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1.
World Neurosurg ; 140: 267-270, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32428721

RESUMO

BACKGROUND: Tuberculosis is a common disease; however, the prevalence of calvarial tuberculosis is very rare. Most cases of calvarial tuberculosis occur in young patients. We report a rare case of calvarial tuberculosis in an elderly patient. CASE DESCRIPTION: An 89-year-old woman presented with a forehead skin defect. Radiologic imaging showed bony erosion 20 × 10 mm in size with adjacent dural enhancement in the left frontal bone. The patient underwent surgical treatment. Pathology revealed chronic granulomatous inflammation with caseous necrosis, consistent with tuberculosis. Antituberculous medications were prescribed for 6 months. CONCLUSIONS: A careful assessment should be performed to obtain an appropriate diagnosis in cases of osteolytic lesions of the skull.


Assuntos
Dermatopatias/etiologia , Crânio/patologia , Tuberculose Osteoarticular/complicações , Idoso de 80 Anos ou mais , Antituberculosos/uso terapêutico , Feminino , Humanos , Dermatopatias/tratamento farmacológico , Dermatopatias/patologia , Dermatopatias/cirurgia , Crânio/cirurgia , Tuberculose Osteoarticular/tratamento farmacológico , Tuberculose Osteoarticular/patologia , Tuberculose Osteoarticular/cirurgia
2.
World Neurosurg ; 140: 56-59, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32437994

RESUMO

BACKGROUND: Xanthomas are benign lipomatous deposits that can be found systemically in various tissues including bones. Their presence in the skull remains a rare entity. Despite their benign characteristics, imaging modalities are often unable to distinguish them from malignant lesions. This leads to a diagnostic dilemma in patients with underlying malignancy. This case report highlights such a case where clinical history of prostate cancer and image findings were concordant with that of metastatic deposit in the parietal skull region. CASE DESCRIPTION: This 65-year-old gentleman was diagnosed with prostatic adenocarcinoma. During systemic workup for his tumor, he was found to have a right parietal skull lesion. Magnetic resonance imaging of the brain, as well as a bone scan, were consistent with that of a metastatic deposit. As treatment would be drastically affected by the diagnosis, an excision biopsy was performed. The histology was consistent with that of a bone xanthoma. CONCLUSIONS: Xanthomas are benign lesions that can be seen deposited in appendicular and axial skeleton. Skull lesions are rare with most case descriptions focusing on their presence in the frontoorbital regions and mandible and temporal bone. They usually have a benign course but may present with symptoms due to localized mass effect. Surgical intervention and histologic diagnosis may still be required in these lesions due to their lack of imaging characteristics that confirm their diagnosis through noninvasive methods.


Assuntos
Crânio/patologia , Xantomatose/patologia , Idoso , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/patologia , Diagnóstico Diferencial , Humanos , Masculino , Metástase Neoplásica/diagnóstico , Metástase Neoplásica/patologia , Neoplasias da Próstata/patologia , Xantomatose/diagnóstico
3.
BMC Med Genet ; 21(1): 90, 2020 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-32370745

RESUMO

BACKGROUND: ERF-related craniosynostosis are a rare, complex, premature trisutural fusion associated with a broad spectrum of clinical features and heterogeneous aetiology. Here we describe two cases with the same pathogenic variant and a detailed description of their clinical course. CASE PRESENTATION: Two subjects; a boy with a BLSS requiring repeated skull expansions and his mother who had been operated once for sagittal synostosis. Both developed intracranial hypertension at some point during the course, which was for both verified by formal invasive intracranial pressure monitoring. Exome sequencing revealed a pathogenic truncating frame shift variant in the ERF gene. CONCLUSIONS: Here we describe a boy and his mother with different craniosynostosis patterns, but both with verified intracranial hypertension and heterozygosity for a truncating variant of ERF c.1201_1202delAA (p.Lys401Glufs*10). Our work provides supplementary evidence in support of previous phenotypic descriptions of ERF-related craniosynostosis, particularly late presentation, an evolving synostotic pattern and variable expressivity even among affected family members.


