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

Renal haemangiomas, an unusual cause of renal haematuria, are benign vascular dysplasias of uncertain etiology. Usually asymptomatic, their clinical manifestation is a unilateral renal haematuria associated or not to obstructive urological disease through accumulation of clots in the urinary tract and arterial hypertension when associated to a major arteriovenous shunt. Arteriographic diagnosis is based on the size of the vascular malformation but the absence of findings in the arteriography does not eliminate the presence of small-sized haemangiomas or microhaemangiomas responsible for the renal chronic haematuria, also labelled as "essential haematuria", which sometimes can be diagnosed through endoscopic examination of the renal cavities. This report presents one case of renal haemangioma which appeared as a massive, sudden haematuria and prompted haemodynamic instability requiring haemotherapy. Following arteriographic diagnosis, selective transarterial embolization was undertaken with three modified Gianturco's metal helicoids, to which the patient responded favourably. The report includes a review of the clinical, pathological, diagnostic and therapeutical features of renal haemangiomas.
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PMID:[Renal hemangiomas: a clinical case and review of the literature]. 163 65

Computed tomography (CT) allows earlier diagnosis of intracranial cavernous angioma than was formerly possible. However, cerebellar lesions are uncommon. Cerebellar cavernous angioma with hemorrhage was diagnosed in a 54-year-old male who suddenly developed nausea and vomiting, then declined over the following week and developed ataxia and nystagmus. Blood pressure was normal, and he had no history of hypertension or hemorrhagic diathesis. Precontrast CT revealed an irregularly-shaped, hyperdense lesion in the left cerebellum and an associated hematoma. Injection of contrast medium did not significantly enhance the lesion. Vertebral angiography demonstrated only an avascular mass in the cerebellum. A semiliquid hematoma was evacuated and a vascular nodule was removed from the posterior wall of the hematoma cavity. The histopathological diagnosis was cavernous angioma. Nine sufficiently documented reports of cerebellar cavernous angioma are reviewed and the clinical and radiological features of these lesions are discussed.
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PMID:Cavernous angioma of the cerebellum--case report. 247 64

Cerebral cavernous angioma is a rare vascular malformation at any age and is very rare in childhood. In the literature available to us, we have been able to trace only 50 cases, to which we have added the 6 cases from our own series. The incidence in pediatric group is higher at 0-2 years (26.8%) and at 13-16 years (35.7%). The clinical onset shows epilepsy in 45.4% of cases, hemorrhagic syndrome in 27.3%, intracranial hypertension in 16.4%, and focal neurological deficits in 10.9%. Furthermore, we discuss the neuroradiological features (CT, angiography, and MRI) and the therapy of pediatric cavernous angioma.
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PMID:Cerebral cavernous angioma in children. 267 61

Retinal arterial macroaneurysms represent a distinct clinical entity. Macroaneurysms are seen in the elderly with a marked female predominance and a strong association with hypertension and arteriosclerotic vascular changes. The classic appearance provides an easy diagnosis; however, variable presentations, such as subretinal hemorrhage, macular exudate, and epiretinal membranes can make the diagnosis difficult. The differential diagnosis of retinal arterial macroaneurysms include retinal telangiectasia, angiomatosis retinae, venous macroaneurysms, background diabetic retinopathy, and cavernous hemangioma. The clinical characteristics of the reported cases are summarized, and our series of 60 patients is presented. The natural history of most macroaneurysms is spontaneous involution without loss of vision. However, visual loss may occur secondary to macular edema, exudate, hemorrhage and neurosensory retinal detachment, and photocoagulation may expedite visual recovery. Photocoagulation treatment may be applied directly to the macroaneurysm, indirectly by surrounding the macroaneurysm, or as a combination of these two methods.
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PMID:Retinal arterial macroaneurysms. 305 91

A case of multiple spontaneous intracerebral hematomas is presented. A 67-year-old man with 7 years history of hypertension had sudden clumsiness in his right hand and an hour later dysarthria appeared. A CT scan taken 3 hours after the onset revealed two well demarcated high density areas in the left putamen and in the parietal subcortex. A diagnosis of multiple intracerebral hematomas was made. On neurological examination he was midly stuporous (13 points of Glasgow Coma Scale). Dysarthria, right hemiparesis and right extensor plantar response were seen. CT scan of 6 hours later disclosed the same findings as the previous study. He recovered well and neurologically free in a few days. On the following CT scans both hematomas were isodense 2 weeks later, and ring-like enhancement effect was noted. CT scan showed normal appearance 7 weeks later. On MRI using 0.5 T unit t-1 and t-2 weighted spin echo images of these hematomas also showed the similar chronological changes. The history, these CT and MRI studies suggest that two hematomas of this case occurred almost simultaneously in one cerebral hemisphere. No causative factors such as blood dyscrasias, AVM, angioma, septicemia, malignancies or sinus thrombosis was identified. We consider that a hypertensive intracerebral hematoma of the putamen was followed by the parietal intracerebral hematoma within a few hours, although amyloid angiopathy was not completely excluded because no cerebral biopsy of the lesion was performed.
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PMID:[A case report of simultaneous multiple intracerebral hematomas]. 338 86

