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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Successful embolisation of an arteriovenous angioma of the kidney with gel foam suspension is described, with a two year follow-up. Embolisation cured hypertension, which had otherwise resisted treatment, and stopped haematuria. The need for careful follow-up is stressed with long-term observations using both angiography and scintigraphy of the affected kidney. The intra-arterial embolisation with gel foam resulted in a redistribution of blood-flow which led to complete success of treatment even thought the vascular malformation had not been totally obliterated.
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PMID:[Arterio-venous angioma of the kidney: embolisation and two year follow-up (author's transl)]. 15 93

Angiomas of the kidney are benign vascular dysplasias, which usually can be identified angiographically. If there are no clinical symptoms treatment is not necessary. In cases of hematuria and/or hypertension either intra-arterial superselective embolization seems to cause less functional loss of the renal parenchyma, whereas excision often leads to heminephrectomy or even total nephrectomy. Even if the angioma is initially not completely embolized followup study to 2 years has shown complete occlusion of the angioma, either owing to inflammatory reactions or redistribution of blood flow and diminished blood pressure. Two cases of renal angiomas are presented. Treatment consisted of intra-arterial superselective embolization in 1 case and surgical clipping of the supplying arterial branch in the other.
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PMID:Treatment of arteriovenous angiomas of the kidney: surgical intervention and intra-arterial embolization. 51 33

Spontaneous intracerebral haemorrhages are dealt with on the basis of a great number of clinical and neuropathological cases. They amounted to 4.9 per cent of the patients admitted to the hospital and 5.2 per cent of the autopsies. In two thirds hypertension was found about 20 per cent were ruptured aneurysms. In 3 per cent of the respective autopsies no cause was found. The clinical courses are dealt with in greater detail. Eighty per cent of the hypertensive haemorrhages are located in the cerebral hemisphere; among these, 60 to 80 per cent show ventricular perforations. This percentage is still higher in thalamus--brain stem haemorrhages. Two theories on the aetiology are discussed. Traumatic haemorrhages are especially dealt with in connection with late apoplexy. Deformations of the cerebral vessels, too, are described in detail. Among the aneurysms, 82 per cent belong to the circulus willisi. Angiomas were found in 15.2 per cent of the autopsies in case of cerebral haemorrhages, but in 58 per cent of the surgically treated intracerebral haemorrhages. These figures are higher than those given in the relevant literature. Among 1600 cerebral tumours, there were 2.2 per cent massive cerebral haemorrhages. The cases are compiled in a table.
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PMID:Pathology of intracerebral hemorrhage. 57 54

A case of renovascular hypertension caused by a dissecting aneurysm of the main right renal artery owing to a subadventitial angioma is described. The right kidney was not functioning but, nevertheless, an aortorenal bypass was done and function of the kidney was recovered. Although the hypertension was controlled for 6 months it recurred. A nephrectomy was performed and the hypertension was cured.
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PMID:Dissecting aneurysm of renal artery owing to subadventitial angioma. 63 92

The aetiopathogenesis, clinical picture, diagnosis and treatment of pulmonary arteriovenous fistula are examined in the light of a case observed at the Florence University Surgery Clinic in 1970 and marked by multiple truncular fistulae at the middle and inferior lobes of the right lung. The condition is seen as an instance of congenital angiodysplasia with arteriovenous shunt. A clear distinction is drawn between true fistulae, as seen in the reported case, and angioma and aneurysm. Stress is laid on the importance of radical management, though it is conceded that surgery should occasionally be renounced in the absence of symptoms, or where lung hypertension is particularly marked.
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PMID:[Pulmonary arteriovenous fistula within the picture of congenital angiodysplasias. Clinical case]. 100 97