Assuntos
Craniossinostoses/genética , Predisposição Genética para Doença , Hipertensão Intracraniana/genética , Proteínas Repressoras/genética , Adulto , Craniossinostoses/complicações , Craniossinostoses/patologia , Craniossinostoses/cirurgia , Feminino , Heterozigoto , Humanos , Lactente , Hipertensão Intracraniana/complicações , Hipertensão Intracraniana/patologia , Hipertensão Intracraniana/cirurgia , Masculino , Mães , Crânio/patologia , Crânio/cirurgia
4.
World Neurosurg ; 139: 415-418, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32360734

RESUMO

BACKGROUND: Primary central nervous system lymphoma (PCNSL) occurs frequently in a deep intraparenchymal location. It rarely occurs in the meninges, and bone invasion is uncommon. CASE DESCRIPTION: A 12-year-old boy was admitted to our hospital with a history of headache and seizures. Magnetic resonance imaging showed a 4-cm-sized dural-based mass with osteolytic bone change. Craniotomy and tumor removal were performed. Operative findings showed a dural-based hard tumor, including necrosis and hemorrhage, and the skull was focally destroyed by tumor cells. The tumor was completely removed. Pathologically, large atypical cells with pleomorphic nuclei and frequent mitoses were found. The tumor cells were immune-positive for CD30, epithelial cell antigen, and anaplastic lymphoma kinase. The final diagnosis was anaplastic lymphoma kinase-positive anaplastic large cell lymphoma (ALCL). There was no evidence of systemic cancer. The boy underwent chemotherapy following the Non-Hodgkin Lymphoma-Berlin-Frankfurt-Münster protocol. There was no recurrence after a 16-month chemotherapy-off period. CONCLUSIONS: ALCL is not a common type of PCNSL, and central nervous system ALCL frequently involves the dura and meninges compared with PCNSL in general. However, osteolytic bone lesions are rarely seen in ALCL. This case thus represents a rare case of dural-based ALCL with bone invasion.


Assuntos
Neoplasias Encefálicas/patologia , Dura-Máter/patologia , Linfoma Anaplásico de Células Grandes/patologia , Crânio/patologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Encefálicas/tratamento farmacológico , Criança , Humanos , Linfoma Anaplásico de Células Grandes/tratamento farmacológico , Masculino
5.
World Neurosurg ; 139: 253-259, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32305608

RESUMO

BACKGROUND: Sarcoidosis is a granulomatous disease most often affecting the lungs, but extrapulmonary manifestations are also common. While virtually any organ system can be involved, skeletal manifestations are present in 1%-13% of cases. Skull lesions are even more rare. We found 14 case reports describing symptomatic skull lesions in patients with no prior history of sarcoid to better understand the symptomology and disease progression. CASE DESCRIPTION: Here we present the case of a 57-year-old female with history of sarcoidosis and new-onset forgetfulness, confusion, and headaches who was found to have multiple skull lesions with epidural extension. On histopathologic examination of the excised lesion, noncaseating granulomas were observed and diagnoses of skull sarcoidosis and neurosarcoid were made. Since the patient was actively treated with corticosteroids, the plan was to initiate infliximab. CONCLUSION: Sarcoidosis affecting the skull and central nervous system is exceedingly rare and can mimic many pathologies including metastatic bone disease, multiple myeloma, and eosinophilic granulomatosis. With a wide differential, surgical specimen is needed for concrete diagnosis and treatment. While the rates of skeletal involvement are low, a skeletal survey might be an important step in monitoring disease burden in patients, especially as lesions can be asymptomatic.


Assuntos
Doenças Ósseas/patologia , Doenças do Sistema Nervoso Central/patologia , Sarcoidose/patologia , Crânio/patologia , Feminino , Granuloma/patologia , Humanos , Pessoa de Meia-Idade
6.
World Neurosurg ; 138: 408-410, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32247791

RESUMO

Civilian gunshot wounds to the brain are associated with high overall mortality; however, outcomes can vary significantly depending on bullet trajectory. This report details the outcome of a patient who sustained a bifrontal gunshot wound with multiple associated calvarial and frontal sinus fractures. Although surgery for penetrating brain injury is most frequently employed for relief of mass effect and decompression of vital structures, this case report describes a more comprehensive technique involving duroplasty, obliteration of the frontal sinus, and cranial vault reconstruction with the aim of decreasing the rate of cerebrospinal fluid leak, infection, reoperation, and readmission.


