Improvement of Respiratory Depression in a Patient with Primary Medullary Hemorrhage Following Removal of Hematoma in the Half-sitting Position
| Autor: | Shinya Ichimura, Masato Nakaya, Helmut Bertalanffy, Raita Fukaya, Masahito Fukuchi, Koji Fujii, Goroku Moriwaki, Yoichi Mochizuki |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Medullary cavity Nausea Posture Patient Positioning 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Hematoma medicine Humans Depression (differential diagnoses) Aged business.industry Apnea medicine.disease Prognosis Surgery Dissection Vomiting Ataxic respiration Female Neurology (clinical) medicine.symptom business Respiratory Insufficiency Intracranial Hemorrhages 030217 neurology & neurosurgery |
| Zdroj: | Journal of neurological surgery. Part A, Central European neurosurgery. 79(2) |
| ISSN: | 2193-6323 |
| Popis: | Primary medullary hemorrhage is a rare event that may result in ataxic respiration. Although it remains controversial whether primary medullary hemorrhage should be managed conservatively or surgically, recent advancements in neuroimaging and microsurgical techniques have shown promise for improving outcomes and prognosis following surgery. The present report discusses the case of a 70-year-old woman admitted to our institution due to sudden-onset nausea and vomiting. The patient underwent surgical removal of a right medullary hematoma for the treatment of daytime respiratory depression and nocturnal apnea while in the half-sitting position. Following surgery, her spontaneous respiration improved, and she was discharged with independent gait. Despite the risk of venous air embolism, accumulating evidence suggests that the half-sitting position is suitable for brainstem surgery because gravity-assisted blood and irrigation drainage from the surgical field allows for cleaner dissection and reduces the need for bipolar coagulation. |
| Databáze: | OpenAIRE |
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