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- W2438014425 abstract "Los quistes aracnoideos son divertículos de duramadre con contenido similar al líquido cefalorraquídeo. El 1% se presenta en la médula espinal; se localizan típicamente en la parte posterior de la médula espinal torácica y son una causa rara de compresión medular. Se presenta el caso de un paciente masculino de 15 años, previamente sano, quien acude a valoración por paraparesia espástica de 20 meses de evolución, la cual comienza después de un evento anestésico por osteosíntesis de tobillo. Presenta disminución de la sensibilidad y fuerza de miembros pélvicos, que se incrementa gradualmente hasta presentar anestesia a nivel de dermatomos T12 a L4, hipoestesia L5 y S1 bilateral y fuerza 4+/5 bilateral, en la raíz L2 y 2+/5 en L3, L4, L5, S1, hiperreflexia, Babinski y clonus, sin alteraciones en los reflejos sacros. Mediante resonancia magnética se diagnostica quiste aracnoideo extradural de T6 a T9. Se realizó laminotomía T6 a T10, resección del quiste, cierre del defecto dural y laminoplastia. En el seguimiento a 12 meses el paciente presenta recuperación de la sensibilidad, mejoría de la fuerza muscular hasta 4+/5 en L2 a S1 y normorreflexia. Después de la anestesia espinal se produjeron cambios en la presión del líquido cefalorraquídeo y expansión del quiste, lo que desencadenó el déficit neurológico, haciendo evidente su presencia. A pesar del tiempo que se mantuvo la compresión, el paciente presentó una adecuada evolución clínica. Arachnoid cysts are dural diverticula with liquid content similar to cerebrospinal fluid, with 1% occurring in the spinal cord. They locate mainly in the dorsal region of the thoracic spine, and are unusual causes of spinal cord compression. The case is presented of a previously healthy 15-year-old boy, with a 20-month history of spastic paraparesis that started apparently after epidural block for ankle osteosynthesis. There was decreased sensitivity and strength of the pelvic limbs and gradually presented with anaesthesia from T12 to L4 dermatomes, L5 and S1 bilateral hypoaesthesia and 4+/5 bilateral strength, in the L2 root and 2+/5 in L3, L4, L5, S1, hyperreflexia, Babinski and clonus, but with no alteration in the sacral reflexes. In the magnetic resonance it was diagnosed as an extradural arachnoid cyst from T6 to T9. The patient underwent a T6 to T10 laminotomy, cyst resection, dural defect suture, and laminoplasty. One year after surgery, the patient had recovered sensitivity, improvement of muscle strength up to 4+/5 in L2 to S1, and normal reflexes. After the anaesthetic procedure, increased pressure and volume changes within the cyst could cause compression of the spinal cord, leading to symptoms. Despite being a long-term compression, the patient showed noticeable improvement." @default.
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- W2438014425 date "2016-11-01" @default.
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- W2438014425 title "Presentación clínica de quiste aracnoideo epidural dorsal posterior a anestesia epidural" @default.
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- W2438014425 doi "https://doi.org/10.1016/j.circir.2015.10.005" @default.
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