1.Renal Artery Embolization of Perirenal Hematoma in Hemorrhagic Fever with Renal Syndrome: A Case Report.
Hee Seok CHOI ; Yong Seok LEE ; Jae Cheol HWANG ; Ji Hyon LIM ; Kyung Soo KIM ; Yup YOON
Korean Journal of Radiology 2007;8(4):348-350
Hemorrhagic fever with renal syndrome (HFRS) is an acute viral disease characterized by fever, hemorrhage and renal failure. Among the various hemorrhagic complications of HFRS, spontaneous rupture of the kidney and perirenal hematoma are very rare findings. We report here on a case of HFRS complicated by massive perirenal hematoma, and this was treated with transcatheter arterial embolization.
*Embolization, Therapeutic
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Hematoma/radiography/*therapy/virology
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Hemorrhagic Fever with Renal Syndrome/*complications
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Humans
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Kidney Diseases/radiography/*therapy/virology
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Male
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Middle Aged
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*Renal Artery/radiography
2.A Less Invasive Approach for Ruptured Aneurysm with Intracranial Hematoma: Coil Embolization Followed by Clot Evacuation.
Je Hoon JEONG ; Jun Seok KOH ; Eui Jong KIM
Korean Journal of Radiology 2007;8(1):2-8
OBJECTIVE: The presence of an intracerebral hematoma from a ruptured aneurysm is a negative predictive factor and it is associated with high morbidity and mortality rates even though clot evacuation followed by the neck clipping is performed. Endovascular coil embolization is a useful alternative procedure to reduce the surgical morbidity and mortality rates. We report here on our experiences with the alternative option of endovascular coil placement followed by craniotomy for clot evacuation. MATERIALS AND METHODS: Among 312 patients who were admitted with intracerebral subarachnoid hemorrhage during the recent three years, 119 cases were treated via the endovascular approach. Nine cases were suspected to show aneurysmal intracerebral hemorrhage (ICH) on CT scan and they underwent emergency cerebral angiograms. We performed immediate coil embolization at the same session of angiographic examination, and this was followed by clot evacuation. RESULTS: Seven cases showed to have ruptured middle cerebral artery (MCA) aneurysms and two cases had internal carotid artery aneurysms. The clinical status on admission was Hunt-Hess grade (HHG) IV in seven patients and HHG III in two. Surgical evacuation of the clot was done immediately after the endovascular coil placement. The treatment results were a Glasgow Outcome Scale score of good recovery and moderate disability in six patients (66.7%). No mortality was recorded and no procedural morbidity was incurred by both the endovascular and direct craniotomy procedures. CONCLUSION: The results indicate that the coil embolization followed by clot evacuation for the patients with aneurysmal ICH may be a less invasive and quite a valuable alternative treatment for this patient group, and this warrants further investigation.
Treatment Outcome
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Tomography, X-Ray Computed
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Retrospective Studies
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Middle Aged
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Male
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Intracranial Aneurysm/radiography/*therapy
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Humans
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Hematoma/radiography/*therapy
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Female
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Embolization, Therapeutic/*methods
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Drainage/*methods
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Cerebral Angiography
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Aneurysm, Ruptured/radiography/*therapy
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Adult
3.Small-sized acute subdural hematoma: operate or not.
Kyeong Seok LEE ; Hack Gun BAE ; Il Gyu YUN
Journal of Korean Medical Science 1992;7(1):52-57
A retrospective study of 90 cases of small-sized (less than 3 mm on the printed CT film) acute (within 24 hours) subdural hematoma (SASDH) is presented. From March 1985 to December 1986, the SASDH were immediately operated on (operation rate: 86.0%). From January 1988 to December 1989, we attempted to treat them conservatively (operation rate: 49.1%). The patient population for this study consisted of 38 surgically-treated patients in the first period (Group I), 26 surgically-treated patients in the second period (Group IIs), and 26 conservatively-treated patients in the second period (Group IIc). We compared the clinical features, radiologic findings, and outcome of these 3 groups. The clinical features of Group I, including age, sex, Glasgow Coma Scale (GCS) score on admission, pupillary status on arrival, and interval from injury to the CT, did not differ significantly from those of Group II (P greater than 0.01). The only difference was the timing of the operation. In Group I, 20 patients (52.6%) received an operation within 4 hours, while in Group IIs, only 7 patients (26.9%) underwent surgery within 4 hours (P less than 0.05). The radiologic findings of Group I, including the thickness and volume of the hematoma, the degree of midline shift, and the frequency of skull fracture, also did not differ from those of Group II (P greater than 0.1). However, the outcome of Group II strikingly differed from that of Group I. The mortality rate was 76.3% in Group I, while it was 44.2% in Group II (P less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)
Acute Disease
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Adult
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Female
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Glasgow Coma Scale
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Hematoma, Subdural/mortality/pathology/radiography/*therapy
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Humans
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Male
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Time Factors
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Treatment Outcome
4.Treatment of Spontaneous Cervical Spinal Subdural Hematoma with Methylprednisolone Pulse Therapy.
