ABSTRACT
INTRODUCTION: Capillary angiomas are extremely rare in the spinal intradural space (being even less frequent in the intramedullary location)10-24. We analyze the characteristics of these lesions. METHODS: We present a case report of a patient with a symptomatic spinal-intradural capillary hemangioma at the thoracic level, followed by a review of the literature. RESULTS: We found a total of 41 patients reported with single angiomas, and three more patients with multiple lesions. Most patients were male (33/44 patients), and the mean age was 53,5 years. The localization of these lesions was mainly in the dorsal spine (24), cauda equina (15) and conus medullaris (6), with one case reported in the cervical spine 11. Most patients presented with back pain, mielopathy or radiculopathy. Contrary to the case of cavernous angiomas, we did not find cases of capillary angiomas presenting with subarachnoid or intramedullary hemorrhage. The imaging characteristics (isointense at T1WI, hyperintense at T2WI and with intense contrast enhancement) were constant in almost all the reports. CONCLUSIONS: Spinal intradural capillary angiomas are rare vascular lesions, frequently mistaken for intradural tumors. It affects mostly males in the fifth or sixth decade of life, and is preferentially located in the thoracolumbar spine. It can be occasionally associated with marked spinal cord edema, specially when there is a intramedullary component. These lesions have a good prognosis after surgical treatment, and must be taken into account in the differential diagnosis of intradural tumors of thoracolumbar spine and cauda equina.
Subject(s)
Humans , Male , Spinal Cord Neoplasms/diagnosis , Thoracic Vertebrae , Low Back Pain , Hemangioma, Capillary/surgery , Hemangioma, Capillary/complications , Hemangioma, Capillary/diagnosis , Magnetic Resonance ImagingABSTRACT
Introducción: El vasoespasmo cerebral es una complicación temida y aun no resuelta en los pacientes que cursan con hemorragia subaracnoídea neurismática (HSA), y que significa una importante morbi-mortalidad en dichos pacientes. Material y métodos: Se revisaron los registros de 161 pacientes ingresados en el Hospital Carlos Van Buren de Valparaíso por HSA entre entre Mayo de 2007 y Agosto de 2009, comparando la aparición de complicaciones isquémicas y resultados funcionales, según fuesen o no tratados con Simvastatina (40 mg/día). Resultados: El grupo de pacientes tratados con Simvastatina presentó significativamente menos infartos cerebrales (9,30 por ciento vs. 24,58 por ciento, p=0,02) y menos mortalidad intrahospitalaria (1,24 por ciento vs. 11,80 por ciento, p=0,04). Conclusiones: Si bien el diseño del estudio impide atribuir las diferencias encontradas al uso de Simvastatina, dado el contexto del mismo, es muy probable que así sea. El uso de estatinas en la hemorragia subaracnoídea aneurismática, como profilaxis del vasoespasmo es aún un tema controversial y promisorio, que se encuentra en plena etapa de estudio y desarrollo.
Background: Vasospasm is a feared complication in patients who present with aneurysmal subarachnoid hemorrhage (SAH) and that means significant morbidity and mortality in these patients. Material and methods: We reviewed the records of 161 patients admitted to the Hospital Carlos Van Buren with SAH between May 2007 and August 2009, comparing the occurrence of ischemic complications and functional results as they were or not treated with simvastatin (40mg/day). Results: The patient group treated with simvastatin had significantly fewer strokes (p = 0.02) and fewer hospital mortality (p = 0.04). Conclusions: Although the study design precludes attributing the differences found when using simvastatin, given the context, it is likely to be so. The use of statins in aneurismal subarachnoid hemorrhage for vasospasm prophylaxis is still a controversial and promising topic, wich is under full development and study.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aortic Rupture , Intracranial Aneurysm/complications , Subarachnoid Hemorrhage/complications , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Brain Ischemia/prevention & control , Brain Ischemia/therapy , Simvastatin/adverse effects , Simvastatin/therapeutic use , Vasospasm, Intracranial/complications , ChileABSTRACT
En esta presentación, 9 pacientes con tumores anexiales sólidos o complejos son sometidos a quistectomía transvaginal asistida laparoscópicamente. La quistectomía fue realizada a través de colpotomía colocando el ovario en una bolsa introducida por laparoscopia, previniendo el derrame del contenido quístico. El promedio de edad de las pacientes fue de 30 años y el tamaño de los tumores varió entre 50 y 120 mm. El tiempo operatorio promedio fue de 61 minutos. Siete tumores fueron teratomas quísticos maduros, uno fue un cistoadenoma seroso y otro correspondió a un cuerpo lúteo hemorrágico. No hubo derrame de contenido quístico dentro de la cavidad pelviana y no hubo complicaciones