Publicación Oficial de la Sociedad Ecuatoriana de Neurología, de la Liga Ecuatoriana Contra la Epilepsia y de la Sociedad Iberoamericana de Enfermedad Cerebrovascular

complications

 

Caracterización Clínica y Desenlaces Hospitalarios en Adultos Con Meningitis en un Hospital de Alta Complejidad en Colombia (2019–2021). Clinical Characteristics And In-Hospital Outcomes In Adults With Meningitis In A High-Complexity Hospital In Colombia (2019–2021)

Introduction: Bacterial meningitis in adults is a time-dependent medical emergency due to its rapid progression, risk of septic shock, and severe neurological complications. The objective was to characterize the clinical profile, cerebrospinal fluid (CSF) cytochemical findings, and in-hospital outcomes in adult patients with a clinical diagnosis of meningitis.

Methods: A single-center, retrospective observational cohort study was conducted at a high-complexity hospital in Tunja, Colombia, a regional referral center. Patients with a clinical diagnosis of meningitis who underwent diagnostic lumbar puncture between 2019 and 2021 were included.

Results: Thirty-two patients were included, with a median age of 52 years and a male predominance. The most frequent symptoms were headache and fever; 53.1% presented with altered mental status at admission. CSF analysis showed pleocytosis with predominance of polymorphonuclear cells, low glucose levels, and elevated protein concentrations. In-hospital mortality was 21.9%, 25.0% of patients required admission to the intensive care unit, and 84.4% developed at least one complication.

Conclusions: Patients exhibited a clinical and cytochemical profile consistent with bacterial etiology and a high frequency of adverse outcomes (mortality ~22% and 84% complications). These findings highlight the severity of the condition and the need for timely diagnosis and treatment.

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Hematoma Subdural en Puerperio Temprano por Anestesia Regional

Intracranial subdural hematoma is an entity characterized by the rupture of the bridging veins that are found in the subdural space and promote the slow outflow of blood. A 23-year-old first-time pregnant patient presented with severe preeclampsia, for which an emergency cesarean section was performed using regional anesthesia. During the postpartum period, the patient presented a single generalized seizure episode with secondary headache. The imaging study reported the presence of a lamellar subdural hematoma. This type of injury is a rare complication of lumbar puncture, where factors such as the use of very large needles, large dural orifice, multiple punctures, pregnancy, dehydration, use of anticoagulants, coagulopathies, cerebral vascular anomalies and atrophy cerebral.

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