ABSTRACT
Cavernous hemangiomas, also known as deep hemangiomas are benign tumors of blood vessels, including normal and abnormal vascular structures, that develop in skin tissue and sometimes even in deep tissues. Its intraneural development in the peripheral nerve is very rare with less than 50 cases reported in the literature. We present a case of a cavernous hemangioma of the medial sural nerve in a patient with symptoms of severe pain and allodynia with complete resolution of symptoms with microsurgery.
Subject(s)
Hemangioma, Cavernous , Humans , Hemangioma, Cavernous/complications , Hemangioma, Cavernous/diagnostic imaging , Hemangioma, Cavernous/surgery , Peripheral Nerves/pathologyABSTRACT
La meralgia parestésica es un desorden neurológico causado por una neuropatía del nervio femorocutáneo lateral. Su etiología puede ser idiopática o iatrogénica. Se caracteriza por dolor, parestesias y entumecimiento en la cara anterolateral del muslo. Su diagnóstico es básicamente clínico, aunque pueden ser útiles pruebas de imagen o neurofisiológicas. A pesar de que el tratamiento conservador suele ser eficaz en la mayoría de los pacientes, existen casos refractarios que pueden precisar de otras formas de tratamiento. Los procedimientos quirúrgicos disponibles son la descompresión nerviosa (neurólisis) o la sección (neurectomía) y las ablaciones por radiofrecuencia. Presentamos un caso de meralgia parestésica invalidante refractaria en el cual empleamos la estimulación medular como posible técnica eficaz en el alivio del dolor y poder evitar la realización de una neurectomía del nervio femorocutáneo lateral (AU)
Meralgia paresthetica is a neurological disorder caused by a neuropathy of the lateral femoral cutaneous nerve. Its etiology can be spontaneous or iatrogenic. It is characterized by pain, paresthesia, and numbness in the anterolateral aspect of the thigh. Diagnosis is based on clinical examination, although image and neurophysiological tests can be useful as well. Despite conservative measures use to be effective in most of patients, refractory cases can benefit from alternative treatments. Available surgical procedures are: nerve decompression (neurolysis) or section (neurectomy) and radiofrequency ablation. We present a case of refractory meralgia paresthetica where spinal cord stimulation was used as a possible effective technique in pain relief and to avoid the neurectomy of the lateral femoral cutaneous nerve (AU)
Subject(s)
Humans , Female , Adult , Femoral Neuropathy/diagnosis , Nerve Compression Syndromes/diagnosis , Spinal Cord Stimulation , Femoral Neuropathy/therapy , Nerve Compression Syndromes/therapy , Treatment OutcomeABSTRACT
Meralgia paresthetica is a neurological disorder caused by a neuropathy of the lateral femoral cutaneous nerve. Its aetiology can be spontaneous or iatrogenic. It is characterized by pain, paresthesia, and numbness in the anterolateral aspect of the thigh. Diagnosis is based on clinical examination, although image and neurophysiological tests can be useful as well. Despite conservative measures use to be effective in most of patients, refractory cases can benefit from alternative treatments. Available surgical procedures are: nerve decompression (neurolysis) or section (neurectomy) and radiofrequency ablation. We present a case of refractory meralgia paresthetica where spinal cord stimulation was used as a possible effective technique in pain relief and to avoid the neurectomy of the lateral femoral cutaneous nerve.
