scholarly journals Spinal Capillary Hemangioma: Report of Five Surgical Cases and Literature Review

2017 ◽  
Vol 3 (4) ◽  
pp. 196-203
Author(s):  
Liang Zhang ◽  
Zhifeng Zhang ◽  
Jifeng Shang ◽  
Wenqing Jia ◽  
Jun Yang ◽  
...  
Keyword(s):  
Management Strategy ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Capillary Hemangioma ◽  
Neurological Deficits ◽  
En Bloc ◽  
Limb Weakness ◽  
Intradural Extramedullary ◽  
Early Surgical Intervention

Objective Capillary hemangioma is a benign vascular malformation that is usually encountered in soft-tissue. Rarely, it may occur in the neuraxis, and spinal capillary hemangioma (SCH) is a rare variant of it. Existing literature on SCH is limited because of its rarity. As a result, epidemiological and clinical characteristics as well as management strategy for SCH are still lacking. Here, we present a report on five patients with pathologically proven SCH, treated in Beijing Tiantan Hospital between 2013 and 2015. Methods Patients' age, gender, clinical manifestations, radiological features, operative methods, and surgical outcomes were retrospectively reviewed, and an updated review of the literature was also provided. Results Four patients were men and one was a woman, with a median age at presentation of 43 years (range: 15–66 years). Two lesions were intramedullary, two epidural, and one intradural extramedullary. The thoracic segment was most commonly affected (n = 3, 60%), followed by the cervical (n = 1, 20%) and lumbar (n = 1, 20%) segments. Common symptoms, in descending order, were numbness and paresthesia, limb weakness, and pain. The surgical procedure was successfully performed with total resection of the tumor achieved in 4 patients and subtotal in 1 patient. During an average follow-up period of 32 months (range: 27–43 months), recovery of the clinical symptoms was observed in all five patients. Conclusions SCH is a rare benign vascular disease, for which surgical resection of the lesion, by the en bloc method, is recommended. Clinically, it usually manifests with progressive myelopathy, but early surgical intervention usually produces good results and may prevent permanent neurological deficits.

scholarly journals Endoscopically controlled surgery with open hemilaminectomy for the treatment of intradural extramedullary tumors: an operative technique and short-term outcomes of 20 consecutive cases

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Xiaorong Yan ◽  
Huiqing Wang ◽  
Cai Li ◽  
Yuanxiang Lin ◽  
Lin Lin ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Spinal Deformity ◽  
Tumor Recurrence ◽  
Clinical Symptoms ◽  
Short Term ◽  
Before And After ◽  
Intradural Extramedullary ◽  
Controlled Surgery

Abstract Background To present a surgical technique for the treatment of intradural extramedullary (IDEM) tumors by using endoscopically controlled surgery with open hemilaminectomy technique. Methods In this study, 20 patients with 22 IDEM tumors were enrolled. An endoscopically controlled surgery with open hemilaminectomy was employed to remove the tumors. Data related to clinical symptoms and medical images before and after surgery were collected for perioperative evaluation and follow-up analysis. Results All the tumors in 20 patients were well removed. The clinical symptoms were significantly reduced in all the patients as well. The short-term follow-up data showed that there was no tumor recurrence or spinal deformity. Conclusion The endoscopically controlled surgery with open hemilaminectomy technique provided favorable exposure and satisfactory resection to the IDEM tumors. It may be an effective surgical method for treating IDEM tumors. Larger samples and longer follow-up data are needed to verify its long-term effectiveness.

scholarly journals Posttraumatic thoracic epidural capillary hemangioma – A rare case report

2020 ◽  
Vol 11 ◽  
pp. 179 ◽  
Author(s):  
G. Sudhir ◽  
Vignesh Jayabalan ◽  
T. H. Manohar ◽  
Saikrishna Gadde ◽  
Venkatesh Kumar ◽  
...  
Keyword(s):  
Epidural Space ◽  
Lower Limb ◽  
Histopathological Examination ◽  
Cord Compression ◽  
Capillary Hemangioma ◽  
Vascular Lesions ◽  
Surgical Removal ◽  
En Bloc ◽  
Limb Weakness ◽  
Thoracic Epidural

