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A Canga

Publications and source records attributed to A Canga.

14 recordsLinked to original sources
PubMed2002

[Cauda equina meningioma in a girl: presentation of a case and review of the literature].

Meningiomas are unusual in childhood, and the intraspinal location is very uncommon. Those arising from lumbar dura matter are the most rare among spinal neoplasms of meningeal origin. We present the case of a 12-years-old girl with a cauda equina meningioma. As in previously reported cases, the initial complain was back pain with radicular irradiation. The girl had few neurological findings, with pyramidal signs of both lower limbs as single neurological impairment. She underwent surgical treatment through an open door laminoplasty and the tumour was completely removed without neurological deficit. After 2-year of follow-up she remains asymptomatic.

Back Pain↗
PubMed2001

[Intradural lumbar disk hernia].

Intradural disc herniation is a rare complication of degenerative disc disease. A correct diagnosis of this process is frequently difficult. If this entity is not preoperatively diagnosed and is omitted at surgery, severe neurologic sequels may be provoked. We report a case of a pathologically proven intradural disc herniation preoperatively diagnosed by MR imaging. Clinically, it was manifested by sudden onset of right leg ciatalgia and progressive right lower extremity weakness. The patient also referred a one-month history of sexual dysfunction. MR imaging revealed interruption of the low signal of the anulus fibrosus and of the posterior longitudinal ligament at L2-L3 level and a voluminous disc fragment migrated in the dural sac that showed rim enhancement with gadolinium.The clinical, neuroradiological, and surgical management of lumbar intradural disc herniation are reviewed.

Humans↗
PubMed2000

Usefulness of gadolinium-enhanced MR imaging in the evaluation of the vascularity of scaphoid nonunions.

OBJECTIVE: The objective of this article is to identify the role of gadolinium-enhanced MR imaging in the preoperative evaluation of the vascular status of the proximal fragment in scaphoid nonunions. SUBJECTS AND METHODS: Thirty consecutive patients (27 men and three women; age range, 19-52 years; mean age, 28 years) with nonunion of the scaphoid were prospectively examined with unenhanced and gadolinium-enhanced MR imaging. MR images and surgical findings were classified in four groups according to the vascular status of the proximal fragment (normal bone, moderate ischemic bone, severe ischemic bone, and avascular necrosis). Sensitivity, specificity, and accuracy of unenhanced and gadolinium-enhanced MR studies were calculated. Surgical findings were used as the gold standard. The postoperative rate of union at 12 months was evaluated for each group. RESULTS: Unenhanced MR imaging showed a global sensitivity of 36%, specificity of 78%, and accuracy of 68% in the preoperative evaluation of the vascular status of the proximal fragment. Correlation with the surgical findings was not statistically significant (p < 0.149). Global sensitivity, specificity, and accuracy of gadolinium-enhanced MR imaging were 66%, 88%, and 83%, respectively. Correlation with the surgical findings was good (p < 0.0001). Gadolinium-enhanced sequences allowed accurate diagnosis and enabled the creation of prognostic groups having better correlation with surgical findings and postoperative results. CONCLUSION: Gadolinium-enhanced MR imaging is the most reliable imaging method for investigating the vascularity of the proximal pole in scaphoid nonunions.

Adult↗
PubMed1999

Neuroimaging diagnosis of Tolosa-Hunt syndrome: MRI contribution.

OBJECTIVE: To present our experience in the neuroradiological diagnosis of six patients with Tolosa-Hunt syndrome. METHODS: Computerized tomograms and MRI, with and without contrast enhancement, of the cranium and orbits of patients fulfilling IHS criteria for the diagnosis of Tolosa-Hunt syndrome were analyzed. RESULTS: Standard CT scan, with and without contrast enhancement, disclosed an enlarged cavernous sinus in one patient and was normal in the remaining five. In comparison, MRI was clearly abnormal in the four patients on whom it was performed, showing a convex enlargement of the symptomatic cavernous sinus by an abnormal tissue isointense with gray matter on short TR/TE images and iso-hypointense on long TR/TE scans. This abnormal tissue markedly increased in signal intensity after contrast injection and, in two patients, extended into contiguous regions, mainly the orbital apex and subtemporal fossa ipsilaterally. One patient had follow-up studies after successful treatment with corticosteroids. Although diminished in size, the abnormal tissue was still visible on MRI after 3 months of treatment and only disappeared after 6 months of treatment. CONCLUSIONS: These MRI findings help in the differential diagnosis of the Tolosa-Hunt syndrome from conditions such as meningioma, lymphoma, and sarcoidosis, as well as confirming the similarities of the Tolosa-Hunt syndrome and orbital pseudotumor. In the presence of painful ophthalmoplegia, the finding by MRI of cavernous sinus enlargement, with the herein described signal and extension characteristics and slow resolution with corticosteroid treatment, is highly suggestive of the Tolosa-Hunt syndrome.

