Bilateral cortical atrophy after severe brain trauma and extradural homatoma

• Published in: Arquivos de neuro-psiquiatria Vol. 65; no. 4B; pp. 1237 - 1240
• Main Authors: Louzada, Paulo Roberto, Vaitsman, Rafael Pereira, Souza, Arthur Borges Martins de, Coutinho, Pedro de Oliveira, Lengruber, Renata Teixeira, Neves, Francisco Weldes Brito das, Missaka, Herbert, Lima, Marco Aurélio Albuquerque, Salame, José Massoud
• Format: Journal Article
• Language: English
• Published: Brazil Academia Brasileira de Neurologia - ABNEURO 01-12-2007
• Subjects: Adult; Atrophy - etiology; Atrophy - surgery; Cerebral Cortex - pathology; Cerebral Cortex - surgery; Craniocerebral Trauma - complications; Craniocerebral Trauma - diagnosis; Craniocerebral Trauma - surgery; Fatal Outcome; Glasgow Coma Scale; Hematoma, Epidural, Cranial - diagnosis; Hematoma, Epidural, Cranial - etiology; Hematoma, Epidural, Cranial - surgery; Humans; Male; NEUROSCIENCES; PSYCHIATRY; Tomography, X-Ray Computed; epidural hematoma; injúria secundária; hematoma extradural; secondary injury; traumatismo craniano grave; severe head injury; brain atrophy; atrofia cerebral; extradural hematoma; hematoma epidural
• ISSN: 0004-282X; 1678-4227; 0004-282X
• DOI: 10.1590/S0004-282X2007000700029

We report the case of a severe head injured 43-year old male patient with a large extradural hematoma, Glasgow Coma Scale 3 and dilated fixed pupils. Patient was promptly submitted to surgical evacuation of the lesion, but remained in persistent vegetative state in the post-operative time. Head computed tomography scans performed before surgery, and at early and late post-operative periods comparatively revealed extreme bilateral cortical atrophy. Late consequences of severe head trauma drastically affect the prognosis of patients, being its prevention, and neuroprotection against secondary injury still a therapeutical challenge for neurosurgeons.