Craniotomia descompressiva no edema cerebral grave: a propósito de 30 casos operados

Silva, José A. Gonçalves da; Silva, Cláudio E. Gonçalves da; Sousa, Maricélia B. Rodrigues

doi:10.1590/S0004-282X1976000300003

Resumos

Craniotomia descompressiva uni ou bilateral foi empregada como tratamento paliativo em 30 casos de edema cerebral grave de etiologia predominantemente traumática. Coma, midríase e descerebração caracterizaram o quadro clínico na maioria dos casos. A sobrevida foi de 46,6%.

Uni or bilateral decompressive craniotomy was carried out in 30 patients bearing severe cerebral edema of etiology predominantly traumatic. Coma, midriasis and decerebrate state were the mostly commonly clinical features presented. The average survival in the series was 46.6%.

Craniotomia descompressiva no edema cerebral grave. A propósito de 30 casos operados

Descompressive craniotomy in acute brain edema: report of 30 cases

José A. Gonçalves da Silva^I; Cláudio E. Gonçalves da Silva^II; Maricélia B. Rodrigues Sousa^III

^IFaculdade de Medicina da Universidade Federal da Paraíba: Professor contratado de Clínica Neurológica e Neurocirúrgica

^IIFaculdade de Medicina da Universidade Federal da Paraíba: Assistente

^IIIFaculdade de Medicina da Universidade Federal da Paraíba: Acadêmica estagiária

RESUMO

Craniotomia descompressiva uni ou bilateral foi empregada como tratamento paliativo em 30 casos de edema cerebral grave de etiologia predominantemente traumática. Coma, midríase e descerebração caracterizaram o quadro clínico na maioria dos casos. A sobrevida foi de 46,6%.

SUMMARY

Uni or bilateral decompressive craniotomy was carried out in 30 patients bearing severe cerebral edema of etiology predominantly traumatic. Coma, midriasis and decerebrate state were the mostly commonly clinical features presented. The average survival in the series was 46.6%.

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Full text available only in PDF format.

Hospital Santa Izabel 58000 João Pessoa, PB Brasil.

1. CLARK. K.; NASH. T. M. & HUTCHISON, G. C. The failure of circunferential craniotomy in acute traumatic cerebral swelling. J. Neurosurg. 29:367, 1968.
2. CUSHING, H The establishment of cerebral hernia as a decompressive measure for inaccessible brain tumors; with the description of intermuscular methods of making the bone defect in temporal and occipital regions. Surg. Gynec. Obstet. 1:297, 1905.
3. EVANS, J. P. & SCHEINKER, M. Histologic studies of the brain following head trauma. Post-traumatic infarction of cerebral arteries, with consideration of the associated clinical picture. Arch. Neurol. Psychiat. (Chicago) 50:258, 1943.
4. EVANS J. P.; RYDER, H. W.; KRISTOFF, F. V.; ESPEY, F. F. & KIMBELL, F. D. Acute head injury. U.S. Armed Forces Med. J. 7:1001, 1951.
5. FREEDMAN, H. Recovery from the decerebrate state associated with supratentorlal spacetaking lesions. J. Neurosurg. 9:52, 1952.
6. GURDJIAN, E. S. & THOMAS, L. M. Surgical management of the patient with head injury. Clin. Neurosurg. 12:56, 1964.
7. HORSLEY, V. On the technique of operations on the central nervous system. Brit. med. J. 2:411, 1906.
8. HUDSON, W. H. A new decompression operation for the brain. Ann. Surg. 55:744, 1912.
9. JEFFERSON, G. The tentorial pressure cone. Arch. Neurol. Psychiat. (Chicago) 40:857, 1938.
10. JENNETT, W. B. & STERN, W. E. Tentorial herniation, the midbrain and the pupil. Experimental studies in brain compression. J. Neurosurg. 17:598, 1960.
11. KESSEL, F. K.; GUTTMANN, L. & MAURER, G. Druckentlastung bei Schaedeltraumen. In Neurotraumatologie. Urban & Schwarzenberg, Muenchen, 1969, p. 381.
12. KJELLBERG, R. N. & PRIETO, A. JR. Bifrontal decompressive craniotomy for massive cerebral edema. J. Neurosurg. 34:488, 1971.
13. McKENZIE, K. G. Gioblastoma: a point of view concerning treatment. Arch. Neurol. Psychiat. (Chicago) 36:542, 1936.
14. MUNRO, D. & SISON, W. R. Hernia through the incisura of the tentorium cerebelli in connection with craniocerebral trauma. New Eng. J. Med. 247:699, 1952.
15. ROBERTSON, R. C. L. & POLLARD, C. Jr. Decerebrate state in children and adolescents. J. Neurosurg. 12:13, 1955.
16. SCHEINKER, M. Transtentorial herniation of the brain stem. A characteristic clinicopathologic syndrome; pathogenesis of hemorrhages in the brain stem. Arch. Neurol. Psychiat. (Chicago) 52:289, 1945.
17. SCHWARZ, G. A. & ROSNER, A. A. Displacement and herniation of the hippocampal gyrus through the incisura tentorii: a clinicopathologic study. Arch. Neurol. Psychiat. (Chicago) 46:297, 1941.
18. SPILLER, W. G. & FRAZIER, C. H. Cerebral decompression: palliative operations in the treatment of tumors of the brain, based on the observation of fourteen cases. J. Amer. med. Ass. 47:744, 1906.

