RESUMO
Botulinum toxin injections are the most effective approach for the treatment of focal dystonia. Despite growing demand and clinical indications over the years, there are few reports or publications of its use and benefit to patients seen at the Sistema Único de Saúde - SUS (Unified Health System). Analyzing the Datasus data (Unified Health System Information Department of Brazilian Ministry of Health), it was noticed that in Brazil the percentage of dystonic patient benefited from this procedure is still low. We therefore suggest some strategies to increase the dispensation of the toxin by the Brazilian Unified Health system for the dystonic patients.
RESUMO
Os autores apresentam um caso raro de um neurinoma cervical em paciente que vinha apresentando inicialmente sintomas relacionados com hidrocefalia. Os sintomas melhoraram inicialmente apos a colocaçäo de derivaçäo ventrículo-peritoneal (DVP), embora a tetraparesia progredisse. A TC de cronio pos-operatoria mostrou catéter ventricular bem posicionado e normalizado do tamanho dos ventrículos. Ressonancia magnética de coluna cervical revelou tumor intradural, extramedular, no nível. Apás a ressecçäo tumoral, houve importante melhora da tetraparesia. Em casos de hidrocefalia de causa desconhecida, deve-se procurar descartar a existência de tumores intraraquidianos.