RESUMO
A 31-year-old woman with acquired immunodeficiency syndrome (AIDS) was found to harbor both a pulmonary smooth-muscle tumor and an intracranial extraaxial smooth-muscle tumor of the parasellar region. The frequency of smooth-muscle tumors (leiomyoma and leiomyosarcoma) has increased with AIDS, but much more so in children than in adults. Only nine cases of human immunodeficiency virus-related smooth-muscle tumors have been previously reported in adults, and only one of these was located intracranially.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Neoplasias Encefálicas/patologia , Neoplasias Pulmonares/patologia , Tumor de Músculo Liso/patologia , Adulto , Feminino , Humanos , Imageamento por Ressonância Magnética , Transtornos Relacionados ao Uso de SubstânciasRESUMO
A 54-year-old black male with a 15-year history progressive lower extremity weakness was evaluated with a thoracic MRI that revealed epidural lipomatosis extending from T1-T10 with an associated syrinx at T1-3. He was neither overweight nor taking steroids. A multilevel thoracic laminectomy with resection of lipoma was performed without directly addressing the syrinx. Postoperatively, his symptoms improved and an MRI obtained 1 year after surgery demonstrated resolution of the syrinx. This is the only case of epidural lipomatosis with an associated syrinx that we have seen reported in the world literature.
Assuntos
Lipomatose/complicações , Siringomielia/complicações , Doenças Torácicas/complicações , Espaço Epidural/patologia , Humanos , Laminectomia/métodos , Lipomatose/diagnóstico , Lipomatose/cirurgia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Siringomielia/diagnóstico , Siringomielia/cirurgia , Doenças Torácicas/diagnóstico , Doenças Torácicas/cirurgiaRESUMO
Epidural lipomatosis is a condition in which excess adipose tissue is deposited circumferentially about the spinal cord in the epidural space. It is most frequently seen in patients on chronic steroid treatment for a variety of medical problems and can present as nonspecific back pain, radiculopathy, or frank spinal cord compression. Diagnosis and treatment have generally relied on multi-level decompressive laminectomy after myelography and computed tomography. The immunocompromised state and the reported postoperative mortality (22%) of these patients, however, suggests that nonoperative therapy may be preferable whenever possible. Five cases of epidural lipomatosis are reported, and previous literature is reviewed for presentation, evaluation, and treatment of this condition.
Assuntos
Lipomatose/induzido quimicamente , Síndromes de Compressão Nervosa/etiologia , Prednisona/efeitos adversos , Raízes Nervosas Espinhais , Adulto , Idoso , Espaço Epidural , Feminino , Humanos , Terapia de Imunossupressão , Masculino , Pessoa de Meia-Idade , Mielografia , Prednisona/uso terapêutico , Compressão da Medula Espinal/etiologiaRESUMO
Three cases of glioblastoma multiforme are presented. These cases have in common the fact that all three patients were relatives but not blood relatives. There had been prolonged intimate contact between them before the development of the neoplastic lesion.
Assuntos
Neoplasias Encefálicas/transmissão , Glioblastoma/transmissão , Adulto , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/mortalidade , Neoplasias Encefálicas/cirurgia , Saúde da Família , Feminino , Glioblastoma/diagnóstico por imagem , Glioblastoma/mortalidade , Glioblastoma/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Tomografia Computadorizada por Raios XRESUMO
The increase in the prevalence of head injury in the civilized world has become the focus of worldwide attention. With the aid of modern technology and a high index of suspicion, early diagnosis and definitive treatment with acceptable outcome has become within reach. This article reviews recent developments in diagnosis and advances in therapy.