Assuntos
Encéfalo/cirurgia , Craniotomia/métodos , Traumatismos Cranianos Penetrantes/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Ferimentos por Arma de Fogo/cirurgia , Encéfalo/patologia , Drenagem , Feminino , Traumatismos Cranianos Penetrantes/etiologia , Traumatismos Cranianos Penetrantes/patologia , Humanos , Hemorragias Intracranianas/etiologia , Hemorragias Intracranianas/cirurgia , Pessoa de Meia-Idade , Crânio/patologia , Crânio/cirurgia , Ferimentos por Arma de Fogo/complicações , Ferimentos por Arma de Fogo/patologia
7.
J Bone Miner Metab ; 38(5): 639-647, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32303916

RESUMO

INTRODUCTION: Collagen from marine esponges has been used as a promising material for tissue engineering proposals. Similarly, photobiomodulation (PBM) is able of modulating inflammatory processes after an injury, accelerating soft and hard tissue healing and stimulating neoangiogenesis. However, the effects of the associated treatments on bone tissue healing have not been studied yet. In this context, the present study aimed to evaluate the biological temporal modifications (using two experimental periods) of marine sponge collagen or sponging (SPG) based scaffold and PBM on newly formed bone using a calvaria bone defect model. MATERIAL AND METHODS: Wistar rats were distributed into two groups: SPG or SPG/PBM and euthanized into two different experimental periods (15 and 45 days post-surgery). A cranial critical bone defect was used to evaluate the effects of the treatments. Histology, histomorfometry and immunohistological analysis were performed. RESULTS: Histological findings demonstrated that SPG/PBM-treated animals, 45 days post-surgery, demonstrated a higher amount of connective and newly formed bone tissue at the region of the defect compared to CG. Notwithstanding, no difference among groups were observed in the histomorphometry. Interestingly, for both anti-transforming growth factor-beta (TGF-ß) and anti-vascular endothelial growth factor (VEGF) immunostaining, higher values for SPG/PBM, at 45 days post-surgery could be observed. CONCLUSION: It can be concluded that the associated treatment can be considered as a promising therapeutical intervention.


Assuntos
Organismos Aquáticos/química , Colágeno/farmacologia , Terapia com Luz de Baixa Intensidade , Crânio/patologia , Tecidos Suporte/química , Cicatrização/efeitos dos fármacos , Animais , Modelos Animais de Doenças , Masculino , Ratos Wistar , Crânio/efeitos dos fármacos , Fator de Crescimento Transformador beta/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo
8.
World Neurosurg ; 139: 387-394, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32339731

RESUMO

BACKGROUND: Lesions of the skull make up a small but important part of neurosurgical practice. Several systemic disorders may involve the cranial vault including neoplastic and non-neoplastic conditions. Sarcoidosis of the skull is a little-known cause of calvarial involvement that has been rarely reported in the literature. The available information about skull sarcoidosis (SS) is sparse and is not well described; for this reason, we consider that a detailed description of this uncommon condition is necessary. METHODS: An illustrative case of SS is presented; in addition, a PubMed and Scopus search adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed to include studies reporting patients with SS. Different information was analyzed in these cases to describe the characteristics of this condition. Also, different sources of literature were analyzed to complete the description of this clinical entity. RESULTS: The search yielded 22 cases of patients with SS showing a variety of clinical manifestations. All studies were case reports. Most patients diagnosed with SS had no previous history of systemic sarcoidosis. Different characteristics of SS are analyzed and described in this paper. CONCLUSIONS: The information collected from this review shows that SS is a rare condition that frequently is observed in patients without previous diagnosis of sarcoidosis. SS may manifest in different ways, and even may be found incidentally in some patients. The diagnosis of SS should be considered when multiple lytic skull lesions are observed, especially in cases of patients without a previous history of malignancy.


Assuntos
Doenças Ósseas/patologia , Sarcoidose/patologia , Crânio/patologia , Feminino , Humanos , Pessoa de Meia-Idade
10.
Zh Nevrol Psikhiatr Im S S Korsakova ; 120(3. Vyp. 2): 13-15, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32307424

RESUMO

The aspects of disruption of venous blood outflow from face region into skull are well-known; they can occur at any age - from neonatal to old age, however, the possible compensation mechanisms for such disorders are usually difficult to identify. A description is given of a unique case of unilateral epistaxis and a homolateral (right-sided) headache that developed much later. Examination revealed hypoplasia of the left sigmoid sinus and blood overflow of the right sigmoid sinus. After prescription of betahistine in a dose of 24 mg before bedtime and after awakening the headache and nosebleeds disappeared on the second day. The effect was persistent. The case demonstrates previously unknown compensation mechanisms for venous outflow - a retrograde outflow from the skull to the face region.


