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

A 9-week-old infant manifested continuous vomiting for 1 week accompanied by a tense fontanel, "sun setting" of the eyes, frequent opisthotonos, and hypertonicity. The head circumference was at the 50th percentile. Computerized tomography (CT) revealed acute hydrocephalus and a posterior fossa subdural hematoma. The brain stem and cerebellum were of greater density (54 Hounsfield units) than normal cerebral white matter (42 Hounsfield units) whereas the subdural hematoma was the same density as normal cerebral white matter ("isodense"). The cerebellum and brain stem became enhanced by contrast (68 Hounsfield units), but no enhancement occurred in the cerebral white matter or subdural hematoma. A shunt followed by occipital craniectomy resolved both the hydrocephalus and subdural hematoma. Repeat CT scan 15 days postoperatively disclosed continuing higher density of the cerebellum and brain stem (60 Hounsfield units) relative to cerebral white matter. Increased density of the infantile cerebellum has been noted previously but not to the same extent as in this patient.
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PMID:Infantile chronic subdural hematoma of the posterior fossa diagnosed by computerized tomography. Case report. 92 50

One hundred female patients scheduled for elective breast surgery (mean age 60 +/- 11 years were randomly assigned to receive one of two premedications: ketobemidone (Ketogan) 1-1.5 ml or midazolam 4-5 mg, intramuscularly. The effects on preoperative anxiety and postoperative emetic sequelae were studied. All patients were anaesthetised with thiopentone, fentanyl and atracurium, and ventilated with a mixture of nitrous oxide in oxygen with supplementary isoflurane. Sixty-nine percent of the midazolam- and 50% of the ketobemidone-premedicated patients experienced a reduction in anxiety. Midazolam was found to be more effective than ketobemidone in reducing anxiety among more tense patients--those with a VAS grading before premedication of 2 or more (P less than 0.05). Midazolam-premedicated patients were also assessed by observers as being more relaxed (P less than 0.05). No difference was seen in the frequency of emetic sequelae: 20 patients in the midazolam group and 14 patients in the ketobemidone group vomited once or more during the 24-h observation period. There was no difference between the two groups in time until an analgetic was required. In conclusion, midazolam seemed more effective in reducing preoperative anxiety than ketobemidone without any negative effects on postoperative emesis or time until an analgetic was required.
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PMID:Premedication before elective breast surgery, a comparison between ketobemidone and midazolam. 168 Feb 66

This report describes two cases of intrauterine volvulus without associated intestinal malrotation. Polyhydramnios was present in one neonate; the presentation was very sudden and catastrophic in the other. Neither plain films nor contrast enema indicated the correct preoperative diagnosis in these infants. A "normal" plain film or enema in a suspected case of volvulus may lead to a delay in surgical management resulting in extensive ischemic necrosis of the bowel, often with extremely high mortality. Bile emesis or aspirate in neonates demands a high index of suspicion of intestinal obstruction. Shock, bloody diarrhea, and tense and distended abdomen are ominous, indicating volvulus often with gangrene.
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PMID:Intrauterine volvulus without malrotation. 176 23

Cases of penicillin-resistant pneumococcal meningitis have been reported in other countries since 1977, but never before reported in Taiwan. In 1990, two cases of the disease were diagnosed here. Case one was a two-year-old boy who had had fever and vomiting for several days prior to admission. Under the impression of meningitis, a spinal tap was done. The CSF yielded pneumococcus, which was misinterpreted as sensitive to penicillin. Penicillin (400,000 units/kg/day) was given parenterally without effect. On the 12th day after admission, another spinal tap still yielded pneumococcus. This time the sensitivity test was reread with great care, and then reported to be penicillin-resistant pneumococcus. Minimal inhibitory concentration (MIC) of penicillin was performed simultaneously and it revealed 0.1 microgram/ml. Vancomycin (60 mg/kg/day) was substituted for penicillin. The patient became afebrile two days later, and was discharged ten days later without sequelae. Case two, a five-month-old girl, was diagnosed to have meningitis because of fever, vomiting, tense fontanel and seizure on admission. After a spinal tap was done, she was put on ampicillin and cefotaxime. The fever subsided two days later. At that time, the CSF was reported to grow pneumococcus, again misread as sensitive to penicillin. The antibiotics was switched to penicillin, but fever recurred. The second spinal tap still yielded pneumococcus which was sensitive to penicillin but resitstant to oxacillin. Based on experience with the first case, penicillin was changed to vancomycin, and performed MIC immediately. The MIC was 1.0 microgram/ml. The patient became afebrile two days later, and was discharged in good condition after ten days of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Penicillin-resistant pneumococcal meningitis: report of two cases]. 177 62

Four mature infants developed intracranial haemorrhage at ages from ten hours to five weeks. No predisposing or provoking factors could be demonstrated. The symptoms were apnoea, vomiting, pyrexia, irritability, tremor, hypertonicity, seizures and tense fontanelle. The diagnosis was established by ultrasound scanning and confirmed by computed tomographic scanning. The infants developed hydrocephalus requiring treatment. During the period of observation, these infants showed normal psychomotor development and the neurological findings were normal.
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PMID:[Intracranial hemorrhage in mature infants without predisposing factors]. 218 Jan 63

