ABSTRACT
Background Trigeminal neuralgia (TN) is a craniofacial pain characterized by sudden onset, brief, severe, recurrent shooting pain within one or more branches of the trigeminal nerve (CN V). Based on its clinical presentation, TN may be classified as purely paroxysmal or paroxysmal with concomitant continuous pain (CCP), previously known as typical and atypical, respectively. Microvascular decompression (MVD) surgery for releasing the CN V from a neurovascular conflict is an effective and safe treatment for TN. During MVD of patients manifesting TN with CCP, the involvement of an abnormal arachnoid tissue is a common finding. The etiology and pathophysiology behind the appearance of this tissue are unknown; however, it is more commonly found in this variant of the disease. Methods From January 2015 to December 2016, a total of 330 patients diagnosed with TN were evaluated at our clinic. Among them, 31 individuals (9.4%) presented with paroxysmal TN with CCP, with 16 patients (51.6%) undergoing MVD. During surgery, samples of altered arachnoid tissue were collected from five patients and subjected to Hematoxylin-Eosin staining and immunohistochemistry for S100 and CD2 Results In a long-term follow-up, 80% of patients operated by DMV remains pain free. Analysis of biopsies revealed chronic fibrosis (n=4), hyperplasia of neurothelial cells (n=3), dystrophic calcifications (n=1). Immunohistochemistry was positive for S100 (n=3) and CD20 (n=3) inflammatory markers. Conclusion Chronic inflammation in the arachnoid tissue involved in paroxysmal TN with CCP could be a contributor to the pathophysiology of this variant of the disease.
ABSTRACT
La aspergilosis invasora es una causa importante de morbilidad y mortalidad en pacientes gravemente inmunodeficientes, especialmente en aquellos con neutropenia o receptores de trasplante de médula ósea o de órganos sólidos. Informamos sobre una hialohifomicosis esplénica morfológicamente sugestiva de ser causada por Aspergillus spp. en un paciente de 22 años de edad con anemia aplásica, tratado con múltiples transfusiones y antibióticos de amplio espectro(AU)
Invasive aspergillosis is an important cause of morbidity and mortality in severely immunocompromised patients, especially those who are neutropenic or who have undergone bone marrow or solid-organ transplant. We report a case of hyalohyphomycosis morphologically suggestive of an Aspergillus spp. in a 22-year-old patient with aplastic anaemia, treated with multiple transfusions and broad spectrum antibiotics(AU)
Subject(s)
Humans , Male , Adult , Anemia, Aplastic/complications , Anemia, Aplastic/pathology , Aspergillus/isolation & purification , Aspergillus/pathogenicity , Pancytopenia/microbiology , Granuloma/complications , Risk Factors , Indicators of Morbidity and Mortality , Necrosis/diagnosis , Necrosis/microbiology , Spleen/anatomy & histology , Spleen/microbiology , Spleen/pathology , Splenic Diseases/microbiology , Pleural Effusion/complicationsABSTRACT
Invasive aspergillosis is an important cause of morbidity and mortality in severely immunocompromised patients, especially those who are neutropenic or who have undergone bone marrow or solid-organ transplant. We report a case of hyalohyphomycosis morphologically suggestive of an Aspergillus spp. in a 22-year-old patient with aplastic anaemia, treated with multiple transfusions and broad spectrum antibiotics.
