Thrombosis of the venous channels in the brain is an uncommon cause of cerebral infarction relative to arterial disease, but it is an important consideration because of its potential morbidity. (See Prognosis.) Knowledge of the anatomy of the venous system is essential in evaluating patients with cerebral venous thrombosis (CVT), since symptoms associated with the condition are related to the area of thrombosis. For example, cerebral infarction may occur with cortical vein or sagittal sinus thrombosis secondary to tissue congestion with obstruction. (See Presentation.) Lateral sinus thrombosis may be associated with headache and a pseudotumor cerebri–like picture. Extension into the jugular bulb may cause jugular foramen syndrome, while cranial nerve palsies may be seen in cavernous sinus thrombosis as a compressive phenomenon. Cerebral hemorrhage also may be a presenting feature in patients with venous sinus thrombosis. (See Presentation.) Imaging procedures have led to easier recognition of venous sinus thrombosis (see the images below), offering the opportunity for early therapeutic measures. (See Workup.) Left lateral sinus thrombosis demonstrated on magn Left lateral sinus thrombosis demonstrated on magnetic resonance venography (MRV). This 42-year-old woman presented with sudden onset of headache. Physical examination revealed no neurologic abnormalities. View Media Gallery Axial view of magnetic resonance (MR) venogram dem Axial view of magnetic resonance (MR) venogram demonstrating lack of flow in transverse sinus. View Media Gallery The following guidelines for CVT have been provided by the American Heart Association and the American Stroke Association [1] : In patients with suspected CVT, routine blood studies consisting of a complete blood count, chemistry panel, prothrombin time, and activated partial thromboplastin time should be performed. Screening for potential prothrombotic conditions that may predispose a person to CVT (eg, use of contraceptives, underlying inflammatory disease, infectious process) is recommended in the initial clinical assessment. Testing for prothrombotic conditions (including protein C, protein S, or antithrombin deficiency), antiphospholipid syndrome, prothrombin G20210A mutation, and factor V Leiden can be beneficial for the management of patients with CVT. Testing for protein C, protein S, and antithrombin deficiency is generally indicated 2-4 weeks after completion of anticoagulation. There is a very limited value of testing in the acute setting or in patients taking warfarin. In patients with provoked CVT (associated with a transient risk factor), vitamin K antagonists may be continued for 3-6 months, with a target international normalized ratio of 2.0-3.0. In patients with unprovoked CVT, vitamin K antagonists may be continued for 6-12 months, with a target international normalized ratio of 2.0-3.0. For patients with recurrent CVT, venous thromboembolism (VTE) after CVT, or first CVT with severe thrombophilia (ie, homozygous prothrombin G20210A; homozygous factor V Leiden; deficiencies of protein C, protein S, or antithrombin; combined thrombophilia defects; or antiphospholipid syndrome), indefinite anticoagulation may be considered, with a target international normalized ratio of 2.0-3.0. For women with CVT during pregnancy, low-molecular-weight heparin (LMWH) in full anticoagulant doses should be continued throughout pregnancy, and LMWH or vitamin K antagonist with a target international normalized ratio of 2.0-3.0 should be continued for ≥6 weeks postpartum (for a total minimum duration of therapy of 6 months). It is reasonable to advise women with a history of CVT that future pregnancy is not contraindicated. Further investigations regarding the underlying cause and a formal consultation with a hematologist or maternal fetal medicine specialist are reasonable. It is reasonable to treat acute CVT during pregnancy with full-dose LMWH rather than unfractionated heparin. For women with a history of CVT, prophylaxis with LMWH during future pregnancies and the postpartum period is reasonable. Next: Etiology What to Read Next on Medscape Related Conditions and Diseases Quiz: Do You Know the Complications, Proper Workup, and Best Treatment Practices for Ischemic Stroke? Quiz: How Much Do You Know About Hypothyroidism? Quiz: Do You Know the Risk Factors, Symptoms, and Potential Treatments for Alzheimer Disease? Quiz: How Much Do You Know About Hypertension? 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If you suspect that you have sleep apnea, the usual first step is to discuss your suspicions with your primary care physician. If you don’t have a primary care physician, you can go directly to a clinician who is a sleep specialist. But check your health care insurance coverage first. Some policies require you to see a primary care physician first, and some policies limit the sleep centers and testing facilities whose services they will pay for. Unfortunately, you may discover that your policy offers limited or no coverage for the diagnosis and treatment of sleep apnea, in which case you may wish to switch insurers if and when you can.

Testosterone treatment in adolescent boys with constitutional delay

Because of his weight, Jimmie Jones was on the waiting list for a new kidney for 17 years. University of Illinois Hospital surgeons used robotic surgery to give him a life without dialysis.

In 5 minutes find out how and why a normal cell becomes a cancer cell: risk factors and treatment.

