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1.
Acta cir. bras ; 28(3): 228-232, Mar. 2013. tab
Artigo em Inglês | LILACS | ID: lil-667935

RESUMO

PURPOSE: To investigate the correlation between lateralization of cerebral basal ganglia hemorrhage and handedness. METHODS: Medical records and computed tomography (CT) scans for 84 patients with primary hypertensive intracerebral hemorrhage (ICH) in basal ganglia were reviewed. Data of gender, age, handedness, and location of basal ganglia hematoma were statistically analyzed. Data of age, gender, handedness, health condition, and mean blood flow velocity (BFV) in middle cerebral arteries (MCAs) and anterior cerebral arteries (ACAs) on both sides of 114 healthy individuals were statistically analyzed. RESULTS: We found out that the patients with right basal ganglia hemorrhage were mostly left-handed, while patients with left basal ganglia hemorrhage were mostly right handed (p=0.021, r=0.251). And the mean BFV in the right MCAs of left-handed ones are relatively higher, the mean BFV in the left MCAs of right-handers are relatively higher (p=0.008, r=0.248). CONCLUSION: There 's a correlation between lateralization of cerebral basal ganglia hemorrhage and handedness.


Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hemorragia dos Gânglios da Base/patologia , Lateralidade Funcional , Artéria Cerebral Anterior/fisiopatologia , Hemorragia dos Gânglios da Base , Velocidade do Fluxo Sanguíneo/fisiologia , Artéria Cerebral Média/fisiopatologia , Fatores Sexuais
2.
Acta cir. bras ; 27(10): 727-731, Oct. 2012. tab
Artigo em Inglês | LILACS | ID: lil-650563

RESUMO

PURPOSE: To compare curative effect of different treatments for hypertensive cerebral hemorrhage of 25 to 35ml. METHODS: In this study, 595 cases were enrolled and grouped regarding treatments including conservative treatment, evacuation with microinvasive craniopuncture technique within 6h and 6-48h after the attack. RESULTS: After follow up for three months after the attack, the assessment based on the Activity of Daily Living (ADL) indicated no significant difference among conservative treatment and surgical interventions (p>0.05). However, surgical interventions showed advantages of shorter hospitalization, quick removal of hematoma and obvious reduction of cost. CONCLUSION: The microinvasive craniopuncture technique to drain the hematoma within 6-48h may be a good way in treating hypertensive hemorrhage of basal ganglia region.


OBJETIVO: Comparar o efeito curativo de diferentes tratamentos da hemorragia hipertensiva cerebral de 25 a 35ml. MÉTODOS: Foram analisados 595 casos agrupados segundo tratamento conservador e evacuação com técnica de punção transcraniana dentro de 6h ou de 6 às 48h do início do quadro clínico. RESULTADOS: O seguimento após três meses e avaliado pelo Escore de Atividade de Vida Diário, indicou que não houve diferenças significantes entre os tratamentos conservador e cirúrgico (p>0.05) O tratamento cirúrgico mostrou vantagem com hospitalização mais curta e redução de custos. CONCLUSÃO: A técnica de punção transcraniana para drenagem de hematoma dos núcleos da base pode ser uma boa alternativa de tratamento.


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hemorragia dos Gânglios da Base/terapia , Gânglios da Base/cirurgia , Hemorragia Intracraniana Hipertensiva/terapia , Procedimentos Neurocirúrgicos/métodos , Hemorragia dos Gânglios da Base/patologia , Gânglios da Base/patologia , Distribuição de Qui-Quadrado , Hematoma/cirurgia , Tempo de Internação , Punções/métodos , Fatores de Tempo , Resultado do Tratamento
4.
Arq. neuropsiquiatr ; 61(2B): 376-380, Jun. 2003. ilus, tab
Artigo em Inglês | LILACS | ID: lil-342779

