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2.
J Surg Case Rep ; 2015(2)2015 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-25687442

RESUMO

Generally, giant cell tumors are rare and their localization in the spine is even more so. They are locally aggressive leading to spine instability and neurologic deficits. Radical excision is highly advocated. A role of radiotherapy in these tumors is controversial. We report the case of a giant cell tumor localized in D1 and D2 on a 39-year-old patient, presented with interscapular back pain, paraparesis grade 3/5 and sphincter dysfunction. Thoracic spine computed tomogarphy and magnetic resonance imaging showed a vertebral body tumor in D1 and D2, compressing the spinal cord at the same level. The patient initially underwent decompressive laminectomy of affected levels and stabilized with laminar hooks and rods. Second surgery performed through an anterior approach whereby tumor excision together with corpectomy of D1 and D2 carried out, autograft was placed and plate applied. Three weeks postoperatively, the patient's neurologic deficit recovered fully and back pain subsided.

3.
Neurochirurgie ; 60(6): 307-11, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25239381

RESUMO

Infundibular dilatations (IFDs) are conical, triangular, or funnel-shaped enlargements at the origin of cerebral arteries, and they are primarily located (7-25%) on the posterior communicating artery (PComA). Progression over time into a saccular aneurysm with a risk of rupture of a previously demonstrated IFD has rarely been reported. We report the case of a 60-year-old female who presented 10 years earlier with a subarachnoid hemorrhage caused by a left internal carotid artery aneurysm rupture. At that time, the carotid angiography showed the left internal carotid artery aneurysm and a right posterior communicating artery infundibular dilatation. Neck clipping for the left internal carotid artery aneurysm was performed and the patient was discharged with no neurological deficit. Ten years later, the patient suffered a second fatal subarachnoid hemorrhage; carotid angiography revealed a right posterior communicating artery aneurysm developed from the previously documented infundibular dilatation with a de novo right anterior choroidal artery aneurysm. This case is another proof of the small but growing number of examples of infundibular transformation over time, as well as their risk of progression into saccular aneurysms and subsequent rupture.


Assuntos
Aneurisma Roto/etiologia , Aneurisma Intracraniano/etiologia , Doenças das Artérias Carótidas/etiologia , Artéria Carótida Interna/patologia , Dilatação Patológica , Progressão da Doença , Feminino , Humanos , Pessoa de Meia-Idade , Risco , Hemorragia Subaracnóidea/etiologia , Fatores de Tempo
4.
Surg Neurol Int ; 5(Suppl 4): S208-10, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25184102

RESUMO

BACKGROUND: Schwannomas are tumors of peripheral nerves that develop from the nerve sheath. Foraminal schwannomas are rare and account for 1-5% of all spinal schwannomas. The lumbosacral root schwannoma is a rare cause of sciatica and may raise confusion in diagnosis with late discovery of the tumor. CASE DESCRIPTION: We report the case of a patient 30 years of age with chronic left sciatica in whom lumbosacral magnetic resonance imaging (MRI) revealed a tumor involving the S1 nerve root. The excision of the tumor was simple. Histological examination revealed a benign schwannoma. The evolution was favorable postoperative with no neurological deficit, which confirms the good prognosis of this tumor. CONCLUSION: Nerve root schwannomas should be considered in the differential diagnosis of sciatica, especially when signs and symptoms of sciatica cannot be simply explained by prolapsed disc syndrome, which can often delay the diagnosis. Through this case presentation, the authors try to discuss the clinical and radiological features of this condition.

