Hemorragia intracerebral traumática tardia: registro de cinco casos

Ramina, Ricardo; Krüger, Jutta; Marcu, Harry

doi:10.1590/S0004-282X1980000300005

Resumos

São relatados os casos de cinco pacientes que apresentaram hemorragia intracerebral tardia como consequência de traumatismo crânio-encefálico. O diagnóstico e o acompanhamento evolutivo dos pacientes foi efetuado com o auxilio da tomografia axial computorizada (CT-scan). Os possíveis mecanismos responsáveis por essa ocorrência são analisados.

Five cases of traumatic delayed intracerebral hemorrhage are reported. At the admission two patients showed only contusional injury and three had acute intracranial hematomas, one with an extradural infratentorial and two with supratentorial hematomas, which were immediately removed. Repeated CT-scans revealed the delayed intracerebral hemorrhage. Three patients developed an intracerebral hemorrhage within the first 24 hours after admission. The possible mechanisms producing these lesions are discussed. The high mortality of these patients (four in our serie) is associted with severe brain damage after the traumatism.

Hemorragia intracerebral traumatica tardia: registro de cinco casos

Delayed traumatic intracerebral hemorrhage: report of 5 cases

Ricardo Ramina^I; Jutta Krüger^I; Harry Marcu^II

^IDepartamento de Neurocirurgia. Universidade de Frankfurt/Main, Alemanha Ocidental: Diretor, Prof. Dr. Hugo Ruf

^IIDepartamento de Neuroradiologia. Universidade de Frankfurt/Main, Alemanha Ocidental: Diretor, Prof. Dr. Hugo Ruf

RESUMO

São relatados os casos de cinco pacientes que apresentaram hemorragia intracerebral tardia como consequência de traumatismo crânio-encefálico. O diagnóstico e o acompanhamento evolutivo dos pacientes foi efetuado com o auxilio da tomografia axial computorizada (CT-scan). Os possíveis mecanismos responsáveis por essa ocorrência são analisados.

SUMMARY

Five cases of traumatic delayed intracerebral hemorrhage are reported. At the admission two patients showed only contusional injury and three had acute intracranial hematomas, one with an extradural infratentorial and two with supratentorial hematomas, which were immediately removed. Repeated CT-scans revealed the delayed intracerebral hemorrhage. Three patients developed an intracerebral hemorrhage within the first 24 hours after admission. The possible mechanisms producing these lesions are discussed. The high mortality of these patients (four in our serie) is associted with severe brain damage after the traumatism.

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Dr. Ricardo Ramina - Klinikum der Johann Wolfgang Goethe-Universitãt, Zentrum der Neurochirurgie - Schleusenweg 2-16 - 6000 Frankfurt/Main - West-Germany.

