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[PMID]:28468141
[Au] Autor:Wan Y; Fei X; Jiang D; Chen H; Shi L; Wang Z
[Ad] Endereço:*Department of Neurosurgery, Suzhou Kowloon Hospital Affiliated With Shanghai Jiao Tong University School of Medicine †Department of Neurosurgery, The First People's Hospital of Kunshan Affiliated With Jiangsu University, Suzhou, China.
[Ti] Título:Clinical Observation of Treatment of Chronic Subdural Hematoma With Novel Double Needle Minimally Invasive Aspiration Technology.
[So] Source:J Craniofac Surg;28(3):646-649, 2017 May.
[Is] ISSN:1536-3732
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The aim of the present study was to explore the clinical effects, including the prevention of complications, of the treatment of chronic subdural hematoma with double needle aspiration. METHODS: The clinical data of 31 patients with chronic subdural hematoma treated by double YL-1 needle double skull drilling and 31 controls treated by traditional drilling and drainage were analyzed retrospectively. RESULTS: In the YL-1 needle group, only 1 patient was with hematoma recurrence, 1 patient was with intracranial pneumocephalus, and the remaining patients who were followed up for 3 months achieved a clinical cure. In the traditional drilling and drainage group, 13 patients were with hematoma recurrence within 3 months after the operation and 7 patients were with postoperative intracranial pneumocephalus. CONCLUSIONS: The method of double YL-1 needle is better than the traditional drilling and drainage method for the treatment of chronic subdural hematoma because it reduces the postoperative recurrence rate and complications.
[Mh] Termos MeSH primário: Hematoma Subdural Crônico/cirurgia
Procedimentos Cirúrgicos Minimamente Invasivos/instrumentação
Agulhas
Paracentese/normas
Trepanação/instrumentação
Trepanação/normas
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Drenagem/métodos
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Pneumocefalia/etiologia
Complicações Pós-Operatórias/etiologia
Recidiva
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180126
[Lr] Data última revisão:
180126
[Sb] Subgrupo de revista:D
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1097/SCS.0000000000003462


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[PMID]:28631684
[Au] Autor:Garov EV; Zelenkova VN; Stepanova EA; Meparishvili AS
[Ad] Endereço:L.I. Sverzhevsky Research and Clinical Institute of Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152.
[Ti] Título:[Multiple pneumocele associated with temporal bone hyperpneumatization].
[Ti] Título:Mnozhestvennoe pnevmotsele pri giperpnevmatizatsii visochnoi kosti..
[So] Source:Vestn Otorinolaringol;82(3):58-61, 2017.
[Is] ISSN:0042-4668
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:The authors consider in brief epidemiology, diagnostics, and variants of the surgical treatment of the rare clinical condition pneumocele and pneumoencephalocele of the temporal bone. Diagnostic and surgical modalities for the management of multiple pneumocele associated with temporal bone hyperpneumatization are discussed.
[Mh] Termos MeSH primário: Doenças Ósseas
Pneumocefalia
[Mh] Termos MeSH secundário: Adolescente
Doenças Ósseas/diagnóstico
Doenças Ósseas/etiologia
Doenças Ósseas/fisiopatologia
Doenças Ósseas/cirurgia
Perda Auditiva/diagnóstico
Perda Auditiva/etiologia
Seres Humanos
Masculino
Processo Mastoide/diagnóstico por imagem
Processo Mastoide/patologia
Processo Mastoide/cirurgia
Procedimentos Cirúrgicos Otológicos/métodos
Pneumocefalia/diagnóstico
Pneumocefalia/fisiopatologia
Pneumocefalia/cirurgia
Osso Temporal/diagnóstico por imagem
Osso Temporal/patologia
Osso Temporal/cirurgia
Tomografia Computadorizada Espiral/métodos
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170927
[Lr] Data última revisão:
170927
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170621
[St] Status:MEDLINE
[do] DOI:10.17116/otorino201782358-61


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[PMID]:28479524
[Au] Autor:Kim JH; Kim CH; Lee CY
[Ad] Endereço:Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
[Ti] Título:Efficacy of Arachnoid-Plasty on Chronic Subdural Hematoma Following Surgical Clipping of Unruptured Intracranial Aneurysms.
