Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 45
Filtrar
2.
Rev Recent Clin Trials ; 15(1): 70-75, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31744452

RESUMO

INTRODUCTION: Controlling of secondary traumatic brain injuries (TBI) is necessary due to its salient effect on the improvement of patients with TBI and the final outcomes within early hours of trauma onset. This study aims to investigate the effect of intravenous tranexamic acid (TAX) administration on decreased hemorrhage during surgery. METHODS: This double-blind, randomized, and placebo-controlled trial was conducted on patients referring to the emergency department (ED) with IPH due to brain contusion within 8 h of injury onset. The patients were evaluated by receiving TXA and 0.9% normal saline as a placebo. The following evaluation and estimations were performed: intracranial hemorrhage volume after surgery using brain CT-scan; hemoglobin (Hb) volume before, immediately after, and six hours after surgery; and the severity of TBI based on Glasgow Coma Score (GCS). RESULTS: 40 patients with 55.02 ± 18.64 years old diagnosed with a contusion and intraparenchymal hemorrhage. Although the (Mean ± SD) hemorrhage during surgery in patients receiving TXA (784.21 ± 304.162) was lower than the placebo group (805.26 ± 300.876), no significant difference was observed between two groups (P=0.83). The (Mean ± SD) Hb volume reduction immediately during surgery (0.07 ± 0.001 and 0.23 ± 0.02) and six hours after surgery (0.04 ± 0.008 and 0.12 ± 0.006) was also lower in TXA group but had no significant difference (P = 0.89 and P = 0.97, respectively). CONCLUSION: Using TXA may reduce the hemorrhage in patients with TBI, but this effect, as in this study, was not statistically significant and it is suggested that a clinical trial with a larger population is employed for further investigation.


Assuntos
Antifibrinolíticos/administração & dosagem , Perda Sanguínea Cirúrgica/prevenção & controle , Contusão Encefálica/cirurgia , Hemorragia Encefálica Traumática/prevenção & controle , Ácido Tranexâmico/administração & dosagem , Adulto , Idoso , Contusão Encefálica/complicações , Contusão Encefálica/tratamento farmacológico , Hemorragia Encefálica Traumática/etiologia , Hemorragia Encefálica Traumática/mortalidade , Método Duplo-Cego , Feminino , Escala de Coma de Glasgow , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Taxa de Sobrevida , Resultado do Tratamento
3.
Eur J Trauma Emerg Surg ; 45(3): 481-487, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29541804

RESUMO

PURPOSE: In 2007, Essentia Health St. Mary's Medical Center (SMMC), a Level II trauma center in northeastern Minnesota, implemented a protocol for patients who presented with blunt head trauma and were receiving warfarin for anticoagulation. The purpose of this study was to determine the incidence and risk factors of early delayed, warfarin-associated intracranial hemorrhage (ICH). METHODS: Adult patients with signs and symptoms of head injury on warfarin who were admitted by protocol to SMMC between March 2007 and June 2015 were included. Patients were observed for neurologic change and received a follow-up head CT scan within 24 h after an initial negative scan. RESULTS: Among the 232 episodes of care studied, there were 204 patients. The average age was 71; 51% of patients were female. Most patients presented with Glasgow Coma Scale score of 15 and had signs of head trauma. The majority of patients (63%) had a therapeutic International Normalized Ratio (INR) for their indicated condition, but 19% of patients had a supratherapeutic INR and 19% had a subtherapeutic INR. The incidence of early delayed ICH was 1.7%; none of these cases required operative intervention or were fatal. CONCLUSIONS: For patients who were anticoagulated with warfarin and had sustained minor traumatic brain injury, implementation of our protocol showed low incidence of early delayed ICH in the first 24 h. We believe withholding warfarin for several days and careful follow-up regarding its resumption is warranted, especially in the setting of supratherapeutic INR.


