Assuntos
Malformação de Arnold-Chiari/cirurgia , Descompressão Cirúrgica/métodos , Procedimentos Neurocirúrgicos/métodos , Complicações Pós-Operatórias/prevenção & controle , Siringomielia/cirurgia , Malformação de Arnold-Chiari/complicações , Criança , Pré-Escolar , Dura-Máter/cirurgia , Humanos , Siringomielia/complicaçõesRESUMO
INTRODUCTION: The authors present the case of a 5-year-old girl with traumatic hydrocephalus secondary to a retroclival haematoma associated with atlanto-occipital dislocation (AOD) after a motor vehicle accident. Clinical history and neuroimaging of the patient are described. DISCUSSION: Computed tomography (CT) imaging of the head revealed a retroclival haematoma with secondary hydrocephalus. The cranio-cervical junction showed an AOD that was initially overlooked. Traumatic AOD is a rare diagnosis although in the recent years it has become an emergent entity due to the improvement of emergency medical treatment on the field. CONCLUSION: An initial diligent imaging study and interpretation should be made to avoid misdiagnosis and to provide adequate treatment. This is the first case reported of the association of AOD, hydrocephalus and retroclival haematoma. A brief review of the literature is also presented.
Assuntos
Articulação Atlantoccipital/lesões , Hemorragia Cerebral Traumática/complicações , Luxações Articulares/complicações , Acidentes de Trânsito , Pré-Escolar , Evolução Fatal , Feminino , Escala de Coma de Glasgow , Humanos , Hidrocefalia/etiologia , Hipertensão Intracraniana/etiologia , Procedimentos Neurocirúrgicos , Hemorragia Subaracnóidea/diagnóstico por imagem , Hemorragia Subaracnóidea/etiologia , Hemorragia Subaracnóidea/patologia , Tomografia Computadorizada por Raios X , Ultrassonografia Doppler TranscranianaRESUMO
INTRODUCTION: Orbital emphysema can be associated with optic nerve and vascular compromise, with subsequent potentially irreversible visual loss. MATERIALS AND METHODS: We report a 4-year-old girl who presented right orbital emphysema after posterior fossa surgery for pilocytic astrocytoma resection in the sitting position. Endoscopic third ventriculostomy (ETV) had been previously carried out for the treatment of symptomatic obstructive hydrocephalus. Our hypothesis is that periorbital emphysema developed due to air passing from the intracranial to the extracranial compartment through the ETV burr hole. RESULT AND DISCUSSION: The emphysema resolved spontaneously without any sequelae. To our knowledge, this is the first description of orbital emphysema after posterior fossa surgery in the sitting position.