[So] Source:World Neurosurg;104:303-310, 2017 Aug.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: We aimed to elucidate the effects of arachnoid plasty (ARP) on chronic subdural hematoma (CSDH) occurrence following clipping surgery. METHODS: In total 217 patients (ARP, n = 97; non-ARP, n = 120) who had undergone unruptured intracranial aneurysm (UIA) surgical clipping via the pterional approach were retrospectively assessed. Predisposing factors for CSDH development following the surgery were investigated. Thickness and volume of the subdural fluid collection (SDFC) were measured to determine whether ARP affects postoperative SDFC. RESULTS: The occurrence of postoperative CSDH was higher in patients without ARP compared to those with ARP (12.5 vs. 3.1%; P = 0.01). In multivariate analyses, having an SDFC volume ≥15 mL on postoperative day (POD) 8, (odds ratio [OR] = 15.113; range = 3.159-72.290), and male sex (OR = 4.274; range = 1.291-14.148) were identified as independent predictive factors. Having had ARP (OR = 0.228; range = 0.056-0.927) was, as an independent variable, negatively correlated with the occurrence of CSDH (P < 0.05). Moreover, SDFC volume ≥15 ml on POD 8 was significantly less common in the ARP group compared with the non-ARP group (P = 0.03). CONCLUSION: Patients who underwent ARPs developed fewer CSDHs following UIA clipping surgery. The factors that predicted the development of CSDH included male sex, SDFC volume on POD 8, and ARP. In addition, the ARP patients had lower SDFC volumes (<15 mL). These findings suggested that ARP reduced the incidence of CSDHs after surgical clippings in patients with unruptured aneurysms.
[Mh] Termos MeSH primário: Aracnoide-Máter/cirurgia
Hematoma Subdural Crônico/prevenção & controle
Aneurisma Intracraniano/cirurgia
Complicações Pós-Operatórias/prevenção & controle
Instrumentos Cirúrgicos
[Mh] Termos MeSH secundário: Angiografia Cerebral
Angiografia por Tomografia Computadorizada
Feminino
Seguimentos
Hematoma Subdural Crônico/etiologia
Seres Humanos
Masculino
Meia-Idade
Análise Multivariada
Pneumocefalia/etiologia
Pneumocefalia/prevenção & controle
Complicações Pós-Operatórias/etiologia
Estudos Retrospectivos
Fatores de Risco
Derrame Subdural/prevenção & controle
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170927
[Lr] Data última revisão:
170927
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170509
[St] Status:MEDLINE


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[PMID]:28213557
[Au] Autor:Iglesias-Deus A; Pérez-Muñuzuri A; López-Suárez O; Crespo P; Couce ML
[Ad] Endereço:Neonatal Unit, Department of Pediatrics, Hospital Clínico Universitario de Santiago, IDIS (Health Research Institute of Santiago de Compostela), Santiago de Compostela, Spain.
[Ti] Título:Tension pneumocephalus induced by high-flow nasal cannula ventilation in a neonate.
[So] Source:Arch Dis Child Fetal Neonatal Ed;102(2):F173-F175, 2017 Mar.
[Is] ISSN:1468-2052
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The use of high-flow nasal cannula (HFNC) therapy as respiratory support for preterm infants has increased rapidly worldwide. The evidence available for the use of HFNC is as an alternative to nasal continuous positive airway pressure (CPAP) and in particular to prevent postextubation failure. We report a case of tension pneumocephalus in a preterm infant as a complication during HFNC ventilation. Significant neurological impairment was detected and support was eventually withdrawn. Few cases of pneumocephalus as a complication of positive airway pressure have been reported in the neonatal period, and they all have been related to CPAP. This report reinforces the need to be aware of this rare but possible complication during HFNC therapy, as timely diagnosis and treatment can prevent neurological sequelae. We also stress the importance of paying close attention to flow rate, nasal cannula size and insertion, and mouth position, and of regularly checking insertion depth.
