We report a unique case of a 12-year-old girl with unilateral proptosis form orbital extension of an extensive bilateral cephalhematoma. Loss of vision in the left eye due to severe proptosis was reversed by prompt aspiration and tarsorrhaphy.
Cerebral Hemorrhage/*complications/radiography ; Child ; Exophthalmos/*etiology/radiography ; Female ; Hematoma/*complications/radiography ; Humans

There has been considerable controversy concerning divergence paralysis, an entity described as early as 1883 by Parinaud. We recently observed a patient with divergence paralysis, who on CT scan presented a small hematoma in the tegmentum of the brainstem. This case may support the theory that the center for divergence exists in the upper brainstem.
Cerebral Hemorrhage/complications* ; Cerebral Hemorrhage/radiography ; Hematoma/complications* ; Hematoma/radiography ; Human ; Male ; Middle Age ; Paralysis/etiology* ; Tegmentum Mesencephali*/radiography ; Tomography, X-Ray Computed

We report the first case in Korea of a chronic expanding hematoma, which presented as a huge mass in the pleural cavity. A 67-year-old woman exhibiting a slowly-expanding intrathoracic mass, as revealed by a chest radiograph, was admitted to our hospital. The patient had undergone a pneumonectomy 37 years earlier during treatment for pulmonary tuberculosis. Computed tomography revealed a huge mass in her right hemithorax. The differential diagnosis of this mass included chronic empyema combined with a malignancy, such as lymphoma or a soft tissue sarcoma. The tumor, which was classified as an encapsulated chronic hematoma, was removed surgically. Samples sent for histopathological and microbiological analysis revealed no evidence of neoplasia or infection. The patient was finally diagnosed with a chronic expanding hematoma of the thorax. This case is particularly rare due to the patient's development of a very large mass after undergoing treatment for tuberculosis more than 30 years earlier.
Tomography, X-Ray Computed ; Radiography, Thoracic ; Positron-Emission Tomography ; Pleural Cavity/*pathology/radiography/radionuclide imaging ; Male ; Humans ; Hematoma/*pathology/radiography/radionuclide imaging ; Dyspnea/etiology ; Chronic Disease ; Aged

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 ; Hematoma/radiography/*therapy/virology ; Hemorrhagic Fever with Renal Syndrome/*complications ; Humans ; Kidney Diseases/radiography/*therapy/virology ; Male ; Middle Aged ; *Renal Artery/radiography

PURPOSE: This study compared the value of ultrasonography(US) in the diagnosis of sternal fractures with those of conventional radiography and bone scan. MATERIAL AND METHOD: From March 2000 to March 2001, in Gil Medical Center, Gachon Medical College, 44 patients(22 women and 22 men, mean age 46 years, range 5~81 years) complained of tenderness in the sternal area. The cases histories of these patients with clinically suspected sternal fracture due to blunt trauma were prospectively studied. At the time of admission, conventional radiography(sternal view) was done. At one day after admission, sternal ultrasonography was obtained, and after 4~5 days, a bone scan was done. Sternal ultrasonographic findings, conventional radiographic findings, and bone-scan findings were compared. In addition, a 12-lead ECG was done. When it was necessary, cardiac enzyme was checked and echocardiography was performed. RESULT: In 21 of 44 patients(48%), a sternal fracture was found by sternal US. Only 9 of 21 patients (43%) were diagnosed as having a sternal fracture by using conventional radiography. 23 of 44 patients (52%) have negative findings on sternal US; they also had negative findings on conventional radiography. Except for 7 unchecked patients, 13 of 21 patients(62%) were diagnosed as having a sternal fracture by bone scan, and among the 23 patients who had negative findings on sternal US, the 19 patients checked with a bone scan also had negative findings. CONCLUSION: Sternal US can find sternal fractures that are difficult to find on conventional radiography. Compared with bone scan, sternal US takes a shorter time and sternal US is not difficult. Additionally, combined lesions with sternal fractures(peristernal hematoma, soft tissue swelling) and costal cartilage fractures are diagnosed more easily when using sternal US.
Diagnosis ; Echocardiography ; Electrocardiography ; Female ; Fractures, Cartilage ; Hematoma ; Humans ; Male ; Prospective Studies ; Radiography ; Ultrasonography*

