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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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An inguinal hernia is a bulging of the intestine through a defect or weak spot in the wall of the lower abdomen. This video shows how inguinal hernias form and how they are treated.
#TotalExtraperitonealLaparoscopicInguinalHerniaRepair #TEP #laparoscopy
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This video demonstrate Laparoscopic Cholecystectomy Full Length Skin to Skin Video with Infrared Cholangiography performed by Dr R K Mishra at World Laparoscopy Hospital. Infrared Cholegiography is performed by using Indocyanine Green during laparoscopic cholecystectomy surgery for gallbladder removal. Bile duct injury remains the most feared complication of laparoscopic cholecystectomy. Intraoperative cholangiography (IOC) is the current gold standard for biliary imaging and may reduce injury, but is not widely used because of the difficulties of doing it. Near-Infrared Fluorescence Cholangiography (NIRF-C) is a novel non-invasive method for real-time, radiation-free, intra-operative biliary mapping during laparoscopic cholecystectomy. We have experienced that NIRF-C is a safe and effective method for identifying biliary anatomy during laparoscopic cholecystectomy. Indocyanine green is a cyanine dye is very popular and used for many years in medical diagnostics. It is used for determining cardiac output, hepatic function, liver, and gastric blood flow, and for ophthalmic angiography. Now the use of this dye in lap chole has improved the safety of this surgery by NEAR INFRARED FLUORESCENT CHOLANGIOGRAPHY.
For more information please contact:
World Laparoscopy Hospital
Cyber City, Gurugram, NCR DELHI
INDIA 122002
Phone & WhatsApp: +919811416838, + 91 9999677788
Learn the SIRS Criteria and how to calculate it. Greater than or equal to 2 or more of the following: Temperature Fever of greater than 38°C (100.4°F) or Less than 36°C (96.8°F) Heart Rate Greater than 90 beats per minute Respiratory Rate Greater than 20 breaths per minute or PaCO2 of less than 32mm Hg White Blood Cell Count Greater than 12,000cells/mm³ or Less than 4,000cells/mm³ or Greater than 10% Bands
Lumpectomy means that a focal area of cancer is going to be removed. A lot of patients with a lumpectomy don’t need any specific breast reconstruction, explains Dr. Miguel Angel Medina, Director of Microsurgery with Miami Cancer Institute.
Al the end of surgical treatment, all those patients go on to need radiation therapy. For patients who have large breasts, physicians have to take a larger lumpectomy than normal.
How are seizures and epilepsy treated? What should I do if someone has a seizure? When seizure medications don't work, what else can be tried? These are just a few of the questions that you'll find answered here. Some treatment goals are common to everyone. Everyone should know what to do when a person is having a seizure. All people with seizures and their families should know that the real goal of treating epilepsy is to stop seizures or control them as best as possible. But you are more than just a seizure and how epilepsy affects you and your family may be different from someone else. Don't forget the most important goal of the Epilepsy Foundation - helping people with seizures and their families lead full and unrestricted lives according to their own wishes. Patient and doctor discussing treatment options"No seizures, no side effects" is the motto for epilepsy treatment. Not every person will reach that goal right now, but research and getting the "right care at the right time" can help more people achieve it each year. You may learn things here that can help you right away or later on. While seizure medicines are the mainstay of epilepsy treatment, there are other approaches to think about too. We hope these sections will help you learn about different treatments and get the help you need. Learn about the basics of Treatment 101 to help you get started. Look at Receiving Quality Care to see what to expect when you have just been diagnosed or after you have already started treatment. Then learn about specific treatments, what to do if seizures don't stop, and how to develop your health care team. You'll also find tools to help you manage your epilepsy or learn about research studies in other sections, so don't stop here!
Ettore Vulcano, MD, Foot and Ankle Orthopedic Surgeon at Mount Sinai West, discusses a new minimally invasive bunion surgery that has patients walking immediately after surgery, and getting back to an active lifestyle much quicker than with the traditional surgery.
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There is a strong association with obesity. In children younger than 10 years, it is associated with metabolic endocrine disorders {hypothyroidism, panhypopituitarism, hypogonadism, renal osteodystrophy, growth hormone abnormalities). SCFE is considered chronic if it has been present more than 3 weeks and acute if it has been present for 3 weeks or less. It is called "stable" if the patient can bear weight and "unstable" if the patient cannot ambulate. Unstable SCFE is associated with more complications, including avascular necrosis of the femoral head (AVN). SCFE is diagnosed by x-ray of the pelvis and bilateral hips. The underlying cause is a widened epiphyseal growth plate, due to abnormal cartilage maturation and endochondral ossification. The treatment is surgical, requiring immediate internal fixation with a single screw. Delay in treatment {> 24 hours) leads to increased AVN, SCFE progression from stable to unstable, and high risk of future degenerative arthritis. Prophylactic contralateral fixation of the unaffected hip is not routinely done in the U.S., except in patients with endocrine abnormalities.
Wernicke's aphasia is a neurological disorder typically caused by stroke. It affects the Wernicke's region in the brain's left hemisphere which is reasoned to be responsible for processing of meaning, especially as it relates to verbal communication, hence the problems with speech witnessed in these patients
This surgical animation is for patient education and describes a laparoscopic colectomy, which is a type of minimally invasive surgery for colon cancer. Laparoscopic colectomy, also called minimally invasive colectomy, involves several small incisions in your abdomen. Instead of a big incision, the surgeon makes a few small cuts (0.5-1 centimeters) in the abdominal cavity to insert a surgical camera and instruments and perform the operation. A slightly bigger incision, about 3.5 centimeters wide, is made to remove the tumor.
When compared to traditional open surgery, laparoscopic colectomy can result in much less pain and swifter recovery. Depending on the procedure, most laparoscopic colectomy patients leave the hospital and return to normal activities more quickly than patients recovering from open surgery.
Colorectal cancer is the second leading cause of cancer death in the United States.
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