Moyamoya disease (MD) is a chronic idiopathic vasculopathy characterized by bilateral stenosis of the distal internal carotid arteries (ICA’s) with subsequent formation of abnormal collateral vessels. The underlying ...Moyamoya disease (MD) is a chronic idiopathic vasculopathy characterized by bilateral stenosis of the distal internal carotid arteries (ICA’s) with subsequent formation of abnormal collateral vessels. The underlying etiology is unknown [1]. Patients with MD are predisposed to intracranial hemorrhage or cerebral ischemia given the fragile nature of the collateral circulation. Although there is no curative treatment for MD, there are surgical palliative procedures that can augment cerebral blood flow to areas of impaired perfusion and circumvent the abnormal collateral circulation. Medical management exists for patients who are not surgical candidates. Because the incidence of MD peaks during the second and third decades of life, it can potentially affect women of childbearing age [2]. However, the optimal anesthetic and obstetric management of the parturient with MD remains controversial. We present a case of a primigravida with a history of MD who underwent intracranial bypass grafting prior to conception and subsequently had a successful cesarean delivery that was complicated by transient ischemic attacks (TIA) in the postpartum period.展开更多
Gynecomastia is a common finding in male patients, however, abscess is a rare finding in male patients. Typical management for benign gynecomastia is to continued surveillance and no additional annual imaging is requi...Gynecomastia is a common finding in male patients, however, abscess is a rare finding in male patients. Typical management for benign gynecomastia is to continued surveillance and no additional annual imaging is required [1]. Breast abscess in male is managed with incision and drainage and antibiotics [2], however, the management of gynecomastia superimposed with recurrent ab-scess does not have clear management and should be managed on an indi-vidual basis. We present a case of a 44-year-old man who with a recurrent left breast abscess in addition to persistent gynecomastia. The abscess was drained and cultured. The culture grew Citrobacter koseri(diversus) and patient was placed on Bactrim DS for 7 days and was referred to the breast clinic for fur-ther evaluation. This study aims to elucidate and review the literature to iden-tify similar cases and potential management of male patients with recurrent abscess and gynecomastia.展开更多
文摘Moyamoya disease (MD) is a chronic idiopathic vasculopathy characterized by bilateral stenosis of the distal internal carotid arteries (ICA’s) with subsequent formation of abnormal collateral vessels. The underlying etiology is unknown [1]. Patients with MD are predisposed to intracranial hemorrhage or cerebral ischemia given the fragile nature of the collateral circulation. Although there is no curative treatment for MD, there are surgical palliative procedures that can augment cerebral blood flow to areas of impaired perfusion and circumvent the abnormal collateral circulation. Medical management exists for patients who are not surgical candidates. Because the incidence of MD peaks during the second and third decades of life, it can potentially affect women of childbearing age [2]. However, the optimal anesthetic and obstetric management of the parturient with MD remains controversial. We present a case of a primigravida with a history of MD who underwent intracranial bypass grafting prior to conception and subsequently had a successful cesarean delivery that was complicated by transient ischemic attacks (TIA) in the postpartum period.
文摘Gynecomastia is a common finding in male patients, however, abscess is a rare finding in male patients. Typical management for benign gynecomastia is to continued surveillance and no additional annual imaging is required [1]. Breast abscess in male is managed with incision and drainage and antibiotics [2], however, the management of gynecomastia superimposed with recurrent ab-scess does not have clear management and should be managed on an indi-vidual basis. We present a case of a 44-year-old man who with a recurrent left breast abscess in addition to persistent gynecomastia. The abscess was drained and cultured. The culture grew Citrobacter koseri(diversus) and patient was placed on Bactrim DS for 7 days and was referred to the breast clinic for fur-ther evaluation. This study aims to elucidate and review the literature to iden-tify similar cases and potential management of male patients with recurrent abscess and gynecomastia.