Assuntos
Anticoagulantes/efeitos adversos , Hemorragia Encefálica Traumática/diagnóstico por imagem , Varfarina/efeitos adversos , Acidentes por Quedas , Acidentes de Trânsito , Adulto , Idoso , Idoso de 80 Anos ou mais , Concussão Encefálica/complicações , Hemorragia Encefálica Traumática/induzido quimicamente , Hemorragia Encefálica Traumática/etiologia , Protocolos Clínicos , Feminino , Humanos , Coeficiente Internacional Normatizado , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Tomografia Computadorizada por Raios X
6.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 62(3): 228-230, mayo-jun. 2018. ilus
Artigo em Espanhol | IBECS | ID: ibc-177328

RESUMO

La hemorragia cerebelosa (HC) distal es una complicación infrecuente pero grave tras cirugía espinal. Aunque el mecanismo de aparición sigue siendo desconocido, sucede tras la pérdida de líquido cefalorraquídeo (LCR) por desgarro dural, no siempre objetivado, lo que produce un sangrado venoso a distancia. El pronóstico depende en gran medida de la gravedad de dicha hemorragia. Se presenta el caso de una mujer de 67 años que sufrió, además de HC, hemorragia subaracnoidea (HSA) y hematoma subdural (HS) tras artrodesis lumbar programada que requirió craniectomía descompresiva


Remote cerebellar haemorrhage is a rare but serious complication after spinal surgery. Although the mechanism is not well known, it always occurs after loss of cerebrospinal fluid due to dural tear, not always identified, which produces remote venous bleeding. Prognosis depends largely on the severity of this bleeding. We report a case of 67-year-old female who suffered a cerebellar and subarachnoid haemorrhage and subdural haematoma after elective lumbar fusion surgery and eventually required decompressive craniectomy


Assuntos
Humanos , Feminino , Idoso , Hemorragia Encefálica Traumática/etiologia , Fístula Vascular/etiologia , Artrodese/efeitos adversos , Craniectomia Descompressiva/métodos , Hemorragia Subaracnóidea/etiologia , Derrame Subdural/etiologia
7.
Accid Anal Prev ; 117: 98-105, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29679852

RESUMO

This study estimated the frequency and risk of Moderate-to-Maximal traumatic brain injuries sustained by occupants in motor vehicle crashes in the US. National Automotive Sampling System - Crashworthiness Data System crashes that occurred in years 2001-2015 with light vehicles produced 2001 or later were incorporated in the study. Crash type, crash severity, car model year, belt usage and occupant age and sex were controlled for in the analysis. The results showed that Moderate concussions account for 79% of all MAISbrain2+ injuries. Belted occupants were at lower risks than unbelted occupants for most brain injury categories, including concussions. After controlling for the effects of age and crash severity, belted female occupants involved in frontal crashes were estimated to be 1.5 times more likely to sustain a concussion than male occupants in similar conditions. Belted elderly occupants were found to be at 10.5 and 8 times higher risks for sub-dural haemorrhages than non-elderly belted occupants in frontal and side crashes, respectively. Adopted occupant protection strategies appear to be insufficient to achieve significant decreases in risk of both life-threatening brain injuries and concussions for all car occupants. Further effort to develop occupant and injury specific strategies for the prevention of brain injuries are needed. This study suggests that these strategies may consider prioritization of life-threatening brain vasculature injuries, particularly in elderly occupants, and concussion injuries, particularly in female occupants.


Assuntos
Acidentes de Trânsito , Lesões Encefálicas Traumáticas/prevenção & controle , Cintos de Segurança , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Concussão Encefálica/etiologia , Concussão Encefálica/prevenção & controle , Hemorragia Encefálica Traumática/etiologia , Hemorragia Encefálica Traumática/prevenção & controle , Lesões Encefálicas/etiologia , Lesões Encefálicas/prevenção & controle , Lesões Encefálicas Traumáticas/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Veículos Automotores , Risco , Fatores Sexuais , Ferimentos e Lesões , Adulto Jovem
8.
Eur J Pediatr ; 176(6): 689-696, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28343321

