Fatal Outcome ; Humans ; Infant ; Intracranial Hemorrhages ; etiology ; Male ; Siblings ; Vitamin K Deficiency ; complications

Viper bite envenomation represents a significant occupational hazard among agricultural workers in India. The viper bite envenomation is usually suspected when a patient presents with predominant local symptoms at the bitten site, including pain, swelling, and necrosis. Further, systemic findings such as diffuse intravascular coagulation, hypotension, and shock may alert physicians of viper bite envenomation rather than a neurotoxic snake bite. However, cerebral complications are rare in viper bites but may potentially fatal. Central nervous system involvement in a viper bite is either due to neurotoxins or hemorrhagins present in the venom, which may induce cerebral thrombosis, ischemia, infarction, and hemorrhage. Here we present a case of a previously healthy adult male who succumbed to extensive subarachnoid, intracerebral, and intraventricular hemorrhages involving bilateral cerebral hemispheres following viper snake bite envenomation. This report highlights the importance of anticipating cerebral complications in viper bite envenomation, a rare occurrence. It also emphasizes the need for early antisnake venom administration to prevent and control systemic envenomation and its complications.
Adult ; Humans ; Male ; Snake Bites/complications* ; Hemorrhage/etiology* ; Intracranial Hemorrhages ; Shock ; India

Brain Stem/pathology* ; Death, Sudden/etiology* ; Fatal Outcome ; Humans ; Intracranial Hemorrhages/mortality* ; Leukemia/pathology*

Meningiomas causing intracranial hemorrhage are rare, and hemorrhage from a lateral ventricular meningioma seems to be even rarer. We report a case of trigonal meningioma in a 43-year-old woman who presented with intraventricular hemorrhage, and describe the CT, MRI and angiographic findings.
Adult ; Case Report ; Female ; Human ; Intracranial Hemorrhages/*etiology/radiography ; Lateral Ventricles/*radiography ; Meningeal Neoplasms/*complications/*radiography ; Meningioma/*complications/*radiography

Adolescent ; Adult ; China ; epidemiology ; Cholesterol ; blood ; Female ; Humans ; Intracranial Hemorrhages ; blood ; epidemiology ; etiology ; Logistic Models ; Male ; Risk Factors ; Triglycerides ; blood

OBJECTIVETo explore whether Val279Phe single nucleotide polymorphisms (SNPs) in the 9th exon of platelet-activating factor acetylhydrolase (PAF-AH) are associated with intracranial hemorrhage in preterm infants.

METHODSA case-control study was performed. Polymerase chain reaction (PCR) was used to test genotype and allele frequencies of the 9th exon Val279Phe SNPs of PAF-AH in 58 preterm infants with intracranial hemorrhage (hemorrhage group) and 65 preterm infants without intracranial hemorrhage (control group).

RESULTSThere were significant differences in genotype frequency of Val279Phe SNPs in the 9th exon of PAF-AH between the hemorrhage and control groups (P<0.05). Frequency of normal genotype in the hemorrhage group (63.8%) was significantly lower than in the control group (81.5%). In contrast, frequency of heterozygous genotype (34.5%) in the hemorrhage group was significantly higher than in control group (16.9%). There were also significant differences in allele frequency of Val279Phe SNPs in the 9th exon of PAF-AH between the two groups (P<0.05). T allele frequency in the hemorrhage group (19.0%) was significantly higher than in the control group (10.0%).

CONCLUSIONSVal279Phe SNPs in the 9th exon of PAF-AH may be associated with intracranial hemorrhage in preterm infants.

1-Alkyl-2-acetylglycerophosphocholine Esterase ; genetics ; Female ; Humans ; Infant, Newborn ; Infant, Premature ; Intracranial Hemorrhages ; etiology ; genetics ; Male ; Polymorphism, Single Nucleotide

Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Intracranial Hemorrhages ; etiology ; pathology ; Magnetic Resonance Imaging ; Prognosis ; Tomography, X-Ray Computed

OBJECTIVETo study the risk factors for intracranial hemorrhage in very low birth weight infants.

METHODSData from 169 very low birth weight (VLBW) infants (birth weight 1000-1500 g; gestational age 23-36 weeks) were studied retrospectively. Twenty-nine perinatal and postnatal factors were analyzed by Crosstabs Test with SPSS 12.0. A logistic regression analysis was used to identify the risk factors associated with the development of intracranial hemorrhage.