RESUMO

In the present study, we have evaluated the use of intraventricular pressure catheters in thalamic and ganglionic hemorrhages. Ten patients admitted in our Emergency Department in Glasgow Coma Scale (GCS) equal or below 13 enrolled the study (at least one point should have been lost in the eye opening score to exclude purely aphasic patients that were fully alert). After a complete clinical and neurological evaluation, computed tomography scans were obtained and the volume of the hematomas, as well as presence or absence of hydrocephalus, were considered. Intraventricular pressure catheters connected in parallel to external derivation systems were implanted and patients were thereafter sent to the ICU. Patients that presented mass effect lesions with sustained increased ICP levels or clinical and neurological deterioration were submitted in addition, to the surgical evacuation of the hematomas. Clinical evolution, complications and the rehabilitation of the patients were recorded. Clinical outcome was assessed with the Glasgow Outcome Score. In all but three patients the initial intracranial pressure levels were bellow 20 mmHg (mean for all patients was 14.1 ± 6.5 mmHg). Notwithstanding, these three patients were extremely difficult to treat. For this group of patients mortality was 100 percent. Among the patients that presented ICP levels bellow 20 mmHg, 04 developed hydrocephalus and 03 did not display ventricular dilation. As expected, the major benefits concerning the intraventricular pressure catheters connected in parallel with external derivation systems were observed in the group of patients that presented ICP levels bellow 20 mmHg and had hydrocephalus. Mild non-statistically significant correlations for all the three groups were achieved either when the initial GCS and ICP levels (r=-0.28, p=0.43) or when ICP levels and the volumes of the hematomas were compared (r=0.38, p=0.28). In addition, no significant correlations were observed concerning the final outcome of the patients and the variables previously evaluated


Assuntos
Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Hemorragia Cerebral , Pressão Intracraniana , Monitorização Fisiológica , Idoso de 80 Anos ou mais , Hemorragia dos Gânglios da Base , Cateteres de Demora , Hemorragia Cerebral , Drenagem , Escala de Coma de Glasgow , Prognóstico , Tálamo , Tomografia Computadorizada por Raios X , Resultado do Tratamento
5.
Rev. bras. psiquiatr ; 25(1): 40-42, Mar. 2003.
Artigo em Inglês | LILACS | ID: lil-332163

RESUMO

Currently, basal ganglia (BG) are considered regulators of motor and emotional activity. It's operationality encompass Obsessive Compulsive Disorder (OCD). The case of a patient suffering with severe OCD is described of note, his symptoms disappeared following a hemorrhage of the left BG. However, once the hemorrhage was reabsorbed his symptoms returned. It is possible that lesions affecting cerebral OCD association circuits may influence the evolution of obsessive-compulsive symptoms


Assuntos
Adulto , Humanos , Masculino , Hemorragia dos Gânglios da Base , Transtorno Obsessivo-Compulsivo , Hemorragia dos Gânglios da Base/complicações , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/diagnóstico , Remissão Espontânea , Fatores de Tempo
6.
Arq. neuropsiquiatr ; 60(2B): 362-366, June 2002. ilus, tab
Artigo em Inglês | LILACS | ID: lil-310851

RESUMO

PURPOSE: The authors present a prospective study on 10 patients with stereotactic infusion of tissue plasminogen activator (rtPA) intraparenchimal hemorrhage. METHODS: Between 1999 and 2000, 10 patients with deep seated hematomas in the basal ganglia were selected for stereotactic infusion of rtPA and spontaneous clot drainage. RESULTS: All cases had about 80 percent reduction of the hematoma volume in the CT scan at the third day. The intracranial pressure was normalized by the third day too. There were no local or systemic complications with the use of this trombolitic. The results were shown by the Glasgow Outcome Scale with six patients in V, three in IV and one in III after 3 months. CONCLUSION: Early treatment and drainage with minimally invasive neurosurgery , can make these patients with deep-seated hematomas recover the consciousness and they can be rehabilitated earlier avoiding secondary complications


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Hemorragia dos Gânglios da Base , Fibrinolíticos , Hematoma , Hemorragia Intracraniana Hipertensiva , Proteínas Recombinantes , Técnicas Estereotáxicas , Ativador de Plasminogênio Tecidual , Hemorragia dos Gânglios da Base , Terapia Combinada , Drenagem , Fibrinólise , Escala de Coma de Glasgow , Hematoma , Infusões Intra-Arteriais , Hemorragia Intracraniana Hipertensiva , Procedimentos Cirúrgicos Minimamente Invasivos , Estudos Prospectivos , Resultado do Tratamento
7.
Rev. méd. Urug ; 17(2): 140-146, ago. 2001. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-329489

RESUMO

Se analizan características clínicas y tomográficas de los pacientes portadores de hematomas gangliobasales con vistas a individualizar aquellos que pueden beneficiarse con el tratamiento quirúrgico de los mismos. Los factores más significativos son: edad, localización del hematoma en la región ganglio basal, existencia o no de prolongación lobar del hematoma, tamaño del mismo y estado y evolución clínica del enfermo. La cirugía precoz está indicada en un reducido número de pacientes


Assuntos
Humanos , Hemorragia dos Gânglios da Base , Hemorragia Cerebral , Hematoma
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