Acoustic Stimulation↗
PubMed1999

Tolosa-Hunt syndrome: focus on MRI diagnosis.

Experience with modern neuroimaging techniques, computed tomography (CT) and magnetic resonance imaging (MRI) scans, in the diagnosis of Tolosa-Hunt syndrome (THS) is reviewed. Conventional CT scan remains normal in about two-thirds of these patients. In the reported 22 patients meeting the IHS criteria for a THS diagnosis on whom an MRI study was performed, MRI revealed a convex enlargement of the symptomatic cavernous sinus by an abnormal tissue isointense with gray matter on short TR/TE images and isohypointense on long TR/TE images. This abnormal tissue markedly increases in signal intensity after contrast injection. MRI seems also to be the ideal technique to follow progressive resolution of the abnormal tissue after steroids. Therefore, normal MRI would probably exclude THS, whereas in the appropriate clinical setting of steroid-responsive painful ophthalmoplegia, MRI showing the cavernous sinus abnormality described here suggests a diagnosis of THS. From these data, we propose that the fourth IHS criterion for THS diagnosis, "Exclusion of other causative lesions by neuroimaging and (not compulsory) carotid angiogram" should be changed to "Finding by MRI of specific cavernous sinus abnormalities (with the characteristics described herein) which slowly resolve with steroid treatment".

Humans↗
PubMed1998

Soft tissue Burkitt's lymphoma: radiological findings.

An unusual case is reported of a soft tissue mass in the lower extremity, without bone involvement, in an 85-year-old woman; the histopathological diagnosis was Burkitt's lymphoma. Pertinent clinical history, histological examination, and imaging procedures allowed early diagnosis. To our knowledge, the radiological findings in Burkitt's lymphoma with this unusual clinical presentation have not been described previously.

Aged↗
PubMedDate not supplied

[Buttock mass and malignant sciatic nerve tumor].

Malignant peripheral nerve sheath tumors (MPNST) are rare. We report a case of a MPNST of the proximal sciatic nerve in the thigh, unassociated with pre-existing type 1 neurofibromatosis or history of radiation therapy. A 71-year-old man had a 6 month history of constant, severe, burning pain affecting the sole of the left foot. One month after the onset, the pain radiated to the left calf, posterior aspect of the thigh and buttock, and distal leg weakness followed. Three months prior to admission, the patient developed a large and painful mass in the buttock, that occupied the entire left gluteal region on examination. There was severe weakness of ankle and toe dorsiflexion and plantarflexion, decreased sensation on the lateral and posterior aspect of the left leg as well as on the dorsal and plantar surfaces of the foot, and absent ankle jerk. EMG showed denervation and motor unit loss in the short head of biceps femoris and muscles supplied by tibial and peroneal nerves on the left side. Magnetic resonance imaging revealed a 10-cm enhancing mass of the left sciatic nerve from the upper thigh to the greater sciatic notch. In surgery, a large MPNST with a high Ki67 labeling index (> 60 %) was subtotally removed from the sciatic nerve, and adjuvant radiation therapy was administered. In the ensuing months the tumor invaded the entire pelvic region. A high sciatic malignant tumor can present with a rapidly growing buttock mass and unilateral, neuropathic foot pain imitating the tarsal tunnel syndrome.

Aged↗
PubMedDate not supplied

[Design of a vaccination campaign against hepatitis b virus].

Plans for a vaccination campaign among the health care personnel at the "Valle del Nalón" Hospital are discussed. For this purpose, first of all, the serological testing to determine the markers as compared to the VHB was done using the ELISA technique, and in following, the vaccine based on genetic engineering, ENGERIX BR was provided, initially according to the criteria established to this effect by law, and then from a less restricted view, according to the principles which are given in the text. We have observed that 14.74% of the workers in our town have some positive marker priori to the vaccination and that 1.81% are carriers. The level of tolerance was that of 45.79%, said level being related to the professional group in question and the service in which they work, differences obtained in both cases being statistically quite significant (p less than 0.0001).

Hepatitis B↗