Historia natural de la hernia de disco lumbar. ¿Tiene el realce con gadolinio valor pronóstico? / Natural history of lumbar disc hernias: does gadolinium enhancement have any prognostic value?

Objetivos. Evaluar qué porcentaje de hernias de disco desaparece tras un año de seguimiento y a qué ritmo; valorar si el uso del realce con gadolinio en RM tiene valor predictivo de la desaparición de la hernia; y estudiar si el patrón del realce ayuda a predecir la desaparición del fragmento. Material y métodos. Se incluyeron en este estudio prospectivo 118 pacientes con clínica de lumbociática aguda y que presentaban una hernia de disco diagnosticada mediante TC. A 72 pacientes se les realizó una RM con gadolinio cada 6 meses hasta el año o hasta que la hernia de disco desaparecía, y se relacionó la presencia de protrusión, extrusión y el patrón de realce con la desaparición o persistencia del material discal. Se realizó un estudio estadístico univariable y multivariable. Resultados. Un 59% de las hernias de disco desaparecieron tras un año de seguimiento, y de ellas el 66% lo hicieron en los primeros 8 meses. Un 83% de las hernias extruidas desaparecieron, y este dato tiene significación estadística en el análisis multivariable (p < 0,005). La ausencia de realce tiene asociación con la persistencia de la hernia, con significación estadística en el análisis univariable. El patrón de realce no ayuda a predecir la desaparición de la hernia. Hubo 5 hernias que desaparecieron muy pronto, dentro de los primeros 2 meses. Conclusiones. Un alto porcentaje de hernias de disco desaparecen, se ha encontrado la asociación estadísticamente significativa entre extrusión y desaparición, y falta de correlación entre el patrón de captación de gadolinio y la desaparición de la hernia(AU)

Objectives. To evaluate the percentage of disc hernias that have disappeared after one year of follow-up and the time to disappearance. To determine whether gadolinium enhancement is useful for predicting whether the hernia will disappear. To analyze whether the pattern of enhancement can help predict whether the fragment will disappear. Material and methods. This prospective study included 118 patients with acute symptoms of lumbosciatica and a herniated disc diagnosed by CT. In 72 patients, we performed gadolinium-enhanced MRI every 6 months for one year or until the herniation disappeared; we related the findings of protrusion, extrusion, and the enhancement pattern with the disappearance or persistence of herniated disc material. We analyzed the results with univariate and multivariate statistics. Results. The 59% of the hernias disappeared within 1 year of follow-up and 66% disappeared within the first 8 months of follow-up. The 83% of the extruded hernias disappeared, and this was significant in the multivariate analysis (P<.005). The absence of enhancement was significantly associated with the persistence of the hernia in the univariate analysis. The enhancement pattern was not useful for predicting whether the hernia would disappear. Five hernias disappeared within the first two months. Conclusions. A high percentage of disc hernias disappear. We found a significant association between extrusion and disappearance but no correlation between the pattern of gadolinium uptake and the disappearance of the herni(AU)

[Natural history of lumbar disc hernias: does gadolinium enhancement have any prognostic value?]. / Historia natural de la hernia de disco lumbar. ¿Tiene el realce con gadolinio valor pronóstico?

OBJECTIVES: To evaluate the percentage of disc hernias that have disappeared after one year of follow-up and the time to disappearance. To determine whether gadolinium enhancement is useful for predicting whether the hernia will disappear. To analyze whether the pattern of enhancement can help predict whether the fragment will disappear. MATERIAL AND METHODS: This prospective study included 118 patients with acute symptoms of lumbosciatica and a herniated disc diagnosed by CT. In 72 patients, we performed gadolinium-enhanced MRI every 6 months for one year or until the herniation disappeared; we related the findings of protrusion, extrusion, and the enhancement pattern with the disappearance or persistence of herniated disc material. We analyzed the results with univariate and multivariate statistics. RESULTS: The 59% of the hernias disappeared within 1 year of follow-up and 66% disappeared within the first 8 months of follow-up. The 83% of the extruded hernias disappeared, and this was significant in the multivariate analysis (P<.005). The absence of enhancement was significantly associated with the persistence of the hernia in the univariate analysis. The enhancement pattern was not useful for predicting whether the hernia would disappear. Five hernias disappeared within the first two months. CONCLUSIONS: A high percentage of disc hernias disappear. We found a significant association between extrusion and disappearance but no correlation between the pattern of gadolinium uptake and the disappearance of the hernia.