RESULTSMultivariate logistic analysis revealed that rupture of membranes (OR=0.146, 95%CI=0.22-0.964, P < 0.05), 1-minute Apgar score < or = 7 (OR=0.112, 95%CI=0.21-0.591, P < 0.01), pulmonary surfactant therapy (OR=0.110, 95%CI=0.24-0.504, P < 0.01), mechanical ventilation therapy (OR =0.076, 95%CI=0.009-0.668, P < 0.05), mechanical ventilation duration > 72 hrs(OR=0.053, 95%CI=0.007-0.410, P < 0.01), prothrombin time > 20 seconds (OR=4.186, 95%CI=1.606-10.923, P < 0.01), pH value on day 1 of life < 7.25 (OR=0.421, 95%CI=0.179-0.995, P < 0.05) and hyponatremia on day 1 (OR= 0.27, 95%CI=0.077-0.940, P < 0.05) or 2 (OR=2.480, 95%CI=1.053-5.838, P < 0.05) of life were risk factors for intracranial hemorrhage.

CONCLUSIONS1-minute Apgar score < or =7 and mechanical ventilation treatment were leading risk factors for intracranial hemorrhage, followed by abnormal coagulation and electrolytes related to perinatal asphyxia in VLBW infants. These findings can be used to improve the surveillance and prophylaxis measures in VLBW infants at high risk.

Female ; Humans ; Infant, Newborn ; Infant, Very Low Birth Weight ; Intracranial Hemorrhages ; etiology ; Logistic Models ; Male ; Risk Factors

OBJECTIVETo investigate the effect of premature rupture of membranes (PROM) on maternal infections and outcome of preterm infants.

METHODSA total of 441 preterm infants and 387 mothers were enrolled as subjects. According to the presence or absence of PROM, the mothers were divided into non-PROM group with 104 mothers, PROM duration <72 hours group with 90 mothers, and PROM duration ≥72 hours group with 193 mothers. The three groups were compared in terms of clinical features of mothers and infants and complications.

RESULTSCompared with the control group and the PROM duration <72 hours group, the PROM duration ≥72 hours group had significantly higher maternal age, incidence rate of umbilical vasculitis, and rate of antibiotic use; the PROM duration ≥72 hours group had a significantly higher incidence rate of moderate-to-severe chorioamnionitis than the control group (P<0.05), while there was no significant difference between the PROM duration ≥72 hours group and the PROM duration <72 hours group (P>0.05). Compared with the control group and the PROM duration <72 hours group, the PROM duration ≥72 hours group had significantly higher incidence rates of pneumonia and intracranial hemorrhage in preterm infants; the PROM duration ≥72 hours group had a significantly higher incidence rate of congenital infection and a significantly longer mean length of hospital stay compared with the control group (P<0.05), while there were no significant differences between the PROM duration ≥72 hours group and the PROM duration <72 hours group (P>0.05). The multivariate analysis showed that PROM duration ≥72 hours was an independent risk factors for pneumonia (OR=2.200, 95%CI: 1.386-3.492) and intracranial hemorrhage (OR=2.331, 95%CI: 1.420-3.827) in preterm infants.

CONCLUSIONSPROM duration ≥72 hours significantly increases the risk of placental infection in mothers and it is an independent risk factor for pneumonia and intracranial hemorrhage in preterm infants.

Adolescent ; Adult ; Chorioamnionitis ; etiology ; Female ; Fetal Membranes, Premature Rupture ; Humans ; Infant, Newborn ; Infant, Premature ; Intracranial Hemorrhages ; etiology ; Logistic Models ; Pregnancy ; Pregnancy Complications, Infectious ; etiology ; Time Factors ; Young Adult

A patient received combined spinal-epidural anesthesia for a scheduled total knee arthroplasty. After an injection of spinal anesthetic and ephedrine due to a decrease in blood pressure, the patient developed a severe headache. The patient did not respond to verbal command at the completion of the operation. A brain CT scan revealed massive subarachnoid and intraventricular hemorrhages, and a CT angiogram showed a ruptured aneurysm. Severe headaches should not be overlooked in an uncontrolled hypertensive patient during spinal anesthesia because it may imply an intracranial and intraventricular hemorrhage due to the rupture of a hidden aneurysm.
Aged ; Anesthesia, Epidural/*adverse effects ; Anesthesia, Spinal/*adverse effects ; Aneurysm, Ruptured/*chemically induced/*complications ; Cerebral Ventricles/*physiopathology ; Humans ; Intracranial Hemorrhages/*etiology ; Male ; Subarachnoid Hemorrhage/*etiology