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Tuberculoma of the conus medullaris: case report 总被引:3,自引:0,他引:3
Türeyen K 《Neurosurgery》2002,50(3):651-2; discussion 652-3
OBJECTIVE AND IMPORTANCE: Intramedullary spinal tuberculoma is a rare form of central nervous system tuberculosis. This article describes an affected patient who presented with left leg paresis. CLINICAL PRESENTATION: A 46-year-old man presented with a 7-day history of left leg weakness. The patient's medical history included infection with pulmonary tuberculosis 15 years previously, at which time he had been treated with antituberculosis therapy. The neurological examination performed at admission revealed left leg paresis with Grade 2/5 power in all muscle groups. The patient reported no urinary or bowel problems. INTERVENTION: Surgery was performed with the patient in the prone position. The procedure involved laminectomies at T11, T12, and L1, followed by a midline myelotomy. The mass was excised completely. Histopathological examination revealed a granulomatous lesion that contained Langhans' giant cells, inflammatory cells, and evidence of caseating necrosis. The patient was prescribed a 6-month course of antituberculosis therapy with pyrazinamide, isoniazid, and rifampin. CONCLUSION: The outcome was favorable. Recently, a number of authors have reported success with medical management of intraspinal tuberculoma. Intraspinal tuberculoma produces a mass effect that can jeopardize spinal cord function. The optimal treatment is a combination of microsurgical resection and antituberculosis chemotherapy. 相似文献
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Ali Kurtsoy M.D. R. Kemal Koc I. Suat Oktem Olgun Kontas Ahmet Selcuklu Aydin Pasaoglu 《Neurosurgical review》1997,20(1):55-58
A case of a ganglioglioma of the conus medullaris extending between T-12 and L2 segments is reported. The tumor was succesfully removed by third stage operation. Ganglioglioma located in the conus medullaris is extremely rare. The best treatment of spinal cord ganglioglioma is totally tumor excision even when multiple stage operations are necessary. 相似文献
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Agrawal A Shetty BJ Makannavar JH Shetty L Shetty J Shetty V 《Neurosurgery》2006,59(2):E428; discussion E428
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The medullary conus represents a distinct entity of the spinal cord regarding its anatomical, clinical and microsurgical features.
An overview of the pathologic processes of this region is provided. Epidemiological, clinical and neuroradiological characteristics
of neoplastic (glial tumors, non-glial tumors, metastasis, primary melanomas) and non-neoplastic lesions (granulomatous lesions,
abscess, parasitic infections, vascular, demyelinating and dysembryogenetic lesions) are discussed. Main MR imaging characteristics
used to differentiate neoplastic from non-neoplastic lesions consist in pathological spinal cord expansion, gadolinium-enhancement
and tumoural cyst formation. Management strategies differ substantially, depending on the kind of lesion. According to the
suspected pathological entity radical resection, biopsy or conservative treatments are reasonable options. Intraoperative
electrophysiological monitoring is a fundamental part of the surgical setting. 相似文献
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Gallia GL Burger PC Suk I Bagley CA Wolinsky JP Garonzik IM Gokaslan ZL 《Neurosurgery》2006,58(6):E1214; discussion E1214
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A 71-year-old woman had the sudden onset of a neurogenic bladder and a stepwise increase in paraparesis that left her unable to stand or walk. Magnetic resonance imaging showed what appeared to be a tumor in the conus medullaris. After laminectomy, the lesion was localized by ultrasound examination, and a biopsy was performed. The deficits remained unchanged postoperatively. Microscopic examination of the biopsy specimen showed necrosis and pathologic changes consistent with infarction of the conus medullaris. An anomalous arterial supply of the conus medullaris is the most likely cause of this unusual problem. The patient gradually regained her ability to walk, but the neurogenic bladder persists. 相似文献
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OBJECTIVE: To illustrate the dilemmas in the diagnosis and management of intramedullary tuberculomas of the spinal cord. METHODS: Case report of a 32 year-old man with tuberculous meningitis. The presence of unexplained urinary retention and progressive weakness in the legs led to the discovery of an additional tuberculoma of the conus medullaris. SETTING: Dicle University Diyarbakir, Turkey. RESULTS: The patient was on a 1-year course of isoniazid, pyrazinamide and rifampicin, and responded well to conservative treatment. Our patient's unique features were represented by the worsening of neurological symptoms while being treated with adequate anti-tuberculous medication. CONCLUSION: We present a case of intramedullary tuberculoma of the conus medullaris to illustrate the dilemmas in the diagnosis and management of this curable disease, and review of the literature to date. 相似文献
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Intramedullary teratoma is extremely rare and to our knowledge has been reported in only nine cases in the literature. We report a case of mature cystic teratoma of the conus medullaris. The case was diagnosed by magnetic resonance imaging and operated with microneurosurgical techniques. 相似文献
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Syringomyelia and syringobulbia associated with an ependymoma of the cauda equina involving the conus medullaris: case report 总被引:1,自引:0,他引:1
A patient with syringomyelia and syringobulbia secondary to an asymptomatic ependymoma of the cauda equina involving the conus medullaris is described. Delayed metrizamide computed tomography myelography was decisive for making the diagnosis of a highly extended syrinx associated with the tumor. Syringomyelic symptoms improved remarkably following the removal of the tumor, and the syrinx was not visualized in a postoperative study. The pathogenesis of syringomyelia associated with a caudally located spinal cord tumor is discussed. 相似文献
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Intramedullary spinal tuberculoma presenting as a conus tumor: a case report and review of the literature 总被引:3,自引:0,他引:3
Intramedullary spinal tuberculoma is a rare form of central nervous system tuberculosis. Although tuberculosis is unusual
in the west, it is still prevalent in Asia and Africa. We report a case in which the diagnosis was made histologically without
evidence of symptoms of systemic tuberculosis. The lesion, located in the conus medullaris, mimicked a conus tumor. The patient
was a 20-year-old man who presented with a history of progressive leg weakness, urinary urgency, and impotence. There was
no history of, or recent contact with, tuberculosis. A diagnosis of an intramedullary tumor in the conus medullaris was made
by MRI. The patient underwent a T11-L1 laminectomy and total resection of the lesion with microsurgical technique. Histologic
examination revealed a granulomatous lesion containing Langhans’ giant cells, inflammatory cells, and caseating necrosis.
Antituberculous medication was instituted as soon as the diagnosis was made. Neurologic symptoms and signs slowly improved
postoperatively. A combination of microsurgical resection and antituberculous chemotherapy should be the choice of treatment
for intramedullary tuberculomas.
Received: 11 January 1997 Revised: 1 April 1997 Accepted: 17 April 1997 相似文献
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