Síndrome del desfiladero torácico neurogénico causado por la arteria escapular descendente: comunicación de un caso / Neurogenic thoracic gland syndrome caused by the descending descending artery: case report

El síndrome del desfiladero torácico es una entidad clínica compleja que abarca varias situaciones donde hay compresión del paquete vásculo-nervioso que suministra las extremidades superiores en el canal cervicotorácico. El síndrome se puede dividir en neurogénico y vascular de acuerdo con la estructura comprometida, siendo la primera la más frecuente. Entre las causas descritas están las costillas cervicales, anomalías de la primera costilla, músculos anómalos o hipertrofiados, traumatismos y tumores de la región. Describimos el caso de una paciente de 47 años que presenta un cuadro de cervicobraquialgia asociado con parestesias y paresia en la mano izquierda compatible con síndrome del desfiladero torácico en que la causa de la compresión era la arteria escapular descendente. Fue realizada una revisión de la literatura siendo encontrado sólo un caso similar.

The thoracic outlet syndrome is a complex clinical entity that encompasses several situations where there is compression of the neurovascular bundle that supplies the upper limbs in the cervicothoracic channel. It can be divided in neurogenic and vascular according to the structure committed, the first being the most frequently found. Among the causes described there are cervical ribs, anomalies of the first rib, anomalous or hypertrophied muscles, trauma and tumors of the region. We report the case of a 47 year old patient who presents with a clinical picture of cervicobrachialgia associated with paresthesia and paresis on the left hand compatible with thoracic outlet syndrome in which the cause of compression was the descending scapular artery.We conducted a literature review and found only one similar case.

Evaluación de la histotoxicidad del 2-octyl-cyanoacrilato en el cerebro del conejo / Histotoxicity evaluation of 2-octyl-cyanoacrylate on the rabbit's brain

The aim of the present study was to evaluate the effect of the 2-octyl-cyanoacrylate, on a rabbit's brain. The study was undertaken to investigate the histological behavior of the brain with this synthetic tissue adhesive. We evaluated a total of 12 rabbits, wich were randomized into 2 groups of 6 rabbits each. Following fronto-temporo-parietal craniectomy, 1 cm of the cranium was removed and the dura mater was 0,5 cm sectioned. In the control group, dura mater was sutured with 6-0 polypropylene interrupted sutures. In the study group, the brains were covered by using 2-octyl-cyanoacrylate (high viscosity), before closurewith 6-0 polypropylene suture. Rabbits were sacrificed on day 7 following operation. Integrity of the sutures, existence of abscess, wound infection and adhesion formation were recorded. The heads were removed including the site of operation and then, the specimens were sent for histological examination. Mean weights of each study group increased. The body temperatures of the animals were normal in the two groups. The histopathological evaluation of the brains treated with the synthetic glue revealed 50 per cent of inflammatory response with focal necrosis in the cortex. Only one rabbit had a normal brain. Results under experimental conditions, indicate that this new substance, 2-octyl-cyanoacrylate, can not be considered as safe supportive material for intradural procedures directly involving the brain tissue.