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1.
Rev. Assoc. Med. Bras. (1992) ; 68(1): 37-43, Jan. 2022. tab, graf
Article in English | LILACS | ID: biblio-1360694

ABSTRACT

SUMMARY OBJECTIVE: This study aimed to develop and validate a practical nomogram to predict the occurrence of post-traumatic hydrocephalus in patients who have undergone decompressive craniectomy for traumatic brain injury. METHODS: A total of 516 cases were enrolled and divided into the training (n=364) and validation (n=152) cohorts. Optimal predictors were selected through least absolute shrinkage and selection operator regression analysis of the training cohort then used to develop a nomogram. Receiver operating characteristic, calibration plot, and decision curve analysis, respectively, were used to evaluate the discrimination, fitting performance, and clinical utility of the resulting nomogram in the validation cohort. RESULTS: Preoperative subarachnoid hemorrhage Fisher grade, type of decompressive craniectomy, transcalvarial herniation volume, subdural hygroma, and functional outcome were all identified as predictors and included in the predicting model. The nomogram exhibited good discrimination in the validation cohort and had an area under the receiver operating characteristic curve of 0.80 (95%CI 0.72-0.88). The calibration plot demonstrated goodness-of-fit between the nomogram's prediction and actual observation in the validation cohort. Finally, decision curve analysis indicated significant clinical adaptability. CONCLUSION: The present study developed and validated a model to predict post-traumatic hydrocephalus. The nomogram that had good discrimination, calibration, and clinical practicality can be useful for screening patients at a high risk of post-traumatic hydrocephalus. The nomogram can also be used in clinical practice to develop better therapeutic strategies.


Subject(s)
Humans , Decompressive Craniectomy/adverse effects , Brain Injuries, Traumatic/surgery , Brain Injuries, Traumatic/complications , Hydrocephalus/surgery , Hydrocephalus/etiology , Hydrocephalus/epidemiology , Cohort Studies , Nomograms
2.
Arch. argent. pediatr ; 119(5): e526-e530, oct. 2021. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1292776

ABSTRACT

La hidrocefalia es una condición clínica que consiste en un cúmulo de líquido cefalorraquídeo a nivel encefálico. Una de las causas, poco frecuente, es el síndrome de Dandy-Walker. Se presenta el caso de un recién nacido con diagnóstico prenatal de hidrocefalia secundaria a una malformación de Dandy-Walker y sospecha de genitales ambiguos. Tras el nacimiento, se confirma el diagnóstico prenatal de malformación de Dandy-Walker asociado a manifestaciones extracraneales poco frecuentes como hipospadias interescrotal y dilatación del seno coronario secundario a persistencia de la vena cava superior izquierda. Con este caso clínico queremos exponer la complejidad del síndrome de Dandy-Walker debido a sus múltiples asociaciones, que marcarán el pronóstico del paciente y la necesidad de tratamiento multidisciplinar.


Hydrocephalus is a clinical condition that consists of an accumulation of cerebrospinal fluid around the brain; Dandy-Walker syndrome is a rare cause of it. We present the case of a newborn with prenatal diagnose of hydrocephalus due to a Dandy-Walker malformation, as well as ambiguous genitalia. After birth, diagnosis of Dandy-Walker malformation associated with uncommon extracranial manifestations is confirmed. Specifically, the baby presents interscrotal hypospadias and coronary sinus dilatation due to the persistence of the left superior vena cava. With the exposition of this case, we bring out the complexity of the Dandy-Walker syndrome due to the malformations associated with it; the ones that will determine the prognosis and the need of a multidisciplinary treatment


Subject(s)
Humans , Male , Pregnancy , Infant, Newborn , Dandy-Walker Syndrome/complications , Dandy-Walker Syndrome/diagnosis , Hydrocephalus/diagnosis , Hydrocephalus/etiology , Prognosis , Vena Cava, Superior , Brain
3.
Rev. chil. pediatr ; 91(1): 105-110, feb. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1092794

ABSTRACT

Resumen: Introducción: El Síndrome de Guillain-Barré (SGB) es raramente diagnosticado en lactantes menores de 1 año. Su asociación con el Síndrome de Wiskott Aldrich (SWA), es aún menos frecuente, y ha sido previa mente reportada sólo en dos pacientes a nuestro conocimiento. La hidrocefalia, es una complicación conocida, pero infrecuente del SGB. Objetivo: presentar el caso clínico de un lactante en el que se asocian las patologías de SGB, SWA e hidrocefalia. Caso Clínico: varon de 9 meses, portador de SWA hospitalizado en unidad de cuidados intensivos por hipotonía aguda y compromiso del estado gene ral. Evolucionó con parálisis fláccida, falla ventilatoria y arreflexia generalizada. Una punción lumbar mostró disociación albuminocitológica, y el estudio electrofisiológico mostró signos de polineuropatía desmielinizante severa. Se trató con inmunoglobulina, evolucionando en forma satisfactoria. Por bradicardia intermitente, se realizó tomografla axial computada cerebral (TAC), que mostró signos de una hidrocefalia aguda, manejada mediante válvula derivativa ventrículo peritoneal con favorable respuesta. En el largo plazo, se sometió a trasplante de médula ósea y debió ser reintervenido por complicaciones valvulares, sin embargo, su desarrollo psicomotor es normal sin secuelas neurológi cas evidentes hasta los 3 años. Conclusión: Presentamos el tercer caso de SGB en un paciente porta dor de SWA, destacando ser el primero de ellos en un lactante menor de 1 año. Adicionalmente, este niño presentó una hidrocefalia aguda como complicación del SGB. Consideramos relevante tener presente estas comorbilidades, debido a que su pronto diagnóstico y manejo oportuno, permiten una mejor recuperación neurológica y evitan complicaciones potencialmente letales.


Abstract: Introduction: Guillain-Barre Syndrome (GBS) is rarely diagnosed in the first year of life. The association of GBS with Wiskott-Aldrich syndrome (WAS) is even less frequent and has been previously reported in only two children to our knowledge. Hydrocephalus is a known but rare complication of GBS. Objective: To describe the case of an infant in which GBS, WAS and hydrocephalus appear clinically associated. Clinical Case: A nine-months-old male infant with a history of WAS was admitted to our ICU with acute hypotonia and poor general condition. He developed flaccid paralysis, absent deep tendon reflexes, and respiratory failure. A lumbar puncture showed albuminocytologic dissociation. GBS was suspected and an electromyography was performed, showing a demyelinating polyneuropathy. He was successfully treated with intravenous immunoglobulins. During hospitalization, he presented intermittent bradycardia, so a brain CT scan was performed, showing acute hydrocephalus which was managed through an external ventricular drain achieving favorable response. In the long term, the patient underwent bone marrow transplant and had to be reoperated due to valve-related complications. However, his psychomotor development is normal, with no obvious neurological sequelae. Conclusion: We present the third case of GBS in a patient with WAS, which is the first infant younger than one year. Additionally, he presented acute hydrocephalus as a complication of GBS. We suggest considering these three comorbidities since their early diagnosis and prompt management allow bet ter neurological recovery and avoid potentially lethal complications.