PURPOSE: To evaluate the anti-subsidence effect of suspensionplasty using abductor pollicis longus (APL) tendon in carpometacarpal (CMC) arthritis of the thumb. METHODS: From June 2009 to May 2016, hematoma distraction arthroplasty (HDA; group A, 10 cases) and HDA with suspensionplasty using APL tendon (group B, 7 cases) were performed in total 17 patients with CMC arthritis. The K-wire was fixed from 1st metacarpal to 2nd metacarpal in both group to maintain the empty space for 6 weeks until the fibrous tissue fill the space. We measured the preoperative trapezium space height with picture archiving and communication (PACS) system and compare the height with that was measured postoperatively. Additionally the subsidence rate checked sequentially with follow-up plain radiography. RESULTS: The subsidence ratios (subsidence/trapezium height) were average 33.2% in group A and 31.4% in group B. There is no statistical difference between two groups. Six weeks after pin removal almost of subsidence occurred, and then from 3 months after surgery to 6 months after surgery, few subsidence was occurred and it is average only 8% of total subsidence. The trial of distraction the empty space when perform the Kirschner wire (K-wire) fixation, it does not influence the prevention of subsidence. Between distraction height and subsidence, there was no statistical relevance. CONCLUSION: Although suspensionplasty was known as one of methods to prevent the subsidence, it is thought to be not very helpful method to prevent subsidence of thumb in CMC arthritis.
Arthritis* ; Arthroplasty ; Carpometacarpal Joints ; Follow-Up Studies ; Hematoma ; Humans ; Methods ; Radiography ; Tendons ; Thumb*

Pure epidural cavernous hemangioma of the spine without vertebral involvement is rare. Due to the slow growth of this lesion, the most common symptoms are chronic pain, myelopathy, and radiculopathy. In our case, the patient complained of an acute onset sensory deficit of the C4 dermatome. An MRI revealed an epidural mass with an acute hematoma. Here, we report a case of a pure epidural cavernous hemangioma that presented with acute neurologic symptoms caused by intralesional hemorrhage and an acute epidural hematoma, which were demonstrated on the patient's MRI.
Tomography, X-Ray Computed ; Middle Aged ; Male ; Hyperesthesia/*diagnosis/etiology ; Humans ; Hematoma, Epidural, Spinal/complications/*diagnosis/radiography ; Hemangioma, Cavernous, Central Nervous System/complications/*diagnosis/radiography ; Epidural Space/radiography ; Epidural Neoplasms/complications/*diagnosis/radiography ; Cervical Vertebrae

Pure epidural cavernous hemangioma of the spine without vertebral involvement is rare. Due to the slow growth of this lesion, the most common symptoms are chronic pain, myelopathy, and radiculopathy. In our case, the patient complained of an acute onset sensory deficit of the C4 dermatome. An MRI revealed an epidural mass with an acute hematoma. Here, we report a case of a pure epidural cavernous hemangioma that presented with acute neurologic symptoms caused by intralesional hemorrhage and an acute epidural hematoma, which were demonstrated on the patient's MRI.
Tomography, X-Ray Computed ; Middle Aged ; Male ; Hyperesthesia/*diagnosis/etiology ; Humans ; Hematoma, Epidural, Spinal/complications/*diagnosis/radiography ; Hemangioma, Cavernous, Central Nervous System/complications/*diagnosis/radiography ; Epidural Space/radiography ; Epidural Neoplasms/complications/*diagnosis/radiography ; Cervical Vertebrae

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 ; Adult ; Female ; Glasgow Coma Scale ; Hematoma, Subdural/mortality/pathology/radiography/*therapy ; Humans ; Male ; Time Factors ; Treatment Outcome

Superior mediastinal widening, as seen on chest radiographs of traumatized patients, has been considered the hallmark of mediastinal injury. The usual causes of superior mediastinal widening are rupture of the aorta, esophagus or trachea, and hematoma as a result of spinal fracture. Posterior dislocation of the sternoclavicular joint is rarely a cause. We report a case of superior mediastinal widening resulting from traumatic posterior dislocation of the stern-oclavicular joint, and describe the CT findings, including those of 3-D imaging.
Aorta ; Dislocations* ; Esophagus ; Hematoma ; Humans ; Imaging, Three-Dimensional ; Joints ; Radiography, Thoracic ; Rupture ; Spinal Fractures ; Sternoclavicular Joint* ; Trachea