Madrigal FMÁ, Fernández MMT

Language: Spanish
References: 7
Page: 145-150
PDF size: 289.61 Kb.

ABSTRACT

Introduction: A paresis must be the object of a detailed analysis to know its correct etiology. Physical examination should include a thorough neurological assessment to guide the location of the lesion.
Clinical case: Patient with paresis of the lower right extremity, hyperreflexia, clonus, and decreased thermal and algic sensitivity below the xiphoid process is preseneted. These findings point to the dorsal vertebral level, D8, possible location of a lesion that affects the pyramidal motor pathway and the sensory pathway. Clinical suspicion is confirmed by MRI that showed the presence of intramedullary mass, possible ependymoma.
Conclusions: The knowledge of the anatomy of the nerve bundles that run through the spinal cord, and the nerve information they provide contain clinical and sensory clinical signs, allowing to discern which nerve bundles are injured. This clinical judgment can lead, in a much more concrete way, to the type of explorations and complementary tests that may be necessary to diagnose and reduce health costs, as well as the waiting time for a possible surgical treatment.

REFERENCES

1. Grimm S, Chamberlain MC. Adult primary spinal cord tumors. Expert Rev Neurother. 2009;9(10):1487-95.

2. Landriel F, Ajler P, Tedesco N, Bendersky D, Vecchi E. Multicentric extramedullary myxopapillary ependymomas: Two case reports and literature review. Surg Neurol Int. 2012;3:102.

3. Ogul H, Bagcier F, Tas N, Kantarci M. Multiple spinal myxopapillary ependymomas presented with back pain. Spine J. 2015;15(10):1.

4. Zhu F, Ding J, Li Y, Mao D, He X, Chen W, et al. Benign ependymoma with extensive intracranial and spinal cerebrospinal fluid dissemination: case report and literature review. Br J Neurosurg. 2017;21:1-4.

5. Mechtler LL, Nandigam K. Spinal cord tumors: new views and future directions. Neurol Clin. 2013;31(1):241-68.

6. Diaz E, Morales H. Spinal Cord Anatomy and Clinical Syndromes. Semin Ultrasound CT MR. 2016;37(5):360-71.

7. Honda A, Iizuka Y, Hirato J, Kiyohara H, Iizuka H. Multiple intradural-extramedullary spinal ependymomas including tumors with different histological features. Eur Spine J. 2017;26(Suppl 1):222-4.