scholarly journals Spontaneous Hyphema from Iris Microhemangiomatosis in an Elderly Patient with Hypertensive Crisis

2020 ◽  
Vol 11 (1) ◽  
pp. 68-72
Author(s):  
Pedro J.  Nuova ◽  
Dinah Zur ◽  
Anat Loewenstein ◽  
Matias Iglicki

Background: Iris microhemangiomatosis is a rare vascular iris tumor, with potential severe complications such as increased intraocular pressure (IOP). We aim to describe a case report of a patient presenting with hyphema secondary to iris microhemangiomatosis triggered by excessive high blood pressure. Case Presentation: A 74-year-old woman was treated for hypertensive crisis. After her high blood pressure had been controlled and stabilized, she was discharged home. However, the same day, she complained about an acute decrease in vision in her left eye. Best corrected visual acuity was 20/20 on the right eye and 20/200 on the left eye. On biomicroscopy, a hyphema was seen. Iris neovascularization was absent, IOP and fundus examination were normal. After spontaneous resolution of the hyphema, a fluorescein angiography of the anterior segment was performed, which revealed bilateral subtle early hyperfluorescence with late staining scattered at the pupillary margin. The patient was diagnosed with iris microhemangiomatosis. During the follow-up of 24 months, the blood pressure was stable and well controlled. The patient did not experience any recurrent hemorrhage. Discussion and Conclusion: Spontaneous hyphema is the most common complication of iris vascular tumors. We report the occurrence of a spontaneous hyphema triggered by uncontrolled blood pressure in a patient with a very rare condition, i.e., iris microhemangiomatosis. In order to avoid complications of microhemangiomatosis such as uncontrolled glaucoma or recurrent bleeding requiring surgery, blood pressure should be monitored closely and controlled.

2019 ◽  
Vol 43 (1) ◽  
pp. 21-25
Author(s):  
Mohammed Senna Hassan

   Twenty Iraqi ducks hearts ( 10 male and 10 female ) have been  used for   demonstration  and illustration of heart's valves  and chambers  as well as  anatomical   and morphological site of view to explain what modifications had been take place for ducks heart  to perform  his normal life at the  circumstances  of  high  blood  pressure  and  pulse  rate. The heart  which has distinctly pointed  apex  was  built   in simple  manner located  in a transparent  taught  heart  pericardial  sac. It   was pyramidal in shape  externally  and  has a longitudinal  salcus  passing  to the  right  side, the  anterior of  the   heart  is  divided  into two  unequal  anterior  chamber  similar  to  those of mammalian  hear  .The heart valves are modified  in  order to  minimize  the  fraction  that occur as a result of  high  blood  pressure  and  pulse  rate  of  the  duck  heart , also  the  muscular  trabeculae   replace  the  chordate  tendineae  , which  were  present in the  mammalian    heart  in order to  minimize  the  fraction  resulting  from high  pulse  rate..    


2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Kaoutar Cherrabi ◽  
Hind Cherrabi

Abstract Background Otomastoiditis is a very frequent affection and a current complication of mal-treated benign ear infections in children. However, this a very rare case of the association of two rare complications of otomastoiditis in a newborn. On the one hand, septic arthritis of the temporomandibular joint which is a very rare condition that is difficult to diagnose, and when unrecognized or not treated accordingly, it can resolve in serious infectious complication and or definitive injury to the temporomandibular joint. On the other hand, osteomyelitis of the clavicle is also very rare, and only a few cases have been cited in the literature concerning infants. Case presentation This 46-day-old infant was brought to pediatric emergency consultation for 2 swelling inflammatory bulges, one in the right mastoid and pre-auricular regions, and another in the right basi-cervical area. The infant was hypertrophic febrile, hypotonic, and pale. He had preserved archaic reflexes. Besides, blood test showed an inflammatory syndrome, inflammatory anemia, and no other abnormalities. Upon supplementary computed tomodensitometry exam, the diagnosis of a combination of septic arthritis of the right temporomandibular joint and sub-periosteal abscess of the ipsilateral clavicle in a context of hypotrophy and malnutrition was suspected. A pus sample was obtained for bacteriological evaluation, after which the infant had a course of intravenous associated antibiotics, along with nutritional assessment and management. Surgical drainage of both collections was performed. The 6-month follow-up was satisfactory, without clinical signs of functional impact on temporomandibular joint, or acromioclavicular joint. Conclusion This work stresses the necessity of thorough clinical examination of infants even in cases of benign ear infections, as well as the importance of adapted treatment and follow-up, which could allow early diagnosis, appropriate treatment, or even prevention of severe complications that can be associated with such benign conditions.


