Background:
In December 2019, in Wuhan, a new virus emerged, causing severe acute respiratory syndrome (SARS) secondary to infection by a type of coronavirus, causing coronavirus disease (COVID-19). The pandemic caused by the new coronavirus has had implications in the central nervous system. COVID-19 is known to be characterized by coagulation activation and endothelial dysfunction, causing ischemic and hemorrhagic vascular syndromes.
Case Description:
A 27-year-old male patient case with progressive decrease in visual acuity, associated with respiratory symptoms and intense headache. Multilobar infiltrate with a reticulonodular pattern is evident on chest CT scan. Brain CT scan with pituitary macroadenoma apoplexy was shown. SARS-Cov2 was confirmed, and respiratory support initiated. However, the patient died shortly afterward, secondary to pulmonary complications.
Conclusion:
The angiotensin-converting enzyme (ACE) II receptor is expressed in circumventricular organs and in cerebrovascular endothelial cells, which play a role in vascular autoregulation and cerebral blood flow. For this reason, is rational the hypothesize that brain ACE II could be involved in COVID-19 infection. Underlying mechanisms require further elucidation in the future.
Los meningiomas son los tumores cerebrales no gliales primarios más comunes, con una tasa de incidencia del 13-19% en series grandes de tumores intracraneales primarios13 Los meningiomas se consideran benignos, bien circunscritos y de crecimiento lento4. Están clasificados en grado I, grado II y III por la Organización Mundial de la Salud (OMS) para los tumores del sistema nervioso central9. La tasa de recurrencia de meningiomas atípicos (grado II de la OMS) es del 30-40%13. Resección quirúrgica del tumor y el implante dural es el tratamiento de elección1.
Descripción del caso. Mujer de 42 años con antecedentes de tumor frontoparietal derecho que requiere craneotomía parietal derecha, resección subtotal de la lesión y colocación del sistema Ommaya; presenta convulsiones clónicas simples de hemicuerpo izquierdo, cefalea holocraneal y hemiparesia izquierda. Tomografía y resonancia magnética (RM) del cráneo, que realza con la administración de contraste, con edema perilesional, hernia transcalvaria y porción proximal del catéter Ommaya.
Conclusiones. El presente caso de absceso meningioma parasagital atípico recurrente, es un caso raro en la literatura. La colocación de cualquier tipo de drenaje adyacente al tumor funciona como un cuerpo extraño y aumenta el riesgo de infecciones y, por lo tanto, de abscesos intratumorales, lo que infiere un pronóstico peor.
Objective: Depressed skull fractures are the result of trauma injuries. They are present in approximately 3% of patients who arrive to an emergency room with skull trauma. The main objective of surgical repair in depressed fractures is correction of cosmetic deformity and the prevention of infections. Material and methods: A retrospective and transversal study was performed by our department between April 2016 and May 2017. Sixteen patients that underwent a craniotomy for skull trauma with depressed fracture were included in the study. The diagnosis was made by simple cranial CT scan alongside a threedimensional reconstruction. Results: Of the sixteen patients included, 5 were females (31.2%) and 11 males (68.8%). Twelve of the cases were an exposed fracture. In 7 cases, the fracture was located at parietal bone; 5 were located at frontal bone and 4 at the temporal bone. The average Glasgow coma score in the sample was 13. There were no complications nor deaths. Conclusions: The remodeling and repositioning of the autologous bone graft allow an adequate cosmetic result and it also avoids the placement of implants without increasing the costs and additional risks.
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