MyMedR

Fulltext Spontaneous intramural oesophageal haematoma: a case report

Seneviratne SA, Kumara DS, Drahaman A

Med J Malaysia, 2012 Oct;67(5):536-7.

Spontaneous intramural oesophageal haematoma is a rare disease and presents with the classic triad of symptoms of chest pain, dysphagia and haematemesis. Flexible oesophagoscopy and contrast enhanced CT scan is helpful in the diagnosis and also to exclude other sinister pathologies. Most are managed conservatively and the patient we report also was managed conservatively with a successful outcome.

Matched MeSH terms: Hematoma*

Fulltext Neuropsychiatric manifestations of acute-on-chronic subdural hematoma in a lady with learning disability: a case report

Chua, S.Y., Seed, H.F., Yeoh, C.M., Thong, K.S.

Malaysian Journal of Psychiatry, 2016;25(1):0-0.

MyJurnal

Chronic subdural hematoma manifests differently and may mimic the
presentation of psychiatric illnesses. Many a time, physicians are quick to
judge that new onset of psychiatric symptoms is due to the worsening of the
existing psychiatric illness. We reported a case of a lady with learning
disability presenting with neuropsychiatric symptoms who was found to have
an acute-on-chronic subdural hematoma. We discussed regarding the new
onset of neuropsychiatric features seen in patients with chronic subdural
hematoma and its management.

Matched MeSH terms: Hematoma; Hematoma, Subdural, Chronic

Fulltext Predictors and Outcomes of Neurological Deterioration in Intracerebral Hemorrhage: Results from the TICH-2 Randomized Controlled Trial

Law ZK, Dineen R, England TJ, Cala L, Mistri AK, Appleton JP, et al.

Transl Stroke Res, 2021 Apr;12(2):275-283.

PMID: 32902808 DOI: 10.1007/s12975-020-00845-6

Neurological deterioration is common after intracerebral hemorrhage (ICH). We aimed to identify the predictors and effects of neurological deterioration and whether tranexamic acid reduced the risk of neurological deterioration. Data from the Tranexamic acid in IntraCerebral Hemorrhage-2 (TICH-2) randomized controlled trial were analyzed. Neurological deterioration was defined as an increase in National Institutes of Health Stroke Scale (NIHSS) of ≥ 4 or a decline in Glasgow Coma Scale of ≥ 2. Neurological deterioration was considered to be early if it started ≤ 48 h and late if commenced between 48 h and 7 days after onset. Logistic regression was used to identify predictors and effects of neurological deterioration and the effect of tranexamic acid on neurological deterioration. Of 2325 patients, 735 (31.7%) had neurological deterioration: 590 (80.3%) occurred early and 145 (19.7%) late. Predictors of early neurological deterioration included recruitment from the UK, previous ICH, higher admission systolic blood pressure, higher NIHSS, shorter onset-to-CT time, larger baseline hematoma, intraventricular hemorrhage, subarachnoid extension and antiplatelet therapy. Older age, male sex, higher NIHSS, previous ICH and larger baseline hematoma predicted late neurological deterioration. Neurological deterioration was independently associated with a modified Rankin Scale of > 3 (aOR 4.98, 3.70-6.70; p hematoma size, intraventricular and subarachnoid extension increased the risk of neurological deterioration. Neurological deterioration increased the risk of death and dependency at day 90. Tranexamic acid reduced the risk of early neurological deterioration and warrants further investigation in ICH. URL: https://www.isrctn.com Unique identifier: ISRCTN93732214.

Matched MeSH terms: Hematoma/etiology

Spontaneous retroperitoneal haematoma in severe dengue: A case report

Ab Rahman SS, Nik Mazian A, Samad SZ

Trop Med Int Health, 2023 Nov;28(11):864-868.

