Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Incidental or intentional durotomy causing cerebrospinal fluid (CSF) leakage, leading to the formation of a pseudomeningocele is a known complication in spinal surgery. Herniation of nerve roots into such a pseudomeningocele is very rare, but can occur up to years after initial durotomy and has been described to cause permanent neurologic deficit. However, cauda equina fiber herniation and entrapment into a pseudomeningocele has not been reported before. Here, we present a case of symptomatic transdural cauda equina herniation and incarceration into a pseudomeningocele, 3 months after extirpation of a lumbar Schwannoma. A 59-year-old man, who previously underwent intradural Schwannoma extirpation presented 3 months after surgery with back pain, sciatica and loss of bladder filling sensation caused by cauda equina fiber entrapment into a defect in the wall of a pseudomeningocele, diagnosed with magnetic resonance imaging. On re-operation, the pseudomeningocele was resected and the herniated and entrapped cauda fibers were released and replaced intradurally. The dura defect was closed and the patient recovered completely. In conclusion, CSF leakage can cause neurological deficit up to years after durotomy by transdural nerve root herniation and subsequent entrapment. Clinicians should be aware of the possibility of this potentially devastating complication. The present case also underlines the importance of meticulous dura closure in spinal surgery.
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PMID:Cauda equina entrapment in a pseudomeningocele after lumbar schwannoma extirpation. 1992 48

Schwannoma is a benign nerve sheath tumor composed of Schwann cells. A solitary schwannoma in the thorax is not rare, but a patient with Neurofibromatosis type 2 (NF2) and multiple thoracic schwannomas is extremely rare. We report the case of a 27-year-old woman with NF2 and two large schwannomas in her mediastinum and chest wall. We performed thoracic surgery on the patient, but she developed a cerebral hernia immediately after the operation. We report this case in order to analyze the relationship between the operation and cerebral hernia and find a way to prevent this consequence in the future. We conclude that a cranial MRI must be performed for patients with multiple thoracic schwannomas before the surgery. If there is a tumor inside the cranium, the disease in the brain must be treated first to prevent the occurrence of cerebral hernia or hemorrhage.
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PMID:Cerebral hernia caused by a thoracic surgery for multiple schwannomas in a patient with Neurofibromatosis type 2. 2354 12