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Simultaneous intrahepatic and subgaleal hemorrhage in antiphospholipid syndrome following anticoagulation therapy

World Journal of Gastroenterology 2013年第38期19卷 6494-6499页

作者： In-Chul Park Yang-Hyun Baek Sang-Young Han Sung-Wook Lee Won-Tae Chung Sung-Won Lee Sang-Hyeon Kang Duk-Song Cho Division of Gastroenterology and Hepatology Department of Internal MedicineCollege of MedicineDong-A University

Warfarin is a widely used *** differences in drug response,a narrow therapeutic range and the risk of bleeding render warfarin difficult to use *** 18-year-old woman with antiphospholipid syndrome received long-term warfarin therapy for a recurrent deep vein *** years later,she developed right flank *** diagnosed intrahepatic and subgaleal hemorrhages secondary to anticoagulation *** stopping oral anticoagulation,a follow-up computed tomography showed improvement in the *** restarting warfarin because of a recurrent thrombosis,the intrahepatic hemorrhage *** decided to start clopidogrel and hydroxychloroquine instead of *** patient has not developed further recurrent thrombotic or bleeding *** hemorrhage is a very rare complication of warfarin,and our patient experienced intrahepatic and subgaleal hemorrhage although she did not have any risk factors for bleeding or instability of the international normalized ratio control.

关键词： Warfarin Liver subgaleal Hemorrhage Antiphospholipid syndrome

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Management of Post-Craniotomy Persistent CSF subgaleal Collection in Skull Base Procedures: Local Experience

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Open Journal of Modern Neurosurgery 2020年第1期10卷 114-121页

作者： Hosam Shata Mahmoud Saad Ahmed Nageeb Taha Neurosurgery Department Mansoura University Mansoura Egypt

Background: Post-craniotomy CSF collection is a problem that may cause severe complications as meningitis, wound disruption, prolonged hospitalization, and additional surgeries. Objective: To evaluate our cases with resistant post-operative subgaleal CSF collection, trying to identify causes and optimal management. Methods: Retrospective review of elective skull base cases during the period of January 2104 to January 2019 identification of cases with post-operative CSF subgaleal collection, which either managed conservatively or needed a second surgery. Results: 219 patients, 30 of them suffered subgaleal CSF collection, 22 patients improved with non-operative measures, eight patients needed second surgery with pericranial graft augmentation, and obliteration of subgaleal space resulted in resolution of CSF leak with no morbidities. Conclusion: Meticulous tensionless dural closure, obliteration of subgaleal space, tethering of dural grafts to bone edges are useful techniques in preventing post-operative CSF leak.

关键词： subgaleal CSF Post-Operative Dural Repair Craniotomy

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Pott puffy tumor in an unusual location

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Open Journal of Pediatrics 2013年第2期3卷 147-150页

作者： Richard H. Schwartz Carla Zingariello Rebecca Levorson John S. Myseros Riva Kamat Theodore W. Fetter Department of Neurosciences Division of Neurosurgery Children’s National Medical Center Washington DC USA Department of Pediatrics Inova Fairfax Hospital for Children Falls Church USA Department of Surgery Section of Otolaryngology—Head-Neck Surgery Inova Fairfax Hospital for Children Falls Church USA

Pott puffy tumor is almost always associated with an outward extension of suppurative acute frontal sinusitis. Pathogenesis includes osteomyelitis of the frontal bone with local spread of the infection to the outer cortex and termination of the suppurative process in a frontal subgaleal abscess. An unusual ectopic location of Pott puffy tumor is the tempo-parietal subgaleal space, located exterior to the squamous portion of the temporal bone. In this location, Pott puffy tumor is considered a suppurative complication of otomastoiditis. Reported here is a 4-year-old boy who developed amoxicillin-resistant acute otitis media, silent mastoiditis, temporal bone subperiosteal abscess, subgaleal abscess, and an epidural abscess. He had several fenestra of the tegmen mastoideum as a result of osteiitis of the temporal bone, which we believe permitted spread of the oto-mastoiditis to temporal bone, subgaleal space, and epidural space. Surgical specimens obtained from the middle ear and subgaleal abscess after 24-hours of intravenously-administered combination antibiotic therapy did not reveal any aerobic or anaerobic bacterial pathogens. This is only the second such pediatric case that we found during a careful search of the literature.

关键词： Pott Puffy Tumor Epidural Abscess subgaleal Abscess

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