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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of intracerebral hemorrhage and characteristic angiographic changes associated with methamphetamine is reported. A 23-year-old woman suddenly complained of headache, nausea, vomiting and gait disturbance several minutes after intravenous injection of 30 mg of methamphetamine. She was admitted with consciousness disturbance, aphasia and right hemiparesis 26 hours after the onset. CT scan revealed subcortical hemorrhage in the left fronto-parietal region. Left carotid angiogram showed irregular segmental arterial narrowing, "beading" of the anterior and middle cerebral arteries. Emergency craniotomy was performed and a left fronto-parietal hematoma was removed totally. Histologically, the surgical specimen showed many vessels in which included thrombi with perivascular hemorrhage. Post-operative course was uneventful. Repeat carotid angiogram 4 months after the operation revealed normal anterior and middle cerebral arteries. We discussed about associations between the abuse of methamphetamine and the occurrence of intracranial hemorrhage and characteristic angiographic changes. As far as we know, there were 23 reports in an extensive review of the literature on intracranial hemorrhage associated with methamphetamine abuse. In the present case "beading" of the intracranial vessels may be related to angiitis induced by methamphetamine. Both the presence of arterial inflammation and increased blood pressure caused by sympathomimetic action of methamphetamine are probably the important factors in the occurrence of intracranial hemorrhage associated with methamphetamine.
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PMID:[Intracerebral hemorrhage and characteristic angiographic changes associated with methamphetamine--a case report]. 379 Mar 61

A 32-year-old healthy man developed vomiting, blurred vision, and consciousness disturbance following cervical manipulation. Physical examination showed stuporous consciousness and spontaneous horizontal nystagmus. Computed tomography (CT) and magnetic resonance (MR) imaging of the brain revealed infarction in the territory of the basilar artery. Studies of MR angiography and vertebral angiography disclosed dissection of the right vertebral artery at the atlantoaxial segment. Antiedematous drugs were prescribed and the patient gradually improved. Neurologic examination six months later demonstrated mild cerebellar ataxia. Physicians and patients should be aware that vertebro-basilar dissection may follow cervical manipulation, and, more importantly, should attempt to prevent progressive infarction.
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PMID:Vertebral artery dissection complicated by cervical manipulation: a case report. 763 91

Stroke was the leading cause of death in Taiwan for 19 years (1963-1981). About 60% of the hospitalized patients dying of stroke suffered from cerebral hemorrhage (CH). This fact denotes an important role of CH in causing fatal stroke. The widely use of computed tomography (CT) in Taiwan in the past decade enables clear differentiation between CH and cerebral infarction (CI). In Taiwan, the ratio of CH: CI is 1:1.5, which is 3.5 times higher than that of the Western countries. CH is most prevalent between aged 55 and 65 years; the male to female ratio after adjusted to that of general population is around 1.1:1. Hypertension is the most important risk factor (86.7%) and spontaneous CH is, therefore, often referred to as "hypertensive CH". CH has a predilection to occur in the putamen (41%), thalamus (23%), putaminothalamus (9.7%), subcortical white mater (9.3%), brainstem (6.5%), and cerebellum (5.9%). Motor dysfunction (80%) is the most frequent clinical manifestation, followed by disturbance of consciousness (50%), and language problems (31.1%). In addition to motor and consciousness disturbance, vomiting (30.8%) and headache (27%) are among important initial presentations, especially for cerebellar and intraventricular hemorrhage. For patients with stable condition after CH, medical treatment is the mainstay of therapy. If condition deteriorates during medical treatment, surgical intervention may be considered for patients with cerebellar, lobar, or putaminal hemorrhage. In Taiwan, 11.6% of patients with CH receive surgical treatment. The mortality rate one month after CH was 53.7% before the CT era; it has decreased to 23.3% in recent years.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Cerebral hemorrhage in Taiwan]. 791 73

The neuropaediatric emergency can be considered according to 1. The primary symptom, single or combined or 2. The diagnosed disease as a whole. Primary combined symptoms are: 1. Disturbance of Consciousness, fever, emesis, skin bleeding (inflammation). 2. Disturbance of consciousness, emesis, normal temperature, stretched fontanel (brain pressure). 3. Disturbance of consciousness, seizure disorder, normal temperature (epileptic fit). 4. Disturbance of consciousness, seizure disorder, fever (febrile seizure). 5. Disturbance of consciousness, bruise marks, normal temperature, accident (skull-cerebral trauma) Procedure used by the physician: 1. Avoidance of additional sequelae (aspiration, injury). 2. Protection of vital functions. 3. Ascertainment of causes. 4. Creating an intravenous access. 5. Drug therapy. 6. If necessary, intubation and respiration. 7. Transport to hospital
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PMID:[Neuropediatric emergency]. 811 63