Background: Capillary hemangiomas are benign vascular lesions commonly seen in subcutaneous tissues. The most common site of origin is from the vertebral body, and only a few cases of isolated lesions in thoracic epidural space, especially after trauma, have been reported in the literature. Case Description: We report a case of 63-year-old male with progressive bilateral lower limb weakness and exaggerated lower limb deep tendon reflexes without bowel and bladder involvement. His history revealed T7 fracture with paraparesis which was treated surgically, and implants were removed a year later. MRI showed an epidural lesion from T6-T8 extending into the right T7-8 foramen which showed hypointensity on T1, hyperintensity on T2, and homogenous enhancement in contrast images with severe cord compression. Laminectomy was done and the lesion was removed en bloc. Histopathological examination revealed it to be capillary hemangioma. The neurology came back to normal after 3 months. Conclusion: Although capillary hemangiomas are rare lesions, it has to be considered in the differential diagnosis of epidural space-occupying lesions which require early surgical removal to prevent a progressive and permanent neurological deficit.

scholarly journals Endoscopically-controlled surgery with open hemi-laminectomy for the treatment of intradural extramedullary tumors: An operative technique and short-term outcomes of 20 consecutive cases

2020 ◽  
Author(s):  
Xiaorong Yan ◽  
Huiqing Wang ◽  
Cai Li ◽  
Yuanxiang Lin ◽  
Lin Lin ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Spinal Deformity ◽  
Tumor Recurrence ◽  
Clinical Symptoms ◽  
Short Term ◽  
Before And After ◽  
Intradural Extramedullary ◽  
Controlled Surgery

Abstract Background To present a surgical technique for the treatment of intradural extramedullary (IDEM) tumors by using endoscopically-controlled surgery with open hemi-laminectomy technique. Methods In this study, 20 patients with 22 IDEM tumors were enrolled. An endoscopically-controlled surgery with open hemi-laminectomy was employed to remove the tumors. Data related to clinical symptoms and medical images before and after surgery were collected for perioperative evaluation and follow-up analysis. Results All the tumors in 20 patients were well removed. The clinical symptoms were significantly reduced in all the patients as well. The short term follow-up data showed that there was no tumor recurrence or spinal deformity. Conclusion The endoscopically-controlled surgery with open hemi-laminectomy technique provided favorable exposure and satisfactory resection to the IDEM tumors. It may be an effective surgical method for treating IDEM tumors. Larger samples and longer follow-up data are needed to verify its long-term effectiveness.

Giant intracranial capillary hemangioma associated with enlarged head circumference in a newborn

2008 ◽  
Vol 1 (6) ◽  
pp. 488-492 ◽  
Author(s):  
Thomas Daenekindt ◽  
Frank Weyns ◽  
Kuan Hua Kho ◽  
Dieter Peuskens ◽  
Koen Engelborghs ◽  
...  
Keyword(s):  
Recent Literature ◽  
Endovascular Embolization ◽  
Capillary Hemangioma ◽  
Neurological Deficits ◽  
Conservative Approach ◽  
Temporal Fossa ◽  
Natural Behavior ◽  
Intracranial Lesion ◽  
The Right

✓ The authors describe the case of a patient with an intracranial capillary hemangioma, and they review the recent literature on intracranial capillary hemangiomas with special attention to their differential diagnosis and management. The only sign in this 7-week-old boy was head enlargement. There were no neurological deficits, and imaging revealed a large intracranial lesion in the right temporal fossa. The results of biopsy confirmed the diagnosis, and, after endovascular embolization, the entire lesion was resected. The incidence of intracranial capillary hemangioma is very low but may be underestimated. In the present case, the size of the tumor prompted surgical treatment. The natural behavior of extracranial capillary hemangiomas, however, suggests that a conservative approach with follow-up and steroid therapy may also be considered.