[Mh] Termos MeSH primário: Cânula/efeitos adversos
Pressão Positiva Contínua nas Vias Aéreas/efeitos adversos
Pneumocefalia/etiologia
[Mh] Termos MeSH secundário: Desenho de Equipamento
Evolução Fatal
Feminino
Seres Humanos
Recém-Nascido
Recém-Nascido Prematuro
Imagem por Ressonância Magnética
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170420
[Lr] Data última revisão:
170420
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170219
[St] Status:MEDLINE
[do] DOI:10.1136/archdischild-2015-309777


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[PMID]:28189868
[Au] Autor:Martinez-Perez R; Gómez E; Rayo N
[Ad] Endereço:Department of Clinical Neurological Sciences, University of Western Ontario, London, Ontario, Canada. Electronic address: rafa11safin@hotmail.com.
[Ti] Título:Spontaneous Tension Pneumocephalus: A Rare Complication of Shunting.
[So] Source:World Neurosurg;100:710.e11-710.e13, 2017 Apr.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Spontaneous tension pneumocephalus (STP) is a rare but serious complication derived from shunting procedures. Few cases have been published with purely intraventricular location. Treatment options and physiopathology considerations are discussed in this case report. CASE DESCRIPTION: A 75-year-old woman with a 15-year-old lumboperitoneal (LP) shunt insertion was treated with a ventriculoperitoneal shunt for her normotensive hydrocephalus. Two months later she was brought to the emergency room showing symptoms of lethargy and confusion. A helicoidal computed tomography (CT) scan revealed a bone defect in the floor of the right temporal fossa. The patient underwent a temporal craniotomy for closing the bone and dural defect, and the LP shunt was removed, at which point her condition improved. CONCLUSIONS: A high-resolution CT scan of the skull base is useful to localize the point where the air enters into the intracranial cavity in STP cases. Coexistent or preceding otologic symptoms might direct the suspicion toward an otogenic origin. Shunt removal, or adjusting the opening pressure, if feasible, is recommended. Otherwise, dural repair and covering of the bone defect have acceptable rates of success and should be performed before any other more aggressive techniques to avoid the risk of hearing loss.
[Mh] Termos MeSH primário: Derivações do Líquido Cefalorraquidiano/efeitos adversos
Pneumocefalia/etiologia
Pneumocefalia/cirurgia
Complicações Pós-Operatórias/cirurgia
[Mh] Termos MeSH secundário: Idoso
Feminino
Seres Humanos
Hidrocefalia de Pressão Normal/cirurgia
Pneumocefalia/diagnóstico por imagem
Complicações Pós-Operatórias/diagnóstico por imagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170213
[St] Status:MEDLINE


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[PMID]:28158169
[Au] Autor:Figueiera HD; Guimaraes J; Sousa AL; Regalado AM
[Ad] Endereço:Anesthesiology, Intensive Care and Emergency Department, Centro Hospitalar do Porto, Porto, Portugal.
[Ti] Título:Pneumocephalus Following Unidentified Dural Puncture: A Case Report with an Unusual Neurological Presentation.
[So] Source:Pain Physician;20(2):E329-E334, 2017 Feb.
[Is] ISSN:2150-1149
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Pneumocephalus is a rare consequence of epidural anesthesia, which may occur following inadvertent or unidentified dural puncture when the loss of resistance to air technique is applied to identify the epidural space. Headache is the most common symptom presented in this condition, usually with sudden onset. This case report describes an unusual presentation of diffuse pneumocephalus after an unidentified dural puncture. The patient (male, 67 years old) was submitted to epidural catheter placement for the treatment of acute exacerbation of ischemic chronic pain using loss of resistance to air technique. No cerebrospinal fluid or blood flashback was observed after needle withdrawal. Shortly after the intervention, the patient presented symptoms of lethargy, apathy, and hypophonia, which are not commonly associated with pneumocephalus. No motor or sensory deficits were detected. Cranial computed tomography showed air in the frontal horn of the left ventricle, subarachnoid space at interhemispheric fissure and basal cisterns, confirming the diagnosis of diffuse pneumocephalus. The patient remained under vigilance with oxygen therapy and the epidural catheter left in place. After 24 hours, cranial computed tomography showed air in the temporal and frontal horns of the left ventricle, with no air in the subarachnoid space. The patient presented no neurological signs or symptoms at this time. Although headache is the most common symptom presented in reported cases of pneumocephalus, this case shows the need for the clinician to be aware of other signs and symptoms that may be indicative of this condition, in order to properly diagnose and treat these patients.Key words: Pneumocephalus, continuous epidural analgesia, ischemic chronic pain, loss-of-resistance to air technique, dural puncture, headache, unusual presentation.
