RESUMO
Pain originating from sacroiliac joint may also cause pain in the lumbar and gluteal region in 15% of the population. The clinical manifestation represents a public health problem due to the great implications on the quality of life and health-related costs. However, this is a diagnosis that is usually ignored in the general clinical practice; probably because of the unknown etiology, making harder to rule out the potential etiologies of this pathology, or maybe because the clinical criteria that support this pathology are unknown. By describing several diagnostic techniques, many authors have studied the prevalence of this pathology, finding more positive data than expected; coming to the conclusion that even though there is no diagnostic gold standard yet, an important amount of cases might be detected by properly applying several tests at the physical examination. Thus, it is necessary to have knowledge of the physiopathology and clinical presentation so that diagnosis can be made to those patients that manifest this problem. We present a clinical approach for the neurosurgeon.
RESUMO
Intradiploic epidermoid cyst is an uncommonly occurring neoplasm, and only about 200 cases are reported in the form of isolated case report. It is presumed to occur due to ectodermal cells in inclusion in the bone tissue during embryonic life neural tube closure. It commonly remains asymptomatic or rarely presents as a bony lump in the skull bone. Authors report present an interesting case, which presented with swelling, and underwent successful surgical resection. Pertinent literature along with diagnosis and management is briefly reviewed. These lesions can erode the bone and involve the brain parenchyma due to their proximity to the brain. Radiological imaging is very helpful in accurate diagnosis of these lesions and in differentiating intradural from intradiploic varieties of epidermoid. We present an unusual case of this pathology.
RESUMO
Chiari malformation is characterized by caudal displacement of the cerebellar tonsils that penetrate into the spinal canal through the foramen magnum, achieving reach the atlas or axis. trunk and any drop of the fourth ventricle is observed. Typically is seen in young adults. In some cases scoliosis and Syringomyelic cavities may occur. The authors present (as far as they know) the first case in the literature with long term follow-up, of a caucasian woman with an unusual form of cerebellar atrophy and Chiari Type I malformation, suffering from weakness in his upper and lower extremities with rapidly progression. The patient was successfully treated with suboccipital decompression and C1 laminectomy.
La malformación de Chiari se caracteriza por un desplazamiento caudal de las amígdalas cerebelosas que penetran hacia el canal raquídeo por el foramen mágnum, logrando llegar hasta el atlas o el axis. No hay descenso del tronco y tampoco del cuarto ventrículo. Típicamente se observa en adultos jóvenes. En algunos casos hay escoliosis y cavidades siringomiélicas. Los autores presentan lo que a su conocimiento es el primer caso de la literatura con seguimiento a largo plazo de una mujer de raza blanca con una forma inusual de atrofia cerebelosa y malformación de Chiari tipo I, que sufre de debilidad en sus extremidades superiores e inferiores rápida y progresivamente. La paciente fue tratada con éxito mediante descompresión suboccipital y laminectomia C1.
Assuntos
Malformação de Arnold-Chiari/diagnóstico , Malformação de Arnold-Chiari/patologia , Cerebelo/patologia , Adolescente , Malformação de Arnold-Chiari/complicações , Atrofia/etiologia , Feminino , HumanosRESUMO
Las neoplasias intracraneales múltiples son infrecuentes, representan alrededor del 4 por ciento de todos los tumores cerebrales. Estas lesiones se observan ocasionalmente en pacientes con neurofibromatosis y en tratados con radioterapia. Presentamos el caso de un paciente portador de meningioma y una lesión de estirpe glial manejado en nuestro servicio de neurocirugía.
Multiple intracranial neoplasms are rare, representing about 4 percent of all brain tumors. These lesions are occasionaly observed in patients with neurofibromatosis and in patients treated with radiotherapy. We report the case of a patient with a meningioma and a glial lineage lesion , handled in our service of neurosurgery, University of Cartagena, Colombia.
Assuntos
Masculino , Humanos , Pessoa de Meia-Idade , Astrocitoma/cirurgia , Neoplasias Encefálicas , Craniotomia/métodos , Imageamento por Ressonância Magnética/métodos , Neoplasias Meníngeas , Meningioma/diagnóstico , Meningioma/cirurgia , Neuroimagem/métodosRESUMO
Chiari malformation Type I (CM-I) is a congenital disorder, which is basically a tonsillar herniation (≥ 5 mm) below the foramen magnum with or without syringomyelia. The real cause behind this malformation is still unknown. Patients may remain asymptomatic until they engender a deteriorating situation, such as cervical trauma. The objective of this case report is to give a broad perspective on CM-I from the clinical findings obtained in a patient with asymptomatic non-communicating syringomyelia associated with a CM-I exacerbated within 2 years of a TBI, and to discuss issues related to that condition.
RESUMO
El trauma craneoencefálico severo representa por lo menos la mitad de las muertes relacionadas con trauma, la patofisiología celular y clínica esta extensamente estudiada y documentada, las opciones de monitorización y tratamiento constituyen los paradigmas actualmente para la el progreso en la sobrevida disminuyendo la probabilidad de secuelas, junto con los principios de manejo general que incluyen entre otros el control de la temperatura, tensión arterial, sedación, ventilación, nutrición hacen posible la calidad en la atención de nuestros pacientes.
Severe brain trauma accounts for at least half of the deaths related to trauma, cellular pathophysiology and clinic it is extensively studied and documented , the monitoring and treatment options are currently paradigms for progress in decreasing the likelihood of survival sequels along with general management principles which include among others the temperature control, blood pressure, sedation, ventilation, nutrition enables quality care for our patients.
