Neurosurgery
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Case Reports
Posttraumatic syringomyelia: its characteristic magnetic resonance imaging findings and surgical management.
Posttraumatic syringomyelia should be considered in any patient showing a delayed neurological deterioration after spinal cord injury. The purpose of this article is to assess the posttraumatic syringomyelia on magnetic resonance images and to evaluate the results of its surgical treatment. Fourteen patients with posttraumatic syringomyelia were studied. ⋯ Shunt malfunction was encountered in three of the four syringoperitoneal shunts and in the one ventriculoperitoneal shunt. Final neurological outcomes were satisfactory in all 11 patients who underwent surgery. Motor function improved in eight of nine patients, sensory disturbance improved in five of five patients, and relief of local pain or numbness was obtained in four of four patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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The cases of gigantism sisters with somatotroph adenomas unrelated to multiple endocrine neoplasia (MEN) Type 1 are reported. The sisters grew rapidly since they were 5 or 6 years old and were diagnosed to have gigantism with pituitary adenoma by computed tomographic scan and magnetic resonance imaging. A serum endocrinological examination showed the elevated growth hormone values. ⋯ This incidence is much higher than that of MEN Type 1 patients with pituitary adenomas. The cause of the familial occurrence of pituitary adenomas is still unclear, although autosomal recessive inheritance has been suggested. It has been stated that point mutations in codon 201 or 227 of the Gs alpha gene located in chromosome 20 were found in about 35 to 40% of somatotroph adenomas.(ABSTRACT TRUNCATED AT 250 WORDS)
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During the period from 1977 to August 1992, 100 intramedullary tumors in 94 patients were operated on in the Department of Neurosurgery at the Nordstadt Hospital in Hannover, Germany. Of these, 45% presented with associated syringes. A syrinx was more likely to be found above (49%) than below (11%) the tumor level. ⋯ However, surgical results and long-term prognosis were not influenced significantly by an associated syrinx. The most important factor determining long-term outcome was the preoperative level of neurological function. We propose that factors independent of the tumor, disturbances of cerebrospinal fluid and extracellular fluid flow in particular, have major roles in the pathogenesis of syrinx formation associated with intramedullary tumors.
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Desmoid tumors are uncommon fibroblastic proliferative lesions usually occurring in the abdominal wall of adults. We report an unusual case of such a tumor presenting as a rapidly growing cervical paraspinous mass in a 19-month-old girl. After surgical resection without adjuvant therapy, the child is recurrence free after 17 months. ⋯ We found magnetic resonance imaging to be the best imaging method for evaluation, because it was able to distinguish the tumor from the surrounding muscle. Careful postoperative surveillance is warranted, because these tumors have a high rate of recurrence. Although rare, desmoid tumor should be considered in the differential diagnosis of a paraspinous soft tissue tumor in a pediatric patient.