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Osteochondroma is a rare condition in the spine that may be indolent due to its slow growth. The authors present a case of 32-year-old man with subclinical osteochondroma in the cervical spine presenting as Brown-Sequard syndrome after trivial neck trauma. After resection of the tumor through hemilaminectomy, his symptoms were improved with mild residual sequelae.
RESUMEN
OBJECTIVE: To assess the authors' experience of wound management following scalp mass surgery after introducing a policy of leaving hair unshaved and allowing patients to use shampoo. METHODS: The authors retrospectively reviewed 93 patients who underwent outpatient-based excision of a scalp or skull mass. Surgical complications, mass depth, and maximal mass size were analyzed. All of the surgeries were performed without shaving around the lesion; the hair was simply parted along the proposed incision, and the parting was maintained using adhesive plasters. Routine antiseptic scalp preparations, skin closure with staples after mass excision, and topical ointment on the day following surgery were used, and use of shampoo was allowed. The staples were removed on postoperative days 7-10. RESULTS: The masses were located in the skin (23 cases), subcutaneously (64 cases), and subgaleally (6 cases). All patients except one had satisfactory wound healing. No infections occurred. CONCLUSIONS: Leaving hair unshaved and allowing patients to use shampoo can be applied in wound management after scalp mass surgery.
Asunto(s)
Procedimientos Quirúrgicos Ambulatorios/métodos , Remoción del Cabello/efectos adversos , Cuero Cabelludo/cirugía , Adolescente , Adulto , Anciano , Antiinfecciosos Locales/uso terapéutico , Profilaxis Antibiótica , Niño , Preescolar , Femenino , Cabello/fisiología , Humanos , Lactante , Masculino , Persona de Mediana Edad , Pomadas , Estudios Retrospectivos , Enfermedades de la Piel/cirugía , Neoplasias Cutáneas/cirugía , Jabones , Cicatrización de Heridas , Adulto JovenRESUMEN
OBJECTIVE: To present the profiles of spinal cord tumors that can be removed through a unilateral hemilaminectomy and to demonstrate its usefulness for benign spinal cord tumors that significantly occupy the spinal canal. METHODS: From June 2004 to October 2010, 25 spinal cord tumors were approached with unilateral hemilaminectomy. We calculated the cross-sectional occupying ratio (CSOR) of tumor to spinal canal before and after the operations. RESULTS: The locations of the tumors were intradural extramedullary in 20 cases, extradural in 2, and intramedullary in 3. The levels of the tumors were lumbar in 12, thoracic 9, and cervical 4. In all cases, the tumor was removed grossly and totally without damaging spinal cord or roots. The mean height and width of the lesions we195re 17.64 mm (3-47.5) and 12.62 mm (4-32.7), respectively. The mean CSOR was 69.40% (range, 27.8-96.9%). Postoperative neurological status showed improvement in all patients except one whose neurologic deficit remained unchanged. Postoperative spinal stability was preserved during the follow-up period (mean, 21.5 months) in all cases. Tumor recurrence did not develop during the follow-up period. CONCLUSION: Unilateral hemilaminectomy combined with microsurgical technique provides sufficient space for the removal of diverse spinal cord tumors. The basic profiles of the spinal cord tumors which can be removed through the unilateral hemilaminectomy demonstrate its role for the surgery of the benign spinal cord tumors in various sizes.
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The intravenous administration of gadopentetate dimeglumine (GD) is relatively safe and rarely causes systemic toxicity in the course of routine imaging studies. However, the general safety of intrathecal GD has not been established. We report a very rare case of an overdose intrathecal GD injection presenting with neurotoxic manifestations, including a decreased level of consciousness, global aphasia, rigidity, and visual disturbance.
Asunto(s)
Medios de Contraste , Gadolinio DTPA , Inyecciones Espinales , Síndromes de Neurotoxicidad , Adulto , Afasia/etiología , Afasia/patología , Afasia/fisiopatología , Encéfalo/efectos de los fármacos , Encéfalo/patología , Medios de Contraste/administración & dosificación , Medios de Contraste/toxicidad , Gadolinio DTPA/administración & dosificación , Gadolinio DTPA/toxicidad , Humanos , Masculino , Rigidez Muscular/etiología , Rigidez Muscular/patología , Rigidez Muscular/fisiopatología , Síndromes de Neurotoxicidad/etiología , Síndromes de Neurotoxicidad/patología , Síndromes de Neurotoxicidad/fisiopatología , Tomografía Computarizada por Rayos X , Trastornos de la Visión/etiología , Trastornos de la Visión/patologíaRESUMEN
The authors report a case of spinal dural arteriovenous fistula (SDAVF) that is supplied by a lateral sacral artery. A 73-year-old male presented with gait disturbance that had developed 3 years ago. Spinal magnetic resonance imaging suggested a possible SDAVF. Selective spinal angiography including the vertebral arteries and pelvic vessels showed the SDAVF fed by left lateral sacral artery. The patient was subsequently treated with glue embolization. Three days after the embolization procedure, his gait disturbance was much improved.
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When a tear occurs in one of the major cervicocerebral arteries and allows blood to enter the wall of the artery and split its layers, the result is either stenosis or aneurysmal dilatation of the vessel. Vertebral artery dissection (VAD) is an infrequent occurrence but is a leading cause of stroke in young and otherwise healthy patients. This article discusses recent developments in understanding of the epidemiology and pathogenesis of VAD and the various clinical manifestations, methods of diagnosis, and approaches to treatment.