RESUMEN
PURPOSE: Selective dorsal rhizotomy (SDR) is a surgical technique used to treat spasticity in children secondary to cerebral palsy (CP). METHOD: We report, to the best of our knowledge for the first time, the case of a child who underwent SDR for the management of spasticity secondary to Leigh syndrome. RESULT: SDR resulted in excellent functional outcome with significant improvement in spasticity. This result contributes to the mounting evidence that SDR could be used to alleviate spasticity secondary not only to CP but also to other pathologies as well.
Asunto(s)
Manejo de la Enfermedad , Enfermedad de Leigh/complicaciones , Enfermedad de Leigh/cirugía , Espasticidad Muscular/etiología , Espasticidad Muscular/cirugía , Rizotomía , Adolescente , Humanos , Enfermedad de Leigh/diagnóstico por imagen , Masculino , Espasticidad Muscular/diagnóstico por imagen , Rizotomía/métodos , Resultado del TratamientoRESUMEN
PURPOSE: Selective dorsal rhizotomy (SDR) is a neurosurgical procedure used to treat spasticity in children with cerebral palsy (CP). The vast majority of studies to date suggest SDR is particularly effective in reducing lower limb spasticity in spastic diplegia with long-lasting effect. METHOD: We report, to the best of our knowledge for the first time, the case of a teenager who underwent SDR for the management of spasticity secondary to transverse myelitis. RESULTS: This is an unusual indication for SDR which resulted in completely loose lower limbs and an excellent functional outcome. At a follow-up 18 months following the procedure, the child had no re-occurrence of his symptoms. CONCLUSION: This report raises the possibility that the use of SDR could be expanded to include other pathologies. We discuss the case and the relevant literature. Our spasticity service at NUH has to date inserted 300 baclofen pumps and performed 60 SDRs mainly in children with cerebral palsy.
Asunto(s)
Espasticidad Muscular/etiología , Espasticidad Muscular/cirugía , Mielitis Transversa/complicaciones , Rizotomía/métodos , Resultado del Tratamiento , Adolescente , Humanos , Imagen por Resonancia Magnética , Masculino , Médula Espinal/patologíaRESUMEN
We report the case of a 14-month-old infant presenting with unresponsiveness and seizure following thoracic surgery. Imaging showed full territory left middle cerebral artery infarct and signs of raised intracranial pressure (ICP) that required emergency decompressive craniectomy (DC). The child made a good functional recovery. We discuss the case.
Asunto(s)
Craniectomía Descompresiva , Infarto de la Arteria Cerebral Media/cirugía , Tratamiento de Urgencia , Humanos , Lactante , Hipertensión Intracraneal/etiología , Hipertensión Intracraneal/cirugía , Masculino , Resultado del TratamientoRESUMEN
We report a case of an interventricular ependymoma which was surgically removed but also required bilateral transection of the fornices resulting in memory impairment which gradually improved. Functional MR images using a memory paradigm showed that recovery correlated with cortical plasticity involving activation of the orbitofrontal cortex and the middle temporal gyrus.
