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Biomedical subjects

Z Israel

Publications and source records attributed to Z Israel.

27 records · Page 2Linked to original sources

Hyperextension fracture-dislocation of the thoracic spine with paraplegia in a patient with diffuse idiopathic skeletal hyperostosis.

The case is described of a hyperextension thoracic spine fracture in a patient with diffuse idiopathic skeletal hyperostosis (DISH). A 70-year-old woman awoke paraplegic after retroperitoneal surgery after having been positioned in the hyperextended axially rotated position. Imaging demonstrated a T9-10 fracture-dislocation with severe pressure on the spinal cord, as well as findings typical of DISH. This case emphasizes the danger inherent in manipulating the ankylosed hyperostotic spine. It is proposed that patients undergoing surgery in this position should be evaluated for DISH as an additional risk factor.

Aged↗

Fever as the initial sign of malfunction in non infected ventriculoperitoneal shunts.

Sixty eight children were treated for ventriculoperitoneal shunt malfunction in our department during the years 1984-1989. Fifteen (22%) developed fever above 37.5 degrees C as a presenting sign of their shunt malfunction. Physical examination did not reveal any reason for the fever. Cerebrospinal fluid, urine and blood cultures were all negative. All the children were operated upon and the malfunction corrected. Fever subsided twenty four to thirty six hours after the operation in all the patients. Fever of unknown origin in children with shunted hydrocephalus might be the first sign of a developing shunt malfunction and a neurosurgical examination should be requested.

Adolescent↗

Massive intracranial bleeding requiring emergency splenectomy in a patient with CMV-associated thrombocytopenia.

We describe a previously healthy male patient, with severe immune thrombocytopenic purpura (ITP) following CMV infection which was refractory to steroids and intravenous immunoglobulin, who developed massive intracranial bleeding. Despite an extremely low platelet count (2x10(9)/liter) which was refractory to platelet transfusions, successful emergency splenectomy was performed, with rapid resolution of the thrombocytopenia. Bleeding complications are extremely rare in viral-associated ITP. Emergency splenectomy should be considered in the presence of life-threatening bleeding when other modalities fail to produce a rise in the platelet count. Infection with CMV should be ruled out in cases of severe, treatment-resistant ITP.

Cerebral Hemorrhage↗