Subject(s)
Humans , Male , Infant , Wiskott-Aldrich Syndrome/complications , Guillain-Barre Syndrome/diagnosis , Guillain-Barre Syndrome/etiology , Hydrocephalus/diagnosis , Hydrocephalus/etiology
4.
Arq. neuropsiquiatr ; 77(11): 806-814, Nov. 2019. tab
Article in English | LILACS | ID: biblio-1055184

ABSTRACT

ABSTRACT Aneurysmal subarachnoid hemorrhage is a condition with a considerable incidence variation worldwide. In Brazil, the exact epidemiology of aneurysmal SAH is unknown. The most common presenting symptom is headache, usually described as the worst headache ever felt. Head computed tomography, when performed within six hours of the ictus, has a sensitivity of nearly 100%. It is important to classify the hemorrhage based on clinical and imaging features as a way to standardize communication. Classification also has prognostic value. In order to prevent rebleeding, there still is controversy regarding the ideal blood pressure levels and the use of antifibrinolytic therapy. The importance of definitely securing the aneurysm by endovascular coiling or surgical clipping cannot be overemphasized. Hydrocephalus, seizures, and intracranial pressure should also be managed. Delayed cerebral ischemia is a severe complication that should be prevented and treated aggressively. Systemic complications including cardiac and pulmonary issues, sodium abnormalities, fever, and thromboembolism frequently happen and may have na impact upon prognosis, requiring proper management.


RESUMO Hemorragia subaracnoidea aneurismática (aHSA) é uma condição com grande variação de incidência mundialmente. No Brasil, não dispomos de números epidemiológicos exatos. A apresentação clínica mais comum da HSA é a cefaleia, usualmente descrita como a pior da vida. A tomografia de crânio, quando feita nas primeiras 6 horas do ictus, tem uma sensibilidade próxima a 100%. É importante classificar a hemorragia utilizando escalas clínicas e radiológicas, como forma de padronizar a comunicação, e também predizer prognóstico. Para prevenção de ressangramento, ainda há controvérsias quanto aos níveis pressóricos ideais e uso de antifibrinolíticos. O tratamento definitivo do aneurisma, por sua vez, é fundamental, seja por meio endovascular ou cirúrgico. Hidrocefalia, crises epilépticas e a pressão intracraniana devem ser manejadas de forma apropriada. Isquemia cerebral tardia é uma complicação grave que deve ser prevenida e tratada agressivamente. Complicações sistêmicas, incluindo cardíacas, pulmonares, anormalidades de sódio, febre e tromboembolismo ocorrem frequentemente e podem ter impacto no prognóstico, necessitando de manejo adequado.


Subject(s)
Humans , Subarachnoid Hemorrhage/complications , Subarachnoid Hemorrhage/physiopathology , Seizures/etiology , Seizures/physiopathology , Seizures/therapy , Subarachnoid Hemorrhage/therapy , Brain Ischemia/etiology , Brain Ischemia/physiopathology , Brain Ischemia/therapy , Risk Factors , Hydrocephalus/etiology , Hydrocephalus/physiopathology , Hydrocephalus/therapy
6.
Arq. neuropsiquiatr ; 75(7): 433-438, July 2017. tab, graf
Article in English | LILACS | ID: biblio-888297

ABSTRACT

ABSTRACT Objective The literature describes various cerebrospinal fluid (CSF) drainage techniques to alleviate posthemorrhagic hydrocephalus in preterm newborns; however, consensus has not been reached. The scope of this study was describing a case series of premature neonates with posthemorrhagic hydrocephalus and assessing the outcomes of different approaches used for CSF diversion. Methods A consecutive review of the medical records of neonates with posthemorrhagic hydrocephalus treated with CSF drainage was conducted. Results Forty premature neonates were included. Serial lumbar puncture, ventriculosubgaleal shunt, and ventriculoperitoneal shunt were the treatments of choice in 25%, 37.5% and 37.5% of the cases, respectively. Conclusion Cerebrospinal fluid diversion should be tailored to each case with preference given to temporary CSF drainage in neonates with lower age and lower birth-weight, while the permanent ventriculoperitoneal shunt should be considered in healthier, higher birth-weight neonates born closer to term.


RESUMO Objetivo A literatura descreve várias opções de drenagem liquórica (DL) para alivio da hidrocefalia pós-hemorrágica (HPH) em neonatos prematuros; contudo, não existe um consenso sobre a melhor abordagem. O escopo deste estudo foi descrever uma série de casos de neonatos prematuros, portadores de HPH, verificando os resultados de diferentes técnicas utilizadas para DL. Métodos Revisão consecutiva dos prontuários de neonatos com diagnostico de HPH submetidos a DL. Resultados Quarenta recém-nascidos prematuros foram incluídos. A punção lombar seriada (PL), a derivação ventriculosubgaleal (VSG) e a derivação ventrículo peritoneal (VP) foram o tratamento escolhido em 25%, 37,5% e 37,5% dos casos, respectivamente. Conclusão As opções de DL devem ser avaliadas caso a caso, sendo dada preferência às drenagens temporária em prematuros com idade e peso mais baixos ao nascer, enquanto o shunt definitivo (derivação VP) pode ser considerado naqueles prematuros mais saudáveis, com idade e peso superiores.


