Craniotomia descompressiva não osteoplástica na lesão difusa do tipo IV de Marshall − Relato de caso e discussão

Resumo

Os autores apresentam um caso de tumefação encefálica difusa pós-traumática, em que a paciente em coma, com 6 pontos na escala de Glasgow e anisocórica, foi submetida à craniotomia descompressiva não osteoplástica, com resultado satisfatório e evolução para Glasgow de 15 pontos no sétimo pós-operatório.

Abstract

The authors show a patient with post traumatic encephalic swelling, with 6 points at Glasgow scale on admission. Decompressive craniectomy was performed and the patient has a good outcome, with 15 points at the Glasgow scale, seven days after the neurosurgery.

Palavras-chave

traumatismos encefálicos - tomografia computadorizada por raios X - neurocirurgia - hipertensão intracraniana - craniectomia descompressiva

Keywords

brain injuries - tomography X-ray computed - neurosurgery - intracranial hypertension - decompressive craniectomy

• Referências

• 1 Cameron PA, Rainer TH, Mak P. Motor vehicle deaths in Hong Kong: opportunities for improvement. J Trauma 2004; 56 (4) 890-893
• 2 Hukkelhoven CW, Steyerberg EW, Rampen AJ , et al. Patient age and outcome following severe traumatic brain injury: an analysis of 5600 patients. J Neurosurg 2003; 99 (4) 666-673
• 3 Mar J, Arrospide A, Begiristain JM, Larrañaga I, Elosegui E, Oliva-Moreno J. The impact of acquired brain damage in terms of epidemiology, economics and loss in quality of life. BMC Neurol 2011; 11: 46
• 4 Martins ET, Linhares MN, Sousa DS , et al. Mortality in severe traumatic brain injury: a multivariated analysis of 748 Brazilian patients from Florianópolis City. J Trauma 2009; 67 (1) 85-90
• 5 McArthur DL, Chute DJ, Villablanca JP. Moderate and severe traumatic brain injury: epidemiologic, imaging and neuropathologic perspectives. Brain Pathol 2004; 14 (2) 185-194
• 6 Rosi Júnior J. Neurônio: perguntas e respostas em neurocirurgia. São Paulo: Scortecci; 2011
• 7 Guerra WK, Gaab MR, Dietz H, Mueller JU, Piek J, Fritsch MJ. Surgical decompression for traumatic brain swelling: indications and results. J Neurosurg 1999; 90 (2) 187-196
• 8 Polin RS, Shaffrey ME, Bogaev CA , et al. Decompressive bifrontal craniectomy in the treatment of severe refractory posttraumatic cerebral edema. Neurosurgery 1997; 41 (1) 84-92
• 9 Josan VA, Sgouros S. Early decompressive craniectomy may be effective in the treatment of refractory intracranial hypertension after traumatic brain injury. Childs Nerv Syst 2006; 22 (10) 1268-1274
• 10 Quinn TM, Taylor JJ, Magarik JA, Vought E, Kindy MS, Ellegala DB. Decompressive craniectomy: technical note. Acta Neurol Scand 2011; 123 (4) 239-244
• 11 Rosenfeld JV, Cooper J. What is the role for decompressive craniectomy in severe traumatic brain injury? Re: Decompressive craniectomy: surgical control of intracranial hypertension may improve outcome. Injury 2010; 41 (9) 899-900
• 12 Rosi Júnior J, Oliveira PGD, Montanaro AC, Godoy R. Craniotomia descompressiva em doença cérebro-vascular isquêmica extensa supratentorial. An Paul Med Cir 2002; 129: 76-81
• 13 Kim JJ, Gean AD. Imaging for the diagnosis and management of traumatic brain injury. Neurotherapeutics 2011; 8 (1) 39-53
• 14 Maas AI, Hukkelhoven CW, Marshall LF, Steyerberg EW. Prediction of outcome in traumatic brain injury with computed tomographic characteristics: a comparison between the computed tomographic classification and combinations of computed tomographic predictors. Neurosurgery 2005; 57 (6) 1173-1182
• 15 Bor-Seng-Shu E, Aguiar PH, de Almeida Leme RJ, Mandel M, Andrade AF, Marino Jr R. Epidural hematomas of the posterior cranial fossa. Neurosurg Focus 2004; 16 (2) ECP1
• 16 Bor-Seng-Shu E, Hirsch R, Teixeira MJ, De Andrade AF, Marino Jr R. Cerebral hemodynamic changes gauged by transcranial Doppler ultrasonography in patients with posttraumatic brain swelling treated by surgical decompression. J Neurosurg 2006; 104 (1) 93-100
• 17 Honeybul S. Complications of decompressive craniectomy for head injury. J Clin Neurosci 2010; 17 (4) 430-435
• 18 Huang X, Wen L. Technical considerations in decompressive craniectomy in the treatment of traumatic brain injury. Int J Med Sci 2010; 7 (6) 385-390
• 19 Asano Y, Ryuke Y, Hasuo M, Simosawa S. Cranioplasty using cryopreserved autogenous bone. No To Shinkei 1993; 45 (12) 1145-1150
• 20 Belmahi A, Gharib NE, Bencheikh R, Abbassi A, Mizahi M. Reconstruction of large scalp and calvarium defects by using the semi-free latissimus dorsi flap associated with methylmethacrylate implant for cranioplasty. Ann Chir Plast Esthet 2002; 47 (4) 298-303
• 21 Dujovny M, Aviles A, Agner C, Fernandez P, Charbel FT. Cranioplasty: cosmetic or therapeutic?. Surg Neurol 1997; 47 (3) 238-241
• 22 Ducic Y. Titanium mesh and hydroxyapatite cement cranioplasty: a report of 20 cases. J Oral Maxillofac Surg 2002; 60 (3) 272-276
• 23 Joffe J, Harris M, Kahugu F, Nicoll S, Linney A, Richards R. A prospective study of computer-aided design and manufacture of titanium plate for cranioplasty and its clinical outcome. Br J Neurosurg 1999; 13 (6) 576-580
• 24 Luparello D, Bruschi S, Verna G , et al. Cranioplasty with polymethylmethacrylate. The clinico-statistical considerations. Minerva Chir 1998; 53 (6) 575-579
• 25 Rosi Júnior J, Oliveira PGD, Montanaro AC, Godoy R. Cranioplastia autóloga pós craniectomia descopressiva: Análise prospectiva. An Paul Med Cir 2005; 132: 19-22