Assuntos
Acondroplasia , Ligamento Amarelo , Ossificação Heterotópica , Acondroplasia/diagnóstico por imagem , Humanos , Ligamento Amarelo/diagnóstico por imagem , Ligamento Amarelo/cirurgia , Região Lombossacral , Ossificação Heterotópica/diagnóstico por imagem , Ossificação Heterotópica/cirurgia , OsteogêneseRESUMO
BACKGROUND: Extensive spinal epidural hydatidosis may contribute to extensive spinal cord compression. Multilevel laminectomy with surgical excision remains the gold standard for treating these lesions which are typically invasive, and have a high recurrence rate. CASE DESCRIPTION: A 35-year-old female with recurrent extensive spinal epidural hydatid cysts was treated with a limited laminectomy and uniquely with irrigation-aspiration with isotonic saline water through an epidural catheter under fluoroscopic guidance and x-ray control. The postoperative MRI documented the hydatid cysts have collapsed and the patient's paraparesis improved. She developed no disease recurrence or renewed deficits over the next 12 months. CONCLUSION: Through a laminectomy, an epidural catheter may be introduced under fluoroscopic guidance/x-ray control to uniquely irrigate with isotonic saline/aspirate and decompress-the epidural hydatid cysts. This is particularly useful in patients with significant comorbidities, who are not candidates for more aggressive surgical decompression. Further, all patients should be continued on prolonged chemotherapy and should be monitored closely due to the high rate of recurrence of these cysts.
RESUMO
We present a case of a papillary tumour at the cerebellopontine angle in a 54-year-old man. He presented with right-sided ear pain associated with dizziness and hearing loss. The radiological diagnosis was in favor of acoustic neurinoma. Surgical excision was performed and the diagnosis of the endolymphatic sac tumour was made. Endolymphatic tumour is a low grade adenocarcinoma that originates from the endolymphatic sac. The definitive diagnosis requires a combination of clinical features, radiological finding and pathological correlation.
Assuntos
Adenocarcinoma/diagnóstico , Neoplasias Cerebelares/diagnóstico , Ângulo Cerebelopontino/patologia , Neoplasias da Orelha/diagnóstico , Adenocarcinoma/etiologia , Adenocarcinoma/patologia , Neoplasias Cerebelares/patologia , Tontura , Neoplasias da Orelha/patologia , Saco Endolinfático/patologia , Perda Auditiva/etiologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Granular cell astrocytoma (GCA) is a rare type of infiltrative brain tumor with most reported cases occurring in the suprasellar region. A pineal localization is extremely rare, with only 4 previously reported cases in the literature. The authors describe the case of a 16-year-old boy who developed signs of increased intracranial pressure and Parinaud syndrome. Cranial CT and MRI revealed a well-demarcated and enhanced mass in the pineal region accompanied by obstructive hydrocephalus. Subtotal resection was performed via a subtemporal approach. A histological diagnosis of GCA was made. Three years after surgery, the patient was alive and well without adjuvant therapy, and serial MRI showed no signs of progression of a small residual tumor. After a thorough review of the different epidemiological, clinical, and imaging features; treatments; and prognoses of GCAs in other intracranial localizations, the authors analyzed features of this tumor in the pineal region.
Assuntos
Astrocitoma/diagnóstico , Astrocitoma/cirurgia , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/cirurgia , Tumor de Células Granulares/diagnóstico , Tumor de Células Granulares/cirurgia , Hidrocefalia/etiologia , Glândula Pineal , Adolescente , Astrocitoma/química , Astrocitoma/complicações , Astrocitoma/patologia , Biomarcadores Tumorais/análise , Neoplasias Encefálicas/química , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/patologia , Diagnóstico Diferencial , Tumor de Células Granulares/química , Tumor de Células Granulares/complicações , Tumor de Células Granulares/patologia , Cefaleia/etiologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Neoplasia Residual/diagnóstico , Glândula Pineal/patologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Vertigem/etiologiaAssuntos
Encefalopatias/diagnóstico por imagem , Neoplasias Encefálicas/diagnóstico por imagem , Tuberculoma Intracraniano/diagnóstico por imagem , Encefalopatias/patologia , Criança , Diagnóstico Diferencial , Lobo Frontal/patologia , Humanos , Masculino , Lobo Parietal/patologia , Lobo Temporal/patologia , Tomografia Computadorizada por Raios X , Tuberculoma Intracraniano/patologiaRESUMO
Pediatric intramedullary schwannoma without neurofibromatosis is extremely rare with only five cases reported so far. We present this rare finding in an 10-year-old boy who presented with a sudden onset of weakness in the lower limbs. An intraoperative diagnosis of schwannoma enabled us to carry out a total excision of the tumor, which resulted in near complete recovery at 10 months follow-up. Although rare, this diagnosis should be considered when a child presents with a solitary intramedullary tumor since its total resection can be achieved improving surgical outcome.