2018 ◽  
Vol 02 (03) ◽  
pp. 201-204
Author(s):  
Ferdinand Chu ◽  
Ko Sit ◽  
King Kwok

AbstractIdiopathic bronchial pulmonary arterial malformation (BPAM) is a very rare condition. The authors present a case of BPAM in which a right bronchial artery communicates with a main upper lobe branch of the right pulmonary artery. It was successfully treated by embolization in one setting. The patient remained asymptomatic and well during the follow-up period. The authors therefore conclude that if the embolic material/device is carefully chosen, it is a safe and effective means of treating BPAM.


2016 ◽  
Vol 84 (1-2) ◽  
Author(s):  
Enrico Mossello ◽  
David Simoni

<p>High blood pressure and cognitive impairment often coexist in old age, but their pathophysiological association is complex. Several longitudinal studies have shown that high blood pressure at midlife is a risk factor for cognitive impairment and dementia, although this association is much less clear in old age. The effect of blood pressure lowering in reducing the risk of dementia is only borderline significant in clinical trials of older subjects, partly due to the insufficient follow-up time. Conversely, dementia onset is associated with a decrease of blood pressure values, probably secondary to neurodegeneration. Prognostic effect of blood pressure values in cognitively impaired older subjects is still unclear, with aggressive blood pressure lowering being potentially harmful in this patients category. Brief cognitive screening, coupled with simple motor assessment, are warranted to identify frail older subjects who need a more cautious approach to antihypertensive treatment. Values obtained with ambulatory blood pressure monitoring seem more useful than clinical ones to predict the outcome of cognitively impaired older subjects. Future studies should identify the most appropriate blood pressure targets in older subjects with cognitive impairment. </p><p><strong>Riassunto</strong></p><p>Ipertensione arteriosa e decadimento cognitivo spesso coesistono in età avanzata, sebbene la loro associazione sia complessa dal punto di vista fisiopatologico. Diversi studi longitudinali hanno mostrato che elevati valori pressori in età adulta rappresentano un fattore di rischio per decadimento cognitivo e demenza, sebbene tale associazione sia molto meno chiara in età avanzata. L’effetto della terapia antiipertensiva è risultato ai limiti della significatività statistica nel ridurre il rischio di demenza negli studi di intervento su soggetti anziani, in parte a causa della durata insufficiente del follow-up. D’altra parte, l’insorgenza di demenza è associata con una riduzione dei valori pressori, probabilmente secondaria alla neurodegenerazione. L’effetto prognostico dei valori pressori in anziani con decadimento cognitivo non è stato ancora chiarito, in presenza di un possibile effetto dannoso di un trattamento antiipertensivo aggressivo in questa categoria di pazienti. Un breve screening cognitivo, associato con una semplice valutazione motoria, è raccomandato per identificare gli anziani fragili, che necessitano di un approccio più cauto alla terapia antiipertensiva. I risultati del monitoraggio della pressione arteriosa nelle 24 ore sembrano più utili della misurazione clinica per predire la prognosi degli anziani cognitivamente compromessi. Studi futuri dovrebbero identificare gli obiettivi pressori più appropriati nel trattamento di anziani con decadimento cognitivo.</p>


Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4596-4596
Author(s):  
Matthew Richards ◽  
Kim Le ◽  
Mercedes Lorenzo-Medina ◽  
Langsjoen Dane ◽  
Carmen Arango ◽  
...  

Abstract Abstract 4596 Background: Localized Laryngeal Amyloidosis (LA) is a rare condition. There is limited understanding of its natural history. Our aim is to report the clinical evolution of a patient diagnosed with localized LA. Methods: Case report. Results: In May 2002, a 43-year-old gentleman presented with hoarseness and a CT scan of the neck showed a thickening of the right vocal cord with a mass that measured 2.9 × 1.2 cm in widest diameter. The patient had this mass removed surgically and the pathology showed a positive Congo red staining and a positive birefringence under polarized light, diagnostic of amyloidosis. No evidence of systemic amyloidosis or an overt B-cell lymphoma was found in this patient. Patient lost follow-up until October 2008 when he was found to have soft tissue induration around the left false vocal cord area. The biopsy showed again amyloidosis. Conclusions: LA recurrences can manifest several years after initial diagnosis. Long-term follow-up is essential. Disclosures: No relevant conflicts of interest to declare.


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