Hidatidosis torácica con invasión del canal vertebral / Hydatid thoracic spinal canal invasión

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A case of extensive spinal cysticercosis involving the whole spinal canal in a patient with a history of cerebral cysticercosis.

Although cysticercosis is the most common parasitic disease affecting the central nervous system, spinal cysticercosis is rare. A rare form of spinal cysticercosis involving the whole spinal canal is presented. A 45-year-old Korean male had a history of intracranial cysticercosis and showed progressive paraparesis. Spinal magnetic resonance scan showed multiple cysts compressing the spinal cord from C1 to L1. Three different levels (C1-2, T1-3, and T11-L1) required operation. Histopathological examination confirmed cysticercosis. The patient improved markedly after surgery.

Spinal intradural extramedullary hydatidosis: report of three cases.

OBJECTIVE: Spinal hydatid cyst is a serious form of hydatid disease affecting fewer than 1% of all patients with hydatid disease. We report 3 healthy patients who presented with progressive paraparesis attributed to a histologically proven intradural hydatid cyst. METHODS: There were 2 children (1 boy, 1 girl) and 1 adult with a mean age of 12 years. The median follow-up duration was 16 months. Spinal magnetic resonance imaging was performed in the 3 patients, and an anatomic and topographical diagnosis of the intradural hydatid cyst was made. RESULTS: Magnetic resonance imaging scans revealed cystic lesions with peripheral contrast enhancement. Surgery was performed through laminectomy, complete resection was achieved, and antihelminthic treatment with albendazole 10 mg/kg-1 per day for 6 months was included in the postoperative treatment. The patients improved after surgery with normal motor function. CONCLUSION: This localization is rare and serious, but its prognosis is excellent if diagnosis is made early enough and surgery is performed in time to prevent cyst rupture.

A Case of Extensive Spinal Cysticercosis Involving the Whole Spinal Canal in a Patient with a History of Cerebral Cysticercosis

Although cysticercosis is the most common parasitic disease affecting the central nervous system, spinal cysticercosis is rare. A rare form of spinal cysticercosis involving the whole spinal canal is presented. A 45-year-old Korean male had a history of intracranial cysticercosis and showed progressive paraparesis. Spinal magnetic resonance scan showed multiple cysts compressing the spinal cord from C1 to L1. Three different levels (C1-2, T1-3, and T11-L1) required operation. Histopathological examination confirmed cysticercosis. The patient improved markedly after surgery.

Magnetic resonance imaging findings of spinal intramedullary spirocercosis.

Spirocerca lupi is a nematode infecting dogs in tropical and subtropical areas. Aberrant S. lupi migration to different body organs, including the spinal cord, has been documented. To date, the diagnosis of aberrant spinal cord migration was made at post-mortem examination or as an incidental finding, during spinal surgery. We describe two dogs with acute asymmetric paraparesis that were subsequently diagnosed with spinal cord spirocercosis. In magnetic resonance (MR) images of the spine, T2 hyperintense lesions were seen in the spinal cord of both dogs. The lesions appeared isointense on T1-weighted images and focal enhancement was detected after gadolinium administration. The MR imaging findings were compatible with focal inflammation, presumably along the parasite migration tract. Gross and microscopic pathologic findings confirmed the diagnosis of aberrant spinal intramedullary migration of S. lupi in one dog, and in the other dog, the clinical and imaging findings were supportive of this diagnosis.

Hydatid cysts in uncommon locations in the same patient: simultaneous cardiac and spinal involvement.