Five cases of brain-stem hematoma are described. The cause of these hematomas was identified as "cryptic angioma" (1 cavernous angioma, 1 telangiectasia, 3 arteriovenous malformations). So, they are so-called "secondary hematoma", as opposed to brain-stem hematoma in relation with hypertension. Such secondary hematomas are reported in the literature: 37 operated on cases and 22 untreated cases were found. The clinical picture does not seem to be typical. The presentation appears to be either with the acute onset of a stroke, or with a subacute onset including relapsing symptoms. A progressive deterioration suggesting a pontine glioma or mimicking demyelination is not rare. The CT scanner appearance is often characteristic showing a high density area in the brain-stem which enhanced after injection of contrast medium with an aspect of "halo". Angiography is usually negative. The natural history of brain-stem hematoma due to rupture of a cryptic angioma is not well documented, but it seems that prognosis is very poor. So, the authors insist on surgical evacuation which is effective and safe allowing the diagnosis of brain-stem hematoma and in some cases the identification of the malformation.
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PMID:[Secondary hematoma of the brain stem. Apropos of 5 cases]. 376 36

The authors report on factors influencing the outcome after hemorrhagic strokes in infants, children, and adolescents over a period of 14 years. Their series comprised primary hemorrhage in 24 cases (46.2%), including 5 cases of vitamin K deficiency; arteriovenous malformation in 20 cases (38.5%); intracranial aneurysm and moya-moya disease in 3 cases (5.7%) each; and spinal angioma in 2 cases (3.9%). Ten of 52 patients with juvenile hemorrhagic strokes died despite surgical treatment. These fatal cases involved an intraparenchymal hematoma with ventricular casts, and unilateral hydrocephalus suggesting acute, uncontrollable intracranial hypertension. The "child's biologic plasticity" plays an important role in the favorable prognosis in infants, children, and adolescents with hemorrhagic strokes. On the contrary, cases with intraventricular hemorrhage due to any pathologic condition have an unfavorable prognosis.
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PMID:Hemorrhagic stroke in infancy, childhood, and adolescence. 376 53

8 cases of cavernous haemangiomas operated and histologically proven are presented. 5 patients (5/8) were admitted because of epileptic seizures, one patient (1/8) because of pure headache, another one because of a focal neurological defect and the last because of intracranial hypertension. Computed axial tomography is a sensitive procedure for detection of cavernomas. Of 7 cases examined by this technique, 7 (7/7) have shown a well circumscribed round or oval hyperdense nodule, with calcifications in 6/7 cases, a slight surrounding oedema in 3/7 cases and without mass effect, except if there is a visible hematoma at operation (2/8). After contrast administration, 5/7 malformations were enhanced and 2/7 displayed draining veins, a fact that we underline. The differential diagnosis includes a low grade calcified glioma, a thrombosed arterio-venous malformation, a venous angioma or an intracerebral hematoma. Surgical excision is the best treatment of these vascular malformations that bleed frequently, and improved all the patients in this series (8/8).
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PMID:[Intracerebral cavernous angiomas]. 408 98

Two cases of pheochromocytomas in multiple locations are described. In the first case, a 5-year-old girl had surgery for a pheochromocytoma that was nonsecreting but had obstructed the renal artery. Ten years later, hypertension recurred and 2 adrenal pheochromocytomas, one on the left and one on the right side, were discovered. In addition, a papillary angioma was present in the fundus of the right eye, which indicated a phacomatosis. The child was cured. In the second case, another 5-year-old girl had a secreting pheochromocytoma in the upper thoracic region. Six months after extirpation of the tumour, a second pheochromocytoma was found in the right adrenal gland. These findings indicate 4 points of interest: 1. The thoracic localization. This prompted a review of all the available literature with the conclusion that this form of tumour is extremely rare. 2. The association of a pheochromocytoma and renal arterial stenosis. This has been observed by a number of other authors as well. 3. The coincidence of a pheochromocytoma as part of a phacomatosis and pheochromocytomas associated with Sipple's syndrome. 4. The multiple tumour sites. The necessity of generalized examinations in patients with pheochromocytomas to determine the presence of a phacomatosis or Sipple's syndrome is apparent.
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PMID:Rare forms of pheochromocytoma in children. 613 68

The material includes 11 traumatic lesions of the kidney after needle biopsy, one hemangioma of the kidney with arteriovenous fistula and 4 renal exclusions for malignant hypertension. In traumatic lesions of the kidney after needle biopsy, embolization was followed by 90,9 p. cent excellent, permanent results without any marked loss of renal parenchyma and with simple post-operative follow-up. A hemangioma with congenital arteriovenous fistula required complex embolization owing to multiple pedicles and caused devascularisation of part of the lower pole of the kidney. The clinical result was satisfactory, but an arteriographic control carried out as a routine 3 months later after the embolization showed the development of newly formed vessels around the renal pelvis. However, no relapse of the hematuria occurred after a follow-up of 2 years. During the same period, spontaneous disappearance of 3 hemangiomas of the kidney sent up for embolization was noted, which led us to treat only hemangiomas which bled and prefer embolization in order to keep the kidney intact. In malignant hypertension, embolization proved efficacious and lasting in one case of small unilateral kidney. Carried out in two stages in one case of chronic nephritis with small kidneys, it proved efficacious on one side, insufficient on the other and had to be followed by nephrectomy. Finally, embolization of a remaining kidney due to chronic glomerulonephritis, technically incomplete, was followed by an uncontrollable attack of hypertension with later death of the patient. The blood supply of the kidney must thus be interrupted completely and embolization should not be undertaken unless it appears technically possible. The degree of pain following embolization suggests the possibility of peridural anesthesia.
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PMID:[Embolization of benign non tumoral diseases of the kidney (author's transl)]. 627 23


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