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Thermography by Specialty
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
As discussed in Chapter 5 (Physiology), the arteries generally run deep in the body, avoiding injury and heat loss. Arteries can only be seen thermographically, where they run close to the skin surface. An exception is seen in arteritis – arterial inflammation occurring in various autoimmune diseases. Arteritis may be detected thermographically not because the arteries involved are warmer than the surrounding tissues, but because the inflammatory process emits NO, which diffuses through to the local skin surface, preventing it from vasoconstricting. Thus arteritis affecting the more superficial arteries may appear in thermograms of properly cooled and vasoconstricted subjects. The thermographic signs of arteritis should prompt a search for underlying disease. As arteritis may cause intraluminal blood clotting and embolism, thermal signs of arteritis are important to disclose to the patient and emphasize in exam reports.
Non-DR Retinal Vascular Diseases
Published in Ching-Yu Cheng, Tien Yin Wong, Ophthalmic Epidemiology, 2022
Sobha Sivaprasad, Luke Nicholson, Shruti Chandra
As already mentioned, the age group of patients with CRAO varies considerably depending on the etiology; however the most common age group of patients is 60 years or older. As described by Hayreh et al., the non-arteritic subtypes occur at a mean age of 63 years (range 20–90 years). However, the arteritic subtype, due to its association with giant cell arteritis, has been documented to occur in an older population, mean age 74 years (range 62–87 years). Between the two eyes, some studies have shown higher incidence in the right eye whereas some have shown a higher incidence in the left, and some studies show both eyes to be equally affected (66, 74, 76). However, considering the multiple papers published regarding CRAO there has been no evidence to support increased incidence on either side. Bilateral involvement is seen in about 1–2% of cases. There is no evidence in the literature to suggest that race or any other demographic feature predisposes to CRAO development (65).
Management of vascular complications during nonvascular operations
Published in Sachinder Singh Hans, Mark F. Conrad, Vascular and Endovascular Complications, 2021
Kush Sharma, M. Ashraf Mansour
Pseudoaneurysm is the most common nonischemic complication where patients can either undergo primary repair, vein patch angioplasty, or radial artery ligation in the setting of ruptured pseudoaneurysm.40 Patients may also have thrombin injection to the radial artery pseudoaneurysm, which appears to be safe and effective for iatrogenic injury.42 Patients can also have infections with severe infectious arteritis. Management would be antibiotics, excision and wide debridement, and/or irrigation with debridement of abscess.40
Updates in the diagnosis and management of Takayasu’s arteritis
Published in Postgraduate Medicine, 2023
Anupam Somashekar, Yiu Tak Leung
The most common vasculitis disease activity indexes that have been historically used in clinical studies are the NIH disease activity index and Birmingham Vascular Activity Score (BVAS). BVAS has only been validated in small and medium vessel vasculitis and never been validated in Takayasu arteritis. Studies also alluded to Kerr et al. with description of ‘active disease’ including a combination of constitutional symptoms, bruits, new angiographic findings, and elevated acute phase reactants and is now known as the provider global assessment. In 2013, another scoring system called the Indian Takayasu Clinical Activity Score (ITAS2010) was developed and included the six major organ systems affected by Takayasu arteritis. It was later modified to include ITAS-ESR and ITAS-CRP including each of the acute phase reactants [63]. An important limiting factor is that none of these scoring systems include imaging findings in their disease activity scoring.
Polyarteritis nodosa: an evolving primary systemic vasculitis
Published in Postgraduate Medicine, 2023
The first clear description of arterial inflammation (i.e. vasculitis) was presented by Joseph Hodgson in 1815 [2]. Soon thereafter (1852), Karl von Rokitansky presented the first reported case of PAN, describing a 23-year-old with fever and diarrhea. At autopsy, ‘with the exception of the aorta and most of its more prominent root branches, and also of the brain arteries, all arteries were aneurysmic’ [3]. The classic description of PAN was provided by an internist, Adolf Kussmaul, and pathologist, Rudolf Maier, in 1866 with the description of a 27-year-old presenting with numbness, malaise, subcutaneous nodules, and weakness. At autopsy, inflammatory nodules were noted along medium-sized arteries, leading to the suggested name of periarteritis nodosa. They published the first detailed drawings of the microscopic findings, including neutrophilic infiltration of the walls of blood vessels [4]. To distinguish the disease from tertiary syphilis, the name was changed to PAN in the early 1900s [5]. Initially, all patients with noninfectious arteritis were classified as PAN. Several key events have led to redefining the disease.
Spontaneous extracranial arterial dissections in a case of patient with osteogenesis imperfecta
Published in International Journal of Neuroscience, 2021
XiaoJia Tang, Jing Jian, YuHan Luo, Hongyang Fan, PeiPei Liu, YingZhu Chen
Stroke is the second most common cause of death and leading cause of adult disability worldwide. Indeed, stroke represents the first cause of death in China [9]. Ischemic stroke of unusual etiology includes patients with rare cause of stroke, such as: (a) carotid artery dissection; (b) hematological disorders; (c) infections; (d) primary inflammatory arteritis; (e) cerebral infarction secondary to venous thrombosis; and (f) miscellaneous disorders [7]. Similarly, spontaneous internal carotid artery dissection (SICAD) is one of the main causes of ischemic stroke in young people, accounting for 20 to 25% of the cases [10]. The earliest symptoms of SICAD can manifest as headaches, neck pains, incomplete Horner syndrome, as well as brain and retinal ischemia symptoms (50 to 95% of patients). These symptoms often occur within 1 month from the start of the headache and may result in a transient ischemic attack, arterial-infarction, and hemodynamic cerebral infarction [11]. However, the pathogenesis of carotid dissection is not yet fully understood. In fact, although a history of neck trauma is common, it is not universal. Moreover, hematological disorders are uncommon causes of cerebrovascular disease. It has been estimated that 1% of cerebral infarctions in young adults are due to a hematological disorder [12].