Ruptura de aneurisma intracraniano tratado com oclusão cirúrgica e craniectomia descompressiva: relato de caso

Authors

  • Erlan Pércio Lopes Rufino
  • Pedro Lukas do Rêgo Aquino
  • Lucas Michael Silva Loureiro
  • Hetevaldo Tavares de Lira Filho
  • Túlio Maranhão Neto
  • Márcio Martins de Melo Alves
  • Eduarda Silvestre Ribeiro da Costa Gomes
  • Luana Cristina Rodrigues de Oliveira Costa
  • Matheus Araújo de Oliveira Farias
  • Lucas Monteiro Barros Nunes

DOI:

https://doi.org/10.37085/jmmv2.n1.2020.pp.15-19

Keywords:

Aneurisma intracerebral, Hemorragia subaracnóide, Aneurisma roto, Hipertensão intracraniana

Abstract

Os aneurismas intracranianos saculares são oriundos da dilatação e enfraquecimento de artérias do polígono de Willis e sua gênese está associada, principalmente, a fatores genéticos, assim como hipertensão arterial sistêmica e tabagismo. A ruptura desses aneurismas leva à hemorragia subaracnoide (HSA), sendo uma importante causa de mortalidade nos serviços de emergência. A terapêutica se concentra na prevenção e tratamento das complicações. Relatamos um caso de uma mulhercom 57 anos admitida no serviço de urgência neurocirúrgica com história de cefaleia súbita intensa e rebaixamento do nível de consciência. Foi realizada tomografia computadorizada do crânio sem contraste que evidenciou HSA escore IV na escala de Fisher e uma arteriografia cerebral observando aneurisma em artéria cerebral média esquerda.

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Author Biographies

Erlan Pércio Lopes Rufino

Hospital da Restauração, Recife, Brasil.

Pedro Lukas do Rêgo Aquino

Hospital Universitário Oswaldo Cruz, Universidade de Pernambuco, Recife, Brasil.

Lucas Michael Silva Loureiro

Hospital Universitário Oswaldo Cruz, Universidade de Pernambuco, Recife, Brasil.

Hetevaldo Tavares de Lira Filho

Hospital da Restauração, Recife, Brasil.

Túlio Maranhão Neto

Hospital da Restauração, Recife, Brasil.

Márcio Martins de Melo Alves

Instituto de Medicina Integral Professor Fernando Figueira, Faculdade Pernambucana de Saúde, Recife, Brasil.

Eduarda Silvestre Ribeiro da Costa Gomes

Universidade Católica de Pernambuco, Recife, Brasil.

Luana Cristina Rodrigues de Oliveira Costa

Universidade Católica de Pernambuco, Recife, Brasil.

Matheus Araújo de Oliveira Farias

Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Brasil.

Lucas Monteiro Barros Nunes

Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Brasil.

References

Hemphill JC, Greenberg SM, Anderson CS, Becker K, Bendok BR, Cushman M, et al (2015) Guidelines for the Management of Spontaneous Intracerebral Hemorrhage: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association. Stroke 46:2032-60.

Jauch EC, Saver JL, Adams HP, Bruno A, Connors JJB, Demaerschalk BM, et al (2013) Guidelines for the early management of patients with acute ischemic stroke: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 44(3):870–947.

Jüttler E, Unterberg A, Woitzik J, Bösel J, Amiri H, Sakowitz OW, et al (2014) Hemicraniectomy in Older Patients with Extensive Middle-Cerebral-Artery Stroke. N Engl J Med 370(12):1091-100. 4. Mackey J (2014) Evaluation and management of stroke in young adults. Continuum (Minneap Minn) 20:352–69.

Turcato C, Pereira SW, Ghizoni MF (2006) Hemorragia subaracnóide. ACM Arq Catarin Med 35(2):78–84.

Powers WJ, Derdeyn CP, Biller J, Coffey CS, Hoh BL, Jauch EC, et al (2015) American Heart Association/American stroke association focused update of the 2013 guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment: A guideline for healthcare professionals from the American Heart Association/American stroke association. Stroke 46:3020–35.

Prabhakaran S, Ruff I, Bernstein RA (2015) Acute stroke intervention: A systematic review. JAMA 313:1451–62.

Blok KM, Rinkel GJE, Majoie CBLM, Hendrikse J, Braaksma M, Tijssen CC, et al (2015) CT within 6 hours of headache onset to rule out subarachnoid hemorrhage in nonacademic hospitals. Neurology 84(19):1927–32.

Perry JJ, Alyahya B, Sivilotti MLA, Bullard MJ, Émond M, Sutherland J, et al (2015) Differentiation between traumatic tap and aneurysmal subarachnoid hemorrhage: Prospective cohort study. BMJ (Online).

Raya AK, Diringer MN (2014) Treatment of subarachnoid hemorrhage. Critical Care Clinics 30:719–33.

Lot G, Houdat E, Cophignon J, Casasco A, George B (1999) Combined management of intracranial aneurysms by surgical and endovascular treatment. Modalities and results from a series of 395 cases. Acta Neurochir 141:557-562.

Raftopoulos C, Mathurin P, Boscherini D, Billa RF, Van Boven M, Hantson P (2000) Prospective analysis of aneurysm treatment in a series of 103 consecutive patients when endovascular embolization is considered the first option. J Neurosurg 93(2):175–82.

Byrne JV, Sohn MJ, Molyneux AJ (1999) Five-year experience in using coil embolization for ruptured intracranial aneurysms: Outcome and incidence of late rebleeding. J Neurosurg 90(4):656–63.

Civit T, Auque J, Marchal JC, Bracard S, Picard L, Hepner H (1996) Aneurysm Clipping after Endovascular Treatment with Coils: A Report of Eight Patients. Neurosurgery 38(5):955–61.

Hacein-Bey L, Connoly JRS, Mayer SA, Young WL, Pile-Spellman J, Solomon RA (1998) Complex intracranial aneurysms: combined operative and endovascular approaches. Neurosurgery 43:1304-1313.

Moon JW, Hyun DK (2017) Decompressive Craniectomy in Traumatic Brain Injury: A Review Article. Korean J Neurotrauma 13(1):1.

Gopalakrishnan MS, Shanbhag NC, Shukla DP, Konar SK, Bhat DI, Devi BI (2018) Complications of Decompressive Craniectomy. Front Neurol 9 (NOV):977.

Published

2020-12-21

How to Cite

Pércio Lopes Rufino, E. ., Lukas do Rêgo Aquino, P. ., Michael Silva Loureiro, L. ., Tavares de Lira Filho, H. ., Maranhão Neto, T. ., Martins de Melo Alves, M. ., Silvestre Ribeiro da Costa Gomes, E. ., Cristina Rodrigues de Oliveira Costa, L. ., Araújo de Oliveira Farias, M. ., & Monteiro Barros Nunes, L. . (2020). Ruptura de aneurisma intracraniano tratado com oclusão cirúrgica e craniectomia descompressiva: relato de caso. Jornal Memorial Da Medicina, 2(1), 15–19. https://doi.org/10.37085/jmmv2.n1.2020.pp.15-19

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