PMID: 37778744 DOI: 10.1111/tmi.13936

Dengue is endemic in over 100 countries worldwide, predominantly in the subtropical and tropical regions and the incidence has been increasing globally. Patients with severe dengue may develop massive bleeding, disseminated intravascular coagulopathy and multi-organ failure. Bleeding may occur in various body cavities and muscles; however, bleeding in the retroperitoneal space is uncommon. We report a case of a 37-year-old gentleman who presented with a 4-day history of fever associated with chills and rigours. On Day 6 of illness, he complained of left lumbar and left iliac fossa pain which was aggravated by movement. A computed tomography angiography scan of the abdomen showed the presence of a retroperitoneal haematoma, left iliopsoas and quadratus lumbarum intramuscular haematoma with active bleeding and left abdominal wall muscles haematoma. His condition gradually improved after multiple blood transfusions and he gained full recovery. Spontaneous retroperitoneal haematoma is an uncommon complication of severe dengue infection. Early diagnosis based on high index of clinical suspicion using appropriate imaging will aid in prompt management of these cases and may prevent deaths.

Matched MeSH terms: Hematoma/complications; Hematoma/etiology

Rectus sheath haematoma

Salleh HB

Med J Malaysia, 1975 Jun;29(4):311-4.

PMID: 127923

Matched MeSH terms: Hematoma/diagnosis*

Fulltext Recurrent Nasal Septal Hematoma and Abscess: A Rare Manifestation of Leukemia

Hong CX, Husain S, Wan Hamizan AK, Zahedi FD

Clin Med Res, 2021 Mar;19(1):35-38.

PMID: 33582646 DOI: 10.3121/cmr.2020.1552

Nasal septal abscess and hematoma are rare clinical entities. To the best of our knowledge, there have only been 2 cases of nasal septal abscess associated with haematological malignancy reported in the literature. Herein, we present a unique case of recurrent spontaneous nasal septal hematoma and abscess in a patient prior to and after the diagnosis of acute myelogenous leukemia. Its rarity in immunocompromised population, clinical presentation, treatment and complications are further discussed.

Matched MeSH terms: Hematoma/etiology

Tranexamic Acid Within 4.5 Hours of Intracerebral Hemorrhage With the CTA Spot Sign: Systematic Review and Individual Patient Meta-analysis

Yassi N, Yogendrakumar V, Churilov L, Meretoja A, Wu T, Campbell BCV, et al.

Neurology, 2024 Dec 24;103(12):e210104.

PMID: 39586046 DOI: 10.1212/WNL.0000000000210104

BACKGROUND AND OBJECTIVES: The antifibrinolytic agent tranexamic acid has been tested in intracerebral hemorrhage trials with overall neutral results. Ongoing contrast extravasation on CT angiography (spot sign) can identify individuals with ongoing bleeding who may benefit from anti-fibrinolytic therapy. We aimed to investigate the effect of tranexamic acid on hematoma growth in patients with spot signs treated within 4.5 hours of onset.

METHODS: We conducted a systematic review and individual patient meta-analysis, which we report according to the Preferred Reporting Items for Systematic Review and Meta-analyses of Individual Participant Data guidelines. PubMed and Embase were searched from inception to May 29, 2023, using the terms ((stroke) AND (randomised OR randomized) AND (tranexamic acid) AND (haemorrhage OR hemorrhage)). We included randomized trials comparing tranexamic acid with placebo in participants with primary intracerebral hemorrhage who had a spot sign and who had follow-up imaging within the required timeframe. Individual patient data were provided by each study and were integrated by the coordinating center. Data were pooled using a random-effects model. The primary endpoint was hematoma growth within 24 hours, defined as ≥33% relative or ≥6 mL absolute hematoma expansion compared with baseline, analyzed using mixed-effects-modified Poisson regression with robust standard errors, adjusted for baseline hematoma volume. Safety outcomes were mortality and major thromboembolic events within 90 days.

