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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">En el &#250;ltimo per&#237;odo se han recogido 5 adultos y 3 ni&#241;os con estados disr&#225;ficos ocultos&#44; en forma de lipomielomeningoceles lumbosacros&#44; asociados o no a m&#233;dula anclada&#44; cuya afectaci&#243;n neurol&#243;gica y ortop&#233;dica fue atribuida inicialmente a otros procesos&#46; Siguiendo la escala cl&#237;nica para estas lesiones del Sick Children Hospital de Toronto&#44; s&#243;lo 1 caso se encontraba en el grado 0&#44; al mostrar &#250;nicamente problemas esfinterianos vesicales ocasionales&#59; el resto presentaba alg&#250;n tipo de estigma externo&#44; como lipomas subcut&#225;neos&#44; senos d&#233;rmicos e hipertricosis&#44; diversos grados de debilidad y alteraciones sensitivas en miembros inferiores&#44; deformidades otop&#233;dicas generalmente en pie y cadera&#44; alteraciones en la marcha y&#44; finalmente&#44; trastornos esfinterianos&#46; En los primeros casos de la serie el diagn&#243;stico se bas&#243; exclusivamente en el estudio simple&#44; mielogr&#225;fico y mediante TC del raquis lumbosacro&#59; en los cuatro &#250;ltimos&#44; el estudio de la lesi&#243;n se complet&#243; con RM&#46; Con esta bater&#237;a de pruebas se confirm&#243; siempre la presencia de una masa lipomatosa de diferente entidad&#44; y generalmente con extensi&#243;n extrarraqu&#237;dea&#44; en contacto con las estructuras neurales segmentarias&#44; asoci&#225;ndose a dilataci&#243;n local y oclusi&#243;n parcial o total del fondo de saco dural en 5 casos&#44; a diastematomielia en 1&#44; a filum terminale engrosado en 2 y a m&#233;dula anclada en 4&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">En los 7 &#231;asos sintom&#225;ticos se intent&#243; paliar el cuadro mediante la cirug&#237;a&#44; con resecci&#243;n subtotal de la masa lipomatosa&#44; secci&#243;n del filum terminale y reparaci&#243;n del fondo de saco dural&#46; S&#243;lo en 3 casos&#44; 1 adulto y 2 ni&#241;os&#44; se observ&#243; alguna mejor&#237;a significativa&#44; principalmente en la actividad esfinteriana&#59; en el resto no se detect&#243; ning&#250;n cambio&#46;</p>"
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        "resumen" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Three children and five adults with occult spinal dysraphism&#44; namely lumbosacral lipomyelomeningoceles usually with tethered spinal cord&#44; whose neurological symptoms and orthopedic deformities were initially attributed to other processes&#44; were lastly treated&#46; Following the Hospital for Sick Children of Toronto clinical scale&#44; only 1 case presenting with occasional bladder dysfunction was graded as 0&#59; the rest showed sorne type of cutaneous lesions as subcutaneous lipomas&#44; dermal sinus&#44; tail-like appendages or hypertrichosis&#44; diverse degrees of weakness and sensation alterations in the lower limbs&#44; orthopedic deformities generally in the hip and&#47;or the foot&#44; gait impairment and finally sphincterian disturbances&#46; In the first cases&#44; definitive diagnosis was confirmed by X-ray&#44; myelographic and CT-scanning studies of the lumbrosacral region&#59; in the last 4 cases&#44; the lesion was also detected by MR&#46; With these imaging procedures&#44; a lipomatous mass with extraspinal extension and in contact with the segmentary neural structures was constantly found associated to local widdening and partial or total occlusion of the dural sac in 5 cases&#44; to diastematomyelia in 1&#44; to thickened filum terminale in 2&#44; and to tethered spinal cord in 4&#46; In the 7 symptomatic cases&#44; surgical approach to the lesion was attempted carrying through subtotal mass removal&#44; filum terminale section and dural sac repairingo In 3 cases&#44; 1 adult an 2 children&#44; a ligth improvement was observed&#44; mainly in regarding to urinary incontinence&#59; the rest remained unchanged&#46;</p>"
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Lipomielomeningoceles
J. Broseta, G. García-March, Mª.J. Sánchez-Ledesma, J. Gonçalves, J.A. Barcia-Albacar, A. García-Palomo, I. Silva
Servicio y Cátedra de Neurocirugía, Complejo Hospitalario y Universidad de Salamanca, Salamanca

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