一名 13 ½ 岁男孩因非典型腓总神经节导致完全性足下垂。

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie Pub Date : 2024-10-22 DOI:10.1016/j.neuchi.2024.101606

Maite Jiménez Siebert, Nadine Kaiser, Kai Ziebarth

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引用次数: 0

摘要

导言：因硬膜内神经节压迫导致的腓肠神经麻痹在儿科并不常见，需要手术治疗。本病例的独特之处在于，神经节呈拉长状而非典型的圆形囊肿，从而延误了诊断和治疗：本病例中，一名13岁半的男孩因形状异常的硬膜内神经节而导致腓总神经麻痹。膝关节核磁共振成像显示，腓肠肌外侧插入部和腓骨头之间有一个拉长的腓肠神经节，压迫神经的长度达 10 厘米。经过手术减压和物理治疗后，腓总神经恢复良好，术后一年达到 M 4 - 5：目前腓总神经节的不典型形状延误了诊断和正确治疗。虽然这种情况在儿童中很少见，但在腓骨神经麻痹的诊断过程中必须特别注意，因为手术时间决定了神经功能的预后。

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Complete foot drop due to atypical peroneal ganglion in a 13 ½ year old boy

Introduction

Peroneal nerve palsy due to compression by an intraneural ganglion is an uncommon entity in the pediatric setting with a need for surgical treatment. Uniquely in this case, the ganglion presented as an elongated instead of a typical round cyst, delaying diagnosis and treatment.

Case presentation

We present the case of a 13 ½ year old boy with increasing peroneal nerve palsy due to an atypically shaped intraneural ganglion. An MRI of the knee revealed an elongated peroneal ganglion compressing the nerve between the lateral insertion of the gastrocnemius muscle and fibular head over a length of 10 cm. After surgical decompression and physiotherapy the peroneal nerve recovered well, achieving M 4–5 one year after surgery.

Conclusion

The atypical shape of the present peroneal ganglion delayed diagnosis and correct treatment. Though rare in the pediatric setting, this entity must be specifically looked for during the diagnostic workup of peroneal palsy, for time to surgery determines neurological outcome.

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来源期刊

Neurochirurgie 医学-临床神经学

CiteScore

2.70

自引率

6.20%

发文量

100

审稿时长

29 days

期刊介绍： Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal. With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published. Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.