ABSTRACT
A 58-year-old woman with spastic paraparesis had bony hemangiomas involving the spine, sacrum, and skull. Multiple bony lesions, paravertebral mass, abnormal serum protein levels, and myelopathy suggested multiple myeloma or metastatic neoplasm. Decompressive laminectomy demonstrated a benign capillary hemangioma.
Subject(s)
Hemangioma/diagnostic imaging , Neoplasm Metastasis/diagnostic imaging , Spinal Cord Compression/diagnostic imaging , Spinal Neoplasms/diagnostic imaging , Diagnosis, Differential , Female , Humans , Middle Aged , Myelography , Thoracic Vertebrae/diagnostic imagingABSTRACT
Delay in the diagnosis of meningiomas of the tuberculum sellae and planum sphenoidale is detrimental to the patient in terms of visual recovery, morbidity and mortality. Early accurate diagnosis of these tumors is possible through the use of computed tomography which is recommended for all patients with unexplained impairment of vision. In this article 105 cases of meningiomas of the planum sphenoidale and tuberculum sellae are reviewed. In only five cases was the diagnosis made within three months of the onset of the symptoms.
Subject(s)
Meningeal Neoplasms/diagnostic imaging , Meningioma/diagnostic imaging , Cerebral Angiography , Female , Humans , Male , Meningeal Neoplasms/complications , Meningeal Neoplasms/surgery , Meningioma/complications , Meningioma/surgery , Middle Aged , Retrospective Studies , Tomography, X-Ray Computed , Vision Disorders/etiologyABSTRACT
We report a combined otoneurosurgical approach in the treatment of a patient with meningitis due to an arachnoid cyst, extending through the dura and petrous bone into the middle ear. The combination of mastoid surgery and temporal craniotomy including opening the dura was necessary to determine the nature of the problem, excise the disease and repair the defects. Two recent cases at our Institution of cerebrospinal otorhinorrhea and chronic ear disease illustrate the difficulty in carrying out definitive repair of dural defects from within the mastoid cavity. Case 2 had three bouts of meningitis and two brain abscesses separated by 25 years. Case 3 had eight bouts of meningitis in 19 years. The authors recommend at otoneurosurgical team approach in patients with cerebrospinal otorhinorrhea permitting treatment of the temporal bone, dura and brain.
