Spontaneous Hemorrhage within the Neck of a Neurofibromatosis Type 1 Patient

Hung, Min Chen; Yang, Eric H.; Huang, Ying; Chang, Rei-Yeuh

doi:10.1016/j.jemermed.2011.05.024

Cited by 10 publications

(10 citation statements)

References 27 publications

(26 reference statements)

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“…To the best of our knowledge, several cases of thyrocervical bleeding have been reported after invasive procedures, traumatic accidents, infective and vascular diseases with an unexpected association with the neurofibromatosis-1; all cases were treated successfully with endovascular coils, suggesting the value of this interventional approach [4][5][6][7]. As contrary, we found a case of a woman treated for haemoptysis with embolisation of the thyrocervical branch through microspheres that led to a spinal cord infarct [8].…”

Section: Introductionmentioning

confidence: 76%

Pitfalls in the embolisation of a thyrocervical trunk bleeding: a case report

et al. 2020

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Introduction: An intrathoracic bleeding from the thyrocervical branch is not common in blunt trauma, but an interventional radiologist should be aware of the risks in order to prevent complications. Case presentation: A 30-year-old male presented with a right pneumo-haemothorax due to active bleeding revealed at contrast-enhanced CT, as a consequence of a fall occurred in the previous week. The patient was treated with endovascular embolisation in an angiographic room with coils placement, since the right thyrocervical artery was found to be supplying the pneumo-haemothorax. A radiculo-medullary branch rose from the thyrocervical trunk, impeding the proximal embolization with microparticles and needing selective isolation of the bleeding artery with the catheter to avoid spinal cord injuries. The treatment had a successful result and the following CT control showed signs of recovering, without any complication. Conclusion: Our paper presents a rare contingency, warning the operator to bear in mind the presence of arteries feeding the spinal cord. This crucial detail precludes the use of microparticles embolisation to prevent neurologic sequelae, whereas the use of endovascular coils for embolization should be mandatory. Moreover, this case reminds that the post-traumatic bleeding deriving from a cervical trauma may also occur later.

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Section: Introductionmentioning

confidence: 76%

Pitfalls in the embolisation of a thyrocervical trunk bleeding: a case report

et al. 2020

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“…The vessels, which are injured, are not always directly associated with NF-1 and the pathologic mechanism of lesions may be due to intimal thickening of the vascular wall that creates obstructive lesions ( 7 ). Hematoma formation is not common in NF-1, however there are some reports regarding traumatic or spontaneous vascular ruptures in NF patients ( 4 , 8 - 12 ). Moreover, it is important to perform a complete preoperative evaluation, to consider related imaging and to be aware of the probable anesthetic complications associated with the disease ( 13 ).…”

Section: Discussionmentioning

confidence: 99%

Developing Cervical Hematoma Following Jaw Thrust Maneuver Triggered Diagnosis of Neurofibromatosis: A Case Report and Brief Literature Review

2017

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A 25-year-old man underwent an excision of a thigh mass under general anesthesia without any complication. After the operation, he developed oxygen desaturation requiring a jaw thrust maneuver. A rapidly expanding hematoma on the right side of the neck was formed shortly after the application of the maneuver. The patient was returned to the operation room for a neck exploration. Damage to the facial artery and vein was noted. Further evaluations confirmed the diagnosis of Neurofibromatosis type 1 (NF-1). It is recommended that considering the probable risk of arising hematoma in NF-1 patients, application of jaw thrust maneuver should be performed meticulously.

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“…Several cases describe successful endovascular treatment of acute haemorrhage in NF1, even from multiple bleeding sites [ 11 , 13 , 17 – 19 ]. Failure after coiling, however, has been described [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Fatal Retroperitoneal Bleeding Caused by Neurofibromatosis: A Case Report and Review of the Literature

Moerbeek

Buijtenen

Heuvel

et al. 2015

Case Reports in Medicine

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A young female was brought into the emergency department with pulseless electrical activity (PEA) after local resection of neurofibromateous lesions. Chest ultrasonography was normal. Abdominal ultrasonography was not performed. After successful resuscitation a total body CT-scan was performed to rule out potential bleeding sources. However, haemodynamic instability reoccurred and the scan had to be aborted at the thoracoabdominal level. No thoracic abnormalities were found. Resuscitation was reinitiated and abdominal ultrasonography was performed, showing a large amount of abdominal fluid. A progressive fall in haemoglobin was noted. Emergency laparotomy was performed, revealing a large retroperitoneal haematoma. Despite ligation and packing, bleeding continued. Postoperative angiography showed active bleeding from a branch of the left internal iliac artery, which could be successfully coiled. Unfortunately, the patient died five days later due to irreversible brain damage. Revision of an MRI scan made one year earlier showed a 10 cm large retroperitoneal neurofibromatous lesion exactly at the location of the current bleeding. This case shows that patients with neurofibromatosis might develop spontaneous life-threatening bleeding from retroperitoneal located lesions. Furthermore, it points out the necessity of focused assessment with ultrasonography of the abdomen in all patients with PEA of unknown origin.

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Spontaneous Hemorrhage within the Neck of a Neurofibromatosis Type 1 Patient

Cited by 10 publications

References 27 publications

Pitfalls in the embolisation of a thyrocervical trunk bleeding: a case report

Pitfalls in the embolisation of a thyrocervical trunk bleeding: a case report

Developing Cervical Hematoma Following Jaw Thrust Maneuver Triggered Diagnosis of Neurofibromatosis: A Case Report and Brief Literature Review

Fatal Retroperitoneal Bleeding Caused by Neurofibromatosis: A Case Report and Review of the Literature

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