1. ADAMS, J. H. - The Neuropathology of Head Injuries. In Hand-book of Clinical Neurology, Vol 23, Part I, pag. 35-65, edited by P.J. Vinken and G. W. Buryn. North-Holland Publishing Company. Amsterdam, 1975.
2. AUSTARHEIM, K. - Delayed traumatic intracerebral hemorrhage: report of one case with necropsy. Acta Pathol. Microbiol. Scand. 38:177, 1966.
3. BARATHAM, G. & DENNYSON, G. W. - Delayed traumatic intracerebral haemorrhage. J. Neurol. Neurosurg. Psychiatry (London) 35:698, 1972.
4. BOLLINGER, O. - Ueber traumatische spaetapoplexie; ein Beitrag zur Lehre von der Hirnerschutterung. Internationale Beitrage zur wissenchaftlichen Medizin. Festschrift Rudolf Virchow, Berlin- A. Hirschwald, vol 2, 457-470, 1891.
5. BROCK, M. - Experimental luxury perfusion in the cerebral cortex of the cat Progress in Brain Research (Amsterdam) 30:125, 1968.
6. BROWN, F.; MULLAN, S. & DUDA, E. E. - Delayed traumatic intracerebral hematomas. J. Neurosurg. 48:1019, 1978.
7. COURVILLE, C. B. & BLOMQUIST, O. A. - Traumatic intracerebral hemorrhage, Arch. Surgery 41:1-28, 1940.
8. EVANS, J. P. & SCHEINKER, I. M. - Histologic studies of the brain following head trauma: post-traumatic cerebral swelling and edema. J. Neurosurg. 2:306, 1945.
9. EVANS, J. P. & SCHEINKER, I. M. - Histologic studies of the brain following heal trauma: post-traumatic petechial and massive intracerebral hemorrhage. J. Neurosurg. 3:101, 1946.
10. FELL, D. A.; FITZGERALD, S.; MOIEL, R. H. & CARAM, P. - Acute subdural hematomas: review of 144 cases. J. Neurosurg. 42:37, 1975.
11. GURDJIAN, E. S. & THOMAS, L. M. - Traumatic intracranial hemorrhage. In Brock's Injuries of the Brain and Spinal Cord and Theirs Coverings, Chapter 8, Springer Publishing Company Inc. New York 1974.
12. HEPPNER, V. F.; TRITTHART, H. & HOLZER, P. - Die operative Therapie der traumatischen intrazerebralen Haematome. Wiener Medizinische Wochenschrift 19:635, 1978.
13. JAMIESON, K. G. & YELLAND. J. D. N. - Surgically treated traumatic subdural hematomas. J. Neurosurg. 37:137, 1972.
14. JAMIESON, K. G. & YELLAND, J. D. N. - Traumatic intracerebral hematoma: report of 63 surgically treated cases. J. Neurosurg. 37:528, 1972.
15. LANGERHAUS, R. - Die traumatische Spaetapoplexie. A. Hirschwald, Berlin, 1903.
16. LANKSCH W.; GRUMME, T. & KAZNER, E. - Schaedelhirnverletzungen im Computer-Tomogramm. Springer Verlag, Berlin- Heidelberg- New York 1978.
17. LASSEN, N. A. - On the regulation of cerebral blood flow in diseases of the brain with special regard to the luxury perfusion syndrome of the brain tissue, e.i. a syndrome characterized by relative hyperemia or absolute hyperemia of the brain tissue. Progress in Brain Research (Amsterdam) 30:123, 1968.
18. MCKISSOCK, R. A. & WALSH, L. - Primary intracerebral haemorrhage: results of surgical treatment in 244 consecutive cases. Lancet 2:683, 1959.
19. MORIN, M. & PITTS. F. W. - Delayed apoplexy following head injury, J. Neurosurg. 33:542, 1970.
20. MUEKE, R.; HEIENBROK, W. & KUEHNE, D. - Spontane intrazerebrale Haematome; neue Gesichtspunkte seit Einfuehrung der Oomputertomographie. Zbl. Neurochirurgle 39:135, 1978.
21. NEJAD KARIMI, A.; HAMEL, E. & FROWEIN, R. A. - Verlauf der traumatischen intracerebrelan Haematome. Der Nervenarzt 50:432, 1979.
22. PAXTON, R. & AMBROSE, J. - The Emi scanner: a brief review of the first 650 patients. British J. Radiol. 47:530, 1974.
23. PIA, H. W. - The surgical treatment of intracerebral and intraventricular hematomas. Acta Neurochirurg. (Wien) 27:149, 1972.
24. SNOEK, J.; JENNETT, B.; ADAMS, J.; GRAHAM, D. I. & DOYLE, D. - Computerised tomography after recent severe head injury in patients without acute intracranial haematoma. J. Neurol. Neurosurg. and Psychiat. (London) 42: 215, 1979.
25. SUSSMANN, B. J.; BARBER, J. B. & GOALD, H. -- Experimental intracerebral hematoma, reduction of oxygen tension in brain and cerebrospinal fluid. J. Neurosurg. 41:177, 1974.
26. MERINO DE VILLASANTE, J. M. & TAVERAS, J. M. - Computerized tomography in acute head trauma. Amer. J. Roentg. 126:765, 1976.
27. WEIGEL, K.; OSTERTAG, C. B. & MUNDINGER, F. - CT Follow-up Control of Traumatic Intracerebral Hemorrhage. Adv. in Neurosurgery. Vol 5, Springer-Verlag, Berlin-Heidelberg, 1978.

Datas de Publicação

Publicação nesta coleção
21 Ago 2012
Data do Fascículo
Set 1980

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ADAMS, J. H. - The Neuropathology of Head Injuries. In Hand-book of Clinical Neurology, Vol 23, Part I, pag. 35-65, edited by P.J. Vinken and G. W. Buryn. North-Holland Publishing Company. Amsterdam, 1975.

[2] 2. AUSTARHEIM, K. - Delayed traumatic intracerebral hemorrhage: report of one case with necropsy. Acta Pathol. Microbiol. Scand. 38:177, 1966.

[3] 3. BARATHAM, G. & DENNYSON, G. W. - Delayed traumatic intracerebral haemorrhage. J. Neurol. Neurosurg. Psychiatry (London) 35:698, 1972.

[4] 4. BOLLINGER, O. - Ueber traumatische spaetapoplexie; ein Beitrag zur Lehre von der Hirnerschutterung. Internationale Beitrage zur wissenchaftlichen Medizin. Festschrift Rudolf Virchow, Berlin- A. Hirschwald, vol 2, 457-470, 1891.

[5] 5. BROCK, M. - Experimental luxury perfusion in the cerebral cortex of the cat Progress in Brain Research (Amsterdam) 30:125, 1968.

