Hemorragia intracerebral ou simplesmente hemorragia cerebral é um tipo de sangramento Os hematomas intracerebrais agudos ocorrem no momento da lesão, O risco de morte por sangramento intraparenquimatoso na lesão cerebral. CORRELACIÓN CLÍNICO-TOMOGRÁFICA DEL HEMATOMA INTRAPARENQUIMATOSO. Article · January with 12 Reads. Eugenio de Zayas Alba. on ResearchGate | On Feb 6, , Equipo Revisor and others published MICROHEMORRAGIAS MÃšLTIPLES Y HEMATOMA INTRAPARENQUIMATOSO }.
|Published (Last):||25 August 2004|
|PDF File Size:||15.91 Mb|
|ePub File Size:||18.72 Mb|
|Price:||Free* [*Free Regsitration Required]|
The association of the posterior fossa chronic subdural hematoma with spontaneous parenchymal hemorrhage without anticoagulation therapy was never related in the literature, to our knowledge.
Four years before the last admission he underwent PCTG at our Unit with a good functional result; entry into the foramen ovale with a gauge needle-cannula was readly achieved under lateral fluoroscopic control, a intrapqrenquimatoso French Fogarty catheter was placed into the Meckel,s cave and the balloon was inflated for hemato,a minute showing the typical pear shape. Kuether el al, 13 reported the case of a year-old man who developed a direct high-flow carotid cavernous fistula which required endovascular treatment; the Intraparenquimatoos catheter was apparently inflated into the lumen of the internal carotid artery despite that no arterial hemorrhage was noted during the procedure.
Postoperative complications of intracranial neurological surgery.
Three patients had hemorrhages of the ipsilateral intratemporal lobea two of these died and one inteaparenquimatoso disabled. The anatomy of the gasserian ganglion and the distribution of pain in relation to injections and operations for trigeminal neuralgia.
External carotid artery fistula due to micro-compression of the gasserian ganglion for relief of trigeminal neuralgia. Chronic subdural hematoma of the posterior fossa is an uncommon entity, and spontaneous lesions are very rarely described, occurring mostly during anticoagulation therapy.
Though it seems very difficult for the 14 needle gauge used in PCTG penetrating these small diameter cranial base holes, this risk may be prevented by careful fluoroscopic control resurting not only to the routine lateral projection, but to anteroposterior or submentovertex ones if necessary. Postoperative transient diplopia occurring in patients showing a pear-shaped balloon during surgery and satisfactory functional result have been attributed to IV or VI nerve compression against the tentorium intra;arenquimatoso within the cavernous sinus 14,17, We indirectly assumed that the intraparenquimatoao was inside the Meckel,s cave in these instances, but we have not an explanation for these atypical shapes This 68 year-old normotensive man had been suffering from typical trigeminal neuralgia located at the second and third trigeminal divisions on the left side for 6 years.
Percutaneous trigeminal nerve compression. An overview hemayoma chronic subdural hematoma: Direct carotid cavernous fistula after trigeminal balloon microcompression gangliolysis: Case report and pathogenic considerations.
Percutaneous microcompression of the gasserian ganglion for trigeminal neuralgia. Churchill Livingstone, New York ; pp: We have also observed marked rises in arterial blood pressure during compression of the gasserian ganglion even under general anesthesia, which may be easily controlled with nitroprusside or better prevented by injecting lidocaine into the Meckel,s cave before inflating the balloon 4,16, Chronic subdural hematomas are common neurosurgical lesions.
Posterior fossa subdural hematoma. When it is placed too medial it may go directly into the cavernous sinus and the internal carotid artery may be punctured. Sweel 25has emphasized that intracranial hemorrhages occurring in patients exposed to percutaneous trigeminal lesioning procedures are not always puncture-related, but can be attributed to an anticoagulant or bleeding tendency, or to abrupt arterial blood pressure rises occurring during surgery.
Clin Neurol Neurosurg ; En Textbook of Stereotactic and Functional Neurosurgery. A suboccipital right craniectomy was performed and a typical chronic subdural hematoma was drained after opening the dura-mater. Occasionally we have observed another atypical balloon shapes such as oval, irregular or round which resulted in a good functional result as revealed by long-lasting pain control with the corresponding hemifacial hipoesthesia, despite that the nipple protruding through the poros trigemini and providing the typical pear-shape of a properly placed balloon was not observed.
The patient was taken to the operating room. As stated above we never stopped PCTG because the occurrence of arterial bleeding through the needle, even if suggestive of carotid origin as it invariably disappeared following needle replacement excepting in the patient in whom repeated puncture of the foramen ovale always resulted in brisk and pulsatile arterial bleeding most likely arising from the carotid artery. Reiwlta et al, 18 reported a patient who developed an arteriovenous fistula in the region of the territory of the external carotid artery with the fistulous connection arising at the origin of the middle meningeal artery from the pterygopalatine artery which was punctured because of the posterolateral direction of the needle emerging from the foramen ovale; the clinical course was benign with spontaneous closure of the fistula 19 days after puncture.
Though different types of intracranial bleeding have been reported in the largest series of patients undergoing radiofrequency RF lesioning of the gasserian ganglion 26,27to our knowledge this is the first report of focal intracranial hemorrhage complicating PCTG. Types of intracerebral hemorrhage include see related articles for full list: CASE A year-old hypertensive woman presented to another emergency service 15 days before admission to our hospital with a history of sudden headache and gait disturbance.
Excluding the patient reponed here, and some complaining from postoperative transient headache and showing discrete meningeal sings suggestive of mild subsrachnoid hemorrhage, we have not had intracranial hemorrhagic complications in more than percutaneous retrogas-serian trigeminal procedures about two thirds RF lesions and one third PCTG. In a review of cases from Sambasivan 2none in the posterior fossa was reported, and Tsai et al.
She was submitted to a CT scan of the head and treated conservatively with diagnosis of spontaneous cerebellar hemorrhage, and discharged five days after without intercurrences. There was a marked midline shift. Consequently, he has recommended performing careful preoperative coagulation studies as most patients suffering trigeminal neuralgia are old and many are on aspirin and other drugs, carbamazepine among them, which are able to increase bleeding risk.
Gerber and Mullan 7 reported two extracranial pterygoid arteriovenous fistulas in the region of the foramen ovale fed by the maxillary artery in one instance; intrapxrenquimatoso fistula caused tinnitus which resolved spontaneously in one case and required transarterial embolization in other.
Another foramen close to the ovale is the innominate foramen or canaliculus of Arnold. In patients on anticoagulation therapy, intracranial bleeding should always be suspected in the presence of neurological symptoms. In fact, when reviewing the literature extratrigeminal complications following PCTG seem less frequent than with other hematomaa techniques in which the peedle has to entry the trigeminal cistern ,5,9,11,22, The postoperative CT scan was unremarkable.
In our patient the combination of a subdural hematoma located not only at the temporal convexity, but also in the basal and medial parts of the temporal fossa, together with the anterobasal intratemporal hematoma suggest that they resulted from bridging vein and parenchymal dysruption caused by the needle or a misplaced balloon.
On opening the dura, the old, liquefied blood gushed out, suggesting hypertension in the posterior fossa.
Percutaneous compression trigeminal ganglion. We and other authors have observed postoperative transient oculo-motor palsies when a balloon showing an “in vitro” like appearance is kept inflated more than the time necessary for checking its shape; however, the exact mechanism of oculomotor dysfunction in these cases remains to be determined.