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

Thirteen of 394 (3.3%) regularly dialyzed patients of the Regional Kidney Disease Program developed subdural hematoma. The following factors contributed to formation of subdural hematoma: head trauma, ultrafiltration to control excessive accumulation of fluid and hypertension, anticoagulants, and frequent vascular access infection and clotting. Neurologic symptoms and signs, which may be similar to dialysis disequilibrium, aid only in signifying the presence, not the ultimate localization, of subdural hematoma. Our experience underscores the frequency of bilateral disease, irrespective of neurologic findings. Skull films, lumbar puncture, and electroencephalography were of little diagnostic help. Although valuable and safe, brain scanning was not as useful as desired due to occurrences of false-negative studies and failure to identify bilaterality of lesions. Cerebral angiography was always diagnostic. Surgical intervention yielded disappointing results, and only 2 patients (15%) survived. A review of 9 other patient reports is included.
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PMID:Subdural hematoma in regularly hemodialyzed patients. 109 74

Twenty-three extracranial carotid artery aneurysms were encountered in 19 patients. Arteriosclerosis was evident in 16 aneurysms. Severe arterial hypertension affected all patients with arteriosclerotic lesions. Trauma, penetrating neck injury once, and blunt neck injury three times caused four aneurysms. Three aneurysms resulted from earlier carotid artery operations. All 19 patients were symptomatic. Neurologic symptoms affected 13 individuals. Local symptoms referable to the aneurysmal mass troubled 15 patients. Twenty-one aneurysms were treated operatively. There was no operative mortality. Aneurysmectomy with arterial reconstruction was performed 16 times. Aneurysmorrhaphy was undertaken on four occasions and carotid ligation once. Two strokes and multiple cranial nerve injury accounted for three operative complications. No neurologic complications occurred during follow-up totaling 360 man-months. These lesions may be successfully treated by a carefully performed, properly selected operation.
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PMID:Aneurysms of extracranial carotid arteries. 125 72

The first known case of a "brown tumor" associated with secondary hyperparathyroidism causing paraplegia is described. A 69-year-old white woman with chronic renal failure due to hypertension was admitted for back pain, and while she was under observation, paraplegia developed. A complete block was demonstrated by myelography. Computed tomography confirmed a mass at the level of obstruction, and results of biopsy were consistent with "brown tumor." Neurologic symptoms were markedly improved with high-dose corticosteroids and a debulking procedure. This entity is important to recognize because prompt treatment of the hyperparathyroidism or decompression of the tumor mass by surgical means or corticosteroid administration can provide marked improvement in symptoms.
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PMID:Brown tumor in secondary hyperparathyroidism causing acute paraplegia. 375 52

A population based study was carried out over a 25-year period (1972-1997) to disclose the clinical and pathological features of aortic dissection based on the analysis of 79 (71 acute and 8 chronic) consecutive cases of disease observed in an defined population of 106,000 inhabitants. Of the 79 patients 65 (82.3%) were admitted to hospital and 14 (17.7%) died out of hospital. Their ages ranged from 36 to 97 years (mean, 65.4 yrs), 49 (62.0%) were men and 30 (38.0%) were women with means 61.2 and 69.1 years, respectively. The male/female ration was 1.6:1. All but two operated patients died. The pain was the leading symptom. Every patients had some kind of cardiovascular and respiratory signs. Neurologic symptoms occurred in 27/65 (41.5%) patients. In five patients the clinical picture of abdominal catastrophe and in two patients renal failure occurred. The major vessels were affected in 32/75 (42.7%) autopsies. Aortic rupture were seen in 64/79 (81.0%) cases. Five spontaneous healings were observed. The hypertension, the advantaged age and the arteriosclerosis are regarded as the mean predisposing factors.
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PMID:[Clinicopathology of aortic dissection]. 971 88