INTRODUCTION: The spine and cardiac cavities are uncommon locations for hydatid disease. Spinal and cardiac hydatid cases separately constitute only 0.5-1% of all hydatid cases. We reported a case with spinal and cardiac involvement simultaneously. Clinical and radiological findings of this unique case are discussed. CASE REPORT: A thirty-four-year-old male patient was admitted to hospital with pain at the low back and left thigh. He had undergone surgery for lumbosacral hydatidosis twice before. Cysts had been removed totally in the last operation. The disease relapsed with widespread involvement of the sacropelvic region. During the investigation, we diagnosed a cyst in the cardiac cavity, incidentally. The cyst in the cardiac cavity was removed totally. DISCUSSION: Hydatid disease is still an endemic disease in South America and some Mediterranean countries including Turkey. Cysts rarely involve the spine and cardiac cavities. The simultaneous involvement of the sacropelvic region and the cardiac cavity is an extremely rare condition. Cardiac cysts have a poor prognosis. Prompt surgical extraction of the cyst is a critical mainstay of the management.

Cauda equina syndrome caused by primary lumbosacral and pelvic hydatid cyst: a case report.

INTRODUCTION: Hydatid disease occurs in humans as a result of faeco-oral contamination and spinal echinococcosis is rare even in areas where echinococcosis is endemic. Hydatid cyst primarily occurs in the liver and lungs. Bone involvement constitutes only 0.5-2% of all hydatidoses. About half of the bone involvement occurs in vertebrae. The thoracic spine is the most common site of the spinal hydatidosis. Primary hydatid cysts of the lumbar and sacral spinal canal are very rare. CASE REPORT: We present a 31-year-old man with cauda equina syndrome caused by a primary hydatid cyst of the lumbosacral and pelvic areas. He had been admitted to hospital with left foot and low back pain three years ago. Magnetic resonance imaging revealed an intraspinal hydatid cyst extending from L2 to S2. The cyst had been totally removed. He was symptom-free for three years. After three years, he presented with acute cauda equina syndrome. His neurological examination revealed total plegia of dorsal flexion of the left foot and perianal hypoaesthesia. MRI showed lumbosacral and pelvic hydatidosis again. After total removal of the cyst, his neurological status revealed immediately relief. DISCUSSION: Hydatid cyst is an important health problem in some countries including Turkey. Bone involvement is seen in only 0.5-2% of cases. Furthermore sacral and lumber vertebral involvement is extremely rare. We presented a case with a spinal hydatid cyst which classified as a combination of intraspinal extradural, vertebral and paravertebral forms according to the Braitwate and Lees classification. Surgical excision and additional medical treatment is still the most effective treatment. Cysts located intraspinally have a tendency to rupture spontaneously. For this reason the high recurrence rate (30- 40%) is still a major problem in management.

Aberrant extradural spinal migration of Spirocerca lupi: four dogs.

Spirocerca lupi is a nematode mainly affecting dogs but has been found in other animals, particularly carnivores. Anatomical areas of typical and aberrant migration vary. This report describes four cases of Spirocerca lupi causing neurological symptoms, similar to thoracolumbar disc syndrome, as a result of aberrant migration of the nematode into the spinal canal. In two of the cases, the nematode could be demonstrated intraoperatively. The third was discovered on post-mortem examination, while the fourth case displayed compelling evidence of Spirocerca lupi involvement. Surgical removal of the Spirocerca lupi nematode would be the treatment of choice in cases of spinal migration, with therapeutic and preventive treatment with doramectin instituted to treat remote sites and prevent re-infection. In areas endemic for spirocercosis, Spirocerca lupi should be considered as an important differential diagnosis in cases that are presented with clinical signs suggestive of a spinal cord lesion.

Unusual dumbbell tumours of the mediastinum and thoracic spine.

Due to a lack of large clinical series in the literature of chondrosarcomas and hydatid disease presenting as mediastinal dumbbell tumours, clinicians have limited experience on this topic. We present three unusual cases of dumbbell tumour involving the spinal canal; two patients had chondrosarcoma originating from Th8-Th9 and Th10-Th12; one patient had a hydatid cyst at Th5-Th6. We performed a single-stage combined thoracic-neurosurgical approach in two patients, and a double-staged approach in one patient. During the intraspinal dissection, an operating microscope was used under electrophysiological monitoring. Spinal canal reconstruction was not required for any of the cases. Preoperative knowledge of neuroforaminal extension and the relations between the tumour and adjacent neural-vascular structures is essential to prevent spinal cord damage and plan the surgical approach. In chondrosarcomas, prognosis depends on patient age, histological grade, extent of surgery and response to radiotherapy and/or chemotherapy. In this article, the diagnostic and surgical difficulties of these unusual tumours and current treatment modalities are discussed with a review of the relevant literature.