Subject(s)
Humans , Male , Female , Infant, Newborn , Cerebrospinal Fluid Shunts/methods , Cerebral Hemorrhage/surgery , Hydrocephalus/surgery , Infant, Premature , Cerebral Hemorrhage/complications , Cerebral Hemorrhage/diagnostic imaging , Retrospective Studies , Treatment Outcome , Ultrasonography, Doppler, Transcranial , Hydrocephalus/etiology , Hydrocephalus/diagnostic imaging
7.
Säo Paulo med. j ; 135(2): 146-149, Mar.-Apr. 2017. tab, graf
Article in English | LILACS | ID: biblio-846293

ABSTRACT

ABSTRACT CONTEXT AND OBJECTIVE: Neurocysticercosis is prevalent in developing countries and manifests with several neurological signs and symptoms that may be fatal. The cysts may be parenchymal or extraparenchymal and therefore several signs and symptoms may occur. Depending on their location, neurosurgical procedures may be required, sometimes as emergencies. The aim here was to review 10-year statistics on all surgical neurocysticercosis cases at a large public tertiary-level hospital. DESIGN AND SETTING: Retrospective cohort at a large public tertiary-level hospital. METHODS: All surgical neurocysticercosis cases seen between July 2006 and July 2016 were reviewed. Parenchymal and extraparenchymal forms were considered, along with every type of surgical procedure (shunt, endoscopic third ventriculostomy and craniotomy). The literature was reviewed through PubMed, using the terms “neurocysticercosis”, “surgery”, “shunt” and “hydrocephalus”. RESULTS: 37 patients underwent neurosurgical procedures during the study period. Most were male (62.16%) and extraparenchymal cases predominated (81%). Patients aged 41 to 50 years were most affected (35.13%) and those 20 years or under were unaffected. Ventricular forms were most frequently associated with hydrocephalus and required permanent shunts in most cases (56.57%). CONCLUSIONS: The treatment of neurocysticercosis depends on the impairment: the parenchymal type usually does not require surgery, which is more common in the extraparenchymal form. Hydrocephalus is a frequent complication because the cysts often obstruct the cerebrospinal flow. The cysts should be removed whenever possible, to avoid the need for permanent shunts.


RESUMO CONTEXTO E OBJETIVO: A neurocisticercose é prevalente em países em desenvolvimento e manifesta-se com vários sinais e sintomas neurológicos que podem ser fatais. Os cistos podem ser parenquimatosos ou extraparenquimatosos, portanto vários sinais e sintomas podem estar presentes. Dependendo da sua localização, procedimentos neurocirúrgicos podem ser necessários, às vezes em caráter emergencial. O objetivo foi revisar dados estatísticos de um período de 10 anos de todos os casos cirúrgicos de neurocisticercose num grande hospital público terciário. TIPO DE ESTUDO E LOCAL: Coorte retrospectiva de um grande hospital público terciário. MÉTODOS: Todos os casos cirúrgicos de neurocisticercose de pacientes tratados entre julho 2006 e julho 2016 foram revisados. As formas parenquimatosas e extraparenquimatosas foram consideradas, assim como tipo de procedimento cirúrgico (derivação, terceiroventriculostomia endoscópica e craniotomia). A literatura foi revisada por meio da PubMed, utilizando-se os termos “neurocysticercosis”, “surgery”, “shunt” e “hydrocephalus”. RESULTADOS: 37 pacientes foram submetidos a procedimentos neurocirúrgicos nesse período, a maioria do sexo masculino (62.16%%) e casos extraparenquimatosos predominaram (81%). Pacientes com idade 41-50 anos foram os mais afetados (35,13%) e aqueles com 20 anos ou menos não foram afetados. As formas ventriculares mais frequentemente estiveram associadas a hidrocefalia e necessitaram da realização de shunts definitivos na maior parte dos casos (56,57%). CONCLUSÕES: O tratamento depende da forma de acometimento: o tipo parenquimatoso usualmente não necessita de cirurgia que é mais comum na forma extraparenquimatosa. Hidrocefalia é uma complicação frequente pois muitas vezes os cistos obstruem o fluxo liquórico. A remoção dos cistos deve ser realizada sempre que possível para evitar a necessidade de derivações definitivas.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Young Adult , Neurocysticercosis/surgery , Magnetic Resonance Imaging , Sex Factors , Retrospective Studies , Neurocysticercosis/diagnosis , Neurocysticercosis/epidemiology , Epilepsy/etiology , Hydrocephalus/etiology
8.
Rev. bras. neurol ; 53(1): 5-14, jan.-mar. 2017. tab
Article in English | LILACS | ID: biblio-832724

ABSTRACT

Neurocysticercosis (NCC) is the brain infection caused by larval stages of the helminth Taenia solium. The embryos of Taenia travel through the bloodstream and can reach the brain, muscles, eyes, and various organs. In the brain, the psychiatric manifestations are mood disorders, depression and anxiety, which are commonly associated with epilepsy and sensory-motor deficits. Neurocysticercosis is a frequent parasitic disease in the world population; it is endemic in Central and South America, Asia and Sub-Saharan Africa. In the present review, we report the major symptoms and signals of neurocysticercosis common to neurological and psychiatric illnesses. We briefly present Epidemiology of those manifestations and analyze the relationship between pathological changes and NCC symptomatology. OBJECTIVES AND METHODOLOGY: A literature review was conducted to characterize epidemiological, neurological and psychiatric manifestations of NCC. The final 90 papers were selected of a set of 937 publications from 2010 to 2016. RESULTS: NCC is a major cause of epilepsy in endemic areas; further- more, leads to a diversity of motor and sensitive deficits, manifestations vary from headache to severe intracranial hypertension. Potentially fatal conditions include arteritis, encephalitis and hydrocephalus. Depression and cognitive decline remain among the most important psychiatric manifestations. Neuropsychiatric manifestations, Epidemiology, and neuroimaging provide diagnostic criteria. Brain scans may reveal one or diverse cysts filled with fluid within a scolex (parasite's head). CONCLUSION: NCC's diversity of presentations encourage health professionals to consider it in diagnoses, especially in endemic countries, and also in non-endemic areas because migrants and travelers are subject to contagious. Treatment consists in use of antiparasitic drugs (albendazol, praziquantel) and drugs to treat associated conditions (anticonvulsants, corticosteroids). Surgery is reserved to extirpate the parasite from particular locations (eyes, spinal cord, cerebral ventricles) or to differentiate NCC from tumors, tuberculosis, mycosis, etc. Prevention includes treatment of intestinal helminthiasis, sanitation in animal farming, food preparing hygiene, quality control of water and food.


