Lobectomia temporal no infarto cerebral com efeito de massa

Abstract

Cerebral edema secondary to ischemia can threaten life, mainly due to frequent failure of medical management. Imminent herniation of the temporal lobe can be timely detected by clinical signs and CT-scan. Eight patients (4M, 4F; 48-74 years, mean 62) with ischemic stroke and imminent herniation, were surgically decompressed by a standard temporal lobectomy as described by Olivier for temporal lobe epilepsy. Six patients survived, two died and were considered failure of the procedure, probably due to late surgical indication. In conclusion, temporal lobectomy is life-saving for patients with large ischemic cerebral infarction with mass effect and deteriorating signs of brain stem compression.

Blunt Carotid Injury in Children

“…In this series good outcomes were obtained following surgical resection of infarcted brain tissue in 2 patients who would otherwise have succumbed to intracranial hypertension. While no studies were found regarding the use of decompressive surgery in children, many small studies exist which recommend decompressive resection of infarcted tissue [26][27][28] or decompressive craniectomy [22,29,30] in adult patients with intracranial hyperten sion secondary to infarct-related edema. We believe that infarcted brain, as with any other intracranial mass lesion, should be removed in children with medically intractable intracranial hypertension.…”