RESUMO
Conjoined twinning is a very rare occurrence with no genetic predisposition. Twisting of conjoined twins around the axis of their connecting tissue bridge, close to the third trimester, has not been previously reported. We describe a unique case of in utero twisting of conjoined omphalopagus twins who survived without any adverse effects. Fetal US and fetal MRI played a vital role in the diagnosis and perinatal management of these twins.
Assuntos
Feto/patologia , Diagnóstico Pré-Natal/métodos , Gêmeos Unidos , Ultrassonografia/métodos , HumanosRESUMO
We present a neonate with heterotopic nasopharyngeal brain tissue causing airway obstruction. Preoperative imaging showed extension of the mass along major neurovascular pathways into the cranial vault. Preoperative identification of intracranial extension is essential for planning surgery to prevent postoperative cerebrospinal fluid leaks or possible meningitis.
Assuntos
Obstrução das Vias Respiratórias/congênito , Coristoma/congênito , Doenças Nasofaríngeas/congênito , Neuroglia , Obstrução das Vias Respiratórias/etiologia , Obstrução das Vias Respiratórias/patologia , Seio Cavernoso/patologia , Coristoma/patologia , Coristoma/cirurgia , Feminino , Humanos , Recém-Nascido , Imageamento por Ressonância Magnética , Doenças Nasofaríngeas/etiologia , Doenças Nasofaríngeas/patologia , Doenças Nasofaríngeas/cirurgia , Neoplasia Residual , Palato Mole/patologia , Base do Crânio/patologiaRESUMO
OBJECTIVE: This paper reports and discusses on the possible etiology of postoperative contralateral facial nerve palsy after uneventful evacuation of a subdural haematoma or hygroma after mild head trauma in two children with pre-existing middle cranial fossa subarachnoid cysts. RESULTS: Two 14- and 15-year-old boys had prolonged headaches after mild head injuries. CT showed a right-sided middle cranial fossa arachnoid cyst in each patient. In one patient, an ipsilateral subdural haematoma was identified, and in the other, bilateral hygromas were identified. Exacerbation of symptoms required emergency evacuation of the subdural haematoma in the first child, and bilateral external drainage of the hygroma in the other child. In both children the late postoperative period was complicated by peripheral facial nerve palsies contralateral to the arachnoid cyst. CONCLUSION: Facial nerve palsy may be a complication of hygroma or haematoma drainage. The etiology is not clear; traction of the facial nerve due to displacement of the brainstem may be the most likely explanation.