RESUMO
En este artículo se ha realizado una revisión sistemática de los aspectos prácticos más destacables del manejo del traumatismo craneoencefálico en base a la literatura médica que hemos considerado relevante. El trabajo se ha desarrollado en diferentes apartados que comprenden la epidemiología, pronóstico y clasificación, anatomía patológica y fisiopatología, evaluación clínica y tratamiento. Se han tratado con especial énfasis las conexiones entre los rasgos fisiopatológicos con mayor grado de evidencia, de acuerdo con las guías de práctica clínica, y los esquemas de manejo terapéutico (AU)
A systematic revision of the main practical aspects related with the head injury management has been made in this article on the basis of relevant literature. The paper has been developed in different sections consisting of epidemiological factors, prognosis and classification, neuropathology and pathophysiology, clinical evaluation and treatment. According to clinical guidelines, the connections between the pathophysiological features with higher evidence degree and the schemes of therapeutic approahes have been emphasized (AU)
Assuntos
Feminino , Humanos , Masculino , Traumatismos Cranianos Penetrantes/líquido cefalorraquidiano , Traumatismos Cranianos Penetrantes/fisiopatologia , Lesão Axonal Difusa/líquido cefalorraquidiano , Lesão Axonal Difusa/metabolismo , Infarto Cerebral/sangue , Infarto Cerebral/genética , Neurônios/citologia , Necrose/cirurgia , Traumatismos Cranianos Penetrantes/complicações , Traumatismos Cranianos Penetrantes/metabolismo , Lesão Axonal Difusa/patologia , Lesão Axonal Difusa/psicologia , Infarto Cerebral/complicações , Infarto Cerebral/fisiopatologia , /normas , Neurônios/patologia , Necrose/complicaçõesRESUMO
A systematic revision of the main practical aspects related with the head injury management has been made in this article on the basis of relevant literature. The paper has been developed in different sections consisting of epidemiological factors, prognosis and classification, neuropathology and pathophysiology, clinical evaluation and treatment. According to clinical guidelines, the connections between the pathophysiological features with higher evidence degree and the schemes of therapeutic approaches have been emphasized.
Assuntos
Traumatismos Craniocerebrais , Dano Encefálico Crônico/etiologia , Dano Encefálico Crônico/prevenção & controle , Edema Encefálico/etiologia , Lesões Encefálicas/diagnóstico , Lesões Encefálicas/etiologia , Lesões Encefálicas/metabolismo , Lesões Encefálicas/fisiopatologia , Lesões Encefálicas/reabilitação , Lesões Encefálicas/cirurgia , Morte Celular , Circulação Cerebrovascular , Traumatismos Craniocerebrais/classificação , Traumatismos Craniocerebrais/complicações , Traumatismos Craniocerebrais/diagnóstico , Traumatismos Craniocerebrais/epidemiologia , Traumatismos Craniocerebrais/fisiopatologia , Cuidados Críticos/métodos , Diagnóstico por Imagem/métodos , Gerenciamento Clínico , Serviços Médicos de Emergência/métodos , Metabolismo Energético , Escala de Coma de Glasgow , Humanos , Hipertensão Intracraniana/etiologia , Hipertensão Intracraniana/terapia , Monitorização Fisiológica/métodos , Exame Neurológico , Neurônios/metabolismo , Neurônios/patologia , Procedimentos Neurocirúrgicos , PrognósticoRESUMO
We report a case of radiation-induced sarcoma in a 50 year-old male patient who was treated with total resection and radiation for right temporal lobe PNET. He received a dose of 60-Gy. A sequential magnetic resonance image 32 months after the completion of radiation therapy and 34 months after surgery showed a mass in the right temporal cerebral convexity. The postoperative diagnosis was sarcoma. Two years later the patient was operated because of a new lesion with similar characteristics. The follow up from the PNET diagnosis is 5 years and 10 months and the survival from sarcoma diagnosis is now 3 years and there is no evidence of recurrence. The development of sarcoma subsequent to cranial irradiation is an infrequent event but it should be considered in the differential diagnosis of a lesion that progresses several years after radiation therapy or when a new lesion appear.
