ABSTRACT
Gliomatosis cerebri is defined as an infiltration, by an infiltrative glioma, of more than two cerebral lobes. Depending on response to treatment (chemotherapy and radiotherapy), clinical course may prolong over several months. Surgical excision has a very limited role in the management of this diagnosis. We present the case of a 48 year-old woman in whom a decompressive temporal lobectomy was performed in the context of a gliomatosis. Relief of intracranial hypertension allowed further treatment and a survival of 23 months. Relevant literature on the subject has been reviewed. There is the possibility of offering a decompressive lobectomy in selected cases of gliomatosis, allowing to undergo other treatment modalities.
Subject(s)
Brain Neoplasms/therapy , Intracranial Hypertension/physiopathology , Neoplasms, Neuroepithelial/therapy , Brain Neoplasms/complications , Brain Neoplasms/diagnosis , Female , Humans , Intracranial Hypertension/etiology , Middle Aged , Neoplasms, Neuroepithelial/complications , Neoplasms, Neuroepithelial/diagnosis , Treatment OutcomeABSTRACT
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Subject(s)
Humans , Female , Middle Aged , Neoplasms, Fibrous Tissue , Solitary Fibrous Tumors , Meningioma/complications , Meningioma , Immunohistochemistry/methods , Diagnosis, Differential , Craniotomy/methods , Craniotomy , Olfactory Pathways/pathology , Olfactory Pathways , Olfactory Nerve Diseases/pathology , Olfactory Nerve DiseasesABSTRACT
La aparición de un pannus inflamatorio periodontoideo en pacientes afectos de artritis reumatoide, es sobradamente conocida. Menos frecuente es la existencia de masas periodontoideas, de aspectos similar al pannus, pero no vinculadas con la inflamación reumática. La cirugía transoral asociada a artrodesis posterior se consideró durante mucho tiempo como un a e las formas más eficaces para resolver el pannus en aquellos casos que se presentaban con deterioro neurológico secundario a esta masa de partes blandas. Presentamos dos casos de desaparición de una lesión proliferativa alrededor de la apófisis odontoides mediante una artodesis posterior occipito-cervical. Se trataron dos mujeres de 67 y 60 años respectivamente, con clínica de dolor y deterioro neurológico progresivo. Existían antecedentes de una posible fractura antigua de odontoides en un caso y de una artrodesis cervical anterior amplia por espondiloartrosis en el otro. Ambos pacientes mejoraron neurológicamente después de una artrodesis por vía posteiror (AU)
Inflamatory periodontoid pannus is quite common in patients with rheumatoid arthritis. However, the occurrence of a pannus-like periodontoid mass that is unassociated with rheumatic inflammation is less frequent. Transoral surgery associated with a posteori stabilization has long been considered one of the most efficient methods to resolve the problem of instability in patients presenting neurological deficits secondary to the pannus. We present two cases of non rheumatic etiology, in which an occipito cervical arthrodesis was used to resolve the proliferative lesion around the odontoid apophysis. Two women (67 and 60 years old respectively) presented symptoms of pain and neurological deterioration with an antecedent of possible past odontoid fracture in one case, and previous large anterior cervical arthrodesis to correct spondylarthrosis in the other case. Both patient´s neurological condition imporved after placement of an arthrodesis through a posterior approach (AU)
Subject(s)
Female , Humans , Male , Arthritis, Rheumatoid/congenital , Arthritis, Rheumatoid/pathology , Arthrodesis/methods , Arthrodesis/rehabilitation , Diabetes Mellitus/genetics , Drug Hypersensitivity/complications , Collagenases/administration & dosage , Pharmaceutical Preparations/administration & dosage , Arthritis, Rheumatoid/genetics , Arthritis, Rheumatoid/metabolism , Arthrodesis/nursing , Arthrodesis , Diabetes Mellitus/blood , Drug Hypersensitivity/prevention & control , Collagenases , Pharmaceutical PreparationsABSTRACT
Inflamatory periodontoid pannus is quite common in patients with rheumatoid arthritis. However, the occurrence of a pannus-like periodontoid mass that is unassociated with rheumatic inflammation is less frequent. Transoral surgery associated with a posterior stabilization has long been considered one of the most efficient methods to resolve the problem of instability in patients presenting neurological deficits secondary to the pannus. We present two cases of non rheumatic etiology, in which an occipito-cervical arthrodesis was used to resolve the proliferative lesion around the odontoid apophysis. Two women (67 and 60 years old respectively) presented symptoms of pain and neurological deterioration with an antecedent of possible past odontoid fracture in one case, and a previous large anterior cervical arthrodesis to correct spondylarthrosis in the other case. Both patient's neurological condition improved after placement of an arthrodesis through a posterior approach.