The "great arteries" in this anomaly refer to the aorta and the pulmonary artery, the two major arteries carrying blood away from the heart. In cases of transposition of the great arteries, these vessels arise from the wrong ventricle. They are "transposed" from their normal position so that the aorta arises from the right ventricle and the pulmonary artery from the left ventricle. Other heart defects may occur along with transposition of the great arteries. About 25 percent of children with transposition will also have a ventricular septal defect (VSD) . In nearly a third, the branching pattern of the coronary arteries as they leave the transposed aorta is unusual. Infants may also have narrowing below the pulmonary valve that blocks blood flow from the left ventricle to the lungs.

The etiology of BOO is diverse and definitely gender specific. Often anatomic causes induce functional abnormality that remains somewhat unique for each individual, regardless of sex. A full appreciation of the possible etiologies of obstruction is necessary in order to identify overt and more subtle scenarios. In women, iatrogenic causes of obstruction are the most common. Other entities account for far fewer of the cases. The obstruction evaluation in women is somewhat more diverse in terms of modalities used, with no single grouping of techniques that are generally apropos. Individualized evaluation remains a tenet of analysis, and urodynamic criteria used to diagnose BOO in women continue to evolve.

Symptoms range from nonspecific and constitutional to sudden cardiac death. [18] In about 20% of cases, myxomas may be asymptomatic and discovered as an incidental finding. Signs and symptoms of mitral stenosis, endocarditis, mitral regurgitation, and collagen vascular disease can simulate those of atrial myxoma. A high index of suspicion aids in diagnosis. Symptoms of left-sided heart failure include the following: Dyspnea on exertion (75%) that may progress to orthopnea, paroxysmal nocturnal dyspnea, and pulmonary edema is observed. [19, 20] Symptoms are caused by obstruction at the mitral valve orifice. Valve damage may result in mitral regurgitation.

Beckwith-Wiedemann Syndrome (BWS) is a congenital overgrowth syndrome, which can affect all systems of the body. It was first recognised in 1963-64 by Dr J. Bruce Beckwith, a paediatric pathologist in America and, independently, by Dr H.E. Wiedemann, a German geneticist.

remove a staggering number of heartworms. If you don't have your pet on heartworm prevention, go to your vet, get your pet tested and put on heartworm prevention right away!

SPIDER Surgery-- Single Incision Gallbladder Removal

Everyone feels sad or low sometimes, but these feelings usually pass with a little time. Depression—also called “clinical depression” or a “depressive disorder”—is a mood disorder that causes distressing symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. To be diagnosed with depression, symptoms must be present most of the day, nearly every day for at least 2 weeks.

The cause for TS is unknown. Early research suggested that TS is an inherited condition (often, the person's near or distant relatives have had some form of transient or chronic tic disorder or associated symptoms). Recent studies point to a combination of environmental and genetic factors as a cause of the disorder. The specific genes involved in the development of TS are still being investigated. Studies suggest that TS has a neurological basis and results from an abnormality which affects the brain's metabolism of certain neurotransmitters (chemicals in the brain that regulate behavior.) Current research being funded by the Tourette Syndrome Association (TSA) will help provide more information about the causes and genetic factors of TS.

Roman Nowygrod, MD, a surgeon at NewYork-Presbyterian/Columbia University Medical Center, explains the different surgical approaches to treat Peripheral Arterial Disease (PAD).

The heart's conductions system controls the generation and propagation of electric signals or action potentials causing the hearts muscles to contract and the heart to pump blood.

Coronary artery vasospasm, or smooth muscle constriction of the coronary artery, is an important cause of chest pain syndromes that can lead to myocardial infarction (MI), ventricular arrhythmias, and sudden death. It also plays a key role in the development of atherosclerotic lesions.Nov 22, 2016

A pneumothorax (noo-moe-THOR-aks) is a collapsed lung. A pneumothorax occurs when air leaks into the space between your lung and chest wall. This air pushes on the outside of your lung and makes it collapse. In most cases, only a portion of the lung collapses.

Hepatitis B is a liver infection caused by the Hepatitis B virus (HBV). Hepatitis B is transmitted when blood, semen, or another body fluid from a person infected with the Hepatitis B virus enters the body of someone who is not infected. This can happen through sexual contact; sharing needles, syringes, or other drug-injection equipment; or from mother to baby at birth. For some people, hepatitis B is an acute, or short-term, illness but for others, it can become a long-term, chronic infection. Risk for chronic infection is related to age at infection: approximately 90% of infected infants become chronically infected, compared with 2%–6% of adults. Chronic Hepatitis B can lead to serious health issues, like cirrhosis or liver cancer. The best way to prevent Hepatitis B is by getting vaccinated.

Scientists have developed a gene editing technique which targets HIV-1 DNA. Through the technique, scientists successfully edited the virus out the genome in human cells; their study also showed the technique can prevent viral replication in cleared cells. Using CRISPR/Cas9 gene editing, the team tested patient cells grown in a lab which were no longer susceptible to HIV infection.

Setting up a chest tube drainage system