A case of a large empty sella was reported, which was intrasellar herniation of the third ventricle associated with a prolactinoma. The patient was a 46-year-old female admitted due to consciousness disturbance with pyrexia and vomiting. She had amenorrhea, galactorrhea and sterility in her past history. On admission, physical and neurological examinations revealed severe dehydration, systemic edema, systemic hypotension, nuchal rigidity, papilloedema and goiter. A spinal tap was performed and revealed an increase in CSF pressure. Laboratory data indicated CSF lymphocytosis, an increase in CSF protein content, high titers of serum microsome test, a low concentration of anterior pituitary hormones in serum except for PRL, and an unusually high concentration of PRL in serum and CSF (4680 and 222ng/ml, respectively). Plain films of the skull showed destructive enlargement of the sella turcica. The patient was diagnosed as having non-bacterial meningitis, chronic thyroiditis and a prolactinoma with hypopituitarism and was then admitted to our department. Except for amenorrhea she was asymptomatic under the administration of levothyroxine, hydrocortisone and bromocriptine. CT scan, MRI, pneumoencephalography and CT cisternography as further examinations disclosed the intrasellar herniation of cisterns and the third ventricle, which were surrounded by an intrasellar parenchymal layer. This layer was thought to be still viable prolactinoma tissue. We supposed the third ventricle entered the enlarged sellar cavity following the spontaneous degeneration of the large prolactinoma. Although we could find some documented reports of similar cases, the complete herniation of the third ventricle secondary to degeneration of an adenoma might be rare.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Empty sella as an intrasellar herniation of the third ventricle secondary to spontaneous degeneration of a prolactinoma]. 813 65

We report a case of multiphasic disseminated encephalomyelitis (MDEM) following viral illness presenting as multiple sclerosis (MS) in a 7-year-old boy. The patients had two episodes of alternating hemiparesis and other neurologic symptoms following viral infection, which were separated by 3 years. Neuroimaging studies demonstrated multiple, discrete, small nodules and large globular lesions in the cerebral white matter, basal ganglia, brainstem and cerebellar areas. Based on typical appearance of magnetic resonance imaging (MRI) and clinical manifestations including systemic symptoms such as fever, nausea, vomiting, headache and seizures followed by consciousness disturbance and other multifocal neurologic signs, the diagnosis of MDEM rather than that of MS was made. Because it is difficult to differentiate between MDEM and MS on the basis of the clinical history, the cerebrospinal fluid examination and evoked potential studies, this report emphasizes that the MRI study of the brain may provide an important clue for the diagnosis.
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PMID:Multiphasic disseminated encephalomyelitis mimicking multiple sclerosis. 889 Dec 39

Pericarditis is a frequent and serious complication of chronic uremia. The uremic pericarditis can get much improvement by aggressive heparin-free hemodialysis therapy. However, the presenting symptoms and signs are too nonspecific to identify at early stage. Cardiac tamponade is the late and fatal complication, and need the immediate & adequate management. A 35-year-old female patient suffered from nausea, vomiting and right upper quadrant dull pain in November 1993, and was admitted to a local hospital. Uremia (BUN: 210 mg/dl, serum Cr.: 13.2 mg/dl) and abnormal liver function (SGOT: 330 IU/L, SGPT: 449 IU/L) were found, then she received regular hemodialysis therapy. About 10 days later, acute exacerbation of liver function (SGOT: 2,488 IU/L, SGPT: 1,048 IU/L), consciousness disturbance and hypotension occurred during hemodialysis. She was referred to our ER immediately. At ER, she had been on comatous, shock state with pulseless electric activity. After resuscitation and serial evaluation, cardiac tamponade was diagnosed. Emergent pericardiocentesis and then bilateral partial pericardiectomy were done about 2 hours later. The pericardial effusion was bloody without evidence of malignancy, bacterial or TB infection. The pathology of pericardium revealed chronic inflammation only. HBsAg, Anti-HCV Ab, and anti-HAV IgM were undetectable. So the etiology of acute hepatitis was diagnosed as ischemic hepatitis. Her general condition and vital sign became stable thereafter. The liver function also improved rapidly. She was discharged one month later and received maintainance hemodialysis therapy and no evidence of recurrence till now.
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PMID:[Acute uremic pericarditis presented as cardiac tamponade with acute ischemic hepatitis: a case report]. 904 74

