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Craniectomía descompresiva en el manejo del traumatismo cráneo–encefálico grave en pediatría. Ángel J. Lacerda Gallardo1, Daisy Abreu. Request PDF on ResearchGate | Craniectomía descompresiva en ictus isquémico maligno de arteria cerebral media | Introduction Medically managed. Complicación tras craniectomía descompresiva: el «síndrome del paciente trepanado» de aparición precoz. Visits. Download PDF. B. Balandin Moreno.

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Assessment of outcome after severe brain damage.

She had good evolution after decompressive craniectomy without shunting. We hypothesize that the fluid could get out of the arachnoidal space into the pseudomeningocele due to CSF pulsations and was directed to the subdural space.

Delayed massive cerebral fat embolism secondary to severe polytrauma. Neurologists and ENT made an exhaustive study and peripheral craniectojia and other neurological problems were excluded.

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These two cases have in common that both presented cerebellar symptoms, have pseudomeningocele and needed a new surgery for solving the symptoms. T1 axial infratentorial; C: The vertigo of the initial cerebellar infarction had clearly resolved and there were no other signs of a new ischemia to explain the dsscompresiva worsening, the clinical symptoms were typical of an expanding mass. In the eight remaining patients, PDC was performed in the same clipping and evacuation of the associated hematoma.


Resultados Ocho pacientes fueron mujeres y tres hombres.

The MRI and CT scan did not show any signs of blood products like a subdural chronic hematoma to explain this collection. She was discharged in 7 days, ambulatory, without dizziness. Curr Treat Options Neurol ; International subarachnoid aneurysm trial ISAT of neurosurgical clipping versus endovascular coiling in patients with ruptured intracranial aneurysms: In the control CT scan at one month after surgery the hygromas have disappeared, the patient was symptomatic.

This mechanical valve system could be formed between the injured parenchyma and the dura mater. The patient received medical treatment with steroids and acetazolamide and got better for two weeks.

This case shows an infrequent problem of CSF circulation at posterior fossa that resulted in vertigo of central origin. CiteScore measures average citations received per document published.

Craniectomía descompresiva en infarto cerebral maligno

The Impact Factor measures the average number of citations received descompresiav a particular year by papers published in the journal during the two receding years. J Neurosurg ; We implanted a ventriculoperitoneal shunt, medium pressure, and the fistula closed definitely.

We cannot explain why the ventricular catheter did not avoid the high pressure in the posterior fossa, and why the CSF produced in the ventricles could travel forward those compartments, but not go back.

The PDC was effective in controlling intracranial pressure in all six surviving patients. A control CT scan shows normal ventricular size and a collection where the cerebellar infarction had occurred. These could suggest that the bigger arachnoidal gaps provided more fluid getting out and dissecting to descomprediva subdural space, causing more severe symptoms.


This fact, together with the impressive results of the primary decompressive craniotomy PDC in the malignant infarction of the middle cerebral artery suggests a possible beneficial effect of decompressive technique in aSAH.

Improved outcome after rupture of anterior circulation aneurysms: We present a case of expansive CSF collection in the cerebellar convexity. The collection had no blood signal and caused big mass effect over posterior fossa structures with an incipient medullar deformity.

The appearance of a pathological cavity in the central nervous descompresiav after a surgery or a trauma could originate disturbances of CSF circulation.

However, two of these six patients had unfavorable outcomes.

Hospital Universitario Vall d’Hebron, Barcelona. After the shunt was implanted, the patient symptoms got worse slowly in weeks, with severe vertigo, nausea and vomiting associated with upright position and movements, but not when she was at bed. Early desckmpresiva surgery in malignant infarction of the middle cerebral artery: A higroma-ventricle-peritoneal shunt solved the symptoms of the patient.

Conclusion Subdural hygromas in the posterior fossa can be symptomatic and not always resolve spontaneously.