[Conservative treatment of laminar extradural hematomas in children]. / Tratamento conservador dos hematomas extradurais laminares na infância.

We successfully treated by nonsurgical methods 15 children with laminar epidural hematomas (EH), with minimal neurological symptoms and no signs of brain herniation. These EH were discovered 30 minutes to 5 days after head injury. The majority were localized in the parietal region. All children recovered without surgery from 2 to 12 days after hospitalization and all had evidence on CT scan of spontaneous clot reabsorption. We discuss the criteria for patient selection for this kind of treatment on EH in children.

[Traumatic extradural hematoma in childhood and normal early computed tomography: report of 2 cases]. / Hematoma extradural traumático na infância e tomografia computadorizada precoce normal. Relato de dois casos.

The cases of two children with traumatic extradural hematoma with an early normal CT scan are reported. Consciousness impairment occurred in them respectively 20 and 60 hours after admission, and CT at this occasion evidenced extradural hematoma. Serial neurological examinations are recommended for children with large traumatic cephalohematoma associated or not to skull fracture and in whom an initial early CT was normal, since they can lately develop extradural hematoma.

Actual asymptomatic epidural hematomas in childhood. Report of three cases.

It is well known that the mortality of epidural hematoma (EDH) cases is directly related to the patient's level of consciousness at the time of surgery. The authors report three actually asymptomatic patients with mild head injury, in whom the diagnosis of EDH was possible because of quite broad indications for computed tomographic (CT) scanning, which allowed diagnosis and treatment in an early phase. These cases illustrate the possibility of an EDH in a totally asymptomatic patient.

Extradural hematomas in children.

The authors studied 58 patients, under 12 years of age, admitted to the Emergency Room of the Sao Paulo University Hospital between September 1987 and November 1991 with the diagnosis of traumatic extradural hematoma. Emphasis was given to the etiology of injury, the time interval from head injury to emergency room evaluation, the clinical features and the outcome after surgical and nonsurgical management. The site of hematoma was defined and correlated with the presence of skull fractures. Computerized tomography is the main diagnostic method, although it is not definitive. Fifteen patients were treated nonsurgically according to rigid clinical and radiological parameters. The overall mortality rate was 3.4%.

Spontaneous epidural hematoma following a shunt in an infant with congenital factor X deficiency. Case report and literature review.

The authors describe a case of an infant with congenital factor X deficiency. The patient presented with a central nervous system hemorrhage followed by hydrocephalus. He underwent a ventriculoperitoneal shunt and, during the postoperative period, developed a spontaneous epidural hematoma, which was evacuated. The clinical and pathophysiological aspects of this case are discussed based on a literature review.

Tratamento cirurgico de compressao de nervo optico por traumatismo craniencefalico / Surgical treatment of optic nerve compression by craniocerebral trauma: a case report

A abordagem operatoria das lesoes traumaticas do nervo optico e raramente descrita E relatado caso de doente submetido a descompressao cirurgica do canal optico para tratamento da compressao mecanica do nervo optico provocada por fragmento osseo.Com o tratamento houve melhora imediata da visa

Estudo comparativo do efeito da metilprednisolona e dexametasona no edema cerebral traumatico. / Comparative study of the effect of methylprednisolone and dexamethasone in traumatic brain edema

Os autores apresentam um estudo comparativo do efeito da metilprednisolona e dexametasona no edema cerebral traumatico. Foram estudados 60 doentes portadores de contusao cerebral grave, constituindo 3 grupos de 20. O primeiro grupo foi medicado com metilprednisolona, o segundo com dexametasona e o terceiro grupo de doentes nao recebeu corticoides, sendo considerado como controle. A analise dos resultados mostrou que nao houve diferencas significativas quanto a evolucao, variacao de pressao intracraniana e incidencia de complicacao, quando comparados os 3 grupos

Medida continua da pressao intracraniana com parafusos (modificacao tecnica). / Continuous measurement of intracranial pressure with subarachnoidal screws (technical note)

A medida continua de pressao intracraniana e importante para a adequada avaliacao de muitas afeccoes neurologicas e neurocirurgicas. A medida da pressao intracraniana por meio de parafusos colocados no espaco subaracnoideo periencefalico e pratica, segura, fidedigna e simples, sendo ha varios anos empregada em muitos centros neurocirurgicos de destaque 3,4,7,10,12,13, 14,15,17. Numerosos problemas tecnicos e complicacoes sao observados com o emprego dos parafusos originais 1,19. Os autores apresentam modificacoes da tecnica de confeccao e de aplicacao dos parafusos atualmente utilizados, a fim de minorar os problemas observados com os parafusos tradicionais