Medicina Fluminensis, Vol. 61 No. 1, 2025.
Studija slučaja
https://doi.org/10.21860/medflum2025_323590
Epileptic Seizure Resulting in Cervical Trauma Led to Discovery of Underlying Spina Bifida and Spinal Hamartoma – a Case Report
Alen Šarić
; Sveučilište u Rijeci, Medicinski fakultet, Rijeka, Hrvatska
Barbara Kolbah
; Klinički bolnički centar Rijeka, Klinika za neurokirurgiju, Rijeka, Hrvatska
Dean Girotto
; Klinički bolnički centar Rijeka, Klinika za neurokirurgiju, Rijeka, Hrvatska; Sveučilište u Rijeci, Medicinski fakultet, Katedra za neurokirurgiju, Rijeka, Hrvatska
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* Dopisni autor.
Sažetak
Aim: The aim of this study is to present the issue of failure in controlling refractory epilepsy caused by congenital brain malformation. Another important aspect of this study is the connection between congenital malformations that can lead to refractory epilepsy, spinal bifida, and extremely rare spinal tumors found in the presented case. Case report: We report a young female patient with a vertebral fracture and subluxation as sequelae to an epileptic attack. Refractory epilepsy in our patient is known to be caused by periventricular nodular heterotopia. The fracture was managed with surgical decompression and anterior C4/C5 fusion. Postoperative MRI revealed a syringomyelia C5/C6 and spina bifida occulta, along with two posterior epidural masses that were radiologically described as hematomas. Surgical resection and analysis revealed that they were an ependymal cyst and a formation without a clear pathological conclusion. At initial examination, the patient was severely tetraparetic, but after physical rehabilitation, she had complete recovery. Conclusions: Failure in adequate treatment of refractory epilepsy can lead to serious consequences and spinal fractures. Congenital malformations are common cause of refractory epilepsy, and are associated with other malformations, so it is necessary to make a screening for other malformations. Benign spinal tumors are a rare finding, but it is important to recognize them early, and consensus among pathologists is necessary to define accurate differences between them for improved treatment outcome.
Ključne riječi
drug resistant epilepsy; periventricular nodular heterotopia; spina bifida occulta; spinal cord injuries; spinal cord neoplasms
Hrčak ID:
323590
URI
Datum izdavanja:
1.3.2025.
Posjeta: 221 *