Spinal Cord Syndrome Due to Extramedullary Epithelioid Hemangioendothelioma of the Thoracic Spine: A Case Report and Literature Review.

We report a 48-year-old male patient with spinal epithelioid hemangioendothelioma in T3 and T4 who began with symptoms of paresthesia in the lower limbs and distal weakness of the right lower limb, back pain, increased limitation in walking, urinary incontinence, and constipation. A safe maximum resection was performed, finding residual disease during the PET/CT scan, so it was decided to treat with radiotherapy, and there was a good response to this treatment. A literature review of epithelioid hemangioendothelioma of the thoracic spine was done which showed a mean age of presentation of 41 years and a male-female ratio of 1:0.53. The main symptom was pain, which was present in 100% of the patients, and wide surgery was performed in 56.8% of the patients, intralesional surgery in 31.8%, and biopsy in 11.4%. A total of 46.6% of patients received radiation therapy, and only 6.6% received chemotherapy. The patients had an average follow-up of 38 months. We recommend that extension studies such as PET/CT scans be performed after surgical resection. This can serve as a follow-up with hemangioendothelioma epithelioma patients about metastatic disease or residual disease that will guide us in giving adjuvant treatments, such as radiotherapy or chemotherapy, for better control of the disease.

Mature Spinal Teratoma: A Case Report.

We presented an unusual case of a teratoma in a 76-year-old female who began four years ago with paresthesias and hypoesthesias in the sacral and gluteal regions. She denied weakness or gait instability. The magnetic resonance imaging showed an intradural lesion within the cauda equina at levels L2-L3. We decided to perform a posterior midline approach to the lumbar region to expose L2-L3 levels. After doing the L2-L3 laminectomy and the durotomy, we found a solid lesion surrounded by nerve roots with heterogeneous content. Through the meticulous separation of the nerve roots surrounding the lesion, we punctioned it, observing the exit of melanocytic material. Histopathological findings showed germinal neoplasia without immature neuroepithelium or malignant component; therefore, the diagnosis of mature teratoma was made. The patient was discharged without any aggregate neurological deficit. At the six-month follow-up visit, the patient continued with paresthesia in the gluteal region without motor weakness and reported minimal gait improvement.

A Technical Note on Alternating Laminectomies Plus Folding Cystectomy: A Novel Technique for Spinal Arachnoid Cyst.

We report the case of a 33-year-old male patient with no past medical history presenting to our tertiary referral center with progressive (two years) deficit of lower limb motor impairment (2/5 Medical Research Council [MRC] scale) and sensory impairment. T2- and T1-weighted MRI images clarified the nature of the cyst from T3 to T8. In our case, surgical management was warranted to relieve tension over the spinal cord, thus improving symptoms. Two multilevel laminectomies were performed, one centered on the proximal pole and the other on the distal pole; subsequently, the epidural cyst was gradually folded until it was totally extracted without complications. In the present study, we discuss a technique of extended spinal compressive arachnoid cyst. To the best of our knowledge, this technique has not been previously described in the existing body of literature. Here, we present a case of a successful procedure that seems both efficient and safe. Further study will be required to confirm its safety and efficacy.

A Postoperative Complication of Takotsubo Syndrome in the Spinal Surgery: A Case Report.

We present the case of a 32-year-old woman with a diagnosis of lumbar root syndrome and spondylolisthesis, which is why she underwent surgery. Anterior discectomy and intersomatic box placement plus posterior fixation were performed with percutaneous transpedicular screws in L5-S1. At 24 hours of the procedure, the patient presents sustained hypotension, adding sudden and intense chest pain with neck irradiation, dyspnea, and diaphoresis, as well as electrocardiographic abnormalities and elevation of cardiac enzymes suggestive of an acute coronary syndrome, subsequently evidence of basal hypokinesis in the echocardiogram. After providing hemodynamic support and analgesic management, the symptoms were resolved, and the electrocardiogram (ECG) and cardiac enzymes were normalized, allowing an adequate postoperative evolution.