Neurocisticercose é a infecção cerebral causada pelos estágios lar- vais do helminto Taenia solium. Os embriões da Taenia deslocam-se através da corrente sanguínea e podem atingir o cérebro, músculos, olhos e vários órgãos. No cérebro, as manifestações psiquiátricas são transtornos de humor, depressão e ansiedade, as quais estão comumente associados com epilepsia e deficiências sensório-motoras. Neurocisticercose é uma parasitose frequente na população mundial, é endêmica na América Central e do Sul, Ásia e África subsaariana. Na presente revisão, relatamos os principais sintomas e sinais de neurocisticercose pertinentes a doenças neurológicas e psiquiátricas. Nós brevemente apresentamos a Epidemiologia dessas manifestações, e analisamos a relação entre alterações patológicas e sintomatologia da NCC. OBJETIVOS E METODOLOGIA: Uma revisão da literatura foi conduzida para caracterizar a epidemiologia, as manifestações neurológicas e psiquiátricas de NCC. Os 90 artigos finais foram selecionados de um conjunto de 937 publicações entre 2010 a 2016. RESULTADOS: NCC é uma importante etiologia de epilepsia em áreas endêmicas, além disso causa uma diversidade de deficiências motoras e sensoriais, as manifestações variam de cefaleia a severa hipertensão intracraniana. Condições potencialmente fatais incluem arterites, encefalites e hidrocefalia. Depressão e declíneo cognitive permanecem entre as mais importantes manifestações psiquiátricas. Manifestações neuropsiquiátricas, epidemiologia e neuroimagem provêm os critérios de diagnóstico. As imagens cerebrais podem revelar um ou diversos cistos preenchidos com líquido e o escólex (cabeça) do parasito. CONCLUSÕES: A diversidade de apresentações da NCC encoraja os profissionais de saúde a considerá-la dentre os diagnósticos, especialmente em países endêmicos; e também em áreas não-endêmicas, pois migrantes e viajantes estão sujeitos ao contágio. O tratamento consiste no uso de antiparasíticos (albendazol, praziquantel) e medicamentos para tratar condições associadas (anticonvulsivantes, corticosteróides). Cirurgia é reservada para remoção do parasito de locais particulares (olhos, medula espinhal, ventrículos cerebrais) ou para diferenciar NCC de tumores, tuberculose, micose, etc. Prevenção inclui o tratamento de helmintíases intestinais, sanidade animal, higiene ao preparar alimentos, controle da qualidade da água e alimentos.


Subject(s)
Humans , Neurocysticercosis/complications , Neurocysticercosis/diagnosis , Neurocysticercosis/epidemiology , Praziquantel/therapeutic use , Albendazole/therapeutic use , Incidence , Cognition Disorders/etiology , Neurocysticercosis/drug therapy , Taenia solium/pathogenicity , Depression/etiology , Epilepsy/etiology , Neuroimaging/methods , Hydrocephalus/etiology
9.
Rev. bras. neurol ; 52(4): 33-35, out.-dez. 2016.
Article in English | LILACS | ID: biblio-831707

ABSTRACT

Tuberculous Meningitis (TBM) is a severe manifestation of tuberculosis that represents 1% of the cases of infection by Mycobacterium tuberculosis. Children are among the other age groups the most affected and when present, HIV-1 is responsible for poorer prognosis. It was carried out a search on the databases of Pubmed, Lilacs and Scielo, looking for articles that approach the principals news aspects of neurologic complications caused by TBM. The literature cite as major neurologic findings the hydrocephalus in approximately 80% patients, meningeal irritation, coma, seizures, intracranial pressure signs, cranial nerve palsy, hemiparesis and disorders in the movement. Neurologic sequelae occur in up to 50% of survivors and early diagnosis is crucial to reduce the occurrence of major functional losses. In this way, discussions presenting more specific methods for TBM as well as better assessment of the signs and symptoms of the disease is necessary for a better prognosis and lower mortality rate of these patients.


A meningite tuberculosa (MTB) é uma manifestação grave da tuberculose que representa 1% dos casos de infecção por Mycobacterium tuberculosis. As crianças estão as faixas etárias mais afetadas e quando presente, o HIV-1 é responsável pelo pior prognóstico. Foi realizada uma revisão de bancos de dados Pubmed, Lilacs e Scielo, à procura de artigos que abordem os principais aspectos das complicações neurológicas causadas pela MTB. Os principais achados neurológicos compreendem a hidrocefalia em aproximadamente 80% dos pacientes, irritação meníngea, coma, convulsões, sinais de pressão intracraniana, paralisia de nervo craniano, hemiparesia e distúrbios movimento. Sequelas neurológicas ocorrem em até 50% dos sobreviventes e o diagnóstico precoce é crucial para reduzir a ocorrência de perdas. Desta forma, as discussões apresentando métodos mais TBM, bem como uma melhor avaliação dos sinais e sintomas da doença é necessária para um melhor prognóstico e menor taxa de mortalidade desses pacientes.


Subject(s)
Humans , Infant , Child, Preschool , Child , Tuberculosis, Meningeal/complications , Tuberculosis, Meningeal/diagnosis , Hydrocephalus/etiology , Nervous System Diseases/etiology , Tuberculosis/complications , Tuberculosis/diagnosis , Tomography, X-Ray Computed/methods , Disease Progression , Mycobacterium tuberculosis/isolation & purification
10.
Rev. bras. ter. intensiva ; 28(2): 141-146, tab
Article in Portuguese | LILACS | ID: lil-787734

ABSTRACT

RESUMO Objetivo: Comparar a evolução clínica da hemorragia subaracnóidea perimesencefálica com a da hemorragia subaracnóidea não perimesencefálica. Métodos: Estudo retrospectivo, que incluiu pacientes portadores de hemorragia subaracnóidea sem causa conhecida em um hospital terciário localizado na região norte de Portugal. Os dados epidemiológicos, clínicos e de imagem foram analisados estatisticamente, levando em conta a divisão dos pacientes em duas categorias: hemorragia subaracnóidea perimesencefálica e hemorragia subaracnóidea não perimesencefálica. Resultados: Cumpriram os critérios de inclusão 62 pacientes, 46,8% deles com hemorragia subaracnóidea perimesencefálica e 53,2% com hemorragia subaracnóidea não perimesencefálica. As caraterísticas demográficas, assim como os antecedentes clínicos, foram similares entre os grupos. As complicações foram observadas mais comumente no grupo com hemorragia subaracnóidea não perimesencefálica, sendo que 84,8% desses pacientes tiveram, no mínimo, uma complicação, comparados a 48,3% dos pacientes com hemorragia subaracnóidea perimesencefálica. Vasoespasmo, infecções e hidrocefalia foram as complicações mais comuns - todas observadas mais frequentemente nos pacientes com hemorragia subaracnóidea não perimesencefálica. Dois pacientes vieram a falecer, ambos com hemorragia subaracnóidea não perimesencefálica. A mediana do tempo de permanência no hospital foi maior nos pacientes com hemorragia subaracnóidea não perimesencefálica (21 dias, em comparação aos 14 dias observados nos pacientes com hemorragia subaracnóidea perimesencefálica). Não se observaram recidivas de sangramento durante o acompanhamento (tempo médio de 15 ± 10,3 meses). Conclusão: As hemorragias subaracnóideas perimesencefálica e não perimesencefálica tiveram formas diferentes de evolução clínica, principalmente no que se referiu à taxa de complicações e ao tempo mediano de permanência no hospital. Assim, a abordagem dessas duas formas de hemorragia subaracnóidea deve ser distinta, tanto em busca de melhorar o tratamento dos pacientes quanto para obter um melhor aproveitamento dos recursos de saúde.


