[Type A intramural hematoma of aorta: An undervalued clinical entity]. / Hématome intramural aortique de type A : une entité clinique sous-évaluée.

Intramural hematoma of the ascending aorta occurs after rupture of the vasa vasorum. Previously considered as a first step of acute aortic dissection, it was later defined as a separate entity that may or may not lead to arterial dissection. The debate about the most appropriate treatment for a 69-year-old patient with intramural hematoma of the ascending aorta, led to this extensive review of the literature demonstrating that intramural hematoma type A is a life-threatening condition requiring urgent surgical support.

[Medial dislocation of hip screw following internal fixation of a pertrochateric metastasis in the femur with gamma nails]. / Mediale Schenkelhalsschraubendislokation nach Gammanagelosteosynthese einer pertrochantären Femurmetastase.

If the standard technical guidelines are ignored so that the antirotation screw is not correctly placed during gamma nail osteosynthesis, dislocation of the hip screw is possible. In the rare cases of migration into the pelvis, the consequences may be lethal.

Acute and long-term effects of massive balloon dilation on the aortic wall and vasa vasorum.

To investigate the acute and long-term effects on the vasa vasorum after massive overdilation, canine aortic segments were dilated with Gruentzig balloon catheters to more than 100% over normal size. In the acute study, the significant lumen increase was the result of intimal and medial rupture with stretching and thinning of the adventitia. In these areas, the vasa vasorum were stretched and severed, causing adventitial hemorrhage. In the chronic study, areas of previous subtotal wall rupture with adventitial thinning were repaired by scar tissue. This repair included formation of a neomedia, hyperplasia of the adventitia, and proliferation of the vasa vasorum. No progression of luminal dilatation was seen. This study showed that in subtotal aortic wall rupture, even a severely damaged adventitia is capable of preserving the lumen from further dilatation and rupture until healing. Blood flow to the damaged vessel wall was reestablished by revascularization via capillary budding in the aortic wall.

Traumatic arteriovenous malformation of the eyelid.

Traumatic arteriovenous malformations (AVM) are formed by an abnormal and usually complex communication between arteries and veins. In contrast to congenital AVMs which occur most commonly in the head and neck, traumatic AVMs are usually reported in the extremities and are commonly the result of military conflicts. In 1757, William Hunter delivered his classical treatise on true and false aneurysms and described a traumatic fistula between the brachial artery and vein following phlebotomy. Approximately thirty cases of acquired traumatic AVMs of the facial region appear in the literature. Only two cases of acquired AVMs of the eyelid region have been reported--one of a post inflammatory origin and one which developed spontaneously. This paper presents the case of a large traumatic AVM of the right lower eyelid along with a discussion of the principles and management of these vascular lesions.