Pneumoencéfalo intraventricular após perfuração acidental de dura-máter. Relato de caso

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dc.contributor.authorBarbosa, Fabiano Timbó
dc.contributor.authorCunha, Rafael Martins da
dc.contributor.authorRocha, Anita Perpétua Carvalho [UNESP]
dc.contributor.authorSilva Júnior, Hélio José Leal
dc.contributor.institutionCentro de Ensino Superior de Maceió
dc.contributor.institutionHospital Escola Doutor José Carneiro
dc.contributor.institutionClínica Santa Juliana
dc.contributor.institutionEscola de Ciências Médicas de Alagoas
dc.contributor.institutionHospital Unimed
dc.contributor.institutionHospital da Sagrada Família
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.contributor.institutionHospital Regional da Unimed
dc.contributor.institutionHospital do Coração
dc.contributor.institutionHospital Geral de Fortaleza
dc.date.accessioned2014-05-27T11:22:00Z
dc.date.available2014-05-27T11:22:00Z
dc.date.issued2006-10-16
dc.description.abstractBACKGROUND AND OBJECTIVES: The loss of resistance to air to identify the epidural space is widely used. However, the accidental perforation of the dura mater is one of the possible complications of this procedure, with an estimated incidence between 1% and 2%. The objective of this report was to describe the case of a patient with intraventricular pneumocephalus after the accidental perforation of the dura mater using the loss of resistance with air technique. CASE REPORT: Female patient, 26 years old, 75 kg, 1.67 m, physical status ASA I, with a 38-week pregnancy, was referred to the obstetric service for a cesarean section. Venipuncture was performed after placement of the monitoring. The patient was placed in a sitting position for administration of the epidural anesthesia. During the identification of the epidural space with the loss of resistance with air technique, an accidental perforation of the dura mater was diagnosed by observing free flow of CSF through the needle. The technique was modified to epidural anesthesia and anesthetics were administered by the needle placed in the subarachnoid space. In the first 24 hours, the patient developed headache and she was treated with caffeine, dypirone, hydration, hydrocortisone, and bed rest; despite those measures, the patient's symptoms worsened and evolved to headache in decubitus. A CT scan of the head showed the presence of pneumocephalus. After evaluation by a specialist, the patient remained under observation, with progressive improvement of the symptoms and was discharged from the hospital in the fifth day, without complications. CONCLUSIONS: Pneumocephalus after accidental perforation of the dura mater presented headache with the characteristics of headache secondary to loss of CSF, but with spontaneous resolution after the air was absorbed. Invasive measures, such as epidural blood patch, were not necessary. © Sociedade Brasileira de Anestesiologia, 2006.en
dc.description.affiliationCentro de Ensino Superior de Maceió
dc.description.affiliationUnidade de Emergência Dr. Armando Lages Hospital Escola Doutor José Carneiro
dc.description.affiliationClínica Santa Juliana
dc.description.affiliationFarmacologia Centro de Ensino Superior de Maceió
dc.description.affiliationFarmacologia Escola de Ciências Médicas de Alagoas
dc.description.affiliationHospital Unimed, Maceió
dc.description.affiliationHospital da Sagrada Família
dc.description.affiliationDor
dc.description.affiliationAnestesiologia UNESP
dc.description.affiliationHospital Regional da Unimed, Fortaleza
dc.description.affiliationHospital do Coração
dc.description.affiliationHospital Geral de Fortaleza
dc.description.affiliation, R. C. P., 113/202. Ed. Erich Fromm., Farol 57051-150 Maceió, AL
dc.description.affiliationUnespAnestesiologia UNESP
dc.format.extent511-517
dc.identifierhttp://dx.doi.org/10.1590/S0034-70942006000500009
dc.identifier.citationRevista Brasileira de Anestesiologia, v. 56, n. 5, p. 511-517, 2006.
dc.identifier.doi10.1590/S0034-70942006000500009
dc.identifier.file2-s2.0-33749574289.pdf
dc.identifier.issn0034-7094
dc.identifier.issn1806-907X
dc.identifier.scieloS0034-70942006000500009
dc.identifier.scopus2-s2.0-33749574289
dc.identifier.urihttp://hdl.handle.net/11449/69170
dc.language.isopor
dc.relation.ispartofRevista Brasileira de Anestesiologia
dc.relation.ispartofjcr0.850
dc.relation.ispartofsjr0,320
dc.rights.accessRightsAcesso aberto
dc.sourceScopus
dc.subjectComplications: headache, pneumocephalus
dc.subjectcaffeine
dc.subjectdipyrone
dc.subjecthydrocortisone
dc.subjectadult
dc.subjectbed rest
dc.subjectcase report
dc.subjectcerebrospinal fluid flow
dc.subjectcesarean section
dc.subjectcomputer assisted tomography
dc.subjectconvalescence
dc.subjectdura mater
dc.subjectepidural anesthesia
dc.subjectepidural space
dc.subjectfemale
dc.subjectheadache
dc.subjecthospital admission
dc.subjecthospital discharge
dc.subjecthuman
dc.subjectpatient monitoring
dc.subjectpneumocephalus
dc.subjectpregnancy
dc.subjectsubarachnoid space
dc.subjectvein puncture
dc.titlePneumoencéfalo intraventricular após perfuração acidental de dura-máter. Relato de casopt
dc.title.alternativeIntraventricular pneumocephalus after accidental perforation of the dura mater. Case reporten
dc.typeArtigo
dcterms.licensehttp://www.scielo.br/revistas/rba/paboutj.htm

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