RESUMO
A course of small doses of heparin given subcutaneously before and after elective operations has been reported to reduce the incidence of deep venous thrombosis and pulmonary embolism in general surgical patients. To test the safety of mini-dose heparin for neurosurgical patients, mini-dose heparin was used for 150 adult patients undergoing elective neurosurgical procedures. No operative complications were thought to be related to heparin administration. Postoperatively, there were four wound seromas, two hematomas, and one non-fatal pulmonary embolus. Seven patients died postoperatively, of whom five had no evidence of pulmonary embolus. Although no conclusions were drawn as to the effectiveness of mini-dose heparin in preventing deep venous thrombosis or pulmonary emboli, it was believed that the method could be used safely and without fear of increased intracranial or intraspinal bleeding for neurosurgical patients.
Assuntos
Heparina/administração & dosagem , Neurocirurgia , Heparina/efeitos adversos , Humanos , Cuidados Pós-Operatórios , Complicações Pós-Operatórias/prevenção & controle , Embolia Pulmonar/prevenção & controle , Tromboflebite/prevenção & controleRESUMO
The authors describe a case of subarachnoid hemorrhage secondary to moyamoya disease in an adult Negro. To the authors' knowledge, this is the first such case reported. Moyamoya, the Japanese word for "puff of smoke," describes the characteristic angiographic appearance of the collateral arterial network associated with internal carotid artery occlusion. The cause is unknown. Treatment consists of supportive care; the prognosis is variable.
Assuntos
Doenças das Artérias Carótidas/complicações , Hemorragia Subaracnóidea/etiologia , População Negra , Doenças das Artérias Carótidas/genética , Circulação Colateral , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The 14th myelographically demonstrated case of lumbosacral nerve root avulsion is presented with a summary of the previously reported cases. In most cases lumbosacral nerve root avulsion is associated with pelvic fractures and sacroiliac dislocation, which cause a stretching force to be applied to the nerves of the lumbar and sacral plexuses, and in turn to the nerve roots intradurally. This force causes nerve root avulsion in the intradural course of the nerve root. The myelographic defect is a pseudomeningocele or diverticulum-like outpouching created by the tearing of the arachnoid covering of the nerve roots. Myelography clearly indicates nerve root avulsion and surgical exploration is not indicated.