Parálisis fascicular del III nervio craneal / Fascicular paralysis of the III cranial nerve

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Lipoma del ángulo pontocerebeloso: comunicación de un caso / Cerebellopontine angle lipoma: a case report

Introducción. Los lipomas intracraneales son tumores poco frecuentes, sobre todo los localizados en el ángulo pontocerebeloso (APC), que suponen sólo el 0,05 por ciento del total. Caso clínico. Presentamos un caso de lipoma del APC diagnosticado en una mujer de 38 años, manifestado por hipoacusia y en el que la resonancia magnética (RM) fue la prueba complementaria de principal ayuda diagnóstica. Existía una imagen hiperintensa en T1 en el APC derecho que no captaba contraste y que traducía un tumor graso. Conclusiones. Se discuten las manifestaciones clínicas del lipoma del APC, los medios para su diagnóstico (centrados principalmente en el valor de la RM) y la conducta a seguir ante estos tumores según la experiencia de los relativamente pocos casos descritos hasta la fecha. Se recalca la idea de que estas lesiones, actualmente, se consideran alteraciones del desarrollo embrionario, y no propiamente neoplasias (AU)

Introduction. Intracranial lipomas are infrequent tumours and especially so when they are situated in the cerebellopontine angle (CPA), when they only constitute 0.05% of the total number. Case report. We present the case of a CPA lipoma diagnosed in a 38-year-old female with hypoacusis as the presenting symptom and in which magnetic resonance (MR) was the complementary test that proved most useful as a diagnostic aid. There was a hyperintense image in T1 in the right-side CPA that did not take up contrast and which was interpreted as a fatty tumour. Conclusions. We discuss the clinical manifestations of CPA lipomas, the means that can be used to diagnose them (mainly focused on the value of MRI) and the procedure to be followed in dealing with these tumours according to the experience obtained from the relatively scarce number of cases reported to date. We underline the idea that these lesions are currently considered to be embryonic development disorders rather than actual neoplasias (AU)

[Cerebellopontine angle lipoma: a case report]. / Lipoma del ángulo pontocerebeloso: comunicación de un caso.

INTRODUCTION: Intracranial lipomas are infrequent tumours and especially so when they are situated in the cerebellopontine angle (CPA), when they only constitute 0.05% of the total number. CASE REPORT: We present the case of a CPA lipoma diagnosed in a 38-year-old female with hypoacusis as the presenting symptom and in which magnetic resonance (MR) was the complementary test that proved most useful as a diagnostic aid. There was a hyperintense image in T1 in the right-side CPA that did not take up contrast and which was interpreted as a fatty tumour. CONCLUSIONS: We discuss the clinical manifestations of CPA lipomas, the means that can be used to diagnose them (mainly focused on the value of MRI) and the procedure to be followed in dealing with these tumours according to the experience obtained from the relatively scarce number of cases reported to date. We underline the idea that these lesions are currently considered to be embryonic development disorders rather than actual neoplasias.

[Hemichorea induced by diabetic ketoacidosis and striatal hyperdensity on computerized axial tomography]. / Hemicorea inducida por cetoacidosis diab tica e hiperdensidad estriatal en la tomograf a axial computarizada.

INTRODUCTION: Hyperglycaemia, usually not ketotic, may cause hemichorea hemiballism. The mechanism of this physiopathological syndrome is still not clear. It usually occurs in elderly ladies and is associated with hyperdensity in the striate area contralateral to the affected side, on CT and MR potentiated in T1. CLINICAL CASE: Three days before hospital admission, and 86 year old woman presented with the acute onset of choreiform movements of her left limbs, particularly her left arm. She had not taken neuroleptic drugs and there was no family history of chorea. On neurological examination there were no other unusual findings. Laboratory tests showed hyperglycemia with metabolic acidosis and ketone bodies in the urine. On the CT scan there was a hyperdense lesion in the right striate area, but this did not act as a space occupying lesion. Treatment was started with intravenous insulin and the symptoms disappeared 48 hours later. CONCLUSIONS: We emphasize the rarity of the association of hemichorea and diabetic ketoacidosis. From the histological studies done in some of these patients, it seems that the hyperdensity of the striate area may be due to the proliferation of hypertrophic astrocytes secondary to small ischemic lesions. When the hyperglycaemia is treated, the chorea disappears within a few days and it is unusual for neuroleptic treatment to be required. In cases of hemichorea, hyperglycaemia should be ruled out, as should structural causes (tumors, infarcts, hematomas, traumatic lesions, etc.).

Hemicorea inducida por cetoacidosis diabética e hiperdensidad estriatal en la tomografía axial computadorizada / Hemichorea induced by diabetic ketoacidosis and striatal hyperdensity on computerized axial tomography

Introducción. La hiperglucemia habitualmente no cetósica puede ser causa de hemicorea-hemibalismo. Este síndrome de fisiopatología aún no aclarada, suele darse en ancianas y asociarse a hiperdensidad en el estriado contralateral al hemicuerpo afectado, en TAC y RM potenciada en T1. Caso clínico. Mujer de 86 años que inicia de forma aguda, tres días antes del ingreso, movimientos coreicos de sus extremidades izquierdas, más evidentes en la superior. No había historia de consumo de neurolépticos ni antecedentes familiares de corea. La exploración neurológica no mostraba otros datos de interés. Analíticamente destacaba una hiperglucemia con acidosis metabólica y cuerpos cetónicos en la orina. En la TAC se evidenció una lesión hiperdensa en el estriado derecho sin efecto de masa. Se instauró tratamiento con insulina endovenosa con lo que la sintomatología cesó en 48 horas. Conclusiones. Resaltamos lo infrecuente de la asociación hemicorea y cetoacidosis diabética. Según estudios histológicos realizados en algunos de estos pacientes, la hiperdensidad del estriado puede deberse a proliferación de astrocitos hipertróficos secundaria a lesiones isquémicas pequeñas. Con el tratamiento de la hiperglucemia la corea remite en pocos días, siendo raro el tener que asociar neurolépticos. Ante un caso de hemicorea se debe descartar hiperglucemia además de causas estructurales (tumores, infartos, hematomas, lesiones traumáticas, etc.) (AU)

Cefalea sexual asociada a tumor intracraneal / Sexual headache associate to intracranial tumour

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Parálisis periódica hiperpotasémica: una rara complicación de la enfermedad de addison / Hyperpotassemic periodic paralysis: A rare complication of Addison's disease

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