Hematoma epidural secundario al empleo de cabezal autoestático en un adulto

Abstract

ResumenEl cabezal autoestático es un instrumento utilizado habitualmente en las intervenciones neuroquirúrgicas y a pesar de su utilización adecuada, puede ser el causante de algunas complicaciones graves como la perforación craneal y el desarrollo de hemorragias intracraneales. Presentamos el caso de un paciente varón de 19 años sometido a una ventriculocisternostomía endoscópica y que presentó un hematoma epidural secundario a la penetración intracraneal de uno de los pinchos del cabezal.PALABRAS CLAVE: Complicación. Cabezal autoestático. Hematoma epidural. Ventriculostomía endoscópica. Epidural haematoma due to an headrest in an adult SummaryA head fixation device with pins is commonly used for immobilization of the patients during neurosurgical procedures. Despite its appropiate management, may be the cause of some serious complications such as skull perforation and intracranial injuries.We report the case of a 19-years-old young admitted for a endoscopic third ventriculostomy who developed an epidural haematoma due to the penetration of the skull by a pin.

Pin-site epidural hematoma: A catastrophic complication of cranial fixation in a child

“…A review of literature showing the patient characteristics, pathology for which the surgery was done, and time when this complication was detected of previously reported cases[ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 ] is summarized in Table 1 . The majority of such cases, like in ours, occurred in children with posterior fossa tumors.…”

“…The majority of such cases, like in ours, occurred in children with posterior fossa tumors. [ 1 2 3 7 ] However, this complication has been reported even in adults[ 4 13 ] and also following surgery for supratentorial[ 1 5 11 12 13 14 ] and cervical spinal[ 6 ] pathology.…”

“…However, in most of the cases, the hematoma was discovered either following CT scan done immediately after surgery[ 2 3 4 7 ] (one exception being a case in Vitali and Steinbok's series[ 2 ] where it was detected at the time of pin application) or later when the patient showed signs of neurological deterioration. [ 5 6 9 10 11 13 ] In light of our experience, we feel that if other factors such as retraction injury and increased airway pressure can be ruled out, it would be wiser to get a scan done intraoperatively after closing the wound temporarily which would help to detect hematoma early and prevent tentorial herniation. Our delay in doing the same was contributory for the extremely protracted and stormy course of the patient.…”

Epidural Hematoma, a Rare Complication After the Use of Mayfield Clamp: A Case Report and Review of the Literature

“…Diagnosis, treatment and outcome describes aftermath of each of the cases. 1 3 4 6 11 13 14 16 17 18 20 21 24 25 26) EDH: epidural hematoma, yo: year old, CT: computed tomography, ICP: intracranial pressure, CSF: cerebrospinal fluid, EVD: external ventricular drainage, AED: antiepileptic drugs.…”

“…Diagnosis, treatment and outcome describes aftermath of each of the cases. 1 3 4 6 11 13 14 16 17 18 20 21 24 25 26)…”