RESUMEN
Pituitary abscesses are rare. Occasionally they will arise in pre-existing pituitary pathology. We report such an occurrence within a Rathke's cleft cyst. On the basis of history and imaging, this was indistinguishable from more commonly encountered pituitary pathology.
Asunto(s)
Infecciones por Acinetobacter/diagnóstico , Absceso Encefálico/diagnóstico , Absceso Encefálico/microbiología , Quistes del Sistema Nervioso Central/diagnóstico , Neoplasias Hipofisarias/diagnóstico , Infecciones por Acinetobacter/microbiología , Adolescente , Absceso Encefálico/patología , Quistes del Sistema Nervioso Central/microbiología , Quistes del Sistema Nervioso Central/patología , Diagnóstico Diferencial , Femenino , Humanos , Imagen por Resonancia Magnética , Neoplasias Hipofisarias/microbiología , Neoplasias Hipofisarias/patología , RecurrenciaAsunto(s)
Adenocarcinoma/tratamiento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Neoplasias del Colon/tratamiento farmacológico , Demencia Vascular/inducido químicamente , Enfermedades Desmielinizantes/inducido químicamente , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Demencia Vascular/patología , Enfermedades Desmielinizantes/patología , Diagnóstico Diferencial , Femenino , Fluorouracilo/administración & dosificación , Fluorouracilo/efectos adversos , Humanos , Levamisol/administración & dosificación , Levamisol/efectos adversos , Persona de Mediana EdadAsunto(s)
Anhídridos/síntesis química , Antineoplásicos Alquilantes/síntesis química , Neoplasias Encefálicas/tratamiento farmacológico , Carmustina/síntesis química , Sistemas de Liberación de Medicamentos/métodos , Anhídridos/farmacocinética , Antineoplásicos Alquilantes/farmacocinética , Materiales Biocompatibles/química , Materiales Biocompatibles/farmacocinética , Carmustina/farmacocinética , Ácidos Decanoicos/química , Ácidos Decanoicos/farmacocinética , Preparaciones de Acción Retardada , Combinación de Medicamentos , Almacenaje de Medicamentos , Peso Molecular , Poliésteres/química , Poliésteres/farmacocinética , Espectrofotometría InfrarrojaRESUMEN
We present the case of a child who developed the syndrome of cerebrospinal fluid (CSF) overdrainage with slit-like ventricles on CT in the setting of a disconnected distal shunt valve. Upgrading the shunt alleviated his symptoms. It is suggested that the presence of a patent fibrous tract allowed the overdrainage of CSF.
Asunto(s)
Hidrocefalia/cirugía , Hipotensión Intracraneal/etiología , Complicaciones Posoperatorias/etiología , Derivación Ventriculoperitoneal/instrumentación , Niño , Falla de Equipo , Humanos , Hipotensión Intracraneal/diagnóstico por imagen , Hipotensión Intracraneal/cirugía , Masculino , Complicaciones Posoperatorias/diagnóstico por imagen , Complicaciones Posoperatorias/cirugía , Reoperación , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: To determine whether the time between onset of anisocoria and surgery for hematoma evacuation in the head-injured patient is a useful prognostic variable for outcome in the comatose patient with an acute epidural hematoma. DESIGN: Prospective. MATERIALS AND METHODS: Twenty-one patients with an acute traumatic epidural hematoma and an admission Glasgow Coma Scale score of less than 8 were analyzed. RESULTS: Anisocoria was present in 14 (67%) patients. Mortality rate was three times higher in this group than in the patients without anisocoria; however, this difference was not statistically significant (p = 0.21, Fisher's exact test). None of the patients with an anisocoria-craniotomy latency of 70 minutes or less died and all of these patients had a good or reasonable outcome. Analysis of the anisocoria-craniotomy latency in ten patients revealed that a lapse of more than 90 minutes was associated with a greater mortality compared with patients with a latency of less than 90 minutes (p = 0.0238, Fisher's exact test). CONCLUSIONS: In patients with an acute epidural hematoma, reducing the anisocoria-surgery interval below 90 minutes is significantly associated with a better outcome (p = 0.0238, Fisher's exact test).
Asunto(s)
Anisocoria/etiología , Traumatismos Craneocerebrales/complicaciones , Craneotomía , Hematoma Epidural Craneal/cirugía , Adolescente , Adulto , Anciano , Traumatismos Craneocerebrales/mortalidad , Femenino , Hematoma Epidural Craneal/etiología , Hematoma Epidural Craneal/mortalidad , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Factores de Tiempo , Resultado del TratamientoRESUMEN
A rare case of intracranial seeding from a craniopharyngioma is presented. A 12-year-old boy underwent radical resection of a suprasellar craniopharyngioma 2 years previously. There had been no evidence of recurrence during follow-up. He became symptomatic 1 week prior to admission, when imaging showed a recurrent tumor. The metastatic, subfrontal craniopharyngioma was not anatomically connected to the suprasellar region, but originated from the floor of the anterior fossa along the former surgical approach. The significance of this finding and its relation to recurrent craniopharyngioma is discussed.
