ABSTRACT
A technique for percutaneous catheter drainage of cystic masses in the subarachnoid space was developed and shown to be safe and effective in an 18-year-old boy with life-threatening, recurrent neuroenteric cysts that compressed the brain stem, cerebellum, and spinal cord. Percutaneous drainage through a C1-C2 approach was performed on 11 separate occasions. Decompression was always accomplished and no infection or other complication occurred, even with continuous catheter drainage for 9 months. This technique provides opportunities for interventional neuroradiologic therapy in the subarachnoid space. It appears to be suited for percutaneous drainage of intraspinal and intracranial cysts when surgery is not indicated due to intractability or inaccessibility.
Subject(s)
Arachnoid Cysts/therapy , Catheterization/methods , Drainage/methods , Adolescent , Arachnoid Cysts/diagnostic imaging , Humans , Male , Radiography, Interventional , Spina Bifida Occulta/therapy , Subarachnoid SpaceABSTRACT
A case of congenital intradural neuroblastoma with paraspinous involvement in a newborn is reported. A newborn presenting with paraplegia was treated with decompressive laminectomy and an attempt to debulk the tumor followed by postoperative radiation and chemotherapy. Literature review and treatment of the intraspinal neuroblastoma is presented along with the differential diagnosis of infantile intraspinal tumors. This is the first reported case describing congenital intradural neuroblastoma with no extradural component in a newborn.
Subject(s)
Neuroblastoma/congenital , Spinal Cord Neoplasms/congenital , Female , Humans , Infant, Newborn , Neuroblastoma/surgery , Radiotherapy Dosage , Spinal Cord Neoplasms/surgeryABSTRACT
10 premature infants were found to have posthemorrhagic hydrocephalus (PHH) over a 4-year period. All weighed less than 2,500 g. The diagnosis was established by ventricular puncture and ventriculogram. Ventriculo-peritoneal (V-P) shunt placement was done in each infant soon after establishing the diagnosis, while the cerebrospinal fluid (CSF) was bloody. The mean age of infants at surgery was 21.4 days (range 16-33 days). Shunt obstruction occurred in 3 infants and infection in 1. No other complication was observed. All infants improved markedly in the immediate postoperative period, especially respirator-dependent infants. All survived; preliminary follow-up revealed that 3 were severely retarded and 2 mildly retarded; 5 infants were normal. Our preliminary experience with early V-P shunt procedure in the treatment of PHH has been favorable and follow-up appears encouraging.