Assuntos
Traumatismos Craniocerebrais/terapia , Adulto , Idoso , Antibacterianos/uso terapêutico , Anticonvulsivantes/uso terapêutico , Barbitúricos/uso terapêutico , Edema Encefálico/complicações , Otorreia de Líquido Cefalorraquidiano/etiologia , Rinorreia de Líquido Cefalorraquidiano/etiologia , Criança , Traumatismos Craniocerebrais/diagnóstico , Diuréticos/uso terapêutico , Epilepsia Pós-Traumática/tratamento farmacológico , Feminino , Hematoma Epidural Craniano/terapia , Humanos , Masculino , Manitol/uso terapêutico , Meningite/prevenção & controle , Pessoa de Meia-Idade , Monitorização Fisiológica , Pseudotumor Cerebral/terapia , Edema Pulmonar/prevenção & controle , Respiração Artificial/métodos , Fraturas Cranianas/complicações , Esteroides/uso terapêuticoRESUMO
It should be obvious from the magnitude of the problem, its persistence in our society, and the failures of our treatment methods to date, though much improved over our past efforts, that much remains to be learned and understood about low back pain and sciatica. The causes, the treatments, and the methods of prevention all need to be researched further. The intellectually honest, inquiring clinician has an opportunity to make a meaningful contribution in this area.
Assuntos
Deslocamento do Disco Intervertebral/terapia , Eletromiografia , Humanos , Deslocamento do Disco Intervertebral/diagnóstico , Deslocamento do Disco Intervertebral/tratamento farmacológico , Período Intraoperatório , Microcirurgia , Mielografia , Complicações Pós-Operatórias , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
The authors report two cases in which the appearance of sacral perineural cysts, as seen in the computerized tomography scan, prompted the possible diagnosis of a neoplastic lesion. Additional investigation led to the proper diagnosis.
Assuntos
Cistos/diagnóstico por imagem , Doenças da Coluna Vertebral/diagnóstico por imagem , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sacro , Tomografia Computadorizada por Raios XRESUMO
A 20-year-old asymptomatic woman suddenly had complete right ophthalmoplegia associated with right ptosis and impairment of the sensory and motor functions of the right papillary cranial nerve. These symptoms were found to be caused by a chromophobe adenoma of the pituitary gland. Complete resolution of the patient's symptoms followed surgical aspiration of the tumor with subsequent radiation therapy.
Assuntos
Adenoma Cromófobo/complicações , Oftalmoplegia/etiologia , Neoplasias Hipofisárias/complicações , Adenoma Cromófobo/radioterapia , Adenoma Cromófobo/cirurgia , Adulto , Feminino , Humanos , Neoplasias Hipofisárias/radioterapia , Neoplasias Hipofisárias/cirurgia , Fatores de TempoAssuntos
Transplante Ósseo , Vértebras Cervicais/cirurgia , Fraturas Ósseas/cirurgia , Fraturas Fechadas/cirurgia , Acidentes de Trânsito , Adolescente , Adulto , Traumatismos em Atletas/diagnóstico por imagem , Traumatismos em Atletas/cirurgia , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/lesões , Mergulho , Seguimentos , Fraturas Fechadas/diagnóstico por imagem , Ginástica , Humanos , Luxações Articulares/diagnóstico por imagem , Luxações Articulares/cirurgia , Masculino , Radiografia , TíbiaRESUMO
The biosynthesis and initial processing of the methionine-enkephalin precursor preproenkephalin A were examined by cell-free translation of mRNA from brain and adrenal medulla. A novel antiserum raised against Met-enkephalin-Arg6-Phe7 was shown to react with bovine adrenal medulla fractions (apparent Mr 34,000) containing proenkephalin A. Affinity-purified antibodies from this antiserum were used to immunoprecipitate cell-free translated [35S]Met-enkephalin-containing protein. A protein of apparent Mr 30,000 +/- 500 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis was the only Met-enkephalin precursor consistently synthesized by translation of mRNA from bovine or guinea pig striatum, rat brain, or bovine adrenal medulla. The presence of [35S]Met-enkephalin sequences in this protein was confirmed by high pressure liquid chromatography of trypsin/carboxypeptidase B digests. Dog pancreas endoplasmic reticulum membranes converted the Mr 30,000 protein to an immunoreactive protein of apparent Mr 28,500 that lacked significant core glycosylation. These results suggest that 1) a protein similar or identical to bovine adrenal medullary preproenkephalin A is the major Met-enkephalin precursor synthesized in brain as well as adrenal medulla, and 2) preproenkephalin A is converted to a protein resembling proenkephalin A, presumably by removal of a signal peptide.
