ABSTRACT
Isolated neurosarcoidosis is a very rare disease, which makes up 5-15% of sarcoidosis cases. Hydrocephalus is a rare clinical feature with a prevalence of 6% among these patients. Considering neurosarcoidosis in the differential diagnosis of a unique parenquimal mass lesion could help in the early identification of this disease. We report the case of a 27-year-old African man who developed with a sole intracranial mass lesion mimicking radiologically a glioma, which finally came out as an isolated neurosarcoidosis. There is a difficulty in diagnosis when isolated neurosarcoidosis appears. In addition, the low prevalence of the disease entails a not standardized medical treatment. Natural outcome is poor even when hydrocephalus is resolved. Multimodal treatments including complete pharmacological treatment do not seem to assure a better outcome in these patients until date
La neurosarcoidosis cerebral aislada es una enfermedad muy rara, que representa entre el 5-15% de los casos de sarcoidosis. La hidrocefalia es una característica clínica poco frecuente, con una prevalencia del 6% entre estos pacientes. Considerar la neurosarcoidosis en el diagnóstico diferencial de una lesión de tipo masa parenquimatosa única puede ayudar en la identificación temprana de esta enfermedad. Presentamos el caso de un varón africano de 27 años de edad, que presenta una lesión de tipo masa única intracraneal que simulaba radiológicamente un glioma, y que finalmente se reveló como una neurosarcoidosis aislada. Es difícil establecer un diagnóstico cuando aparece una neurosarcoidosis cerebral aislada. Además, la baja prevalencia de la enfermedad conlleva un tratamiento médico no estandarizado. El pronóstico natural es malo, incluso cuando se resuelve la hidrocefalia. Hasta la fecha, los tratamientos multimodales, incluido el tratamiento farmacológico completo, no parecen asegurar un mejor resultado en estos pacientes
Subject(s)
Humans , Male , Adult , Sarcoidosis/diagnostic imaging , Sarcoidosis/surgery , Hydrocephalus/surgery , Brain Edema/diagnostic imaging , Central Nervous System Diseases/pathology , Hydrocephalus/diagnostic imaging , Diagnosis, Differential , Brain Diseases/diagnostic imaging , Biopsy , Adrenal Cortex Hormones/therapeutic use , Brain Edema/pathology , Brain Edema/surgeryABSTRACT
Isolated neurosarcoidosis is a very rare disease, which makes up 5-15% of sarcoidosis cases. Hydrocephalus is a rare clinical feature with a prevalence of 6% among these patients. Considering neurosarcoidosis in the differential diagnosis of a unique parenquimal mass lesion could help in the early identification of this disease. We report the case of a 27-year-old African man who developed with a sole intracranial mass lesion mimicking radiologically a glioma, which finally came out as an isolated neurosarcoidosis. There is a difficulty in diagnosis when isolated neurosarcoidosis appears. In addition, the low prevalence of the disease entails a not standardized medical treatment. Natural outcome is poor even when hydrocephalus is resolved. Multimodal treatments including complete pharmacological treatment do not seem to assure a better outcome in these patients until date.
Subject(s)
Central Nervous System Diseases , Hydrocephalus , Sarcoidosis , Adult , Central Nervous System Diseases/complications , Central Nervous System Diseases/diagnosis , Humans , Hydrocephalus/etiology , Magnetic Resonance Imaging , Male , Sarcoidosis/complications , Sarcoidosis/diagnosisABSTRACT
Los quistes aracnoideos intraselares son una patología muy rara, con muy pocos casos descritos en la literatura científica. Su fisiopatología permanece todavía poco clara, con diferentes hipótesis sobre su formación. El diagnóstico diferencial con otras lesiones quísticas selares puede ser extremadamente complicado. Presentamos 2 casos clínicos de 2 quistes aracnoideos sintomáticos que fueron tratados quirúrgicamente mediante abordaje transesfenoidal, así como los resultados de una revisión bibliográfica (AU)
Intrasellar arachnoid cysts are an uncommon pathology, with only a few cases reported in scientific literature. Their physiopathology is still unknown, with different hypothesis about their development. Differential diagnosis with other cystic sellar lesions is difficult. We report two cases of two intrasellar arachnoid cysts that were treated surgically usingtranssphenoidal approach and present a review of the literature (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Arachnoid Cysts/surgery , Sella Turcica/pathology , Diagnosis, Differential , Turbinates/surgery , Magnetic Resonance SpectroscopyABSTRACT
