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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.51 no.1 São Paulo Mar. 1993

http://dx.doi.org/10.1590/S0004-282X1993000100019 

Lobectomia temporal no infarto cerebral com efeito de massa

 

Temporal lobectomy in ischemic infarction with mass effect

 

 

Luis Fernando MartinsI; Valter da CostaI; Joaquim da CostaI; Sebastião Eurico de Melo-SouzaII

IInstituto de Neurologia de Goiânia: Neurocirurgião
IIInstituto de Neurologia de Goiânia: Neurologista, Coordenador de Ensino e Pesquisa

 

 


RESUMO

Uma complicação frequentemente fatal do infarto isquêmico extenso é o desenvolvimento de efeito de massa por edema. O componente de «swelling» pode ser combatido, mas o edema isquêmico citotóxico dos primeiros dias não responde ao tratamento clínico. Este estudo mostra o resultado da abordagem cirúrgica em casos com deterioração clínica e grande efeito de massa à tomografia computadorizada, nos quais se procedeu a lobectomia temporal do lado do infarto, com finalidade descompressiva. Dos 8 casos, 6 sobreviveram com efeito benéfico quase imediato à cirurgia. Apesar da pequena amostra e de não haver um controle rigoroso de amostragem, os autores sugerem que a técnica é de valor na conduta de tais casos e recomendam estudos posteriores melhor controlados.

Palavras-chave: acidente vascular encefálico, infarto cerebral, herniação do lobo temporal, lobectomia temporal.


SUMMARY

Cerebral edema secondary to ischemia can threaten life, mainly due to frequent failure of medical management. Imminent herniation of the temporal lobe can be timely detected by clinical signs and CT-scan. Eight patients (4M, 4F; 48-74 years, mean 62) with ischemic stroke and imminent herniation, were surgically decompressed by a standard temporal lobectomy as described by Olivier for temporal lobe epilepsy. Six patients survived, two died and were considered failure of the procedure, probably due to late surgical indication. In conclusion, temporal lobectomy is life-saving for patients with large ischemic cerebral infarction with mass effect land deteriorating signs of brain stem compression.

Key words: stroke, brain infarction, temporal lobe herniation, temporal lobectomy.


 

 

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

 

 

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Aceite: 27-junho-1992.

 

 

Trabalho realizado no Instituto de Neurologia de Goiânia.
Dr. Sebastião Eurico de Melo-Souza — Caixa Postal 1181 - 74001-970 Goiânia GO - Brasil.