RESUMO
A 65 year-old woman with a filum terminale ependymoma is reported, presenting with acute cauda equina compression syndrome due to intratumoural and subsequent spinal subarachnoid hemorrhage (SAH) following therapy with oral anticoagulants. Few cases of spinal ependymoma have been reported with an acute cauda equina compression syndrome as the initial and only symptom, and the unique feature of our patient's anticoagulant status has only been described once in this setting. Although intratumoural hemorrhage is very well known since the myxopapillary variant is unique to the cauda equina and consists of loose connective tissue and numerous small blood vessels that are prone to bleeding, spinal SAH is seldom seen and the different hypotheses about the pathophysiological mechanisms that might promote bleeding still remain unresolved and will be discussed in this paper, as well as the special clinical features of spinal SAH and some diagnostic and therapeutic implications. A review of the literature (Medline search 1983-1993) revealed only 13 cases, including ours, of spinal SAH due to cauda equina ependymoma, and the results of this review together with our findings are described in this paper.
Assuntos
Anticoagulantes/efeitos adversos , Cauda Equina , Ependimoma/complicações , Síndromes de Compressão Nervosa/etiologia , Neoplasias do Sistema Nervoso Periférico/complicações , Hemorragia Subaracnóidea/induzido quimicamente , Doença Aguda , Idoso , Ependimoma/diagnóstico , Feminino , Hemorragia/induzido quimicamente , Hemorragia/complicações , Humanos , Neoplasias do Sistema Nervoso Periférico/diagnóstico , Hemorragia Subaracnóidea/complicaçõesRESUMO
Bilateral obturator hernias were diagnosed in a 61-year-old woman by CT-scan examination, permitting an elective surgical repair by preperitoneal interposition of Teflon mesh. The condition developed in a patient presenting with a 15-year history of chylous ascites, occasioned by primary hypoplasia of the lymphatic system and cirrhosis of the liver.
Assuntos
Ascite Quilosa/complicações , Hérnia do Obturador/diagnóstico por imagem , Feminino , Hérnia do Obturador/complicações , Hérnia do Obturador/cirurgia , Humanos , Pessoa de Meia-Idade , Politetrafluoretileno , Próteses e Implantes , Telas Cirúrgicas , Fatores de Tempo , Tomografia Computadorizada por Raios XRESUMO
A 19-year-old girl presenting with an isolated unilateral adrenal hemorrhage after a motorcycle cross-country race without evidence of direct trauma, is reported. The lesion was diagnosed by abdominal ultrasonography, and treated surgically by thoracolaparotomy. Recovery has resulted. A review of literature shows the rarity of the condition.