RESUMO

Traumatic brain injury (TBI) is one of the leading causes of death and disability in children, and progressive hemorrhagic injury (PHI) post TBI is associated with poor outcomes. Therefore, the objective of this study was to develop and validate a prognostic model that uses the information available at admission to determine the likelihood of PHI occurrence after TBI in children. The identified demographic data, cause of injury, clinical predictors on admission, computed tomography scan characteristics, and routine laboratory parameters were collected and used to develop a PHI prognostic model with logistic regression analysis, and the prediction model was validated in 68 children. Eight independent prognostic factors were identified: lower Glasgow coma scale score (3 ~ 8) (6 points), intra-axial bleeding/brain contusion (4 points), midline shift ≥5 mm (9 points), platelets <100 × 109/L (11 points), prothrombin time >14 s (6 points), international normalized ratio >1.25 (7 points), D-dimer ≥5 mg/L (14 points), and glucose ≧10 mmol/L (11 points). We calculated risk scores for each child and defined three risk groups: low risk (0-16 points), intermediate risk (17-36 points), and high risk (37-68 points). In the development cohort, the PHI rates after TBI for the low-, intermediate-, and high-risk groups were 10.1, 47.9, and 84.2%, respectively. In the validation cohort, the corresponding PHI rates were 10.9, 47.5, and 85.4%, respectively. The C-statistic for the point system was 0.873 (p = 0.586 by the Hosmer-Lemeshow test) in the development cohort and 0.877 (p = 0.524 by the Hosmer-Lemeshow test) in the validation cohort. CONCLUSION: Using admission predictors, we developed a relatively simple risk score that accurately predicted the risk of PHI after TBI in children. What is Known: • TBI is one of the leading causes of death and disability in children, and PHI post TBI is associated with poor outcomes. •Prediction of patients at low risk of PHI could help reduce treatment costs, whereas identification of patients at high risk of PHI could direct early medical intervention to improve outcomes. What is New: • This study firstly developed a risk score system by assessing the admission information that could provide an earlier prediction of the occurrence of PHI after acute TBI in children.


Assuntos
Hemorragia Encefálica Traumática/diagnóstico , Lesões Encefálicas Traumáticas/complicações , Adolescente , Hemorragia Encefálica Traumática/etiologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Técnicas de Apoio para a Decisão , Progressão da Doença , Feminino , Humanos , Modelos Logísticos , Masculino , Análise Multivariada , Admissão do Paciente , Prognóstico , Estudos Retrospectivos , Medição de Risco , Fatores de Risco
9.
Phys Sportsmed ; 44(3): 324-6, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27074595

RESUMO

Head injuries are relatively common in ice hockey, with the majority represented by concussions, a form of mild traumatic brain injury. More severe head injuries are rare since the implementation of mandatory helmet use in the 1960s. We present a case of a 27 year-old male who sustained a traumatic intraparenchymal hemorrhage with an associated subdural hematoma resulting after being struck by a puck shot at high velocity. The patient presented with expressive aphasia, with no other apparent neurologic deficits. Acutely, he was successfully treated with observation and serial neuroimaging studies ensuring an absence of hematoma expansion. After a stable clinical picture following 24 hours of observation, the patient was discharged and managed with outpatient speech therapy with full resolution of symptoms and return to play 3 months later. We will outline the patient presentation and pertinent points in the management of acute head injuries in athletes.


Assuntos
Afasia/etiologia , Contusão Encefálica/complicações , Hóquei/lesões , Adulto , Afasia/terapia , Contusão Encefálica/etiologia , Hemorragia Encefálica Traumática/etiologia , Hematoma Subdural/etiologia , Humanos , Masculino , Volta ao Esporte , Fonoterapia , Conduta Expectante
10.
J Neurotrauma ; 32(22): 1789-95, 2015 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-26413767

RESUMO

Hypopituitarism may often occur in association with traumatic brain injury (TBI). Identification of reliable predictors of pituitary dysfunction is of importance in order to establish a rational testing approach. We searched the records of patients with TBI, who underwent neuroendocrine evaluation in our institution between 2007 and 2013. One hundred sixty-six adults (70% men) with TBI (median age: 41.6 years; range: 18-76) were evaluated at a median interval of 40.4 months (0.2-430.4).Of these, 31% had ≥1 pituitary deficiency, including 29% of patients with mild TBI and 35% with moderate/severe TBI. Growth hormone deficiency was the most common deficiency (21%); when body mass index (BMI)-dependent cutpoints were used, this was reduced to 15%. Central hypoadrenalism occurred in10%, who were more likely to have suffered a motor vehicle accident (MVA, p = 0.04), experienced post-traumatic seizures (p = 0.04), demonstrated any intracranial hemorrhage (p = 0.05), petechial brain hemorrhages (p = 0.017), or focal cortical parenchymal contusions (p = 0.02). Central hypothyroidism occurred in 8% and central hypogonadism in 12%; the latter subgroup had higher BMI (p = 0.03), were less likely to be working after TBI (p = 0.002), and had lower Global Assessment of Functioning (GAF) scores (p = 0.03). Central diabetes insipidus (DI) occurred in 6%, who were more likely to have experienced MVA (p < 0.001) or sustained moderate/severe TBI (p < 0.001). Patients with MVA and those with post-traumatic seizures, intracranial hemorrhage, petechial brain hemorrhages, and/or focal cortical contusions are at particular risk for serious pituitary dysfunction, including adrenal insufficiency and DI, and should be referred for neuroendocrine testing. However, a substantial proportion of patients without these risk factors also developed hypopituitarism.