RESULTS: Of 197 studies identified, 3 were eligible, contributing 162 participants for the primary analysis (60 female and 102 male). Hematoma growth occurred in 36 of 74 (49%) participants treated with tranexamic acid, compared with 48 of 88 (55%) participants treated with placebo (adjusted risk ratio 0.86, 95% CI 0.84-0.89, p < 0.001). Adjusted median absolute hematoma growth was 1.60 mL (95% CI 0.77-2.43) lower with tranexamic acid vs placebo. No differences in functional outcome or safety were observed.

DISCUSSION: Tranexamic acid modestly reduced hematoma growth in patients with CT angiography spot signs treated within 4.5 hours of onset. Given the trials in the meta-analysis were individually neutral, these results require further validation before clinical application.

Matched MeSH terms: Hematoma/drug therapy

Fulltext Chronic subdural hematoma: a review at General Hospital, Kuala Lumpur

Cheah FKC, Ujang MA

Med J Malaysia, 1987 Sep;42(3):177-81.

PMID: 3506640

Forty-eight patients treated surgically for chronic subdural hematoma in General Hospital Kuala Lumpur were studied retrospectively. The clinical presentations were insidious and nonspecific. A high clinical index of suspicion for this disease is required. Diagnosis is confirmed by CAT Scan of the brain with or without cerebralangiography. Treatment consists or burr-holes and drainage

Matched MeSH terms: Hematoma, Subdural/epidemiology*; Hematoma, Subdural/surgery

Spontaneous orbital haematoma in a scurvy child: A forgotten diagnosis

Cheah SC, Tang IP, Matthew TJH, Ooi MH, Husain S

Int J Pediatr Otorhinolaryngol, 2020 Oct;137:110224.

PMID: 32896344 DOI: 10.1016/j.ijporl.2020.110224

Spontaneous unilateral orbital haematoma in children is not common and very rarely caused by scurvy. Scurvy is a clinical syndrome with a spectrum of clinical manifestations due to severe prolonged vitamin C deficiency leading to impairment of collagen synthesis over skin, bone, teeth and blood vessels. This paper presents a unique case of a 7- year-old girl with learning difficulty who presented with spontaneous right proptosis due to scurvy. Imaging studies suggestive of intra- orbital extraconal haemorrhage. The child was treated with a higher than recommended dose of vitamin C initially in emergency situation. She responded well and discharged without complication. Spontaneous orbital haematoma due to scurvy is very rare with less than 10 cases published in literature. The present case should raise the awareness regarding this forgotten disease and importance of balance nutrition amongst children.

Matched MeSH terms: Hematoma/diagnosis; Hematoma/etiology*

Dengue shock syndrome with retroperitoneal haematoma requiring repeated artery angioembolization

Teh YH, Tan YP, Zain MM

Med J Malaysia, 2017 08;72(4):254-256.

PMID: 28889142 MyJurnal

Eyelid reconstruction is complex and challenging since it is not only for structural and functional restoration, but also for an acceptable aesthetic result. In full thickness eyelid injuries, it will involve both anterior and posterior lamella. Therefore, when reconstructing the defect, it requires at least two layers; one will be a flap with blood supply, and the other can be a free graft. In this case, a rotational advancement cheek flap and composite graft were used to reconstruct the lower eyelid.

Matched MeSH terms: Hematoma/etiology*; Hematoma/therapy

Fulltext Lingual haematoma: yet another unusual cause of upper airway obstruction

Ng KP

Med J Malaysia, 1998 Mar;53(1):112-4.

PMID: 10968150

An episode of acute upper airway obstruction was caused by a lingual haematoma, when a patient with end stage renal failure suffered a hypocalcaemic fit and bit his tongue. The large haematoma and profuse bleeding caused the patient to obstruct and become hypoxic, and rendered laryngoscopy and intubation impossible, requiring an urgent tracheostomy to secure the airway.

Matched MeSH terms: Hematoma/complications*

Exteriorization of the subdural pocket for chronic recurrent subdural hematoma

Chee CP

Neurosurgery, 1988 Apr;22(4):780-2.

