RESUMO
A 67-year-old woman presented to the emergency department due to acute dyspnea. Computed tomography of the chest showed a pronounced bilateral pulmonary artery embolism. Echocardiography demonstrated a large floating thrombus in the right atrium and right ventricle, which extended through a persistent foramen ovale via the left atrium into the left ventricle. A thrombectomy was later successfully performed.
Assuntos
Forame Oval Patente , Forame Oval , Embolia Pulmonar , Trombose , Idoso , Feminino , Forame Oval Patente/diagnóstico , Forame Oval Patente/diagnóstico por imagem , Humanos , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/cirurgia , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/etiologia , Trombose/diagnóstico , Trombose/cirurgiaRESUMO
Over 2 years, 16 patients with a total of 23 lesions of the craniovertebral junction and the upper cervical spine were treated. Clinically important aspects of diagnosis and classification are outlined. The conditions treated included fractures of the occipital condyle and atlas, dens-axis, and hanged-man fractures. Standard operative treatment, which has to be modified in cases of combined injuries, is presented. Surgery is frequently indicated, especially in elderly and polytraumatized patients. In addition, 2 cases of atlanto-occipital dislocation are described: 1 of these patients survived for 5 days after early atlanto-occipital fusion.