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miércoles, 7 de noviembre de 2012
DX (presumptive): Cervical Spine Racemous Neurocysticercosis
Hello, after a long time here is my new post. Thank's for all your questions, congratulations and support for this blog. That helps me to stay motivated enough to pursue posting. Ok..a quick reminder of the past case:
Male with quadriparesia..
This was an interesting one. Image findings are consistent with a cervical multicystic mass with extra and intramedullar component. It compresses the cervical cord creating gross edema (mielitis) that is the actual cause of the patients symptoms. Edema ranges from C2 towards C7 level.
The imaging challenge was that the tumor has extra and intramedullar component. Differential diagnosis include Neurocysticercosis, Neurofibromatosis, Schwanomma, Cystic Astrocytoma.
The patient underwent surgery and we were invited to perform an Ultrasound.
Male with quadriparesia..
This was an interesting one. Image findings are consistent with a cervical multicystic mass with extra and intramedullar component. It compresses the cervical cord creating gross edema (mielitis) that is the actual cause of the patients symptoms. Edema ranges from C2 towards C7 level.
The imaging challenge was that the tumor has extra and intramedullar component. Differential diagnosis include Neurocysticercosis, Neurofibromatosis, Schwanomma, Cystic Astrocytoma.
The patient underwent surgery and we were invited to perform an Ultrasound.
Dr. Leal (neurosurgeon) with a posterior cervical approach.
That's me (on the right) with Dr. Sanchez (gazing the camera..hehe) prior to surgical ultrasound.
Long axis view of the spine depicting fibrous inflamatory changes. No clear cyst was found.
Anterior border spine echogenicity consistent with fibrous changes.
The spine was engorged and it was no possible for the neurosurgeon to extract any mass without nerve damage. The Dura was very adhesive to spine.
The patient was given Cysticidal drugs only because of image findings and in matter of weeks miraculosly symptoms have substantially improved. MR control (not posted) showed reduced edema and no extradural mass (only intramedullar). The prognosis is still poor though. The reason is due to the fact that a spinal infarct is highly probable.
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