[Intubation using an illuminating stylet in a patient with a catecholamine-secreting paraganglioma]. / Intubación con estilete iluminado en una paciente con paraganglioma secretor de catecolaminas.

Laryngoscopy and tracheal intubation produce intense noxious stimuli and are associated with an adrenergic response that can be deleterious in patients with concomitant diseases. Illuminating stylets effectively aid blind intubation by lighting the trachea, and using such devices has been associated with lower incidences of sore throat, dysphonia, and adverse hemodynamic events in comparison with rigid laryngoscopy. We report the case of a female patient with a catecholamine-secreting vagal paraganglioma. She developed multiple hypertensive episodes that were difficult to control during surgical resection of the tumor. It was decided to perform orotracheal intubation with a Light Wand (Vital Signs, Inc., Totowa, NJ, USA) to avoid oropharyngeal stimulation and to attenuate the hypertension and arrhythmias associated with laryngoscopy in such patients. The procedure was carried out without difficulty on the first attempt, in spite of tracheal displacement. The maximum increases in blood pressure and heart rate were observed 1 minute after intubation and were less than 30% of basal levels. We believe that using this light wand while intubating this patient helped keep the expected hemodynamic response to a minimum during laryngoscopy.

[Spontaneous epidural spinal hematoma: report of 2 cases and review of the literature]. / Hematoma epidural espinal espontáneo: presentación de 2 casos y revisión de la bibliografía.

Spontaneous spinal epidural hematoma is an uncommon cause of cord compression. This lesion has been correlated with some precipitant factors, but frequently is idiopathic. It's a unusual process, more uncommon in children, and there are only 350 cases reported in the literature. Etiology is unknown and there are several theories about it. The clinical presentation is remarkably uniform, with local back and radicular pain followed by sensory and motor disfunction. Early diagnosis and treatment are very important for the functional recovery of the patient. In this article, the literature is reviewed, especially the etiological and therapeutic aspects, and two new cases are reported. These cases can help to define the etiology of this entity.