Diagnostic and therapeutic values of intraoperative electrophysiological neuromonitoring during resection of intradural extramedullary spinal tumors: a single-center retrospective cohort and meta-analysis

2019 ◽  
Vol 30 (6) ◽  
pp. 839-849 ◽  
Author(s):  
Wataru Ishida ◽  
Joshua Casaos ◽  
Arun Chandra ◽  
Adam D’Sa ◽  
Seba Ramhmdani ◽  
...  
Keyword(s):  
Evoked Potentials ◽  
Predictive Value ◽  
Meta Analysis ◽  
Tumor Resection ◽  
Diagnostic Value ◽  
Neurological Deficits ◽  
Spinal Tumors ◽  
Intradural Extramedullary ◽  
Baseline Characteristics

OBJECTIVEWith the advent of intraoperative electrophysiological neuromonitoring (IONM), surgical outcomes of various neurosurgical pathologies, such as brain tumors and spinal deformities, have improved. However, its diagnostic and therapeutic value in resecting intradural extramedullary (ID-EM) spinal tumors has not been well documented in the literature. The objective of this study was to summarize the clinical results of IONM in patients with ID-EM spinal tumors.METHODSA retrospective patient database review identified 103 patients with ID-EM spinal tumors who underwent tumor resection with IONM (motor evoked potentials, somatosensory evoked potentials, and free-running electromyography) from January 2010 to December 2015. Patients were classified as those without any new neurological deficits at the 6-month follow-up (group A; n = 86) and those with new deficits (group B; n = 17). Baseline characteristics, clinical outcomes, and IONM findings were collected and statistically analyzed. In addition, a meta-analysis in compliance with the PRISMA guidelines was performed to estimate the overall pooled diagnostic accuracy of IONM in ID-EM spinal tumor resection.RESULTSNo intergroup differences were discovered between the groups regarding baseline characteristics and operative data. In multivariate analysis, significant IONM changes (p < 0.001) and tumor location (thoracic vs others, p = 0.018) were associated with new neurological deficits at the 6-month follow-up. In predicting these changes, IONM yielded a sensitivity of 82.4% (14/17), specificity of 90.7% (78/86), positive predictive value (PPV) of 63.6% (14/22), negative predictive value (NPV) of 96.3% (78/81), and area under the curve (AUC) of 0.893. The diagnostic value slightly decreased in patients with schwannomas (AUC = 0.875) and thoracic tumors (AUC = 0.842). Among 81 patients who did not demonstrate significant IONM changes at the end of surgery, 19 patients (23.5%) exhibited temporary intraoperative exacerbation of IONM signals, which were recovered by interruption of surgical maneuvers; none of these patients developed new neurological deficits postoperatively. Including the present study, 5 articles encompassing 323 patients were eligible for this meta-analysis, and the overall pooled diagnostic value of IONM was a sensitivity of 77.9%, a specificity of 91.1%, PPV of 56.7%, and NPV of 95.7%.CONCLUSIONSIONM for the resection of ID-EM spinal tumors is a reasonable modality to predict new postoperative neurological deficits at the 6-month follow-up. Future prospective studies are warranted to further elucidate its diagnostic and therapeutic utility.

Surgery of Intradural Extramedullary Tumors

Neurosurgery ◽  
2014 ◽  
Vol 75 (5) ◽  
pp. 509-514 ◽  
Author(s):  
Roberto Tarantino ◽  
Pasquale Donnarumma ◽  
Loenzo Nigro ◽  
Marika Rullo ◽  
Antonio Santoro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rating Scale ◽  
Neurological Deficits ◽  
Statistical Interpretation ◽  
Intradural Extramedullary ◽  
Examination Quality ◽  
Clinical Records ◽  
University Of Rome