[6] 6. BROWN, F.; MULLAN, S. & DUDA, E. E. - Delayed traumatic intracerebral hematomas. J. Neurosurg. 48:1019, 1978.

[7] 7. COURVILLE, C. B. & BLOMQUIST, O. A. - Traumatic intracerebral hemorrhage, Arch. Surgery 41:1-28, 1940.

[8] 8. EVANS, J. P. & SCHEINKER, I. M. - Histologic studies of the brain following head trauma: post-traumatic cerebral swelling and edema. J. Neurosurg. 2:306, 1945.

[9] 9. EVANS, J. P. & SCHEINKER, I. M. - Histologic studies of the brain following heal trauma: post-traumatic petechial and massive intracerebral hemorrhage. J. Neurosurg. 3:101, 1946.

[10] 10. FELL, D. A.; FITZGERALD, S.; MOIEL, R. H. & CARAM, P. - Acute subdural hematomas: review of 144 cases. J. Neurosurg. 42:37, 1975.

[11] 11. GURDJIAN, E. S. & THOMAS, L. M. - Traumatic intracranial hemorrhage. In Brock's Injuries of the Brain and Spinal Cord and Theirs Coverings, Chapter 8, Springer Publishing Company Inc. New York 1974.

[12] 12. HEPPNER, V. F.; TRITTHART, H. & HOLZER, P. - Die operative Therapie der traumatischen intrazerebralen Haematome. Wiener Medizinische Wochenschrift 19:635, 1978.

[13] 13. JAMIESON, K. G. & YELLAND. J. D. N. - Surgically treated traumatic subdural hematomas. J. Neurosurg. 37:137, 1972.

[14] 14. JAMIESON, K. G. & YELLAND, J. D. N. - Traumatic intracerebral hematoma: report of 63 surgically treated cases. J. Neurosurg. 37:528, 1972.

[15] 15. LANGERHAUS, R. - Die traumatische Spaetapoplexie. A. Hirschwald, Berlin, 1903.

[16] 16. LANKSCH W.; GRUMME, T. & KAZNER, E. - Schaedelhirnverletzungen im Computer-Tomogramm. Springer Verlag, Berlin- Heidelberg- New York 1978.

[17] 17. LASSEN, N. A. - On the regulation of cerebral blood flow in diseases of the brain with special regard to the luxury perfusion syndrome of the brain tissue, e.i. a syndrome characterized by relative hyperemia or absolute hyperemia of the brain tissue. Progress in Brain Research (Amsterdam) 30:123, 1968.

[18] 18. MCKISSOCK, R. A. & WALSH, L. - Primary intracerebral haemorrhage: results of surgical treatment in 244 consecutive cases. Lancet 2:683, 1959.

[19] 19. MORIN, M. & PITTS. F. W. - Delayed apoplexy following head injury, J. Neurosurg. 33:542, 1970.

[20] 20. MUEKE, R.; HEIENBROK, W. & KUEHNE, D. - Spontane intrazerebrale Haematome; neue Gesichtspunkte seit Einfuehrung der Oomputertomographie. Zbl. Neurochirurgle 39:135, 1978.

[21] 21. NEJAD KARIMI, A.; HAMEL, E. & FROWEIN, R. A. - Verlauf der traumatischen intracerebrelan Haematome. Der Nervenarzt 50:432, 1979.

[22] 22. PAXTON, R. & AMBROSE, J. - The Emi scanner: a brief review of the first 650 patients. British J. Radiol. 47:530, 1974.

[23] 23. PIA, H. W. - The surgical treatment of intracerebral and intraventricular hematomas. Acta Neurochirurg. (Wien) 27:149, 1972.

[24] 24. SNOEK, J.; JENNETT, B.; ADAMS, J.; GRAHAM, D. I. & DOYLE, D. - Computerised tomography after recent severe head injury in patients without acute intracranial haematoma. J. Neurol. Neurosurg. and Psychiat. (London) 42: 215, 1979.

[25] 25. SUSSMANN, B. J.; BARBER, J. B. & GOALD, H. -- Experimental intracerebral hematoma, reduction of oxygen tension in brain and cerebrospinal fluid. J. Neurosurg. 41:177, 1974.

[26] 26. MERINO DE VILLASANTE, J. M. & TAVERAS, J. M. - Computerized tomography in acute head trauma. Amer. J. Roentg. 126:765, 1976.

[27] 27. WEIGEL, K.; OSTERTAG, C. B. & MUNDINGER, F. - CT Follow-up Control of Traumatic Intracerebral Hemorrhage. Adv. in Neurosurgery. Vol 5, Springer-Verlag, Berlin-Heidelberg, 1978.

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Hemorragia intracerebral traumática tardia: registro de cinco casos

Delayed traumatic intracerebral hemorrhage: report of 5 cases

Resumos

Datas de Publicação