RESUMO
Intraneural ganglion cyst of the tibial nerve is very rare. To date, only 5 cases of this entity in the popliteal fossa have been reported. We report a new case and review the previously reported cases. A 40-year-old man experienced a mild vague pain in the medial half of his right foot for 3 years. Magnetic resonance imaging scan demonstrated a soft-tissue mass along the right tibial nerve. At surgery, an intraneural ganglion cyst was evacuated. After 12 months, the patient was pain-free with no signs of recurrence. Trauma might be a contributing factor to the development of intraneural ganglion cysts. Application of microsurgical techniques is encouraged.
Assuntos
Cistos Glanglionares/diagnóstico , Cistos Glanglionares/fisiopatologia , Nervo Tibial/patologia , Nervo Tibial/fisiopatologia , Neuropatia Tibial/diagnóstico , Neuropatia Tibial/fisiopatologia , Adulto , Diagnóstico Diferencial , Erros de Diagnóstico/prevenção & controle , Pé/inervação , Pé/fisiopatologia , Cistos Glanglionares/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Microcirurgia/métodos , Microcirurgia/normas , Procedimentos Neurocirúrgicos/métodos , Procedimentos Neurocirúrgicos/normas , Dor/etiologia , Dor/fisiopatologia , Ciática/diagnóstico , Ciática/fisiopatologia , Nervo Tibial/cirurgia , Neuropatia Tibial/cirurgia , Resultado do TratamentoRESUMO
BACKGROUND: Up to now, extra-dural haematomas (EDH) in elderly patients have been known for their poor prognosis and few studies have focused on the particularity of EDH in the elderly. Most clinical studies relating to EDH have generally focused on its occurrence in children and the middle-aged, grouping people of over 50 and 60 years together as the elderly. The purpose of this paper is to present a series of EDH cases in the elderly. METHOD: 500 EDH patients (of all ages) were admitted to our Department from January 1990 to December 2003 and this is a retrospective study of 14 of those patients who were aged 70 years and over. FINDINGS: The study consists of 8 women and 6 men with an average age of 74 years. A high incidence of disease predisposes elderly to falls, which are the most frequent cause of head trauma. The elderly are less likely to manifest signs or symptoms of increased intracranial pressure due to cerebral atrophy, and almost all haematomas occurred in the parietal area. Post-operative results were satisfactory and only one death was recorded. CONCLUSION: This study shows that the elderly, presenting EDH after a fall, have a better prognosis than is often feared.
Assuntos
Acidentes por Quedas/mortalidade , Hematoma Epidural Craniano/diagnóstico , Hematoma Epidural Craniano/mortalidade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Transtornos Cognitivos/etiologia , Transtornos Cognitivos/fisiopatologia , Comorbidade , Craniotomia , Descompressão Cirúrgica , Feminino , Hematoma Epidural Craniano/cirurgia , Humanos , Masculino , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/fisiopatologia , Prognóstico , Estudos Retrospectivos , Hemorragia Subaracnóidea/diagnóstico , Hemorragia Subaracnóidea/mortalidade , Hemorragia Subaracnóidea/cirurgia , Telencéfalo/diagnóstico por imagem , Telencéfalo/imunologia , Telencéfalo/patologia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
The authors report a case of a huge colloid cyst of the septum pellucidum with acute worsening. A 42-year-old man was admitted for unexplained lethargy. A brain CT scan disclosed a huge intra-ventricular lesion. He experienced a sudden deterioration with coma, and was managed with bilateral ventricular external shunting. Total removal was performed a few days later using a right frontal trans-ventricular approach. The discussion focuses on colloid cyst potential to mimic other intracranial lesions, rendering accurate diagnosis difficult and leading to possibly inappropriate management in similar cases.
