RESUMEN
BACKGROUND: A rare case of a left temporal arteriovenous malformation (AVM) with bleeding 10 days after removal of another hemorrhagic AVM in the frontal lobe is reported. METHOD: A 47-year-old man had an attack of headache and vomiting and was admitted to our hospital. On admission, a CT scan showed subcortical hemorrhage in the left frontal lobe. Left carotid angiography revealed four AVMs and a vertebro-basilar angiogram demonstrated a vascular malformation. FINDINGS: First, a hemorrhagic AVM was removed with a hematoma. Following the operation, left carotid angiograms continued to show, AVMs, particularly a temporal AVM with increased blood flow, and after 10 days this hemorrhaged. This was surgically resected and the remaining small AVMs were treated by stereotactic radiosurgery. INTERPRETATION: The patient had a high risk of hemorrhage. Adding hemodynamic stress to this situation, hemorrhage would have been expected to occur at an early time after the initial intervention for hemorrhagic AVM. Considering the risk of hemorrhage, other AVMs should undergo surgery as soon as possible after resection of hemorrhagic AVM.
Asunto(s)
Hemorragia Cerebral/etiología , Lóbulo Frontal/patología , Malformaciones Arteriovenosas Intracraneales/patología , Angiografía Cerebral , Hemorragia Cerebral/patología , Hemodinámica , Humanos , Malformaciones Arteriovenosas Intracraneales/complicaciones , Malformaciones Arteriovenosas Intracraneales/cirugía , Masculino , Persona de Mediana Edad , Factores de Riesgo , Lóbulo Temporal/patologíaRESUMEN
We evaluated the clinical significance of serum CA 19-9 in various cancers, benign diseases and healthy controls. The percentage of positive cases for CA 19-9 (higher than 37 U/ml) was 83% in pancreas cancer, 78% in biliary tract cancer and 75% in urinary tract cancer. Benign diseases showed a low frequency of positive cases for CA 19-9, and their serum levels of CA 19-9 were low. Benign diseases with high serum levels of CA 19-9 were rarely seen, but they were easy to differentiate from malignant tumors by simultaneous examination of other tumor markers. In cancer patients with high serum levels of CA 19-9, CA 19-9 showed a weak positive correlation to CEA and ferritin.