[Mh] Termos MeSH primário: Analgesia Epidural/efeitos adversos
Pneumocefalia/etiologia
[Mh] Termos MeSH secundário: Idoso
Anestesia Epidural
Espaço Epidural
Seres Humanos
Masculino
Punções/efeitos adversos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170717
[Lr] Data última revisão:
170717
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170204
[St] Status:MEDLINE


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[PMID]:28120070
[Au] Autor:de Divitiis O; Di Somma A; Cavallo LM; Cappabianca P
[Ad] Endereço:Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli "Federico II", Naples, Italy. oreste.dedivitiis@unina.it.
[Ti] Título:Tips and Tricks for Anterior Cranial Base Reconstruction.
[So] Source:Acta Neurochir Suppl;124:165-169, 2017.
[Is] ISSN:0065-1419
[Cp] País de publicação:Austria
[La] Idioma:eng
[Ab] Resumo:Reconstruction procedures come last in skull base surgery, but they are not the least important phase-rather, reconstruction is one of the most important steps required to prevent complications. In our opinion, there are three general principles upon which a good reconstruction of the skull base stand: (1) anatomo-surgical knowledge; (2) approach/route selection; and (3) the cooperation of the skull base surgical team. In general, three major complications may occur when a good skull base reconstruction has not been achieved, i.e., cerebrospinal fluid (CSF) leak, pneumoencephalus, and infection. Reconstruction of skull base defects requires a thorough knowledge of surgical anatomy, disease, and patient risk factors. Various reconstruction techniques are available, from free tissue grafting to vascularized flaps. Possible complications that can occur after these procedures need to be considered.The reconstruction phase of the surgical procedure is a fundamental step in any surgical approach and it must not be ignored.
[Mh] Termos MeSH primário: Neuroendoscopia/métodos
Complicações Pós-Operatórias/epidemiologia
Procedimentos Cirúrgicos Reconstrutivos/métodos
Base do Crânio/cirurgia
[Mh] Termos MeSH secundário: Vazamento de Líquido Cefalorraquidiano/epidemiologia
Seres Humanos
Procedimentos Neurocirúrgicos/métodos
Pneumocefalia/epidemiologia
Infecção da Ferida Cirúrgica/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170126
[St] Status:MEDLINE
[do] DOI:10.1007/978-3-319-39546-3_26


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[PMID]:28070116
[Au] Autor:Srikumar T; Pabbathi S; Fernandez J; Nanjappa S
[Ad] Endereço:Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA.
[Ti] Título:Aspergillus Terreus Brain Abscess Complicated by Tension Pneumocephalus in a Patient with Angiosarcoma.
[So] Source:Am J Case Rep;18:33-37, 2017 Jan 10.
