Internal carotid artery dissection(ICAD) results from disruption of the intima of the arterial wall, and can lead to intrusion of blood into the arterial wall and form an intramural hematoma. The hematoma can compress...Internal carotid artery dissection(ICAD) results from disruption of the intima of the arterial wall, and can lead to intrusion of blood into the arterial wall and form an intramural hematoma. The hematoma can compress the true lumen of the vessel, causing functional stenosis or occlusion. The classic triad signs of ICAD include pain in the ipsilateral neck, head and orbital regions; a(partial) Horner syndrome; and cerebral or retinal ischemia. However, not all ICAD patients present with this classic signs. In some cases, ocular manifestations are the initial(and sometimes the only) findings. We summarize the ocular manifestations associated with ICAD in 3 categories: visual symptoms, oculosympathetic palsy, and ocular motor nerve palsy.展开更多
Aortocaval compression syndrome is also known as a supine hypotensive syndrome, it is very common in late pregnancy especially in supine positioning under neuraxial anesthesia. It is occurred when the inferior vena ca...Aortocaval compression syndrome is also known as a supine hypotensive syndrome, it is very common in late pregnancy especially in supine positioning under neuraxial anesthesia. It is occurred when the inferior vena cava and the aorta were compressed by the uterus, and often manifested as hypotension, tachycardia, nausea, dizziness, and syncope. Besides, reducing of uteroplacental perfusion may result in morbidity or even mortality to the fetus. It is critical to recognize the cause of hypotension in the pregnant patient, and it is necessary to alleviate the compressing pressure of uterus on the inferior vena cava immediately if suspected of aortocaval compression. We report a pregnant woman with rheumatoid arthritis (RA) who experienced refractory hypotension resistant to large doses of vasopressor therapy when undergoing cesarean delivery with combined spinal-epidural anesthesia.展开更多
To the Editor:A 29-year-old nulliparous woman(weight 68 kg,height 159 cm)at 31±1 gestational weeks was admitted to the West China Second Hospital,complaining of lower limb edema for 3 months and dyspnea for 1 wee...To the Editor:A 29-year-old nulliparous woman(weight 68 kg,height 159 cm)at 31±1 gestational weeks was admitted to the West China Second Hospital,complaining of lower limb edema for 3 months and dyspnea for 1 week,which had become more severe over the last 2 days.She was confirmed pregnant at a local hospital after experiencing amenorrhea for 40 days.All routine tests were normal until she was found to be anemic without symptoms at 18 gestational weeks.Her hemoglobin(Hb)was 77 g/L without thalassemia.After oral intake of a polysaccharide iron complex for 4 weeks,her Hb increased to 81 g/L with edema in her lower limbs.Urine testing was positive for protein(+)and occult blood(3+).At 30 gestational weeks,she felt chest distress,palpitations,and fatigue and could not maintain a supine position at night.A routine blood examination showed an Hb level of 67 g/L,and the transthoracic echocardiography showed mild mitral stenosis with moderate regurgitation and mild pericardial effusion.展开更多
基金Supported by Research and Development Program of Shaanxi Province, China (No.2017SF-279)Science and Technology Planned Projects of Xi’an, China [No.2017116SF/YX010(8)]Science and Technology Planned Projects of Xi’an, China [No.201805104YX12SF38(2)]
文摘Internal carotid artery dissection(ICAD) results from disruption of the intima of the arterial wall, and can lead to intrusion of blood into the arterial wall and form an intramural hematoma. The hematoma can compress the true lumen of the vessel, causing functional stenosis or occlusion. The classic triad signs of ICAD include pain in the ipsilateral neck, head and orbital regions; a(partial) Horner syndrome; and cerebral or retinal ischemia. However, not all ICAD patients present with this classic signs. In some cases, ocular manifestations are the initial(and sometimes the only) findings. We summarize the ocular manifestations associated with ICAD in 3 categories: visual symptoms, oculosympathetic palsy, and ocular motor nerve palsy.
文摘Aortocaval compression syndrome is also known as a supine hypotensive syndrome, it is very common in late pregnancy especially in supine positioning under neuraxial anesthesia. It is occurred when the inferior vena cava and the aorta were compressed by the uterus, and often manifested as hypotension, tachycardia, nausea, dizziness, and syncope. Besides, reducing of uteroplacental perfusion may result in morbidity or even mortality to the fetus. It is critical to recognize the cause of hypotension in the pregnant patient, and it is necessary to alleviate the compressing pressure of uterus on the inferior vena cava immediately if suspected of aortocaval compression. We report a pregnant woman with rheumatoid arthritis (RA) who experienced refractory hypotension resistant to large doses of vasopressor therapy when undergoing cesarean delivery with combined spinal-epidural anesthesia.
文摘To the Editor:A 29-year-old nulliparous woman(weight 68 kg,height 159 cm)at 31±1 gestational weeks was admitted to the West China Second Hospital,complaining of lower limb edema for 3 months and dyspnea for 1 week,which had become more severe over the last 2 days.She was confirmed pregnant at a local hospital after experiencing amenorrhea for 40 days.All routine tests were normal until she was found to be anemic without symptoms at 18 gestational weeks.Her hemoglobin(Hb)was 77 g/L without thalassemia.After oral intake of a polysaccharide iron complex for 4 weeks,her Hb increased to 81 g/L with edema in her lower limbs.Urine testing was positive for protein(+)and occult blood(3+).At 30 gestational weeks,she felt chest distress,palpitations,and fatigue and could not maintain a supine position at night.A routine blood examination showed an Hb level of 67 g/L,and the transthoracic echocardiography showed mild mitral stenosis with moderate regurgitation and mild pericardial effusion.