Tae Jin SONG ; Jun Bum LEE ; Young Chul CHOI ; Kyung Yul LEE ; Won Joo KIM
Yonsei Medical Journal 2011;52(4):692-694
We report herein a case of hyperacute onset of spontaneous cervical spinal subdural hematoma treated with methylprednisolone pulse therapy that showed good results. A 57-year-old man was admitted for posterior neck pain and paraparesis which occurred an hour ago. MRI revealed a ventral subdural hematoma distributed from the level of C1 down to T3, compressing the spinal cord. Conservative management with methylprednisolone pulse therapy was administered considering the patient's poor general condition. Although emergent surgical decompression is necessary in most cases of spinal subdural hematoma, conservative management with steroid therapy could be effective.
Cervical Vertebrae/pathology/radiography
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Glucocorticoids/administration & dosage/*therapeutic use
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Hematoma, Subdural, Spinal/*drug therapy/pathology/radiography
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Humans
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Magnetic Resonance Imaging
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Male
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Methylprednisolone/administration & dosage/*therapeutic use
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Middle Aged
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Paraparesis/drug therapy/pathology/radiography
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Tomography, X-Ray Computed
5.Endovascular Stent Graft for Treatment of Complicated Spontaneous Dissection of Celiac Artery: Report of Two Cases.
Ung Rae KANG ; Young Hwan KIM ; Young Hwan LEE
Korean Journal of Radiology 2013;14(3):460-464
We report 2 cases of complicated spontaneous dissection of the celiac artery, which were successfully treated by a stent graft. The first patient was a 47-year-old man who presented with acute abdominal pain. CT scan showed ruptured saccular aneurysm with surrounding retroperitoneal hematoma. The second patient was a 57-year-old man with progressive dissecting aneurysm. Endovascular stent graft was placed in the celiac trunk to control bleeding, and to prevent rupture in each patient. Follow-up CT scans showed complete obliteration of a dissecting aneurysm.
Abdominal Pain/etiology/radiography
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Aneurysm, Dissecting/*therapy
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Aneurysm, Ruptured/prevention & control
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Celiac Artery/*injuries
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Hematoma/etiology/radiography
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Hemorrhage/etiology/radiography
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Humans
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Male
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Middle Aged
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Retroperitoneal Space
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Rupture, Spontaneous/therapy
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*Stents
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Tomography, X-Ray Computed/adverse effects
6.Transcatheter coil embolization of the inferior epigastric artery in a huge abdominal wall hematoma caused by paracentesis in a patient with liver cirrhosis.
Yun Ji PARK ; Sang Yeon LEE ; Seong Hun KIM ; In Hee KIM ; Sang Wook KIM ; Seung Ok LEE
The Korean Journal of Hepatology 2011;17(3):233-237
Therapeutic paracentesis is considered to be a relatively safe procedure and is performed commonly for the control of massive ascites in patients with liver cirrhosis. The commonest puncture site, approximately 4 or 5 cm medial of left anterior superior iliac spine, can be located across the route of the inferior epigastric artery, which is one of the sites of potential massive bleeding. In a 46-year-old woman with liver cirrhosis and refractory ascites, a huge abdominal wall hematoma developed after therapeutic paracentesis. The patient was not stabilized by conservative treatment, and inferior epigastric artery injury was confirmed on angiography. Angiographic coil embolization of the inferior epigastric artery was conducted, after which the bleeding ceased and the hematoma stopped growing. This case indicates that physicians performing paracentesis should be aware of the possibility of inferior epigastric artery injury and consider early angiographic coil embolization when a life-threatening abdominal wall hematoma develops.
Abdominal Wall
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Angiography
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Ascites/surgery
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Embolization, Therapeutic
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Epigastric Arteries/*injuries
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Female
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Hematoma/*etiology/radiography/therapy
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Humans
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Liver Cirrhosis/*diagnosis
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Middle Aged
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Paracentesis/*adverse effects
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Tomography, X-Ray Computed
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Wounds, Nonpenetrating/complications
7.MR Imaging in a Child with Scurvy: a Case Report.
Seung Woo CHOI ; Sun Won PARK ; Young Se KWON ; In Suk OH ; Myung Kwan LIM ; Won Hong KIM ; Chang Hae SUH
Korean Journal of Radiology 2007;8(5):443-447
Scurvy is very rare disease in industrialized societies. Nevertheless, it still exists in higher risk groups including economically disadvantaged populations with poor nutrition, such as the elderly and chronic alcoholics. The incidence of scurvy in the pediatric population is very low. This study reports a case of scurvy in a 5-year-old girl with cerebral palsy and developmental delay based on MRI findings.
Ascorbic Acid/blood/therapeutic use
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Bone Diseases, Metabolic/etiology
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Cerebral Palsy/complications
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Child, Preschool
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Cholecalciferol/blood
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Developmental Disabilities/complications
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Drainage
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Female
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Femur/pathology/radionuclide imaging/surgery
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Fever/etiology
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Follow-Up Studies
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Hematoma/diagnosis/etiology/surgery
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Humans
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Knee/radiography
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Magnetic Resonance Imaging/*methods
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Muscle Weakness/etiology
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Rare Diseases
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Scurvy/complications/*diagnosis/drug therapy
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Thigh/pathology
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Vitamins/therapeutic use