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Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report two cases of spontaneous epidural hematoma associated with the hemorrhagic diathesis and the paranasal sinusitis. Case 1: A 31-year-old man with a history of subtotal gastrectomy because of gastric cancer. He complained of headache at left temporal region, but CT scan showed no abnormal finding. After about 12 hours, he was found in comatose state. Emergency CT scan showed left epidural hematoma. He had the thrombocytemia and hemorrhagic diathesis which were supposed to be the side effect of the chemotherapy or DIC. Although the epidural hematoma was removed at emergency, he died 5 days after the operation, because of severe brain swelling. Case 2: A 34-year-old woman with a history of paranasal sinusitis. At 3 weeks after her fourth delivery, she had a headache and a right orbital swelling. She was admitted to the otorhinolaryngologist under the diagnosis of the acute paranasal sinusitis and orbital phlegmone. After admission, the level of consciousness became worse, she was given neurosurgical consultation. Angiogram showed right temporal mass lesion. At operation, the epidural hematoma was found and evacuated. She was discharged without any neurological deficits.
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PMID:[Spontaneous epidural hematoma--report of two cases]. 408 48

The authors report three cases of jaundice which developed during pregnancy and which rapidly resulted in the death of the patients. One case was a fulminant case of cytomegalovirus hepatitis and the other two were cases of acute steatosis of pregnancy. The clinical features are marked by the rapid development of a neurological syndrome resulting in coma and the association of blood dyscrasias due to major hepato-cellular failure resulting in DIC. The rapid progression of the disease generally results in the death of the mother and the child. However, there are some reports of survival with total cure after rapid extraction of the foetus, which justify an active therapeutic attitude.
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PMID:[Severe jaundice with fatal outcome in pregnancy]. 609 54

Intensive care unit patients are a group with an increased risk for the development of septicemia. The combination of illness (trauma, burn, surgery, metabolic coma etc.) and iatrogenic factors (foreign bodies, ventilation, drugs etc.) make them more susceptible to severe infections. Rapid diagnosis of septicemia is important, since the prognosis is dependent on rapid treatment. Sedation and ventilation may mask the primary symptoms of septicemia, and in these cases the condition is not diagnosed until signs of complications (shock, disseminated intravascular coagulation, multiple organ failure) appear. Aside from clinical observation and laboratory results, hemodynamic symptoms may be indicative of septicemia. In the presence of septic signs, blood, tracheal secretion, urine etc. must be cultivated without delay, before starting empirical treatment. Surveillance cultures may make for more appropriate initial treatment, though they pose the problem of differentiation between colonization and infection.
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PMID:[Infection in intensive care medicine: predisposition, pathogenesis and diagnosis]. 638 99

Described is the clinical course of a 26-year-old woman who died following an overdose of the MAO inhibitor phenelzine. Signs and symptoms of toxicity were delayed in onset. Initial findings of excessive neuromuscular activity were followed by severe hyperthermia, coma, cardiovascular collapse, acute renal failure, hemolysis, rhabdomyolysis, and disseminated intravascular coagulation. A review of the literature suggests that these features are not unusual following MAO inhibitor overdosage. The pathophysiology and management of MAO inhibitor poisoning are discussed.
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PMID:Monoamine oxidase inhibitor overdose. 639 5

A 29 year-old Japanese woman with hyperemesis gravidarum became comatose and died. The autopsy revealed a typical case of Wernicke's encephalopathy complicated by disseminated intravascular coagulation (DIC). Repeated vomiting and parenteral nutrition without vitamins led to Wernicke's encephalopathy and a spontaneous abortion 24 h before death triggered the induction of DIC.
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PMID:Wernicke's encephalopathy in early pregnancy complicated by disseminated intravascular coagulation. 641 34

Forty children with severe head injury were studies retrospectively. All were admitted to the medical center within 6 hours after injury. Seventeen had Glasgow Coma Scales of 3 to 4 and 23 scales of 5 to 7. Computerised tomography (CT) findings and coagulation abnormalities in the first 12 and intracranial pressure (ICP) in the first 24 hours after injury were examined in relation to the final result. Compressed basal cisterns in CT, presence of moderate to severe consumption coagulopathy (CC) and moderate to severe intracranial hypertension (ICP greater than 20 mmHg) all correlated significantly with fatal outcome. In contrast, survivors usually had patent basal cisterns on CT, normal coagulation data or only moderate CC and slight to rarely moderate intracranial hypertension. It is concluded that by using the proposed criteria, early assessment of severity and prediction of outcome after severe paediatric head injury is possible. In contrast to the Glasgow Coma Scale these criteria are applicable and retain predictive power also in children who receive early and intensive ICP-lowering therapy.
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PMID:Early prediction of outcome after severe head injury in children. 643 99

