RESUMO
BACKGROUND: The eyebrow approach is a keyhole technique that gives a wide access to the anterior circle of Willis. METHODS: A 4-cm linear incision is placed in the upper limit of the eyebrow and a small supraorbital bone flap is raised. A wide arachnoid dissection is essential to maximize the working space. One or multiple aneurysms may be treated by the same approach. CONCLUSIONS: The eyebrow approach is a safe technique for selected aneurysms of the anterior circle of Willis.
Assuntos
Círculo Arterial do Cérebro/cirurgia , Craniotomia/métodos , Aneurisma Intracraniano/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Craniotomia/efeitos adversos , Sobrancelhas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Retalhos Cirúrgicos/cirurgiaRESUMO
BACKGROUND: Endoscopic endonasal optic nerve decompression (EEOND) is indicated in traumatic and endocrine orbitopathies as well as in idiopathic intracranial hypertension. CASE: We present a patient with bilateral nonspecific inflammatory orbitopathy (NSIO) and optic nerve compression presenting with acute severe visual loss. Bilateral orbital and optic nerve decompression was performed as an emergency procedure with a favorable ophthalmological result. CONCLUSION: EEOND is an effective and safe technique in acute orbitopathies and should be taken in consideration in atypical clinical settings causing severe acute visual loss.
Assuntos
Descompressão Cirúrgica/métodos , Endoscopia/métodos , Doenças do Nervo Óptico/cirurgia , Órbita/inervação , Órbita/cirurgia , Doenças Orbitárias/cirurgia , Nervos Periféricos/cirurgia , Adulto , Terapia Combinada , Serviços Médicos de Emergência , Humanos , Imunossupressores/uso terapêutico , Masculino , Doenças Orbitárias/tratamento farmacológico , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Transtornos da Visão/etiologia , Testes VisuaisRESUMO
Unstable clavicular fractures can be treated surgically with pins and wires or with plates. The migration of metallic devices such as Kirschner wires (K-wires) from the shoulder to a variety of anatomical proximal and distal locations is well documented. Spinal migration, however, is rare and is normally associated with severe spinal injury. This article presents the case of a man who presented with cervicothoracic migration of a K-wire after treatment of a clavicular fracture sustained during a sports accident. The distinctive feature in this case, when compared to the existing literature, is its fortuitous detection by imaging studies and its surgical removal without neurological sequelae.