Resection of Thoracic Plasmacytoma and Corpectomy Through the Anterolateral Thoracic Approach: A Case Report.

This case report details the case of a 57-year-old male who initially manifested low back pain radiating from the lumbar region to the left leg. Progressive symptoms included paresthesia on the plantar surfaces of both feet and gait instability attributed to weakness in the pelvic limbs. Computed tomography imaging revealed osteolytic lesions in the T9, T10, and T11 vertebral bodies, resulting in compression of the spinal cord. Subsequent contrast-enhanced magnetic resonance imaging validated these findings, confirming the presence of an extradural tumor. In accordance with the Spinal Instability Neoplastic Score (SINS), the case was categorized as indicative of potential spinal instability. Consequently, a surgical intervention was performed to excise the lesion. Thus, the role of SINS played a pivotal role in guiding the decision-making process for the chosen treatment modality.

Mortalidad asociada al diagnóstico de síndrome de Guillain-Barré en adultos ingresados en instituciones del sistema sanitario mexicano / Mortality associated with a diagnosis of Guillain-Barré syndrome in adults of Mexican health institutions

Introducción. El síndrome de Guillain-Barré (SGB) es una urgencia neurológica que constituye la principal causa de parálisis flácida en el mundo, y que afecta a todos los grupos etarios. Se desconocen notablemente las características epidemiológicas esenciales del SGB en la mayor parte de los países de América Latina. Objetivo. Determinar la mortalidad asociada con el diagnóstico de SGB en altas hospitalarias efectuadas durante el año 2010 en instituciones de la Secretaría de Salud, México. Pacientes y métodos. Se analizó la base de datos de altas hospitalarias de instituciones que pertenecen a la Secretaría de Salud. Se identificaron los casos de SGB mediante el código G61.0 de la Clasificación Internacional de Enfermedades, 10.ª revisión (CIE-10). Se excluyeron los registros de pacientes menores de 18 años y los casos sin información demográfica completa. Resultados. Durante el año 2010 se registraron 2.634.339 altas de hospitales que pertenecen a la Secretaría de Salud. Se identificó un total de 467 hospitalizaciones por SGB en adultos (mediana de edad: 41 años; 62,1% hombres) de 121 instituciones sanitarias de los 32 estados federados de México. Durante el verano y otoño se registró la mayor frecuencia de hospitalizaciones por SGB. La mediana de la estancia hospitalaria fue de 8 días y la tasa de mortalidad hospitalaria, del 10,5%. La probabilidad de muerte se asoció directamente con la edad, sin una tendencia particular respecto al sexo, hospital de atención o entidad federativa. Conclusiones. En 2010, la mortalidad hospitalaria por SGB en esta parte del sistema sanitario mexicano fue más alta de la que se informa en estudios contemporáneos. Se observó una asociación estacional con la frecuencia de hospitalizaciones por SGB (AU)

Introduction. Guillain-Barré syndrome (GBS) is a neurological emergency representing the main cause of flaccid paralysis around the world, affecting all age groups. Little is known about the essential epidemiology of GBS in most Latin American countries. Aim. To determine the mortality associated with the diagnosis of GBS in hospital discharges during 2010 in hospitals of the Ministry of Health, Mexico. Patients and methods. We analyzed the database of hospital discharges of institutions pertaining to the Ministry of Health. Study cases were identified by the code G61.0 of the International Classification of Diseases, 10th revision (ICD-10). We excluded records of patients younger than 18 years and patients without complete demographic information. Results. During the year 2010 there were 2,634,339 discharges from hospitals of the Ministry of Health. We identified a total of 467 hospitalizations due to GBS in adults (median age: 41 years; 62.1% male) from 121 health institutions of the 32 Republic States. The highest frequency of GBS hospitalizations occurred during summer and fall. The median hospital stay was 8 days. The hospital mortality rate was 10.5%. The probability of death was directly associated with age, without a particular trend regarding gender, hospital care or state. Conclusions. In 2010 GBS hospital mortality in this part of the Mexican health system was higher than that reported in contemporary studies. A seasonal association was observed regarding the frequency of hospitalizations for GBS (AU)