ABSTRACT Objective: To compare the clinical evolution of perimesencephalic subarachnoid hemorrhage and non-perimesencephalic subarachnoid hemorrhage. Methods: The study was conducted retrospectively in a tertiary hospital center in the north region of Portugal. Included patients had no identifiable cause for subarachnoid hemorrhage. Several epidemiologic, clinical and imaging aspects were statistically analyzed, taking into account the differences in perimesencephalic subarachnoid hemorrhage and non-perimesencephalic subarachnoid hemorrhage. Results: Sixty-two patients met the inclusion criteria (46.8% - perimesencephalic subarachnoid hemorrhage; 53.2% - non-perimesencephalic subarachnoid hemorrhage). Demographic and clinical background characteristics were similar in both groups. Complications were more frequent in patients with non-perimesencephalic subarachnoid hemorrhage - 84.8% of the patients had at least one complication versus 48.3% in perimesencephalic subarachnoid hemorrhage. Vasospasm, infection and hydrocephaly were the most common complications (each was detected more frequently in the non-perimesencephalic subarachnoid hemorrhage group than in perimesencephalic subarachnoid hemorrhage group). Two patients died, both had a non-perimesencephalic subarachnoid hemorrhage. The median inpatient time was longer in the non-perimesencephalic subarachnoid hemorrhage group (21 versus 14 days). No incidents of rebleeding were reported during the follow-up period (mean time of 15 ± 10.3 months). Conclusion: Perimesencephalic subarachnoid hemorrhage and non-perimesencephalic subarachnoid hemorrhage are two different entities that have different clinical outcomes, namely in terms of complication rate and median inpatient time. The management of these patients should respect this difference to improve treatment and optimize health care resources.


Subject(s)
Humans , Male , Female , Adult , Aged , Subarachnoid Hemorrhage/physiopathology , Vasospasm, Intracranial/etiology , Hydrocephalus/etiology , Infections/etiology , Portugal , Subarachnoid Hemorrhage/complications , Time Factors , Retrospective Studies , Follow-Up Studies , Vasospasm, Intracranial/epidemiology , Tertiary Care Centers , Hydrocephalus/epidemiology , Infections/epidemiology , Length of Stay , Middle Aged
11.
Rev. bras. anestesiol ; 66(2): 200-203, Mar.-Apr. 2016. graf
Article in English | LILACS | ID: lil-777400

ABSTRACT

ABSTRACT BACKGROUND AND OBJECTIVES: Pulmonary edema is caused by the accumulation of fluid within the air spaces and the interstitium of the lung. Neurogenic pulmonary edema is a clinical syndrome characterized by the acute onset of pulmonary edema following a significant central nervous system insult. It may be a less-recognized consequence of raised intracranial pressure due to obstructive hydrocephalus by blocked ventricular shunts. It usually appears within minutes to hours after the injury and has a high mortality rate if not recognized and treated appropriately. CASE REPORT: We report a patient with acute obstructive hydrocephalus due to ventriculo-atrial shunt dysfunction, proposed to urgent surgery for placement of external ventricular drainage, who presented with neurogenic pulmonary edema preoperatively. She was anesthetized and supportive treatment was instituted. At the end of the procedure the patient showed no clinical signs of respiratory distress, as prompt reduction in intracranial pressure facilitated the regression of the pulmonary edema. CONCLUSIONS: This report addresses the importance of recognition of neurogenic pulmonary edema as a possible perioperative complication resulting from an increase in intracranial pressure. If not recognized and treated appropriately, neurogenic pulmonary edema can lead to acute cardiopulmonary failure with global hypoperfusion and hypoxia. Therefore, awareness of and knowledge about the occurrence, clinical presentation and treatment are essential.


RESUMO JUSTIFICATIVA E OBJETIVOS: o edema pulmonar é causado pelo acúmulo de líquido nos alvéolos e no interstício pulmonar. Edema pulmonar neurogênico é uma síndrome clínica caracterizada por edema pulmonar de início agudo após um acometimento súbito do sistema nervoso central. Pode ser uma consequência menos reconhecida de pressão intracraniana aumentada por causa da hidrocefalia obstrutiva por derivações ventriculares bloqueadas. Geralmente aparece em minutos ou horas após o insulto e tem uma alta taxa de mortalidade, caso não seja identificado e tratado adequadamente. RELATO DE CASO: relatamos o caso de paciente com hidrocefalia obstrutiva aguda por causa da disfunção da derivação ventrículo-atrial, programado para cirurgia em caráter de urgência para a colocação de derivação ventricular externa, que apresentou edema pulmonar neurogênico no pré-operatório. A paciente foi anestesiada e o tratamento de manutenção instituído. No fim do procedimento, a paciente não apresentou quaisquer sinais de distúrbio respiratório, pois a redução rápida da pressão intracraniana facilitou a regressão do edema pulmonar. CONCLUSÕES: este relato aborda a importância da identificação de um edema pulmonar neurogênico como uma possível complicação no período perioperatório resultante de um aumento da pressão intracraniana. Quando não identificado e tratado adequadamente, o edema pulmonar neurogênico pode levar à insuficiência cardiorrespiratória aguda, com hipoperfusão global e hipóxia. Portanto, a conscientização e o conhecimento de sua ocorrência, apresentação clínica e seu tratamento são essenciais.