PMID: 3374793

The author describes a new operative method for treating chronic recurrent subdural hematoma. The subdural pocket is exteriorized so that it is in continuity with the subgaleal space through a limited extradural pocket and an L-shaped linear craniectomy. This procedure has been carried out in two patients with recurrent chronic subdural hematoma, both of whom made complete recoveries despite initial recurrence of the subdural hematoma.

Matched MeSH terms: Hematoma, Subdural/surgery*

Fulltext A lesion mistaken for malignant melanoma of the posterior uvea: a case report

Sukumaran K, Chandran S, Visvaraja S, Couper NT, Tan PE

Med J Malaysia, 1984 Dec;39(4):317-9.

PMID: 6544942

A case is presented to illustrate the difficulties
encountered in the clinical diagnosis of an intraocular mass. The fundus was not visible ophthalmoscopically because of opaque media. The anterior surface of the iris showed three discrete hyperpigmented nodular patches. Ultrasound showed an intraocular mass occupying half the posterior segment. The eye did not have useful vision and was enucleated after a clinical diagnosis of malignant melanoma of the choroid was made. The eye did not contain a melanoma but an organised blood clot after an extensive vitreous haemorrhage because of systemic hypertension.

Matched MeSH terms: Hematoma/diagnosis

Fulltext Delayed Post-operative Spinal Epidural Haematoma after Posterior Spinal Surgery: Report of Two Cases

Chung WH, Tan RL, Chiu CK, Kwan MK, Chan C

Malays Orthop J, 2020 Nov;14(3):170-173.

PMID: 33403080 DOI: 10.5704/MOJ.2011.027

Delayed post-operative spinal epidural haematoma (DPSEH) is diagnosed when the onset of symptoms is more than three days from the index surgery. DPSEH is a rare but serious complication of spinal surgery. Missed diagnosis will result in irreversible neurological deficit which may lead to permanent disabilities. We report two cases of DPSEH who presented with worsening neurological deficit four days after the index surgery. Magnetic resonance imaging (MRI) showed the presence of an epidural haematoma compressing the spinal cord. Surgical evacuation of haematoma were performed for both patients. Both patients experienced neurological improvement. Surgeons should have high index of suspicion to identify delayed onset of spinal epidural haematoma (SEH) and timely intervention should be taken to avoid irreversible neurological damage.

Matched MeSH terms: Hematoma, Epidural, Cranial; Hematoma, Epidural, Spinal

Fulltext Unilateral ischaemic retinopathy and bilateral subdural haemorrhage in an infant with non-accidental injury: An ophthalmological approach

Ee CL, Mohd Abdullah AA, Samsudin A, Khaliddin N

Ulus Travma Acil Cerrahi Derg, 2019 09;25(5):527-530.

PMID: 31475330 DOI: 10.5505/tjtes.2018.57059

Non-accidental injury (NAI) is not an uncommon problem worldwide, which leads to significant morbidity and mortality in infants. The presence of retinal or subdural haemorrhages, or encephalopathy with injuries inconsistent with the clinical history is highly suggestive of NAI. In this study, we report on a case of a a 3-month-old infant who presented to the casualty department with a very sudden onset of recurrent generalised tonic-clonic seizures. There was no history of trauma or visible external signs. She was found to have bilateral subdural haemorrhages and atypical unilateral ischaemic retinopathy. Retinal photocoagulation was performed with subsequent resolution of vitreous and retinal haemorrhages. However, visual recovery in that eye remained poor. The findings showed that a high index of suspicion of NAI is required in infants with intracranial haemorrhage and unilateral retinal haemorrhages.

Matched MeSH terms: Hematoma, Subdural*

Fulltext Intraspinal epidural hematoma in a warfarinized patient presenting with back pain: a case report

Jolina, W.N., Dazlin Masdiana, S., Afliza, A.B.