Assuntos
Face/irrigação sanguínea , Crânio/irrigação sanguínea , Veias/fisiologia , beta-Histina/uso terapêutico , Cavidades Cranianas/patologia , Cavidades Cranianas/fisiopatologia , Epistaxe/tratamento farmacológico , Epistaxe/fisiopatologia , Face/patologia , Cefaleia/tratamento farmacológico , Cefaleia/patologia , Cefaleia/fisiopatologia , Humanos , Crânio/patologia
11.
Plast Reconstr Surg ; 145(4): 779e-787e, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32221223

RESUMO

BACKGROUND: Dermoid cysts are benign lesions lined by keratinizing squamous epithelium that also contain epidermal adnexa (hair follicles, hair shafts, sebaceous glands, and both apocrine and eccrine sweat glands) and mesodermal derivatives (smooth muscle fibers, vascular stroma, nerves, and collagen fibers). Craniofacial dermoid cysts represent approximately 7 percent of all dermoids and have an incidence ranging between 0.03 and 0.14 percent. METHODS: The authors conducted a single-center, consecutive, nonrandomized comparative case series over a 20-year period of all patients treated surgically for craniofacial dermoid at the Royal Children's Hospital in Melbourne, Australia. Six hundred forty-seven patients had craniofacial dermoids and adequate information to be included in the study. The authors also conducted a thorough review of the literature using the MEDLINE and Embase databases. RESULTS: Six hundred forty-seven patients amounted to 655 lesions in our case series. The age at surgery ranged from 2 months to 18 years, with an average age of 25.65 months. The depth of the lesions was stratified using a classification system, and the risk of intracranial extension was assessed using these data. Midline nasal lesions are established as high risk by other studies, but frontal, temporal, and occipital lesions were found to be as risky if not more risky for intracranial extension. CONCLUSIONS: Several classification systems for craniofacial dermoid cysts have used both broader anatomical locations and physical characteristics to group these lesions and identify those warranting preoperative imaging. The authors propose a system using more specific classification of anatomical location to assist in the prompt identification of high-risk lesions and facilitate sound preoperative planning. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.


Assuntos
Encéfalo/diagnóstico por imagem , Cisto Dermoide/patologia , Neoplasias Faciais/patologia , Neoplasias Cutâneas/patologia , Crânio/diagnóstico por imagem , Adolescente , Austrália , Encéfalo/patologia , Criança , Pré-Escolar , Cisto Dermoide/classificação , Cisto Dermoide/diagnóstico por imagem , Cisto Dermoide/cirurgia , Face , Neoplasias Faciais/classificação , Neoplasias Faciais/diagnóstico por imagem , Neoplasias Faciais/cirurgia , Feminino , Humanos , Lactente , Imagem por Ressonância Magnética , Masculino , Invasividade Neoplásica/diagnóstico por imagem , Invasividade Neoplásica/patologia , Planejamento de Assistência ao Paciente/normas , Guias de Prática Clínica como Assunto , Cuidados Pré-Operatórios/métodos , Cuidados Pré-Operatórios/normas , Medição de Risco , Neoplasias Cutâneas/classificação , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/cirurgia , Crânio/patologia , Tomografia Computadorizada por Raios X , Ultrassonografia
12.
Braz Oral Res ; 34: e007, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32049108