Subject(s)
Femoral Neuropathy , Nerve Compression Syndromes , Spinal Cord Stimulation , Humans , Femoral Neuropathy/therapy , Femoral Neuropathy/complications , Spinal Cord Stimulation/adverse effects , Nerve Compression Syndromes/etiology , Nerve Compression Syndromes/therapy , Paresthesia/etiology , Pain/complicationsABSTRACT
Introducción. La afectación de la columna vertebral en la gota es una complicación extremadamente infrecuente. La dorsalgia y la cuadriplejía son algunas manifestaciones que se pueden presentar, aunque estos síntomas se ven con más frecuencia en otras patologías más prevalentes, como los tumores medulares. Caso clínico. Se presenta un caso inusual de compresión medular dorsal en D10-D11 causado por el depósito extradural de material tofáceo en una paciente de 52 años con gota tofácea crónica incontrolada. Además de un tratamiento médico intensivo, la paciente requirió cirugía (hemilaminectomía y descompresión medular) y rehabilitación posterior. La evolución general y neurológica fue satisfactoria (AU)
Introduction. Spine involvement in gout is an extremely uncommon complication. Dorsalgia and quadriplegia are some manifestations that may occur, although these symptoms are seen more frequently in other more prevalent pathologies, such as spinal tumors. Case report. We present an unusual case of thoracic spinal cord compression at T10-T11 level caused by the extradural deposit of tophaceous material in a 52-year-old woman with uncontrolled chronic tophaceous gout. In addition to intensive medical treatment, the patient required surgery (hemilaminectomy and spinal decompression) and subsequent rehabilitation. Overall and neurological evolution were satisfactory (AU)
Subject(s)
Humans , Female , Middle Aged , Spinal Cord Compression/etiology , Gout/complications , Decompression, Surgical/methods , Laminectomy/methods , Paraplegia/surgery , Spinal Cord Compression/surgeryABSTRACT
Introducción. El mutismo acinético se considera una alteración del estado motivacional de la persona, por el cual el paciente es incapaz de iniciar respuestas verbales o motoras de carácter voluntario, aun teniendo preservadas las funciones sensomotoras y de vigilancia. Caso clínico. Varón de 43 años, intervenido de una fístula arteriovenosa del cerebelo complicada con hidrocefalia, que respondió espectacularmente al tratamiento con bromocriptina. Conclusión. Típicamente se ha descrito el mutismo acinético como una complicación transitoria de las cirugías de la fosa posterior. Sin embargo, también puede aparecer tras múltiples fallos valvulares en pacientes con hidrocefalia (AU)
Introduction. Akinetic mutism is considered as an alteration of the motivational state of the person, which the patient is unable to initiate verbal or motor responses voluntary, even with preserved sensorimotor and surveillance functions. Case report. A 43 year-old male involved in a cerebellum arteriovenous fistula complicated with hydrocephalus, who responded dramatically to treatment with bromocriptine. Conclusion. Typically, akinetic mutism is described as a transient surgeries posterior fossa. However, it can also occur after multiple valvular failure in patients with hydrocephalus (AU)
Subject(s)
Humans , Male , Adult , Bromocriptine/therapeutic use , Akinetic Mutism/drug therapy , Postoperative Complications/drug therapy , Arteriovenous Fistula/surgery , Hydrocephalus/etiology , Tomography, X-Ray ComputedABSTRACT
INTRODUCTION: Ring chromosome 20 syndrome is a rare genetic disorder, with a late diagnosis. CASE REPORT: A 43-year-old woman who had had refractory epilepsy since the age of six years, for which she was treated with deep brain stimulation of the centromedian nucleus, and also a ring chromosome 20. CONCLUSIONS: From the findings of the study it can be concluded that deep brain stimulation of the centromedian nucleus is ineffective in patients with ring chromosome, but note must be taken of the importance of genetic characterisation for the management of refractory epilepsy.
TITLE: Estimulacion del nucleo centromediano en la epilepsia farmacorresistente asociada al cromosoma 20 en anillo.Introduccion. El sindrome del cromosoma 20 en anillo es una alteracion genetica infrecuente, con un diagnostico tardio. Caso clinico. Mujer de 43 años con epilepsia farmacorresistente desde los 6 años, tratada mediante estimulacion cerebral profunda del nucleo centromediano y con un cromosoma 20 en anillo. Conclusiones. Del estudio se extrae la conclusion de la inefectividad de la estimulacion cerebral profunda del nucleo centromediano en pacientes con cromosoma en anillo, pero se apunta la importancia de la caracterizacion genetica para el manejo de la epilepsia farmacorresistente.
Subject(s)
Deep Brain Stimulation , Drug Resistant Epilepsy/therapy , Intralaminar Thalamic Nuclei , Adult , Drug Resistant Epilepsy/genetics , Female , Humans , Ring ChromosomesABSTRACT
Introducción. El síndrome del cromosoma 20 en anillo es una alteración genética infrecuente, con un diagnóstico tardío. Caso clínico. Mujer de 43 años con epilepsia farmacorresistente desde los 6 años, tratada mediante estimulación cerebral profunda del núcleo centromediano y con un cromosoma 20 en anillo. Conclusiones. Del estudio se extrae la conclusión de la inefectividad de la estimulación cerebral profunda del núcleo centromediano en pacientes con cromosoma en anillo, pero se apunta la importancia de la caracterización genética para el manejo de la epilepsia farmacorresistente (AU)
Introduction. Ring chromosome 20 syndrome is a rare genetic disorder, with a late diagnosis. Case report. A 43-year-old woman who had had refractory epilepsy since the age of six years, for which she was treated with deep brain stimulation of the centromedian nucleus, and also a ring chromosome 20. Conclusions. From the findings of the study it can be concluded that deep brain stimulation of the centromedian nucleus is ineffective in patients with ring chromosome, but note must be taken of the importance of genetic characterisation for the management of refractory epilepsy (AU)
