-Decompressive craniotomy (DC) is applied to treat post-traumatic intracranial hypertension (ICH).The purpose of this study is to identify prognostic factors and complications of unilateral DC. Eighty-nine patients submited to unilateral DC were retrospectively analyzed over a period of 30 months. Qui square independent test and Fisher test were used to identify prognostic factors. The majority of patients were male (87%). Traffic accidents had occurred in 47% of the cases. 64% of the patients had suffered severe head injury, while pupillary abnormalities were already present in 34%. Brain swelling plus acute subdural hematoma were the most common tomographic findings (64%). Complications occurred in 34.8% of the patients: subdural effusions in 10 (11.2%), hydrocephalus in 7 (7.9%) and infection in 14 (15.7%). The admittance Glasgow coma scale was a statistically significant predictor of outcome ( p=0.0309).KEY WORDS: head injury, intracranial hypertension, decompressive craniotomy. Craniotomia descompressiva: análise de fatores prognósticos e complicações em 89 pacientesResumo -A craniotomia descompressiva (CD) é técnica utilizada para tratamento da hipertensão intracraniana (HIC) pós-traumática. O objetivo do estudo foi determinar fatores prognósticos e complicações nos pacientes submetidos a esta técnica. Realizou-se estudo retrospectivo de 89 pacientes submetidos à CD unilateral para tratamento da HIC pós-traumática durante 30 meses. Utilizou-se testes do Qui-quadrado de independência e teste exato de Fisher para análise de fatores independentes de prognóstico. A maioria dos pacientes era do sexo masculino (87%). A causa mais comum foi o acidente de trânsito (47%). A maioria apresentava traumatismo cranioencefálico grave (64%), 34% já apresentavam anisocoria. O achado tomográfico mais comum foi a associação entre tumefação cerebral e hematoma subdural agudo (64%). Em 34,8% dos pacientes houve complicações inerentes à técnica: coleção subdural (11,2%), hidrocefalia (7,9%) e infecção (15,7%). A escala de coma de Glasgow à admissão correlacionou-se estatisticamente como fator prognóstico (p=0,0309). Decompressive craniotomy (DC) is a surgical method performed to immediately reduce intracranial pressure (ICP). It is usually indicated in cases of brain swelling (BS) and acute subdural hematoma (ASDH), or even for nontraumautic lesions in order to accommodate the swollen brain 1 . It consists of a unilateral craniotomy and dural augmentation. The bone can be temporarily stored in the abdominal subcutaneous tissue or can be disposed in case of a subsequent cranioplasty (with methylmethacrylate or titanium plate, among other materials). PALAVRAS-CHAVERecent studies have been evaluating DC efficacy when performed early in patients with severe traumatic brain injury (TBI) and with intracranial hypertension (ICH), yielding a superior result as compared to late performance or to specific clinical procedures (barbiturate coma and hypothermia) [2][3][4][5][6] . The purpose of this study was to evaluate prognostic...

Mast cells contain heparin, histamine, hydrolytic enzymes, and possibly serotonin in metachromatic cytoplasmic granules, and are not visualized in routine histological preparations. Special fixation, frozen sections, and toluidine blue staining are essential for counting the number of mast cells in tissue sections. Histological preparations for counting mast cells were made from arteries of the circle of Willis in persons who died after chest or abdominal trauma (control group) and in patients who had subarachnoid hemorrhage (SAH) after aneurysm rupture. The arteries were removed within 6 hours of death, taking care to avoid damage to their structure, and were immersed in the fixative solution. This preliminary note, reporting findings in only a few cases, is justified by the interesting discovery of a marked increase in mast cell population in the muscular layer of arteries after SAH. The series is small because of the difficulty in obtaining suitable material, since mast cells virtually disappear when autopsy is performed later than 6 hours after death. It is concluded from this study that there is an increase of mast cell population in cerebral arterial walls after SAH, mainly in the muscular layer, and that the number of mast cells is higher in arteries closer to the aneurysm.

-We re p o rt two cases of trigeminal neuroma that were operated on by the neuro s u rg e ry team at Felício Rocho Hospital, Belo Horizonte, Minas Gerais State, Brazil. Endoscopic assisted micro s u rg e ry was the technique used to approach the gasserian region tumor with good results.KEY WORDS: trigeminal schwannoma, posterior fossa tumors, endoscopic brain surg e ry, micro n e u ro s u rg e ry.

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O papel da craniotomia descompressiva (CD) no tratamento da hipertensão intracraniana (HIC) refratária ainda não está estabelecido na literatura. Atualmente é recomendada como opção, pois há deficiência de trabalhos classe I ou II que suportem seu emprego. Trabalhos recentes têm avaliado a eficácia da CD quando aplicada precocemente no tratamento da HIC pós traumática. No presente trabalho analisam-se 21 pacientes nos quais a CD foi realizada precocemente. A maioria dos pacientes apresentava traumatismo cranioencefálico grave (Escala de coma glasgow <9) e tomografia de crânio evidenciando tumefação cerebral (brain swelling) ou hematoma subdural agudo. A principal complicação inerente à técnica foi a hidrocefalia (28,5%). Boa reabilitação social ocorreu em 11 pacientes (52,5%). Parece que a CD, quando realizada precocemente, é eficaz no tratamento da HIC refratária, ressaltando-se ainda a necessidade de estudos classe I e II que suportem esta opinião.