[Is] ISSN:1941-5923
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND Aspergillus terreus is an evolving opportunistic pathogen, and patients with A. terreus often have poor outcomes due to its intrinsic resistance to several systemic antifungal agents. Here we present a unique case of intracranial abscesses of A. terreus in a patient with recurrent angiosarcoma, complicated by development of tension pneumocephalus. CASE REPORT A 67-year old gentleman with history of scalp angiosarcoma with wide excision two years prior presented to the hospital for left arm clumsiness, altered mental status, and low-grade fever. Staphylococcus aureus and Proteus mirabilis bacteremia was detected, and Computed Tomography (CT) of the head showed right frontal lobe abscesses. He was started on steroids, intravenous vancomycin and cefepime, and was eventually discharged. He presented to the hospital again due to persistent and worsening symptoms. MRI showed progression of the brain lesions, and surgical biopsy and culture of lesions revealed A. terreus and gram-positive cocci. He was started on trimethroprim/sulfamethoxazole and voriconazole and symptoms improved. On post-op day four, he acutely decompensated with total loss of left arm strength; MRI demonstrated tension pneumocephalus. Conservative management was undertaken with continuous supplemental oxygen. Serial x-ray imaging over the next week demonstrated resolution of the pneumocephalus, and the patient was able to regain all proximal lower and upper extremity strength. CONCLUSIONS Never before has a case of A. terreus been associated with angiosarcoma or tension pneumocephalus in the literature. Proper identification and prompt diagnosis of species is crucial in the immunocompromised patient. Tension pneumocephalus should be included in the differential diagnosis of nontraumatic hemiparesis for emergent evaluation and management.
[Mh] Termos MeSH primário: Aspergilose/complicações
Aspergillus/isolamento & purificação
Bacteriemia/microbiologia
Abscesso Encefálico/microbiologia
Hemangiossarcoma/complicações
Hospedeiro Imunocomprometido
Pneumocefalia/microbiologia
Neoplasias Cutâneas/complicações
Staphylococcus aureus/isolamento & purificação
[Mh] Termos MeSH secundário: Idoso
Antibacterianos/uso terapêutico
Aspergilose/tratamento farmacológico
Bacteriemia/tratamento farmacológico
Abscesso Encefálico/complicações
Abscesso Encefálico/diagnóstico
Abscesso Encefálico/tratamento farmacológico
Cefalosporinas/uso terapêutico
Progressão da Doença
Combinação de Medicamentos
Quimioterapia Combinada
Glucocorticoides/uso terapêutico
Seres Humanos
Imagem por Ressonância Magnética/métodos
Masculino
Pneumocefalia/diagnóstico
Pneumocefalia/tratamento farmacológico
Proteus mirabilis/isolamento & purificação
Sulfametizol/uso terapêutico
Tomografia Computadorizada por Raios X/métodos
Resultado do Tratamento
Trimetoprima/uso terapêutico
Vancomicina/uso terapêutico
Voriconazol/uso terapêutico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Cephalosporins); 0 (Drug Combinations); 0 (Glucocorticoids); 25W8454H16 (Sulfamethizole); 6Q205EH1VU (Vancomycin); 79735-35-6 (trimethoprim sulfamethizole); 807PW4VQE3 (cefepime); AN164J8Y0X (Trimethoprim); JFU09I87TR (Voriconazole)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170320
[Lr] Data última revisão:
170320
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170111
[St] Status:MEDLINE


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[PMID]:28067182
[Au] Autor:Taube MA; Potter GM; Lloyd SK; Freeman SR
[Ad] Endereço:Department of Otolaryngology,Salford Royal NHS Foundation Trust,UK.
[Ti] Título:Successful conservative treatment of an intracranial pneumatocele with post-traumatic hypoglossal nerve palsy secondary to diffuse temporal bone pneumocele: case report and review of the literature.
[So] Source:J Laryngol Otol;131(2):181-184, 2017 Feb.
[Is] ISSN:1748-5460
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: A pneumocele occurs when an aerated cranial cavity pathologically expands; a pneumatocele occurs when air extends from an aerated cavity into adjacent soft tissues forming a secondary cavity. Both pathologies are extremely rare with relation to the mastoid. This paper describes a case of a mastoid pneumocele that caused hypoglossal nerve palsy and an intracranial pneumatocele. CASE REPORT: A 46-year-old man presented, following minor head trauma, with hypoglossal nerve palsy secondary to a fracture through the hypoglossal canal. The fracture occurred as a result of a diffuse temporal bone pneumocele involving bone on both sides of the hypoglossal canal. Further slow expansion of the mastoid pneumocele led to a secondary middle fossa pneumatocele. The patient refused treatment and so has been managed conservatively for more than five years, and he remains well. CONCLUSION: While most patients with otogenic pneumatoceles have presented acutely in extremis secondary to tension pneumocephalus, our patient has remained largely asymptomatic. Aetiology, clinical features and management options of temporal bone pneumoceles and otogenic pneumatoceles are reviewed.
