Sudden Death in Adults Caused by Intracranial Pathology: A Systematic Review.

AIM: To review the literature, and to identify the main intracranial pathologies that cause sudden deaths in adults. MATERIAL AND METHODS: The systematic review was carried out in concordance with the PRISMA checklist. RESULTS: Epilepsy and intracranial hemorrhage have been found to be the two main causes of sudden and unexplained deaths in adults due to intracranial pathologies. Intracranial neoplasms are not among the two main causes of SD, as they are usually discovered before fatality, so their rate of SD is not so extensive. It is noticed that the highest incidence of this type of death is also related to the abusive use of alcohol and other drugs, such as cocaine, heroin and nicotine. There is a possibility that the actual incidence of SD in adults due to intracranial pathologies is even greater, since there is a lack of reliability in autopsies and the fact that most SD in adults are not witnessed. CONCLUSION: The most recurrent etiologies of SD in adults are epilepsy, intracranial hemorrhage, meningitis or purulent abscess and tumors. Thus, it represents real challenge for neurosurgeons, since their understanding, accurate diagnosis and adequate treatment of these pathologies, in addition to healthy lifestyle habits by people can reduce the possibility of SD.

Gestação heterotópica espontânea: relato de caso com diagnóstico e manejo oportunos / Spontaneous heterotopic pregnancy: a case report with appropriate diagnosis and management

Introdução: A gravidez heterotópica é um fenômeno obstétrico muito raro em concepções espontâneas no qual gestações tópica e ectópica coexistem. O diagnóstico é difícil, mas, se realizado precocemente, o prognóstico é favorável. Descrição do caso: Paciente do sexo feminino, de 35 anos de idade, admitida com quadro de dor abdominal e pequeno sangramento vaginal. Diagnosticada precocemente e tratada cirurgicamente por gravidez heterotópica naturalmente concebida. Como resultado, a gravidez tópica seguiu sem intercorrências. Conclusão: Esse caso enfatiza a necessidade de considerar esse diagnóstico diferencial e analisar clínica e ecograficamente as características globais da pelve, mesmo na ausência de fatores de risco em gestações tópicas.(AU)

Introduction: Heterotopic pregnancy (HP) is a rare obstetric phenomenon in spontaneous conceptions in which intrauterine and ectopic pregnancies coexist. The diagnosis is difficult, but, if performed early, the prognosis is favorable. Case description: A 35-year-old woman was admitted with abdominal pain and light vaginal bleeding. She was early diagnosed and surgically treated for a naturally conceived heterotopic pregnancy. As a result, the intrauterine pregnancy went on healthily. Conclusion: This case emphasizes the need to regard HP as a differential diagnosis and analyze the global pelvis characteristics both clinically and in ultrasound scans, even in the absence of risk factors when dealing with intrauterine pregnancies.(AU)