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Arquivos Brasileiros de Neurocirurgia, Sep 1, 2022
Introduction The occurrence of malignant ocular melanomas is uncommon, and the association of the... more Introduction The occurrence of malignant ocular melanomas is uncommon, and the association of these tumors with intradural extramedullary metastases in the cervical spine is exceptionally rare. Case Report A 62-year-old woman undergoing adjuvant chemotherapy after surgical treatment for malignant ocular melanoma begins to experience vertigo and headache. The condition evolved with walking difficulty and neck pain that was exacerbated by swallowing and mobilizing the neck. During her ocular melanoma follow-up, lesions suggestive of metastasis in the central nervous system were not evidenced until this moment. The physical examination did not show significant findings, and a cranial computed tomography scan was performed. The image showed a hyperdense lesion with postcontrast enhancement inside the vertebral canal, at the level of C1-C2. Spinal decompression and subtotal resection were performed. The anatomopathological report revealed intradural metastasis of a malignant ocular melanoma. The postoperative period was uneventful, with significant pain improvement and no recurrences.
Arquivos Brasileiros de Neurocirurgia, Sep 1, 2022
Introduction Ventriculoperitoneal (VP) shunt is commonly used in the treatment of hydrocephalus a... more Introduction Ventriculoperitoneal (VP) shunt is commonly used in the treatment of hydrocephalus and may present complications in up to 30% of patients. The present report addresses an uncommon complication in the abdominal cavity, in which the catheter caused extrinsic compression of the gastric wall. Case report A 30-year-old man presented a decreased level of consciousness, associated with severe headache and vomiting. He had a history of congenital neurotoxoplasmosis and VP shunt insertion at 7 years of age. Imaging exams demonstrated the formation of an encapsulated retrogastric pseudocyst and extrinsic compression of the gastric wall by a VP shunt catheter. Through videolaparoscopy, decompression of the gastric wall and removal of the pseudocyst were performed, with the reestablishment of the drainage of cerebrospinal fluid. An analysis of the distal fragment of the removed catheter revealed obstruction by fibrotic material. The patient was discharged with a reestablished baseline after four days of hospitalization. Comments The literature shows that $ 47% of the complications presented by patients are related to the distal end of the catheter, and 8.2% of these come from
Arquivos Brasileiros de Neurocirurgia, Mar 8, 2022
Introduction Primitive neuroectodermal tumors are rare neoplasms of the central nervous system th... more Introduction Primitive neuroectodermal tumors are rare neoplasms of the central nervous system that occur in children, with few reports in adults. These tumors are found most often in the cerebral hemispheres, with spinal cord disorders being rare. Case Report A 71-year-old man with motor and sensory deficits in the upper limbs, cervical pain, and urinary incontinence presented to the Neurosurgery Service. The physical examination revealed grade-III motor strength on the right side, grade IV-on the left upper limb, and grade IVþ on the left lower limb. A magnetic resonance imaging scan showed an expansive intramedullary lesion with a C3-C4 epicenter. Spinal decompression, lesional biopsy, and adjuvant radiotherapy were performed. The anatomopathological report showed a primitive neuroectodermal tumor. After a new treatment with adjuvant radiotherapy (20 Â 1.8 Gy in the skull and neuroaxis and 5 Â 1.8 Gy in tumor boost), the patient progressed without recurrence. Conclusion Since the characteristics of the tumor are similar to those of medulloblastoma, it is necessary to expand the studies on these lesions, to better understand their pathophysiology and list better diagnostic and therapeutic methods, in addition to those already available.
Revista Brasileira de Cancerologia, May 6, 2022
Este é um artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons Attribut... more Este é um artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons Attribution, que permite uso, distribuição e reprodução em qualquer meio, sem restrições, desde que o trabalho original seja corretamente citado.
JBNC - JORNAL BRASILEIRO DE NEUROCIRURGIA
Introdução: de acordo com a literatura, a ruptura ou sangramento dos cistos aracnoides (CA) são e... more Introdução: de acordo com a literatura, a ruptura ou sangramento dos cistos aracnoides (CA) são eventos incomuns geralmente causados por traumas, e, como pacientes jovens com CA têm uma probabilidade muito baixa de desenvolver um hematoma subdural espontâneo, o seguinte relato pode ser considerado relevante. Objetivo: descrever um caso raro de hematoma subdural espontâneo agudo associado a um cisto aracnoide ipsilateral, e estudá-lo por meio de uma revisão sistemática. Métodos: relato de caso e revisão sistemática, realizada em três bases de dados: PubMed, Embase e BVS. Resultados: foram identificados 2 relatos de uma série de casos, 2 relatos de caso associados a revisão narrativa, e 5 relatos de caso isolados, totalizando 9 referências selecionadas. Relato do caso: menino de 15 anos com dores de cabeça, vômitos e fotofobia por 5 semanas foi diagnosticado com um hematoma subdural no lado esquerdo. A avaliação neurológica mostrou sinais de hipertensão intracraniana. Este é um dos raros casos documentados de cisto aracnoide coexistindo com uma hemorragia subdural ipsilateral. Conclusão: hematomas subdurais espontâneos raramente estão ligados a cistos aracnoides, mas sintomas como papiledema, cefaleia e náuseas são úteis na triagem. A craniotomia é menos utilizada em prol de métodos menos invasivos. Houve um aumento de casos relatados em jovens e crianças devido à melhoria nos métodos diagnósticos.
Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery
Introduction Ventriculoperitoneal (VP) shunt is commonly used in the treatment of hydrocephalus a... more Introduction Ventriculoperitoneal (VP) shunt is commonly used in the treatment of hydrocephalus and may present complications in up to 30% of patients. The present report addresses an uncommon complication in the abdominal cavity, in which the catheter caused extrinsic compression of the gastric wall. Case report A 30-year-old man presented a decreased level of consciousness, associated with severe headache and vomiting. He had a history of congenital neurotoxoplasmosis and VP shunt insertion at 7 years of age. Imaging exams demonstrated the formation of an encapsulated retrogastric pseudocyst and extrinsic compression of the gastric wall by a VP shunt catheter. Through videolaparoscopy, decompression of the gastric wall and removal of the pseudocyst were performed, with the reestablishment of the drainage of cerebrospinal fluid. An analysis of the distal fragment of the removed catheter revealed obstruction by fibrotic material. The patient was discharged with a reestablished basel...
Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery
Introduction The occurrence of malignant ocular melanomas is uncommon, and the association of the... more Introduction The occurrence of malignant ocular melanomas is uncommon, and the association of these tumors with intradural extramedullary metastases in the cervical spine is exceptionally rare. Case Report A 62-year-old woman undergoing adjuvant chemotherapy after surgical treatment for malignant ocular melanoma begins to experience vertigo and headache. The condition evolved with walking difficulty and neck pain that was exacerbated by swallowing and mobilizing the neck. During her ocular melanoma follow-up, lesions suggestive of metastasis in the central nervous system were not evidenced until this moment. The physical examination did not show significant findings, and a cranial computed tomography scan was performed. The image showed a hyperdense lesion with postcontrast enhancement inside the vertebral canal, at the level of C1-C2. Spinal decompression and subtotal resection were performed. The anatomopathological report revealed intradural metastasis of a malignant ocular melan...
Revista Brasileira de Cancerologia
Introduction: A giant cell tumor (GCT) is a rare tumor, usually benign, which can be locally aggr... more Introduction: A giant cell tumor (GCT) is a rare tumor, usually benign, which can be locally aggressive, with an almost unknown incidence in the skull. Case report: Case report of a pediatric patient diagnosed with Ewing’s sarcoma (ES) and later GCT when sought medical care for an increased volume in the zygomatic arch and the right preauricular region. Imaging exams showed an expansive lesion in the zygomatic and squamous portion of the right temporal bone, with an extradural intracranial component in the middle fossa, with no evidence of infiltration. From the anatomopathological view, fusocelullar neoplasia was seen. The CD68 marker was positive and the S100 marker was negative. Tumor resection by microsurgery was performed. The patient remains in follow-up, with imaging exams at neurosurgery and orthopedics, the latest magnetic resonances of the skull showing a reduction in the size of the lesion. In addition, the patient did not submit to adjuvant therapy and is currently witho...
Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery, 2022
Introduction Primitive neuroectodermal tumors are rare neoplasms of the central nervous system th... more Introduction Primitive neuroectodermal tumors are rare neoplasms of the central nervous system that occur in children, with few reports in adults. These tumors are found most often in the cerebral hemispheres, with spinal cord disorders being rare. Case Report A 71-year-old man with motor and sensory deficits in the upper limbs, cervical pain, and urinary incontinence presented to the Neurosurgery Service. The physical examination revealed grade-III motor strength on the right side, grade IV- on the left upper limb, and grade IV+ on the left lower limb. A magnetic resonance imaging scan showed an expansive intramedullary lesion with a C3-C4 epicenter. Spinal decompression, lesional biopsy, and adjuvant radiotherapy were performed. The anatomopathological report showed a primitive neuroectodermal tumor. After a new treatment with adjuvant radiotherapy (20 × 1.8 Gy in the skull and neuroaxis and 5 × 1.8 Gy in tumor boost), the patient progressed without recurrence. Conclusion Since th...
