RESUMO
PURPOSE: Superficial siderosis, a progressive, debilitating, neurological disease, often presents with bilateral impairment of auditory and vestibular function. We highlight that superficial siderosis is often due to a repairable spinal dural defect of the type that can also cause spontaneous intracranial hypotension. METHODS: Retrospective chart review of five patients presenting with moderate to severe, progressive bilateral sensorineural hearing loss as well as vestibular loss. All patients had developed superficial siderosis from spinal dural defects: three after trauma, one after spinal surgery and one from a thoracic discogenic microspur. RESULTS: The diagnosis was made late in all five patients; despite surgical repair in four, hearing and vestibular loss failed to improve. CONCLUSIONS: In patients presenting with progressive bilateral sensorineural hearing loss, superficial siderosis should be considered as a possible cause. If these patients also have bilateral vestibular loss, cerebellar impairment and anosmia, then the diagnosis is likely and the inevitable disease progress might be halted by finding and repairing the spinal dural defect.
Assuntos
Perda Auditiva Neurossensorial , Siderose , Humanos , Siderose/complicações , Siderose/diagnóstico , Estudos Retrospectivos , Audição , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/etiologia , Imageamento por Ressonância Magnética/efeitos adversosRESUMO
Carcinoid tumours are malignant tumours of neuroendocrine origin. Spinal-cord compression from carcinoid metastasis is uncommon, and intradural spinal carcinoid is rare. We report an instance of intramedullary carcinoid metastasis of the conus medullaris in the context of stable, asymptomatic systemic disease. To our knowledge this is the first reported case of intramedullary carcinoid metastasis.
Assuntos
Tumor Carcinoide/diagnóstico , Carcinoma Broncogênico/diagnóstico , Neoplasias Pulmonares/diagnóstico , Compressão da Medula Espinal/diagnóstico , Neoplasias da Medula Espinal/diagnóstico , Neoplasias da Medula Espinal/secundário , Adulto , Tumor Carcinoide/cirurgia , Carcinoma Broncogênico/cirurgia , Feminino , Humanos , Neoplasias Pulmonares/cirurgia , Compressão da Medula Espinal/cirurgia , Neoplasias da Medula Espinal/cirurgiaRESUMO
Quadriplegia developed suddenly 1 month after coarctation repair in a 53-year-old human. Cervical cord ischemia caused by thrombosis in an enlarged anterior spinal artery collateral was diagnosed on magnetic resonance scan and spinal angiography. After urgent cord decompression and anticoagulation there was neurologic improvement over a period of several months. Urgent investigation of neurologic abnormalities occurring late after coarctation repair may enable intervention to avert permanent neurologic sequelae.