RESUMO
A retrospective analysis of 50 patients who suffered subarachnoid hemorrhage (SAH) treated at UNICAMP between April 1988 and March 1992 is made, distributed as 34% in Hunt & Hess grade I, 38% in grade II, 16% in grade III, and 12% in grade IV. Males were predominant (66.6%), and patients age varied around 47 +/- 12.13 years old. Only 13 patients (26%) were admitted within the first 24 hours after bleeding, with an overall average of 20.45 days of delay. From all cases only one had a rebleeding, survived and was submitted to surgery. Four patients died after surgery (8%). Timing of operation and prognostic chances were available, being 27.30 days after SAH for Hunt & Hess group I. It is analyzed also the timing for diagnosis-which responded for the most delay, and treatment for the other groups, and a historical comparison with previous series since year 1956 of the same Hospital were documented. Good results were observed in 38 cases (76%). The overall results in terms of mortality and morbidity is, in comparison, in accordance with the literature, and is ameliorated from the past series due to technical improvement, despite worsen difficulties in managing admittance, diagnosis and treatment faster, which is required to deal with the disease.
Assuntos
Aneurisma Intracraniano/cirurgia , Hemorragia Subaracnóidea/cirurgia , Adulto , Idoso , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos RetrospectivosRESUMO
The authors report a case of a hemorrhage of the brainstem after craniotomy for resection of a huge arachnoid cyst of the sylvian fissure on the left hemisphere. The previous simptomatology included clinical signs of increased intracranial pressure, and the computerized tomography showed midline shift. Some factors may contribute to brain hemorrhage post-operatively: cerebral edema, ipsilateral changes in the venous reflux and blood perfusion, although the physiopathology remains obscure. A more careful approach is suggested in such cases with intracranial hypertension.
Assuntos
Cistos Aracnóideos/cirurgia , Tronco Encefálico , Hemorragia Cerebral/etiologia , Craniotomia/efeitos adversos , Mesencéfalo , Cistos Aracnóideos/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
A case of spinal intramedullary cysticercosis in a 13-year-old Brazilian female and a case of spinal leptomeningeal infestation by cysticercosis in a 51 year-old Brazilian female are presented. A review of 95 published cases of medullar cysticercosis since 1856 shows the incidence of this condition. Extramedullary forms are explained by the downward migration of larvae from the cerebral to the spinal subarachnoid space and most larvae are expected to be stopped in the upper portions of the spinal canal due to peculiarities of the anatomy of the spinal cord.