RESUMO
INTRODUCTION: The term «gossypiboma¼ comes from the Latin gossypium, which refers to a genus of cotton plants, and from the Swahili word boma, which translates as «place of concealment¼. It may be mistaken for tumorous lesions or abscesses due to the way it is encapsulated, as evidenced in imaging examinations, and its variable and non-specific clinical features, which give rise to difficulty in its diagnosis and significant morbidity. AIM: To synthesise the available evidence on the presence of gossypibomas during neurosurgical procedures. DEVELOPMENT: A review was performed that included a search for articles in English and Spanish published in the last 15 years in PubMed, Ebsco Host, Embase, Mediclatina, Cochrane, Lilacs and Scopus, between January and June 2019, using the keywords «gossypiboma¼, «textiloma¼, «neurosurgery¼ and «neurosurgical procedures¼. In all, a total of 630 articles were found in the search, although, after selecting them by title and abstract, 22 case report articles were included for this review process. Altogether 36 individuals were identified, of whom 21 (58.3%) were women, and whose mean age was 56.1 years. Surgical sponges were observed as gossypibomas in 20 cases (55.6%). CONCLUSIONS: Gossypiboma is a complication secondary to surgical procedures that presents fairly unspecific signs and symptoms. The time that elapses before it appears usually ranges from a few days to several years after surgery and is correlated with multiple medical and legal implications.
TITLE: Gossypibomas en neurocirugía.Introducción. El término «gossypiboma¼ proviene del latín gossypium, que hace referencia a un género de plantas de algodón, y de la palabra kiswahili boma, que se traduce como «lugar de escondite¼. Puede confundirse con lesiones tumorales o abscesos debido a la forma de encapsulación evidenciada en los exámenes imaginológicos y su clínica variable e inespecífica, situación que genera dificultad para el diagnóstico y una morbilidad importante. Objetivo. Sintetizar la evidencia disponible sobre la presencia de gossypibomas durante la realización de procedimientos quirúrgicos en neurocirugía. Desarrollo. Se realizó una revisión en la cual se incluyó una búsqueda de artículos en inglés y castellano publicados en los últimos 15 años en PubMed, Ebsco Host, Embase, Mediclatina, Cochrane, Lilacs y Scopus, entre enero y junio de 2019, utilizando las palabras clave «gossypiboma¼, «textiloma¼, «neurosurgery¼ y «neurosurgical procedures¼. El total de artículos encontrados en la búsqueda fue de 630; sin embargo, tras la selección por título y resumen fueron 22 los artículos de informe de caso que se incluyeron. Se identificó a un total de 36 individuos, de los cuales 21 (58,3%) eran mujeres, y cuya edad media era de 56,1 años. En 20 casos (55,6%) se observaron esponjas quirúrgicas como gossypibomas. Conclusiones. El gossypiboma es una complicación secundaria a procedimientos quirúrgicos, con signos y síntomas bastante inespecíficos. Su tiempo de aparición suele oscilar entre unos cuantos días hasta varios años después de realizada la cirugía y se correlaciona con múltiples implicaciones médicas y legales.
Assuntos
Corpos Estranhos , Procedimentos Neurocirúrgicos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Corpos Estranhos/diagnóstico , Corpos Estranhos/epidemiologia , Corpos Estranhos/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
The perioperative management of patients with brain tumours is a challenge for the neurosurgeon and the entire surgical team. The treating physician should consider factors such as the type of tumour, extent of disease, treatment received, the presence of comorbidities and prognosis of the disease itself. The successful execution of all aspects involved in perioperative management in patients with brain tumours will help prolong the life and improve the quality of life of patients.
Assuntos
Neoplasias Encefálicas , Neurocirurgia , Papel do Médico , Cuidados Pré-Operatórios , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/cirurgia , Humanos , Convulsões/etiologia , Convulsões/terapia , Tromboembolia Venosa/etiologia , Tromboembolia Venosa/terapiaRESUMO
Chiari malformation type I and Poland's syndrome are two rare diseases and their simultaneous presentation had not been previously described in the literature. We report the case of a 27 year old male with history of Poland's syndrome, who referred headache and motor impairment of the intrinsic muscles of the left hand. In a cervical spine MR a Chiari I malformation with syringomyelia from C1 to T2 was found, which was treated by foramen magnum decompression, dural plasty and removal of the posterior arch of the atlas. A discussion of the embryological mechanisms that might be involved in the coexistence of these two entities is presented, emphasizing the role of para-axial mesoderm.
Assuntos
Malformação de Arnold-Chiari/epidemiologia , Síndrome de Poland/epidemiologia , Adulto , Malformação de Arnold-Chiari/etiologia , Malformação de Arnold-Chiari/cirurgia , Comorbidade , Humanos , Imageamento por Ressonância Magnética , Masculino , Síndrome de Poland/etiologia , Síndrome de Poland/cirurgiaRESUMO
Metastases of prostate cancer to intracranial meninges are rare and often confused with meningiomas or chronic subdural hematomas. These usually occur in patients with a known cancer diagnosis in advanced stages of the disease, and only in some rare cases do its manifestations precede the detection of the primary tumour. The clinical presentation is unspecific. However, due to the affinity of this tumour for the base of the skull, it must be included in the differential diagnosis of men over 70 years of age with cranial nerve palsy. The treatment of these lesions has not been standardized. Within the therapeutic options we find surgical resection, chemotherapy, radiotherapy or a combination of these measures, and yet survival is poor. We present the case of a 77 year old male patient whose initial symptoms of prostate cancer were caused by a metastatic lesion to the dura, confirmed by histopathology. We also review the epidemiological, clinical and imaging highlights of this condition.