RESUMEN
OBJECTIVES: Sarcoidosis affects the spinal cord in only 0.43% of patients with sarcoidosis. Usually there is systemic involvement prior to the development of cord lesions. We present a case of sarcoid isolated to the intramedullary spinal cord, which was a diagnostic and therapeutic challenge. We review the case and then present a review of the literature with an emphasis on presentation, diagnosis and treatment. METHODS: We have reviewed a patient who presented with an isolated sarcoid granuloma affecting the cervical spinal cord. All pertinent history and physical information was extracted from the patient's chart and through patient interview. Laboratory, radiographic and pathological investigations are presented. RESULTS AND CONCLUSIONS: Fourteen patients have been reported with isolated intramedullary spinal cord sarcoidosis. Current practice supports the role of surgery for biopsy; mainstay of treatment is corticosteroids.
Asunto(s)
Granuloma/patología , Sarcoidosis/patología , Enfermedades de la Médula Espinal/patología , Adulto , Diagnóstico Diferencial , Femenino , Humanos , Imagen por Resonancia MagnéticaRESUMEN
Cervical myelopathy consequent on ossification of posterior longitudinal ligament (OPLL) is very rare in Caucasians. A 65-year-old Anglo-Saxon woman developed progressive gait disturbance, paresthesia in both legs and urinary urge incontinence. Radiological examination showed OPLL from fifth to seventh cervical vertebral level; the dense OPLL was graphically displayed by three-dimensional computerized tomography. Medial corpectomy, C5 to C7, and removal of OPLL, with subsequent fusion C4 to T1 using a free fibula graft resulted in clinical improvement. Three dimensional computerized tomographic imaging is a valuable diagnostic procedure in OPLL.
Asunto(s)
Ligamentos Articulares/patología , Osificación Heterotópica/complicaciones , Enfermedades de la Médula Espinal/etiología , Anciano , Femenino , Humanos , Osificación Heterotópica/diagnóstico por imagen , Osificación Heterotópica/epidemiología , Radiografía , Enfermedades de la Médula Espinal/diagnóstico por imagen , Enfermedades de la Médula Espinal/epidemiología , Población BlancaRESUMEN
Two patients with congenital anomaly of the craniovertebral junction causing disabling hemifacial spasm (HFS) are presented. In one patient, complete cessation of the HFS occurred for a period of two years following simple bony decompression of the craniovertebral junction raising unanswered questions as to the exact pathogenesis of HFS. Eventually both patients required microvascular decompression at the root entry zone of the facial nerve.
Asunto(s)
Músculos Faciales , Vértebras Lumbares/anomalías , Enfermedades Musculares/fisiopatología , Cráneo/anomalías , Adulto , Angiografía Cerebral , Femenino , Humanos , Vértebras Lumbares/diagnóstico por imagen , Microcirculación , Cráneo/diagnóstico por imagenRESUMEN
We report a case of primary malignant schwannoma of the trigeminal nerve, and review the 5 previously reported cases. Clinical presentation, along with radiological and pathological features are discussed.
Asunto(s)
Neoplasias de los Nervios Craneales/patología , Neurofibroma/patología , Nervio Trigémino , Terapia Combinada , Neoplasias de los Nervios Craneales/terapia , Femenino , Humanos , Persona de Mediana Edad , Neurofibroma/terapiaRESUMEN
The problem of intracranial aneurysm causing subarachnoid hemorrhage in several members of three different families is illustrated and discussed in this report.
Asunto(s)
Aneurisma Intracraneal/genética , Adulto , Angiografía Cerebral , Femenino , Humanos , Aneurisma Intracraneal/complicaciones , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/cirugía , Masculino , Persona de Mediana Edad , Linaje , Hemorragia Subaracnoidea/etiología , Tomografía Computarizada por Rayos XRESUMEN
The pedigree of two interrelated families with 10 affected members suffering from malignant supratentorial gliomas is reported. In addition, three other unrelated families with two members each who were treated for different types of brain tumors are described. Genetic implications are discussed.