A 6-month-old girl was admitted to another hospital because of consciousness disturbance, preceded by 2 weeks of decreased activity and vomiting. She was referred to our hospital after ventricular drainage had been instituted for hydrocephalus and the tumor in the pineal region. The patient was noted to have conjugate upward gaze palsy and papilledema. CT scan and MRI revealed a large tumor in the pineal region with tumoral hemorrhage and a small mass in the right frontal lobe. At surgery, the pineal region tumor was removed subtotally. Histological examination showed the tumor to be composed of sheets of large polyhedra or round cells with an eccentric round nuclei, prominent nucleoli, and cytoplasmic inclusions. Immunohistochemical studies were positive for GFAP, vimentin, S-100, CK, EMA, and SMA, but negative for AFP, HCG, PLAP, and CEA. Following surgery, she received three 5-day cycles of chemotherapy, consisting of intravenous administration of cisplatin 20 mg/m2/day and etoposide 60mg/m2/day. After these therapies, MRI showed a decrease in the area of high intensity in the pineal region, but almost no change in the right frontal mass lesion. Follow-up radiological examination showed that the tumor had grown rapidly one month after chemotherapy and the patient died 5 months after her first hospitalization. Malignant rhabdoid tumor of the CNS is rare and remarkably malignant. This tumor should be treated using multidisciplinary management with surgery, intensive chemotherapy, and radiotherapy depending on the patient's age.
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PMID:[A case of malignant rhabdoid tumor in the pineal region in early infancy]. 930 Apr 49

To evaluate the antiemetic effect of the epidural administration of droperidol on cisplatin-induced emesis, nine adult gastric cancer patients receiving intraoperative cisplatin chemotherapy were studied. After removal of the stomach, 0.05 mg/kg droperidol with 5 ml saline was injected into the epidural space through the epidural catheter. Thirty minutes later, 60 mg/m2 cisplatin was administered intravenously over 1h. Subsequently, the same dose of droperidol was also injected epidurally every 6 h for 18 h. Postoperatively, the antiemetic effect was evaluated until 30 h after the first epidural droperidol. As a result, all patients expressed almost complete antiemesis until 25 h. After 26 h, some patients complained of mild emesis. No potential side effects, such as hypotension, consciousness disturbance, and extrapyramidal signs, were noticed. Therefore, the present pilot study implies that a sole epidural administration of droperidol remarkably suppresses cisplatin-induced emesis.
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PMID:Epidural administration of droperidol suppresses cisplatin-induced emesis: preliminary findings. 952 20

We experienced a patient with panhypopituitarism which occurred following extensive brainstem and cerebellar infarction due to dissection of basilar artery (BAD). Panhypopituitarism followed by BAD has not yet been reported in the literature. The patient was a 67-years-old man who was admitted to our hospital because of a sudden onset of consciousness disturbance and vomiting. On the day of admission, he was drowsy and had left IIIrd nerve palsy, skew deviation, occular bobbing, and left hemiparesis. His neurological state was rapidly deteriorated, and fell almost into apneic state, requiring artificial ventilation for a week. Cerebral angiography demonstrated a double lumen sign of the basilar artery confirming the diagnosis of dissection. There were extensive hypodensities in the brainstem and bilateral cerebellar hemispheres on CT. On day 20, he suddenly became shocked following infection. Even after the effective and successful treatment of infection, severe hypotension continued that required administration of chatecholamine agents. Laboratory examinations revealed that he had panhypopituitarism. Supplement therapy with adrenocortical hormones made his circulatory state improved, and could finally be stopped on day 100. In the present case, subclinical hypopituitarism was considered to occur mainly from compression of the pituitary stalk and hypothalamus by the enlarged BAD. Increased intracranial pressure and upward herniation may also have made the pituitary function worse, and the infection finally triggered the adrenal crisis. The BAD occurs more frequently than previously considered, and should be kept in mind as a cause of secondary panhypopituitarism.
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PMID:[Panhypopituitarism following basilar artery dissection with extensive brainstem and cerebellar infarction: a case report]. 961 74


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