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남지혜,황재우,윤화영,최민철,윤정희 한국임상수의학회 2020 한국임상수의학회지 Vol.37 No.6
Contrast-enhanced ultrasonography (CEUS) has been applied to evaluate parenchymal organs in human and veterinary medicine. However, to our knowledge, there is no report on the identification of active bleeding and the bleeding site in veterinary clinical patients. Herein, we describe the use of CEUS in two cases of abdominal bleeding caused by ruptured lesions with malignant abdominal tumors. One dog had a splenic hemangiosarcoma, which had metastasized to the liver; the other dog had hepatic cell carcinomas in the left hepatic lobe, which were lobectomized, and another nodule was identified in the right hepatic lobe. Immediately after the rupture of these oncogenic lesions was suspected, CEUS was performed to identify the bleeding sites. The active bleeding sites were confirmed by hyperechoic pooling signs in the arterial phase, and extravasation could be observed within the defects showing hypoechoic perfusions in the delayed phase of the CEUS. Microbubbles were also observed in the ascites; thus, CEUS could detect the presence of hemorrhage and accurately identify the bleeding site. Collectively, the study findings suggest the usefulness of CEUS in emergent situations as it enables rapid and noninvasive evaluation of bleeding points in case of active bleeding in dogs.
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채권병,하영수,박종운,김영,이상돈,전호규,김재중 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.8
Pontine hematoma would be diagnosed and made its follow-up readily as the extent of hematoma could be clearly defined since the CT scan was available, especially with MRI in recent. Authors attemped to analyse 20 cases of pontine hematoma clinically, considering factors to influence their prognosis, admitted in Inha hopital from March 1989 to February 1992. Classification of pontine hematoma was made out according to the findings of brain CT scan taken on admission : 2 cases of Type T1 to the hematoma localized in the tegmentum unilaterally, 1 case of Type T2 to those in the tegmentum bilaterally with some extent into the 4th ventricle, 12 in Type T3 to those in the tegmentum, midbrain and mostly the 4th ventricle, and 5 in Type B to those in the basis pontis mainly with tegmentum and midbrain. Of 219 spontaneous intracerebral hematoma, pontine hematoma was 9.1%. 17 hypertension and 11 previous CVA episodes including 7 cerebral infarction and 4 ICH were encountered. Age distribution was 50% in 6th decade and male to female ratio was 3:2. On admission 14 cases were under 6 in Glassgow coma scale, 16 small reactive pupils and 1 ocular bobbing. Particularly, nuclear facial paralysis was 14 in initial bilateral type, of which 7 dead within 10 days, 5 fixed in left facial paralysis and 1 case into right paralysis later. Four surgical interventions were 1 simple EVD, 1 Urokinase irrigation through EVD, 1 steretactic aspiration and 1 direct hematoma removal. Prognosis was related to various factors : GCS on entry, volume and classification of hematoma, in addition to laterality of nuclear facial paralysis. Clinical course was better in cases over 10 GCS on entry, volume and classification of hematoma, in addition to laterality of nuclear facial paralysis. Clinical course was better in cases over 10 GCS. Type T1 and T2, and unilateral facial paralysis in which the ratio of left to right was 2:1, while it was very poor in patients who were GCS below 6. Type B and bilateral facial paralysis. On the contrary, 7 of 20 cases were dead within 10 days, 13 patients alive for more 3 months after the hemorrage were observed with fixed facial paralysis in nuclear type, 1 bilateral, 4 right, and 8 left side. It is suggested and requested for further careful follow-up that the hemorrage may occur from the border zone between paramedian, short and long circumferential arteries supplying transection area of the pons unilaterally, near on around the facial nucleus, more frequent in left side.
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