Introduction: Pneumocephalus is a frequent complication following neurosurgical procedures. The d... more Introduction: Pneumocephalus is a frequent complication following neurosurgical procedures. The diagnosis is based on tomographic findings and the clinical evolution of the patient. Therefore, we detail the physiopathological mechanisms that trigger this complication. Clinical Case: We present the clinical case of an 85-year-old man who underwent a keyhole craniotomy and subdural drainage placement due to the diagnosis of a chronic subdural hematoma (CSDH) and subsequently developed sudden tension pneumocephalus which triggered the death of the patient due to intracranial hypertension. Conclusion: Tension pneumocephalus is a life-threatening complication that must be suspected early and must be treated as an emergency. Keywords: Hematoma, Subdural, Chronic, Pneumocephalus, Drainage, Craniotomy (Source: MeSH NLM)
Objetivo: Describir las características clínicas, quirúrgicas y postoperatorias en pacie... more Objetivo: Describir las características clínicas, quirúrgicas y postoperatorias en pacientes con diagnóstico de infarto maligno de la arteria cerebral media sometidos a craniectomía descompresiva. Material y métodos: Estudio observacional, descriptivo, retrospectivo, tipo serie de casos, realizado entre marzo 2017 y marzo 2020. Se recolectaron los datos de pacientes consecutivos con diagnóstico de infarto de arteria cerebral media. Resultados: Diez casos fueron revisados. Ochenta por ciento fueron hombres, la edad promedio fue 64 años y 60% de los pacientes fueron mayores de 60 años. En la admisión, el Glasgow promedio fue de 11 puntos y el mRS fue de 4. El tiempo promedio desde el diagnostico hasta la cirugía fue de 89,7 horas. La arteria cerebral anterior estuvo comprometida en dos casos. La transformación hemorrágica ocurrió en tres casos. El diámetro anteroposterior promedio de la plaqueta ósea fue de 116 mm. El tiempo promedio de estancia en UCI y estancia hospitalar...
Infections of the central nervous system are a medical emergency, potentially lethal and associat... more Infections of the central nervous system are a medical emergency, potentially lethal and associated with increased morbidity and mortality. We present the case of a male with risk factors and clinical deterioration, in which the brain computed tomography scan showed a subdural collection following a head injury, which underwent surgical evacuation revealing a subdural empyema. The culture of the subdural collection yielded a positive result to Enterobacter cloacae.
The approach to the upper cervical spine is a challenge for surgeons, not only for its complex an... more The approach to the upper cervical spine is a challenge for surgeons, not only for its complex anatomy but also for the great variety of pathologies. Klippel–Feil syndrome (KFS) is a congenital disease characterized by the fusion of two or more cervical segments and is associated with various musculoskeletal and vascular malformations. However, there is no consensus on the type of surgery, approach, level of fixation or fusion. We report the case of a KFS, associated with multiple anatomical variants, who suffered a traumatic cervical injury and underwent surgical treatment.
Objective Determine predictors of in-hospital mortality in patients with severe traumatic brain i... more Objective Determine predictors of in-hospital mortality in patients with severe traumatic brain injury (TBI) who underwent decompressive craniectomy. Materials and Methods This retrospective study reviewed consecutive patients who underwent a decompressive craniectomy between March 2017 and March 2020 at our institution, and analyzed clinical characteristics, brain tomographic images, surgical details and morbimortality associated with this procedure. Results Thirty-three (30 unilateral and 3 bifrontal) decompressive craniectomies were performed, of which 27 patients were male (81.8%). The mean age was 52.18 years, the mean Glasgow coma scale (GCS) score at admission was 9, and 24 patients had anisocoria (72.7%). Falls were the principal cause of the trauma (51.5%), the mean anterior–posterior diameter (APD) of the bone flap in unilateral cases was 106.81 mm (standard deviation [SD] 20.42) and 16 patients (53.3%) underwent a right-sided hemicraniectomy. The temporal bone enlargement...
