Elastoma perfurante em cicetrizes antigas de queimaduras térmicas associado a aneurismas cerebrais múltiplos / Elastoma perforans in old scars of thermal burns associated to multiple cerebral aneurysms

Os autores descrevem um caso de elastoma perfurante que se desenvolveu em cicatrizes antigas de queimadura térmica em uma mulher de 33 anos que apresentou aneurisma cerebral múltiplo e hemorragia subaracnóide devido à ruptura de um aneurisma na artéria carótida interna esquerda, seis anos após o evento dermatológico. O quadro clinicopatológico demonstrou características de elastose perfurante serpiginosa focal e adquirida, doença que pode estar associada a outras anomalias do tecido conjuntivo e a aneurismas do polígono de Willis. Foram discutidos os prováveis mecanismos patogênicos da doença. Os achados justificam o conceito de um distúrbio localizado do tecido elástico na pele e nas artérias

Cerebral aneurysms: assessment of 50 cases operated on and comparison with previous series

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 percent in Hunt & Hess grade 1,38 percent in grade II , 16 percent in grade III, and 12 percent in grade IV. Males were predominant (66.6 percent), and patients age varied around 47+12.13 years old. Only 13 patients (26 percent) 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 percent). 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 percent). 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.