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Query: UMLS:C0344329 (collapse)
 28,634 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Spontaneous bilateral carotid and vertebral artery dissections (CADs and VADs) are rare. A 29-year-old female presented with a collapse, 4 weeks after a sudden onset of severe neck and shoulder pain. CT scan revealed diffuse subarachnoid hemorrhage (SAH) and early hydrocephalus. Angiography revealed bilateral CADs and VADs, along with multiple fusiform and saccular aneurysms. Systemic vessels - including the renal arteries - were normal, and no risk factors or underlying vasculopathy were apparent. The presumed source of SAH (a posterior cerebral artery aneurysm) was successfully clipped. Each dissection, by contrast, was managed conservatively with heparin prophylaxis; and spontaneous CAD and VAD resolution occurred within 6 months. We present a unique case of four-vessel dissection associated with multiple disparate saccular and fusiform aneurysms. We suspect that underlying vasculopathy - perhaps novel - may become apparent with time.
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PMID:Spontaneous bilateral carotid and vertebral artery dissections associated with multiple disparate intracranial aneurysms, subarachnoid hemorrhage and spontaneous resolution. Case report and literature review. 1770 78

Eight dissections in four embalmed cadavers were performed to investigate the possibility of vascularized scapular grafting for osteonecrosis of the humeral head. When the angular branch was used as the nutrient vessel, the mean length of the vascular pedicle was 12.4 cm, which was sufficient for transferring the scapula into the humeral head. Based on the anatomical study, a 27-year-old man with corticosteroid-induced osteonecrosis of the right humeral head was treated by vascularized scapular grafting. The pedicled vascularized scapula was successfully transferred into the humeral head using the angular branch. The patient's right shoulder pain disappeared following surgical recovery. He had no limitations of right shoulder motion 3 years after the surgery. Magnetic resonance imaging at 1 year after the surgery indicated revascularization of the humeral head. The humeral head did not collapse during a 3-year follow-up with radiographic evaluation. This procedure has the potential to be a new joint-preserving procedure for osteonecrosis of the humeral head.
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PMID:Vascularized scapular grafting for treatment of osteonecrosis of the humeral head. 1892 68

During a dissection on a 103-year-old female cadaver, a bilateral spontaneous tenodesis of the long head of the biceps (LHB) with massive rotator cuff tear was discovered at the bicipital groove. Neer et al. have introduced the term of cuff-tear arthropathy to define severe disorganization of the glenohumeral joint with collapse of the humeral head that occurs following some massive tears of the rotator cuff, and we found this aspect during our dissection. The tendon of the LHB is a well-known source of shoulder pain, and the majority of degenerative changes in the LHB are associated with pathology of the rotator cuff. When there are complete rotator cuff tears and a rupture of the LHB, the ineluctable evolution of the shoulder is the ascension of the humeral head and the creation of a neoarticulation like in our case. This aspect is an acromial acetabulization as described roentgenographically by Hamada et al.
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PMID:Bilateral spontaneous tenodesis of the long head of the biceps at the bicipital groove with massive rotator cuff tear on a 103-year-old female cadaver: the natural evolution of the human shoulder? 2137 6

Pneumothorax (PTX) is the presence of an excessive amount of air between the two layers of the pleura. The clinical results depend on the extent of lung collapse. Bedside lung ultrasonography (BLUS) is a valuable way to diagnose PTX in the emergency department. The lung point is a pathognomonic sign of PTX. Here, we present a previously healthy 17-year-old male with left shoulder pain for 2 days, who was referred to the emergency department (ED). He had no history of trauma. BLUS was performed by the emergency physician. The lung point was detected with BLUS, and he was diagnosed with primary spontaneous PTX. Needle aspiration was performed. The patient was followed up with BLUS. Evidence of PTX was absent in BLUS after 6 h, and the patient was discharged for follow-up by a respiratory physician. In this case, the lung point in BLUS helped us make an accurate diagnosis of primary spontaneous PTX and invasive management of disease was arranged accordingly.
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PMID:Bedside ultrasonographic diagnosis of pneumothorax. 2524 80

Rapidly destructive arthritis (RDA) of the shoulder is a rare disease. Here, we report two cases, with different destruction patterns, which were most probably due to subchondral insufficiency fractures (SIFs). Case 1 involved a 77-year-old woman with right shoulder pain. Rapid destruction of both the humeral head and glenoid was seen within 1 month of the onset of shoulder pain. We diagnosed shoulder RDA and performed a hemiarthroplasty. Case 2 involved a 74-year-old woman with left shoulder pain. Humeral head collapse was seen within 5 months of pain onset, without glenoid destruction. Magnetic resonance imaging showed a bone marrow edema pattern with an associated subchondral low-intensity band, typical of SIF. Total shoulder arthroplasty was performed in this case. Shoulder RDA occurs as a result of SIF in elderly women; the progression of the joint destruction is more rapid in cases with SIFs of both the humeral head and the glenoid. Although shoulder RDA is rare, this disease should be included in the differential diagnosis of acute onset shoulder pain in elderly female patients with osteoporosis and persistent joint effusion.
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PMID:Rapid destruction of the humeral head caused by subchondral insufficiency fracture: a report of two cases. 2594 71

The bilateral shoulder pain of an 81-year-old Japanese woman due to falls persisted despite celecoxib treatment, and plain X-rays later showed bilateral collapsed humeral heads. After ruling out osteoarthritis, infectious arthritis, crystal-induced arthritis, neuropathic arthropathy, and osteonecrosis, we diagnosed bilateral shoulder joint rapidly destructive arthrosis (RDA). Lumbar bone mineral density showed very low T-score (-4.1). Primary osteoporosis was observed. Histology of biopsied humeral head indicated the features of fracture healing process: callus formation and osteoclasts without empty lacunae. Her history thus included an insufficiency fracture due to severe osteoporosis. Bilateral humeral head replacement was performed; her shoulder joint function improved. This case is extremely rare in that RDA was caused by simultaneous bilateral shoulder joint collapse within a very short time, with minimal or low mechanical stress and severe osteoporosis.
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PMID:Rapidly Destructive Arthrosis of Bilateral Humeral Heads Caused by Subchondral Insufficiency Fracture. 3036 11