Subject(s)
Humans , Female , Adolescent , Pulmonary Edema/etiology , Cerebrospinal Fluid Shunts/adverse effects , Intracranial Hypertension/complications , Hydrocephalus/etiology , Pulmonary Edema/pathology , Pulmonary Edema/therapy , Acute Disease , Intracranial Hypertension/therapy , Hydrocephalus/pathology
12.
Arq. neuropsiquiatr ; 73(12): 1019-1025, Dec. 2015. tab, graf
Article in English | LILACS | ID: lil-767611

ABSTRACT

ABSTRACT Introduction Treatment of hydrocephalus is accomplished primarily through a ventricular-peritoneal shunt (VPS). This study aims to describe the application of retrograde ventricle-sinus shunt (RVSS) in patients with hydrocephalus after surgical treatment of myelomeningocele. Method A prospective, randomized and controlled pilot study. We consecutively enrolled 9 patients with hydrocephalus after surgical repair of myelomeningocele from January 2010 to January 2012. These patients underwent elective RVSS or VPS. Five underwent RVSS and 4 underwent VPS. Patients were followed for one year with quarterly evaluations and application of transcranial Doppler. Results RVSS group showed outcomes similar to those of VPS group. Doppler revealed significant improvement when comparing preoperative to postoperative period. RVSS group had significantly higher cephalic perimeter than VPS group. Neuropsychomotor development, complications and subjective outcomes did not differ between groups. Conclusion RVSS shunt is viable; it is an alternative option for the treatment of hydrocephalus.


RESUMO O tratamento da hidrocefalia é realizado principalmente através de uma derivação ventrículo-peritoneal (DVP). Nosso objetivo é descrever a aplicação da derivação ventrículo-sinusal retrógrada (DVSR) em pacientes com hidrocefalia após o tratamento cirúrgico de mielomeningocele. Método Estudo prospectivo, randomizado e controlado. Selecionados consecutivamente 9 pacientes com hidrocefalia após correção cirúrgica de mielomeningocele de janeiro de 2010 a janeiro de 2012. Eles foram submetidos à DVSR ou DVP. Cinco foram submetidos à DVSR e 4 à DVP. Foram seguidos por 1 ano com realização trimestral de avaliações e aplicação do Doppler transcraniano. Resultados O grupo DVSR apresentou desfechos semelhantes ao grupo DVP. O Doppler mostrou melhora significativa quando comparado o pré-operatório com o pós-operatório. O grupo DVSR apresentou perímetro cefálico significativamente maior que o grupo DVP. O desenvolvimento neuropsicomotor e complicações não diferiram entre os grupos. Conclusão A derivação ventrículo-sinusal retrógrada é viável; ela é uma opção para o tratamento de hidrocefalia.


Subject(s)
Female , Humans , Infant , Male , Hydrocephalus/surgery , Meningomyelocele/surgery , Ventriculoperitoneal Shunt/methods , Hydrocephalus/etiology , Meningomyelocele/complications , Prospective Studies , Tomography, X-Ray Computed , Treatment Outcome
13.
Rev. chil. pediatr ; 86(5): 357-360, oct. 2015. ilus
Article in Spanish | LILACS | ID: lil-771650

ABSTRACT

Introducción: El síndrome del cráneo en trébol, o síndrome de Kleeblattschädel, es una malformación rara en la cual el cráneo presenta un aspecto de trébol. Es causado por el cierre prematuro de varias suturas, evidenciándose desde antes del nacimiento. Objetivo: presentar nuestra experiencia en un caso de síndrome del cráneo en trébol, y actualizar la información de la literatura. Caso clínico: lactante de sexo femenino, 5 meses de edad, diagnósticos al nacimiento de Fisura labio-Palatina e Hidrocefalia. A los 30 días de vida se instaló válvula ventrículo peritoneal, y se procedió a enucleación ocular bilateral por proceso infeccioso. Se controla en Genética donde se confirma macrocefalia y craneosinostosis tipo cráneo en trébol. El estudio citogenético 46XX, Ecocardiografía normal, TAC de cerebro mostró anomalias múltiples asociadas a hidrocefalia y malformaciones inespecíficas. Conclusión: El cráneo en trébol puede presentarse aisladamente o asociado a otras anomalías congénitas, conformando varios síndromes de craneosinostosis, como Crouzon, Pfeiffer o Carpenter. También puede ser componente de la secuencia de rotura amniótica o de diversas displasias, como la campomélica, tanatofórica tipo ii, o la distrofia torácica asfixiante de Jeune. El caso descrito no cumple con todas las características necesarias para incluirlo dentro de un síndrome específico, y no habiendo antecedentes familiares que sugieran patrón de herencia ni anomalías cromosómicas se concluye que se trata de un caso de anomalías congénitas de presentación esporádica.


Introduction: Cloverleaf skull syndrome, or Kleeblattschädel syndrome, is a rare malformation in which the skull has a cloverleaf appearance. It is caused by the premature closure of several sutures, being evident before birth. Objective: To present our experience in a case of cloverleaf skull syndrome, and update the information from the literature. Clinical case: A female infant of 5 months of age, diagnosed at birth with cleft lip and palate and hydrocephaly. A peritoneal ventricle valve was implanted at 30 days of life, and an ocular enucleation was performed due to an infectious process. The patient was followed-up in Genetics, where it confirmed a macrocephaly and craniosynostosis type cloverleaf skull. The 46XX cytogenetic study and echocardiography were normal. The brain CT scan showed multiple anomalies associated with hydrocephaly and non-specific malformations. Conclusion: Cloverleaf skull may be present in isolated form or associated with other congenital abnormalities, leading to various craniosynostosis syndromes, such as Crouzon, Pfeiffer or Carpenter. It may also be a component of the amniotic rupture sequence or to different dysplasias, such as campomelic dysplasia, thanatophoric dysplasia type 2, or the asphyxiating thoracic dystrophy of Jeune. The case presented does not fulfil all the characteristics needed to be included within a specific syndrome, and on not having a family history that suggests a hereditary pattern or chromosome abnormalities, it is concluded that it is a case of a congenital anomaly of sporadic presentation.


