ABSTRACT
We report a case of a 55-year-old woman, that has a mild hypertension, in use of a betablocker drugs, who had a sudden spinal cord compression syndrome with intense cervical pain, tetraplegia and sensitivity level in C4. Extradural spinal hematoma of the cervical spine was diagnosed by magnetic resonance. The patient underwent a laminectomy and aspiration of the hematoma. The patient is on physiotherapy and presents progressive motor and sensitivity improvement.
Subject(s)
Hematoma/diagnosis , Spinal Cord Compression/diagnosis , Spinal Cord , Decompression, Surgical , Female , Hematoma/etiology , Hematoma/surgery , Humans , Laminectomy , Middle Aged , Spinal Cord/surgery , Spinal Cord Compression/etiology , Spinal Cord Compression/surgeryABSTRACT
Spontaneous epidural hematomas are rarely described in literature. They are associated with infectious diseases of the skull, coagulation disorders, vascular malformations of the dura-mater and metastasis to the skull. The authors report two cases of spontaneous epidural hematoma of different etiologies, and study parameters of hemostasis.
Subject(s)
Hematoma, Epidural, Cranial/etiology , Adolescent , Blood Coagulation Disorders/complications , Child , Female , Hematoma, Epidural, Cranial/pathology , Hematoma, Epidural, Cranial/surgery , Humans , Male , Sinusitis/complicationsABSTRACT
The authors report the case of a 7 years old boy with cervical pain and tetraparesis progressing by two months. He presented an intraspinal cystic lesion from C4 to C6. Exeresis of the lesion was undergone by anterior way through a corpectomy of C5-C6 followed by reconstruction with bone graft of the iliac crest and metallic plaque. Anatomic diagnosis of the lesion was enterogenous cyst. Aspects of clinical presentation, embryology and treatment of these cysts are discussed.
Subject(s)
Spina Bifida Occulta/diagnosis , Spinal Cord Neoplasms/diagnosis , Spinal Cord/pathology , Child , Humans , MaleABSTRACT
The authors report a case of a female patient, age 22, who presented episodes of focal seizures, right hemiparesis and dysphasia of five months duration. The neurologic exam revealed bilateral papilledema and computarized tomography of the head showed a cystic lesion (70X77 mm) in the left fronto-temporo-parietal area, midline shift and similar lesions scattered in the brain parenchyma. She was submitted to a left craniotomy with the diagnosis of cerebral cysticercosis and the major cyst (Cysticercus racemosus) and a small cortical cyst (10X10 mm) were removed to aliviate the increased intracraneal pressure and for histopathological examination. Thirteen days after surgery she was discharged without neurological deficits, except mild papilledema. One month later she was treated with praziquantel (50 mg/kg/day) during 21 days. The CSF examination was normal before the treatment started and showed a transient eosinophilic cellular reaction with positivation of the complement fixation test for cysticercosis while on treatment. The CT-Scan performed before the medical treatment revealed ventricular dilatation and several low density areas (10 to 40 mm) scattered in the cerebral parenchyma, including the operative site. CT-Scan performed three months later showed small low density areas only in the left cerebral hemisphere, including the operative site, calcification in the parenchyma, and slight dilatation of the left lateral ventricle. The clinical evolution was uneventful and the neurologic examination was normal three months later.
Subject(s)
Brain Diseases/therapy , Cysticercosis/therapy , Isoquinolines/therapeutic use , Praziquantel/therapeutic use , Adult , Brain Diseases/diagnosis , Brain Neoplasms/diagnosis , Cysticercosis/diagnosis , Diagnosis, Differential , Female , Humans , Tomography, X-Ray ComputedABSTRACT
Os autores relatam 2 casos de criancas hidrocefalicas tratadas com derivacao ventriculo-peritoneal, que apresentaram fistula liquorica pela cicatriz umbilical, que surgiram, 14 e 10 meses apos a instalacao do sistema de derivacao. Em 1 caso houve extrusao do cateter pela cicatriz umbilical. As condutas terapeuticas pertinentes sao discutidas em comparacao com a literatura
Subject(s)
Infant , Humans , Male , Cerebrospinal Fluid Shunts , Fistula , Umbilicus , Catheterization , Hydrocephalus , Postoperative ComplicationsABSTRACT
O caso relatado refe-se a uma crianca hidrocefalica tratada com derivacao ventriculo-atrial e que, 6 anos e 6 meses apos revisao para alongamento do cateter atrial, apresentou firme aderencia deste a veia jugular interna, no ponto da conexao para o alongamento do cateter (proximo a juncao com a subclavia). Para a retirada do mesmo, foi necessaria a disseccao completa e a ligadura da veia jugular interna. A revisao da literatura mostrou 1 caso relatado com fixacao do cateter na veia cava, sem que houvesse conexao no local