RESUMO

The aim of this study was to assess the influence of cyclosporine administration on the repair of critical-sized calvaria defects (CSDs) in rat calvaria filled with diverse biomaterials. Sixty animals were divided into two groups: the control (CTR) group (saline solution) and the cyclosporine (CCP) group (cyclosporine, 10 mg/kg/day). These medications were administered daily by gavage, beginning 15 days before the surgical procedure and lasting until the day the animals were euthanized. A CSD (5 mm Ø) was made in the calvaria of each animal, which was allocated to one of 3 subgroups, according to the biomaterial used to fill the defect: coagulum (COA), deproteinized bovine bone (DBB), or biphasic calcium phosphate ceramics of hydroxyapatite and ß-phosphate tricalcium (HA/TCP). Euthanasia of the animals was performed 15 and 60 days after the surgical procedure (n = 5 animals/period/subgroup). Bone repair (formation) assessment was performed through microtomography and histometry, while the analyses of the expression of the BMP2, Osteocalcin, and TGFß1 proteins were performed using immunohistochemistry. The CSDs not filled with biomaterials demonstrated lower bone formation in the CCP group. At 15 days, less bone formation was observed in the CSDs filled with DBB, a smaller volume of mineralized tissue was observed in the CSDs filled with HA/TCP, and the expression levels of BMP2 and osteocalcin were lower in the CCP group compared to the CTR group. The use of cyclosporine impaired bone repair in CSD, and this effect can be partially explained by the suppression of BMP2 and osteocalcin expression.


Assuntos
Regeneração Óssea/efeitos dos fármacos , Substitutos Ósseos/farmacologia , Inibidores de Calcineurina/farmacologia , Ciclosporina/farmacologia , Osteogênese/efeitos dos fármacos , Animais , Proteína Morfogenética Óssea 2/análise , Imuno-Histoquímica , Masculino , Osteocalcina/análise , Distribuição Aleatória , Ratos , Reprodutibilidade dos Testes , Crânio/efeitos dos fármacos , Crânio/patologia , Fatores de Tempo , Fator de Crescimento Transformador beta1/análise , Microtomografia por Raio-X
13.
Neurocirugía (Soc. Luso-Esp. Neurocir.) ; 31(1): 47-51, ene.-feb. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-190372

RESUMO

Los sarcomas granulocíticos son neoplasias sólidas compuestas de células mieloides inmaduras, de localización extramedular, asociadas a síndromes mieloproliferativos. La afectación del sistema nervioso central es muy infrecuente y puede desarrollarse tras un periodo de remisión completa, coexistir con o preceder a la enfermedad sistémica, siendo esta el elemento fundamental que orienta el diagnóstico radiológico y marca el pronóstico. En este trabajo, presentamos 2 casos de sarcoma granulocítico intracraneal, verificados desde el punto de vista patológico tras ser tratados mediante cirugía, y discutimos sus características clínicas, diagnósticas, terapéuticas y pronósticas tras realizar una revisión bibliográfica de la literatura científica destacada publicada hasta la fecha


Granulocytic sarcomas are solid, extramedullary-located neoplasms composed of immature myeloid cells, associated with myeloproliferative syndromes. Central nervous system involvement is very rare and may develop either after complete remission, coexist with or precede the systemic disease, being the last one that guides the radiological diagnosis and marks the prognosis. In this work, we report 2 pathologically-verified cases of intracranial granulocytic sarcoma treated by surgical means. Their clinical, diagnostic, therapeutic and prognostic features are discussed in the light of the most relevant scientific literature published to date


Assuntos
Humanos , Masculino , Adulto , Idoso , Sarcoma Mieloide/cirurgia , Sistema Nervoso Central/patologia , Sarcoma Mieloide/patologia , Sarcoma Mieloide/diagnóstico por imagem , Crânio/diagnóstico por imagem , Crânio/patologia , Hemorragia Subaracnóidea/complicações , Craniotomia/métodos , Radioterapia Adjuvante/métodos , Meningite/complicações , Progressão da Doença , Imuno-Histoquímica , Diagnóstico Diferencial
14.
PLoS One ; 15(2): e0226312, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32069308

RESUMO

BACKGROUND AND PURPOSE: Disruption of the tumor-brain barrier in meningioma plays a critical role in the development of peritumoral brain edema (PTBE). We hypothesized that osteoporotic conditions may be associated with PTBE occurrence after radiation in patients with intracranial meningioma. METHODS: We measured Hounsfield units (HU) of the frontal skull on simulation brain CT in patients who underwent linear accelerator (LINAC)-based radiation treatment for intracranial meningioma. Receiver operating characteristic curve analysis was performed to determine the optimal cut-off values for several predictive factors. The cumulative hazard for PTBE was estimated and classified according to these factors. Hazard ratios were then estimated to identify independent predictive factors associated with the development of PTBE after radiation in intracranial meningioma patients. RESULTS: A total of 83 intracranial meningiomas in 76 patients who received LINAC-based radiation treatment in our hospital over an approximate 5-year period were included for the study. We found mean frontal skull HU ≤630.625 and gross tumor volume >7.194 cc to be independent predictors of PTBE after radiation treatment in patients with meningioma (hazard ratio, 8.41; P = 0.019; hazard ratio, 5.92; P = 0.032, respectively). In addition, patients who were ≥65 years showed a marginally significant association with PTBE. CONCLUSIONS: Our study suggests that possible osteoporotic conditions, large tumor volume, and older age may be associated with PTBE occurrence after LINAC-based radiation treatment for intracranial meningioma. In the future we anticipate that these findings may enhance the understanding of the underlying mechanisms of PTBE after radiation in meningioma patients.