A brief survey of disseminated intravascular coagulation (DIC) is presented, with clinical, paraclinical and pathologoanatomical characteristic. The difficulties in making the diagnosis at the clinic are stressed upon, authors' observations on one male subject, admitted to the clinic with multiple extensive subcutaneous hemorrhages are reported, that were followed by successive pareses of the lower and upper limbed. The case had a lethal end with manifestations of pulmonary edema and cerebral coma on the base of the disseminated intravascular coagulation. The diagnosis was made, while still living, by skin biopsy and later at necropsy--confirmed thrombus in the lungs, heart, kidneys and brain.
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PMID:[Description of disseminated intravascular coagulation in a case diagnosed intravitally]. 667 87

In acute liver failure there is often evidence of consumption coagulopathy in addition to interference with the synthesis of coagulation enzymes. Seven patients in hepatic coma (Grade IV-V) were treated by baboon liver perfusion bypass. Replacement therapy with antithrombin III (AT-III) proved useful in the management of the consumption coagulopathy. In the course of further work antithrombin III replacement therapy was given to 13 patients with acute liver failure at an early stage, before they could lapse into deep coma. Six patients with a Colombi index (the sum of Factors II, V and VII) below 75% - an unfavourable prognostic sign - survived the episode of acute liver failure. Early replacement with antithrombin III can be used to treat the coagulation abnormalities which occur during acute liver failure and should gain time for liver cell regeneration to take place.
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PMID:Early treatment with AT III in acute liver failure. 667 86

Twenty-four children (aged 3 months to 14 years) with severe head injuries were treated by means of invasive neurointensive care for normalizing intracranial pressure (ICP) involving hyperventilation, control of body temperature, dexamethasone, barbiturates and continuous intracranial and arterial pressure monitoring. The Glasgow Coma Scale before initiation of treatment was 3-4 in 8, 5-6 in 9 and 7 in 7 patients. Moderately to severely elevated ICP was observed in 20 patients. Seven developed acute and subacute space occupying intracranial hematomas. Nineteen children (79%) survived, most often with good recovery and 5 (21%) died. Severely elevated ICP, presence of severe consumption coagulopathy and loss of components in brain auditory evoked potentials were significantly more frequent in the fatal group. We conclude that the prognosis of the severely head injured child can be improved by prompt resuscitation and aggressive neurointensive care but probably not, however, to the extent postulated in recent literature.
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PMID:Treatment and outcome of the severely head injured child. 683 23

Five cases of intracranial hematoma secondary to chronic disseminated intravascular coagulation syndrome (DIC) were reported. Intracranial hematomas included a case of acute subdural hematoma combined with intracerebral hematoma and 4 cases of acute or subacute hematoma. Primary diseases which caused DIC were cancer; a case of carcinoma of choledochus and 4 cases of gastric carcinoma. All cases were in the advanced stage of carcinoma or at least, had metastasis to other organs. They showed coagulation disorders, such as, the reduction of platelets and the hemorrhagic diastasis, which were referred as chronic DIC, before the onset of intracranial hematoma. After the onset of intracranial hematoma, their coagulation disorders got worse and were diagnosed as acute DIC. They showed the rising of FDP, reduction of the serum fibrinogen and platelets and others. The blood transfusion and the trivial head injury were considered a triggers of exacervation from chronic DIC to acute DIC, that is, from compensated DIC to decompensated DIC. The long-term administration of anticancer drugs might play a part of the role as triggers. Initial symptoms of intracranial hematoma were headache in 4 case and dullness in a case. Three cases immediately lapsed into coma after 1 to 2 hours from the onset. Two cases turned out coma state after 4 to 5 days from the onset. Evacuations of hematoma were performed in 3 cases but they gave rise to rebleeding of intracranial hematomas later. All of 5 cases including surgically and non-surgically treated cases died at last. It is certain that DIC is rather common in the advanced stage of cancer. Matsuda reported that DIC existed in 20% of died patients with cancer. Though the incidence of intracranial hematoma secondary to DIC were less than that of cerebral infarct, it is no reasonable to assume that the actual number of the intracranial hematoma secondary to chronic DIC is rare.
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PMID:[Intracranial hematoma secondary to chronic DIC (author's transl)]. 709 72


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