Assuntos
Humanos , Hipertensão Intracraniana/terapia , Monitorização Fisiológica/métodos , Traumatismos Craniocerebrais/cirurgia , Traumatismos Craniocerebrais/complicações , Traumatismos Craniocerebrais/fisiopatologia , Diagnóstico por Imagem/métodos , Unidades de Terapia Intensiva , Assistência Pré-HospitalarRESUMO
Dissection of the vertebral artery is an important but rare cause of cerebrovascular accidents. Here we report a 48-year-old man with toothache since 4 days before who presented to the emergency department with neck pain and final diagnosis of dissecting right vertebral artery pseudoaneurysm. To our knowledge, this maybe the first report of odontogenic pain as the first manifestation of vertebral artery pseudoaneurysm in the literatures.
RESUMO
El absceso cerebral se constituye como un área central supurativa dentro del parénquima cerebral, dentro de una envoltura ampliamente vascularizada. Los patógenos ampliamente aislados en la patogénesis de esta entidad en niños son los Streptococos spp. A pesar del avance en la terapia antimicrobiana, las técnicas neuroquirúrgicas e imagenológicas, que permiten su diagnóstico y ubicación oportuna, el absceso cerebral aún se considera un problema de salud pública, con una importante incidencia, morbilidad y mortalidad en países en vía de desarrollo. Para el manejo de este tipo de infección del SNC, se requerirá de un abordaje multidisciplinario que involucre terapia médico quirúrgica. El objetivo de esta revisión es hacer un abordaje amplio sobre la patobiología del absceso cerebral relacionada con la labor concerniente al neurocirujano.
Brain abscess is formed as a central suppurativa area within the brain parenchyma, within an envelope extensively vascularized. Microorganisms largely isolated in the pathogenesis of this condition in children are Streptococos spp. Despite the progress in antimicrobial therapy, neurosurgical techniques and imagenologic support, which enabling timely diagnosis and location, brain abscess is still considered a public health problem and has an important incidence, morbidity and mortality in developing countries. To handle this type of CNS infection, will require a multidisciplinary approach involving surgical medical therapy. The aim of this review is to make a comprehensive approach on the pathobiology of brain abscess related to the work concerning the neurosurgeon.
Assuntos
Humanos , Lactente , Pré-Escolar , Abscesso Encefálico/complicações , Abscesso Encefálico/diagnóstico , Abscesso Encefálico/epidemiologia , Abscesso Encefálico/etiologia , Abscesso Encefálico , Abscesso Encefálico/terapia , Anti-Infecciosos/administração & dosagem , Sistema Nervoso/microbiologia , Diagnóstico por ImagemRESUMO
El trauma craneoencefálico es una de las principales causas de muerte en el mundo, y gran parte de estos se asocian a heridas por arma de fuego en cráneo. Conocer el manejo, las características y fisiopatología de la lesión nos permitirá saber abordar estos casos cuando se presenten a los diferentes centros asistenciales, al tiempo que nos permitirá tener en cuenta las posibles complicaciones, para evitar su aparición y así buscar mejorar la morbilidad por esta causa. Siempre acompañado de un manejo integral que permita abarcar todas las dimensiones afectadas.
Traumatic brain injury is a of the leading causes of death in the world, and many of these are associated with gunshot wounds in the skull. To know management the characteristics and pathophysiology of the lesion will tell as deal with these cases when presented to medical centers, while enabling us to take into account of possible complications, to prevent its occurrence and so try to improve morbidity from this cause. Always accompanied by an integrated management that can encompass all affected dimensions.
Assuntos
Humanos , Masculino , Traumatismos Craniocerebrais/cirurgia , Traumatismos Craniocerebrais/complicações , Traumatismos Craniocerebrais/fisiopatologia , Traumatismos Craniocerebrais/líquido cefalorraquidiano , Traumatismos Craniocerebrais/mortalidade , Traumatismos Cranianos Penetrantes/classificação , Ferimentos por Arma de Fogo , Craniotomia , Diagnóstico por Imagem , Fístula , Pressão IntracranianaRESUMO
El trauma craneoencefálico severo es una causa importante de mortalidad en pacientes jóvenes a nivel internacional. La hipertensión intracraneal es la causa de más del 80 por ciento de los pacientes con lesión traumática cerebral. Al presentar una traumática secundaria, se inician una seria de mecanismos metabólicos que incrementan la lesión al tejido cerebral, la inducción de hipotermia ha demostrado que puede alterar el curso natural del proceso patológico. Los fundamentos biológicos apuntan a que la hipotermia puede tener un potencial beneficio, aunque algunas publicaciones no han demostrado mejoría, es claro que en un grupo de pacientes principalmente jóvenes, la hipotermia temprana puede ser beneficiosa. Presentamos una práctica revisión de la literatura sobre esta temática.
The severe head trauma is a major cause of mortality in young patients worldwide. Intracranial hypertension is the cause of more than 80 percent of patients with traumatic brain injury. When a traumatic secondary presenter, begin a series of mechanisms that increase metabolic injury to brain tissue, induction of hypothermia has been shown to alter the natural course of the disease process. The biological foundations suggest that hypothermia may have a potential benefit, although some publications have not shown improvement, it is clear that in a group of mostly young patients, early hypothermia may be beneficial. We present a practical review of the literature on this subject.