Cavernous angioma natural history, complications and prognosis

Complication, in medicine, is an unfavorable evolution of a disease, a health condition or a medical treatment. The disease can become worse in its severity or show a higher number of signs, symptoms or new pathological changes, become widespread throughout the body or affect other organ systems. A medical treatment, such as drugs or surgery may produce adverse effects and/or produce new health problem(s) by itself. A new disease may also appear as a complication to a previous existing disease. Therefore, a complication may be iatrogenic, i.e., literally brought forth by the physician.

Medical knowledge about a disease, procedure or treatment usually entails a list of the most common complications, so that they can be foreseen, prevented or recognized more easily and speedily.

Depending on the degree of vulnerability, susceptibility, age, health status, immune system condition, etc. complications may arise more easily. Complications affect adversely the prognosis of a disease. Non-invasive and minimally invasive medical procedures usually favor less complications in comparison to invasive ones.

• Generalized septicemia (infection of the blood) may occur as a complication of an infected wound or abscess
• Allergic shock can be a reaction to several kinds of anesthetics, as a complication in a surgery
• Fractured ribs and sternum may be a complication of cardiopulmonary resuscitation attempts in people suffering severe osteoporosis
• Puerperal fever may be a common complication of childbirth and used to kill a large proportion of mothers before the advent of antisepsis and antibiotics
• Diabetes mellitus may present a series of complications in an advanced or more severe stage, such as gangrene, diabetic foot, blindness, infections, etc.
• Thrombosis in the heart or brain, causing stroke or acute myocardial infarction can be complications of blood coagulation disorders, phlebitis (inflammation of the veins), endocarditis and artificial heart valves
• Eczema vaccinatum is a rare and severe complication of smallpox vaccination in people with eczema
• Hepatotoxic dementia is a possible complication of hepatitis and liver cirrhosis
• Mental retardation is a common complication of untreated hydrocephalus
• A paradoxical reaction to a drug that is the totally the opposite effect of the intended purpose of the drug. As in “benzodiazepines” (pronounced [ˌbenzəʊdaɪˈæzəpiːnz], or “benzos” for short) a class of psychoactive drugs considered a minor tranquilizers with varying hypnotic, sedative, anxiolytic, anticonvulsant, and muscle relaxant drug that may create exactly the opposite effect (paradoxical reaction) on susceptible individuals. ^[1]

• Adverse effect (medicine)
• Diagnosis
• Iatrogenesis
• Nocebo
• Placebo (origins of technical term)
• Prognosis

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Prognosis (older Greek πρόγνωσις, modern Greek πρόγνωση – literally fore-knowing, foreseeing) is a medical term denoting the doctor‘s prediction of how a patient’s disease will progress, and whether there is chance of recovery. Since the 20th century, the word has been increasingly used in non-medical contexts as well, for example in corporate finance.

In medicine today, doctors search for methods of predicting how a patient (given their condition) may respond to treatment. Symptoms and tests may indicate favorable treatment with standard therapies. Likewise, a number of symptoms, health factors, and tests may indicate a less favorable treatment result with standard treatment – this may indicate that a more aggressive treatment plan may be desired.

Two areas where this type of prognosis prediction, or the use of prognostic indicators, is with Hodgkin’s lymphoma and Non-Hodgkin lymphoma. Specifically with Non-Hodgkin lymphoma, physicians have developed the International Prognostic Index to predict patient outcome.

Prognostic scoring is also used for other cancer outcome predictions. A Manchester score is an indicator of prognosis in small cell lung cancer.

Other medical areas prognostic indicators are used is in Drug-Induced Liver Injury (DILI) (Hy’s Law) and use of an exercise stress test as a prognostic indicator after myocardial infarction.

Large areas of medicine are still missing statistical figures on the exact prognosis – in these matters the doctor’s previous experiences largely guides pronouncements in this matter. Medical studies have demonstrated that most doctors are overly optimistic when giving prognostic information, that is, they tend to overstate how long the patient might live. For patients who are critically ill, particularly those in an intensive care unit, there are numerical prognostic scoring systems that are more accurate. The most famous of these is the APACHE II scale. However, this scale is most accurate in the seven days prior to a patient’s predicted death.

Knowing the prognosis helps determine whether it makes more sense to attempt certain treatments or to withhold them, and thus plays an important role in end-of-life decisions.

For the great 19th century physicians, particularly the French school, the main aim of medicine was not to cure disease, but rather to diagnose it and achieve a satisfying prognosis of the patient’s chances. Only several decades later did the focus of efforts in Western medicine shift to curing disease.

• Diagnosis
• Nocebo
• Placebo (origins of technical term)
• Sign (medicine)
• Symptom
• Thought experiment

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he:פרוגנוזה nl:Prognose fi:Prognoosi

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