6.
J Clin Neurosci ; 16(6): 840-1, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19297169

RESUMO

Aspergillosis of the sphenoid sinus is rare in immunocompetent patients. It may be mistaken for a sellar region tumor. A 65-year-old, human immunodeficiency virus-negative man presented with a 3-week history of cranial nerve III paresis and visual deterioration. The patient had a long-term history of tobacco snuff abuse. CT scans and MRI demonstrated a space-occupying lesion of the sellar and sphenoid sinus region. Presumptive diagnosis of pituitary macroadenoma was made and the patient was operated on via a transnasal-transsphenoidal approach. After the sphenoid sinus was opened, a yellow-brownish gluey material with crumbly debris extruded and was aspirated. The dura was intact. Histopathology revealed numerous Aspergillus hyphae without tissue invasion. Postoperatively, the cranial nerve III paresis resolved in a few days and visual acuity improved. Sphenoid sinus aspergillosis should be included in the differential diagnosis of sellar region processes, even in immunocompetent patients. Early diagnosis and transsphenoidal removal provides good results without the need for systemic antifungal therapy in non-invasive aspergillosis.


Assuntos
Neuroaspergilose/patologia , Neoplasias Hipofisárias/diagnóstico , Seio Esfenoidal/microbiologia , Seio Esfenoidal/patologia , Sinusite Esfenoidal/microbiologia , Sinusite Esfenoidal/patologia , Idoso , Aspergillus , Calcinose/diagnóstico por imagem , Calcinose/microbiologia , Calcinose/patologia , Diagnóstico Diferencial , Humanos , Imunocompetência , Imageamento por Ressonância Magnética , Masculino , Neuroaspergilose/diagnóstico por imagem , Neuroaspergilose/cirurgia , Doenças do Nervo Oculomotor/etiologia , Procedimentos Cirúrgicos Otorrinolaringológicos , Sela Túrcica/diagnóstico por imagem , Sela Túrcica/microbiologia , Sela Túrcica/patologia , Seio Esfenoidal/diagnóstico por imagem , Sinusite Esfenoidal/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Baixa Visão/etiologia
7.
J Neurol Sci ; 278(1-2): 123-6, 2009 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-19126443

RESUMO

Cavernous sinus involvement of tuberculosis is rare; only seven cases have been reported in the literature to date. Many factors make the diagnosis difficult in this location, necessitating a surgical procedure. We report the case of a 45-year-old man who presented with a left cavernous sinus syndrome clinically. The lesion mimicked a meningioma of the cavernous sinus in radiological examinations. It was entirely excised through a subtemporal approach. Histopathological examination revealed caseating granuloma and the diagnosis of tuberculoma was established. Postoperative antituberculous drugs completed the treatment and led to complete resolution of neurological symptoms. In our paper, we emphasize the rarity of the lesion in this location, we review all the cases previously published underlining the main epidemiological, clinical, radiological, therapeutic and prognostic features.


Assuntos
Seio Cavernoso/patologia , Meningioma/diagnóstico , Tuberculoma Intracraniano/diagnóstico , Diagnóstico Diferencial , Granuloma/diagnóstico , Granuloma/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Meningioma/patologia , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Tuberculoma Intracraniano/patologia
9.
Neurochirurgie ; 49(5): 540-4, 2003 Nov.
Artigo em Francês | MEDLINE | ID: mdl-14646820

RESUMO

Paraganglioma of the sellar and latero-sellar area is extremely rare. We report a case of latero-sellar and suprasellar paraganglioma of a 58-year-old women which caused deterioration of visual acuity and left exophthalmia without endocrine dysfunction. Magnetic resonance imaging showed a large tumor in the sellar and parasellar area, which extended to the left cavernous sinus and infiltrated the left orbit, the ethmoid, the sphenoidal sinus and the left pterygomaxillary fossa. Surgery by transcranial, left frontotemporal approach, enabled subtotal removal. Definitive histologic examination revealed a paraganglioma with signs of anaplasis. We report our clinical findings and present a review of literature.


Assuntos
Neoplasias do Tronco Encefálico/secundário , Doença de von Hippel-Lindau/complicações , Adenocarcinoma de Células Claras/patologia , Neoplasias do Tronco Encefálico/diagnóstico por imagem , Neoplasias do Tronco Encefálico/patologia , Feminino , Hemangioblastoma/patologia , Humanos , Neoplasias Renais/patologia , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Neoplasias da Retina/patologia , Tomografia Computadorizada por Raios X , Doença de von Hippel-Lindau/diagnóstico por imagem , Doença de von Hippel-Lindau/patologia
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