RESUMO
INTRODUCTION: Spinal epidural haematomas are rare entities associated to spinal traumatic injuries and vascular lesions or which can appear spontaneously. There are no direct reports linking them to heart surgery. CASE REPORT: We report the case of a female aged 43 years who underwent surgery to change a mitral valve because of a rheumatic heart disease, and who, from the immediate post operative period onwards, presented paraplegia with a sensory and motor level that reached C3, breathing troubles and quadriplegia. Diagnosis was performed in five days because it was thought that she was suffering from an ischemic spinal cord infarction. Spiral computerised tomography scans revealed an epidural haematoma of the whole spinal cord from C2 to T12, with acute spinal cord compression. Ingurgitation of the epidural venous plexus and venous hypertension were also observed. CONCLUSION: The study of a growing motor and sensory deficit in a patient with immediate heart surgery must include early imaging in order to rule out a space occupying pathology, such as a spinal epidural haematoma. This case is singular because of the extension involved and the fact that it is directly linked with heart surgery procedure.
Assuntos
Procedimentos Cirúrgicos Cardíacos , Hematoma Epidural Craniano/etiologia , Hematoma Epidural Craniano/patologia , Compressão da Medula Espinal/etiologia , Compressão da Medula Espinal/patologia , Adulto , Vértebras Cervicais , Diagnóstico Diferencial , Feminino , Humanos , Vértebras Torácicas , TomografiaRESUMO
The authors report the magnetic resonance imaging diagnostic features in two cases with respectively lumbar epidural hematoma and cavernous hemangioma of the lumbar epidural space. Enhanced MRI T1-weighted scans show a hyperintense signal rim surrounding the vascular lesion. Non-enhanced T2-weighted scnas showed hyperintense signal.
Assuntos
Hemangioma Cavernoso/patologia , Hematoma Epidural Craniano/patologia , Imageamento por Ressonância Magnética , Neoplasias da Coluna Vertebral/patologia , Adulto , Espaço Epidural , Hemangioma Cavernoso/cirurgia , Hematoma Epidural Craniano/cirurgia , Humanos , Masculino , Neoplasias da Coluna Vertebral/cirurgiaRESUMO
Spontaneous epidural hematomas are rarely described in literature. They are associated with infectious diseases of the skull, coagulation disorders, vascular malformations of the dura-mater and metastasis to the skull. The authors report two cases of spontaneous epidural hematoma of different etiologies, and study parameters of hemostasis.
Assuntos
Hematoma Epidural Craniano/etiologia , Adolescente , Transtornos da Coagulação Sanguínea/complicações , Criança , Feminino , Hematoma Epidural Craniano/patologia , Hematoma Epidural Craniano/cirurgia , Humanos , Masculino , Sinusite/complicaçõesRESUMO
Os hematomas epidurais espontâneos sao raramente descritos na literatura. Estao associados a doenças infecciosas do crânio, distúrbios da coagulaçao, malformaçoes vasculares da dura-máter e metástases na calota craniana. Os autores relatam dois casos de hematomas epidurais espontâneos de diferentes etiologias e discutem aspectos relacionados à hemostasia.
Assuntos
Feminino , Humanos , Adolescente , Criança , Hematoma Epidural Craniano/etiologia , Transtornos da Coagulação Sanguínea/complicações , Hematoma Epidural Craniano/patologia , Hematoma Epidural Craniano/cirurgia , Sinusite/complicaçõesRESUMO
Seven cases of victims of road traffic accidents with extradural haematoma (EH) and diffuse axonal injury (DAI) are reported. Such cases are part of a total of 120 victims of fatal road traffic accidents that were subjected to pathological study. The association of the two lesions occurred in 5.8% of the patients and all cases of EH were associated with DAI. The latter explains the immediate coma (absence of lucid interval) and the grave prognosis for all seven patients. It was noted that EH is relatively infrequent in road traffic accidents, but in such cases it is more severe since it is frequently associated with DAI and immediate coma.
Assuntos
Acidentes de Trânsito/mortalidade , Lesão Axonal Difusa/patologia , Hematoma Epidural Craniano/patologia , Adolescente , Adulto , Encéfalo/patologia , Brasil , Causas de Morte , Coma/mortalidade , Coma/patologia , Lesão Axonal Difusa/mortalidade , Hematoma Epidural Craniano/mortalidade , Humanos , Masculino , PrognósticoRESUMO
Los hematomas epidurales crónicos son entidades raras, que pueden producir consecuencias severas si no se diagnostican y tratan a tiempo. Diferentes etiologías se han involucrado en esta patología, como las traumáticas, anticoagulantes, diátesis hemorrágicas, angiomas espinales, y las espontaneas sin causa evidente. Se describe el caso de un paciente de 69 años quien presentó dolor lumbar de 15 dias de evolución, parestesias en miembros inferiores y dificultad para la marcha, con antecedentes de un traumatismo lumbrar un mes antes de su ingreso. La Rx simple, mielografía, mielo-TAC y resonancia magnética, demostraron una fractura-aplastamiento de L1 con una masa intra-espinal D12-L2, donde la limectomíademostró un hematoma epidural crónico con buena recuperación post-operatoria