RESUMEN
Background Ventriculoperitoneal shunt (VPS) has become the standard treatment for congenital hydrocephalus. In the neurosurgical practice, it is a common procedure which usually results in low rates of complication. However, some serious complications can occur, including infections, intestinal perforation, and even death. Case Description A 19-year-old, female, asymptomatic patient, with a history of appendectomy and revision of the VPS 6 years before, presented spontaneous transanal extrusion of the catheter. Abdominal radiographs and tomography scans showed perforation of the descending colon without peritonitis, with expulsion of the distal tip of the catheter through the anus. The patient underwent removal of the proximal part of the VPS and installation of an external ventricular drain (EVD). On the second postoperative day, there was spontaneous elimination of the distal portion of the catheter, dispensing any additional surgical procedures. With antimicrobial prophylaxis and the contralateral VPS performed, the patient evolved without further complications until discharge. Diverging from cases reported in the literature, the patient in question did not present any abdominal manifestations. Conclusion Intestinal perforation by VPS may be asymptomatic until anal extrusion occurs. However, the early approach should avoid infections, which are associated with increased mortality. Removing only the proximal catheter, together with antimicrobial prophylaxis, can be an effective, safe and less invasive alternative to manage this complication of VPS.
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The COVID-19 pandemic has affected a large number of patients in all countries, overwhelming healthcare systems worldwide. In this scenario, surgical procedures became restricted, causing unacceptable delays in the treatment of certain pathologies, such as glioblastoma. Regarding this tumor with high morbidity and mortality, early surgical treatment is essential to increase the survival and quality of life of these patients. Association between COVID-19 and neurosurgical procedures is quite scarce in the literature, with a few reported cases. In the present study, we present a rare case of a patient undergoing surgical resection of glioblastoma with COVID-19.
Asunto(s)
Humanos , Masculino , Anciano , Neoplasias Encefálicas/cirugía , Glioblastoma/cirugía , COVID-19/tratamiento farmacológico , Neoplasias Encefálicas/diagnóstico por imagen , Resultado del Tratamiento , Glioblastoma/patología , Glioblastoma/diagnóstico por imagen , Procedimientos Neuroquirúrgicos/métodosRESUMEN
Intracranial hypertension (ICH) is a life-threatening condition that can be observed in several diseases. Its clinical presentation is variable, with headache, nausea, vomiting, visual disturbances, papilledema, and alterations in the level of consciousness. The gold standard for the diagnosis of ICHis still the intracranial implantation of invasive devices. Non-invasive techniques, such as ultrasonography of the optic nerve sheath (USONS), have emerged in recent years with promising clinical results. The authors report the case of a patient with progressive headache associated with visual impairment and papilledema, and the eventual diagnosis of idiopathic intracranial hypertension using USONS.
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Humanos , Masculino , Adulto , Nervio Óptico/diagnóstico por imagen , Seudotumor Cerebral/tratamiento farmacológico , Seudotumor Cerebral/diagnóstico por imagen , Presión Intracraneal , Papiledema/diagnóstico por imagen , Retina , UltrasonografíaRESUMEN
Objectives To determine the relationship between alcohol consumption and the incidence of traumatic brain injury (TBI) with diffuse axonal injury (DAI), determining these indices, checking acquired comorbidities and characterizing the patients by gender, age and race/color, as well as describing the characteristics of the motor vehicle collision (vehicle, period of the day, day of the week and site) in people admitted to an emergency hospital in the city of Teresina, in the state of Piauí, Brazil. Methods We have analyzed the data contained in the medical records of patients admitted with a history of motor vehicle collision and severe TBI in intensive care units, based on the forms provided by the Mobile Emergency Care Service (SAMU, in the Portuguese acronym) in the period between February 28 and November 28, 2013. Results In the period covered by the present study, 200 individuals were analyzed, and 54 (27%) had consumed alcohol; of these 11 had DAI. Of the total sample, 17% (34) presented DAI, however, with unknown data regarding the consumption of alcoholic beverages. Conclusion Considering the data, we observed that the profile of the head trauma patients are brown men, mostly (53.5%) aged between 15 and 30 years. The collisions occurred mostly on weekends and at night (55%), and 89.5% of the crashes involved motorcycles.
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Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Adulto Joven , Consumo de Bebidas Alcohólicas/epidemiología , Accidentes de Tránsito/estadística & datos numéricos , Lesión Axonal Difusa/epidemiología , Lesiones Traumáticas del Encéfalo/epidemiología , Factores de Tiempo , Brasil/epidemiología , Consumo de Bebidas Alcohólicas/efectos adversos , Registros Médicos , Epidemiología Descriptiva , Interpretación Estadística de Datos , Lesiones Traumáticas del Encéfalo/etiologíaRESUMEN
Aneurysm of the cervical internal carotid artery is a rare condition, which can trigger severe neurologic complications. The authors report a case of a female patient of 54 years, presenting as a progressive dysphonia, which revealed it to be an aneurysmof the extracranial portion of the internal carotid artery. Endovascular treatment was used.
Aneurisma da artéria carótida interna cervical eÌ uma patologia infrequente, podendo desencadear severas complicações neurológicas. Os autores relatam o caso de uma paciente feminina de 54 anos, apresentando-se por disfonia progressiva, que revelou tratar-se de um aneurisma da porção extracraniana da artéria carótida interna, tendo sido empregado o tratamento endovascular.