Quiste aracnoide espinal: presentacion de un caso / Spinal arachnoidal cyst: case presentation

Objective: to present a case of an extradural arachnoid dorsal cyst in a 30 year-old woman. Description: a patient (30 years, female) who refers eight-months history of radicular pain and progressive right leg weakness, with exacerbations and remissions. On examination the patient had righ hemihypesthesia with T-10 sensitive level and right leg 4/5 palsy. Magnetic resonance imaging showed an extradural cystic lesion in T11-T12 hypointense in T1 and hyperintense en T2, without contrast enhancement. The cyst contained fluid tha demonstrated the same signal as cerebrospinal fluid. Intervention: After laminectomy of T-10 and T-11 the cystic lesion was exposed. The cyst was filled with CSF-fluid like. A surgical resection of the cyst wall was made. A small dural defect that allowed communication between the cyst and the subarachnoid space was revealed during the surgery, and a closure was made with a suture. Histopathological examination confirmed a cystic lesion with a single-cell lining of meningothelial cells, that contained no neural tissue neither ganglion cells. Conclusion: extradural arachnoid cysts showed characteristic images in the MRI in the preoperative stage. There was no need to use other invasive methods such as myelography or mielotomography to decide the indication for surgery or the surgical technique. Definitive diagnosis is based on the free comunication with the subarachnoidal space and the lack of neural tissue in the histopatological examination, which allowed us to distinguish between extradural arachnoid cysts and Tarlov cysts

Linfoma no Hodgkin primario del sistema nervioso central en pacientes inmunocompetentes: nuestra experiencia / Primary non-Hodgkin lymphoma of the central nervous system in immunocompetent patients

Objetivo: Presentar 5 casos de linfomas primarios del sistema nervioso central. (LPS) en pacientes inmunocompetentes. Metodo: se consideraron estas variables: presentacion clinica, Karnofsky preoperatorio, topografia y multiplicidad lesional confirmacion histopatologica (cirugia versus biopsia) y sobrevida. Resultados: Cuatro pacientes presentaron un foco neurologico y uno un sindrome depresivo: todos presentaron Karnofsky > de 70. Las imagenes mostraron cuatro lesiones supratentoriales y una cerebelosa, todas bien delimitadas y captando homogeneamente el contraste: tres se resecaron, dos se biopsiaron estereotacticamente. El tratamiento se realizo con metotrexate aplicando radioterapia conformada en loas recaidas. A largo plazo un paciente vive libre de enfermedad, tres con enfermedad y uno fallecio al cuarto mes. CONCLUSION: Los LPS no presentan caracteristicas clinicoimagenologicas particulares para diferenciarlos de otros tumores pero su incidencia en aumento y el peor pronostico asociado a la reseccion parcial versus biopsia estereotactica, hace importante considerarlos como diagnostico diferencial al evaluar pacientes con masa expansiva intracerebral