RESUMO
A case of reported of complication following surgical treatment of bilateral subdural haematomas in an elderly man. Acute haematoma developed after the operation between the dura and the external surface of the capsule of the haematoma which had been removed several hours earlier through a trepanation hole. Attention is called to the atypical localization of the complication with bleeding externally to the capsule and not into the space left after haematoma evacuation which is usually observed in case of haematoma recurrence. The problem is discussed, whether such bleeding during chronic persistence of haematoma can lead to the development of multilayer and multilocular haematomas. In the presented case quick recognition of the complication followed by reoperation with removal of haematoma and bleeding capsule through craniotomy with rehabilitation treatment after the operation has led to very good therapeutic effect.
Assuntos
Dura-Máter/diagnóstico por imagem , Dura-Máter/cirurgia , Hematoma Subdural/diagnóstico , Hematoma Subdural/cirurgia , Doença Aguda , Idoso , Doença Crônica , Humanos , Masculino , Tomografia Computadorizada por Raios XRESUMO
Case records of one-hundred patients operated on for centrally prolapsed lumbar intervertebral disc were analyzed for establishing of typical clinical symptom complex. Despite the complexity and variety of clinical manifestations five groups of patients were isolated on the basic of their pain features and neurological deficit. Besides, for more exact diagnosis of prolapsed level, the neurological signs were analyzed in relation to these levels. This approach makes possible more precise diagnosis in practice important in view of the possible consequences of central prolapsed of intervertebral disc (PIVD).