RESUMO
BACKGROUND: Decompressive craniectomy (DC) may reduce mortality but might increase the number of survivors in a vegetative state. In this study, we assessed the long-term functional outcome of patients undergoing DC in a middle-income country. METHODS: This was a prospective observational study of patients undergoing DC at a single tertiary hospital in southern Brazil between January 2015 and December 2018. RESULTS: Of the 125 patients who were included in this study, 57.6% (72/125) had a traumatic brain injury (TBI), 21.6% (27/125) had a stroke, 19.2% (24/125) had a cerebral hemorrhage (intracerebral or subarachnoid hemorrhage), and 0.8% (1/125) had a cerebral abscess. The mean age was 45.18 ± 19.6 years, and 71% of the patients were men. The mean initial Glasgow Coma Scale (GCS) score was 7.8 ± 3.6. The in-hospital mortality rate was 44.8% (56/125). Of the survivors, 50.7% (35/69) had a favorable outcome 6 months after DC. After multivariate analysis, a lower initial GCS score (7.5 ± 3.6 versus 8.8 ± 3.5, P = 0.007) and older age (49.7 ± 18.9 versus 33.3 ± 16.2 years, P = 0.0001) were associated with an unfavorable outcome. CONCLUSION: Six months after DC, almost half of the patients who survive have a favorable outcome.
Assuntos
Lesões Encefálicas Traumáticas , Craniectomia Descompressiva , Adulto , Idoso , Lesões Encefálicas Traumáticas/epidemiologia , Lesões Encefálicas Traumáticas/cirurgia , Países em Desenvolvimento , Humanos , Masculino , Estudos Retrospectivos , Resultado do TratamentoAssuntos
Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/diagnóstico por imagem , Artérias Cerebrais/diagnóstico por imagem , Doenças Arteriais Intracranianas/diagnóstico por imagem , Doenças Arteriais Intracranianas/etiologia , Meningioma/complicações , Meningioma/diagnóstico por imagem , Acidente Vascular Cerebral/diagnóstico por imagem , Angiografia Cerebral , Feminino , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Acidente Vascular Cerebral/etiologiaRESUMO
Descrevemos um caso de melanoma de coroide em um paciente do sexo masculino e 56 anos de idade. A angiografia revelou tumor exofítico de 6 diâmetros de disco em olho esquerdo com vascularização própria, sugerindo melanoma de coroide que foi confirmado com ecografia e tomografia ocular, determinando a enucleação do olho afetado.
We describe a case of choroidal melanoma in a 56-year-old male patient. Angiography revealed an exophytic tumor of 6 disc diameters in the left eye with its own vascularization, suggesting choroidal melanoma, which was confirmed by ultrasonography and eye CT, determining the enucleation of the affected eye.