Arquivos Brasileiros de Neurocirurgia, Sep 1, 2022
Introduction The occurrence of malignant ocular melanomas is uncommon, and the association of the... more Introduction The occurrence of malignant ocular melanomas is uncommon, and the association of these tumors with intradural extramedullary metastases in the cervical spine is exceptionally rare. Case Report A 62-year-old woman undergoing adjuvant chemotherapy after surgical treatment for malignant ocular melanoma begins to experience vertigo and headache. The condition evolved with walking difficulty and neck pain that was exacerbated by swallowing and mobilizing the neck. During her ocular melanoma follow-up, lesions suggestive of metastasis in the central nervous system were not evidenced until this moment. The physical examination did not show significant findings, and a cranial computed tomography scan was performed. The image showed a hyperdense lesion with postcontrast enhancement inside the vertebral canal, at the level of C1-C2. Spinal decompression and subtotal resection were performed. The anatomopathological report revealed intradural metastasis of a malignant ocular melanoma. The postoperative period was uneventful, with significant pain improvement and no recurrences.
Arquivos Brasileiros de Neurocirurgia, Sep 1, 2022
Introduction Ventriculoperitoneal (VP) shunt is commonly used in the treatment of hydrocephalus a... more Introduction Ventriculoperitoneal (VP) shunt is commonly used in the treatment of hydrocephalus and may present complications in up to 30% of patients. The present report addresses an uncommon complication in the abdominal cavity, in which the catheter caused extrinsic compression of the gastric wall. Case report A 30-year-old man presented a decreased level of consciousness, associated with severe headache and vomiting. He had a history of congenital neurotoxoplasmosis and VP shunt insertion at 7 years of age. Imaging exams demonstrated the formation of an encapsulated retrogastric pseudocyst and extrinsic compression of the gastric wall by a VP shunt catheter. Through videolaparoscopy, decompression of the gastric wall and removal of the pseudocyst were performed, with the reestablishment of the drainage of cerebrospinal fluid. An analysis of the distal fragment of the removed catheter revealed obstruction by fibrotic material. The patient was discharged with a reestablished baseline after four days of hospitalization. Comments The literature shows that $ 47% of the complications presented by patients are related to the distal end of the catheter, and 8.2% of these come from
Arquivos Brasileiros de Neurocirurgia, Mar 8, 2022
Introduction Primitive neuroectodermal tumors are rare neoplasms of the central nervous system th... more Introduction Primitive neuroectodermal tumors are rare neoplasms of the central nervous system that occur in children, with few reports in adults. These tumors are found most often in the cerebral hemispheres, with spinal cord disorders being rare. Case Report A 71-year-old man with motor and sensory deficits in the upper limbs, cervical pain, and urinary incontinence presented to the Neurosurgery Service. The physical examination revealed grade-III motor strength on the right side, grade IV-on the left upper limb, and grade IVþ on the left lower limb. A magnetic resonance imaging scan showed an expansive intramedullary lesion with a C3-C4 epicenter. Spinal decompression, lesional biopsy, and adjuvant radiotherapy were performed. The anatomopathological report showed a primitive neuroectodermal tumor. After a new treatment with adjuvant radiotherapy (20 Â 1.8 Gy in the skull and neuroaxis and 5 Â 1.8 Gy in tumor boost), the patient progressed without recurrence. Conclusion Since the characteristics of the tumor are similar to those of medulloblastoma, it is necessary to expand the studies on these lesions, to better understand their pathophysiology and list better diagnostic and therapeutic methods, in addition to those already available.
Revista Brasileira de Cancerologia, May 6, 2022
Este é um artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons Attribut... more Este é um artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons Attribution, que permite uso, distribuição e reprodução em qualquer meio, sem restrições, desde que o trabalho original seja corretamente citado.
JBNC - JORNAL BRASILEIRO DE NEUROCIRURGIA
Introdução: de acordo com a literatura, a ruptura ou sangramento dos cistos aracnoides (CA) são e... more Introdução: de acordo com a literatura, a ruptura ou sangramento dos cistos aracnoides (CA) são eventos incomuns geralmente causados por traumas, e, como pacientes jovens com CA têm uma probabilidade muito baixa de desenvolver um hematoma subdural espontâneo, o seguinte relato pode ser considerado relevante. Objetivo: descrever um caso raro de hematoma subdural espontâneo agudo associado a um cisto aracnoide ipsilateral, e estudá-lo por meio de uma revisão sistemática. Métodos: relato de caso e revisão sistemática, realizada em três bases de dados: PubMed, Embase e BVS. Resultados: foram identificados 2 relatos de uma série de casos, 2 relatos de caso associados a revisão narrativa, e 5 relatos de caso isolados, totalizando 9 referências selecionadas. Relato do caso: menino de 15 anos com dores de cabeça, vômitos e fotofobia por 5 semanas foi diagnosticado com um hematoma subdural no lado esquerdo. A avaliação neurológica mostrou sinais de hipertensão intracraniana. Este é um dos raros casos documentados de cisto aracnoide coexistindo com uma hemorragia subdural ipsilateral. Conclusão: hematomas subdurais espontâneos raramente estão ligados a cistos aracnoides, mas sintomas como papiledema, cefaleia e náuseas são úteis na triagem. A craniotomia é menos utilizada em prol de métodos menos invasivos. Houve um aumento de casos relatados em jovens e crianças devido à melhoria nos métodos diagnósticos.
Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery
Introduction Ventriculoperitoneal (VP) shunt is commonly used in the treatment of hydrocephalus a... more Introduction Ventriculoperitoneal (VP) shunt is commonly used in the treatment of hydrocephalus and may present complications in up to 30% of patients. The present report addresses an uncommon complication in the abdominal cavity, in which the catheter caused extrinsic compression of the gastric wall. Case report A 30-year-old man presented a decreased level of consciousness, associated with severe headache and vomiting. He had a history of congenital neurotoxoplasmosis and VP shunt insertion at 7 years of age. Imaging exams demonstrated the formation of an encapsulated retrogastric pseudocyst and extrinsic compression of the gastric wall by a VP shunt catheter. Through videolaparoscopy, decompression of the gastric wall and removal of the pseudocyst were performed, with the reestablishment of the drainage of cerebrospinal fluid. An analysis of the distal fragment of the removed catheter revealed obstruction by fibrotic material. The patient was discharged with a reestablished basel...
Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery
Introduction The occurrence of malignant ocular melanomas is uncommon, and the association of the... more Introduction The occurrence of malignant ocular melanomas is uncommon, and the association of these tumors with intradural extramedullary metastases in the cervical spine is exceptionally rare. Case Report A 62-year-old woman undergoing adjuvant chemotherapy after surgical treatment for malignant ocular melanoma begins to experience vertigo and headache. The condition evolved with walking difficulty and neck pain that was exacerbated by swallowing and mobilizing the neck. During her ocular melanoma follow-up, lesions suggestive of metastasis in the central nervous system were not evidenced until this moment. The physical examination did not show significant findings, and a cranial computed tomography scan was performed. The image showed a hyperdense lesion with postcontrast enhancement inside the vertebral canal, at the level of C1-C2. Spinal decompression and subtotal resection were performed. The anatomopathological report revealed intradural metastasis of a malignant ocular melan...
Revista Brasileira de Cancerologia
Introduction: A giant cell tumor (GCT) is a rare tumor, usually benign, which can be locally aggr... more Introduction: A giant cell tumor (GCT) is a rare tumor, usually benign, which can be locally aggressive, with an almost unknown incidence in the skull. Case report: Case report of a pediatric patient diagnosed with Ewing’s sarcoma (ES) and later GCT when sought medical care for an increased volume in the zygomatic arch and the right preauricular region. Imaging exams showed an expansive lesion in the zygomatic and squamous portion of the right temporal bone, with an extradural intracranial component in the middle fossa, with no evidence of infiltration. From the anatomopathological view, fusocelullar neoplasia was seen. The CD68 marker was positive and the S100 marker was negative. Tumor resection by microsurgery was performed. The patient remains in follow-up, with imaging exams at neurosurgery and orthopedics, the latest magnetic resonances of the skull showing a reduction in the size of the lesion. In addition, the patient did not submit to adjuvant therapy and is currently witho...
Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery, 2022
Introduction Primitive neuroectodermal tumors are rare neoplasms of the central nervous system th... more Introduction Primitive neuroectodermal tumors are rare neoplasms of the central nervous system that occur in children, with few reports in adults. These tumors are found most often in the cerebral hemispheres, with spinal cord disorders being rare. Case Report A 71-year-old man with motor and sensory deficits in the upper limbs, cervical pain, and urinary incontinence presented to the Neurosurgery Service. The physical examination revealed grade-III motor strength on the right side, grade IV- on the left upper limb, and grade IV+ on the left lower limb. A magnetic resonance imaging scan showed an expansive intramedullary lesion with a C3-C4 epicenter. Spinal decompression, lesional biopsy, and adjuvant radiotherapy were performed. The anatomopathological report showed a primitive neuroectodermal tumor. After a new treatment with adjuvant radiotherapy (20 × 1.8 Gy in the skull and neuroaxis and 5 × 1.8 Gy in tumor boost), the patient progressed without recurrence. Conclusion Since th...