Paraplegia due to spinal meningioma during the third trimester of pregnancy: case report and literature review.

INTRODUCTION: Spinal meningiomas represent 25-45% of intradural spinal tumors and ~2% of meningiomas of the central nervous system (CNS), and their occurrence during pregnancy is unusual. We present an updated literature review. CASE REPORT: A 36-year-old woman, at 32.6 weeks of gestation, was hospitalized for urinary tract infection and urinary retention. One month earlier, she had decreased strength in lower limbs, and this weakness rapidly progressed to flaccid paraplegia without sphincters control. Magnetic resonance imaging (MRI) revealed a well-defined intradural extramedullary lesion in T3-T4. Using a posterolateral approach, the tumor was completely removed; however, there was no clinical improvement, and the patient was discharged with an impairment scale (AIS) grade A. Histopathology examination indicated a psammomatous meningioma. DISCUSSION: Meningiomas are benign tumors that are slowly progressive; however, the hemodynamic and hormonal changes of pregnancy are related to their accelerated growth. Reports show that the onset of the symptoms during the third trimester of pregnancy, including early neurological symptoms or signs of spinal cord compression, can be easily attributed to those of pregnancy by both the patient and the doctor. The time to diagnosis and medulla compression time are thus prolonged, which can be further compounded in middle-high income countries due to limitations in obtaining images for evaluation. Although rare, spinal meningiomas should be considered in the differential diagnosis of patients with neurological symptoms during pregnancy. Their early recognition is important to avoid irreversible neurological damage.

Evolución del tratamiento de la tuberculosis en Colombia / Evolution of the treatment of tuberculosis in Colombia

Con base en los artículos escritos por autores colombianos entre 1.901 y 1.976, se persiguió identificar el concepto de la Tuberculosis y su correlación con el tratamiento dado en cada una de las diferentes etapas de su evolución. Para ello, cada uno de los artículos fue reseñado y clasificado de acuerdo a su contenido en categorias así: diagnóstico, tratamiento, enfermedad general o mixto, para luego reclasificarlos según sus aportes, dando así las herramientas al análisis final. Durante el análisis se identificaron varios periodos internos no siempre hallándose correlación entre el concepto y el tratamiento antituberculoso. Además se encontró que el tratamiento es un reflejo del avance médico extranjero, el cual se copia y aplica en el medio colombiano