Assuntos
Edema Encefálico/etiologia , Neoplasias Meníngeas/radioterapia , Meningioma/radioterapia , Osteoporose/complicações , Radiocirurgia/efeitos adversos , Crânio/patologia , Fatores Etários , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Carga Tumoral
15.
J Craniofac Surg ; 31(3): e306-e309, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31934971

RESUMO

Psammomatoid juvenile ossifying fibroma (PJOF) is a rare benign tumor that usually affects the paranasal sinuses, orbit, and skull. In most cases, extensive incisions are necessary for full access to the tumor site. The aim of this paper is to report a case of extensive PJOF in which an intraoral surgical approach was performed with complete excision of the tumor. A female patient, 18-year old had a deforming volume increase in the region of the left facial middle third with an approximate evolution time of 2 years. She complained of headache, epiphora in the left eye, and total obstruction of the left nostril. Extraoral examination showed facial asymmetry with dystopia, ocular proptosis, and considerable sclera exposition of the left eye. Tomography examination showed a mixed aspect lesion on the left side of the face, well delimited. The intraoral surgical approach was chosen for the excision of the lesion. Under general anesthesia and nasotracheal intubation, total resection was performed, followed by exodontia of the directly involved teeth. In the definitive histopathological examination, the diagnosis was confirmed. The patient is currently with 2 years and 6 months of postoperative follow-up and has good healing of intraoral surgical wounds and stable occlusion. Extraoral examination showed harmonic projection of the facial middle third, but still with excessive exposure of the sclera of the left eye due to the defect in the orbital floor. The surgical treatment of PJOF was possible by intraoral approach, even taking into account the limitations of the access and the complexity of the anatomy of the facial bones involved.


Assuntos
Neoplasias Ósseas/cirurgia , Fibroma Ossificante/cirurgia , Adolescente , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/patologia , Face/diagnóstico por imagem , Face/patologia , Feminino , Fibroma Ossificante/diagnóstico por imagem , Humanos , Crânio/diagnóstico por imagem , Crânio/patologia , Tomografia Computadorizada por Raios X
16.
Clin Imaging ; 60(2): 186-193, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31927176

RESUMO

Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic state often characterized by altered mental state and is seen in various clinical settings. Although it is often reversible, it may result in long term sequelae. The typical and atypical neuroimaging findings seen in PRES have been previously well-described in the literature. However, the presence of other co-existing intracranial lesions along with PRES can occasionally confound the imaging findings and poses a diagnostic challenge. Herein, the authors report four cases of PRES with etiologically different co-existing intracranial lesions confounding the clinical and imaging manifestations. When presented with atypical imaging findings in PRES, the possibility of a co-existing intracranial pathology with superimposed imaging findings should be considered.


Assuntos
Imagem por Ressonância Magnética/métodos , Síndrome da Leucoencefalopatia Posterior/patologia , Crânio/patologia , Feminino , Humanos , Masculino , Neuroimagem , Síndrome da Leucoencefalopatia Posterior/complicações , Síndrome da Leucoencefalopatia Posterior/diagnóstico , Síndrome da Leucoencefalopatia Posterior/diagnóstico por imagem , Crânio/diagnóstico por imagem
17.
Ann Hum Biol ; 47(1): 42-47, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31989850

