ABSTRACT
Objective. To analyze the use of intrathecal gadolinium for the accomplishment of cisternography with MRI for diagnosis, location and therapeutic programming of the CSF fistulas. Description. Clinical histories were analyzed, the methodology, diagnoses and therapies of the patients dealt in our service with fistula of cerebrospinal fluid in included/understood period between June of the 2000 and March of the 2008. From 2007 the method of diagnosis employed, was the use of Cisternography with intrathecal gadolinium because it offers the best results for us. Conclusion. The present methodology, using the intrathecal, precocious Gadolinium injection in the presence of a fistula, it offers the precise images not only for diagnoses, but also for the precise site of location and the necessity or not, of surgery.
Subject(s)
Cerebrospinal Fluid , Diagnostic Imaging , Fistula , Magnetic Resonance ImagingABSTRACT
Objetivo: describir un nuevo caso de aneurisma cirsoideo gigante de cuero cabelludo. Descripción: una mujer de 34 años de edad presentó una historia de cefaleas y deformación del cuero cabelludo pulsatil que aumentaba de tamaño con la maniobra de Valsalva. La resonancia magnética, la angiorresonancia y la angiografía digital mostraron una malformación arteriovenosa de cuero cabelludo alimentada exclusivamente por la arteria carótida externa derecha. Intervención: se realizó primero un clipado transitorio de las principales arterias eferentes para reducir la masa. Luego se hizo un colgajo cutáneo exponiendo y extirpando la malformación. Se preservó la vascularización del cuero cabelludo. La evolución postoperatoria fue favorable, retrogradando los síntomas. Conclusión: existen controversias en el manejo de malformaciones complejas del cuero cabelludo pero, pensamos que la elección de la técnica quirúrgica fue apropiada para el caso presentado. Palabras clave: aneurisma cirsoideo, cuero cabelludo, malformación arteriovenosa
Objective: to describe a new case of giant cisoid aneurysm of the scalp. Description: a woman, 34 years-old, presented a history of headaches and a pulsating scalp deformity that increased in size with the Valsalva manoeuvre. Magnetic resonance, angioresonance and digital angiography showed an arteriovenous malformation of the scalp feeded exclusively by the right external carotid artery. Intervention: We performed first clipping of the main efferent arteries, reducing the flow and the mass. Through a cutaneous flap of malformation was exposed and resected. Scalp vascularisation was preserved. Postoperative outcome was uneventful and the symptoms desappeared. Conclusion: There are many controversies in the managment of scalp complex malformations but we think that the surgical technique performed was appropiate for this case. Key words: arteriovenous maformation - cirsoid aneurysm - scalp.
Subject(s)
Humans , Adult , Female , Aneurysm/surgery , Scalp/surgery , Scalp/injuries , Scalp/pathology , Arteriovenous Malformations/surgery , Arteriovenous Malformations/pathologyABSTRACT
Objective: to describe the surgical treatment of an anterior sacral meningocele (ASM). Description: a 67 year-old woman presented with pelvic mass symptoms, and had a previous history of four surgeries with mistaken diagnosis, consulted to the neurosurgery departament for pain treatment. MRI revealed a cystic sacral mass connected with the spinal subarachnoid space, with low density structures in the pedicle. MyeloCT showed no neural elements in the sac. Intervention: an anterior transabdominal approach with wall cyst dissection, excision of the sac and simple ligation of the neck was performed. Conclusion: we presented an uncommon case of ASM in an adult woman, with the transabdominal surgical approach was the treatment of choice in anterior sacral meningocele