Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A rare case of repeated intracerebral hematoma associated with an intracerebral fibrosarcoma is reported. A 43-year-old man was referred to our clinic with headache and vomiting of sudden onset. On admission, he was lethargic. CT revealed a huge intracerebral hematoma in the left temporal lobe with midline shift. Angiography failed to demonstrate any evidence of an intracranial tumor. An operation was performed under the diagnosis of an idiopathic cerebral hematoma. The postoperative course was uneventful and he was discharged without any deficits except for a left upper quadrant homonymous hemianopia. Four and a half months after the first operation, he was readmitted to our clinic with the same symptoms as he had at the first admission. Neuroradiological examination again revealed an intracerebral hematoma in the left temporal lobe. At operation, a pinkish-gray discolored mass at the hematoma wall was found. An intraoperative histological examination of the mass indicated a malignant tumor and the tumor was totally removed. However the patient did not recover from the severe neurological deficits and died 3 months after the second surgery. Histological examinations of the tumor demonstrated a typical fibrosarcoma. Intracerebral primary fibrosarcoma with hemorrhage is quite rare. In such a case with a large hematoma, the presence of a tumor may be obscured on CT scan and angiography. Detailed observation of the hematoma wall using an operating microscope should be performed to allow a correct diagnosis.
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PMID:[A case of primary fibrosarcoma caused by spontaneous intracerebral hematoma]. 185 59

Tissue plasminogen activator (t-PA) is expected to be used for cisternal drainage in subarachnoidal hemorrhage, for dissolving of the residual hematoma after stereotactic evacuation of a cerebral hematoma, and for regional intraarterial injection therapy for occlusion of the primary cerebral artery. This is because the drug exerts a very potent and immediate dissolving-effect on a hematoma when it is locally administered. However, the solubility of t-PA is rapidly decreased at pH 5 or more. At pH 7 or more, precipitation of crystals is observed when the concentration of t-PA exceeds 20 x 10(4) IU/ml. The pH of the t-PA general-purpose solution (for intravenous injection) is adjusted at 4.6 to 4.8 because of its solubility and stability, and the osmotic pressure is also increased with an increase in concentration of t-PA. When the concentration of t-PA is 750 x 10(4) IU/ml, the osmotic ratio is 30 and the pH is 4.82. These features suggest that a locally administered t-PA solution at high concentration may induce meningeal irritation leading to headache and vomiting, and exacerbation of symptomatic cerebral vasospasm when it is used for cisternal drainage. Furthermore, the t-PA solution administered intraarterially at high concentration may induce adverse effects such as dessiocyte and echinocyte deformation of erythrocytes and the sludging phenomenon of leukocytes in the cerebral microcirculation, and a sensation of fever and pain upon injection. Therefore, the dose and method of administration of the t-PA for local intracranial use should be determined by taking into consideration its pH and osmotic pressure.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Intracranial administration of tissue plasminogen activator and its important factors involved concerning the pH and osmotic pressure]. 194 89

Reports of intracerebral hemorrhage (ICH) in patients with hemophilia B are relatively rare. We describe the first clinical results of the use of a monoclonal antibody purified factor IX (FIX) concentrate (Mononine) after an ICH and the long-term outcome of prophylaxis with this product to prevent recurrences. A 44-year-old male with severe hemophilia B was referred to our department because of nausea, vomiting, left lower limb hemiplegia, and left arm paresis. Computed tomography (CT) revealed a right frontal intraparenchymal bleed. The patient was treated with replacement therapy with FIX for 40 days. Computed tomography scans performed on day 40 after the event showed complete disappearance of the cerebral hematoma from the parenchymal tissue. Subsequently, the patient received 25.6 IU/kg(-1) of FIX twice a week. At the 48-month follow-up visit, no more major or minor bleeding events had occurred. Long-term prophylaxis after ICH is recommended.
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PMID:Outcome of long-term prophylaxis after cerebral hemorrhage in a patient with severe hemophilia B. 2107 18