Subject(s)
Humans , Female , Infant , Cleft Lip/pathology , Cleft Palate/pathology , Craniosynostoses/diagnosis , Hydrocephalus/pathology , Cleft Lip/etiology , Cleft Palate/etiology , Craniosynostoses/surgery , Craniosynostoses/physiopathology , Hydrocephalus/surgery , Hydrocephalus/etiology
14.
Arq. neuropsiquiatr ; 73(9): 759-763, Sept. 2015. tab, ilus
Article in English | LILACS | ID: lil-757399

ABSTRACT

Objective Hydrocephalus is one of the main complications associated with myelomeningocele (MM). This study aimed to identify clinical and ultrasonographic criteria for using ventriculoperitoneal (VP) shunts in this group of patients.Method A retrospective cohort study, based on established protocol for VP shunt implant in hydrocephalic children with MM. Parameters used to guide the indication of VP shunts included measurement of head circumference (HC), evaluation of fontanels, and measurement of lateral ventricular atrium (LVA) width by transcranial ultrasonography.Results 43 children were included in the analysis, of which 74% had hydrocephalus and required a VP shunt. These children had LVA width ≥ 15 mm, showed increased HC, or had bulging fontanels.Conclusion VP shunt is required in children with increased HC (≥ 2 standard deviation regarding age group), bulging fontanels, or LVA width of ≥ 15 mm after the closure of MM.


Objetivo Identificar os critérios clínicos e ultrassonográficos para a recomendação do implante de derivações ventrículo peritoneais (DVP) em neonatos portadores de mielomeningocele (MM).Método Estudo de coorte retrospectivo, com base no protocolo estabelecido para o implante de DVP em crianças com hidrocefalia associada a MM. Parâmetros utilizados para orientar a indicação de DVP incluíram a medida da circunferência craniana (CC), a avaliação das fontanelas e a medida da largura lateral do átrio ventricular (LAV), avaliado por ultrassonografia transcraniana.Resultados 43 crianças foram incluídas na análise, dos quais 74% tinham hidrocefalia com recomendações para uso de DVP.Conclusão O aumento da CC e o abaulamento de fontanelas foram os principais critérios para a indicação de DVP. A DVP é necessária em crianças com aumento da CC (≥ 2 desvios padrões para a idade), fontanelas abauladas, ou LAV ≥ 15 mm após o fechamento cirúrgico da MM.


Subject(s)
Female , Humans , Infant, Newborn , Male , Hydrocephalus , Meningomyelocele/complications , Ventriculoperitoneal Shunt , Brazil/epidemiology , Cohort Studies , Hydrocephalus/etiology , Hydrocephalus/surgery , Infant, Low Birth Weight , Infant, Premature , Retrospective Studies , Sensitivity and Specificity
15.
Arq. bras. neurocir ; 34(2): 157-161, jun. 2015. ilus, tab
Article in Portuguese | LILACS | ID: biblio-1991

ABSTRACT

Os tumores neuroectodérmicos primitivos (PNET) são tumores malignos, não diferenciados, raramente apresentados na idade adulta, principalmente os de localização supratentorial. Apresentamos neste artigo o caso de um paciente de 19 anos, que nos chegou transferido de outro hospital com o diagnóstico de hidrocefalia. A existência do PNET associado a carcinomatose leptomeníngea foi comprovada como causa da hidrocefalia.


Primitive neuroectodermal tumors (PNET) are malignant tumors exceptionally present in adulthood, especially those with supratentorial location. In this article, we present the case of a young man who was transfer fromanother institutionwith the diagnosis of hydrocephalus; during his stay, we corroborated the presence of supratentorial PNET associated to leptomeningeal carcinomatosis that was a cause of hydrocephalus.


Subject(s)
Humans , Male , Adult , Hydrocephalus/etiology , Meningeal Carcinomatosis/complications , Neuroectodermal Tumors, Primitive/complications
16.
Arq. bras. neurocir ; 34(1): 64-67, 2015. fig
Article in English | LILACS | ID: biblio-982

ABSTRACT

The vasogenic edema in structures of posterior fossa secondary to elevated hydrostatic pressure can cause obstructive hydrocephalus, a condition called "reversible obstructive hydrocephalus from hypertensive encephalopathy." A case of a 27-year-old woman with arterial hypertension and sign of raised intracranial pressure is reported. Her radiologic studies have showed vasogenic cerebellar edema without structural lesion. This edema leads to obstruction of the cerebral aqueduct. We discuss the clinical and therapeutic aspects of this condition. In this clinical situation, the accurate control of blood pressure is themain goal on medical care, and the need of permanent ventricular shunt is quite infrequent.


O edema vasogênico secundário a elevação da pressão hidrostática capilar pode causar hidrocefalia obstrutiva, a chamada Hidrocefalia Obstrutiva Reversível secundária a Encefalopatia Hipertensiva. Nós apresentamos umcaso de umamulher de 27 anos com hipertensão arterial e sinais de hipertensão intracraniana. Sua investigação radiológica evidenciou sinais de edema vasogênico cerebelar bilateral sem lesão estrutural, determinando obstrução do aqueduto cerebral Nós discutimos os aspectos clínicos e terapêuticos deste caso. Nesta condição, o adequado controle da pressão arterial é a principal medida terapêutica, sendo a necessidade de derivação liquórica permanente infrequente.


Subject(s)
Humans , Female , Adult , Brain Edema/complications , Hydrocephalus/etiology , Hypertensive Encephalopathy/complications
17.
Biomédica (Bogotá) ; 34(4): 506-513, oct.-dic. 2014. tab
Article in Spanish | LILACS | ID: lil-730933

ABSTRACT

La histoplasmosis es una afección polifacética producida por el hongo dimorfo Histoplasma capsulatum , cuyas esporas son inhaladas y llegan al pulmón, órgano primario de infección. La forma meníngea, considerada como una de las manifestaciones más graves de esta micosis, suele presentarse en individuos con alteraciones en la inmunidad celular: pacientes con síndrome de inmunodeficiencia humana adquirida, con lupus eritematoso sistémico o con trasplante de órgano sólido, así como en lactantes, debido a su inmadurez inmunológica. La forma de presentación más usual es de resolución espontánea y se observa en individuos inmunocompetentes que se han expuesto a altas concentraciones de conidias y fragmentos miceliares del hongo. En estas personas, la afección se manifiesta por trastornos pulmonares y por la posterior diseminación a otros órganos y sistemas. Se presenta un caso de histoplasmosis del sistema nervioso central en un niño inmunocompetente.


Histoplasmosis is a multifaceted condition caused by the dimorphic fungi Histoplasma capsulatum whose infective spores are inhaled and reach the lungs, the primary organ of infection. The meningeal form, considered one of the most serious manifestations of this mycosis, is usually seen in individuals with impaired cellular immunity such as patients with acquired immunodeficiency syndrome, systemic lupus erythematous or solid organ transplantation, and infants given their immunological immaturity. The most common presentation is self-limited and occurs in immunocompetent individuals who have been exposed to high concentrations of conidia and mycelia fragments of the fungi. In those people, the condition is manifested by pulmonary disorders and late dissemination to other organs and systems. We report a case of central nervous system histoplasmosis in an immunocompetent child.


