RESUMO
BACKGROUND: Chloroma, also called granulocytic sarcoma, is a localized extramedullary tumor composed of leukemic myeloid cells. It is a rare tumor that can occur in various locations. The association of chloroma with leukemic disease or myeloproliferative disorders is limited to isolated case reports. CASE DESCRIPTION: We report a case of intracranial chloroma in an elderly man with myelofibrosis and progressive hypereosinophilia. The presence of leukemic cells within his pleural aspirate suggested an incipient acute leukemic state. CONCLUSION: We report the first case of intracranial chloroma associated with hypereosinophilia developing in the course of myelofibrosis. The significance of hypereosinophilia in predicting the likelihood of development of central nervous system chloroma and acute leukemia in a patient with myelofibrosis needs further evaluation.
Assuntos
Neoplasias Encefálicas/complicações , Síndrome Hipereosinofílica/complicações , Mielofibrose Primária/complicações , Sarcoma Mieloide/complicações , Doença Aguda , Idoso , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/patologia , Humanos , Síndrome Hipereosinofílica/diagnóstico por imagem , Leucemia/complicações , Masculino , Mielofibrose Primária/patologia , Radiografia Torácica , Sarcoma Mieloide/diagnóstico por imagem , Sarcoma Mieloide/patologia , Tomografia Computadorizada por Raios XRESUMO
We present a case of refractory infantile subdural empyema secondary to pneumococcal meningitis. Initial treatment was with antibiotics and multiple burr hole drainage of the subdural space. As there was no significant improvement with this standard procedure, craniectomy, and juxtapositioning of the temporalis muscle was conducted and the patient recovered promptly.
Assuntos
Empiema Subdural/cirurgia , Procedimentos Neurocirúrgicos/métodos , Músculo Temporal/cirurgia , Encéfalo/diagnóstico por imagem , Empiema Subdural/diagnóstico , Empiema Subdural/microbiologia , Feminino , Humanos , Lactente , Meningite Pneumocócica/complicações , Músculo Temporal/microbiologia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
BACKGROUND: Insertion of a catheter for drainage of a cavity is a routine step in many surgical practices. In neurosurgery, catheters are commonly placed in the subdural, subgaleal, or epidural spaces to prevent haematoma formation. CASE DESCRIPTION: We present three cases of iatrogenic acute subdural hematoma. These were all related to the drainage catheters. In the first case, a subgaleal redivac suction catheter was used after craniotomy for brain abscess. The other two patients had ordinary ventricular catheters placed in the subdural space after burr hole drainage of chronic subdural hematoma. The drainage catheter was removed on postoperative day 5 in the first case and two days after the initial operation in the other two cases. Shortly after the removal of the drains, the conditions of the patients deteriorated rapidly due to the development of acute subdural hematoma. CONCLUSION: Although they are extremely uncommon, life-threatening complications related to a drainage catheter are a real possibility. Therefore, the procedure should not be taken lightly.
Assuntos
Cateterismo/efeitos adversos , Drenagem/efeitos adversos , Hematoma Subdural/etiologia , Doença Iatrogênica , Doença Aguda , Idoso , Drenagem/instrumentação , Hematoma Subdural/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
Patients with cerebellar arteriovenous malformations (AVM) commonly present to the neurosurgical department after having suffered hemorrhages. The subarachnoid space is the usual location for these often repeating episodes of bleedings. In addition, these patients can present with parenchymal hemorrhage. Acute subdural hematoma caused by a ruptured cerebellar AVM is a rare entity and is not generally recognized. The authors present a case of acute posterior fossa subdural hematoma resulting from a ruptured cerebellar AVM.
Assuntos
Aneurisma Roto/complicações , Fossa Craniana Posterior/patologia , Hematoma Subdural/etiologia , Malformações Arteriovenosas Intracranianas/complicações , Aneurisma Roto/patologia , Aneurisma Roto/cirurgia , Fossa Craniana Posterior/cirurgia , Hematoma Subdural/patologia , Hematoma Subdural/cirurgia , Humanos , Malformações Arteriovenosas Intracranianas/patologia , Malformações Arteriovenosas Intracranianas/cirurgia , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X/métodosRESUMO
Dural AVMs can produce a wide variety of symptoms related to raised intracranial pressure, venous congestion, and cerebral ischaemia. We present a unique case of reversible dementia, due to venous hypertension. The cerebral ischaemia was caused by extensive bilateral arteriovenous malformations of the external carotid system, which drained into the superior sagittal and transverse sinuses and resulted in venous hypertension. Although partial occlusion by endovascular embolization and ligation procedures had some effect, only 'scalping and silastic implantation' gave satisfactory amelioration of symptoms.