RESUMEN
True intramedullary epidermoids and true intramedullary lipomas of the spinal cord are very rare lesions. To our knowledge, there has been no reported case associated with an intramedullary spinal lipoma. This is the first reported case with the association of these two lesions. In this report a 3-year-old boy with intramedullary spinal lipoma is presented. We discuss the frequency, clinical features, MRI characteristics and limits of surgical treatment of these tumors and review the associated literature.
Asunto(s)
Carcinoma de Células Escamosas/diagnóstico , Lipoma/diagnóstico , Neoplasias de la Médula Espinal/diagnóstico , Carcinoma de Células Escamosas/cirugía , Preescolar , Humanos , Lipoma/cirugía , Masculino , Neoplasias de la Médula Espinal/cirugíaRESUMEN
Shewanella putrefaciens has a wide geographical distribution, including all forms of sea water, fresh water, fish and soil. In humans, it is an unusual pathogen of wound infections. In this report, a wound infection was presented in a previously healthy man.
Asunto(s)
Traumatismos Craneocerebrales/cirugía , Infecciones por Bacterias Gramnegativas/tratamiento farmacológico , Shewanella putrefaciens/aislamiento & purificación , Infección de la Herida Quirúrgica/tratamiento farmacológico , Infección de la Herida Quirúrgica/microbiología , Adulto , Antibacterianos , Traumatismos Craneocerebrales/diagnóstico , Quimioterapia Combinada/uso terapéutico , Estudios de Seguimiento , Infecciones por Bacterias Gramnegativas/diagnóstico , Humanos , Masculino , Enfermedades Raras , Medición de Riesgo , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
This study investigated the effects of Ginkgo biloba extract (EGb-76l), an anti-oxidant and platelet-activating factor antagonist, on basilar artery vasospasm in an experimental canine subarachnoid hemorrhage model. Morphometric analyses were performed, and serum and cerebrospinal fluid endothelin-l levels were measured by radioimmunoassay. Comparisons were made between treated and untreated groups. Twenty-four mongrel dogs were randomly assigned to three groups. The animals in group 1 (n = 8) were not subjected to subarachnoid hemorrhage and received no treatment. In this group, serum and cerebrospinal fluid endothelin-l levels were measured daily for 8 days. On day 9, the animals were killed and their basilar arteries were excised for histopathological examination. In group 2 (n = 8), subarachnoid hemorrhage was produced using autologous arterial blood, and daily intravenous boluses of saline were administered for the next 8 days. Assessments of endothelin-l levels and the basilar arteries were performed as described for group 1. In group 3 (n = 8), subarachnoid hemorrhage was produced using autologous arterial blood, and daily intravenous boluses of EGb-761 were administered for 8 days. Endothelin-1 levels and the basilar arteries were assessed as described above. The groups' serum endothelin-1, cerebrospinal fluid endothelin-1, and histopathological findings were compared. In group 1, the serum and cerebrospinal fluid endothelin-1 levels did not change significantly over the 8 days, and histopathological examination of the basilar arteries revealed no abnormalities. In group 2, the serum and cerebrospinal fluid endothelin-1 levels increased abruptly and significantly on day 2, and remained high to the end of the study period (day 8). Histopathological examination revealed marked vasospasm. In group 3, the serum and cerebrospinal fluid endothelin-1 levels followed the same pattern observed in group 2; however, the arteries showed significantly less vasospasm than that observed in group 2. The study findings did not provide information about the mechanism of action of the platelet-activating factor-antagonist EGb-761, but they clearly show that this agent decreases morphologic vasospasm in the dog basilar artery.
Asunto(s)
Arteria Basilar/efectos de los fármacos , Endotelina-1/sangre , Extractos Vegetales/uso terapéutico , Factor de Activación Plaquetaria/antagonistas & inhibidores , Hemorragia Subaracnoidea/tratamiento farmacológico , Vasoespasmo Intracraneal/prevención & control , Animales , Arteria Basilar/patología , Perros , Endotelina-1/orina , Ginkgo biloba , Masculino , Hemorragia Subaracnoidea/complicaciones , Vasoespasmo Intracraneal/etiología , Vasoespasmo Intracraneal/patologíaRESUMEN
Chordomas are extradural tumors and usually originate from sacrococcygeal region, vertebral column, and clivus. The authors present a case of spinal intradural chordoma (terminal filum). To the best of their knowledge, this is the first such case in the English-language literature.
Asunto(s)
Cordoma/diagnóstico , Neoplasias de la Columna Vertebral/diagnóstico , Adulto , Cordoma/patología , Cordoma/cirugía , Femenino , Humanos , Laminectomía , Imagen por Resonancia Magnética , Neoplasias de la Columna Vertebral/patología , Neoplasias de la Columna Vertebral/cirugíaRESUMEN
STUDY DESIGN: The authors report a case of an atlas fracture at the anterior arch. OBJECTIVE: To discuss the difficulty in diagnosing this type fracture. SUMMARY OF BACKGROUND DATA: Fractures of the atlas are not uncommon, and actually constitute 10% of all cervical spine injuries in adults. However, in the pediatric population, fractures of atlas are extremely rare, and only a few cases have been described. Only two isolated anterior arcus fractures of the atlas have been reported previously. METHODS: A 2.5-year-old girl was admitted to the authors' department with neck pain and head tilt 2 days after falling from a wall onto the top of the head. Radiographs of the cervical spine reportedly showed no abnormality. Computed tomography of the upper cervical spine showed a fracture in left anterior arch of the C1 vertebra with a 2-mm separation. She was placed in a firm cervical collar and instructed to reduce her daily physical activities. A repeat scan 3 months later showed fusion at the fracture site. RESULTS: The patient was treated with a firm cervical collar, and fusion of the fracture site was documented with computed tomography scan at 12 weeks after the injury. Her cervical collar was removed, and she has been fully active with no restrictions. CONCLUSIONS: On plain radiographs, fractures of the atlas and anterior aspect in particular may remain occult. Accurate diagnosis of atlas fractures depends on further radiologic investigations including computed tomography and magnetic resonance imaging. Experience in treating atlas fractures is insufficient because of a paucity of literature. Immobilization with a firm cervical collar is the treatment of choice in stable atlas fracture.