ABSTRACT
We report a 66-year-old woman who developed sudden-onset bilateral sensorineural deafness due to leptomeningeal carcinomatosis involving the vestibulocochlear nerves. The clinical and diagnostic features of leptomeningeal carcinomatosis are discussed.
Subject(s)
Carcinoma/complications , Hearing Loss, Bilateral/etiology , Hearing Loss, Sudden/etiology , Meningeal Neoplasms/complications , Aged , Carcinoma/pathology , Female , Hearing Loss, Bilateral/pathology , Hearing Loss, Sudden/pathology , Humans , Magnetic Resonance Imaging/methods , Meningeal Neoplasms/pathologyABSTRACT
A 17-year-old male presented with acute onset paraparesis in the lower limbs. Urinary retention was present and the patient required catheterisation. Clinical examination confirmed severe bilateral lower limb weakness and a sensory level at T8. Magnetic resonance imaging (MRI) revealed a haemorrhagic intramedullary tumour extending from T8 to the conus. Microsurgical excision of the tumour was performed and the patient made a good functional recovery. The histology of the tumour demonstrated a ganglioglioma of the spinal cord. Acute paraparesis has not previously been reported with a spinal cord ganglioglioma. We discuss the clinical, diagnostic and pathological features of spinal cord gangliogliomas.
Subject(s)
Ganglioglioma/complications , Ganglioglioma/pathology , Paraparesis/diagnosis , Paraparesis/etiology , Spinal Cord Neoplasms/complications , Spinal Cord Neoplasms/pathology , Acute Disease , Adolescent , Anti-Inflammatory Agents/therapeutic use , Dexamethasone/therapeutic use , Diagnosis, Differential , Ganglioglioma/surgery , Humans , Injections, Intravenous , Magnetic Resonance Imaging , Male , Neoplasm Staging , Neurosurgical Procedures , Paraparesis/drug therapy , Severity of Illness Index , Spinal Cord Neoplasms/surgeryABSTRACT
While mild swallowing difficulties are commonly reported transiently following anterior cervical surgery, marked dysphagia is unusual. The authors report a patient who experienced severe and prolonged dysphagia following elective cervical corpectomies with iliac grafting and anterior plate fusion for multilevel cervical canal stenosis. The literature is reviewed and discussed.
Subject(s)
Cervical Vertebrae/surgery , Deglutition Disorders/surgery , Diskectomy/methods , Aged , Humans , Magnetic Resonance Imaging/methods , Male , Severity of Illness Index , Tomography, X-Ray Computed/methodsABSTRACT
OBJECTIVE AND IMPORTANCE: Paragangliomas of the thoracic spine are rare. Previously described cases involved nonfunctioning tumors. This report documents the diagnosis and surgical treatment for a patient who presented with a functioning thoracic paraganglioma. CLINICAL PRESENTATION: A 53-year-old woman presented with a 10-month history of headaches, facial flushing, and palpitations associated with hypertension. Urinary catecholamine levels were markedly elevated. Magnetic resonance imaging and m-[(123)I]iodobenzylguanidine scans demonstrated an extradural tumor located within the T12 vertebra, with a significant paraspinal component. The neurological examination revealed mild hypesthesia in the right T12 dermatome. INTERVENTION: The patient underwent resection of the tumor after alpha-adrenergic receptor blockade. Grossly complete excision was achieved without neurological complications. Postoperatively, the patient was normotensive and exhibited catecholamine levels within the normal range. CONCLUSION: Functioning paragangliomas of the thoracic spine are rare lesions that are difficult to treat. Successful treatment requires careful surgical planning and expert pharmacological manipulation.
