ABSTRACT

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Objective: To outline the clinical-epidemiological profile of patients who were victims of SCT, to identify the main trauma mechanisms for this injury and its outcome. Methods: Retrospective cross-sectional study, in which the epidemiological data, computed tomography reports and medical records of patients with fractures identified in their examinations at trauma reference hospitals in Curitiba-PR, in 2018, were analyzed. Results: 705 patients were studied. There was a male prevalence (64%), the most affected age group was 21 to 30 years old (18%), the mean age was 48.23 years, the mean female age being approximately 10 years higher. The main mechanisms were traffic accidents (34%), falls from a higher level (29%) and falls from the same level (25%). The most affected segment was the lumbar with 46% of cases. The incidence of surgical treatment was 15%, of spinal cord injury was 5%, and death was the outcome in less than 3% of cases. Conclusions: The profile of the patient victim of SCT in 2018 in Curitiba-PR was that of a young man, victim of a traffic accident with thoracolumbar involvement without spinal cord injury, under conservative treatment.Level of evidence II; Retrospective Study.

Introdução: A aplasia cútis congênita é uma doença rara que apresenta incidência de 1 a cada 10.000 nascimentos. Uma taxa de mortalidade de 20% tem sido relatada, principalmente devido a hemorragia ou meningite naqueles pacientes com envolvimento craniano. Objetivo: Relatar o caso de um pacientee realizar revisão de literatura sobre o assunto. Relato de caso: Paciente do sexo feminino nascida de parto cesáreo, com 37 semanas de gestação. A doença foi diagnosticada intra-útero por meio de exames de imagem (ultra-sonografia obstétrica e ressonância magnética fetal). Nas primeiras 48 horas de vida,a recém-nascida foi submetida a procedimento cirúrgico com o intuito de reparar a lesão. Evoluiu com complicações tardias, como fístula liquórica, meningite e convulsões. Aos dois anos de idade, foi a óbito em decorrência de sepse de foco pulmonar. Conclusão: Aplasia cútis congênita é uma doençarara, que pode atingir somente couro cabeludo, mas também apresentar-se com ausência de parte da calota craniana, o que aumenta a mortalidade devido ao maior risco de complicações como fístula liquórica, meningoencefalite e sangramento.

Objective To analyze the population and the early mortality rate (up to thirty days) of patients victim of spontaneous subarachnoid hemorrhage (SAH) according to the Hunt-Hess clinical scale and the Fisher and modified Fisher radiological scales. Materials and Methods We analyzed 46 medical records and skull computed tomography (CT) scans of patients with spontaneous SAH admitted between February 2014 and December 2017 at Hospital Universitário Evangélico Mackenzie, in the city of Curitiba, state of Paraná, Brazil. The method of the study was exploratory-descriptive, transversal and retrospective, with a quantitative approach. We analyzed epidemiological (gender, age), clinical (life habits, pathologies, Glasgow coma scale and Hunt-Hess scale) and radiological (Fisher and modified Fisher scales) variables, and the Hunt-Hess and the Fisher scales were correlated with risk of death. The data was submitted to statistical analysis considering values of p < 0.05. Result There was a higher prevalence of spontaneous SAH among women (69.5%), as well as among patients aged between 51 and 60 years (34.7%). Regarding the grades on the scales, there was higher prevalence of Fisher 4, Modified Fisher 4 and Hunt-Hess 2. Evolution to death was higher among women (76.4%) and patients aged between 61 and 70 years (35,2%). Conclusion Mortality was higher among patients classified as Fisher 3, Modified Fisher 4 and Hunt-Hess ≥ 3. The Fisher scale is better than the modified Fisher scale to assess the risk of mortality.