Subject(s)
Child , Humans , Male , Diagnostic Errors , Histoplasmosis/diagnosis , Meningitis, Fungal/diagnosis , Acute Kidney Injury/etiology , Amphotericin B/adverse effects , Amphotericin B/therapeutic use , Antifungal Agents/therapeutic use , Cerebrospinal Fluid/microbiology , Device Removal , Headache/etiology , Histoplasma/immunology , Histoplasma/isolation & purification , Histoplasmin/blood , Histoplasmin/cerebrospinal fluid , Histoplasmosis/complications , Histoplasmosis/cerebrospinal fluid , Histoplasmosis/drug therapy , Hydrocephalus/diagnosis , Hydrocephalus/etiology , Hydrocephalus/surgery , Hypokalemia/etiology , Immunocompetence , Itraconazole/therapeutic use , Meningitis, Fungal/complications , Meningitis, Fungal/cerebrospinal fluid , Meningitis, Fungal/drug therapy , Meningitis, Fungal/microbiology , Migraine Disorders/diagnosis , Prosthesis-Related Infections/etiology , Prosthesis-Related Infections/microbiology , Staphylococcal Infections/etiology , Staphylococcus epidermidis/drug effects , Vancomycin Resistance , Ventriculoperitoneal Shunt/adverse effects
18.
Arq. neuropsiquiatr ; 72(9): 715-720, 09/2014. tab, graf
Article in English | LILACS | ID: lil-722140

ABSTRACT

Decompressive craniectomy (DC) is widely used to treat intracranial hypertension following traumatic brain injury (TBI) or cerebral vascular disease. Many studies have discussed complications of this procedure, and hydrocephalus is a common complication of DC. To further evaluate the relationship between DC and hydrocephalus, a review of the literature was performed. Numerous complications may arise after DC, including contusion or hematoma expansion, epilepsy, herniation of the cortex through a bone defect, CSF leakage through the scalp incision, infection, subdural effusion, hydrocephalus and “syndrome of the trephined”. Several hydrocephalus predictors were identified; these included DC, distance from the midline, hygroma, age, injury severity, subarachnoid or intraventricular hemorrhage, delayed time to craniotomy, repeated operation, and duraplasity. However, results differed among studies. The impact of DC on hydrocephalus remains controversial.


A craniectomia descompressiva (CD) é amplamente utilizada para tratar a hipertensão intracraniana após trauma craniencefálico (TC) ou doença cerebrovascular. Vários estudos discutem as complicações deste procedimento, sendo a hidrocefalia uma das complicações mais frequentes. Fizemos uma revisão da literatura para avaliar a relação entre a CD e a hidrocefalia. Podem ocorrer numerosas complicações após a CD, incluindo aumento de volume por contusão ou hematoma, epilepsia e herniação do cortex cerebral através do acesso ósseo. Fístulas liquóricas através a incisão no couro cabeludo, infecções, hematomas subdurais, hidrocefalia e a “síndrome pós-trepanação”. Foram identificados vários fatores preditivos de hidrocefalia: a distância da CD em relação à linha média, a ocorrência de higroma, a idade, a gravidade da lesão, a hemorragia subaracnóidea ou intraventricular, o tempo decorrido até a craniectomia, as reoperações e o uso de plástica com dura-máter. Entretanto, há divergências entre os autores e o impacto da CD na hidrocefalia continua controvertido.


Subject(s)
Female , Humans , Male , Decompressive Craniectomy/adverse effects , Hydrocephalus/etiology , Postoperative Complications/etiology , Brain Injuries/complications , Brain Injuries/surgery , Risk Factors , Stroke/complications , Stroke/surgery
19.
Rev. otorrinolaringol. cir. cabeza cuello ; 74(2): 155-160, 2014. ilus
Article in Spanish | LILACS | ID: lil-726167

ABSTRACT

La trombosis del seno lateral es una complicación potencialmente mortal de la otitis media aguda, aunque infrecuente en la actualidad debido al amplio uso de antibióticos. Sus manifestaciones clínicas son habitualmente fiebre, cefalea y otalgia, agregándose vómitos, edema de papila y compromiso del estado general. El examen diagnóstico de elección es la resonancia magnética en fase venosa y el manejo incluye terapia antibiótica endovenosa, miringotomía con instalación de tubo de ventilación y mastoidectomía, asociado o no a anticoagulación. Se reporta el caso de un escolar de 9 años derivado al Hospital Carlos Van Buren con un hidrocéfalo ótico secundario a una trombosis del seno lateral, manejado con terapia antibiótica endovenosa, mastoidectomía simple, miringotomía con instalación de tubos de ventilación y anticoagulación, evolucionando favorablemente con regresión de la sintomatología y recanalización del seno en el control imagenológico. Se realiza una revisión bibliográfica sobre la presentación clínica, diagnóstico y manejo de la trombosis del seno lateral en niños como complicación de la otitis media aguda.


Lateral sinus thrombosis (LST) is a potentially life threatening complication of acute otitis media. However, report rates have been decreasing since the spreaded use of antibiotic prescription. Patient developing LST usually complain about fever, headache and ear pain. Consequently, they may develop vomiting, papilledema and unhealthy-ness. Magnetic resonance venography (MRV) is considered the gold standard for LST diagnosis. Management procedures include parenteral antibiotics, myringotomy with tympanostomy tube and mastoidectomy, associated or not with anticoagulant therapy. The present study reports the case of a 9-year-old male referred to the Hospital Carlos Van Buren diagnosed with an otitic hydrocephalus secondary to lateral sinus thrombosis, managed with intravenous antibiotic therapy, simple mastoidectomy, myringotomy with tympanostomy tube placement and anticoagulation. Favorable clinical and imagenologic outcomes were obtained. We provide a brief summary about clinical features, diagnosis and management of the LST in children as a complication of acute otitis media.


Subject(s)
Humans , Male , Child , Lateral Sinus Thrombosis/etiology , Lateral Sinus Thrombosis/therapy , Otitis Media/complications , Anti-Bacterial Agents/therapeutic use , Anticoagulants/therapeutic use , Hydrocephalus/etiology , Hydrocephalus/therapy , Lateral Sinus Thrombosis/diagnostic imaging , Magnetic Resonance Imaging , Mastoid/surgery , Tomography, X-Ray Computed
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