RESUMO
Perineural cysts are an uncommon radiological finding and a rare cause of radicular leg pain. We report the clinical findings, imaging and operative appearances of a patient who presented with radicular leg and perineal pain, which was found to be associated with multiple sacral perineural cysts. The diagnostic and treatment options are explored. In particular, the use of percutaneous fine-needle cyst drainage as a guide to the value of surgery is discussed. Postoperative complications, such as pseudomeningocoele can occur, but may be effectively treated with lumbar drainage.
Assuntos
Cistos/diagnóstico , Doenças do Sistema Nervoso Periférico/diagnóstico , Raízes Nervosas Espinhais , Idoso , Cistos/cirurgia , Drenagem/métodos , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Doenças do Sistema Nervoso Periférico/cirurgia , Raízes Nervosas Espinhais/diagnóstico por imagem , Raízes Nervosas Espinhais/cirurgia , Tomografia Computadorizada por Raios XAssuntos
Encefalopatias/complicações , Encefalopatias/diagnóstico , Cisto Epidérmico/complicações , Cisto Epidérmico/diagnóstico , Pseudotumor Cerebral/etiologia , Adulto , Encefalopatias/patologia , Encefalopatias/cirurgia , Diagnóstico Diferencial , Cisto Epidérmico/patologia , Cisto Epidérmico/cirurgia , Feminino , Humanos , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Acuidade VisualAssuntos
Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Segunda Neoplasia Primária/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Antimetabólitos Antineoplásicos/uso terapêutico , Pré-Escolar , Irradiação Craniana/efeitos adversos , Feminino , Humanos , Neoplasias Meníngeas/etiologia , Meningioma/etiologia , Metotrexato/uso terapêutico , Segunda Neoplasia Primária/etiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras/radioterapiaRESUMO
Gliomatosis cerebri is a rare form of primary diffuse brain tumour first described by Nevin in 1938. It was originally considered to be a post-mortem diagnosis before Troost et al reported a clinically diagnosed case in 1987. However antemortem diagnosis remains difficult due to vague clinical symptoms and often non-specific findings on CT scanning. Gliomatosis cerebri has been classified by the World Health Organization as an infiltrative tumoural process, which involves at least two, and usually three, lobes of the brain. Magnetic resonance (MR) imaging shows a diffuse infiltrative process with possible mass effect but no necrosis. Histology is usually of a low grade astrocytic neoplasm which seemingly infiltrates out of proportion to the degree of anaplasia. We report two patients who presented over the past year, whose clinical and radiological features prompted a preoperative diagnosis of gliomatosis cerebri, confirmed by biopsy.
Assuntos
Astrocitoma/diagnóstico , Astrocitoma/terapia , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/terapia , Lobo Frontal , Lobo Temporal , Adulto , Diagnóstico Diferencial , Evolução Fatal , Humanos , Imageamento por Ressonância Magnética , Masculino , Tomografia Computadorizada de Emissão de Fóton ÚnicoRESUMO
We report a unique case of transorbital penetrating head injury with a door-key. The case highlights the difficulties of preoperative ophthalmological assessment in the presence of a retained object and discusses the management of this and related injuries.
Assuntos
Corpos Estranhos no Olho/cirurgia , Ferimentos Oculares Penetrantes/cirurgia , Fraturas Orbitárias/cirurgia , Acidentes por Quedas , Idoso , Dura-Máter/lesões , Corpos Estranhos no Olho/complicações , Ferimentos Oculares Penetrantes/complicações , Feminino , Humanos , Fraturas Orbitárias/complicaçõesRESUMO
Blood loss from scalp lacerations may be considerable. Two cases are described to illustrate the hazards of transferring patients with head injuries without adequate attention to scalp wounds. In such cases referring clinicians must be satisfied that haemostasis is secure. Failure to do this may place the patient at increased risk as a result of the need for additional resuscitation, and therefore delay the definitive management.
