Subject(s)
Giant Cell Tumors/secondary , Skull Base Neoplasms/secondary , Abducens Nerve Diseases/etiology , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Brain Stem/pathology , Cell Transformation, Neoplastic , Cranial Fossa, Posterior/pathology , Deglutition Disorders/etiology , Fatal Outcome , Giant Cell Tumors/pathology , Giant Cell Tumors/surgery , Humans , Immunohistochemistry , Lung Neoplasms/secondary , Magnetic Resonance Imaging , Male , Paresis/etiology , Sarcoma/pathology , Skull Base Neoplasms/pathology , Skull Base Neoplasms/surgery , Tomography, X-Ray ComputedABSTRACT
Traumatic aneurysms are rare lesions. They differ markedly from saccular aneurysms in their clinical presentation and therapy. Early diagnosis of traumatic aneurysms is usually difficult. A 52-year-old female presented with massive epistaxis and ear bleeding caused by a traffic accident. On admission, her consciousness level was 7 points of the Glasgow coma scale. Computed tomography revealed hematoma in the sphenoid sinus and fractures in the right petrous bone, and right acute subdural hematoma. 7 years after trauma, she presented ear bleeding. Cerebral angiography showed a giant traumatic aneurysm at the petrous segment of the right internal carotid artery. Test occlusion of the right internal carotid artery was performed and was well tolerated without development of focal neurological deficits, so the right internal carotid artery was occluded using endovascular techniques. We recommend that more attention be paid to the traumatic aneurysm of the C4 to C5 portion when patients with skull base fracture are diagnosed.
Subject(s)
Aneurysm/therapy , Balloon Occlusion/methods , Carotid Artery Diseases/therapy , Accidents, Traffic , Female , Humans , Middle Aged , Petrous BoneABSTRACT
BACKGROUND: Several surgical procedures have been reported for the treatment of chronic subdural hematoma. Whether irrigation is required is not clear. We compared the results of treatment of chronic subdural hematoma obtained with burr hole drainage and burr hole irrigation retrospectively. METHODS: Forty patients with chronic subdural hematoma underwent surgery at our institution in the last 3 years. The first 20 patients were treated by burr hole irrigation (irrigation group), while the last 20 patients underwent burr hole drainage (drainage group). The rates of recurrence, changes in hematoma size, and number of days of postoperative hospitalization for the two groups were compared. No significant differences were found between the two groups in the presence of head injury, alcohol consumption, age, gender, or preoperative hematoma size. RESULTS: Duration of postoperative hospitalization was 14.1 days in the drainage group and 25.5 days in the irrigation group. Recurrence was observed in 1 case (5%) in the drainage group, and in 5 cases (25%) in the irrigation group. In the drainage group, postoperative hematoma size was significantly decreased compared to preoperative hematoma size on the first postoperative day, after which change in hematoma size was minimal. On the other hand, in the irrigation group, hematoma size was decreased on the first postoperative day, but not to a significant extent. CONCLUSION: For treatment of chronic subdural hematoma, postoperative hospitalization was shorter and the recurrence was less frequent with drainage than with irrigation.
