RESUMO
Trauma is one of the leading causes of death in Brazil. We report on 28 cases of traumatic intracerebral hematomas operated on via a minimally invasive approach. A simplified method of localization and right placement of the burr hole is described in details, as well as the technique used in all cases. Every patient was submitted to pre- and postoperative CT scan (computerized tomography) and had the volume of the hematoma measured before the surgical procedure to compare the efficacy of the treatment. No patient needed a second operation, even though in some cases there were residual hematomas. We believe that this approach can be done with safety and replace a standard craniotomy in selected cases.
Assuntos
Hemorragia Cerebral Traumática/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Acidentes , Adulto , Brasil , Hemorragia Cerebral Traumática/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Trepanação/métodosRESUMO
The tethered spinal cord syndrome is a disease that is part of the group of spinal dysraphisms, that was recently recognized as an individualized nosological entity, yet not frequently diagnosed among us. It is characterized by shortening and thickening of the filum terminale which prevents the ascent of the spinal cord into spinal canal, the conus medularis abnormally remaining in a low place. It is associated in all cases with spina bifida. The diagnosis is simple, once the disease is suspected. It is manifested by progressive motor or sensory deficit in the legs, urinary incontinence, scoliosis and leg or back pain, specially in young children. The plain lumbosacral RX always shows spina bifida. Myelography makes the diagnostic. It shows, basically, the negative image of the thickened filum terminale and the low placed conus medularis. Other exams which can help are the computerized tomography and the ultra-sound of the spinal cord. The surgical treatment is very simple and heals without sequels if done in due time. It consists in a sectioning of the filum terminale through laminectomy. Two cases diagnosed and treated at Hospital da Baleia, from Fundação Benjamin Guimarãcs, Belo Horizonte, are reported in this paper.