Due to the rapid evolution of vascular lesions it is not surprising that most causes of sudden death of cerebral origin are due to vascular pathology. Of the traumatic causes extradural haemorrhage is a fairly common clinical entity but as a cause of death declining in its frequency. Sources of diagnostic error can be attributed to the fact that not all patients with extradural haematomas have marked external evidence of trauma and a significant number, particularly children and adolescents, show no radiological, clinical or for that matter, post-mortem evidence of a fracture. Subdural haematomas of a chronic variety are usually produced by minor trauma and occur predominantly in the older person. Acute subdural haematomas are most frequently the result of trauma and may be rapidly fatal due to the associated massive cerebral damage. That intracranial aneurysm or angioma may rupture into the subdural space and cause an acute or chronic subdural haematoma, is less widely appreciated. The acute spontaneous arterial subdural haematoma due to the rupture of a cortical vessel, usually one affected by atheroma, into the subdural space is an uncommon entity. It should be looked for specifically in patients with minimal trauma and the clinical picture of an acute subdural haematoma. Subarachnoid haemorrhage due to aneurysmal rupture is still the common cause of unexpected rapid demise in young adults. There is very little evidence that antecedent trauma or exertion play a part as precipitating factors. Centrally placed aneurysms situated at the anterior communicating artery origin or terminal carotid seem to be particularly malignant in their effects. Cause of death is usually massive extrusion of blood into the intracranial cavity with increasing intracranial pressure, compressive haematoma formation and widespread arterial spasm with ischaemic consequences. Whether aneurysmal rupture can be caused by trauma cannot really be satisfactorily resolved. Intracerebral haemorrhage is most commonly due to hypertension but, as in the case of other haematomas, bleeding disorders may also be a cause. Intracerebral haematoma may, however, also result from rupture of micro-angiomata and the brain should be carefully examined for them in the young patient without evidence of hypertension. Hypertensive crises occurring in people on monoamine oxidase inhibitors should also be remembered as a cause of intracerebral haemorrhage.
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PMID:Unexpected natural death of cerebral origin in medicolegal practice. 113 58

Conclusions drawn from the post-mortem examination of 226 subjects who died of cerebral haemorrhage are presented. There were slightly more women than men (53%) in the series. Arterial hypertension (68%) was the main cause of death, while renal disease, leukaemia, angioma of the pons, and embolism due to bacterial endocarditis were also observed. The most frequently noted sites are listed. Since cerebral haemorrhage follows the rupture of one or more already damaged deep arteries, as assessment was made of the part played by vascular lesions. 13 cases due to leukaemia and 35 to rupture of aneurysms of the polygon of Willis were discarded. In only 20 cases out of 138 in which convincing microscopic evidence of the vascular situation could be obtained was there an absence of significant alterations. The remaining cases consisted of serious hyalinosis (56%), fibrinoid necrosis (13%), and siderocalciosis (12%). An account is also given of the special pathogenetic conditions applicable to cerebral haemorrhage associated wtih serious gastrointestinal haemorrhage or recent myocardial infarct.
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PMID:[Pathogenesis of cerebral hemorrhage considered in the light of objective lesions in the arteries of the brain (in 226 cases studied by autopsy)]. 119 33

The angiographic findings in 13 patients with renal hemangiomas (one pararenal) are presented. The material suggests, contrary to earlier reports, a predominance for the female sex and the right kidney. Nine of the patients had macroscopic hematuria, of which five had renal colic. Obstruction was found at urography in seven cases. Renal angiography is the definitive diagnostic procedure and should be performed in all cases of unexplained macroscopic hematuria. Diagnosis may eventually be improved by pharmacoangiography or by hemodynamic studies using a dye dilution technique, as small arteriovenous shunts may remain undetected at angiography. Cardiac decompensation was not noted in our material, even though arteriovenous shunting within the hemangioma was seen in eight cases, suggesting that the shunt flow in renal hemangiomas usually does not reach levels high enough to impair the general circulation. Hypertension was present in only one patient, attributed to chronic pyelonephritis. Hematuria disappeared in all nine patients operated upon.
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PMID:Renal hemangiomas. An analysis of 13 cases diagnosed by angiography. 121 8

