Subject(s)
Humans , Male , Adult , Pulmonary Alveoli , Marijuana Smoking/adverse effects , HemorrhageABSTRACT
Selective arterial embolization (SAE) of the uterine arteries is an alternative to surgery when medical management fails in cases of intractable posrtpartum haemorrhage. It is highly efficacious with low complication rate. Here we report a case of repeated broad ligament haematoma managed by selective uterine artery embolization. Present case 28year old P4L4 was referred from a district hospital as post LSCS case with broad ligament haematoma. Patients general condition was very poor at the time of admission. She underwent laparotomy twice and finally uterine artery embolization for repeated broad ligament haematoma and responded. Massive obstetric haemorrhage remains a significant cause of maternal morbidity and mortality. The threshold for uterine artery embolization (UAE) in women with obstetric haemorrhage should be low, as it is coupled with a high clinical effectiveness rate, low complication rate and preservation of fertility. However, it requires an infrastructure, multidisciplinary approach, as well as speedy and effective interaction between various specialties.
ABSTRACT
Background: Lissencephaly is a rare developmental disorder characterized by absence of cerebral convolutions.Pachygyria (broad gyri) or agyria (no gyri) are terms used to describe appearance of cerebral surface. Togetherthese associated conditions are a part of congenital cortical malformations and may result due to arrest ofbrain development before third or fourth month of gestation. Patients suffering from these conditions presentswith significant developmental delays which further depends on the degree of malformation. Results: We reporta case of bilateral symmetrical extensive lissencephaly with pachygyria. The major MRI findings during evaluationof our case were smooth gyral pattern with thickened cortex, thinning of periventricular white matter andprominent VR (Ventricular) spaces.Conclusion: These defects can be idiopathic, associated with chromosomal abnormalities LIS 1 (chromosome 17)or can be to environmental factors (prenatal drugs or intrauterine perfusion failures). In our case Chromosome17 defect was suspected as the parieto-occipital regions were more involved.
ABSTRACT
Background: The circle of Willis is a large arterial anastomotic ring present at the base of the brain uniting the internal carotid and the vertebrobasilar systems. Branches from the internal carotid and vertebral arteries anastomose to form an arterial circle in the basal cisterns and then distribute to supply the brain. The anatomy of the circle is known to vary significantly; the vessels may be absent or sufficiently narrowed altering the hemodynamics of the circle of Willis and affecting its role as a collateral route. These variant forms can be correlated to their phylogeny and embryology. Prior knowledge of these variant forms is important in pathologies and treatment (e.g. parent artery occlusion for carotid aneurysms) resulting occlusion of carotid and vertebral arteries. Context and purpose: Our study was undertaken to observe and compare the morphology of circle of Willis using two entirely different methods; gross dissection (GD) and Magnetic resonance angiography (MRA) and to correlate the variant patterns encountered with the possible underlying developmental events. Gross dissection was carried out in 70 human cadavers and equal numbers of MRA’s of healthy individuals were studied retrospectively. Results: Only 31 cases (22.14%) presented with a complete circle of Willis, out of which 14 (20%) were cadaveric specimen and 17 (24.18%) were in MRA group. Unilateral hypoplastic posterior communicating artery was the most common variation observed in our study (19.28%). Conclusions: The wide variation in completeness of the circle of Willis in general population is similar to earlier observations. Review of phylogeny and embryology makes us familiar with variant forms which would be otherwise difficult to recognize and may be misinterpreted. MRA and gross dissection findings despite certain variations are comparable.