Chronic subdural hematoma with sudden clinical uncal herniation and coma: case report
Rev. chil. neurocir
;
29: 60-62, oct. 2007. ilus
Artigo
em Inglês
| LILACS
| ID: lil-585702
ABSTRACT
Context: Chronic subdural hematomas are frequent diseases in neurosurgery units. Decreased level of consciousness is observed in 28 to 100 percent of cases, nevertheless in rare cases are seen comatous patients. We describe a case of a patient with clinical uncal herniation elapsed by a chronic subdural hematoma. Case report: Patient with previous diagnosis of breast cancer, presented sudden occurrence of a headache followed by decreasing level of consiousness the day before reaching our service. The patient was taken than to another Hospital at 1:00 AM in Glasgow Coma Scale (GCS) 13, with isochonic pupils. At 7:00 AM the GCS went to 7 and the pupils became anisochonic L > R and than transferred to our Unit and immediatly submitted to a computed tomohraphy scanning of the head that showed a chronic subdural hematoma with midline shift. The patient promptly was taken to surgical room and treated with a single burr hole with drainage of hypertensive chronic subdural hematoma. The level of consiousness increased few hours after surgery, being in GCS 15 just 6 hours after, without motor deficits. Conclusion: In spite of commonly progressive evolution chronic subdural hematomas can present with herniation, becoming itself a neurosurgical emergency.
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Índice:
LILACS (Américas)
Assunto principal:
Hemorragia Cerebral
/
Coma
/
Hipertensão Intracraniana
/
Hematoma Subdural Crônico
/
Encefalocele
Limite:
Idoso
/
Feminino
/
Humanos
Idioma:
Inglês
Revista:
Rev. chil. neurocir
Assunto da revista:
Neurocirurgia
Ano de publicação:
2007
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Universidade de Sao Paulo/BR
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