In a 20 year period, from 1971 through 1991, 105 chromaffin tumours--excluding cervical ones--were operated by the same surgeon: 50 during the first 15 years and 55 during the last 5 years. Pheochromocytomas are defined as intra-adrenal chromaffin tumours, and paragangliomas--or ectopic pheochromocytomas--as of extra-adrenal location. Among those tumours, 30 were malignant (i.e. metastatic) and 75 benign. Among the 30 malignant tumours, 14 were ectopic, 2 occurred in a MEN II A setting and were bilateral, 2 were associated with liver adenoma and liver hemangioma respectively suggesting Von Hippel-Lindau syndrome, and one case was associated with a seemingly sporadic primary hyperparathyroidism. 9 out of those 30 malignancies were not associated with hypertension. Among 75 benign pheochromocytomas or paragangliomas, 10 were ectopic, 7 occurred in a MEN setting (6 type II, 1 type I). 3 patients without evidence of MEN or other neuroectodermal abnormalities presented bilateral pheochromocytoma, either synchronous (2) or metachronous (1). 7 cases occurred in a Von Hippel-Lindau syndrome (3 bilateral) and 4 in a neurofibromatosis setting (1 bilateral). 3 other cases were familial without evidence of MEN (including a case of triple tumour: bilateral and ectopic and another ectopic case). 2 other cases were associated with seemingly sporadic hyperparathyroidism. As a whole, in 34 of 75 benign pheochromocytomas or paragangliomas, the tumour was not intra-adrenal, unilateral and sporadic. Among those 75 tumours, 22 were not overtly hypertensive, including 10 out of the 41 seemingly intra-adrenal, solitary and sporadic. The pheochromocytoma, benign, intra-adrenal sporadic, hypertensive accounts for no more than 30% of the subphrenic catecholamine-secretin chromaffin tumours.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Can pheochromocytoma be considered a benign unilateral intra-adrenal sporadic hypertensive tumor ? Reflections on a series of 105 surgically treated subdiaphragmatic chromaffin tumors]. 134 86

Experience with a continuous-pressure controlled, external ventricular drainage system (EVD) in 100 patients (n = 49 female, n = 51 male; mean age, 56.3 yr) with acute hydrocephalus is reported. Cerebrospinal fluid circulation disturbances resulted from hemorrhages caused by subarachnoid hemorrhage (n = 45), parenchymal hemorrhages from angioma (n = 4), anticoagulants (n = 7), or hypertension or other reasons (n = 30); in addition, hydrocephalus developed from infections (n = 3), tumors (n = 2), infratentorial infarction (n = 5), or unknown reasons (n = 4); 52 patients had ventricular hemorrhages. No patient died of system-associated morbidity. Mean time of EVD treatment was 9.5 days, with 40 patients being treated for 10 to 29 days; routine refobacin (5 mg) flushing of the system was performed three times a day. Patients without cerebrospinal fluid leakage had a 2% rate of secondary infection compared with 13% in patients with cerebrospinal fluid leakage due to ventricular catheter placement (P < 0.05; overall infection rate, 5%). A clinical mortality rate of 29% during EVD treatment was observed in subarachnoid hemorrhage patients (Hunt and Hess Grades II, III, IV, and V; n = 9, 9, 18, and 9, respectively); recurrent hemorrhages during EVD treatment occurred in 19 patients (26 hemorrhages), and of these, 10 patients died. System occlusion was seen in 19 cases (12 of 45 patients with subarachnoid hemorrhage), requiring catheter and system renewal in 1 case; system extraction was seen in 3 cases, misplacement was seen in 11 cases, and disconnection was seen in 5 cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Continuous-pressure controlled, external ventricular drainage for treatment of acute hydrocephalus--evaluation of risk factors. 143 14


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