RESUMO
Thoracic spinal epidural lipomatosis, a rare cause of myelopathy, is most commonly associated with exogenous corticosteroid use. The authors present the clinical, magnetic resonance imaging, computed tomography, and surgical findings for two patients with idiopathic epidural lipomatosis, successfully treated with decompressive laminectomy accompanied by fatty debulking, followed for > 3 postoperative years. They review the literature on idiopathic spinal epidural lipomatosis as well as cases associated with exogenous steroid use.
Assuntos
Lipomatose , Compressão da Medula Espinal , Idoso , Espaço Epidural , Humanos , Laminectomia , Lipomatose/diagnóstico , Lipomatose/patologia , Lipomatose/cirurgia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Compressão da Medula Espinal/diagnóstico , Compressão da Medula Espinal/patologia , Compressão da Medula Espinal/cirurgiaRESUMO
A patient with a cystic cervical ependymoma is described. Magnetic resonance imaging identified evidence of previous intratumor hemorrhage, which was confirmed at surgery. The images, operative findings, and pathology are reviewed.
Assuntos
Ependimoma/diagnóstico , Hemorragia/diagnóstico , Imageamento por Ressonância Magnética , Neoplasias da Medula Espinal/diagnóstico , Adulto , Cistos/diagnóstico , Ependimoma/complicações , Feminino , Hemorragia/etiologia , Humanos , Medula Espinal/patologia , Neoplasias da Medula Espinal/complicaçõesRESUMO
Two patients presenting with signs and symptoms suggestive of nerve root compression secondary to extradural masses were found to have ligamentum flavum hematomas. Both patients had neurological deficits preoperatively and regained normal function postoperatively. There was no significant antecedent injury in either case. The symptom course was longer than that for spontaneous epidural hematoma. In one case, there was remodeling of bone, initially suggesting either infection or tumor.
Assuntos
Hematoma/cirurgia , Ligamentos/cirurgia , Adulto , Diagnóstico Diferencial , Hematoma/complicações , Hematoma/diagnóstico , Hematoma Epidural Craniano/diagnóstico , Humanos , Laminectomia , Masculino , Pessoa de Meia-Idade , Síndromes de Compressão Nervosa/etiologia , Raízes Nervosas EspinhaisRESUMO
Glossopharyngeal schwannomas are rare tumors in spite of the fact that acoustic schwannomas account for 8%-10% of intracranial tumors. There have been 23 reported cases in the literature. This report of five cases is the largest series of these tumors. The presentation, radiological workup, operation, and long-term postoperative results will be presented, along with a review of the literature.
Assuntos
Neoplasias dos Nervos Cranianos , Nervo Glossofaríngeo , Neurilemoma , Adulto , Idoso , Neoplasias dos Nervos Cranianos/complicações , Neoplasias dos Nervos Cranianos/diagnóstico , Neoplasias dos Nervos Cranianos/fisiopatologia , Neoplasias dos Nervos Cranianos/terapia , Feminino , Perda Auditiva Funcional/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Neurilemoma/complicações , Neurilemoma/diagnóstico , Neurilemoma/fisiopatologia , Neurilemoma/terapiaRESUMO
A case is reported of eosinophilic granuloma at the cervicothoracic junction presenting with profound quadriparesis preoperatively. The patient underwent excision via an anterior approach, with splitting of the sternum to gain access to the T-1 vertebra. Postoperatively, he has had an excellent return of function.
Assuntos
Granuloma Eosinófilo/cirurgia , Doenças da Coluna Vertebral/cirurgia , Transplante Ósseo , Criança , Granuloma Eosinófilo/diagnóstico , Granuloma Eosinófilo/diagnóstico por imagem , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Masculino , Pescoço , Doenças da Coluna Vertebral/diagnóstico , Doenças da Coluna Vertebral/diagnóstico por imagem , Tórax , Tomografia Computadorizada por Raios XRESUMO
A case of a prepontine (clival) arachnoid cyst is reported. The patient presented with isosexual precocious puberty. Treatment was initially with fenestration by suboccipital craniectomy, however, definitive treatment was via stereotactic transfrontal placement of a cystoperitoneal shunt. Normalization of endocrine function has occurred and has persisted for 1 year. This case is presented as a contrast to the two approaches for the treatment of arachnoid cysts. The case will be described and the literature reviewed.
