RESUMO
A 14-year-old girl presented with a rare case of spontaneous bilateral supratentorial epidural hematomas which developed rapidly following cervical surgery. The hematomas presumably resulted from dural dynamics changes secondary to cerebrospinal fluid loss and intracranial hypotension. Intracranial epidural hemorrhage after spinal surgery is extremely uncommon with only one previous case report. Spontaneous intracranial epidural hematoma is an extremely rare complication, but should be considered as a possible complication of spine surgery, especially in adolescents complicated by delayed consciousness and breathing restoration from anesthesia. This case report expands the presently known clinical spectrum of this uncommon complication.
Assuntos
Aracnoide-Máter/cirurgia , Descompressão Cirúrgica , Hematoma Epidural Craniano/etiologia , Neoplasias Meníngeas/cirurgia , Neurilemoma/cirurgia , Complicações Pós-Operatórias/etiologia , Compressão da Medula Espinal/cirurgia , Adolescente , Amnésia/etiologia , Cistos Aracnóideos/complicações , Cistos Aracnóideos/cirurgia , Infarto Encefálico/etiologia , Vértebras Cervicais , Craniotomia , Recuperação Demorada da Anestesia/etiologia , Dura-Máter/lesões , Feminino , Transtornos Neurológicos da Marcha/etiologia , Hematoma Epidural Craniano/fisiopatologia , Hematoma Epidural Craniano/cirurgia , Hemostasia Cirúrgica , Humanos , Oxigenoterapia Hiperbárica , Hipóxia Encefálica/etiologia , Hipóxia Encefálica/terapia , Hipotensão Intracraniana/etiologia , Imageamento por Ressonância Magnética , Neoplasias Meníngeas/complicações , Neurilemoma/complicações , Paresia/etiologia , Complicações Pós-Operatórias/fisiopatologia , Complicações Pós-Operatórias/cirurgia , Respiração Artificial , Compressão da Medula Espinal/etiologiaRESUMO
OBJECTIVE: To establish an in vitro microtest for determining the sensitivity of Plasmodium falciparum to pyronaridine. METHODS: Pyronaridine-coated plate and culture medium which is easy to use in the field were prepared. P. falciparum parasites from in vitro continuous passage culture (FCC1/HN) were used for experimental tests in the laboratory. When they were proved stable and reliable through repeated determinations, field trials were made in Hainan and Yunnan Provinces during the malaria transmission season with blood samples from clinical falciparum malaria cases. A 4-week in vivo test was carried out as a control. RESULTS: The pyronaridine-coated plate and culture medium were proved to be stable. The effective period of pyronaridine-coated plate, the ampule sealed liquid culture medium and the bottled lyophilized culture medium, all stored at 4 degrees C was 6 months, 2 months and 2 years respectively. Through several years field determinations, the baseline data of pyronaridine-sensitivity of P. falciparum in the country were collected and the sensitivity of P. falciparum to pyronaridine was also revealed to have decreased gradually. The mean drug concentration for in vitro complete inhibition of schizont formation raised by 2-4 times although the clinical therapeutic efficacy of pyronaridine was still satisfactory at the present time. CONCLUSION: The developed in vitro microtest can be used for determination of the sensitivity of P. falciparum to pyronaridine, and it is more convenient and sensitive than the 4-week in vivo method.
