Quiste aracnoideo gigante / Giant arachnoid cyst

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[Reversible porencephalic cyst related to shunt dysfunction]. / Cavidad porencefálica reversible secundaria a disfunción valvular.

INTRODUCTION: The surgical treatment of hydrocephalus is one of the most commonly procedures of modern pediatric neurosurgical practice, and cerebrospinal fluid shunts are the main means of treatment of hydrocephalus, being independent of site of obstruction and ventricular shunt complications are frequent, especially in children. The most common complications are shunt obstructions, mechanical disconnections, overdrainage and infection. CASE REPORT: A 7.5-year-old girl with ventriculoperitoneal shunt presented with intermittent headache. A head computed tomography scan revealed a cyst located in right temporal lobe. After ventriculoperitoneal shunt revision, a gradual resolution of the cyst was demonstrated on computed tomography. CONCLUSIONS: Cerebrospinal fluid porencephaly is a rare postoperative complication of a ventricular shunt that results from dysfunction of the distal catheter, especially in children with taut ventricles.

TITLE: Cavidad porencefalica reversible secundaria a disfuncion valvular.Introduccion. El tratamiento quirurgico de la hidrocefalia es uno de los procedimientos quirurgicos mas habituales en la neurocirugia pediatrica, y las derivaciones ventriculoperitoneales constituyen una herramienta fundamental en el tratamiento de la hidrocefalia tanto infantil como del adulto. Las complicaciones de las valvulas son relativamente frecuentes, sobre todo en la poblacion pediatrica, y, entre estas, las mas habituales incluyen: las obstrucciones, las desconexiones, el hiperdrenaje y las infecciones. Caso clinico. Niña de 7,5 años, portadora de una valvula ventriculoperitoneal, que presentaba cefalea intermitente. Un estudio con tomografia computarizada demostro una lesion quistica temporal derecha. Tras la revision valvular, la tomografia computarizada evidencio la reduccion del quiste. Conclusiones. La formacion de una cavidad porencefalica es una complicacion poco frecuente. Se relaciona con problemas en el cateter distal en pacientes con ventriculos dilatados y de las que existen escasas referencias en la bibliografia.

Cavidad porencefálica reversible secundaria a disfunción valvular / Reversible porencephalic cyst related to shunt dysfunction

Introducción. El tratamiento quirúrgico de la hidrocefalia es uno de los procedimientos quirúrgicos más habituales en la neurocirugía pediátrica, y las derivaciones ventriculoperitoneales constituyen una herramienta fundamental en el tratamiento de la hidrocefalia tanto infantil como del adulto. Las complicaciones de las válvulas son relativamente frecuentes, sobre todo en la población pediátrica, y, entre éstas, las más habituales incluyen: las obstrucciones, las desconexiones, el hiperdrenaje y las infecciones. Caso clínico. Niña de 7,5 años, portadora de una válvula ventriculoperitoneal, que presentaba cefalea intermitente. Un estudio con tomografía computarizada demostró una lesión quística temporal derecha. Tras la revisión valvular, la tomografía computarizada evidenció la reducción del quiste. Conclusiones. La formación de una cavidad porencefálica es una complicación poco frecuente. Se relaciona con problemas en el catéter distal en pacientes con ventrículos dilatados y de las que existen escasas ref rencias en la bibliografía (AU)

Introduction. The surgical treatment of hydrocephalus is one of the most commonly procedures of modern pediatric neurosurgical practice, and cerebrospinal fluid shunts are the main means of treatment of hydrocephalus, being independent of site of obstruction and ventricular shunt complications are frequent, especially in children. The most common complications are shunt obstructions, mechanical disconnections, overdrainage and infection. Case report. A 7.5-year-old girl with ventriculoperitoneal shunt presented with intermittent headache. A head computed tomography scan revealed a cyst located in right temporal lobe. After ventriculoperitoneal shunt revision, a gradual resolution of the cyst was demonstrated on computed tomography. Conclusions. Cerebrospinal fluid porencephaly is a rare postoperative complication of a ventricular shunt that results from dysfunction of the distal catheter, especially in children with taut ventricles (AU)