Medicine & Health, 2018;13(2):188-194.

MyJurnal

Warfarin is an anticoagulant that is commonly used as thrombo-prophylaxis in patients at risk of thrombo-embolic events. However, the use of warfarin is known to cause hemorrhage due to its anticoagulation effect. Although the common sites of hemorrhage are gastrointestinal and genitourinary tract, it can also occur in the least expected location. We report a rare case of spinal cord compression secondary to intraspinal epidural hematoma as a result of overwarfarinization in a patient who had undergone liver transplant. The patient underwent emergency decompression laminectomy of spinal cord and hematoma evacuation after the reversal of overwarfarinization to normal levels.

Matched MeSH terms: Hematoma, Epidural, Cranial; Hematoma, Epidural, Spinal

Spontaneous neonatal scrotal haematoma: an early manifestation of severe haemophilia

Lee JS, Chieng CH, Martin M, Toh TH

BMJ Case Rep, 2021 Apr 28;14(4).

PMID: 33910804 DOI: 10.1136/bcr-2020-241482

We report a term newborn who presented on day 3 of life with unilateral, tender scrotal swelling with skin discolouration, which was subsequently diagnosed as haemophilia A at about 6 months of age. He received intramuscular vitamin K and hepatitis B vaccine at birth uneventfully. The scrotal swelling was treated as an infected hydrocoele, considering the absence of a family history of bleeding disorder and other risks of bleeding tendency, as well as the ultrasonographic features. He also had congenital pneumonia requiring venepuncture, non-invasive oxygen supplementation and intravenous antibiotics, without any complication. The swelling slowly improved over 2 months. He later developed post-trial vaccine injection haematoma at 4 months of age, and multiple non-traumatic bruises when he was 6 months old, leading to the diagnosis. This case demonstrates an uncommon, but a possible, early manifestation of haemophilia A at birth with a unilateral scrotal haematoma.

Matched MeSH terms: Hematoma/etiology

Fulltext Intracranial Subdural Hematoma after Lumbar Spine Surgery: A Case Report

Zakaria AF, Tsuji M

Malays Orthop J, 2019 Nov;13(3):85-87.

PMID: 31890118 DOI: 10.5704/MOJ.1911.016

Intracranial subdural hematoma following lumbar surgery is a devastating but rare complication. It has been implicated due to intracranial hypotension secondary to persistent cerebrospinal fluid leakage. The resultant drop in intracranial pressure presumably causes traction and tearing of venous structures. Patients typically present with postural headaches. However, other symptoms of subdural hematoma, intracranial hypotension and cerebrospinal fluid leak must also be cautioned.

Matched MeSH terms: Hematoma, Subdural; Hematoma, Subdural, Intracranial

Fulltext Spontaneous calf haematoma: case report

Zubaidah NH, Liew NC

Med J Malaysia, 2014 Feb;69(1):44-5.

PMID: 24814632 MyJurnal

Spontaneous calf haematoma is a rare condition and few case reports have been published in the English literature. Common conditions like deep vein thrombosis and traumatic gastrocnemius muscle tear need to be considered when a patient presents with unilateral calf swelling and tenderness. Ultrasound and Magnetic Resonance Imaging are essential for confirmation of diagnosis. The purpose of this paper is to report on a rare case of spontaneous calf hematoma and its diagnosis and management.

Matched MeSH terms: Hematoma

Fulltext Can a chronic expanding haematoma mimic a soft tissue sarcoma?

Muniandy M, Singh VA

BMJ Case Rep, 2009;2009.

PMID: 21686602 DOI: 10.1136/bcr.09.2008.0846

A 68-year-old woman presented with a gradually increasing left gluteal swelling that she had first noted 2 years previously. The results of both clinical and radiological examinations were consistent with soft tissue sarcoma, but the final diagnosis after resection was haematoma.

Matched MeSH terms: Hematoma

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