RESUMEN
OBJECTIVE AND IMPORTANCE: Migration of a foreign material via venous routes into the spinal canal is a very rare incidence. We report the second case in which a foreign body has migrated into the spinal canal via the venous route. CLINICAL PRESENTATION: This 35-years-old man presented with sudden onset of severe low back pain and pain in the right leg four months after an unsuccessful attempt to remove a disconnected cardiac pacemaker lead via the femoral vein. Direct lumbar x-ray demonstrated the broken lead of the cardiac pacemaker at the entrance of the right L5 foramen which was also demonstrated by lumbar CT. SURGICAL INTERVENTION: After right L5 hemilaminotomy, the pacemaker lead was found in a vein of the anterior spinal venous plexus just beneath and lateral to the right L5 root. After dissecting it from the surrounding adipose tissue, the embolised pacemaker lead was taken out. CONCLUSION: We present a case report and review of the literature on migration of foreign material into the spinal canal, factors effecting the flow directions in the spinal veins. This case may be the first evidence that proved Batson's theory of spinal metastases in man.
Asunto(s)
Migración de Cuerpo Extraño/diagnóstico por imagen , Migración de Cuerpo Extraño/etiología , Metástasis de la Neoplasia , Marcapaso Artificial/efectos adversos , Canal Medular/irrigación sanguínea , Canal Medular/diagnóstico por imagen , Nervios Espinales/irrigación sanguínea , Nervios Espinales/diagnóstico por imagen , Adulto , Remoción de Dispositivos/efectos adversos , Electrodos Implantados/efectos adversos , Migración de Cuerpo Extraño/cirugía , Humanos , Masculino , Radiografía , Canal Medular/cirugía , Nervios Espinales/cirugía , Venas/cirugíaRESUMEN
Neurocutaneous melanosis is a rare dysmorphogenesis associated with single or multiple giant pigmented cutaneous nevi and diffuse involvement of the leptomeninges anywhere in the central nervous system (CNS). It is interesting that almost 8-10% of patients had associated Dandy-Walker malformation in the literature, suggesting a common origin of the developmental abnormalities. In this article, we present a 2-year-old patient with neurocutaneous melanosis associated with Dandy-Walker malformation. We reviewed the literature and discuss the pathogenesis based on the preferred hypotheses so far.
Asunto(s)
Síndrome de Dandy-Walker/complicaciones , Melanosis/complicaciones , Síndromes Neurocutáneos/complicaciones , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Encéfalo/cirugía , Preescolar , Síndrome de Dandy-Walker/diagnóstico , Humanos , Hidrocefalia/complicaciones , Hidrocefalia/diagnóstico , Hidrocefalia/cirugía , Imagen por Resonancia Magnética , Masculino , Melanosis/diagnóstico , Síndromes Neurocutáneos/diagnóstico , Tomografía Computarizada por Rayos X , Derivación VentriculoperitonealRESUMEN
Spinal extradural angiolipomas are distinct, benign, and rare lesions composed of mature lipocytes admixed with abnormal blood vessels. They account for 0.14% of all spinal axis tumors. The case described here was a 72-year-old patient presenting with a history of paraparesis, hypoesthesia under the T2 level, hyperreflexia, and urinary overflow incontinence that appeared within 7 days after the administration of a coronary vasodilator drug regimen. The spinal magnetic resonance scan showed a lipomatous mass with signal void lesions, suggesting a vascular component of the tumor. The patient improved rapidly after surgical resection of the epidural tumor and decompression of the cord. According to the present literature, the duration of neurological symptoms ranges from 1 to 180 months (mean 28 months). But this patient's neurological deterioration took place 4 days before hospitalization. We believe that this can be explained by the increased tumor blood volume caused by vasodilator drugs, which in turn exerted a pulsatile compressive effect on the cord.
Asunto(s)
Angiolipoma/diagnóstico , Duramadre/patología , Neoplasias Meníngeas/diagnóstico , Neoplasias de la Columna Vertebral/diagnóstico , Vértebras Torácicas , Anciano , Angiolipoma/complicaciones , Angiolipoma/cirugía , Humanos , Hipoestesia/etiología , Laminectomía , Imagen por Resonancia Magnética , Masculino , Neoplasias Meníngeas/complicaciones , Neoplasias Meníngeas/cirugía , Paraplejía/etiología , Reflejo Anormal , Compresión de la Médula Espinal/etiología , Neoplasias de la Columna Vertebral/complicaciones , Neoplasias de la Columna Vertebral/cirugía , Vértebras Torácicas/patología , Vértebras Torácicas/cirugía , Incontinencia Urinaria/etiologíaRESUMEN
The clinical, radiological and surgical findings of 56 patients with congenital malformations of the craniovertebral junction who underwent surgical intervention in the Department of Neurosurgery, Hacettepe University Medical School were reviewed. The anomalies were classified according to their embryonic origin. Forty-two cases of the series were major abnormalities formed by the combination of more than one germ layer.
Asunto(s)
Articulación Atlantoaxoidea/anomalías , Articulación Atlantooccipital/anomalías , Vértebra Cervical Axis/anomalías , Atlas Cervical/anomalías , Vértebras Cervicales/anomalías , Defectos del Tubo Neural/cirugía , Hueso Occipital/anomalías , Apófisis Odontoides/anomalías , Adolescente , Adulto , Malformación de Arnold-Chiari/clasificación , Malformación de Arnold-Chiari/cirugía , Articulación Atlantoaxoidea/cirugía , Articulación Atlantooccipital/cirugía , Vértebra Cervical Axis/cirugía , Atlas Cervical/cirugía , Vértebras Cervicales/cirugía , Niño , Preescolar , Femenino , Humanos , Síndrome de Klippel-Feil/clasificación , Síndrome de Klippel-Feil/cirugía , Masculino , Persona de Mediana Edad , Defectos del Tubo Neural/clasificación , Examen Neurológico , Hueso Occipital/cirugía , Apófisis Odontoides/cirugía , Platibasia/clasificación , Platibasia/cirugía , Estudios RetrospectivosRESUMEN
The authors report the case of a giant meningioma in a 5-day-old newborn. Congenital meningiomas are extremely rare. Five newborns with meningiomas have been reported in the literature to date. This is the first case of a newborn with a giant meningioma with supra- and infratentorial and intraorbital components.
Asunto(s)
Neoplasias Meníngeas/congénito , Meningioma/congénito , Neoplasias Encefálicas/congénito , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/patología , Neoplasias Encefálicas/cirugía , Humanos , Recién Nacido , Masculino , Neoplasias Meníngeas/diagnóstico , Neoplasias Meníngeas/patología , Neoplasias Meníngeas/cirugía , Meningioma/diagnóstico , Meningioma/patología , Meningioma/cirugíaRESUMEN
63 patients with epidermoid and dermoid cysts were treated surgically during the past sixteen years. Total tumour removal was achieved in 65% of cases. Because of their soft and slow growing nature, adjacent subarachnoidal spaces and clefts were filled and in some cases total removal was impossible. Due to the advances in technology mortality and morbidity rates are greatly decreased.