RESUMO
INTRODUCTION: Benign sphenoid meningioma presenting with an acute intraventricular hemorrhage is extremely uncommon. CASE REPORT: We report a case of a 61-year-old man who was admitted after sudden onset of a severe headache. Brain computed tomography revealed a sphenoid meningioma with acute intraventricular hemorrhage. DISCUSSION: Intraventricular hemorrhage caused by Meningiomas is infrequent. Several hypotheses have been proposed to explain the cause of hemorrhage. CONCLUSION: The benignity of meningiomas is relative because these tumors can cause exceptional complications such as bleeding.
Assuntos
Hemorragia Cerebral/etiologia , Neoplasias Meníngeas/complicações , Meningioma/complicações , Hemorragia Cerebral/diagnóstico por imagem , Hemorragia Cerebral/patologia , Humanos , Masculino , Neoplasias Meníngeas/diagnóstico por imagem , Neoplasias Meníngeas/patologia , Meningioma/diagnóstico por imagem , Meningioma/patologia , Pessoa de Meia-Idade , Neuroimagem , Tomografia Computadorizada por Raios XRESUMO
Introduction Intraspinal gas is a common clinical finding, but an epidural gas pseudocyst in association with lateral disc herniation compressing a nerve root is an exceptional observation. Case Report A 49-year-old man was admitted to our department presenting with sciatica. The neurological examination demonstrated moderate lumbar pain without neurological deficit. A lumbosacral computed tomography showed the presence of degenerated disc herniation and epidural gas collection. Discussion The pathological association between the cyst and the hernia is probably due to the migration of gas pumped from the intervertebral space through a breaking point or lower in the annulus fibrosis, involving its contiguity with the herniated disc. Conclusion An association between a disc herniation and a gas pseudocyst can be a cause of sciatica.
Introdução O gás intraespinal é um achado clínico comum, mas um pseudocisto epidural de gás associado a herniação discal lateral comprimindo uma raiz nervosa é uma observação excepcional. Relato de caso Um homem de 49 anos de idade foi admitido em nosso departamento apresentando sintomas de ciática. O exame neurológico demonstrou dor lombar moderada sem déficit neurológico. A tomografia computadorizada lombossacral mostrou presença de hérnia discal degenerada e coleta epidural de gás. Discussão A associação patológica entre o cisto e a hérnia é provavelmente devida à migração do gás bombeado do espaço intervertebral através de um ponto de ruptura ou menor na fibrose do anel, envolvendo a sua contiguidade com o disco herniado. Conclusão Uma associação entre uma hérnia de disco e um pseudocisto de gás pode ser uma das causas de ciática.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Pneumocefalia , Deslocamento do Disco Intervertebral , CiáticaRESUMO
Only a few publications regarding traumatic hematoma in spinal ligament have been reported compared to spontaneous spinal hematoma. This type of bleeding is classically associated with bone fracture and/or the presence of haemostasis abnormalities. However, in our case the patient presented with traumatic dorsal hematoma in spinal ligament without any associated disc or bone lesion, and no crasis problems. We report a case of a 50-year-old man, who was a victim of a car accident. Neurological examination revealed paraplegia and hypoesthesia below the T4 sensory dermatome. Spinal magnetic resonance imaging revealed an acute hematoma in spinal ligament extending from T5 to T7with spinal cord compression. The patient was not operated; the evolution was marked by spontaneous resorption of hematoma with the gradual recovery of the neurological deficit using functional reeducation.
Assuntos
Equinococose/patologia , Doenças da Coluna Vertebral/patologia , Síndrome de Brown-Séquard/complicações , Síndrome de Brown-Séquard/diagnóstico por imagem , Síndrome de Brown-Séquard/patologia , Síndrome de Brown-Séquard/cirurgia , Equinococose/complicações , Equinococose/diagnóstico por imagem , Equinococose/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Doenças da Coluna Vertebral/complicações , Doenças da Coluna Vertebral/diagnóstico por imagem , Doenças da Coluna Vertebral/cirurgiaAssuntos
Cefaleia/etiologia , Neoplasias Meníngeas/complicações , Neoplasias Meníngeas/patologia , Meningioma/complicações , Meningioma/patologia , Craniotomia , Traumatismos Cranianos Fechados/complicações , Hematoma Subdural Intracraniano/etiologia , Hematoma Subdural Intracraniano/patologia , Hematoma Subdural Intracraniano/cirurgia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Pancoast syndrome remains a rare presentation of pulmonary diseases. Even in endemic area of echinococcosis, lung's hydatid cyst is seldomly revealed by this syndrome. We report a case of a 38 year old male patient who presented to our department with neck and left superior limb pain associated with palmar muscle atrophy and Horner's syndrome. Radiological investigations suggested the diagnosis of hydatid cyst of the left lung apex which was confirmed by surgical excision and pathological examination of the lesion. This case highlights an uncommon etiology of Pancoast syndrome which might mislead physicians in their practice.
