Objective The present paper aims to provide a review on the main complications involving traumatic brain injury (TBI) during pregnancy and on the vegetative state after TBI. Methods A systematic review was performed in concordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria checklist. Results Seven studies were included, of which four were case reports, one was a follow-up, one was a comparative study, and one was a literature review. Discussion Presence of neurological deficits such as hemiparesis, neonatal seizures, cerebral palsy, hemorrhage or hydrocephalus was observed in children of mothers who suffered trauma during pregnancy. The prolongation of a pregnancy in these victims, even in brain death, is within the reach of current medicine. Ethical issues must be considered when deciding to prolong a pregnancy of a woman in brain death. Conclusion For the evaluation of pregnant women with TBI, there is a protocol that can be followed in the emergency care service. The cases reported in the literature suggest that there is no clear limit to restrict support to a pregnant patient in a vegetative state. Further studies should be done to elucidate this matter.
Introduction: The white cerebellum sign is a rare radiological finding, seen in severe traumatic brain injury and severe hypoxia. Radiologically, it is characterized by cerebellar hyperdensity, associated with diffuse cerebral hemispheres hypoattenuation. This paper aims to guide the white cerebellum sign diagnosis in traumatic craniocerebral injuries or not in pediatric patients. Patients and Methods: The authors present a series of five cases that showed the white cerebellum sign from the period about 2007 and 2010, associated with a literature review. Results: The white cerebellum sign was present in 5 patients, three of them were male and 2 female. The mean age was 22 months. The causes of which were: traumatic brain injury (3), drowning (1) and metabolic encephalopathy (1). The skull computerized tomography scan was performed in all cases. All patients were submitted to conservative treatment. There were four deaths and one survived with severe neurological sequelae. Conclusion: The white cerebellum sign is associated with irreversible brain damage, and its pathophysiology is controversial. The imaging tests are important to diagnosis. It has a poor prognosis, associated with the development of diffuse cerebral atrophy or cystic encephalomalacia in those who survive.
Introduction: Ventriculoperitoneal shunt (VPS) is a neurosurgical intervention widely used in the control and treatment of hydrocephalus. The migration of the peritoneal catheter through the abdominal wall is an uncommon complication and its pathophysiology is unknown. Patients and Methods: Two cases of the peritoneal catheter extrusion through the abdominal wall are reported in patients with congenital hydrocephalus. Results: Were discovered after removal of the bypass system and systemic antibiotic therapy, followed by replacement of new bypass, with excellent results. Conclusion: In the presence of this complication, surgical treatment is indicated, through complete removal of the system, systemic antibiotic therapy and subsequent replacement of a new system.
Podendo atingir quase 60% da população maior de 70 anos, os acrocórdons são muito prevalentes em consultórios dermatológicos. Entre as abordagens terapêuticas possíveis estão a crioterapia de contato e a eletrocirurgia. Objetivos: Comparar a tolerância à dor, o resultado estético e a preferência dos participantes entre as técnicas de eletrocoagulação e crioterapia de contato no tratamento de acrocórdons. Métodos: Dez participantes, com no mínimo quatro acrocórdons cada um, tiveram suas lesões divididas em dois grupos. Um grupo foi submetido à eletrocoagulação e o outro à crioterapia de contato. A tolerância à dor foi medida pela escala analógica de dor (EAD). O resultado estético foi avaliado por comparação visual entre os grupos de tratamento, em cada participante. A preferência foi avaliada com perguntas objetivas ao participante. Resultados: Todos os pontos avaliados tiveram significância estatística. Os participantes deram notas mais baixas na EAD às lesões submetidas à crioterapia de contato. O resultado estético avaliado após 30 dias foi superior nas lesões do grupo da eletrocoagulação. Todos os participantes preferiram a técnica de crioterapia de contato. Conclusões: A crioterapia de contato é o método preferido e com melhor tolerância à dor no tratamento de acrocórdons, porém o resultado estético foi melhor com a eletrocoagulação.
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