Assuntos
Neurilemoma/diagnóstico , Neurofibromatoses/complicações , Neoplasias da Coluna Vertebral/diagnóstico , Criança , Humanos , Imageamento por Ressonância Magnética , Masculino , Neurilemoma/complicações , Neoplasias da Coluna Vertebral/complicaçõesAssuntos
Infecções por Campylobacter/diagnóstico , Infecções por Campylobacter/patologia , Campylobacter fetus/isolamento & purificação , Empiema Subdural/diagnóstico , Empiema Subdural/patologia , Hematoma Subdural Crônico/complicações , Idoso , Encéfalo/diagnóstico por imagem , Infecções por Campylobacter/microbiologia , Infecções por Campylobacter/cirurgia , Empiema Subdural/microbiologia , Empiema Subdural/cirurgia , Humanos , Masculino , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: Intracranial dural arteriovenous fistulas with perimedullary venous drainage (IDAVFPD) are classified as type V dural arteriovenous fistulas. Publications are limited to single case reports and small case series. We conducted a systematic review of the literature for patients with IDAVFPD. The aim of this study is to identify the predictive factors of poor prognosis in patients with IDAVFPD. METHODS: We present the case of a 48-year-old man who underwent surgical interruption of IDAVFPD. A complete MEDLINE search was then undertaken for all articles reporting outcomes data for IDAVFPD. According to the results we have divided the patient population into two groups: I, those patients who showed improvement after treatment, and II: those patients who did not show improvement. We conducted a comparative statistical analysis of the epidemiologic, clinical, radiologic, and therapeutic parameters between the two groups. RESULTS: A total of 37 articles comprising with 58 cases were included for analysis with an average follow-up of 12 months. There were 36 patients in group I and 22 in group II. The average age was 57.8 years in group I and 54.3 years in group II (P=0.32). Onset of symptoms was acute or subacute in 57% of patients in group I, and in 50% of patients in group II (P=0.62). Bulbar signs were present in 28% of cases in group I and in 36% of cases in group II (P=0.49). Hyperintensity of the brainstem on T2-weighted sequence magnetic resonance imaging was more common in patients in group II (78%) compared with patients in group I (45%) (P=0.012). Patients who underwent surgical procedure have shown good outcomes compared to patients treated with endovascular approach (P=0.039). CONCLUSIONS: The poor outcomes were correlated to the presence of brainstem signal abnormalities on magnetic resonance imaging, whereas the prognosis does not depend on age, sex, clinical presentation, or anatomic characteristics of the fistula.
Assuntos
Malformações Vasculares do Sistema Nervoso Central/patologia , Malformações Vasculares do Sistema Nervoso Central/fisiopatologia , Malformações Arteriovenosas Intracranianas/patologia , Malformações Arteriovenosas Intracranianas/fisiopatologia , Malformações Vasculares do Sistema Nervoso Central/diagnóstico por imagem , Angiografia Cerebral , Circulação Cerebrovascular/fisiologia , Diagnóstico Diferencial , Drenagem , Humanos , Malformações Arteriovenosas Intracranianas/diagnóstico por imagem , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , PrognósticoAssuntos
Cauda Equina/patologia , Neurilemoma/diagnóstico por imagem , Neurilemoma/patologia , Neoplasias do Sistema Nervoso Periférico/diagnóstico por imagem , Neoplasias do Sistema Nervoso Periférico/patologia , Cauda Equina/diagnóstico por imagem , Feminino , Humanos , Claudicação Intermitente/diagnóstico por imagem , Claudicação Intermitente/etiologia , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Invasividade Neoplásica , Neurilemoma/complicações , Neoplasias do Sistema Nervoso Periférico/complicações , Tomografia Computadorizada por Raios X , Carga TumoralAssuntos
Linfoma de Burkitt/complicações , Neuralgia do Trigêmeo/etiologia , Adolescente , Linfoma de Burkitt/diagnóstico , Seio Cavernoso/patologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Lobo Temporal/diagnóstico por imagem , Lobo Temporal/patologia , Tomografia Computadorizada por Raios X , Neuralgia do Trigêmeo/diagnósticoAssuntos
Doenças Cerebelares/tratamento farmacológico , Fluoxetina/uso terapêutico , Mutismo/tratamento farmacológico , Complicações Pós-Operatórias/tratamento farmacológico , Adolescente , Doenças Cerebelares/diagnóstico , Doenças Cerebelares/etiologia , Humanos , Masculino , Mutismo/diagnóstico , Mutismo/etiologia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Resultado do TratamentoAssuntos
Calcinose/etiologia , Hérnia/etiologia , Laminectomia/efeitos adversos , Complicações Pós-Operatórias/etiologia , Radiculopatia/etiologia , Calcinose/patologia , Calcinose/cirurgia , Hérnia/patologia , Herniorrafia , Humanos , Vértebras Lombares/cirurgia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/patologia , Complicações Pós-Operatórias/cirurgia , Radiculopatia/patologia , Radiculopatia/cirurgia , Raízes Nervosas Espinhais/patologiaRESUMO
Giant cerebral cavernoma is a rare malformation classified as a brain occult vascular lesion. We report a case of initially misdiagnosed giant cavernous angioma revealed by a spontaneous intracerebral hemorrhage. A 40-year-old woman was admitted with right hemiplegia and altered consciousness occurring 3 days prior to presentation. A non-contrast CT scan showed a left parietal gross hematoma, and she was immediately taken to the operating room for emergency surgery. However, the procedure was interrupted by massive bleeding, and therefore a vascular lesion was suspected. Magnetic resonance images suggested a giant cavernous malformation. Afterward, she underwent total removal of this lesion. The postoperative period was uneventful, and histopathological examination confirmed the diagnosis of cavernous angioma. Thus, the differential diagnosis of gross spontaneous intracerebral hematoma should include giant cavernous angioma.