Hemorragia intracerebral ou simplesmente hemorragia cerebral é um tipo de sangramento Os hematomas intracerebrais agudos ocorrem no momento da lesão, O risco de morte por sangramento intraparenquimatoso na lesão cerebral. CORRELACIÓN CLÍNICO-TOMOGRÁFICA DEL HEMATOMA INTRAPARENQUIMATOSO. Article · January with 12 Reads. Eugenio de Zayas Alba. on ResearchGate | On Feb 6, , Equipo Revisor and others published MICROHEMORRAGIAS MÃšLTIPLES Y HEMATOMA INTRAPARENQUIMATOSO }.
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Chronic subdural hematoma of the posterior fossa associated with cerebellar hemorrhage: Chronic subdural hematoma of the posterior fossa is an uncommon entity, and spontaneous lesions are very rarely described, occurring mostly during anticoagulation therapy.
The association of the posterior fossa chronic subdural hematoma with spontaneous parenchymal hemorrhage without anticoagulation therapy was never related in the literature, to our knowledge.
We describe a case of a 64 year-old woman who suffered a spontaneous cerebellar hemorrhage, treated conservatively, and presented 1 month later with a chronic subdural posterior fossa hematoma. We describe a case in a woman. A year-old hypertensive woman presented to another emergency service 15 days before admission to our hospital with a history of sudden headache and gait disturbance.
Her hypertension was well controlled with regularly taken antihypertensive medications. She was submitted to a CT scan of the head and treated conservatively with diagnosis of spontaneous cerebellar hemorrhage, and discharged five days after without intercurrences. Fifteen days later, she presented to our outpatient clinic with complaints of continuous headache, somnolence and urinary incontinence.
Another CT scan was performed and showed hydrocephalus, and a ventriculoperitoneal shunt was inserted Fig 1. On the first postoperative day, the patient presented with somnolence, slurred speech, incoordination and ataxia. A MRI Figs 2 and 3 showed a right posterior fossa extra-axial hematoma, hyperintense both on T1 and T2 sequences, compressing the right cerebellar hemisphere, and a small, contiguous, intraparenchymal right intraparenqhimatoso hematoma in subacute intraparenquimaatoso, with some edema; MRI angiography was normal.
The patient was taken to the operating room. A suboccipital right craniectomy was performed and a typical chronic subdural hematoma was drained after opening the dura-mater. On opening the dura, the old, liquefied blood gushed out, suggesting hypertension in the posterior fossa.
In the postoperative period, the patient improved quickly and was discharged without neurological deficits. The postoperative CT scan was unremarkable.
Chronic subdural hematomas are common neurosurgical lesions. Subdural hematomas of the posterior fossa are very rare in adults 1. The lesions described in the literature are usually acute, related to severe traumatic injuries, with high mortality rates.
In children and mostly in newborns, these lesions appear to be slightly more frequent 1.
Correlación clínico-tomográfica del hematoma intraparenquimatoso
In a review of cases from Sambasivan 2none in the posterior fossa was reported, and Tsai et al. Chronic subdural hematomas of the posterior fossa are among the rarest posttraumatic intracranial lesions.
About half the cases reported are related to traumatic events, mostly minor traumatic injuries. The acute, traumatic lesions of the posterior fossa can result from venous sinus tears, depressed skull fractures or cerebellar contusions, or may also be due to ruptured intracranial aneurysms or arteriovenous malformations.
Term Bank – hematoma intraparenquimatoso – Spanish English Dictionary
The other half has a variety of causes minor trauma not recalled by the patient, anticoagulation therapy, blood clotting disorders and intracranial hypotension or no cause that could be found at all.
The finding of these lesions in patients without a history of trauma is even rarer, with only 15 cases reported, including those related to anticoagulant therapy 1, There seems to be no difference in the mechanism of occurrence of supra and infratentorial chronic subdural hematoma, with the supposed starting point being the mingling of cerebrospinal fluid with blood in a small subdural hematoma.
The reasons that could account for the rarity of posterior fossa chronic subdural hematoma are probably the difficulty in diagnosis before the widespread availability of MRI, because CT scans are not the best tool to see intarparenquimatoso in the posterior fossa, the more uncommon occurrence of venous sinus lesions in the posterior fossa, and the small number of bridging veins in the posterior fossa in comparison with the supratentorial subdural space.
Also, since the occurrence of a chronic subdural hematomas requires first an acute hematoma, the severity of the lesions associated with acute subdural hematomas of the posterior fossa may lead most patients to death, before the chronic hematoma could be diagnosed or even formed 6,8.
Concerning the association of the spontaneous posterior fossa chronic subdural hematoma and itnraparenquimatoso hemorrhage, we were not able to find any report on this issue in the literature, reviewed at Medline since Clinical presentation gematoma these lesions intraparenqquimatoso widely depending on the hematomx or chronic stage of the bleeding.
Acute lesions are usually related to trauma, occur usually in severely ill patients, with coma, headache, vomiting, ocular motor nerves palsies, other cranial nerves palsies and respiratory arrest.
In patients on anticoagulation therapy, intracranial bleeding should always be suspected in the presence of neurological symptoms. The symptoms of brain stem compression or cerebellar signs could suggest the presence of a posterior fossa lesion, a rare lesion even with the use of anticoagulation.
The diagnosis of chronic lesions in the posterior fossa is very difficult. Chronic subdural hematomas of the posterior fossa often present with nonspecific symptoms. In the few cases described, the presenting symptoms were vomiting, headache, cerebellar symptoms, cranial nerve dysfunction, vertigo and nystagmus, not always associated 1,4,5.
The rarity of these lesions precludes treatment protocols, but probably the treatment should not differ from that of chronic supratentorial hematomas, with correction of the coagulation profile if necessary and surgical drainage. To our knowledge, this is the first report of a spontaneous chronic posterior fossa subdural hematoma related to an intraparenchymal cerebellar hemorrhage, without history of trauma, posterior fossa vascular pathology or anticoagulation.
Spontaneous bilateral chronic subdural hematoma of the posterior fossa. Case report and review of literature.
An overview of chronic subdural hematoma: Computed tomography of posterior fossa. J Comp Assist Tomogr ;4: Chronic subdural hematoma in the cerebellopontine angle.
Posterior hematoka subdural hematoma. Simultaneous supra- and infratentorial chronic subdural hematoma. Eur J Radiol ; Spontaneous posterior fossa subdural hematoma as a complication of anticoagulation. Received 4 Julyreceived in final form 27 August Accepted 1 October All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License.
Services on Demand Journal. CASE A year-old hypertensive woman presented to another emergency service 15 days before admission to our hospital with a history of sudden headache and gait disturbance. How to cite this article.