Ferreira Furtado Leopoldo Mandic, Da Costa Val Filho José Aloysio, Moura de Sousa Camila, Dantas François, Costa Júlia da Silva
Pediatric Neurosurgery, Vila Da Serra Hospital, Nova Lima, BRA.
Neurosurgery, Vila da Serra Hospital, Nova Lima, BRA.
Cureus. 2021 Jan 17;13(1):e12755. doi: 10.7759/cureus.12755.
There are several treatment modalities for the management of subdural fluid collection in infants, such as fontanelle puncture and drainage, burr hole irrigation, and subduroperitoneal shunt. This report describes the case of a girl born with congenital neurological impairment due to severe injury of the brain with unknown etiology. At five months of age, she suffered from head trauma and developed somnolence after three days and was diagnosed with a bilateral massive chronic subdural hematoma. Normal fundoscopy did not confirm the non-accidental head trauma. Neuroendoscopy using a single burr hole was performed and complete drainage was achieved. Arachnoid tearing was observed during the procedure. Postoperatively, the patient showed clinical improvement, and brain expansion was observed after one month. The main advantages of neuroendoscopy for bilateral massive chronic subdural hematoma are accurate visualization of the space, minimal invasiveness, and treatment of both sides with reliable drainage control.
婴儿硬膜下积液的治疗方法有多种，如囟门穿刺引流、钻孔冲洗和硬膜下腹腔分流术。本报告描述了一名因病因不明的严重脑损伤而先天性神经功能障碍的女孩的病例。五个月大时，她头部受伤，三天后出现嗜睡，被诊断为双侧大量慢性硬膜下血肿。正常的眼底检查未证实非意外性头部外伤。采用单孔钻孔进行神经内镜检查，实现了完全引流。术中观察到蛛网膜撕裂。术后，患者临床症状改善，一个月后观察到脑膨出。神经内镜治疗双侧大量慢性硬膜下血肿的主要优点是对空间的精确可视化、微创性以及可靠的引流控制下对双侧进行治疗。