Introduction: Pneumocephalus is a frequent complication following neurosurgical procedures. The d... more Introduction: Pneumocephalus is a frequent complication following neurosurgical procedures. The diagnosis is based on tomographic findings and the clinical evolution of the patient. Therefore, we detail the physiopathological mechanisms that trigger this complication. Clinical Case: We present the clinical case of an 85-year-old man who underwent a keyhole craniotomy and subdural drainage placement due to the diagnosis of a chronic subdural hematoma (CSDH) and subsequently developed sudden tension pneumocephalus which triggered the death of the patient due to intracranial hypertension. Conclusion: Tension pneumocephalus is a life-threatening complication that must be suspected early and must be treated as an emergency. Keywords: Hematoma, Subdural, Chronic, Pneumocephalus, Drainage, Craniotomy (Source: MeSH NLM)
Objetivo: Describir las características clínicas, quirúrgicas y postoperatorias en pacie... more Objetivo: Describir las características clínicas, quirúrgicas y postoperatorias en pacientes con diagnóstico de infarto maligno de la arteria cerebral media sometidos a craniectomía descompresiva. Material y métodos: Estudio observacional, descriptivo, retrospectivo, tipo serie de casos, realizado entre marzo 2017 y marzo 2020. Se recolectaron los datos de pacientes consecutivos con diagnóstico de infarto de arteria cerebral media. Resultados: Diez casos fueron revisados. Ochenta por ciento fueron hombres, la edad promedio fue 64 años y 60% de los pacientes fueron mayores de 60 años. En la admisión, el Glasgow promedio fue de 11 puntos y el mRS fue de 4. El tiempo promedio desde el diagnostico hasta la cirugía fue de 89,7 horas. La arteria cerebral anterior estuvo comprometida en dos casos. La transformación hemorrágica ocurrió en tres casos. El diámetro anteroposterior promedio de la plaqueta ósea fue de 116 mm. El tiempo promedio de estancia en UCI y estancia hospitalar...
Infections of the central nervous system are a medical emergency, potentially lethal and associat... more Infections of the central nervous system are a medical emergency, potentially lethal and associated with increased morbidity and mortality. We present the case of a male with risk factors and clinical deterioration, in which the brain computed tomography scan showed a subdural collection following a head injury, which underwent surgical evacuation revealing a subdural empyema. The culture of the subdural collection yielded a positive result to Enterobacter cloacae.
The approach to the upper cervical spine is a challenge for surgeons, not only for its complex an... more The approach to the upper cervical spine is a challenge for surgeons, not only for its complex anatomy but also for the great variety of pathologies. Klippel–Feil syndrome (KFS) is a congenital disease characterized by the fusion of two or more cervical segments and is associated with various musculoskeletal and vascular malformations. However, there is no consensus on the type of surgery, approach, level of fixation or fusion. We report the case of a KFS, associated with multiple anatomical variants, who suffered a traumatic cervical injury and underwent surgical treatment.
Objective Determine predictors of in-hospital mortality in patients with severe traumatic brain i... more Objective Determine predictors of in-hospital mortality in patients with severe traumatic brain injury (TBI) who underwent decompressive craniectomy. Materials and Methods This retrospective study reviewed consecutive patients who underwent a decompressive craniectomy between March 2017 and March 2020 at our institution, and analyzed clinical characteristics, brain tomographic images, surgical details and morbimortality associated with this procedure. Results Thirty-three (30 unilateral and 3 bifrontal) decompressive craniectomies were performed, of which 27 patients were male (81.8%). The mean age was 52.18 years, the mean Glasgow coma scale (GCS) score at admission was 9, and 24 patients had anisocoria (72.7%). Falls were the principal cause of the trauma (51.5%), the mean anterior–posterior diameter (APD) of the bone flap in unilateral cases was 106.81 mm (standard deviation [SD] 20.42) and 16 patients (53.3%) underwent a right-sided hemicraniectomy. The temporal bone enlargement...
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