No abstract

RESUMOAs complicações da Derivação Ventriculoperitoneal (DVP) podem variar de 6% a 40% nas séries da literatura, estando o hematoma subdural crônico (HSDC) presente em até 24% de algumas dessas séries. Preconiza-se o uso de uma válvula de alta pressão, para evitar uma possível hiperdrenagem, nos casos de sintomatologia semelhante à hidrocefalia de pressão normal (HPN) com grande aumento ventricular. Nesse caso, o paciente apresentou a tríade clássica de Hakim-Adams, sendo diagnosticado clinicamente com a hidrocefalia de pressão normal e submetido a uma derivação ventrículo-peritoneal com uma válvula de alta pressão. O paciente evoluiu com a formação de hematoma subdural crônico bilateral (HSDC), sendo necessária a drenagem da coleção sanguínea. O Palavras-chave: Hidrocefalia. Complicações. Hematoma subdural crônico. Síndrome de Hakim. ABSTRACTComplications of ventriculoperitoneal shunt (VPS) can range from 6 to 40% in literature series, being the chronic subdural hematoma present in up to 24% of some of these series. The use of a high pressure valve is praised to avoid a probable hyperdraining in instances of similar symptomatology to normal pressure hydrocephalus (NPH) with huge ventricular increase. In this case, the patient presented the classic Hakim-Adams' triad, being clinically diagnosed with NPH and submitted to a VPS with a high pressure valve. The patient evolved with a bilateral chronic subdural hematoma formation, being necessary a draining of this blood colection. The presented case allows to notice complications after this procedure and also a bibliographic review about NPH's physiopathology.

To describe cardiopulmonary bypass in the elderly under anesthesia of patients undergoing myocardial revascularization in the Intensive Care Unit. Cardiopulmonary bypass (CPB) can alter plasma concentrations of drugs used during anesthesia for cardiac surgery and cause effects on the central nervous system, leading patients to a greater degree of sedation, which alters the time of patient awakening. Method: This is a descriptive-qualitative-exploratory study, of a comprehensive nature, of the systematic type. Results: The three groups were compared in terms of weight, height, age and body mass index (BMI). Regarding intubation time and wake-up time, it was observed that the CPB group had higher values ​​for these variables, with a significant difference. Conclusion: The short duration of action of propofol of approximately 6 to 9 minutes can be explained by the high clearance and rapid distribution of the drug. Propofol concentration at the site of action also increases rapidly due to the rapid equilibrium between plasma and brain concentrations (< 4 minutes).