Assuntos
Neoplasias Encefálicas/secundário , Neoplasias da Mama/cirurgia , Discinesias/etiologia , Radiocirurgia , Núcleo Subtalâmico/cirurgia , Doenças Talâmicas/cirurgia , Neoplasias Encefálicas/cirurgia , Dominância Cerebral , Discinesias/cirurgia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Exame NeurológicoAssuntos
Fístula Artério-Arterial/etiologia , Fístula Artério-Arterial/patologia , Craniotomia/efeitos adversos , Complicações Pós-Operatórias/etiologia , Couro Cabeludo/patologia , Couro Cabeludo/cirurgia , Fístula Artério-Arterial/fisiopatologia , Neoplasias Encefálicas/secundário , Neoplasias Encefálicas/cirurgia , Neoplasias da Mama/patologia , Carcinoma/secundário , Carcinoma/cirurgia , Doenças das Artérias Carótidas/etiologia , Doenças das Artérias Carótidas/patologia , Doenças das Artérias Carótidas/fisiopatologia , Epinefrina/efeitos adversos , Feminino , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Complicações Pós-Operatórias/patologia , Complicações Pós-Operatórias/fisiopatologia , Fluxo Sanguíneo Regional/fisiologia , Couro Cabeludo/irrigação sanguínea , Retalhos Cirúrgicos/irrigação sanguínea , Artérias Temporais/lesões , Artérias Temporais/patologia , Artérias Temporais/fisiopatologia , Vasoconstritores/efeitos adversos , VigíliaRESUMO
Our report describes the occurrence of intratumoral hemorrhage in a vestibular schwannoma, which was treated with microsurgical resection thirteen years and gamma knife surgery (GKS) more than two years prior to the event. Although rare, it is apparent that bleeding into a vestibular schwannoma remains a possibility, even after the tumor has responded favorably to GKS. Long-term followup of patients with vestibular schwannoma who have been treated with GKS is advisable to assess treatment response and to detect adverse events (e.g. hemorrhage) suspected on clinical grounds.
Assuntos
Hemorragia Cerebral/diagnóstico , Microcirurgia , Neuroma Acústico/cirurgia , Hemorragia Pós-Operatória/diagnóstico , Radiocirurgia , Ângulo Cerebelopontino/patologia , Seguimentos , Hemossiderina/metabolismo , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neoplasia Residual/diagnósticoRESUMO
Acute hydrocephalus is a well-documented complication of subarachnoid hemorrhage. The insertion of external ventricular drainage (EVD) has been the standard of care in the management of this complication, aiming primarily at immediate improvement of the clinical condition of these patients, making them more suitable candidates for surgical or endovascular intervention. In our current communication, we review the pertinent literature regarding the relationship of rebleeding and EVD. Several studies have implicated a significantly increased risk of rebleeding in patients with EVD, compared with patients without it. Abrupt lowering of the intracranial pressure could lead to rebleeding due to decreased transmural pressure or removal of the clot sealing the previously ruptured aneurysm. However, a variety of parameters that could affect the rebleeding rate, such as the timing of surgery, the timing and duration of drainage, the size of the aneurysm, as well as the severity of the initial hemorrhage, do not seem to have been adequately explored in the majority of these studies. In addition, a number of clinical trials have failed to provide evidence for the negative role of EVD in the development of rebleeding. Conclusively, further long-term multi-center studies are required in order to establish the exact nature of the relationship between EVD and rebleeding after aneurysmal subarachnoid hemorrhage.
Assuntos
Drenagem/efeitos adversos , Hidrocefalia/terapia , Hemorragia Subaracnóidea/fisiopatologia , Aneurisma Roto/etiologia , Aneurisma Roto/fisiopatologia , Pressão Sanguínea , Drenagem/métodos , Humanos , Hidrocefalia/etiologia , Hidrocefalia/fisiopatologia , Pressão Intracraniana/fisiologia , Recidiva , Fatores de Risco , Ruptura Espontânea/etiologia , Ruptura Espontânea/fisiopatologia , Hemorragia Subaracnóidea/etiologia , Hemorragia Subaracnóidea/terapia , Resultado do TratamentoRESUMO
We report the case of a 32-year-old female with a diagnosis of supratentorial tumour. Total removal of the tumour was achieved in a two-stage procedure. Histopathology revealed a primitive neuroectodermal tumour (PNET), an unusual and highly malignant, mainly infratentorial tumour of childhood that is uncommonly described in the supratentorial compartment of adults. We review the literature and describe the existing knowledge of these tumours.
Assuntos
Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/cirurgia , Tumores Neuroectodérmicos Primitivos/patologia , Neoplasias Supratentoriais , Adulto , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Tumores Neuroectodérmicos Primitivos/cirurgia , Neuroglia/patologia , Literatura de Revisão como AssuntoRESUMO
OBJECTIVES: The atlantoaxial segment of the cervical spine is commonly destabilized in a variety of disorders. Transarticular screw fixation of the C1-C2 joint has been proposed as a biomechanically superior therapeutic modality. The authors present their experience with this technique. METHODS: A retrospective analysis of 23 patients treated with this technique was performed. The mean follow-up period was 39.5 +/- 0.1 months. RESULTS: Mean duration of hospitalization was 3.4 +/- 0.1 days (range, 2 to 11 days). No intraoperative or early postoperative complications were detected. Four patients (17.4%) had postoperative complications unrelated to the primary procedure. The position of the screw was judged as satisfactory in 21 patients (91.3%). Two patients (8.7%) with suboptimal positioning of the screws were neurologically intact but needed no reoperation. Solid osseous fusion was detected in 19 patients (82.6%). CONCLUSIONS: Transarticular C1-C2 screw fixation appears to be a safe and surgically reliable technique. Criteria for its application and refinements in its technical considerations continue to advance its clinically versatile therapeutic potential.