RESUMO
BACKGROUND: Spinal schwannomas are commonly presented with minor symptoms, including radicular pain, sensory deficits, and minor neurologic deficit. Acute neurologic deterioration is uncommon. CASE DESCRIPTION: In this study, a case of cauda equina schwannoma presented with acute neurologic deficit after movement of spinal schwannoma is presented. CONCLUSIONS: It is noted that movement of spinal schwannoma and resultant acute neurologic deterioration should be considered during the follow-up.
Assuntos
Cauda Equina/patologia , Neurilemoma/psicologia , Neoplasias do Sistema Nervoso Periférico/psicologia , Neoplasias da Medula Espinal/psicologia , Idoso , Cauda Equina/diagnóstico por imagem , Humanos , Masculino , Neurilemoma/diagnóstico por imagem , Neurilemoma/patologia , Neoplasias do Sistema Nervoso Periférico/diagnóstico por imagem , Neoplasias do Sistema Nervoso Periférico/patologia , Neoplasias da Medula Espinal/diagnóstico por imagem , Neoplasias da Medula Espinal/patologiaRESUMO
Neuroma formation in the lower extremity can be debilitating to patients, especially when the neuromas are recurrent. The results of an advanced nerve reconstruction technique consisting of nerve transfer combined with nerve allograft and entubulation was evaluated in 4 patients with severe, debilitating, lower extremity neuromas. At a mean follow-up period of 26 months, the mean visual analog scale had improved from 9.5 preoperatively to 1.25 postoperatively (p < .05). These data suggest that techniques using a nerve allograft with a nerve conduit could be of great assistance in successfully managing debilitating neuromas of the lower extremity. Thus, further in-depth evaluation of these techniques is warranted.
Assuntos
Transferência de Nervo/métodos , Neuroma/cirurgia , Neoplasias do Sistema Nervoso Periférico/cirurgia , Qualidade de Vida , Transplante Homólogo/métodos , Adulto , Idoso , Aloenxertos/transplante , Anastomose Cirúrgica , Feminino , Seguimentos , Sobrevivência de Enxerto , Humanos , Extremidade Inferior/patologia , Extremidade Inferior/cirurgia , Masculino , Pessoa de Meia-Idade , Neuroma/diagnóstico , Neuroma/psicologia , Medição da Dor , Dor Pós-Operatória/fisiopatologia , Neoplasias do Sistema Nervoso Periférico/diagnóstico , Neoplasias do Sistema Nervoso Periférico/psicologia , Medição de Risco , Estudos de Amostragem , Resultado do TratamentoRESUMO
Large series of cauda equina tumors in adults are seldom reported. This study was based on the 231 cases collected in the French neurosurgery units for the congress of the Société Française de Neurochirurgie in October 1996. Schwannomas were the most frequent benign tumor in this series, followed by ependymomas. Very few malignant tumors were recorded, usually malignant neurinomas nearly always arising in patients with neurofibromatosis. Some other rare tumors were also observed including paragangliomas. This series confirms the contribution of pre-therapeutic neurological status to functional prognosis. All schwannomas can be cured while ependymomas and paragangliomas may recur after a very long delay. Surgery must be as complete as possible since adjuvant therapies have proven to have little efficacy. This type of tumor requires a very long follow-up. Prognosis is good for hemangioblastoma. When present, abnormal sphincter function is an argument for poor prognosis. It may appear after primary surgery or more often after treatment of recurrence.