Assuntos
Lesões Encefálicas/complicações , Hipopituitarismo/etiologia , Acidentes de Trânsito , Adolescente , Insuficiência Adrenal/etiologia , Adulto , Idoso , Índice de Massa Corporal , Hemorragia Encefálica Traumática/etiologia , Hemorragia Encefálica Traumática/patologia , Lesões Encefálicas/patologia , Córtex Cerebral/patologia , Diabetes Insípido , Feminino , Hormônio do Crescimento Humano/deficiência , Humanos , Hipogonadismo/etiologia , Hipogonadismo/patologia , Hipopituitarismo/patologia , Hipotireoidismo/etiologia , Hipotireoidismo/patologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Convulsões/etiologia , Tomografia Computadorizada por Raios X , Adulto Jovem
11.
Vestn Khir Im I I Grek ; 173(3): 55-62, 2014.
Artigo em Russo | MEDLINE | ID: mdl-25306637

RESUMO

An analysis of the results of the treatment of 132 patients with isolated traumatic parenchymatous injury of the frontal lobes of the brain was made. The treatment strategy was determined in consideration of the traumatic substratum volume and a combination of neurologic status and instrumental data. There were unfavorable risk factors to the course of traumatic parenchymatous injury of the frontal lobes of the brain such as low initial GCS score, the progression of neurologic deficiency in the presence of contusion hemorrhagic foci in the frontal lobe with the volume more than 25 cm3, shifting of midline structures on 5 mm and more or signs of deformation of basilar region cisterns and the presence of mass-effect according to the tomographic data. The developed algorithm allowed improving the results of treatment and the quality of life for patients with traumatic parenchymatous injury of the frontal lobes of the brain.


Assuntos
Hemorragia Encefálica Traumática , Lesões Encefálicas , Lobo Frontal , Procedimentos Neurocirúrgicos , Complicações Pós-Operatórias , Adulto , Idoso , Hemorragia Encefálica Traumática/diagnóstico , Hemorragia Encefálica Traumática/etiologia , Hemorragia Encefálica Traumática/cirurgia , Lesões Encefálicas/complicações , Lesões Encefálicas/diagnóstico , Lesões Encefálicas/mortalidade , Lesões Encefálicas/cirurgia , Feminino , Lobo Frontal/lesões , Lobo Frontal/patologia , Lobo Frontal/cirurgia , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica , Exame Neurológico/métodos , Procedimentos Neurocirúrgicos/efeitos adversos , Procedimentos Neurocirúrgicos/métodos , Seleção de Pacientes , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/mortalidade , Complicações Pós-Operatórias/prevenção & controle , Fatores de Risco , Tempo para o Tratamento , Tomografia Computadorizada por Raios X/métodos , Índices de Gravidade do Trauma , Resultado do Tratamento
12.
Brain Inj ; 28(9): 1216-22, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24865277

RESUMO

BACKGROUND: Remote cerebellar haemorrhage is a rare and unpredictable complication after intracranial and spinal surgery, although less frequently found in the latter. The physiopathology of this phenomenon has not been definitely explained. OBJECTIVES: To describe and discuss the potential implications and pathomechanism of a bilateral remote cerebellar haemorrhage case after spinal surgery and review the literature related to this rare phenomenon. CASE REPORT: A 75 year-old man developed bilateral remote cerebellar haemorrhage after a lumbar laminectomy. Brain CT and MRI examinations showed chronic bilateral remote cerebellar haemorrhage, right haemoventricle and bilateral supratentorial subarachnoid haemorrhage. Subsequently, the patient underwent rehabilitation therapy with improvement of symptoms. CONCLUSION: When large cerebrospinal fluid loss is observed during spinal surgery, brain imaging study should be carried out. The pathogenetic hypothesis of microcirculation vessels tearing, the role of previous spinal surgery and of cerebellar atrophy should be considered and validated with further investigation.


