ABSTRACT
Caso clínico: Paciente masculino de 13 años al que se le disparó, de forma accidental, una escopeta neumática de pesca submarina mientras la cargaba, siendo alcanzado por el arpón en su región maxilar. Al ingreso en el hospital el paciente se encontraba en coma superficial, existía anisocoria por midriasis derecha, hemiparesia izquierda y signo de Babinki homolateral al defecto motor. Se realizó una TAC de cráneo y se observó la entrada del arpón por la región maxilar derecha, su curso por la base craneal anterior, recorrido intracerebral y salida del cráneo por la región parietal izquierda, para quedar alojado debajo de la piel. Conclusiones. La actuación ordenada y escalonada desde el mismo momento del ingreso nos permitió correlacionar la clínica con la imagen, hacer el diagnóstico y el tratamiento oportuno de las complicaciones a medida que fueron apareciendo (AU)
Case report: A 13-year-old boy suffered an accident while loading a pneumatic fishing harpoon - the latter penetrating the maxillary region. Upon admission to hospital the patient was in superficial coma, with right mydriasis anisocoria, left hemiparesis and Babinski sign homolateral to the motor defect. The cranial CAT scan showed the harpoon penetrating the right maxillary region, coursing along the anterior skull base with an intracerebral trajectory and emerging from the left parietal region, lodged beneath the skin. Conclusions: Orderly and protocolized intervention from the moment of admission allowed us to correlate the clinical manifestations with the imaging findings, and to establish the diagnosis and treat the complications as they developed (AU)
Subject(s)
Humans , Male , Child , Head Injuries, Penetrating/complications , Head Injuries, Penetrating/surgery , Head Injuries, Penetrating , Hemorrhage/complications , Hemorrhage/diagnosis , Ventriculostomy/methods , Skull/injuries , Skull , Head Injuries, Penetrating , Mydriasis/complications , Paresis/complications , Cerebrospinal Fluid/cytologyABSTRACT
BACKGROUND: The aim of the present was to study the cytohistology of the bone marrow in intravenous drug addicts (IVDA) and to analyze the possible differences according to the period of drug addiction. METHODS: A prospective study was performed in 60 IVDA patients previously untreated and distributed into three groups: 20 seronegative for the human immunodeficiency virus (HIV), 20 patients in a phase of generalized adenopathic infection (GAI) and 20 patients with AIDS. RESULTS: Cytohistologic examination of the bone marrow aspirates showed plasmocytosis and eosinophilia in all the groups. Selective changes were seen in the red series in 20% of the HIV negative patients and in 25% of the GAI group. The prevalence of cytologic changes was greater in those with AIDS, with hypocellular bone marrow being observed in 65% of the patients with coexistent dismyelopoietic changes in 15%. Pathologic structure showed granulomatous lesions of tuberculous etiology in 30% of the patients with AIDS while in the HIV negative and GAI groups these were found in 10% and 5%, respectively. A greater presence of fibrosis and bone marrow hypoplasia was also found in the group with AIDS, than in the other two groups. CONCLUSIONS: An increased number of bone marrow changes and progressive bone marrow hypocellularity may be observed on advancement of the clinical stages in intravenous drug addict patients. The incidence of tuberculous granulomas is higher in the AIDS group.