[Mh] Termos MeSH primário: Doenças Ósseas/terapia
Tratamento Conservador
Doenças do Nervo Hipoglosso/terapia
Traumatismos do Nervo Hipoglosso/terapia
Processo Mastoide/diagnóstico por imagem
Pneumocefalia/terapia
[Mh] Termos MeSH secundário: Doenças Ósseas/complicações
Doenças Ósseas/diagnóstico por imagem
Traumatismos Craniocerebrais/complicações
Seres Humanos
Doenças do Nervo Hipoglosso/diagnóstico
Doenças do Nervo Hipoglosso/etiologia
Traumatismos do Nervo Hipoglosso/complicações
Traumatismos do Nervo Hipoglosso/diagnóstico por imagem
Masculino
Meia-Idade
Pneumocefalia/complicações
Pneumocefalia/diagnóstico por imagem
Osso Temporal/diagnóstico por imagem
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170213
[Lr] Data última revisão:
170213
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170110
[St] Status:MEDLINE
[do] DOI:10.1017/S0022215116009816


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[PMID]:27903839
[Au] Autor:Can Ç; Bolatkale M; Sarihan A; Savran Y; Acara AÇ; Bulut M
[Ad] Endereço:Department of Emergency Medicine, Merkezefendi State Hospital, Manisa, Turkey.
[Ti] Título:The effect of brain tomography findings on mortality in sniper shot head injuries.
[So] Source:J R Army Med Corps;163(3):211-214, 2017 Jun.
[Is] ISSN:0035-8665
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Penetrating gunshot head injuries have a poor prognosis and require prompt care. Brain CT is a routine component of the standard evaluation of head wounds and suspected brain injury. We aimed to investigate the effect of brain CT findings on mortality in gunshot head injury patients who were admitted to our emergency department (ED) from the Syrian Civil War. METHODS: The study group comprised patients who were admitted to the ED with gunshot brain injury. Patients' GCS scores, prehospital intubations and brain CT findings were examined. RESULTS: 104 patients were included (92% male, mean age 25 years). Pneumocephalus, midline shift, penetrating head injury, patients with GCS scores ≤6 and patients who had to be intubated in the prehospital period were associated with higher mortality (p<0.05). DISCUSSION: The results of this study demonstrated that pneumocephalus, midline shift, a penetrating head injury, GCS scores ≤6 and prehospital intubation are associated with high mortality, whereas patients with temporal bone fracture, perforating or single cerebral lobe head injury had a higher survival rates. The temporal bone has a relatively thin and smooth shape compared with the other skull bones so a bullet is less fragmented when it has penetrated the temporal bone, which could be a reason for the reduced cavitation effect. In perforating head injury, the bullet makes a second hole and so will have deposited less energy than a retained bullet with a consequent reduction in intracranial injury and mortality. Further studies are required to reach definitive conclusions.
[Mh] Termos MeSH primário: Encéfalo/diagnóstico por imagem
Traumatismos Cranianos Penetrantes/diagnóstico por imagem
Pneumocefalia/diagnóstico por imagem
Fraturas Cranianas/diagnóstico por imagem
Osso Temporal/diagnóstico por imagem
Ferimentos por Arma de Fogo/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adulto
Serviços Médicos de Emergência/estatística & dados numéricos
Serviço Hospitalar de Emergência
Feminino
Escala de Coma de Glasgow
Traumatismos Cranianos Penetrantes/complicações
Traumatismos Cranianos Penetrantes/mortalidade
Seres Humanos
Intubação Intratraqueal/utilização
Masculino
Pneumocefalia/etiologia
Prognóstico
Fraturas Cranianas/etiologia
Taxa de Sobrevida
Síria
Osso Temporal/lesões
Tomografia Computadorizada por Raios X
Ferimentos por Arma de Fogo/mortalidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170829
[Lr] Data última revisão:
170829
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161202
[St] Status:MEDLINE
[do] DOI:10.1136/jramc-2016-000632



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