Abstract BACKGROUND: Intradural extramedullary tumors (IDEMTs) are uncommon lesions that cause pain and neurological deficits. OBJECTIVE: To evaluate the effects of surgery for IDEMTs. METHODS: This cohort study recruited all patients operated on for IDEMTs at the Department of Neurology and Psychiatry of Sapienza University of Rome from January 2003 to January 2013. The analysis was conducted on clinical records evaluation over a 1-year follow-up. The Graphic Rating Scale was used to assess pain. Neurological deficits were detected through neurological examination. Quality of life was evaluated with the EuroQol (EQ-5D). Statistical interpretation of the data was performed with SPSS version 19 software. RESULTS: One hundred seven patients were recruited. Three were lost to follow-up. Patients reported lower level of pain 1 year after surgery (before surgery, 6.05; after surgery, 3.65). Mean comparison showed a significant decrease of −2.400 (P &lt; .001). Ninety-two patients (88.5%) were neurologically asymptomatic 1 year after surgery. Only 12 patients (11.5%) presented with a deficit, with a global decrease of 39% (χ2 = 27.6; P &lt; .005). The quality of life in patients was middle to high (mean rating of EQ-5D visual analog score, 61.78%). The lowest levels of quality of life were found in patients with sphincter dysfunctions (mean, 33.4). CONCLUSION: Surgery for IDEMTs has a good outcome. Patients reported lower levels of pain and a drastic reduction in neurological symptoms 1 year after surgery. The quality of life is middle to high. It is influenced mainly by the neurological outcome.

scholarly journals Spontaneous Healing and Complete Disappearance of a Giant Basilar Tip Aneurysm in a Child

2001 ◽  
Vol 7 (2) ◽  
pp. 141-145 ◽  
Author(s):  
C.B. Luo ◽  
Y.L. Chen ◽  
S.W. Hsu ◽  
H. Alvarez ◽  
G. Rodesch ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Cranial Nerve ◽  
Rare Case ◽  
Clinical Symptoms ◽  
Giant Aneurysm ◽  
Neurological Deficits ◽  
Complete Disappearance ◽  
Spontaneous Healing ◽  
Basilar Tip Aneurysm

We report a rare case of spontaneous total thrombosis of a giant basilar tip aneurysm resulting in compression of the brainstem, diagnosed in a two-year-old child who presented with neurological deficits and third cranial nerve impairment. After conservative treatment, the giant aneurysm was completely thrombosed and the clinical symptoms were remarkably improved. MRI demonstrated dramatic shrinkage and ultimately complete disappearance of the giant aneurysm at seven month follow-up.

scholarly journals Surgical Experience in Pediatric Patients with Chiari-I Malformations Aged ≤18 Years

2019 ◽  
Vol 10 (01) ◽  
pp. 85-88 ◽  
Author(s):  
Ghanshyam Das Singhal ◽  
Shakti Singhal ◽  
Gunjan Agrawal ◽  
Deepti Singhal ◽  
Vipin Arora
Keyword(s):  
Pediatric Patients ◽  
Foramen Magnum ◽  
Chiari I Malformation ◽  
Neurological Deficits ◽  
Resonance Imaging ◽  
Surgical Experience ◽  
Limb Weakness ◽  
Lower Limb Weakness ◽  
Chiari I

ABSTRACT Objective: The objective of this study was to retrospectively study Chiari I malformation patients (<18 years) treated surgically. Materials and Methods: Chiari I malformation patients (<18 years) treated surgically at our institute were retrospectively studied. Results: During the study period between January 1999 and June 2011, fifty patients, aged ≤18 years with Chiari malformation, were treated surgically and formed the basis for this series. There were 21 female children (42%) and 29 male children (58%), with a female-to-male ratio of 1:1. At the last follow-up, oropharyngeal symptoms were improved in 33% (n = 3/9). Headache/neck/back pain improved in 69.56% of children (n = 16/23). Upper-extremity pain/weakness/numbness improved in 73.91% of children (n = 17/23). Ataxia improved in 66.66% of children (n = 4/6). Lower-limb weakness/hyperreflexia improved in 83.33% of children (n = 5/6). At follow-up, magnetic resonance imaging for patients with syrinx was available for 75% of patients (n = 30/50) and not available for 25% of patients (n = 10/40). Syrinx was diminished in size or resolved in 66.33% of patients (n = 19/30) and the remaining was same for 36.66% of patients (n = 11/30). Conclusions: The main goal of surgery is to arrest the progression of neurological deficits. Foramen magnum decompression with a lax duroplasty is the surgical procedure of choice.