La hernia medular idiopática es una causa muy poco frecuente de mielopatía, siendo todavía más rara la existencia de una recidiva tras un correcto tratamiento. La herniación se produce a través de un defecto dural en la cara anterior de la duramadre a nivel de la columna torácica, por causas no bien establecidas. La cirugía debe liberar la médula, corrigiendo la alineación de la médula e intentando prevenir la recidiva de este cuadro. Presentamos el caso de una mujer con clínica de síndrome de Brown-Séquard consecuencia de una herniación medular a nivel D5, y que tras una primera cirugía exitosa presentó una recidiva de la herniación tras un traumatismo mínimo (AU)
Idiopathic spinal cord herniation is a rare cause of thoracic myelopathy and its recurrence is even more infrequent. Cord herniation is through an anterior dural defect in thoracic spine with unknown causes. Symptomatic cases must be surgically treated to reduce the hernia and seal the defect to prevent recurrences. We report a patient presenting a Brown-Séquard syndrome secondary to a D5 spinal cord herniation treated successfully and its posterior traumatic recurrence (AU)
Subject(s)
Humans , Female , Middle Aged , Brown-Sequard Syndrome/etiology , Herniorrhaphy/methods , Hernia/complications , Recurrence , Dura Mater/abnormalities , Spinal Cord Diseases/etiologySubject(s)
Cervical Vertebrae/drug effects , Spinal Fractures/drug therapy , Spondylitis, Ankylosing/drug therapy , Teriparatide/therapeutic use , Cervical Vertebrae/injuries , Cervical Vertebrae/surgery , Humans , Male , Middle Aged , Spinal Fractures/surgery , Spondylitis, Ankylosing/surgery , Treatment OutcomeABSTRACT
Intrasellar arachnoid cysts are an uncommon pathology, with only a few cases reported in scientific literature. Their physiopathology is still unknown, with different hypothesis about their development. Differential diagnosis with other cystic sellar lesions is difficult. We report two cases of two intrasellar arachnoid cysts that were treated surgically using transsphenoidal approach and present a review of the literature.
Subject(s)
Arachnoid Cysts , Sella Turcica , Adult , Arachnoid Cysts/diagnosis , Female , Humans , Male , Middle AgedABSTRACT
Idiopathic spinal cord herniation is a rare cause of thoracic myelopathy and its recurrence is even more infrequent. Cord herniation is through an anterior dural defect in thoracic spine with unknown causes. Symptomatic cases must be surgically treated to reduce the hernia and seal the defect to prevent recurrences. We report a patient presenting a Brown-Séquard syndrome secondary to a D5 spinal cord herniation treated successfully and its posterior traumatic recurrence.
Subject(s)
Intervertebral Disc Displacement/etiology , Spinal Cord Injuries/complications , Female , Humans , Middle Aged , RecurrenceABSTRACT
Los pituicitomas son una entidad poco frecuente incluida en la Clasificación de los Tumores del Sistema Nervioso de la Organización Mundial de la Salud (OMS) en el año 2007. Son lesiones originadas en la neurohipófisis y han sido confundidas durante años con otros tumores hipofisarios. Presentamos el caso de una mujer de 31 años diagnosticada de una lesión supraselar en el contexto de un estudio de infertilidad debida a un hipogonadismo-hipogonadotropo con prolactina ligeramente aumentada, a la que se realizó un abordaje pterional consiguiendo su exéresis completa. Tras la cirugía aparecieron hemianopsia bitemporal, diabetes insípida y panhipopituitarismo, y los 2 últimos se corrigieron en pocas semanas. Realizamos además una revisión de sus presentaciones clínicas y radiográficas más frecuentes, así como de los tratamientos planteados en los casos publicados (AU)
Subject(s)
Humans , Female , Adult , Pituitary Neoplasms/surgery , Hemianopsia/etiology , Optic Chiasm/cytology , Postoperative Complications , Hypogonadism/etiologyABSTRACT
Pituicytomas are rare entities which develop in the neurohypophysis. They were included in the last World Health Organization (WHO) Classification of Central Nervous System Tumours in 2007, but for many years they have been confused with other pituitary tumours. We report the case of a 31-year-old woman who was diagnosed of a tumour in the suprasellar region during an infertility study due to hypogonadotropic hypogonadism and slight hyperprolactinemia. A standard pterional approach was performed, achieving total tumour excision. After the surgery the patient suffered bitemporal hemianopsia, diabetes insipidus and panhypopituitarism, although she recovered from the latter 2 in a few weeks. We conducted a review of the most common clinical and radiological features of this entity, as well as the treatments proposed in the literature to treat this rare tumour.