[Primary sacral epidural hydatid cyst: a case report]. / Kyste hydatique épidural sacré primitif: à propos d'un cas.

Primary epidural hydatid cyst of the spinal canal without bone involvement is very rare. The authors report the case of a 35 year old man presenting with lower cauda equina compression. MRI showed a cystic lesion with signal characteristics similar to cerebrospinal fluid. Surgical exploration through a midline posterior approach was used which confirmed the hydatid nature of the cyst. There was no bone lesion. Histological examination confirmed the diagnosis. Hydatid cyst should be suspected in case of cystic lesion causing cord compression or cauda equina syndrome.

[Filariae in vertebral canal, report of a case].

OBJECTIVE: To confirm diagnosis of a special case with chief complaints of abdominal pain and dyskinesia of lower extremities. METHODS: The clinical symptoms, signs, MRI, pathological findings and the results of blood test for microfilaria were analyzed. RESULTS: The patient was a 6-year old girl who had abdominal pain for 10 days dyskinesia of lower extremities for 6 days accompanied by difficulty in urination and defecation. There was tenderness on T7-9 spinous process, sensory dullness below the umbilicus. Babinski's and Oppenheim's sign were bilaterally positive, and ankle clonus was positive. MRI showed space occupying change in the vertebral canal at T7-9 level. The mass of 2 cm x 1 cm x 1 cm size was removed by surgical operation and histopathological study showed obvious fibrous tissue proliferation accompanied by eosinophil, lymphocyte and neutrophil infiltration around a worm-like structure. Night time blood test performed at 23:00 confirmed the presence of microfilaria. CONCLUSION: The diagnosis of filariae in vertebral canal could be confirmed.

Experimental Elaphostrongylus alces infection in goats.

Five goats aged 4 months were each inoculated with approximately 300 third-stage larvae of Elaphostrongylus alces, and killed for post-mortem examination after 14-150 days. No clinical signs of disease were observed during the experiment. Pathological examination revealed that the larvae penetrated the walls of the abomasum and small intestine and migrated towards the caudal vertebral canal. However, the great majority of larvae were apparently destroyed along the migratory route, and development to adult parasites in the vertebral canal was not seen. During migration, the larvae caused focal inflammation and necrosis in the gastrointestinal wall, liver, mesentery and lungs. The study suggests that the only effect of E. alces infection on goats is the formation of focal visceral lesions during abdominal larval migration; it also confirms the infectivity of E. alces for domestic ruminants.

Case report 833: Primary spinal echinococcosis (Echinococcus granulosus) of lumbosacral spine with destruction of the left pedicles of L3-5 and extension of a large paraspinal cystic mass into the spinal canal.

CT is helpful in recognizing the occurrence of hydatid cysts. The increased spatial resolution allows better visualization of details of bone destruction and spinal canal involvement. Paraspinal cystic disease may also show typical and/or characteristic signs of hydatid disease even if serological findings are falsely negative or inconclusive. In the postoperative follow-up, CT may be helpful in assessing residual hydatid cysts and/or in detecting recurrence at an earlier stage.

Recurring tetraparesis attributable to a heartworm in the epidural space of a dog.

Recurring nonambulatory tetraparesis caused by a heartworm in the epidural space was diagnosed in a dog. On myelography and digital subtraction imaging, the parasite appeared as a large extradural mass. Surgical removal of a mature, female Dirofilaria immitis resulted in resolution of the neurologic signs.