RESUMEN
A 22-year-old male had a meniscopathy operation using spinal anesthesia. After the operation, the patient reported a throbbing headache. His brain computed tomography (CT) showed subarachnoid hemorrhage (SAH) and hyperdense dural venous sinuses suspicious for thrombosis. Filling defects were observed in the superior sagittal and right transverse sinuses on the contrast-enhanced magnetic resonance images. The patient was diagnosed with cerebral venous sinus thrombosis (CVST). On the tenth day of his admission, his clinical findings progressed and heparin therapy was initiated after resorption of hemorrhage was observed in a second non-contrast CT scan. The patient developed decreased consciousness the day after heparin administration. A subsequent brain CT revealed intraparenchymal hemorrhage in the right anteroinferior frontal region. Heparin therapy was discontinued, and anti-edema therapy was started. The presentation of CVST with SAH is a rare condition. Furthermore, development of CVST after spinal anesthesia is very rare. In this case, CVST developed after spinal anesthesia, and its first clinical presentation was SAH. To our knowledge, this is the first case CVST presenting with SAH after spinal anesthesia.
Asunto(s)
Anestesia Raquidea/efectos adversos , Trombosis Intracraneal/diagnóstico , Complicaciones Posoperatorias/diagnóstico , Hemorragia Subaracnoidea/diagnóstico , Trombosis de la Vena/diagnóstico , Anticoagulantes/uso terapéutico , Diagnóstico Diferencial , Resultado Fatal , Heparina/uso terapéutico , Humanos , Trombosis Intracraneal/diagnóstico por imagen , Trombosis Intracraneal/tratamiento farmacológico , Masculino , Meniscos Tibiales/cirugía , Complicaciones Posoperatorias/diagnóstico por imagen , Radiografía , Hemorragia Subaracnoidea/diagnóstico por imagen , Lesiones de Menisco Tibial , Trombosis de la Vena/diagnóstico por imagen , Trombosis de la Vena/tratamiento farmacológico , Adulto JovenRESUMEN
AIM: Although surgery is the most effective means of eliminating or reducing seizures in cases of medically refractory epilepsy, the expected or unexpected surgical complications must also be kept in mind in order not to decrease patients' quality of life. The aim of this present study was to assess the surgical complications of temporal lobe epilepsy surgery and their effects on the disease course in patients with intractable epilepsy arising from the temporo-mesial structures. MATERIAL AND METHODS: The records of 58 patients who underwent temporal lobectomy and/or selective amygdalahippocampectomy at Gülhane Military Medical Academy between January 2000 and August 2010 were reviewed for peri- and post-surgical complications. RESULTS: Post-surgical complications were detected in 7 patients (12%). The most common complication of ES was infection in 2 patients (2.9%). Other complications were hemorrhagic infarction, paresis of the frontal branch of the left facial nerve, subdural effusion, anxiety disorder, depressive disorder and late-onset psychosis. CONCLUSION: The results of our study suggest the importance of post-operative care and long-term follow up in order to achieve favorable seizure outcome after epilepsy surgery.
Asunto(s)
Lobectomía Temporal Anterior/efectos adversos , Epilepsia del Lóbulo Temporal/cirugía , Complicaciones Posoperatorias/etiología , Adulto , Amígdala del Cerebelo/cirugía , Trastornos de Ansiedad/etiología , Hemorragia Cerebral/etiología , Trastorno Depresivo/etiología , Enfermedades del Nervio Facial/etiología , Femenino , Estudios de Seguimiento , Hipocampo/cirugía , Humanos , Masculino , Persona de Mediana Edad , Trastornos Psicóticos/etiología , Estudios Retrospectivos , Efusión Subdural/etiología , Infección de la Herida Quirúrgica/etiologíaAsunto(s)
Aeronaves , Presión Atmosférica , Aire Comprimido/efectos adversos , Trastornos de Cefalalgia/diagnóstico , Enfermedades de los Senos Paranasales/diagnóstico , Adolescente , Niño , Femenino , Trastornos de Cefalalgia/tratamiento farmacológico , Trastornos de Cefalalgia/etiología , Humanos , Masculino , Enfermedades de los Senos Paranasales/complicaciones , Enfermedades de los Senos Paranasales/tratamiento farmacológicoRESUMEN
OBJECTIVES: Hot water epilepsy (HWE) or bathing epilepsy is one of the reflex epilepsies induced by hot water pouring over the head, face, neck, or trunk during bathing. The aim of this study was to demonstrate the clinical and electroencephalographic features and the management alternatives of the patients with HWE. METHODS: The age of seizure onset, duration of seizure, family history, interictal and postictal electroencephalography findings, triggering temperature of water, type of seizure, medication, and follow-up results were evaluated for each patient. RESULTS: The mean age at seizure onset was 10.5 years. The mean duration of seizures was 10 years. Interictal EEG recordings showed focal abnormalities in 4 patients and generalized abnormalities in 3 patients. Only one patient had normal interictal EEG findings. Among the 8 patients with HWE, 6 had seizures only during hot bathing, whereas 2 had additional seizures. Seven patients had generalized tonic-clonic seizures and 1 patient had complex partial seizure during their hot bathings. The mean triggering temperature of water was calculated as 41.4 degrees C. The mean duration of follow-up period was 23 months. Five patients became seizure-free during the follow-up period and seizures persisted in 3 patients. Antiepileptic drugs were given (800 mg/d carbamazepine for 2 patients and 600 mg/d phenytoin for 1 patient) to these 3 patients and they also became seizure-free during the follow-up period. CONCLUSIONS: Hot water epilepsy is a benign reflex epilepsy. Lowering water temperature must be the first step for the treatment. If needed, antiepileptic drugs should be considered as an additive treatment.