Quiste aracnoideo intraventricular / Intraventricular arachnoid cyst

Introducción. Los quistes aracnoideos intracraneales son lesiones congénitas de carácter benigno formadas por una membrana aracnoidea que contiene en su interior un líquido de características similares al líquido cefalorraquídeo. La prevalencia de estos quistes es alta en las primeras dos décadas de la vida, y es poco frecuente en ancianos; representan alrededor del 1% de todas las lesiones intracraneales ocupantes de espacio. Presentamos el caso de una paciente con un quiste aracnoideo intraventricular tratado endoscópicamente. Caso clínico. Mujer de 75 años que presenta una hemiparesia progresiva de dos años de evolución. La resonancia magnética craneal mostró una lesión quística intraventricular en la región parietooccipital derecha, con efecto masa local y moderada dilatación de los ventrículos laterales. A través de un agujero de trépano frontal derecho, se realizó una fenestración cistoventricular y apertura del septo pelúcido. No se presentaron complicaciones relacionadas con la cirugía y la paciente fue dada de alta asintomática. Conclusiones. La fenestración neuroendoscópica es un tratamiento efectivo para los quistes aracnoideos intraventriculares, con un escaso índice de complicaciones (AU)

Introduction. Intracranial arachnoids cysts are considered benign developmental anomalies that occur within the arachnoid membrane and generally contain clear and colourless fluid resembling cerebrospinal fluid. The prevalence of these cysts is higher in the first two decades of life, and the incidence is widely quoted as approximately 1% of all space-occupying intracranial lesions. Arachnoids cysts in the elderly person are a rare occurrence. We report the unusual presentation of a woman with an intraventricular arachnoid cyst treated with endoscopic technique. Case report. A 75-year-old woman presented with progressive hemiparesis of two years duration. Cranial MR imaging showed a right parieto-occipital intraventricular cyst with local mass effect and moderate dilatation of lateral ventricles. A right-sided burr hole was made and the arachnoids cyst was reached and cysto-ventricle shunting was realized. This was followed by a septum pellucidum fenestration. There were no complications during the surgery and the patient presented no symptoms at time of discharge. Conclusions. The neuroendoscopic approach to intraventricular arachnoid cysts was effective with few complications (AU)

[Intraventricular arachnoid cyst]. / Quiste aracnoideo intraventricular.

INTRODUCTION. Intracranial arachnoids cysts are considered benign developmental anomalies that occur within the arachnoid membrane and generally contain clear and colourless fluid resembling cerebrospinal fluid. The prevalence of these cysts is higher in the first two decades of life, and the incidence is widely quoted as approximately 1% of all space-occupying intracranial lesions. Arachnoids cysts in the elderly person are a rare occurrence. We report the unusual presentation of a woman with an intraventricular arachnoid cyst treated with endoscopic technique. CASE REPORT. A 75-year-old woman presented with progressive hemiparesis of two years duration. Cranial MR imaging showed a right parieto-occipital intraventricular cyst with local mass effect and moderate dilatation of lateral ventricles. A right-sided burr hole was made and the arachnoids cyst was reached and cysto-ventricle shunting was realized. This was followed by a septum pellucidum fenestration. There were no complications during the surgery and the patient presented no symptoms at time of discharge. CONCLUSIONS. The neuroendoscopic approach to intraventricular arachnoid cysts was effective with few complications.

TITLE: Quiste aracnoideo intraventricular.Introduccion. Los quistes aracnoideos intracraneales son lesiones congenitas de caracter benigno formadas por una membrana aracnoidea que contiene en su interior un liquido de caracteristicas similares al liquido cefalorraquideo. La prevalencia de estos quistes es alta en las primeras dos decadas de la vida, y es poco frecuente en ancianos; representan alrededor del 1% de todas las lesiones intracraneales ocupantes de espacio. Presentamos el caso de una paciente con un quiste aracnoideo intraventricular tratado endoscopicamente. Caso clinico. Mujer de 75 años que presenta una hemiparesia progresiva de dos años de evolucion. La resonancia magnetica craneal mostro una lesion quistica intraventricular en la region parietooccipital derecha, con efecto masa local y moderada dilatacion de los ventriculos laterales. A traves de un agujero de trepano frontal derecho, se realizo una fenestracion cistoventricular y apertura del septo pelucido. No se presentaron complicaciones relacionadas con la cirugia y la paciente fue dada de alta asintomatica. Conclusiones. La fenestracion neuroendoscopica es un tratamiento efectivo para los quistes aracnoideos intraventriculares, con un escaso indice de complicaciones.

[Paediatric neurocysticercosis: two case reports]. / Neurocisticercosis pediatrica: a proposito de dos casos.

