RESUMO
Pneumocephalus is the presence of air in the intracranial space and has multiple causes, including cerebral air embolism. Its presentation may range from asymptomatic to decrease mental status, coma, and seizures. We present a case of cerebral air embolism secondary to acute bleeding inside an emphysema bulla. A 69-year-old female was brought to the emergency room after suffering acute dyspnea, convulsions, and cardiac arrest during a commercial flight. The Head CT showed the presence of multiple small gas collections in the brain, and the Thoracic Angiotomography showed a thin-walled bulla surrounded with pulmonary venous vascular structures and signs of active bleeding. The patient had rapid neurological deterioration with evolution to brain death due to anoxic encephalopathy before the possibility of treatment with pulmonary lobectomy and hyperbaric oxygen therapy. It is important to identify the localization of pneumocephalus to determine its etiology and to deliver the best treatment. Cerebral air embolism may happen when air enters the arterial or venous system, which can cause brain damage due to capillary leak syndrome and local ischemia. Treatment of pneumocephalus includes treating the cause, bed rest, avoidance of Valsalva maneuvers, positive pressure, and hyperbaric oxygen therapy. Early recognition is essential to prevent complications such as irreversible brain lesions and to improve patient outcomes.
RESUMO
Skimboarding is a sport that combines elements from aquatic and terrestrial sports and has gained popularity with increased riskier maneuvers. Spinal cord injuries associated with this sport have rarely been reported. Here we present a case of a previously healthy 44-year-old male with a life-threatening C2/C3 fracture and dislocation after a skimboarding fall. Traumatic facet dislocations in the cervical spine are usually consequent to high-energy transmission injuries, so it is difficult to explain the mechanism of injury in this clinical case. As this sport's practice continues to grow, our purpose is to emphasize that these injuries may occur with irreversible consequences as most of the damage occurs at the time of presentation, so the first step is to alert athletes and the community to prevent them.
RESUMO
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 2019 (COVID-19) emerged in China in December 2019. Healthcare workers (HCWs) are one of the high-risk groups of infection and knowledge of the seroprevalence of SARS-CoV-2 antibodies among this class is very important, not only to understand the spread of COVID-19 among health institutions but also to assess the success of public health interventions. The objective of this prospective study was to determine the seroprevalence of COVID-19 immunoglobulin G (IgG) antibodies after vaccine administration and assess the symptomatology associated with the number of IgG antibodies. A total of 75 HCWs from an intensive care unit were studied three and six months after the second administration of the COVID-19 vaccine. They were divided into three groups: IgG antibodies between 4,160 and 6,350 (group one), greater than 6,350 (group two), and less than 4,160 (group three). After the first administration of the vaccine, 80% had symptoms in both groups one and two, whereas only 13.8% had symptoms in group three. After the second dose of the vaccine, all elements of group one and 80% of group two developed symptoms, but only 40% of group three manifested symptoms. With the exception of one, all professionals showed a decrease in the number of IgG antibodies from three to six months. Our findings show that professionals with a higher number of IgG antibodies had more symptoms and that these rapidly declined over the three-to-six-month period.