Assuntos
Encefalina Metionina/biossíntese , Precursores de Proteínas/biossíntese , Animais , Especificidade de Anticorpos , Química Encefálica , Cromatografia Líquida de Alta Pressão , Cães , Encefalina Metionina/análogos & derivados , Encefalina Metionina/imunologia , Cobaias , Soros Imunes , Peso Molecular , Biossíntese de Proteínas , CoelhosAssuntos
Dura-Máter/patologia , Deslocamento do Disco Intervertebral/cirurgia , Síndromes de Compressão Nervosa/patologia , Raízes Nervosas Espinhais/patologia , Cauda Equina/patologia , Feminino , Humanos , Deslocamento do Disco Intervertebral/patologia , Laminectomia , Pessoa de Meia-Idade , Mielografia , Complicações Pós-Operatórias/patologia , Recidiva , Medula Espinal/patologiaRESUMO
Since 1972, Kiel Surgibone (calf bone) dowels have been inserted in the cervical intervertebral space of 221 patients. The anterior approach was used for cervical interbody fusion. Fusion occurred in every patient who survived long enough for it to occur. No complications occurred that specifically could be attributed to use of this type of grafting material. Kiel surgibone has the advantage of eliminating the need for osteotomy when autologous bone is used or for a bone bank when homologous bone is employed. Kiel Surgibone is supplied sterile and is precisely preshaped.
Assuntos
Vértebras Cervicais , Fraturas Ósseas/cirurgia , Disco Intervertebral , Luxações Articulares/cirurgia , Fusão Vertebral/métodos , Adolescente , Adulto , Idoso , Animais , Transplante Ósseo , Bovinos , Vértebras Cervicais/lesões , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Doenças da Coluna Vertebral/cirurgia , Transplante HeterólogoRESUMO
Surgical treatment of diastematomyelia, with removal of the spur and dural septum, is indicated in adults with progressive symptoms. The patient may improve, or at least the progression of the neurological damage may be halted. The utilization of microneurosurgical techniques was found to be of value in decreasing the danger of spinal cord or nerve injury during the procedure. The seventh case reported in the literature of diastematomyelia with onset of symptoms in adult life is presented.
Assuntos
Defeitos do Tubo Neural/diagnóstico , Adulto , Feminino , Humanos , Defeitos do Tubo Neural/diagnóstico por imagem , RadiografiaRESUMO
Cysticercosis cerebri is a rare neurological diagnosis, which is usually made at the time of operation or at autopsy. Few cases have been reported in North America, and these were usually found in immigrants and in domestic travelers who lived in infested countries. Cysticercosis cerebri is classically divided into four general types: 1) intraparenchymal, 2) basilar cisternal, 3) ventricular, and 4) diffuse cerebral. We are presenting a unique case of solitary ventricular cysticercosis occluding the foramen of Monro, and producing an asymmetrical obstructive hydrocephalus.
Assuntos
Encefalopatias/cirurgia , Ventrículos Cerebrais/cirurgia , Cisticercose/cirurgia , Encefalopatias/diagnóstico por imagem , Encefalopatias/patologia , Ventriculografia Cerebral , Criança , Cisticercose/diagnóstico por imagem , Cisticercose/patologia , Humanos , MasculinoRESUMO
A hematoma in the left iliacus muscle induced by anticoagulant therapy and causing a femoral neuropathy was demonstrated by CT scan. The scan returned to normal after the surgical evacuation of the hematoma. Other possible uses of the CT scan to demonstrate neurological lesions in this region are discussed.