Zer0/∞
No Women's Type
- Joined
- Jan 16, 2022
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CASE REPORT
A 19-year-old man with class II malocclusion and retrognathia was referred for surgical treatment for aesthetic purposes. Orthognathic surgery was performed by an oral and maxillofacial surgeon in northern Brazil, and included a Le Fort I maxillary osteotomy with vertical impaction, bilateral sagittal split ramus osteotomy for mandibular advancement, and genioplasty. The patient complained of headache and somnolence on the first postoperative day (POD) and developed sudden right hemiplegia at POD 2. Computed tomography (CT) showed the line of fracture extending from the maxillary osteotomy to the left optic canal and to the left carotid canal, with osseous fragments impinging the petrous segment of the internal carotid artery. It also revealed an ischemic stroke related to the left middle cerebral artery territory. The patient underwent a left decompressive craniectomy on the same day.
At POD 12, he was transferred by airplane to our institution, located 3000 km away, to receive better medical treatment and start neurological rehabilitation. At admission, neurological examination revealed right hemiplegia, severe motor aphasia, and absent left direct pupillary light reflex with consensual preservation, suggesting left amaurosis due to optic nerve dysfunction. CT and AngioCT better detailed the fractures and neurological injuries
Treatment was focused on clinical stabilization, infection management, orthognathic care, and neurorehabilitation, with specialized physiotherapy, occupational therapy, speech therapy, a nutritionist, and psychology. Several other complications during hospitalization were aspiration pneumonia, urinary tract and COVID-19 infections, hyponatremia, haloperidol impregnation, non-steroidal anti-inflammatory drug (NSAID) allergic reaction, and need for tracheostomy and gastrostomy. At POD 36, with hemiplegia, aphasia, and swallowing partially recovered, the patient was transferred to a specialized transition care clinic and later discharged home after a month.
CT scans performed during follow-up noted left frontal encephalomalacia development and compensatory ipsilateral ventricular enlargement, preventing the skin flap and brain to accommodate naturally inside the craniectomy skull defect. Cranioplasty, with an external ventricular drainage brief placement and polymethyl methacrylate prosthesis confection, was performed 7 months after the ischemic stroke and involved neurosurgeons and plastic surgeons. The hemiplegia and aphasia partially recovered during 12 months of follow-up, and final dental occlusion was appropriate. This report was approved by our institutional ethics committee, and patient consent was given.
tldr-. incel in brazil wants to get an aesthetic bimax , ends up with brain damage , half of his skull gone and a tracheostomy.
But life is precious bro , go slay and thanks for the money goyim
