-Arachnoid cysts (AC) are extra-cerebral cerebrospinal fluid collections of unknown origin. They correspond to 1% of all intracranial nontraumatic space-occupying lesions and appear more frequently in the middle fossa (50%). More than 25% of these cysts are incidental findings and the majority of patients are asymptomatic. Seizures, intracranial hypertension signs, neurological deficits, macrocrania, developmental delay and bulging of the skull are the main signs and symptoms of the lesion. AC rupture and bleeding are rare, usually occurring in young adults and associated with trauma. The risk of hemorrhage does not exceed 0.04% / year. We describe the case of a ten-year-old boy who presented with acute signs of intracranial hypertension secondary to a spontaneous acute subdural hematoma, contralateral to an AC of the middle fossa. Three factors were significant in this case: signs and symptoms occurred spontaneously; the presence of an acute subdural hematoma exclusively contralateral to the AC; successful outcome of the conservative treatment.KEY WORDS: arachnoid cyst, subdural hematoma, pediatric neurosurgery. Hematoma subdural agudo espontâneo contralateral a cisto aracnóideoRESUMO -Os cistos aracnóideos (CA) são coleções liquóricas extra-cerebrais e intra-aracnóideas de origem desconhecida. Correspondem a 1% de todas as lesões expansivas intracranianas não traumáticas e têm ní-tido predomínio na fossa média (50%). Até 25% destes cistos são achados incidentais sendo que a maioria dos pacientes é assintomática. Crises epilépticas, sinais de hipertensão intracraniana, déficits neurológicos focais, macrocrania, atraso no desenvolvimento e abaulamento da calota craniana são os principais sinais e sintomas da lesão. A ruptura dos CA, assim como seu sangramento, são situações raras, geralmente associadas a traumas e acometem adultos jovens. O risco de hemorragia em pacientes com CA não excede 0,04% ao ano. É descrito caso de paciente de dez anos de idade que subitamente apresentou sinais de hipertensão intracraniana secundários a hematoma subdural agudo espontâneo, contralateral a volumoso CA de fossa média. Três fatores foram de relevância neste paciente: a ocorrência de sinais e sintomas espontaneamente, especialmente em um menino; presença de hematoma subdural agudo exclusivamente contralateral ao CA; e a boa evolução com o tratamento conservador. PALAVRAS-CHAVE: cisto aracnóideo, hematoma subdural, neurocirurgia pediátrica.
Bobble-head doll syndrome (BHDS) presents in childhood and is usually associated with lesions of the third ventricle. This disorder is characterized by stereotypical head movements of the type "yes-yes" (up and down) at a frequency of 2 to 3 Hz. Rarely, movements of the type "no-no" (side-to-side) are described. There are a few hypotheses to explain the mechanism responsible for BHDS, but its real pathophysiological characteristics are still unknown. The authors describe the case of a child born with hydrocephalus and Dandy-Walker syndrome. A ventriculoperitoneal shunt was implanted in the child because of progressive head enlargement. One year after shunt placement, she began making frequent horizontal head movements of the type "no-no". There were no other signs or symptoms. Imaging studies demonstrated small ventricles and a posterior fossa cyst with no signs of hypertension. The child's growth, development, and head circumference (within the 5th percentile) remained satisfactory. Three aspects of this case were of interest: the association of BHDS with Dandy-Walker syndrome, the rare occurrence of BHDS of the "no-no" type, and the absence of third ventricle dilation. The authors' findings support the hypothesis that cerebellar malformations themselves can
RESUMO -O uso da ultra-sonografia para diagnóstico de lesões da coluna vertebral é difundido desde a década de oitenta. Suas aplicações envolvem: diagnóstico de lesões medulares traumáticas; uso intra-operatório em cirurgias do trauma e tumores medulares; uso pré-operatório e evolutivo em pacientes com disrafismos espinhais; diagnóstico pré-natal dos disrafismos; diagnóstico dos disrafismos espinhais ocultos ao nascimento. Pacientes com suspeita de disrafismo espinhal oculto (estigmas cutâneos em linha média ou história familiar de disrafismos) representaram a principal indicação do exame que foi realizado em 292 pacientes do Hospital das Clínicas da Universidade Federal de Minas Gerais. Alterações como lipomas do cone medular, medula baixa, filo terminal espesso, cistos da ponta do cone medular e seios dérmicos foram identificados com fidelidade à ultra-sonografia. A interpretação do exame não apresentou dificuldades técnicas. Sua realização é rápida, não é necessária sedação, apresenta baixo custo e idealmente deve ser realizado pelo próprio neurocirurgião devido ao grande número de informações possíveis durante o exame. O exame entretanto não substitui a ressonância magnética mas pode ser um bom método de triagem para os pacientes.PALAVRAS-CHAVE: disrafismo espinhal oculto, ultra-sonografia, diagnóstico. Screening of occult spinal dysraphism by ultrasonographyABSTRACT -Ultrasonography for diagnosis of spinal cord diseases has been used since the eighties. There are different fields for its use: traumatic spine lesions, intra-operative use in trauma and spine tumors surgery, pre-operative and follow up study for spinal dysraphism, occult spinal dysraphism of the newborn. Patients with suspected occult spinal dysraphism are the most important indication for the method. Utrasonography was performed in 292 patients of Hospital das Clínicas, Universidade Federal de Minas Gerais. Lesions such as conus medullaris lipomas, low level of conus medullaris, filum terminale tethering, cauda equina cysts and dermal sinuses can be well demonstrated. There is no difficulty in interpreting the image. The exam does not need sedation; it is safe, fast and cheap. Ideally it should be performed by the neurosurgeon as it may provide many information during the examination. The ultrasonography does not replace magnetic resonance imaging but it is an excellent method for screening.KEY WORDS: occult spinal dysraphism, ultrasound, diagnosis.O uso da ultra-sonografia (US) para diagnóstico de lesões da coluna vertebral é difundido desde a década de oitenta do século passado. Suas aplicações envolvem: diagnóstico de lesões medulares traumáticas 1,2 ; uso intra-operatório em cirurgias do trauma e tumores medulares 3-5 ; uso pré-operatório e evolutivo em pacientes com disrafismos espinhais 6,7 ; diagnóstico pré-natal dos disrafismos 8 ; diagnóstico dos disrafismos espinhais ocultos ao nascimento.Em neurocirurgia pediátrica, a US de coluna é facilitada, principalmente em recém-nascidos, devido à ossificação incompleta dos elementos posterio...
Aplasia cutis congenita is a rare condition characterized by the absence of skin layers. It is most common on the scalp, middle line, and it can be seen as a congenital ulcer involving periosteum, skull and dura. We present the case of a female newborn infant with a dysmorphic facies, a large scalp and skull defect exposing the dura. There was no cerebrospinal fluid leakage. The rarity of cases with large defects and small series reported make difficult to determinate the ideal treatment for aplasia cutis congenita. More studies are necessary to define the etiology and best management of this patients.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.