Assuntos
Hemorragia Encefálica Traumática/terapia , Descompressão Cirúrgica/efeitos adversos , Laminectomia/efeitos adversos , Vértebras Lombares/cirurgia , Idoso , Hemorragia Encefálica Traumática/etiologia , Hemorragia Encefálica Traumática/reabilitação , Humanos , Incidência , Masculino , Medição de Risco , Fatores de Risco , Resultado do Tratamento
13.
J Neurotrauma ; 31(17): 1521-7, 2014 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-24738836

RESUMO

The focus of this paper is to identify and quantify risk factors for early hemorrhagic progression of brain contusions (HPC) in patients with traumatic brain injury (TBI) and to evaluate their impact on patients' outcome. Further, based on abnormal values in routine blood tests, the role of trauma-induced coagulopathy is analyzed in detail. Therefore, a prospective study of 153 TBI patients was completed at one institution between January 2008 and June 2012. The collected data included demographics, initial Glasgow Coma Scale pupillary response, initial and 6 h follow-up computed tomography scan findings, coagulation parameters (international normalized ratio, partial thromboplastin time, platelet count, fibrinogen, D-dimer and factor XIII), as well as outcome data using the modified Rankin score at discharge and after one year. The overall rate of early HPC within the first 6 h was 43.5%. The frequency of coagulopathy was 47.1%. When analyzing for risk factors that independently influenced outcome in the form of mRS ≥4 at both points, the following variables appeared: elevated D-dimer level (≥10,000 µg/L), HPC, and initial brain contusions ≥3 cm. Patients sustaining early HPC had a hazard ratio of 5.4 for unfavorable outcome at discharge (p=0.002) and of 3.9 after one year (p=0.006). Overall, patients who developed early HPC were significantly more likely to be gravely disabled or to die. Unfavorable neurological outcome after an isolated TBI is determined largely by early HPC and coagulopathy, which seem to occur very frequently in TBI patients, irrespective of the severity of the trauma.


Assuntos
Transtornos da Coagulação Sanguínea/epidemiologia , Hemorragia Encefálica Traumática/epidemiologia , Lesões Encefálicas/complicações , Adolescente , Adulto , Idoso , Hemorragia Encefálica Traumática/etiologia , Lesões Encefálicas/mortalidade , Progressão da Doença , Feminino , Escala de Coma de Glasgow , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Fatores de Risco , Tomografia Computadorizada por Raios X , Adulto Jovem
14.
Exp Neurol ; 252: 85-94, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24252180

RESUMO

Recent studies have shown that hemorrhagic injury in the preterm cerebellum leads to long-term neurological sequelae, such as motor, affective, and cognitive dysfunction. How cerebellar hemorrhage (CBH) affects the development and function of the cerebellum is largely unknown. Our study focuses on developing a mouse model of CBH to determine the anatomical, behavioral, and molecular phenotypes resulting from a hemorrhagic insult to the developing cerebellum. To induce CBH in the postnatal mouse cerebellum, we injected bacterial collagenase, which breaks down surrounding blood vessel walls, into the fourth ventricle at postnatal day two. We found a reduction in cerebellar size during postnatal growth, a decrease in granule cells, and persistent neurobehavioural abnormalities similar to abnormalities reported in preterm infants with CBH. We further investigated the molecular pathways that may be perturbed due to postnatal CBH and found a significant upregulation of genes in the inflammatory and sonic hedgehog pathway. These results point to an activation of endogenous mechanisms of injury and neuroprotection in response to postnatal CBH. Our study provides a preclinical model of CBH that may be used to understand the pathophysiology of preterm CBH and for potential development of preventive therapies and treatments.