CLINICAL MANIFESTATIONS OF ANTI-NMDA RECEPTOR ENCEPHALITIS IN CHILDREN

2021 ◽  
Vol 100 (6) ◽  
pp. 113-120
Author(s):  
R.Ts. Bembeeva ◽  
◽  
U.M. Azizova ◽  
N.N. Zavadenko ◽  
E.S. Ilyina ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Autoimmune Encephalitis ◽  
Neurological Dysfunction ◽  
Long Term Results ◽  
Impulsive Behavior ◽  
Speech Impairment ◽  
Prodromal Phase ◽  
Nmdar Encephalitis

The aim of the study was to determine the clinical features of anti-NMDAR encephalitis in children. Materials and methods of research: 11 patients were selected from the group of children with autoimmune encephalitis, who met the diagnostic criteria for reliable anti-NMDAR encephalitis. A retro-prospective analysis of clinical symptoms, laboratory, neurophysiological and neuroimaging data, treatment, duration of primary hospitalization and long-term results of treatment was carried out, neuropsychological testing of patients was performed in the follow-up. Results: the age of the patients was 8.5±4.4 years, the gender composition of boys/girls was 1/10 (9.1%/90.9%). The average follow-up period was 17±12 months. In 73% of cases, there was an acute onset of the disease without a prodromal phase and with rapidly growing signs of neurological dysfunction: behavior change (11/100%), epileptic seizures (11/100%), speech impairment (10/90.9%), movement disorders (10/90.9%), disturbed sleep/wakefulness rhythm (9/81.8%), hallucinations (5/45.5%), autonomic disorders (6/54.5%), sensory disturbance (1/9,1%). In 82% of cases, therapy was required in the intensive care unit. When analyzing EEG monitoring in children, the extreme delta brush pattern was revealed in only one patient. Neuroimaging revealed no specific changes in the substance of the brain. The paraneoplastic nature of the disease could not be established in any case. 4 patients (36.36%) had relapses of the disease after 1.5–27 months. from the onset of the disease. All children showed a favorable outcome without a gross neurological deficit, but complaints of increased fatigue, headaches, poor memory, a decrease in vocabulary, and impulsive behavior persisted.

scholarly journals Testicular Torsion in Children: A 20-Year Retrospective Study in a Single Institution

2011 ◽  
Vol 11 ◽  
pp. 362-368 ◽  
Author(s):  
Chao Yang ◽  
Bin Song ◽  
Juan Tan ◽  
Xin Liu ◽  
Guang-hui Wei
Keyword(s):  
Median Duration ◽  
Testicular Torsion ◽  
Clinical Manifestations ◽  
Acute Scrotum ◽  
Duration Of Symptoms ◽  
Surgical Exploration ◽  
Early Surgical Intervention ◽  
Hormonal Levels

In this paper, we evaluated the historical features and physical examination findings, as well as laboratory tests and ultrasound examinations, in children with testicular torsion (TT), in order to improve diagnosis and treatment in this population. A retrospective review of patients with diagnosis of TT between January 1990 and January 2010 was performed. We included 118 cases in the study, accounting for 9.01% of all cases of acute scrotum. Mean patient age was 9.3 ± 5.6 years. The left side was predominantly affected. The median duration of symptoms up to surgical exploration was 64 h. Absence of cremasteric reflex presented in 94.9% patients. All boys had an ultrasound of the scrotum; decreased or absent blood flow was observed in all orchidectomy patients. Heterogeneous echogenicity presented in all cases of orchidectomy. At surgery, viable testes were present in 46 boys (39%) and preserved; in 72 boys with nonviable testes, they were removed. The median duration of symptoms at presentation was 12 h when the testes were successfully conserved and 90 h when they were removed. Testicular salvage depends critically on early surgical intervention. Ultrasound is a useful tool for the clinical assessment of patients with TT, however, sonographic interpretation must be in conjunction with the clinical manifestations. We advocate immediate surgical exploration with suspected TT. Long-term hormonal levels are within the normal range regardless of the fate of the testis. Further follow-up is needed to confirm fertility after TT.

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