ABSCESO CEREBRAL
Hola a todos en la comunidad de Hive, espero se encuentren muy bien, yo estoy bastante bien, ya casi termino mi rotacion por el bloque de cirugia, actualemente estoy rotando por e piso de hospitalizacion de Neurocirugia, me impresiona mucho ver lo diferente que se manejan los servicios, Neurocirugia es un servicio muy organizado, tranquilo y exigente para con sus residentes de postgrado.
Hello to everyone in the Hive community, I hope you are doing very well, I am quite well, I am almost finished my rotation for the surgery block, I am currently rotating through the Neurosurgery inpatient floor, I am very impressed to see how different the services are managed, Neurosurgery is a very organized, quiet and demanding service for their postgraduate residents.
Como interno de Pre-grado es muy didactico, en mi caso, nuestra coordinadora es la jefa del Servicio de neurociurgia, por lo que ella le exige a los residentes de postgrado que nos enseñen, y nos den la oportunidad de entrar a operaciones.
Yo he tenido la oportunidad de entrar a cirugias de dicho servicio en todas mis guardias, y ya tengo un mes haciendo guardias cada cuatro dias, de 24 horas, sinceramente me lo imaginaba de otra manera, siempre nos han pintado que para ser neurocirujano debes tener muy buen pulso, que estas cirugias son de lo mas delicadas y largas, y pues no, les cuento que ha sido el servicio donde mas me ha gustado entrar a quirofano, el ambiente es muy relajante, y si, toda operacion se debe realizar con mucha delicadeza, pero nada exagerado como nos pintan.
Una de las primeras cirugias a las que entre fue a un absceso cerebral, algo que me impresiona aun mas es que antes de llevar a un paciente a mesa operatoria se le realizan ciertos examenes paraclinicos e imagenologicos para confirmar el diagnostico, pero vale, ejemplo; en la tomografia o resonancia magnetica cerebral muestran que hay un tumor: llamese tumor a cualquier alteracion de los tejidos que cause aumento de volumen, entonces, en la imagen vemos un tumor, se observa el aumento de volumen y se estima que es un abceso cerebral, ya que el paciente no refiere antecedentes de traumatismo o de hipertension arterial para pensar en otra etiologia de este hallazgos tomografico, pero no tenemos la certeza hasta abrir y confirmar que estamos en presencia de un absceso.
As an undergraduate intern is very didactic, in my case, our coordinator is the head of the neurosurgery service, so she requires the postgraduate residents to teach us, and give us the opportunity to enter operations.
I have had the opportunity to go into surgeries of this service in all my shifts, and I already have a month doing shifts every four days, 24 hours, honestly I imagined otherwise, we have always been painted that to be a neurosurgeon you must have a very good pulse, I have always been told that these surgeries are very delicate and long, but no, I tell you that it has been the service where I have most enjoyed entering the operating room, the atmosphere is very relaxing, and yes, any operation must be performed with great delicacy, but nothing exaggerated as we are painted.
One of the first surgeries I underwent was a brain abscess, something that impresses me even more is that before taking a patient to the operating table, certain paraclinical and imaging tests are performed to confirm the diagnosis, but okay, for example, in the CT or MRI brain show that there is a tumor: tumor is any alteration of the tissues that causes an increase in volume, then, in the image we see a tumor, the increase in volume is observed and it is estimated that it is a brain abscess, since the patient does not refer a history of trauma or arterial hypertension to think of another etiology of this tomographic findings, but we do not have the certainty until we open and confirm that we are in the presence of an abscess.
Esta paciente femenina, de 30 años de edad, niega antecedentes de importancia, pero en los hallazgos paraclinicos, reportan Herpes simple positivo, Epstein Barr positivo, por lo que se asume que el absceso cerebral es de probable etiologia viral.
El hospital donde yo trabajo, es un hospital grande, cuenta con 7 quirofanos, no estan dotados, pero los servicios que hacen uso de este siempre buscan la manera de tener lo suficiente, tambien muchas organizaciones, fundaciones, realizan donativos que son de mucha ayuda. Hay 7 quirofanos, pero solo hay un anestesiologo, y no se pueden realizar tantas cirugias al mismo tiempo con tan poco personal de anstesiologia, por lo que las cirugias se atrasan, realizan una lista y se opera lo mas importante, lo que tiene realmente prioridad.
Es un poco duro ver esa situacion, pero bueno, vendran tiempos mejores.
Entonces bien, esta femenina es llevada a mesa operatoria, donde se realiza una craneotomia frontotemporal, el absceso se econtraba en el lobulo frontal derecho, se ingresa al parenquima con la ayuda de un yelco muy pequeño, y se extraen 7cc de contenido purulento no fetido, este contenido es llevado a laboratorio para estudiarlo.
This female patient, 30 years old, denies important antecedents, but in the paraclinical findings, they report positive Herpes simplex, positive Epstein Barr, so it is assumed that the brain abscess is of probable viral etiology.
The hospital where I work, is a large hospital, has 7 operating rooms, they are not endowed, but the services that make use of this always seek ways to have enough, also many organizations, foundations, make donations that are very helpful. There are 7 operating rooms, but there is only one anesthesiologist, and it is not possible to perform so many surgeries at the same time with so few anesthesiology staff, so surgeries are delayed, they make a list and operate the most important, what really has priority.
It is a bit hard to see that situation, but well, better times will come.
So, this female is taken to the operating table, where a frontotemporal craniotomy is performed, the abscess was found in the right frontal lobe, the parenchyma is entered with the help of a very small helmet, and 7cc of purulent content is extracted, this content is taken to the laboratory to study it.
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La recuperacion de este tipo de pacientes es lenta, ellos deben permanecer en hospitalizacion durante varios dias para cumplimiento de tratamiento antibiotico, y para monitorizacion de signos vitales como temperatura, o algun signo sugestivo de complicaciones, y ademas vigilancia neurologica estricta, refiriendonos a si hay signos de hipertension endocraneana, edema cerebral, o si hay deterioro del estado neurologico de la paciente.
La verdad este servicio me ha gustado muchisimo, y sinceramente siempre estuve como predispuesta a que no me gustaba, porque era muy largo, porque las cirugias seguramente son lentas y largas, y no, me impresiono totalmente, me gusto muchisimo entrar a quirofano con neurocirugia, me senti bien y comoda, quie sabe y termine siendo neurocirujana.
Espero les haya gustado mi post y no se impresionen al ver las fotografias como toda mi familia, que no podian creer que yo tomara esas fotos
The recovery of this type of patients is slow, they must remain in hospital for several days for compliance with antibiotic treatment, and for monitoring of vital signs such as temperature, or any signs suggestive of complications, and also strict neurological surveillance, referring to whether there are signs of endocranial hypertension, cerebral edema, or if there is deterioration of the neurological status of the patient.
The truth is that I liked this service very much, and honestly I was always predisposed to not liking it, because it was very long, because the surgeries are surely slow and long, and no, I was totally impressed, I really liked going into the operating room with neurosurgery, I felt good and comfortable, who knows and ended up being a neurosurgeon.
I hope you liked my post and do not be impressed when you see the pictures like all my family, they could not believe that I took those pictures.
Me despido con mis compañeras de guardia.
I say good-bye to my fellow female on-call officers.
Nos vemos.
See you soon
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