INTRODUCTION: Neurocysticercosis, caused by the larvae of Taenia solium, is the most common parasitic infection of the central nervous system in humans. Considered an endemic parasitosis in developing countries including Latin America, Asia and Africa while in Europa, the cases of neurocysticercosis are anecdotal. CASE REPORTS: We report two cases of neurocysticercosis in children of non-Spanish origin who presented with seizures, with the initial diagnosis of brain tumors both were treated with surgery; later, to be the diagnosis of neurocisticercosis antiparasitic therapy was administered. CONCLUSIONS: Neurocysticercosis can be a potential cause of epilepsy even in non-endemic countries. Some cases may be difficult to diagnose and they can be confused with other intracranial lesions. Clinicians should be aware of this condition given increasing incidence in Spain and neurocysticercosis should be always be considered in the differential diagnosis particularly in patients from Latin America and Africa.

Neurocisticercosis pediátrica: a propósito de dos casos / Paediatric neurocysticercosis: two case reports

Introducción. La neurocisticercosis es la enfermedad parasitaria más frecuente del sistema nervioso central y está causada por una infestación por la larva de la Taenia solium. Se trata de una enfermedad endémica en los países en vías de desarrollo, principalmente de América Latina, Asia y África, mientras que su presencia en Europa es anecdótica. Casos clínicos. Presentamos los casos de dos niños de origen no español, que comenzaron con una crisis epiléptica y que fueron diagnosticados inicialmente como tumores cerebrales primarios. Ambos fueron intervenidos quirúrgicamente y al diagnosticarse la parasitosis, recibieron posteriormente tratamiento antiparasitario. Conclusiones. La neurocisticercosis es una causa potencial de epilepsia incluso en aquellos países en los que no endémica. Numerosos casos presentan dificultades en el diagnóstico y se pueden confundir con otras lesiones intracraneales. Los facultativos debemos estar alerta, ya que se trata de una patología con un cierto repunte en España y se debe tener en cuenta en los diagnósticos diferenciales cuando tratamos pacientes procedentes de América Latina o África (AU)

Introduction. Neurocysticercosis, caused by the larvae of Taenia solium, is the most common parasitic infection of the central nervous system in humans. Considered an endemic parasitosis in developing countries including Latin America, Asia and Africa while in Europa, the cases of neurocysticercosis are anecdotal. Case reports. We report two cases of neurocysticercosis in children of non-Spanish origin who presented with seizures, with the initial diagnosis of brain tumors both were treated with surgery; later, to be the diagnosis of neurocisticercosis antiparasitic therapy was administered. Conclusions. Neurocysticercosis can be a potential cause of epilepsy even in non-endemic countries. Some cases may be difficult to diagnose and they can be confused with other intracranial lesions. Clinicians should be aware of this condition given increasing incidence in Spain and neurocysticercosis should be always be considered in the differential diagnosis particularly in patients from Latin America and Africa (AU)

[Primary cranial vault lymphoma]. / Linfoma primario de la calota craneal.

INTRODUCTION: Primary bone lymphomas account for 3-7% of all malignant bone tumours and less than 2% of lymphomas in adults. Having the cranial vault as their primary location is very infrequent. CASE REPORT: A 59-year-old female who presented a painful tumour on the cranial vault which, following radical surgical removal, was found to be an ALK-negative primary large-cell lymphoma. CONCLUSIONS: After reviewing the literature we believe that this is the first case of cranial vault lymphoma in which the translocation of the ALK protein-producing gene has been studied.

Linfoma primario de la calota craneal / Primary cranial vault lymphoma

Introducción. Los linfomas primarios del hueso representan el 3-7% de todos los tumores óseos malignos de los huesos y menos del 2% de todos los linfomas del adulto. Su localización primaria en la bóveda craneal es excepcional. Caso clínico. Mujer de 59 años que presentó una tumoración dolorosa sobre la calota craneal y que tras la extirpación quirúrgica radical se comprobó que se trataba de un linfoma primario de células grandes ALK negativo. Conclusión. Tras la revisión de la bibliografía consideramos que se trata del primer caso de linfoma de calota craneal en el que se estudió la traslocación del gen productor de la proteína ALK (AU)

Introduction. Primary bone lymphomas account for 3-7% of all malignant bone tumours and less than 2% of lymphomas in adults. Having the cranial vault as their primary location is very infrequent. Case report. A 59-year-old female who presented a painful tumour on the cranial vault which, following radical surgical removal, was found to be an ALK-negative primary large-cell lymphoma. Conclusions. After reviewing the literature we believe that this is the first case of cranial vault lymphoma in which the translocation of the ALK protein-producing gene has been studied (AU)

