RESUMO
Un encefalocele es una protrusión del cerebro o de las meninges a través de un defecto craneal que está cerrado o cubierto con la piel. El encefalocele occipital es el tipo más frecuente en EE. UU. y Europa occidental, donde alrededor del 85% de los casos de encefalocele adoptan esta forma. Según nuestro conocimiento, solo existen publicados otros 3 casos de encefalocele occipital doble en la literatura. El presente estudio describe un encefalocele occipital doble en un neonato que además se presentaba tanto supra- como infratorcular. También se analiza la importancia de los estudios de neuroimagen preoperatorios para optimizar los resultados. El paciente, un varón de un día, presentaba 2 encefaloceles occipitales identificados mediante ecografía prenatal. Fue sometido a un cierre del encefalocele occipital en el segundo día posnatal. El niño toleró bien el procedimiento, fue extubado en el primer día del postoperatorio y sigue bien durante el seguimiento
An encephalocele is a protrusion of the brain and/or meninges through a defect in the skull that is closed or covered with skin. Occipital encephaloceles are the most frequent type in North America and Western Europe, where about 85% of encephaloceles take this form. To the best of our knowledge, there are only three other reported cases of double occipital encephaloceles in the literature. The current study reports a double and both supra and infra-torcular occipital encephalocele in a neonate and discusses the importance of preoperative neuroimaging studies to optimize the outcome. The patient was a 1-day-old male child who was identified by prenatal ultrasound to have two occipital encephaloceles. The patient underwent a closure of the occipital encephalocele on the second postnatal day. The infant tolerated the procedure well and was extubated on the first postoperative day. The child continues to do well during follow-up
Assuntos
Humanos , Masculino , Recém-Nascido , Encefalocele/cirurgia , Neuroimagem/métodos , Resultado do Tratamento , Diagnóstico Pré-Natal/métodos , Ultrassonografia Pré-NatalRESUMO
An encephalocele is a protrusion of the brain and/or meninges through a defect in the skull that is closed or covered with skin. Occipital encephaloceles are the most frequent type in North America and Western Europe, where about 85% of encephaloceles take this form. To the best of our knowledge, there are only three other reported cases of double occipital encephaloceles in the literature. The current study reports a double and both supra- and infra-torcular occipital encephalocele in a neonate and discusses the importance of preoperative neuroimaging studies to optimize the outcome. The patient was a 1-day-old male child who was identified by prenatal ultrasound to have two occipital encephaloceles. The patient underwent a closure of the occipital encephalocele on the second postnatal day. The infant tolerated the procedure well and was extubated on the first postoperative day. The child continues to do well during follow-up.
Assuntos
Encefalocele/patologia , Humanos , Recém-Nascido , Masculino , Osso OccipitalRESUMO
PURPOSE: Cerebral vasospasm is the common cause of poor outcome after aneurysmal subarachnoid hemorrhage (aSAH). Although many agents are experimentally and clinicaly used to protect or recover from vasospasm, an effective neurotherapeutic drug is still missing. Erythropoietin (EPO) is recently a promising candidate. The aim of this study is to investigate the dose-dependent effects of recombinant human EPO (rhEPO) on arterial wall in a rat femoral artery vasospasm model. METHODS: Thirty two animals were divided into four groups: vasospasm without any treatment (group A), vasospasm +250 IU/kg rhEPO group (group B), vasospasm +500 IU/kg rhEPO group (group C), and control group (group D). Rat femoral artery vasospasm model was used. For groups B and C, 7 days of 250 IU/kg and 500 IU/kg intraperitoneal rhEPO in 0.3 ml saline were administered respectively; and for groups A and D, 0.3 ml saline were administered intraperitoneally without any treatment. After 7 days, histological and morphometric analyses were carried out. RESULTS: Vasospasm alone group demonstrated the highest vessel wall thicknesses, comparing to other groups (p < 0.001). While for groups B and C, vessel wall thickness values were significantly higher than the control group (p < 0.001), between these two groups, there was no significant difference achieved (p > 0.05). CONCLUSION: In our study, there was no significant difference between the two rhEPO treatment groups, but rhEPO treatment was shown to be histologically and morphometrically effective in vasospasm. However, if dosage of EPO treatment is augmented, successful results may be achieved.