Assuntos
Equinococose/complicações , Pneumopatias Parasitárias/complicações , Síndrome de Pancoast/parasitologia , Adulto , Humanos , MasculinoAssuntos
Anormalidades Múltiplas/diagnóstico por imagem , Coluna Vertebral/anormalidades , Anormalidades Múltiplas/embriologia , Cóccix/anormalidades , Feminino , Humanos , Lactente , Vértebras Lombares/anormalidades , Masculino , Meningomielocele/diagnóstico por imagem , Meningomielocele/embriologia , Mesoderma/anormalidades , Gravidez , Gravidez em Diabéticas , Radiografia , Sacro/anormalidades , Coluna Vertebral/diagnóstico por imagem , Coluna Vertebral/embriologia , Síndrome , Siringomielia/congênito , Siringomielia/diagnóstico por imagem , Siringomielia/embriologiaAssuntos
Traumatismo Múltiplo/diagnóstico por imagem , Fraturas da Coluna Vertebral/diagnóstico por imagem , Vértebras Torácicas/lesões , Acidentes de Trânsito , Adulto , Feminino , Humanos , Traumatismo Múltiplo/cirurgia , Procedimentos de Cirurgia Plástica , Fraturas da Coluna Vertebral/cirurgia , Vértebras Torácicas/cirurgia , Tomografia Computadorizada por Raios XAssuntos
Subluxação do Cristalino/complicações , Subluxação do Cristalino/diagnóstico , Neoplasias do Nervo Óptico/complicações , Neoplasias do Nervo Óptico/diagnóstico , Neoplasias do Nervo Óptico/secundário , Cegueira/diagnóstico , Cegueira/etiologia , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/patologia , Diagnóstico Tardio , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Bone involvement is a common finding in many types of lymphoma. Cranial vault involvement is extremely rare, and the majority of patients are found at staging to have concurrent disease in lymph nodes. Thirty-eight cases of primary lymphoma of the cranial vault have been reported to date. METHODS: This article presents a rare case of primary cranial vault lymphoma and conducts a systematic review of the current literature. A total of 36 articles comprising 38 cases were included for analysis. The relevant demographic, clinical, and imaging characteristics, as well as the treatment and outcomes of this unique disease presentation were studied. RESULTS: The average patient age was 60 years. There was no significant difference in patient gender. The predominant patient complaint was a subcutaneous scalp mass. Of the patients, 11.7% were immunocompromised. CT scans showed signs of osteolysis in 74% of lesions and hyperostosis in 5%, and the cranial vault was observed as normal in 18% of cases. MRI was performed in 23 cases. There was a wide range of histological subtypes, with a slight predominance of diffuse large B-cell lymphoma. Treatment consisted of surgery alone, surgery followed by radiotherapy, and surgery followed by radiotherapy and chemotherapy. The follow-up periods ranged from 5 months to 6 years, with a median value of 7 months. Sixteen patients were followed up to 12 months; 13 of them were alive at 1 year from diagnosis. CONCLUSION: Primary cranial vault lymphoma is an extremely rare finding. It should be considered in the differential diagnosis of scalp masses. Although the analysis of outcome of the reported cases is difficult because of the small number of occurrences of this entity and the variability of follow-up, a combination of surgery, radiotherapy, and chemotherapy seems to offer better outcomes.
Assuntos
Biomarcadores Tumorais/análise , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Linfoma de Zona Marginal Tipo Células B/patologia , Neoplasias Meníngeas/diagnóstico , Neoplasias Meníngeas/patologia , Neoplasias Cranianas/diagnóstico , Neoplasias Cranianas/patologia , Antígenos CD20/análise , Humanos , Linfoma de Zona Marginal Tipo Células B/química , Imageamento por Ressonância Magnética , Masculino , Neoplasias Meníngeas/química , Pessoa de Meia-Idade , Neoplasias Cranianas/químicaAssuntos
Neoplasias Encefálicas/patologia , Encéfalo/patologia , Cisto Dermoide/patologia , Transtornos da Cefaleia/etiologia , Transtornos Parkinsonianos/etiologia , Encéfalo/diagnóstico por imagem , Encéfalo/cirurgia , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/fisiopatologia , Craniotomia , Cisto Dermoide/diagnóstico por imagem , Cisto Dermoide/cirurgia , Feminino , Lobo Frontal/diagnóstico por imagem , Lobo Frontal/patologia , Lobo Frontal/cirurgia , Lateralidade Funcional/fisiologia , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos , Paresia/etiologia , Lobo Temporal/diagnóstico por imagem , Lobo Temporal/patologia , Lobo Temporal/cirurgia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Tremor/etiologiaRESUMO
Os odontoideum is an uncommon abnormality of the cranio-vertebral junction (CVJ) that exists as a separate ossicle apart from a hypoplastic dens. Its genesis and natural history have been debated, and its proper treatment remains uncertain. A 48-year-old woman complained of persistent upper neck pain and paraesthesia of her left side. Magnetic resonance imaging of the CVJ demonstrated an os odontoideum. Dynamic computed tomography scan of the CVJ showed a reduction of the space available for the spinal cord to 50% from extended to flexed position. The patient underwent posterior spinal fusion of C1-C2 using a sublaminar titanium hook and rods fixed in moderate extension. We discuss the usefulness of the dynamic computed tomography (CT) scan in the evaluation of atlantoaxial motion and the management of this pathology.