ABSTRACT
CASE REPORT: The authors report the case of a child with neurocutaneous melanosis associated with a Dandy-Walker complex. Magnetic resonance (MR) images showed shortened T1-weighted images in areas involving the amygdala, mesencephalon, rostral brain stem, and superior cerebellar surface compatible with melanin deposits. There was also partial agenesis of the cerebellar vermis with an enlarged fourth ventricle cyst along with a high-lying torcular and ventricular enlargement. Endoscopic fenestration and biopsy of the cyst wall was performed without evidence of abnormal melanin deposits in the meninges. OUTCOME: The patient eventually required ventriculoperitoneal shunting and at 1-year follow-up did not develop evidence of primary CNS melanoma. ILLUSTRATION: Computed tomography and MR images consistent with neurocutaneous melanosis and the Dandy-Walker complex are presented along with photographs of the cutaneous nevi. DISCUSSION: The major clinical and radiological features of this rare association, with only 11 previously reported cases, are discussed in detail.
Subject(s)
Dandy-Walker Syndrome/complications , Melanosis/complications , Neurocutaneous Syndromes/complications , Female , Humans , Infant , Magnetic Resonance Imaging/methods , Melanosis/pathology , Neurocutaneous Syndromes/pathology , Tomography, X-Ray Computed/methodsABSTRACT
INTRODUCTION: Craniopharyngiomas (CF) are benign tumors, which can be cured by total resection; however, this is not always possible to achieve, thus leading to tumor recurrence. When these tumors achieve disproportionate growth, the treatment is even more difficult, fortunately grotesque CF are not frequent, making experience and data collection more arduous to obtain. CASE REPORTS: Four patients are presented here to illustrate the need for the use of a new term, "monstrous craniopharyngioma," which is proposed with the aim of making the evaluation of the different kinds of treatment available more accurate. CONCLUSIONS: Craniopharyngiomas that have grown into more than one cranial fossa with mixed solid and cystic components pose a special challenge for resection, and therefore a systematic classification and approach are required in order to obtain the best surgical results.
Subject(s)
Craniopharyngioma/surgery , Craniotomy/methods , Hypophysectomy/methods , Pituitary Neoplasms/surgery , Cerebral Angiography/methods , Child , Child, Preschool , Female , Humans , Magnetic Resonance Imaging/methods , Male , Tomography, X-Ray Computed/methods , Treatment OutcomeABSTRACT
Se evaluaron 46 niños con epilepsias farmacoresistentes, en la UMCE del Centro de Ciencias Médicas del Hospital Nacional de Niños Dr. Carlos Sáenz Herrera, de noviembre del 2000 a diciembre del 2001. Para el presente estudio se seleccionaron 22 pacientes que fueron operados y que habían completado 2 años de la cirugía. De ocho callosotomías, seis de ellos están en la clase 3 de Engel, de ocho lobectomías temporales, cuatro se ubican en la clase 1 de Engel y de seis resecciones extratemporales, cuatro se encuentran en la clase 1 de Engel, con lo cual consideramos que los resultados fueron satisfactorios.
