RESUMO
We describe the case of a 19-year-old male diagnosed with Reye syndrome within the context of viral pericarditis and salicylate ingestion. He presented a fatal brain oedema without liver failure. Brain biopsies obtained during a decompressive craniectomy led to the diagnosis.
Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Aspirina/efeitos adversos , Síndrome de Reye/cirurgia , Aciclovir/uso terapêutico , Antivirais/uso terapêutico , Edema Encefálico/etiologia , Edema Encefálico/terapia , Coma/etiologia , Coma/terapia , Craniectomia Descompressiva , Evolução Fatal , Escala de Coma de Glasgow , Humanos , Imageamento por Ressonância Magnética , Masculino , Pericardite/complicações , Ressuscitação , Convulsões/etiologia , Convulsões/terapia , Viroses/complicações , Adulto JovemRESUMO
Reye syndrome is a rare, but severe and often fatal disease. The etiology of the classical Reye syndrome is unknown, but it is typically preceded by a viral infection with a free interval of three to five days. The main physiopathological hypothesis is a mitochondrial metabolism insult causing acute liver failure and encephalopathy. Survivors present serious neurological sequelae. The treatment of Reye syndrome is usually medical with intensive care management. Herein, we present the clinical case of a six-month-old baby diagnosed with Reye syndrome with a fulminant hepatitis, who was successfully liver transplanted with an auxiliary partial orthotopic liver transplantation.
Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Aspirina/efeitos adversos , Transplante de Fígado , Síndrome de Reye/cirurgia , Humanos , Lactente , Falência Hepática Aguda/induzido quimicamente , Falência Hepática Aguda/cirurgia , Masculino , Síndrome de Reye/induzido quimicamente , Síndrome de Reye/patologia , Síndrome de Reye/fisiopatologiaRESUMO
We present two cases that demonstrate the occurrence of symptomatic arachnoid cysts after craniotomy. Both patients presented 1 year postoperatively with generalized seizures as the only symptom. Focal or localizing neurological signs were not present. Both patients responded well to shunting procedures.
Assuntos
Aracnoide-Máter/diagnóstico por imagem , Craniotomia , Cistos/diagnóstico por imagem , Adenoma Cromófobo/cirurgia , Adulto , Aracnoide-Máter/cirurgia , Derivações do Líquido Cefalorraquidiano , Criança , Cistos/cirurgia , Feminino , Humanos , Masculino , Neoplasias Hipofisárias/cirurgia , Complicações Pós-Operatórias/diagnóstico por imagem , Síndrome de Reye/cirurgia , Tomografia Computadorizada por Raios XRESUMO
Cerebral edema may complicate the course of fulminant hepatic failure. Response to conventional therapy has been disappointing. We present a patient with fatal acetaminophen-induced fulminant hepatic failure, with signs and symptoms of cerebral edema, unresponsive to conventional medical therapy. Cranial decompression was carried out. A justification of the need for further evaluation of cranial decompression in such patients is presented.
Assuntos
Acetaminofen/intoxicação , Edema Encefálico/etiologia , Doença Hepática Induzida por Substâncias e Drogas , Adolescente , Edema Encefálico/cirurgia , Feminino , Humanos , Hepatopatias/complicações , Prognóstico , Síndrome de Reye/cirurgiaRESUMO
Report of the successful use of a decompressive craniectomy for the encephalopathy of Reye's syndrome with increased intracranial pressure. The patient had failed to respond to all medical management.
Assuntos
Encefalopatias/cirurgia , Craniotomia/métodos , Pressão Intracraniana , Síndrome de Reye/cirurgia , Arginina/uso terapêutico , Edema Encefálico/cirurgia , Derivações do Líquido Cefalorraquidiano , Criança , Glucose/uso terapêutico , Glicerol/uso terapêutico , Humanos , Hidrocefalia/terapia , Masculino , Neomicina/uso terapêuticoRESUMO
Scribner shunts were placed in nine patients, who had clinical and laboratory evidence of Reye's syndrome and ranged in age from four to fifteen years, to facilitate repeated, rapid exchanges of large volumes of blood. A method of inserting the Scribner shunt is described. Over a period of 30 to 90 minutes, 3 to 8 units of blood were easily exchanged without hemodynamic or mechanical difficulties. There were no infections; all shunts were removed from survivors after four to eight days without permanent sequelae.
