Carotid cavum aneurysm treated with Solitaire™ AB stent. Case report.

BACKGROUND: In the cavum segment the internal carotid artery has more susceptibility formation of aneurysms. The Solitaire™ AB stent is a scaffold that do flow blood diversion and promotes the aneurysms exclusion by thrombosis. CASE REPORT: 63 year old female present pulsatile headache, diplopia, III left cranial nerve paresis and carried a cavum carotid saccular aneurysms of the left carotid artery. By endovascular procedure, we placed a Solitaire™ AB stent. She recovered the III left cranial nerve function in to 2 month and we observed exclusion of the aneurysms by DynaCT in 3 months. CONCLUSION: The reconstruction of an artery by endovascular therapy is an alternative treatment for no ruptured paraclinoid aneurysms.

ANTECEDENTES: La arteria carótida interna a nivel del cavum es más susceptible de formación de aneurismas. El Solitaire™ AB condiciona una redirección del flujo de la sangre que favorece la exclusión por trombosis del aneurisma. CASO CLÍNICO: Mujer de 63 años que presentó cefalea, diplopía, paresia del III nervio craneal y portadora de aneurisma sacular en la arteria carótida interna izquierda a nivel del cavum carotídeo. Se colocó una endoprótesis Solitaire™ AB por procedimiento endovascular. Recuperó la función del III nervio craneal izquierdo a los 2 meses y se observó la exclusión del aneurisma a los 3 meses por DynaCT. CONCLUSIÓN: La endoprótesis para reconstrucción arterial intracraneal es una alternativa terapéutica en aneurismas paraclinoideos no rotos.

Traumatic brain injury with a machete penetrating the dura and brain: Case report from southeast Mexico.

INTRODUCTION: Traumatic Brain Injury (TBI) is a major cause of death and disability in our society, we present the first case report of non-missile penetrating (NMP) cranial trauma with a machete in Mexico, and our objective by presenting this case is to prove the usefulness of recently proposed algorithms in the treatment of NMP PRESENTATION OF CASE: We present the case of a 47 year old woman who received a machete hit to the right side of her head during an assault., she arrived fully conscious to the emergency department (ED), computed tomography was performed and based on the findings of this study and in accordance to recently proposed algorithms for managing NMP cranial trauma a craniotomy was performed, at follow-up the patient presented wtih minor neurological disability in the form of left hemiparesis. DISCUSSION: Non-missile penetrating (NMP) lesions are defined as having an impact velocity of less than 100m/s, causing injury by laceration and maceration, An algorithm for treating NMP cranial trauma has been recently published in the Journal World Neurosurgery by De Holanda et al., in this case we followed the algorithm in order to provide best care available for our patient with good results. CONCLUSION: The use of current algorithms for managing NMP cranial trauma has proved to be very useful when applied on this particular case. GCS on admission is an important prognostic factor in NMP cranial trauma.