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Willem Guillermo Calderon-Miranda, Nidia Escobar Hernandez, Luis Rafael Moscote Salazar and Amit Agrawal

Abstract

Background: Intracranial bleeding has been reported in the literature associated with tooth extraction. Coagulation disorders are often associated with complications after dental extraction. In this case report, we describe a case of spontaneously intracranial subdural hematoma possible after tooth extraction.

Case description: The patient was a 26-y-old female without any underlying diseases. A computerized tomography scan showed a subdural hematoma 48 hours after the dental extraction. She was managed with a burr hole, good postoperative evolution and discharged to home.

Conclusion: Although rare, the presence of headache with signs of alarm after the extraction of a tooth, we must discard intracranial abnormalities. To the best of our knowledge this is the first report in the literature of a spontaneously intracranial subdural hematoma possible after tooth extraction.

Open access

Luis Rafael Moscote-Salazar, Andres M. Rubiano, Willem Guillermo Calderon-Miranda and Amit Agrawal

Abstract

Posttraumatic cerebral infarction is an uncommon cause of morbidity and mortality and many studies have highlighted that trauma needs to considered as causative factor for cerebellar infarction. We present a case of cerebellar infarction in a 35 year old young patient secondary to vertebral fracture involving the vertebral foramen and vertebral artery injury. CT scan cervical spine showed C2-3 fracture on left side with fracture extending into the left vertebral foramen. A CT scan angiogram could not be performed because of poor neurological status. Possibly the infarction was due to left vertebral artery injury. Without surgical intervention prognosis of these patients remain poor. Prognosis of patients with traumatic cerebellar infarction depends on the neurological status of the patient, intrinsic parenchymal damage and more importantly extrinsic compression of the brainstem by the edematous cerebellar hemispheres.

Open access

Marco Zenteno, Liliana Escobar, Angel Lee, Hernando Raphael Alvis-Miranda, Willem Guillermo Calderon-Miranda and Luis Rafael Moscote-Salazar

Abstract

Extracranial internal carotid artery aneurysms (EICAA) are uncommon lesion. These aneurysms can be classified as true or false aneurysms, atherosclerotic, dysplastic, infectious, posttraumatic and iatrogenic aneurysms. The most common presentation is central neurologic dysfunction, either a stroke or a transient ischemic attack. The rupture of these aneurysms can lead to severely impairment and can affect the quality of life of the patients or even may lead to death. Management of these lesions is required in most cases to prevent complications, however there is no treatment guideline or expert consensus for the management. We present a case of an unusual EICAA, associated with kinking of the affected vessel and review the literature.

Open access

Luis Rafael Moscote-Salazar, Willem Guillermo Calderon-Miranda, Andres M. Rubiano, Amit Agrawal and Guru Dutta Satyarthee

Abstract

Among the various injuries caused by the cerebral tramatic lesion are traumatic brain contusions. Hemorrhagic contusions of the basal ganglia are unusual. Different injuries such as cranial fractures, epidural hemorrhage, subdural hematoma, subarachnoid hemorrhage among others may be associated with brain contusions. In some cases traumatic brain injury arises. We present a case of a patient with unilateral cerebral contusion associated with bihemispheric cerebral infarction.

Open access

Luis Rafael Moscote-Salazar, Hernando Raphael Alvis-Miranda, Willem Guillermo Calderon-Miranda, Zenen Antonio Carmona Meza, Nidia Escobar Hernandez, Marco Antonio Blancas-Rivera and Amit Agrawal

Abstract

Solitary plasmacytoma and extramedullary plasmocytoma are tumors of malignant character composed of plasma cells, with a mean age of onset at 60 years. They can appear anywhere where the reticuloendothelial system is present. Usually these tumors lead to the development of multiple myeloma in a period of time ranging from 3 to 5 years. We present a rare case handled in our neurosurgery service associated with an unusually long period of evolution.