RESUMO

Background: The Paris Catacombs contain the remains of approximately 6 million people dating back to the 15th century, when leprosy was endemic in France.Aims: The aim of this palaeopathological study was to identify the presence of leprosy in skulls from the Paris Catacombs.Subjects and methods: Macroscopic examination of skulls in situ for bone changes secondary to oronasal soft tissue infection by leprosy. Skulls were categorised as having "probable" signs of leprosy if they had an enlarged nasal (pyriform) aperture, resorption of the anterior nasal spine, and resorption of the alveolar processes of maxilla, and as having "possible" signs of leprosy if they met one of these three criteria.Results: Skulls from 123 sections within the Catacombs (approximately 1500 remains in total) were triaged, with 367 skulls identified as suitable for examination. Of these, 74 had central facial bone alterations/abnormalities and underwent detailed examination, yielding 0.5% (2/367) classified as having probable, and 5.7% (21/367) possible signs of leprosy.Conclusions: The proportion of skulls with probable signs of leprosy gives an approximate estimate (0.5%) for the prevalence of this disease in the population of Paris (or districts of Paris) during the 15-18th centuries.


Assuntos
Hanseníase/história , Crânio/patologia , Feminino , História do Século XV , História do Século XVI , História do Século XVII , História do Século XVIII , Humanos , Hanseníase/epidemiologia , Hanseníase/patologia , Masculino , Paris/epidemiologia
18.
J Craniofac Surg ; 31(1): e81-e82, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31652213

RESUMO

The authors report a rare case of intraosseous hemangioma of the mandible in a 14-year-old male. Surgical intervention with embolization is as important as histological and radiological examination to reduce the bleeding complication. Magnetic resonance angiography is paramount of importance in these lesions to detect the supplier arteries.


Assuntos
Hemangioma/cirurgia , Mandíbula/cirurgia , Crânio/anormalidades , Coluna Vertebral/anormalidades , Malformações Vasculares/cirurgia , Adolescente , Embolização Terapêutica , Hemangioma/patologia , Humanos , Masculino , Mandíbula/patologia , Procedimentos Cirúrgicos Reconstrutivos , Crânio/patologia , Crânio/cirurgia , Coluna Vertebral/patologia , Coluna Vertebral/cirurgia , Malformações Vasculares/patologia
19.
Clin Imaging ; 59(2): 129-143, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31816540

RESUMO

The diagnosis of a large solitary lytic skull vault lesion in adults is a challenge due to variable aggressiveness and overlapping features. The purpose of this article is to demonstrate the use of an imaging approach to narrow the differential diagnosis when a large solitary lytic skull vault lesion is encountered. The initial imaging assessment using computed tomography (CT) is invaluable in determining lesion aggressiveness based on bony margins and skull tables involvement. Further assessment with magnetic resonance (MR) imaging including diffusion weighted imaging (DWI) aids in soft tissue characterization. We present cases of large solitary lytic skull vault lesions in adults, emphasizing on salient and atypical imaging features, with pathological correlation for better understanding of the disease processes that underlie the imaging features.


Assuntos
Imagem por Ressonância Magnética/métodos , Neoplasias Cranianas/diagnóstico por imagem , Neoplasias Cranianas/patologia , Tomografia Computadorizada por Raios X/métodos , Adulto , Diagnóstico Diferencial , Imagem de Difusão por Ressonância Magnética , Feminino , Humanos , Masculino , Crânio/diagnóstico por imagem , Crânio/patologia
20.
J Forensic Sci ; 65(1): 276-282, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31305956

RESUMO

A body of an unknown adult female was found within a shallow burial ground in Malaysia whereas the skull was exposed and visible on the ground. During autopsy examination, nine insect larvae were recovered from the interior of the human skull and subsequently preserved in 70% ethanol. The larvae were greyish in appearance, each with a posterior elongated breathing tube. A week after the autopsy, more larvae were collected at the burial site, and some of them were reared into adults. Adult specimens and larvae from the skull and from the burial site were sequenced to obtain DNA barcodes. Results showed all adult flies reared from the burial site, as well as the larvae collected from the skull were identified as Eristalinus arvorum (Fabricius, 1787) (Diptera: Syrphidae). Here, we report the colonization of E. arvorum larvae on a human corpse for the first time.


Assuntos
Dípteros/genética , Dípteros/fisiologia , Entomologia Forense , Crânio/patologia , Adulto , Animais , Sepultamento , Código de Barras de DNA Taxonômico , Bases de Dados de Ácidos Nucleicos , Complexo IV da Cadeia de Transporte de Elétrons/genética , Comportamento Alimentar , Feminino , Humanos , Larva/fisiologia , Malásia , Mudanças Depois da Morte
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