RESUMEN
Symptomatic cavernous malformations in the ventral region of the pons are difficult to access surgically. The authors present a case of a 46-year-old woman with a 10-year history of sudden and transitory diplopia and right hemiparesis, followed by five more episodes of mild right hemiparesis. Brain MRI showed a 2.6-cm cavernous malformation in the pons with an exophytic portion in the prepontine cistern. The patient underwent an endoscopic endonasal transclival approach for a complete resection of the lesion. CSF leak was noted and corrected on the sixth postoperative day. The patient progressed with complete motor deficit recovery. The video can be found here: https://youtu.be/ePgpyij2Wpo.
RESUMEN
BACKGROUND: Cerebral venous thrombosis is an uncommon subtype of cerebrovascular accident. The appropriate time interval between decompressive craniectomy and the onset of anticoagulation in patients with cerebral venous thrombosis is a controversial topic among neurosurgeons, neurologists, and intensivists. CASE DESCRIPTION: We present a brief clinical case report of a female patient who underwent decompressive craniectomy. Cerebral venous thrombosis was subsequently diagnosed, and anticoagulation was initiated 24 hours postoperatively. CONCLUSIONS: Early onset of anticoagulation is important for a favorable outcome. Clinical decision making should rely on the following: 1) postoperative imaging studies with no evidence of increase in hematoma, 2) intracranial pressure monitoring for patients on mechanical ventilation, and 3) protocols for immediate suspension of anticoagulants and use of antagonistic drugs in case of an increase in a pre-existing intracranial hemorrhage.
Asunto(s)
Anticoagulantes/administración & dosificación , Craniectomía Descompresiva/efectos adversos , Trombosis Intracraneal/tratamiento farmacológico , Complicaciones Intraoperatorias/tratamiento farmacológico , Trombosis de la Vena/tratamiento farmacológico , Adulto , Craniectomía Descompresiva/métodos , Esquema de Medicación , Femenino , Humanos , Trombosis Intracraneal/diagnóstico por imagen , Trombosis Intracraneal/etiología , Complicaciones Intraoperatorias/diagnóstico por imagen , Complicaciones Intraoperatorias/etiología , Trombosis de la Vena/diagnóstico por imagen , Trombosis de la Vena/etiologíaRESUMEN
Os autores apresentam o caso de um paciente adulto, com sinais e sintomas de compressão de cauda equina, ocasionados por meningocele sacral oculta. Não havia alterações cutâneas no dorso, mas sim deformidade congênita dos pés. Foi feita a remoção cirúrgica do cisto que proporcionou alívio dos sintomas.