We report a 3-year-6-month-old boy with chordoid meningioma in the foramen magnum. Chordoid meningioma represents between 0.5 and 1.0% of all meningiomas, and it is frequently located in the supratentorial region. The patient started with an episode of instability, falls, and headache; after which, he developed cuadriparesis, cervical pain, and neck stiffness, which slightly improved after medical treatment, so he was referred to our hospital. Physical examination revealed left hemiparesis and cervical muscle spasm with left torticollis. Magnetic resonance imaging (MRI) demonstrated an intradural-extramedullary well-circumscribed, homogeneous enhancing mass, in the anterior part of the foramen magnum with cervical extension. The operative technique was the extreme-lateral craniocervical retrocondylar approach with total removal and dural coagulation. Histopathological examination demonstrated a chordoid meningioma, with meningotelial basophilic mucoid chordoma-like component in 80% of the tissue. The immunohistochemical stains were positive to epithelial membrane antigen, vimentin, and S-100 protein. At 10 months follow-up, the patient showed improvement in his neurological deficit with physical rehabilitation, and motor response in his extremities are now normal; neck stiffness with cervical spasm disappeared postoperatively. MRI showed no residual tumor. To our knowledge, this is the first report of a chordoid meningioma on the foramen magnum in a child.
Background Primary spinal epidural lymphoma (PSEL) is one of the rarest categories of tumors. Spinal cord compression is an uncommon primary manifestation and requires to be treated with surgery for the purpose of diagnosis and decompression.
Case Presentation A 45-year-old man presented with a new onset thoracic pain and progress to an anterior spinal syndrome with hypoesthesia and loss of thermalgesia. Magnetic resonance image showed a paravertebral mass that produces medullary compression at T3. The patient was taken up to surgery, where the pathology examination showed a diffuse large B-cell lymphoma.
Conclusions PSEL is a pathological entity, which must be considered on a middle-aged man who began with radicular compression, and the treatment of choice is decompression and biopsy. The specific management has not been established yet, but the literature suggests chemotherapy and radiotherapy; however, the outcome is unclear.
Los oligodendrogliomas, son tumores cerebrales de origen glial, grado II de la clasificación de la Organización Mundial de la Salud (OMS) para tumores cerebrales en humanos; son más frecuentes en adultos y pocos o raros en niños; su presentación y localización común es con crisis convulsivas y en lóbulo frontal cortical y/o subcortical, respectivamente. Un factor pronóstico es el grado de resección y seguimiento a largo plazo e incluye oncológico. Presentamos el caso de un caso pediátrico con resección amplia subtotal de oligodendroglioma frontal – precentral y control de crisis convulsivas.
Los hemangiomas espinales epidurales; son entidades raras. La mayoría de estas lesiones afectan los cuerpos vertebrales y tienen extensión ocasional al espacio epidural. La ocurrencia pura (espinal) de hemangioma epidural es poco común, localizados con más frecuencia en nivel torácico, puede presentarse con síntomas sobre raíz nerviosa y/o compresión medular. Presentamos un caso de hemangioma cavernoso espinal epidural puro a nivel lumbar, manifestado con radiculopatía crónica, con mejoría posterior a la resección quirúrgica total.
Los oligodendrogliomas, son tumores cerebrales de origen glial, grado II de la clasificación de la Organización Mundial de la Salud (OMS) para tumores cerebrales en humanos; son más frecuentes en adultos y pocos o raros en niños; su presentación y localización común es con crisis convulsivas y en lóbulo frontal cortical y/o subcortical, respectivamente. Un factor pronóstico es el grado de resección y seguimiento a largo plazo e incluye oncológico. Presentamos el caso de un caso pediátrico con resección amplia subtotal de oligodendroglioma frontal – precentral y control de crisis convulsivas.
Background:
Before the introduction of high-resolution MR, few disc fragments were misdiagnosed as meningiomas.
Case Description:
A 63-year-old female presented with a 6-month history of mild to moderate pain in the left arm, weakness 4/5 in the left arm C5-C6 distribution, and a loss of the left biceps reflex response. Although the MR study was read as showing a C5-C6 level probable spinal meningioma, this proved to be a sequestrated disc fragment at surgery.
Conclusion:
Rarely, cervical disc herniations may be misdiagnosed on MR studies as spinal meningiomas.
Introduction: Degeneration of the cervical spine (CDSD) prevalence is nearly 90% by the 7th decade. This is the first research that compares the outcomes between the Anterior Approach (AA) and Posterior Approach (PA) to cervical myelopathy (CM) in the elderly. Materials and Methods: A retrospective observational study of electronic health records at the Hospital Central Sur de Alta Especialidad (HCSAE), PEMEX from January 2010 to May 2020 with patients older than 60 years submitted to cervical surgery. For the analysis we elaborated two groups according to the surgical approach: AA vs PA; we analyzed the trans-operative behavior, the immediate outcome, and after 3 months, 6 months, and 1 year. Results: As a total of 145 patients, the prevalence of CM in elderly was the 63.8% with a median age of 69 (64 -75) years. We found statistical differences in strength outcome only in the P3m (p = 0.011), for sensitivity we found major prevalence of affection in the PA group. We didn't report a significant difference in the Neck Disability Index (NDI) at all measures, but the PA presented a major incapacity. The Nurick scale results were significant in all stages (p < 0.05); and presented improvement compared with presurgical period (p < 0.001
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