[Ophthalmic presentation of two cases of esthesioneuroblastoma]. / Debut oftalmológico de dos casos de estesioneuroblastoma.

PURPOSE/METHOD: To report the ophthalmologic presentation of two cases of esthesioneuroblastoma (ENB). A comprehensive ophthalmic assessment was made, including magnetic resonance imaging. A paranasal sinus mass was biopsied in one case and a nasal mass biopsied in the other. CASES REPORT/DISCUSSION: Two women, aged 85 and 32 years respectively, presented to the emergency room with ophthalmic symptoms and signs. The first reported orbital pain and eyelid edema and the second, who was 22 weeks pregnant, reported a spontaneous lower eyelid haematoma, orbital pain and rhinorrhoea. ENB is a rare malignant tumour and its presentation with ophthalmologic symptoms and signs is very infrequent.

Debut oftalmológico de dos casos de estesioneuroblastoma / Ophthalmic presentation of two cases of esthesionneuroblastoma

Objetivo/Método: Presentar el debut de dos casos de estesioneuroblastoma (ENB) con manifestaciones oftalmológicas. Se realizó una exploración oftalmológica completa y estudios de imagen consistentes de Resonancia Magnética (RM). En un caso se realizó biopsia de una masa sinusal y en el otro de una masa nasal. Caso clínico/Discusión: Dos mujeres de 85 y 32 años, esta última embarazada de 21 semanas, acudieron de urgencia por síntomas y signos oculares. El primer caso refería dolor orbitario y edema de párpado y el segundo hematoma palpebral inferior espontáneo, dolor orbitario y rinorrea. El ENB es un tumor maligno poco frecuente que puede debutar con sintomatología oftalmológica

Purpose/Method: To report the ophthalmologic presentation of two cases of esthesioneuroblastoma (ENB). A comprehensive ophthalmic assessment was made, including magnetic resonance imaging. A paranasal sinus mass was biopsied in one case and a nasal mass biopsied in the other. Cases Report/Discussion: Two women, aged 85 and 32 years respectively, presented to the emergency room with ophthalmic symptoms and signs. The first reported orbital pain and eyelid edema and the second, who was 22 weeks pregnant, reported a spontaneous lower eyelid haematoma, orbital pain and rhinorrhoea. ENB is a rare malignant tumour and its presentation with ophthalmologic symptoms and signs is very infrequent (Arch Soc Esp Oftalmol 2008; 83: 317-320)

[Arachnoid metastasis of renal cell carcinoma: review of forms of tumor dissemination and review of its metastasis in the nervous system]. / Metástasis aracnoideas de un carcinoma de células renales: repaso de formas de diseminación del tumor y revision de sus metastásis en el sistema nervioso.

Contribution of one case of renal cells carcinoma, in an adult man, that during evolution developed arachnoid metastasis. The patient was first seen for a brain haemorrhage due to a bleeding metastasis. In later studies, a renal cells carcinoma was found to be the primary site of the brain condition. The evolution showed neurological manifestations in the limbs, and the arachnoid metastasis was detected. The paper includes imaging studies of the referred disease both al brain, renal and spinal level with CT and NMR studies. A revision is made of the different dissemination forms of renal cells tumours, as well as a review of the existing literature with regard to the nervous system metastasis. No case has been found in this review relative to spinal arachnoid dissemination.