsis ; Steroids ; Thrombocytopenia ; Thrombosis ; Venous Thrombosis

Antiphospholipid syndrome (APS) is an acquired systemic autoimmune disorder characterized by a combination of clinical criteria, including vascular thrombosis or pregnancy morbidity and elevated antiphospholipid antibody titers. It is one of the causes of deep vein thrombosis and pulmonary embolism that can be critical due to the mortality risk. Overall recurrence of thromboembolism is very low with adequate anticoagulation prophylaxis. The most effective treatment to prevent recurrent thrombosis is long-term anticoagulation. We report on a 17-year-old male with APS, who manifested blue toe syndrome, deep vein thrombosis, pulmonary thromboembolism, and cerebral infarction despite adequate long-term anticoagulation therapy.
Adolescent ; Antibodies, Antiphospholipid ; Antiphospholipid Syndrome* ; Blue Toe Syndrome ; Cerebral Infarction ; Cerebrovascular Disorders ; Embolism* ; Humans ; Male ; Mortality ; Pregnancy ; Pulmonary Embolism ; Recurrence ; Thromboembolism ; Thrombosis ; Veins* ; Venous Thrombosis