Assuntos
Hemorragia Encefálica Traumática/patologia , Cerebelo/crescimento & desenvolvimento , Cerebelo/patologia , Regulação da Expressão Gênica no Desenvolvimento/fisiologia , Neurônios/patologia , Fatores Etários , Animais , Animais Recém-Nascidos , Transfusão de Sangue Autóloga/efeitos adversos , Hemorragia Encefálica Traumática/etiologia , Contagem de Células , Colagenases/toxicidade , Citocinas/genética , Citocinas/metabolismo , Modelos Animais de Doenças , Comportamento Exploratório/fisiologia , Feminino , Proteínas Hedgehog/genética , Proteínas Hedgehog/metabolismo , Peptídeos e Proteínas de Sinalização Intercelular/genética , Peptídeos e Proteínas de Sinalização Intercelular/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos ICR , Atividade Motora/fisiologia , Atividade Motora/efeitos da radiação , Transdução de Sinais/fisiologia
15.
Acta Neuropathol Commun ; 1: 51, 2013 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-24252601

RESUMO

BACKGROUND: Blast-related traumatic brain injury (TBI) has been a significant cause of injury in the military operations of Iraq and Afghanistan, affecting as many as 10-20% of returning veterans. However, how blast waves affect the brain is poorly understood. To understand their effects, we analyzed the brains of rats exposed to single or multiple (three) 74.5 kPa blast exposures, conditions that mimic a mild TBI. RESULTS: Rats were sacrificed 24 hours or between 4 and 10 months after exposure. Intraventricular hemorrhages were commonly observed after 24 hrs. A screen for neuropathology did not reveal any generalized histopathology. However, focal lesions resembling rips or tears in the tissue were found in many brains. These lesions disrupted cortical organization resulting in some cases in unusual tissue realignments. The lesions frequently appeared to follow the lines of penetrating cortical vessels and microhemorrhages were found within some but not most acute lesions. CONCLUSIONS: These lesions likely represent a type of shear injury that is unique to blast trauma. The observation that lesions often appeared to follow penetrating cortical vessels suggests a vascular mechanism of injury and that blood vessels may represent the fault lines along which the most damaging effect of the blast pressure is transmitted.


Assuntos
Traumatismos por Explosões/fisiopatologia , Lesões Encefálicas/fisiopatologia , Encéfalo/fisiopatologia , Animais , Apoptose/fisiologia , Traumatismos por Explosões/complicações , Traumatismos por Explosões/patologia , Traumatismos por Explosões/psicologia , Encéfalo/patologia , Hemorragia Encefálica Traumática/etiologia , Hemorragia Encefálica Traumática/patologia , Hemorragia Encefálica Traumática/fisiopatologia , Hemorragia Encefálica Traumática/psicologia , Lesões Encefálicas/etiologia , Lesões Encefálicas/patologia , Lesões Encefálicas/psicologia , Dendritos/patologia , Dendritos/fisiologia , Modelos Animais de Doenças , Comportamento Exploratório/fisiologia , Gliose/etiologia , Gliose/patologia , Gliose/fisiopatologia , Masculino , Microglia/patologia , Microglia/fisiologia , Neurônios/patologia , Neurônios/fisiologia , Pressão , Distribuição Aleatória , Ratos , Ratos Long-Evans , Aprendizagem Espacial/fisiologia , Fatores de Tempo
16.
Br J Oral Maxillofac Surg ; 51(8): e296-8, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23958350

RESUMO

Carotid-cavernous sinus fistula is an arteriovenous fistula between the internal carotid artery and the cavernous sinus, and is usually caused by a traumatic tear or a ruptured aneurysm of the cavernous segment of the internal carotid artery. We describe a rare case of delayed intracranial haemorrhage and carotid-cavernous sinus fistula that presented 3 weeks after fracture of the facial bones. The patient developed orbital apex syndrome including ptosis of upper eyelid, pulsatile exophthalmos, chemosis, loss of ocular motility, monocular blindness on the right, and numbness of the right infraorbital region. After transcatheter intra-arterial embolisation, the ptosis and chemosis improved.


Assuntos
Hemorragia Encefálica Traumática/etiologia , Fístula Carótido-Cavernosa/etiologia , Ossos Faciais/lesões , Fraturas Cranianas/complicações , Adulto , Blefaroptose/etiologia , Cegueira/etiologia , Edema/etiologia , Embolização Terapêutica/métodos , Exoftalmia/etiologia , Doenças Palpebrais/etiologia , Feminino , Seguimentos , Humanos , Hipestesia/etiologia , Côndilo Mandibular/lesões , Fraturas Mandibulares/complicações , Fraturas Maxilares/complicações , Oftalmoplegia/etiologia , Órbita/inervação , Fraturas Orbitárias/complicações , Fraturas Zigomáticas/complicações
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...