Asunto(s)
Neoplasias Encefálicas/genética , Glioma/genética , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , LinajeAsunto(s)
Neoplasias Encefálicas/patología , Adolescente , Niño , Preescolar , Humanos , Lactante , Estudios RetrospectivosRESUMEN
The case history of a patient treated for unilateral hereditary retinoblastoma who subsequently developed malignant melanoma and eosinophilic granuloma is presented. Although the association between retinoblastoma and second malignancies including malignant melanoma is established, we have found no reports of third malignancies occurring in such individuals.
Asunto(s)
Granuloma Eosinófilo/complicaciones , Neoplasias del Ojo/complicaciones , Melanoma/complicaciones , Retinoblastoma/complicaciones , Adulto , Neoplasias Óseas/complicaciones , Neoplasias del Ojo/genética , Humanos , Masculino , Retinoblastoma/genéticaAsunto(s)
Angioplastia de Balón , Fístula Arteriovenosa/terapia , Vértebras Cervicales/irrigación sanguínea , Arteria Vertebral/lesiones , Fístula Arteriovenosa/diagnóstico por imagen , Angiografía Cerebral/efectos adversos , Femenino , Humanos , Persona de Mediana Edad , Flebografía , Arteria Vertebral/diagnóstico por imagenRESUMEN
It is rare for patients with diastematomyelia to manifest initial symptoms in adult life. Clinical, radiological, and surgical features of a patient with symptomatic adult diastematomyelia are presented. Pathogenetic mechanisms are considered to include a variety of congenital spinal anomalies, distinct from the spur, as well as mechanical factors.
Asunto(s)
Defectos del Tubo Neural/cirugía , Adulto , Femenino , Humanos , Meningomielocele/diagnóstico , Meningomielocele/cirugía , Mielografía , Defectos del Tubo Neural/diagnóstico , Osteofitosis Vertebral/diagnóstico , Osteofitosis Vertebral/cirugíaRESUMEN
A case of spinal subdural hematoma occurring in association with anticoagulant therapy is reported. Seven similar cases from the literature are reviewed the emphasis on the clinical features, investigation, and the results of treatment. The prognosis for recovery is good, only if the condition is diagnosed and the clot evacuated before severe spinal cord compression and subsequent ischemic necrosis has occurred.
Asunto(s)
Anticoagulantes/efectos adversos , Hematoma Subdural/inducido químicamente , Compresión de la Médula Espinal/etiología , Anciano , Femenino , Hematoma Subdural/complicaciones , Hematoma Subdural/cirugía , Humanos , Compresión de la Médula Espinal/cirugía , Warfarina/efectos adversosAsunto(s)
Tumor Carcinoide/genética , Antígenos HLA/genética , Neoplasia Endocrina Múltiple/genética , Prolactina/metabolismo , Adolescente , Adulto , Tumor Carcinoide/metabolismo , Femenino , Genes Dominantes , Ligamiento Genético , Humanos , Hiperparatiroidismo/genética , Masculino , Persona de Mediana Edad , Neoplasia Endocrina Múltiple/metabolismo , Linaje , Neoplasias Hipofisarias/genética , Neoplasias Hipofisarias/metabolismoAsunto(s)
Neoplasias Encefálicas/diagnóstico , Tomografía por Rayos X/métodos , Adulto , Computadores , Femenino , HumanosRESUMEN
The clinical features of the Chiari Malformation in seven adult patients are presented. It is suggested that the clinical syndromes associated with this malformation, in adults, can be classified as (a) compression of structures at the level of foramen magnum (with or without radiologically demonstrable associated bony anomaly at the cranio-vertebral junction (b) increased intracranial pressure or obstructive hydrocephalus and (c) intramedullary cervical cord syndrome. The usefulness of tomography, and demonstration of the vertebro-basilar circulation in the neuro-radiologic investigation of these patients is emphasized. The surgical procedures performed in the management of these patients are outlined.