4 research outputs found
Gradenigo's Syndrome: Beyond the Classical Triad of Diplopia, Facial Pain and Otorrhea
We report a case of a non-Hodgkin's lymphoma in a young woman presenting with an abdominal mass and an unusual instance of cranial nerve palsies mimicking Gradenigo's syndrome. This condition is characterized by a triad of otorrhea, facial pain and diplopia, related to otitis media in the pre-antibiotic era. Incomplete and atypical clinical features of Gradenigo's syndrome have been described and noninfectious causes may mimic this condition. Careful clinical history and physical examination, including neuroimaging, are necessary to make a differential diagnosis
Asymmetric optic nerve sheath diameter as an outcome factor following cranioplasty in patients harboring the 'syndrome of the trephined'
Decompressive craniectomy (DC) is gaining an increasing role in the neurosurgical treatment of intractable intracranial hypertension, but not without complications. A rare complication is the âsyndrome of the trephinedâ (ST). It occurs when the forces of gravity overwhelm intracranial pressures, leading the brain to become sunken. Objective To determine the usefulness of asymmetric optic nerve sheath diameter (ONSD) as an outcome factor after cranioplasty. Method We followed-up 5 patients submitted to DC and diagnosed with ST. All were submitted to brain MRI to calculate the ONSD. Results Only two patients presented an asymmetric ONSD, being ONSD larger at the site of craniectomy. Surprisingly these patients had a marked neurological improvement after cranioplasty. They became independent a week after and statistically earlier than others. Conclusion It is presumed that the presence of an asymmetric ONSD in trephined patients is an independent factor of good outcome after cranioplasty
Mandibular fracture: analysis of 293 patients treated in the Hospital of Clinics, Federal University of UberlĂąndia
Fratura de mandĂbula: anĂĄlise de 293 pacientes tratados no Hospital de ClĂnicas da Universidade Federal de UberlĂąndia Mandibular fracture: analysis of 293 patients treated in the Hospital of Clinics, Federal University of UberlĂąndia
A fratura de mandĂbula ocupa o segundo lugar entre as fraturas dos ossos da face, tendo havido aumento significativo de casos nos Ășltimos anos. A nĂŁo-identificação e o tratamento inadequado podem levar Ă deformidade estĂ©tica ou funcional permanente. OBJETIVO: Avaliar os casos submetidos Ă redução de fratura de mandĂbula no Hospital de ClĂnicas da Universidade Federal de UberlĂąndia, entre janeiro de 1974 e dezembro de 2002. FORMA DE ESTUDO: coorte historica. PACIENTES E MĂTODO: Duzentos e noventa e trĂȘs pacientes foram submetidos Ă redução de fratura de mandĂbula e retrospectivamente foram avaliados segundo fatores relacionados a: paciente, trauma, quadro clĂnico e tratamento cirĂșrgico. RESULTADOS: Houve uma clara tendĂȘncia de aumento do nĂșmero de fraturas de mandĂbula ao longo dos anos. Houve um predomĂnio no sexo masculino (4:1), com pico de ocorrĂȘncia entre 20 a 29 anos. As principais causas de fratura da mandĂbula neste estudo foram acidentes de trĂąnsito e violĂȘncia, perfazendo juntas 72,4%. Cento e trinta e cinco pacientes apresentavam fratura Ășnica. Os sĂtios mais acometidos foram, em ordem decrescente, sĂnfise, cĂŽndilo, Ăąngulo, corpo, ramo e processo coronĂłide. Foram realizadas redução incruenta (28), cruenta (213) e associação das duas (11 pacientes), sendo que 56,8% dos pacientes foram tratados nos primeiros 3 dias e 50,4% recebeu a alta hospitalar atĂ© o primeiro pĂłs-operatĂłrio. Cerca de 10% dos pacientes apresentaram complicaçÔes, sendo osteomielite a mais freqĂŒente. CONCLUSĂO: A incidĂȘncia de fraturas de mandĂbula foi marcadamente maior no sexo masculino, durante a terceira dĂ©cada de vida. A causa mais comum foi o acidente de trĂąnsito e as regiĂ”es mais atingidas foram sĂnfise e cĂŽndilo. As fraturas isoladas de mandĂbula ocorreram em mais de metade dos casos. A maioria dos pacientes foi tratada nos primeiros trĂȘs dias e recebeu alta atĂ© o primeiro pĂłs-operatĂłrio. A redução cruenta foi tratamento mais comumente empregado. A complicação mais freqĂŒente foi a osteomielite.<br>Mandibular fracture is the second most common facial fracture and there has been a significant increase in number of cases in the last years. Misidentification and inadequate treatment can take to permanent aesthetic or functional deformity. AIM: Evaluate cases of mandibular fracture reduction in the Hospital of Clinics of the Federal University of UberlĂąndia, from January of 1974 to December of 2002. STUDY DESIGN: historical cohort. PATIENT AND METHOD: Two hundred and ninety-three cases of reduction of mandibular fractures were retrospectively analyzed according to factors related to: patient, trauma, signs and symptoms, and surgical treatment. RESULTS: There has been a clear tendency of increase of the number of mandibular fractures along the years. There was higher prevalence in male (4:1), with occurrence peak between 20 to 29 years old. The principal causes of fracture in this study were traffic accidents and violence, representing 72.4%. One hundred and thirty-five patients presented only one fracture. The most injured sites were, in decreasing order, symphysis, condyle, angle, body, ramus, and coronoid. We performed closed reduction (28), open reduction (213) and association of the two (11 patients); 56.8% of the patients were treated within the first 3 days; and, 50.4% were discharged from the hospital until the first postoperative day. About 10% of the patients presented complications, being osteomyelitis the most frequent one. CONCLUSION: The incidence of mandibular fractures was remarkably larger in the male sex, during the third decade of life. The most common cause was traffic accident, and symphysis and condyle were the most injured sites. Isolated fractures occurred in over half of the cases. Most of the patients were treated in the first three days and were discharged until the first postoperative visit. Closed reduction was the treatment most commonly employed. The most frequent complication was osteomyelitis