The dural venous sinuses are spaces between the endosteal and meningeal layers of the dura. They contain venous blood that originates for the most part from the brain or cranial cavity. The sinuses contain an endothelial lining that is continuous into the veins that are connected to them.

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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patient has fever, hypotension, swelling, and erythema of his left leg. Notably, his leg is more painful to palpation than might be expected after visual inspection. These symptoms are very concerning for necrotizing fasciitis. Necrotizing fasciitis is a fulminant infection of the subcutaneous tissue that spreads rapidly along the fascial planes and leads to extensive tissue necrosis and shock. Treatment • Requires surgical debridement & broad-spectrum antibiotics

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

Bioprosthetic valves used in heart valve replacement generally offer functional properties that are more similar to those of native valves.

The word enuresis is derived from a Greek word (enourein) that means “to void urine.” It can occur either during the day or at night (though some restrict the term to bedwetting that occurs at night). Enuresis can be divided into primary and secondary forms.

Acute intermittent porphyria (AIP) is a rare autosomal dominant metabolic disorder affecting the production of heme, the oxygen-binding prosthetic group of hemoglobin. It is characterized by a deficiency of the enzyme porphobilinogen deaminase.

In cases when the presentation is unclear, ultrasonography is the imaging methodology of choice. The characteristic finding is the presence of a "target sign". Ultrasonography is not required in patients with obvious clinical diagnosis (as seen in this patient). Such patients can proceed directly to treatment with diagnostic and therapeutic air (pneumatic) or water-soluble (hydrostatic contrast) enema.

Galactosemia

Body Mass Index (BMI) is a person's weight in kilograms divided by the square of height in meters. A high BMI can be an indicator of high body fatness. BMI can be used to screen for weight categories that may lead to health problems but it is not diagnostic of the body fatness or health of an individual.May 15, 2015

Delayed puberty is defined as the absence of any signs suggestive of puberty by 14 years of age. In this case, the patient's pubertal delay appears to be constitutional because of his positive family history, absence of syndromic features or systemic illness, and bone age of 12 years. Puberty correlates more closely with bone age than chronological age. On follow-up, the patient will most likely demonstrate a similar onset of puberty as his father.

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.

Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism. The liver carries out several necessary functions, including detoxifying harmful substances in your body, cleaning your blood and making vital nutrients.Apr 6, 2016

This patient has infectious mononucleosis (IM), a disease caused by the Epstein-Barr virus. IM is a systemic viral infection that is usually seen in children and adolescents. The common presentation is fever with pharyngitis or tonsillitis, cervical adenopathy, splenomegaly, and mild hepatitis.

Clinical Anatomy Lecture Illustrate The Anatomy Of The Abdominal Wall

In this video, we will cover the function of the liver and how cancer may arise.

ATTENTION! 5 Warning Signs Of BREAST CANCER That Many Women Ignore!

A retroverted uterus (tilted uterus, tipped uterus) is a uterus that is tilted posteriorly. This is in contrast to the slightly "anteverted" uterus that most women have, which is tipped forward toward the bladder, with the anterior end slightly concave.

Instructions for use of FPT kegel exerciser. Kegels work! But kegels performed with progressive resistive weight training work better and faster.

Remove of ascaris lumbricoides worms due to intestinal obstruction