ABSTRACT
We describe a case of dorsal-lumbar vertebral tuberculosis (Pott's disease) first treated with antibiotic therapy, bed rest, and cast. After 2 months of treatment patient's symptoms worsened. Minimally invasive posterior vertebral stabilization was carried out, with excellent clinic and radiographic results.
Subject(s)
Orthopedic Procedures , Tuberculosis, Spinal/surgery , Adult , Antitubercular Agents/administration & dosage , Antitubercular Agents/therapeutic use , Bed Rest , Casts, Surgical , Combined Modality Therapy , Ethambutol/administration & dosage , Humans , Isoniazid/administration & dosage , Magnetic Resonance Imaging , Male , Minimally Invasive Surgical Procedures , Pyrazinamide/administration & dosage , Rifampin/administration & dosage , Rifampin/therapeutic use , Tomography, X-Ray ComputedABSTRACT
An 18-year-old patient with a 5-year history of periodic vertigo, headache and stiff neck is reported. Routine X-ray of the skull showed a mild form of basilar impression while the CT scan demonstrated only a tri-ventricular hydrocephalus. Without using the traditional invasive techniques, diagnosis of Chiari type I malformation was nonetheless clearly pointed out by magnetic resonance imaging of the posterior fossa and spinal cord. Diagnostic problems of this clinically ambiguous and uncharacterized syndrome are discussed.
Subject(s)
Arnold-Chiari Malformation/diagnosis , Adolescent , Arnold-Chiari Malformation/diagnostic imaging , Humans , Magnetic Resonance Imaging , Male , Tomography, X-Ray ComputedABSTRACT
The authors present a review of their clinical experience in the treatment of 127 Parkinsonian patients with L-Dopa alone and in association with a Dopa-decarboxylase inhibitor; the follow-up lasted more than 7 years. In all cases the dosages of L-Dopa, either alone or associated with the decarboxylase inhibitor, were fairly low; the strategy was to reach in each case the minimal effective dose instead of the maximal tolerable one. After 7 years of treatment about 60-65% of the patients had shown improvement, even though to a lesser degree than during the first and second year of therapy; the remaining 35-40% were unchanged or worse. The authors conclude that, despite the decreased efficacy of the therapy with time, the L-Dopa treatment remains of great significance in lengthening and in improving the quality of life of Parkinsonian patients.
