RESUMO
The authors report on a 45-day-old boy with a congenital intramedullary tumor with clinical manifestations since birth. Neurologic examination disclosed severe bilateral lower-limb hypotonia and diplegia, with exacerbated deep tendon reflexes and clonus associated with severe pain at manipulation. Further evaluation of this patient included screening for infections, computed tomographic scan, myelography, and somatosensory evoked potentials. The definite diagnosis was a solid holocord astrocytoma. This report discusses a rare disorder in the neonatal period and makes other medical practitioners aware of this diagnosis. Previously published literature is also reviewed.
Assuntos
Astrocitoma/congênito , Astrocitoma/diagnóstico , Neoplasias da Medula Espinal/congênito , Neoplasias da Medula Espinal/diagnóstico , Astrocitoma/patologia , Humanos , Imuno-Histoquímica , Lactente , Masculino , Cuidados Paliativos , Neoplasias da Medula Espinal/patologia , Vértebras Torácicas/patologiaRESUMO
An infant with congenital torticollis underwent chiropractic manipulation, and within a few hours had respiratory insufficiency, seizures, and quadriplegia. A holocord astrocytoma, with extensive acute necrosis believed to be a result of the neck manipulation, was found and resected. We believe that every child with torticollis, regardless of age, should undergo neurologic and radiologic evaluation before any form of physical treatment is instituted.