RESUMO
Dural ectasia denotes circumferential expansion or dilatation of the dural sac, and has been frequently reported in association with type 1 neurofibromatosis (NF1). The pathogenesis has not been defined, but its correlation with NF1 infers a congenital malformative hypothesis. The neural elements in the dilated sleeve typically are not enlarged or abnormal, nevertheless the enlarged area contain an increased amount of cerebrospinal fluid. The dura in the area of ectasia is extremely thin and fragile, and erodes the surrounding bony structures destabilising the spine and permitting spectacular spinal deformities. We present two cases with lumbosacral dural ectasia, enlargement of the intervertebral foramina and posterior scalloping of vertebral bodies. Neurological examination showed sciatic nerve irritation. As the etiology of this malformation remains uncertain and dysplastic changes of the spine may be intrinsic or secondary controversies remain about optimum treatment. We conclude that patients affected by NF-1 require an accurate neuroradiological study of the whole spine in order to detect possible dural and spinal anomalies. Surgical treatment is indicated only in patients with progressive neurological deterioration. The thin dural sac predisposes to a high morbidity if surgery is undertaken.
Assuntos
Dura-Máter/fisiopatologia , Neurofibromatose 1/fisiopatologia , Adulto , Dilatação Patológica , Dura-Máter/patologia , Humanos , Região Lombossacral , Imageamento por Ressonância Magnética , Masculino , Neurofibromatose 1/diagnóstico , Tomografia , Tomografia Computadorizada por Raios XRESUMO
A case of post-traumatic cerebral air embolism is presented. In the chest-X-radiography fractures of many ribs and hemo-pneumothorax were visible on the right side associated with intra-alveolar, interstitial hemorrhages and mediastinal emphysema. At the end of a CT scan of the head appeared features of arterial air embolism. The patient was diagnosed as brain dead and cardiac arrest occurred one hour after.
Assuntos
Embolia Aérea/etiologia , Traumatismos Cranianos Fechados/complicações , Embolia e Trombose Intracraniana/etiologia , Adolescente , Evolução Fatal , Feminino , Hemotórax/etiologia , Humanos , Enfisema Mediastínico/etiologia , Traumatismo Múltiplo , Pneumotórax/etiologiaRESUMO
A 42-year-old patient with a bilateral extracranial internal carotid occlusion which was associated with a midline intracerebral tumour of the genu of the corpus callosum, is reported. This rare association is discussed in the light of the pathogenetic theories referred to in the literature in similar cases. It is felt that, such cases, although rarely encountered, should stimulate the adoption of more accurate neuroradiological investigations, in patients harbouring brain tumours, in order carefully to plan the anaesthetic and surgical procedures.
