Relato de dois casos de cisticercose medular, sendo o primeiro referente a uma paciente de 13 anos de idade, apresentando a forma intramedular, e o segundo a uma paciente de 51 anos de idade com cisticercose espinhal leptomeníngea. Numa revisão de literatura (desde 1856), foram encontrados 95 casos publicados de cisticercose medular somados a dois de nossa casuística, mostrando a freqüência da doença. Dentro da patogenia da forma extra-medular, os autores defendem a hipótese da migração dos cisticercos do espaço subaracnóide intracraniano para o espinhal, baseando-se na distribuição topográfica dos parásitos na medula.

A case of spinal intramedular cysticercosis in a 13-year-old Brazilian female and a case of spinal leptomeningeal infestation by cysticercosis in a 51 year-old Brazilian female are presented. A review of 95 published cases of medullar cysticercosis since 1856 shows the incidence of this condition. Extramedullar forms are explained by the downward migration of larvae from the cerebral to the spinal subarachnoid space and most larvae are expected to be stopped in the upper portions of the spinal canal due to peculiarities of the anatomy of the spinal cord.

Relata de um caso com verificação cirúrgica de cisticercose espinhal, forma leptomeníngea restrita à cauda eqüina, em paciente adulto. É discutido o papel do sistema venoso vertebral na infestação dos espaços subaracnóideos na neurocisticercose, originando formas clínicas primariamente espinhais.

An adult female patient presented with an exclusively spinal leptomeningeal infestation by cysticercosis (restricted to the cauda equina), verified in surgery. The rôle of the vertebral vein system in the spread of cysticercotic larvae is discussed. A commentary on the possibility that cysticercosis of the batal cisterns may be due to ascending migration of primarily spinal cysticerci, as originally proposed by Isamat de la Riva, is stated.

Comentário crítico da rotina radiodiagnóstica nas radiculopatias Iombossacrala no que concerne ao uso da tomografia computadorizada (CT). São relatadas as observações clínicas de três pacientes nos quais neoplasias acometeram uma única raiz lombossacral, simulando uma hérnia de disco lombar do ponto de vista clínico, com ênfase nos aspectos neurorradiológicos. Recomenda-se o estudo sistemático do sacro e da zona do cone medular em todo caso de radiculopatia lombossacral.

Lumbar-disc protrusions (LDP) constitute well-defined syndromes on clinical and anatomical grounds, and neurosurgeons are prone to rely upon the clinical signs to identify the level of disc protrusion when a «typical» case is found. Sometimes, non-contrasted computerized tomographic (CT) scans centered on the L5-S1, L4-L5 and L3-L4 interspaces and spine roentgenograms are the only special ancilary means in presurgical evaluation. We report three patients from our series, in which neoplasic spinal disease presented as classic LDP (one patient with a cauda equina schwannoma, and two with metastatic carcinoma). The cases were chosen because they posed special problems to the referred radiodiagnostic routine. Systematic CT-evaluation of the sacrum and conus medullaris zone is recommended in every patient with lumbosacral radiculopathy, and intratecal contrast should be employed in patients with unreliable findings or normal CT-scans.