Tumores de la vaina de las raíces nerviosas espinales / Tumours of the nerve root sheath in the spine

Introducción. Los tumores de las vainas nerviosas representan alrededor del 30% de los tumores medulares del adulto. La mayoría son tumores solitarios que se pueden localizar en cualquier punto a lo largo del canal espinal, y cuando aparecen lesiones múltiples, se trata habitualmente de neurofibromas en el contexto de una enfermedad de von Recklinghausen. Objetivo. Analizar las características clínicas y radiológicas, el tratamiento y la evolución de una serie de pacientes con tumores de las vainas nerviosas espinales. Pacientes y métodos. Estudio retrospectivo sobre los pacientes intervenidos de tumores de vainas nerviosas espinales en un período de 25 años. Analizamos la edad, sexo, sintomatología, hallazgos de exploración física, estudios radiológicos practicados, localización del tumor y resultados quirúrgicos. Resultados. La serie consta de 35 varones y 33 mujeres, con una media de edad de 55 años (rango: 12-76 años). El dolor local o radicular fue el primer síntoma en 55 pacientes (80,8%). En 49 casos (66,2%), el tumor estaba localizado en la región lumbosacra, 15 casos eran dorsales (20,2%) y 10 cervicales (13,6%). La exéresis fue completa en 70 tumores (94,5%) y subtotal en 4 (5,5%). Histológicamente, 66 tumores (89,1%) fueron neurinomas, y 8 (10,9%), neurofibromas. Conclusiones. Los tumores de las vainas de las raíces espinales pueden presentarse en cualquier lugar del canal espinal, predominando en la región lumbosacra. La mayor parte de los pacientes comienza con dolor local o radicular, y en la mayoría de los casos es posible la resección completa del tumor con una buena recuperación funcional (AU)

Introduction. Spinal schwannomas account for about 30% of intradural spinal cord tumors in adults. More are solitary tumors, which can occur throughout the spinal canal. The multiple form of neurofibromas is known as von Recklinghausen disease. Aim. To analyze clinical and radiologic characteristics, treatment and evolution of patients with spinal nerve sheath tumor. Patients and methods. This was a retrospective study in a series of patients treated surgically of spinal schwannomas during 25 years. The following variables were evaluated: gender, age, symptomatology, radiological findings, localization, surgical findings and results. Results. We treated 35 male and 33 female with a mean age of 55 years (range: 12-76 years).The most common presurgical symptom was local or radicular pain in 55 patients (80.8%). In 49 cases (66.2%), the tumor was sited in the lumbosacral, in 15 cases (20.2%) in the dorsal tract, and in 10 cases (13.6%) in the cervical tract. Total removal was achieved in 70 cases (94.5%) and subtotal resection in 4 (5.5%). 66 tumors (89.1%) were schwannomas and the other 8 cases (10.9%) neurofibromas. Conclusions. Tumors of the spinal root sheaths can occur at any level of the spinal canal. Most patients present with local and/or radicular pain and in most cases total resection its possible with good functional recovery (AU)

[Tumours of the nerve root sheath in the spine]. / Tumores de la vaina de las raíces nerviosas espinales.

INTRODUCTION: Spinal schwannomas account for about 30% of intradural spinal cord tumors in adults. More are solitary tumors, which can occur throughout the spinal canal. The multiple form of neurofibromas is known as von Recklinghausen disease. AIM. To analyze clinical and radiologic characteristics, treatment and evolution of patients with spinal nerve sheath tumor. PATIENTS AND METHODS: This was a retrospective study in a series of patients treated surgically of spinal schwannomas during 25 years. The following variables were evaluated: gender, age, symptomatology, radiological findings, localization, surgical findings and results. RESULTS: We treated 35 male and 33 female with a mean age of 55 years (range: 12-76 years).The most common pre-surgical symptom was local or radicular pain in 55 patients (80.8%). In 49 cases (66.2%), the tumor was sited in the lumbosacral, in 15 cases (20.2%) in the dorsal tract, and in 10 cases (13.6%) in the cervical tract. Total removal was achieved in 70 cases (94.5%) and subtotal resection in 4 (5.5%). 66 tumors (89.1%) were schwannomas and the other 8 cases (10.9%) neurofibromas. CONCLUSIONS: Tumors of the spinal root sheaths can occur at any level of the spinal canal. Most patients present with local and/or radicular pain and in most cases total resection its possible with good functional recovery.