ABSTRACT
Spinal Cord Injury Without Radiologic Abnormality (SCIWORA) accounts for up to 19% of spinal cord related lesions in pediatric population, mostly comprising the cervical spine. A 2-year-old patient is presented, who suffered a motor-vehicle accident. After being admitted, neither X-Ray nor spinal TC scan showed any structural abnormalities. Neurological examination showed complete sensory and motor loss under T7 as well as bladder and bowel dysfunction. Magnetic resonance imaging (MRI) showed spinal cord lesion extending from T7 to T10. The patient was treated with external immobilization and physical therapy. Thoracic SCIWORA is an uncommon diagnosis that should be considered in pediatric patients who suffer spinal trauma. Spinal cord MRI has proven to be the most accurate modality for diagnosis.
ABSTRACT
OBJECTIVE: We aimed to demonstrate the differences between grade I and II (OMS classification) of intracranial meningiomas. We evaluate their location, Simpson resection grade, re-operations rate, adjuvant treatment and patient outcomes. METHODS: We conduct a retrospective review of Sixty- three clinical records of patients who were diagnosed with meningiomas grade I and II (OMS) between 2009-2015 and received surgical treatment at our Hospital. We evaluated different variables such as age, sex, histological type, Simpson grade resection, location, symptoms, radiotherapy, follow-up, mortality rate and patient outcome. The main aim was to establish the differences between these intracranial tumors. RESULTS: A total of sixty-three patients diagnosed with meningiomas and received surgical treatment; fifty-one were grade I and thirteen with grade II. There were no differences in the rate between man and women. The average age for both types of meningiomas was 57 years old. The typical meningiomas were located in 55% of the cases outside the cranial base vs. 91.6% of the atypical meningiomas (P = 0.03). Typical meningioma had a Simpson resection grade of I, II and III in 74.5% against 58.3% of the atypical (P = 0.2). The atypical meningioma in 33% had more than one-stage surgery vs. 9.8% of the typical (P = 0.03). The patients with a typical meningioma showed a good outcome in 86.2% vs. 53.8 of the grade II (P = 0, 01). The typical meningiomas showed a good outcome in 82.2% of the cases vs. 53.8% of the atypical. The grade II meningiomas received adjuvant treatment in 33.3%, while the grade I only 1.9%. CONCLUSIONS: The atypical intracranial meningiomas have a worse outcome compared with the typical kind and a higher incidence of re-operations. These tumors have a preference for a location outside the cranial base. Concluding that the location could be a risk factor.
ABSTRACT
La complejidad de la irrigación pancreática representa un constante desafío tanto para los cirujanos como para los médicos y estudiantes que se inician en el tema. Las descripciones clásicas presentan discrepancias que sumergen al lector en un mar de confusión. Dada la cualidad proteiforme del tema, el trabajo se centró en la confección de un esquema "patrón" de la irrigación pancreátrica a través de una revisión bibliograáfica, teniéndose en cuenta solo aquellos vasos que figuraban en la literatura médica con prevalencia superior al 50 %. Este esquema- constituido por 13 arterias- fue luego comparado con una muestra original de 22 disecciones anatómicas, confirmándose un 76,92% de semejanza. En base a los hallazgos realizados en las disecciones, sugerimos que la prevalencia de 3 de las 13 arterias debería ser revisada: la APU y los dos ramos que constituyen la arcada PD media.
The complexity concerning the pancreatic blood supply stands as a constant challenge for surgeons and even form those facing the first stages aboarding the subject. Classic descriptions show discrepancies that mislead the reader into a sea of confusion. Given the proteiform shape of this subject, our labour was centered in developing a pattern scheme of the pancreatic irrigation after a bibliographic review-taking into account only those vessels that figured in the medical literature with a prevalence surpassing 50 %. The final scheme containing 13 arteries was then compared with an original sample consisting in 22 anatomic dissections, confirming a correspondence of 76,92 %. In the light of the findings made in the dissections, we suggest that the prevalence of 3 of the 13 arteries should be revisited: the UPA and the two branches constituting the middle PD arcade.