Open access

Luis Rafael Moscote-Salazar, Gabriel Alcalá-Cerra, Hernando Raphael Alvis-Miranda, Omar Ramírez, Willem Guillermo Calderón-Miranda and Andrés M. Rubiano

Abstract

The supratentorial hemorrhage after posterior fossa surgery is an unusual but delicate complication that carries high mortality and morbidity. A 50 year old woman presented vertigo 6 months of evolution, which worsened in the last 2 months accompanied by ataxia. She showed left cerebellar signs, had no focal motor or sensory deficits. A brain MRI identified cerebellopontine angle lesion with mass effect. The patient was treated on suboccipital craniectomy and resection of right posterior fossa tumor, the histopathological diagnosis was consistent with typical meningioma. (WHO Class I).

The postoperative period was satisfactory. A month later, presented clinical symptoms of right-sided hemiparesis, brain CT revealed left frontal supratentorial hematoma, receiving conservative management. Patient was discharged after 10 days. Reports in the literature on this rare complication, detailed cases where the hematoma was presented in hours to days. To our knowledge this is the first report in the literature of supratentorial hemorrhage and posterior fossa surgery one month after the surgical procedure has been performed.

Open access

Luis Rafael Moscote-Salazar, Andres M. Rubiano, Hernando Raphael Alvis-Miranda, Nasly Zabaleta-Churio, Willem Guillermo Calderón-Miranda, Gabriel Alcalá-Cerra and Jorge Aquino-Matus

Abstract

Background: Intracranial hemorrhagic complications are unusual after diagnostic lumbar puncture. Case report: A diagnostic lumbar puncture was performed in a 55 year-old male for acute bacterial meningitis workup. Immediately after the procedure he developed intense headache and a head Computed Tomography (CT) was done which identified an acute subdural fluid collection. No surgical management was offered and conservative medical follow-up was indicated. Conclusion: The occurrence of a headache with red flags after a lumbar puncture may suggest the possibility of an acute subdural hematoma.

Open access

Luis Rafael Moscote-Salazar, Amit Agrawal, Andres M. Rubiano, Mohammed Al Dhahir, Willem Guillermo Calderon-Miranda, Nasly Zabaleta-Churio and Marco Antonio Blancas Rivera

Abstract

Background: Tranexamic acid is used to reduce bleeding, easy to use, affordable and relatively safe. There are few studies on the use of tranexamic acid in trauma and especially in neurosurgery. There is no published study on the trend the use of tranexamic acid in neurotrauma surgery among international doctors. The aim of this study was to evaluate the current practice for use of tranexamic acid during neurotrauma surgery.

Materials and Methods: A 11-question electronic survey was sent to 25 practicing physicians worldwide. Basic demographic information and estimated rates of use of tranexamic acid during neurotrauma surgery.

Results: Twenty five physicians responded to our survey. Very Few trusts (12%) use tranexamic acid during neurotraumasurgery.

Conclusion: Further studies are required to establish guidelines in neurosurgery and neurotrauma, especially. The use of this medicine potentially helps improve patient care with head injury and save lives.

Open access

Huber S. Padilla-Zambrano, Jessica Amaya-Quintero, Ramos-Villegas Yancarlos, Luis Rafael Moscote-Salazar, Willem Guillermo Calderon-Miranda, Joulen Mo-Carrascal, Johanna Maraby and Amit Agrawal

Abstract

The Pneumorrhachis is the presence of air at the level of the spinal canal. It can have several causes among which are: traumatic, iatrogenic among others. Clinical Cases: We present three cases of male patients handled by our neurosurgery service with traumatic pneumorrhachis patients, which were managed in a conservative manner, with control images. Conclusions: pneumorrhachis has traditionally been classified as internal if air is present in the subdural or subarachnoid space and external if the air is located at the epidural level. We propose a classification in degrees (Moscote-Agrawal-Padilla) which is more practical from the clinical and radiological point of view.

Open access

Willem Guillermo Calderon-Miranda, Nidia Escobar-Hernandez, Luis Rafael Moscote-Salazar, Andres M. Rubiano, Marco Antonio Blancas-Rivera, Amit Agrawal, Zenem Carmona-Meza, Hernando Raphael Alvis-Miranda and Gabriel Alcala-Cerra

Abstract

Traumatic brain injury is a common condition in the emergency services, affecting the pediatric and adult population significantly. Patterns of head injury as well as management principles in children are important differences compared to adults. Traumatic brain injury by Domestic pressure cooker is rare and has not been described in children, which to our knowledge is the first report in the literature of this nature.