Assuntos
Toxoplasmose Cerebral/complicações , Macroglobulinemia de Waldenstrom/complicações , Idoso , Antiprotozoários/uso terapêutico , Biópsia , Infecção Hospitalar/complicações , Quimioterapia Combinada , Evolução Fatal , Humanos , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Imageamento por Ressonância Magnética , Masculino , Insuficiência de Múltiplos Órgãos/etiologia , Pneumonia/complicações , Ponte/parasitologia , Ponte/patologia , Pirimetamina/uso terapêutico , Sulfadiazina/uso terapêutico , Toxoplasma/isolamento & purificação , Toxoplasmose Cerebral/diagnóstico , Toxoplasmose Cerebral/tratamento farmacológico , Toxoplasmose Cerebral/parasitologia , Macroglobulinemia de Waldenstrom/tratamento farmacológicoRESUMO
A 45-year-old healthy man presented with 2 weeks history of continuous rippling and quivering movements of his right side of face and neck suggestive of myokymia. MRI scan of the head revealed neurocysticercus in the pons. Treatment with steroids and carbamezapine produced a significant benefit. This is the first report of pontine neurocysticercosis presenting as an isolated facial myokymia.
Assuntos
Doenças do Nervo Facial/diagnóstico , Doenças do Nervo Facial/fisiopatologia , Neurocisticercose/diagnóstico , Neurocisticercose/parasitologia , Ponte/parasitologia , Anti-Inflamatórios/uso terapêutico , Anticonvulsivantes/uso terapêutico , Carbamazepina/uso terapêutico , Diagnóstico Diferencial , Doenças do Nervo Facial/tratamento farmacológico , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neurocisticercose/tratamento farmacológico , Ponte/patologia , Gravação de VideoteipeRESUMO
A very rare case of a pontine hydatid cyst is reported. It was diagnosed preoperatively on the basis of magnetic resonance imaging findings. The patient was operated on in the sitting position. Total excision of the cyst using the Dowling technique and gravity effect was performed through the floor of the fourth ventricle. The patient was discharged without extra neurological sequel. The significance of an accurate preoperative diagnosis, surgical approaches and technique in the management of this pathology is discussed.
Assuntos
Equinococose/cirurgia , Quarto Ventrículo/cirurgia , Procedimentos Neurocirúrgicos/métodos , Ponte/cirurgia , Pré-Escolar , Equinococose/diagnóstico , Humanos , Imageamento por Ressonância Magnética , Masculino , Ponte/parasitologia , Ponte/patologia , Cuidados Pré-Operatórios , TeníaseRESUMO
We report a rare case of anterior pontine hydatid cyst. Diagnosis was established on magnetic resonance imaging (MRI) findings preoperatively and was confirmed during surgery and by laboratory findings of cyst fluid, and section of cyst wall. A classical suboccipital craniectomy was performed, followed by an approach through the floor of the fourth ventricle. After a failed attempt at the Dowling technique, we punctured the cyst, aspirated the contents, then extirpated the cyst membrane. The patient survived suffering only minor morbidity. The surgical technique and pontine myelotomy are discussed.
