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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.47 no.2 São Paulo June 1989

http://dx.doi.org/10.1590/S0004-282X1989000200012 

Hematoma primário do tronco cerebral: considerações a propósito de um caso

 

Primary brain stem hematoma - report of one case

 

 

J. Francisco Salomão; Josué G. Vialogo; José Carlos Lynch

Serviço de Neurocirurgia do Hospital dos Servidores do Estado (INAMPS), Rio de Janeiro

 

 


RESUMO

Os autores relatam o caso de hematoma primário do tronco cerebral em uma paciente de 48 anos, normotensa. A evolução arrastada do processo sugeria tumor de tronco, sendo o diagnóstico de hematoma estabelecido por exploração cirúrgica. Discute-se a origem desses hematomas, conseqüentes à ruptura de angiomas crípticos ou microangiomas, bem como o diagnóstico diferencial com hemorragias hipertensivas do tronco cerebral, patologia de prognóstico sombrio, na maioria das vezes sem indicação cirúrgica. Dão ênfase à necessidade da sistemática exploração das lesões expansivas do tronco cerebral, principalmente em se tratando de indivíduos jovens e normotensos.


SUMMARY

The case of a 48 year-old woman present ng with a primary pontine hematoma is reported. The clinical evolution simulated a brain stem tumor and the diagnosis of hematoma was not established before the operation. The preoperative neurological deficit improved except for a facial nerve palsy. These hematomas are thought to be due to rupture of «cryptic» arteriovenous malformations and should be differentiated from those secondary to systemic hypertension. The diagnosis of brain stein hematomas should be considered in any case of brain stem lesion, especially in young and normotensive patients.


 

 

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