The clinical features of 107 cases of children with hydrocephalus and measured raised intraventricular pressure were analysed retrospectively. Fifty one children had recently been diagnosed as having hydrocephalus, and the remainder had had shunts injected to direct the cerebrospinal fluid. The most common symptoms in the group were vomiting, behavioural changes, drowsiness, and headaches. The most common clinical signs were inappropriately increasing occipitofrontal head circumferences, tense anterior fontanelles, splayed sutures, and distension of the scalp veins. Half the infantile cases of hydrocephalus were without symptoms, and a quarter of the cases with cerebrospinal fluid shunts and measured raised intraventricular pressure were without signs. There were no fewer than 33 different clinical signs including several unusual ones, such as macular rash and sweating. We believe that the presentation of hydrocephalus with raised intraventricular pressure is sufficiently variable, unusual, or even absent to justify the direct measurement of intracranial pressure.
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PMID:Symptoms and signs of progressive hydrocephalus. 292 62

A case of cerebellar ganglioglioma is reported. A 22-year-old female was admitted to the Kurume University Hospital on August 19, 1985, suffering from headache, vomiting and gait disturbance. On admission, neurological examination revealed staggering gait and the right cerebellar ataxia showing dysmetria and dysdiadochokinesis. Mild choked disc in the right fundus was also noted. Plain CT scan showed the low-density area involving the right cerebellar hemisphere and the part of the vermis with internal hydrocephalus. Enhanced CT scan showed the high-density area adjacent to the low-density area suggesting a mural nodule. A vertebral angiogram in the arterial phase showed an expansive lesion in the posterior fossa and the tumor stain, which was also visualized in the venous phase. An emergency suboccipital craniectomy was then performed. With opening the tense dura mater, the cyst formation was noted and 30 ml of xanthochromic fluid was then aspirated. A well demarcated mural nodule was noted in the lateral wall of the cyst. The nodule was then extirpated in toto. The hypertrophy of the cerebellar cortex was not observed. Histologically, the tumor was consisted of nerve fiber, glial fiber and neuronal cells. Its architecture was differed distinctly from that of hamartomatous diffuse hypertrophy of the cerebellar cortex (Lhermitte-Duclos' disease). Immunohistochemically, the neuronal cells revealed positive staining for NSE and S-100, and the glial cells displayed positive staining for GFAP, S-100. The authors reviewed previously reported eleven cases of cerebellar ganglioglioma including the present case. These results showed that cerebellar gangliogliomas have some characteristic clinical features among general intracranial gangliogliomas.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Cerebellar ganglioglioma: a case report]. 304 1

Extraneural metastasis of intracranial ependymoma is a rare pathological entity. Thirty one case reports were traced in the review of the literature and we record one of them. The patient was a 19-year-old male in good health until January 1981 when he was admitted to our hospital with deteriorating mental status. Admission work-up revealed bilateral papilledema, 1-hemiparesis and increased intracranial pressure signs including vomiting. CT scan demonstrated significant abnormality of enhanced mass lesion in the r-temporo-parietal area in which a displacement of the midline structure to the left occurred. R-temporo-parietal craniotomy was performed on the admission day. The globular tumor mass occupied the temporo-parietal area and invaded the cortex. Subtotal resection of the tumor and temporal lobectomy was performed. Microscopic examination of the operative specimen revealed a typical ependymoma pattern. For the next two years, he received operations twice, irradiation (total 14, 170 rads) and various chemotherapy. Two months after the fourth craniectomy, examination revealed scalp overlying the burr opening to be very tense and enlarging as if invaded by the tumor. A large mass occupied the right lateral cervical area and chest X-ray disclosed complete opacity on the right. He gradually developed severe cough and sputum and died two months later on January 1, 1984. At autopsy, the result was that tumor had invaded the subarachnoidal space and subcutaneous area. Extraneural metastases were found to be bronchial lymph nodes, C-4 vertebra, r-cervical lymph node. The histological appearance of these tumors obtained at autopsy was identical to the cerebral tumor.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Extraneural metastases of malignant ependymoma inducing atelectasis and superior vena cava syndrome--a case report and review of the literature]. 395 64

Analysis of 116 cases of subdural haematoma and effusion in infancy showed that in 40% trauma was involved and in 5% meningitis was an aetiological factor; in the remainder there was no known antecedent disease. Apart from retinal or subhyaloid haemorrhages there were no clinical features pathognomonic of the condition, though vomiting was the commonest presenting symptom and a tense fontanelle the commonest finding on examination. Treatment by subdural pleural shunt operation, which allows the fluid to drain into the chest, where it is absorbed, was found to be effective, and there is no longer any justification for the older method of removal of the subdural membrane by craniotomy.
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PMID:Subdural haematoma and effusion in infancy. 566 18

Posttraumatic arteriovenous fistulas affecting the superior mesenteric artery and vein are extremely rare. Twenty-four cases of posttraumatic superior mesenteric arteriovenous fistulas (SMAVFs) have been reported. We presented two cases of SMAVFs occurring in a young woman and man secondary to a gunshot and a grenade shrapnel wound in the epigastrium, respectively. Nausea, heartburn, emesis, and cramping abdominal pain were the clinical signs of SMAVF. Abdominal pains, particularly after meals, tense and meteoristic abdomen, frequent liquid bowel movements, oliguria, subfebrility, abdominal thrill, and bruit were also present. Abdominal duplex ultrasonic scanning and computed tomograms with a contrast agent were especially useful screening tools. As our results demonstrated, those methods were not only suitable for clinical use, but were also as good as arteriography in defining both the exact location and the extent of the mesenteric vessel involvement. However, the superior mesenteric arteriogram remains mandatory for complete preoperative evaluation. Arteriovenous fistulas were successfully treated by suturing the arterial and venous sides of the fistula in one case, and resectioning the fistula and end-to-end anastomosis in the other case.
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PMID:Advances in diagnostics and successful repair of proximal posttraumatic superior mesenteric arteriovenous fistula. 786 58


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