Anesthetic in a patient with cauda equina syndrome resulted from lumbar meningioma
Keywords:
PERIPHERAL NERVOUS SYSTEM DISEASES, CAUDA EQUINA, MENINGIOMA, DIAGNOSTIC IMAGING, MAGNETIC RESONANCE IMAGING.Abstract
Cauda equina meningiomas are rare extramedullary tumors, of mesodermic origin and with general benign characteristics. They arise from meningothelial cells that make up the arachnoid villi. This study presents the case of a 45-year-old female patient with a three-month lumbar pain. Physical examination revealed a decrease of the muscular strength and hypoesthesia in the right lower limb. Magnetic resonance imaging showed an isointense rounded image within the spinal canal at the level of L5. Clinical and imaging assessment led to the diagnostic impression of cauda equina syndrome. The tumor was removed and sent to the pathology department, informing a meningothelial meningioma. The anesthetic strategy to be followed was detailed. The patient progressed favorably.
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Karsy M, Guan J, Sivakumar W, Neil JA, Schmidt MH, Mahan MA. The genetic basis of intradural spinal tumors and its impact on clinical treatment. Neurosurg Focus [revista en internet]. 2015 [citado 17 de febrero 2019]; 39(2). Disponible en: http://thejns.org/doi/full/10.3171/2015.5.FOCUS15143.
Acosta H F, Sosa K F. Caracterización clínica epidemiológica de pacientes operados de tumores raquimedulares. Revista Cubana de Medicina Militar [revista en internet]. 2019 [citado 17 de febrero 2019]; 48(1): 56-66. Disponible en: http://revmedmilitar.sld.cu/index.php/mil/article/view/196.
Ottenhausen M, Ntoulias G, Bodhinayake I, Rupert FH, Schreiber S, Förschler A. Intradural spinal tumors in adults-update on management and outcome. Neurosurg Rev. [revista en internet]. 2018 [citado 17 de febrero 2019]; 41(1): 1-18. Disponible en: https://doi.org/10.1007/s10143-018-0957-x9.
Bakar D, Tanenbaum JE, Phan K, Alentado VJ, Steinmetz MP, Benzel EC. Decompression surgery for spinal metastases: a systematic review. Neurosurg Focus. [revista en internet]. 2016 [citado 17 de febrero 2019]; 41(2): 1-35. Disponible en: https://thejns.org/downloadpdf/journals/neurosurg-focus/41/2/article-pE2.pdf.
Sung C, Hsieh K, Kuo Y. A primary meningioma of the lumbar spine with neck metastasis. The journal of spinal cord medicine [revista en internet]. 2019 [citado 17 de febrero 2019]; 2019(2019): 1-4. Disponible en: https://www.tandfonline.com/doi/abs/10.1080/10790268.2018.1564993.
Karhade AV, Vasudeva VS, Dasenbrock HH, Lu Y, Gormley WB, Groff MW. Thirtyday readmission and reoperation after surgery for spinal tumors: a National Surgical Quality Improvement Program analysis. Neurosurg Focus [revista en internet]. 2016 [citado 17 de febrero 2019]; 41(13). Disponible en: http://thejns.org/doi/full/10.3171/2016.5.FOCUS161683.
Pendleton C, Rincon-Torroella J, Gokaslan ZL, Jallo GI, Quinones-Hinojosa A. Challenges in early operative approaches to intramedullary spinal cord tumors: Harvey Cushing's perspective. J Neurosurg Spine [revista en internet]. 2015 [citado 17 de febrero 2019]; 23(4): 412-8. Disponible en: http://thejns.org/doi/full/10.3171/2014.12.SPINE13427.
Schairer WW, Carrer A, Sing DC, Chou D, Mummaneni PV, Hu SS. Hospital readmission rates after surgical treatment of primary and metastatic tumors of the spine. Spine [revista en internet]. 2014 [citado 17 de febrero 2019]; 39(21): 1801-8. Disponible en: https://journals.lww.com/spinejournal/Fulltext/2014/10010/Hospital_Readmission_Rates_After_Surgical.17.aspx.
Acevedo Cardoso J, Suárez Guerrero, Sánchez Sánchez S. Meningioma de localización lumbar en un paciente con virus de inmunodeficiencia humana. Revista Finlay [revista en internet]. 2017 [citado 17 de febrero 2019]; 7(2): 146-51. Disponible en: http://revfinlay.sld.cu/index.php/finlay/article/view/471.
Samuel N, Tetreault L, Santaguida C, Nater A, Moayeri N, Massicotte EM. Clinical and pathological outcomes after resection of intramedullary spinal cord tumors: a single-institution case series. Neurosurg Focus. [revista en internet]. 2016 [citado 17 de febrero 2019]; 41(2): 1-8. Disponible en: https://thejns.org/downloadpdf/journals/neurosurgfocus/41/2/article-pE8.pdf.
He J, Xiao J, Peng X, Duan B, Li Y, Ai P. Dose escalation by image-guided intensity-modulated radiotherapy leads to an increase in pain relief for spinal metastases: a comparison study with a regimen of 30 Gy in 10 fractions. Oncotarget [revista en internet]. 2017 [citado 17 de febrero 2019]; 8(68): 112330-40. Disponible en: http://www.oncotarget.com/index.php?journal=oncotarget&page=article&op=view&path[]=18979&path[]=60831.
Zwagerman NT, McDowell MM, Hamilton RL, Monaco EA, Flickinger JC, Gerszten PC. Histopathological examination of spine tumors after treatment with radiosurgery. Neurosurg Focus. [revista en internet]. 2016 [citado 17 de febrero 2019]; 41(2): 1-4. Disponible en: http://thejns.org/doi/full/10.3171/2016.5.FOCUS16119.
Montibeller G, Jung G, Machado GA, Cavalcanti M, Ramina R. Use of 5-ALA for Meningioma Surgery: New Concepts of Total Resection. Journal of Neurological Surgery Part B: Skull Base [revista en internet] 2019 [citado 17 de febrero 2019]; 80(S01): A007. Disponible en: https://www.thieme-connect.com/products/ejournals/html/10.1055/s-0039-1679423.
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