Datas de Publicação

Publicação nesta coleção
26 Fev 2013
Data do Fascículo
Set 1976

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

[1] 1. CLARK. K.; NASH. T. M. & HUTCHISON, G. C. The failure of circunferential craniotomy in acute traumatic cerebral swelling. J. Neurosurg. 29:367, 1968.

[2] 2. CUSHING, H The establishment of cerebral hernia as a decompressive measure for inaccessible brain tumors; with the description of intermuscular methods of making the bone defect in temporal and occipital regions. Surg. Gynec. Obstet. 1:297, 1905.

[3] 3. EVANS, J. P. & SCHEINKER, M. Histologic studies of the brain following head trauma. Post-traumatic infarction of cerebral arteries, with consideration of the associated clinical picture. Arch. Neurol. Psychiat. (Chicago) 50:258, 1943.

[4] 4. EVANS J. P.; RYDER, H. W.; KRISTOFF, F. V.; ESPEY, F. F. & KIMBELL, F. D. Acute head injury. U.S. Armed Forces Med. J. 7:1001, 1951.

[5] 5. FREEDMAN, H. Recovery from the decerebrate state associated with supratentorlal spacetaking lesions. J. Neurosurg. 9:52, 1952.

[6] 6. GURDJIAN, E. S. & THOMAS, L. M. Surgical management of the patient with head injury. Clin. Neurosurg. 12:56, 1964.

[7] 7. HORSLEY, V. On the technique of operations on the central nervous system. Brit. med. J. 2:411, 1906.

[8] 8. HUDSON, W. H. A new decompression operation for the brain. Ann. Surg. 55:744, 1912.

[9] 9. JEFFERSON, G. The tentorial pressure cone. Arch. Neurol. Psychiat. (Chicago) 40:857, 1938.

[10] 10. JENNETT, W. B. & STERN, W. E. Tentorial herniation, the midbrain and the pupil. Experimental studies in brain compression. J. Neurosurg. 17:598, 1960.

[11] 11. KESSEL, F. K.; GUTTMANN, L. & MAURER, G. Druckentlastung bei Schaedeltraumen. In Neurotraumatologie. Urban & Schwarzenberg, Muenchen, 1969, p. 381.

[12] 12. KJELLBERG, R. N. & PRIETO, A. JR. Bifrontal decompressive craniotomy for massive cerebral edema. J. Neurosurg. 34:488, 1971.

[13] 13. McKENZIE, K. G. Gioblastoma: a point of view concerning treatment. Arch. Neurol. Psychiat. (Chicago) 36:542, 1936.

[14] 14. MUNRO, D. & SISON, W. R. Hernia through the incisura of the tentorium cerebelli in connection with craniocerebral trauma. New Eng. J. Med. 247:699, 1952.

[15] 15. ROBERTSON, R. C. L. & POLLARD, C. Jr. Decerebrate state in children and adolescents. J. Neurosurg. 12:13, 1955.

[16] 16. SCHEINKER, M. Transtentorial herniation of the brain stem. A characteristic clinicopathologic syndrome; pathogenesis of hemorrhages in the brain stem. Arch. Neurol. Psychiat. (Chicago) 52:289, 1945.

[17] 17. SCHWARZ, G. A. & ROSNER, A. A. Displacement and herniation of the hippocampal gyrus through the incisura tentorii: a clinicopathologic study. Arch. Neurol. Psychiat. (Chicago) 46:297, 1941.

[18] 18. SPILLER, W. G. & FRAZIER, C. H. Cerebral decompression: palliative operations in the treatment of tumors of the brain, based on the observation of fourteen cases. J. Amer. med. Ass. 47:744, 1906.