RESUMEN
External ventricular drain (EVD) placement is one of the most basic and common neurosurgical procedure which most was performed by young neurosurgical trainees. This study is conducted to determinate the safe and accuracy of EVD placement by freehand method. About 129 EVD placements were evaluated in this study. Eighty-three catheters (64.3%) were located in the ipsilateral frontal horn or third ventricle. The functional accuracy was 86%. Of eighteen misplaced catheters, only 4 (3.1%) catheters were nonfunctional, requiring a replacement or reposition. The higher misplaced rate was significantly observed in patients whose head CT scans revealed the lower hydrocephalus ratio (28.85%) and the smaller ventricular size (5.6 mm). Twenty-one (16.2%) new hemorrhages associated with EVD placements were observed. Using the freehand method, EVD placement is a safe and effective procedure in management of these emergent neurosurgical diseases.
Asunto(s)
Ventrículos Cerebrales/cirugía , Derivaciones del Líquido Cefalorraquídeo/efectos adversos , Drenaje/efectos adversos , Hemorragia/etiología , Hemorragia/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Ventrículos Cerebrales/patología , Falla de Equipo , Femenino , Hemorragia/diagnóstico por imagen , Humanos , Hidrocefalia/diagnóstico por imagen , Hidrocefalia/cirugía , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Adulto JovenRESUMEN
Complete fracture-dislocation of thoracolumbar spine without significant neurologic deficits is a rare entity. The possible mechanism may result from the spontaneous decompressive fractures of the spinal elements with sparing of the spinal cord. Here, we report a case of a healthy 50-year-old man who presented with complete fracture-dislocation of T12 through L1 vertebrae without paraplegia. Early diagnosis and early surgery with decompression, reduction, and stabilization is the best policy in management of this unstable spine injury.
Asunto(s)
Luxaciones Articulares/cirugía , Vértebras Lumbares/lesiones , Fracturas de la Columna Vertebral/cirugía , Vértebras Torácicas/lesiones , Accidentes por Caídas , Descompresión Quirúrgica , Humanos , Luxaciones Articulares/diagnóstico por imagen , Vértebras Lumbares/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Fracturas de la Columna Vertebral/diagnóstico por imagen , Vértebras Torácicas/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
Postoperative intracerebral hemorrhages occurring after evacuation of subdural fluid collections have been infrequently reported and remain a devastating complication. The pathophysiological mechanism is still unclear. Disturbed autoregulation and restoration of normal cerebral flow seems to play an important role in this type of event because of rapid decompression. Herein, we present a case of multiple intracerebral hemorrhages in the putamen and cerebellar hemisphere following evacuation of bilateral subdural effusions, and review the relevant literature.