Internal thrombosis

The CT appearance of a cavernoma depends on the amount of internal thrombosis, hemorrhage, and calcification. Examples are shown in Figures 2.2, 2.4a, 2.7a, 2.8a, 2.10a, 2.12a, and 2.13a,b. The lesions appear hyperdense compared to adjacent brain parenchyma, but can have variable attenuation values. Because the density of blood on CT depends on clot formation, the attenuation of a thrombosed cavernoma changes with time. Calcifications do not change that much however, cavernomas tend to calcify only partially (see Figs. 2.12 and 2.13). In patients with a recent hemorrhage, the cavernoma may be suspected on CT mainly by taking into account... 

Handin RI Disorders of coagulation and thrombosis. In Harrison s Principles of Internal Medicine, 15 th ed. Braunwald E et al (editors). McGraw-Hill, 2001. 

Dissection of the internal carotid and vertebral arteries is a common cause of stroke, particularly in young patients. Although many occur due to trauma, it is estimated that over half occur spontaneously. The mechanism of stroke following arterial dissection is either by artery-to-artery embolism, by thrombosis in situ, or by dissection-induced lumenal stenosis with secondary cerebral hypoperfusion and low-flow watershed infarction. Occasionally, dissection may lead to the formation of a pseudoaneurysm as a source of thrombus formation. Vertebrobasilar dissections that extend intracranially have a higher risk of rupture leading to subarachnoid hemorrhage (SAH). ° ... 

BP, blood pressure CBC, complete blood count DVT, deep vein thrombosis ECG, electrocardiogram ERDP/ASA, extended-release dipyridamole plus aspirin Hb, hemoglobin Hd, hematocrit ICP, intracranial pressure ICU, intensive care unit INR, international normalized ratio SAH, subarachnoid hemorrhage. 

Silverstein MD, Heit JA, Mohr DN, et al. (1998) Trends in the incidence of deep vein thrombosis and pulmonary embolism a 25-year population-based study. Arch Intern Med 158 585-593... 

International Society of Thrombosis and Haemostasis (ISTH), 12 151 International Society of Hypertension, on sodium restriction, 22 813 International Solvent Extraction Conferences (ISEC), 10 746, 766 International Standard (ISO) 2370, for flax fiber, 11 614, 616, 617... 

Animals fed spoiled sweet clover were prone to fatal haemorrhages. The canse was traced to the presence of dicoumarol. This compound interferes with the effects of vitamin K in blood coagulation, the blood loses its ability to clot, and minor injnries can lead to severe internal bleeding. Synthetic dicoumarol has been nsed as an oral blood anticoagnlant in the treatment of thrombosis, where the risk of blood clots becomes life threatening. It has since been snperseded by warfarin, a synthetic development based on the natnral prodnct. 

O Brien B, Levine M, WiUan A, et al. Economic evaluation of outpatient treatment with low-molecular-weight heparin for proximal vein thrombosis. Arch Intern Med 1999 159 2298-304. 

Harper P, Monahan K, Baker B. Warfarin induction at 5 mg daily is safe with a low risk of anticoagulant overdose results of an audit of patients with deep vein thrombosis commencing warfarin. Intern Med J 2005 35 717-20. 

Unstable angina, non -wave MI Subcutaneous 120 international units/kg ql2h (maximum 10,000 international units/dose) given with aspirin until clinically stable. Prevention of deep vein thrombosis (DVT) or pulmonary edema in the acutely ill patient Subcutaneous 5000 international units once a day. 

Vitamin K antagonists, such as dicoumarol (8.61, a natural product) and warfarin (8.62), are used as anticoagulants in human therapy (thrombosis, atherosclerosis) and as rat poisons that lead to internal bleeding and death in rodents. Heparin, a polysaccharide consisting of 2-0-sulfonated glucuronic acid and 2-N,6-0-disulfonated glucosamine, is also a widely used anticoagulant, but its effect is connected not with Vitamin K but with enzyme inhibition. 

Warfarin (Fig. 10-22c) is a synthetic compound that inhibits the formation of active prothrombin. It is particularly poisonous to rats, causing death by internal bleeding. Ironically, this potent rodenticide is also an invaluable anticoagulant drug for treating humans at risk for excessive blood clotting, such as surgical patients and those with coronary thrombosis. ... 

FRACTIONATION,BLOOD - PLASMA FRACTIONATION] (Vol 11) International Society of Thrombosis and Haemostasis... 

Belaen B, Geerinckx K, Vergauwe P, Thys J. Internal jugular vein thrombosis after ovarian stimulation. Hum Reprod 2001 16(3) 510-2. 

Grunwald MR, Hofmann LV. Comparison of urokinase, alteplase, and reteplase for catheter-directed thrombolysis of deep venous thrombosis. J Vase Intern Radiol. 2004 15 347-352. 

Mester, L. Kraska, B. Crisba, J. Mester, M. "Sugar-amine Interactions in the Blood Clotting System and Their Effects on Haemostasis", Proc. 5th Intern. Congr. Thrombosis Haemostasis, Paris, 1975. 

In this regard, a forum was recently hosted by the International Society of Thrombosis and Haemostasis [6]. In a definitive move toward standardizing the assay of EMP, six laboratories submitted detailed protocols, which were then published in the Journal of Thrombosis and Haemostasis. This effort is a milestone in the process of reaching a consensus between the different laboratories measuring EMPs and may signal a new era in the area of clinical EMP research. 

Nicolaides A, Bergquist D, Hull R. International Concensus Statement, Prevention of Venous Thrombosis. London, UK Med-Orion Publishing Co, 1997. 

Kaye JA. A trial to evaluate the relative roles of dipyridamole and aspirin in the prevention of deep vein thrombosis in stroke patients. Bracknell, Boehringer Ingelheim (Internal Report), 1990. 

EXPRESS, Expanded PRophylaxis Evaluation Surgery Study EXULT, EXanta Used to Lessen Thrombosis INR, international normalized ratio s.c., subcutaneous METHRO, MElagatran for THRombin inhibition in Orthopedic... 

Michelson AD, Catteneo M, Eikelboom JW, et al. Aspirin resistance position paper of the working group on aspirin resistance, platelet physiology subcommittee of the scientific and standardization committee, International society on thrombosis and haemostasis. J Thromb Haemost 2005 3 1309-131 I. 

Herrmann KA, Sporer B, Yousry TA (2004) Thrombosis of the internal cerebral vein associated with transient unilateral thalamic edema a case report and review of the literature. AJNR Am J Neuroradiol 25 1351-1355 Higgins JNP, Gillard JH, Owler BK et al (2004) MR venography in idiopathic intracranial hypertension unappreciated and misunderstood. J Neurol Neurosurg Psychiatry 75 621-625... 

Hollenhorst RW (1958) Ocular manifestations of insufficiency or thrombosis of the internal carotid artery. Trans Am Ophthalmol Soc 56 474-506... 

MCA infarcts are mainly caused by cardioembolism, internal carotid artery (ICA) thrombosis, dissection or embolism and rarely (in Caucasians) by intrinsic MCA disease. MCA atherothrombotic territory infarctions related to intrinsic MCA disease often cause concomitant small cortical (territorial or borderzone) and subcortical infarcts (Min et al. 2000). 

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