PubMed · 5886872
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I Gonov. 1965. [Retrograde embolectomy].. https://pubmed.ncbi.nlm.nih.gov/5886872/
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Purtscher's retinopathy presents to the clinician as loss of vision in a patient with a history of a possible precipitating event such as recent major trauma, pancreatitis, childbirth or renal failure. The ophthalmological picture is one of ischaemia at the posterior pole with white patches of oedema and haemorrhages concentrated around the optic disc. The most probable pathological cause is embolisation of the peripapillary terminal arterioles supplying the superficial peripapillary capillary net. The nature of the embolic particles remains uncertain. Complement-mediated aggregates, fat, air, fibrin clots and platelet clumps may all be involved in what is most likely to be a multifactorial process. There is at present no recognised treatment for the condition.
25 pathologists have used an analytical assessment-form in order to study 78 orchidectomies. An histological pattern of more than 50% embryonal carcinoma appears to be in accordance with the rate of embols, which are the main risk factor even if exclusively intratesticular. This form might be useful for multicentric studies.
Cerebral emboli, regardless of their nature, can be detected by transcranial Doppler by performing long-term recordings of the middle cerebral artery. The signals detected, called HITS (high intensity transient signals) described in vitro and in vivo have particular physical characteristics. These embolic signals have been identified in patients with prosthetic heart valves, in patients with atrial fibrillation, following myocardial infarction, following cerebrovascular accident, in patients with carotid stenosis or aortic plaques, during cardiac and carotid surgery and during carotid angiography. During assessment of a cerebrovascular accident, the discovery of HITS could be an argument in favour of an embolic origin. This new technique raises great hopes for establishing the relationship between the discovery of emboligenic heart disease and their neurological clinical manifestations. This new technique has many fields of application: investigation of asymptomatic emboli in patients with emboligenic heart disease, efficacy of antiaggregant, anticoagulant or surgical treatments.