RESUMO
Objective. To review the presentation, diagnosis and management of children with spinal dysraphism and CIT. Methods. It is a retrospective review of 146 children of spina bifida over 9 years (2000-2008) and details the clinical course and outcome of seven with associated congenital inclusion tumors. Results. 7/146 (4.7%) had spina bifida with CIT, 5 dermoid cysts and 2 mature teratoma. The diagnosis was missed by the primary physician even in the presence of a neurocutaneous marker. Spinal imaging with MRI was conclusive. All were managed with multilevel laminectomy, near total/total excision of the CIT and detethering of cord. Intramedullary involvement and established neurological deficits at presentation were associated with persistent deficits. Conclusion. Early detection and comprehensive management of CIT with spinal dysraphism ensures social fecourinary continence, preserves renal function, achieves ambulation and enables patients to lead an acceptable quality of life.
Assuntos
Adolescente , Criança , Pré-Escolar , Cisto Dermoide/epidemiologia , Cisto Dermoide/patologia , Cisto Dermoide/cirurgia , Feminino , Humanos , Lactente , Recém-Nascido , Laminectomia , Imageamento por Ressonância Magnética , Masculino , Estudos Retrospectivos , Neoplasias da Medula Espinal/congênito , Neoplasias da Medula Espinal/epidemiologia , Disrafismo Espinal/epidemiologia , Disrafismo Espinal/patologia , Disrafismo Espinal/cirurgia , Teratoma/epidemiologia , Teratoma/patologia , Teratoma/cirurgiaRESUMO
The spinal cord can be involved in a variety of disease processes. These can be congenital or acquired. An acute onset of symptoms usually allows a defined set of causes to be considered including trauma, ruptured vascular anomalies, demyelination, and myelitis. Intramedullary cavernous hemangioma of the spinal cord is a congenital or acquired vascular malformation, and one of the rare causes of hematomyelia. We present such a case, and discuss the symptoms, diagnosis, and suggested best treatment options based on a review of present day literature
Assuntos
Humanos , Masculino , Hemangioma Cavernoso do Sistema Nervoso Central/congênito , Hemangioma Cavernoso do Sistema Nervoso Central/diagnóstico por imagem , Hemangioma Cavernoso do Sistema Nervoso Central/terapia , Hemangioma Cavernoso do Sistema Nervoso Central/cirurgia , Neoplasias da Medula Espinal/congênito , Neoplasias da Medula Espinal/diagnóstico , Neoplasias da Medula Espinal/diagnóstico por imagem , Neoplasias da Medula Espinal/cirurgia , Imageamento por Ressonância Magnética , Líquido CefalorraquidianoRESUMO
Congenital spinal lipomas as a form of dysraphism are frequently reported in literature. A few studies have highlighted their histologic features and found them different from lipomas in other parts of the body. In a review of eight cases of spinal lipomas, we found heterotopic tissue in seven. Neural tissue, muscle, bone and cartilage were frequently encountered. The presence of meningothelial cells in one case was an unusual finding. These findings support the concept of their hamartomatous origin. Malignancy, occurring later in life in one of the heterotopic elements is known, though uncommon, and is one of the reasons, besides neurologic deficit, for long term follow-up.