[Mortality associated with a diagnosis of Guillain-Barré syndrome in adults of Mexican health institutions]. / Mortalidad asociada al diagnóstico de síndrome de Guillain-Barré en adultos ingresados en instituciones del sistema sanitario Mexicano.

INTRODUCTION: Guillain-Barré syndrome (GBS) is a neurological emergency representing the main cause of flaccid paralysis around the world, affecting all age groups. Little is known about the essential epidemiology of GBS in most Latin American countries. AIM: To determine the mortality associated with the diagnosis of GBS in hospital discharges during 2010 in hospitals of the Ministry of Health, Mexico. PATIENTS AND METHODS: We analyzed the database of hospital discharges of institutions pertaining to the Ministry of Health. Study cases were identified by the code G61.0 of the International Classification of Diseases, 10th revision (ICD-10). We excluded records of patients younger than 18 years and patients without complete demographic information. RESULTS: During the year 2010 there were 2,634,339 discharges from hospitals of the Ministry of Health. We identified a total of 467 hospitalizations due to GBS in adults (median age: 41 years; 62.1% male) from 121 health institutions of the 32 Republic States. The highest frequency of GBS hospitalizations occurred during summer and fall. The median hospital stay was 8 days. The hospital mortality rate was 10.5%. The probability of death was directly associated with age, without a particular trend regarding gender, hospital care or state. CONCLUSIONS: In 2010 GBS hospital mortality in this part of the Mexican health system was higher than that reported in contemporary studies. A seasonal association was observed regarding the frequency of hospitalizations for GBS.

TITLE: Mortalidad asociada al diagnostico de sindrome de Guillain-Barre en adultos ingresados en instituciones del sistema sanitario mexicano.Introduccion. El sindrome de Guillain-Barre (SGB) es una urgencia neurologica que constituye la principal causa de paralisis flacida en el mundo, y que afecta a todos los grupos etarios. Se desconocen notablemente las caracteristicas epidemiologicas esenciales del SGB en la mayor parte de los paises de America Latina. Objetivo. Determinar la mortalidad asociada con el diagnostico de SGB en altas hospitalarias efectuadas durante el año 2010 en instituciones de la Secretaria de Salud, Mexico. Pacientes y metodos. Se analizo la base de datos de altas hospitalarias de instituciones que pertenecen a la Secretaria de Salud. Se identificaron los casos de SGB mediante el codigo G61.0 de la Clasificacion Internacional de Enfermedades, 10.ª revision (CIE-10). Se excluyeron los registros de pacientes menores de 18 años y los casos sin informacion demografica completa. Resultados. Durante el año 2010 se registraron 2.634.339 altas de hospitales que pertenecen a la Secretaria de Salud. Se identifico un total de 467 hospitalizaciones por SGB en adultos (mediana de edad: 41 años; 62,1% hombres) de 121 instituciones sanitarias de los 32 estados federados de Mexico. Durante el verano y otoño se registro la mayor frecuencia de hospitalizaciones por SGB. La mediana de la estancia hospitalaria fue de 8 dias y la tasa de mortalidad hospitalaria, del 10,5%. La probabilidad de muerte se asocio directamente con la edad, sin una tendencia particular respecto al sexo, hospital de atencion o entidad federativa. Conclusiones. En 2010, la mortalidad hospitalaria por SGB en esta parte del sistema sanitario mexicano fue mas alta de la que se informa en estudios contemporaneos. Se observo una asociacion estacional con la frecuencia de hospitalizaciones por SGB.