ABSTRACT
Malignant hyperthermia is a hereditary trait characterized by hypercatabolic reactions induced by anesthetic drugs, or physical or emotional stress. Patients must be treated quickly and efficiently in order to prevent irreversible organ damage and death.
Subject(s)
Malignant Hyperthermia , Body Temperature , Dantrolene/therapeutic use , Humans , Malignant Hyperthermia/drug therapy , Malignant Hyperthermia/etiology , Malignant Hyperthermia/physiopathology , PrognosisABSTRACT
Spinal subdural hematoma (SSH) is an uncommon entity. There is a higher incidence among patients with a bleeding diathesis and among those with a bleeding diathesis having a lumbar puncture. The case reported here is of a 65-year-old woman on oral anticoagulants presenting with atypical symptoms who developed SSH over a six-hour period. Emergency investigation and treatment are required because recovery is inversely related to the length of time of spinal cord compression. A review of the literature revealed 37 previously reported cases of nonmajor traumatic SSH.
Subject(s)
Back Pain/etiology , Hematoma, Subdural/chemically induced , Spinal Cord Compression/etiology , Warfarin/adverse effects , Female , Hematoma, Subdural/complications , Humans , Middle Aged , Time FactorsABSTRACT
Although spinal subdural hematoma is a rare condition, it has a higher incidence in persons with a bleeding diathesis and in those with a bleeding diathesis who have had a lumbar puncture. We report a case of a 65-year-old woman on oral anticoagulants presenting with atypical symptoms who developed a spinal subdural hematoma over a six-hour period. This resulted in complete paraplegia of her lower extremities with no improvement after surgical spinal cord decompression.
Subject(s)
Hematoma, Subdural/complications , Spinal Cord Compression/etiology , Spinal Diseases/complications , Female , Hematoma, Subdural/diagnosis , Hematoma, Subdural/surgery , Hemorrhagic Disorders/complications , Humans , Laminectomy , Middle Aged , Paraplegia/etiology , Spinal Cord Compression/diagnosis , Spinal Cord Compression/surgery , Spinal Diseases/diagnosis , Spinal Diseases/surgery , Warfarin/adverse effectsABSTRACT
Pulsus paradoxus is a useful physical sign in the assessment of the severity of asthma in adults. Whether this is also true for asthmatic children was determined by measuring respiratory fluctuations in systolic blood pressure during attacks of asthma in 24 children. A decrease in systolic pressure during inspiration exceeding 15 mm Hg was found only when the 1-second forced expiratory volume was less tha 60 percent of the predicted value. There was a highly significant (P smaller than 0.001) correlation between the degree of pulsus paradoxus and the severity of airway obstruction. In nonasthmatic children the systolic pressure was found to fluctuate by as much as 7 mm Hg during the respiratory cycle. It is concluded that, as in adults, the presence of pulsus paradoxus (larger than or equal to 15 mm Hg) in children indicates that their asthma is very severe.
