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):||15 November 2007|
|PDF File Size:||18.63 Mb|
|ePub File Size:||20.49 Mb|
|Price:||Free* [*Free Regsitration Required]|
Current diagnosis and intrxparenquimatoso in neurology. Percutaneous trigeminal nerve compression. The actual mechanism for intracranial bleeding resulting from percutaneous procedures on the trigeminal ganglion seems to be a direct vascular injury by a misplaced needle 26,27 or the inflated balloon.
Trochlear nerve palsy after repeated percutaneous balloon compression for recurrent trigeminal neuralgia: However, in some cases the tip of the needle is mislocated intracranially as evidenciated by either X-ray control, or the exit of CSF following stylet withdrawal.
Edit article Share article View revision history. Chronic subdural hematoma of the posterior fossa associated with cerebellar hemorrhage: Log in Sign up. Case report and pathogenic considerations. Postoperative complications of intrpaarenquimatoso neurological surgery. Introduction Percutaneous compression of the trigeminal ganglion PCTG is an effective and safe surgical technique for trigeminal neuralgia which is thought to be almost free of major complications ,5,7, Long term results in cases.
Churchill Livingstone, New York ; pp: Miranda Service of Neurosurgery. There seems to be no difference in the mechanism of occurrence of supra and infratentorial chronic subdural hematoma, with the supposed starting point being the mingling of cerebrospinal fluid with blood in a small subdural hematoma.
The other half has a variety of intgaparenquimatoso minor trauma not intrraparenquimatoso by the patient, intraparfnquimatoso therapy, blood clotting disorders and intracranial hypotension or no cause that could be found at all.
Venous bleeding is readly identified, and arterialized blood coming from sources other than the internal carotid artery is also recognizable because its low and non pulsatile flow.
Since during PCTG the peedle has not to be placed beyond the foramen ovale margins, one could expect the number of needle-related intracranial vascular, hemorrhagic or infectious complications to be lower than with radiofrequency RF lesioning or glycerol injection. This can encompass a number of entities that share the acute accumulation of blood in the parenchyma of the brain.
On the other hand, a close observation and careful control of the arterial pressure changes during the operation is mandatory, as many patients develop sudden rises in blood pressure which may also result in intracerebral hemorrhage or ischemic cardiac complications Needle for use during percutaneous compression of gasserian ganglia for trigeminal neuralgia. Her hypertension was well controlled with regularly taken antihypertensive medications. The finding of these lesions in patients without a history of trauma is even rarer, with only 15 cases reported, including those related to anticoagulant therapy 1, In a comment on this report, Apfelbaum 24 reported a personal case of fatal intracerebral hemorrhage following RF lesioning in a patient in whom he was certain that the needle electrode had never exited out of the Meckel, s cave.
Kuether el al, 13 reported the intraparenquimatosl of a year-old man who developed a direct high-flow carotid cavernous fistula which required endovascular treatment; the Fogarty catheter was apparently inflated intraparenquimatooso the lumen of the internal carotid artery despite that no arterial hemorrhage was noted during the procedure.
Chronic subdural hematomas are common neurosurgical lesions. A MRI Figs 2 hemahoma 3 showed a right posterior fossa extra-axial hematoma, hyperintense both on T1 and T2 sequences, compressing the right cerebellar hemisphere, and a small, contiguous, intraparenchymal right cerebellar hematoma in subacute fase, with some edema; MRI angiography was normal.
Clin Neurosurg ; Radiofrequency rhizotomy for trigeminal and other cranial neuralgias. We also observed a low-flow carotid-cavernous fistula in a patient in whom the Meckel,s cave could not be entered which resolved spontaneously in 3 months 17 ; in this patient repeated needle insertions using different trajectories always resulted in brisk, pulsatile arterial bleeding, hematona arising from the internal carotid artery.
The reasons that could account for the rarity of posterior fossa chronic subdural hematoma are probably the difficulty in diagnosis before the widespread availability of MRI, because CT scans are not the best tool to see lesions in the posterior fossa, the more uncommon occurrence of venous sinus lesions in the posterior fossa, and the small number of bridging veins in the posterior fossa in comparison with the supratentorial subdural space.
Changes in the systemic blood pressure and the cardiac rhythm induced by therapeutic compression of the trigeminal ganglion. Hospital “12 de Octubre”. Focal intracranial hemorrhages occurred in 19 patients. On opening the dura, the old, liquefied blood gushed out, suggesting hypertension in the posterior fossa. McGraw Hill, New York,pp: In the patient reported here there were not changes in arterial pressure coincidental with balloon inflation, likely because it was out of the cave.
Balloon compression rhizotomy in surgical management of trigeminal neuralgia. The anatomy of the gasserian ganglion and the distribution of pain in relation to injections and operations for trigeminal neuralgia. WB Saunders Co, Philadelphia, ; pp: Subarachnoid hemorrhage and “normal pressure hydrocephalus”. Though it has been argued that an “in vitro” like, or cylindrical-shaped balloon may also be observed in patients with a large Meckle,s cave 14,22to us it reveals an erroneous location as we have been unable to advance the catheter into the posterior fossa through the poros trigemini following balloon,s deflation when such a shape is initially observed; in contrast, when the pear shape is observed the catheter may be pushed into the posterior fossa following balloon,s deflation whithout any resistance.
In addition, a tortuous carotid artery may pass directly over the foramen ovale making it impossible reaching the ganglion without puncturing the artery When analyzing extratrigeminal complications they found that 5 patients developed a carotid-cavernous fistula and 18 oculomotor palsies.
Postoperative CT scan performed five hours after surgery when the patient was comatose. The mechanism could also be puncture related, but in any case, needle misplacement beyond or out of the foramen ovale initially during insertion is just another technical error which must be also avoided.
There is uncal herniation and marked midline shift. The symptoms of brain stem compression or cerebellar signs could suggest the presence of a posterior fossa lesion, a rare lesion even with the use of anticoagulation.
Another foramen close to the ovale is the innominate foramen or canaliculus inrraparenquimatoso Arnold. Direct carotid cavernous fistula after trigeminal balloon microcompression gangliolysis: A CT scan showed and acute subdural hematoma of the basal and convexity left temporal regions, together with an anterior temporal lobe hematoma on the side of operation.
Read it at Google Books – Find it at Amazon.
Correlación clínico-tomográfica del hematoma intraparenquimatoso
Subdural hematomas of the posterior fossa are very rare in adults 1. To our knowledge, this is the first report of a spontaneous chronic posterior fossa subdural hematoma related to an intraparenchymal cerebellar hemorrhage, without history of trauma, posterior fossa vascular pathology or anticoagulation. About half the cases reported are related to traumatic events, mostly minor traumatic injuries.
Harwood Academic Publishers, London, ; pp: The lesions described in the literature are usually acute, related to severe traumatic injuries, with high mortality rates.