scholarly journals Acute Cervical Disk Herniation Resulting in Sudden and Severe Neurologic Deterioration: A Case Series

2016 ◽  
Vol 02 (03) ◽  
pp. e96-e101
Author(s):  
Ran Harel ◽  
Nachshon Knoller
Keyword(s):  
Case Reports ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Case Series ◽  
Medical Emergency ◽  
Rare Entity ◽  
Disk Herniation ◽  
Neurologic Deterioration ◽  
Cervical Disk Herniation ◽  
Cervical Disk

Objective Nontraumatic acute cervical disk herniation resulting in acute severe neurologic deficit is a rare entity described in a limited number of case reports. We describe the management and outcome in patients presenting with severe neurologic deterioration caused by acutely herniated cervical disks. Methods Four patients (mean age 39.5 years) presented to our tertiary care academic medical center from September 2012 to September 2013 with severe progressive neurologic deficits due to cervical disk herniation and were included in the series. Patients' surgical, medical, and imaging records were retrospectively reviewed under an Institutional Review Board waiver of informed consent. Results Patients in the series presented with acute neurologic deterioration, including paraparesis, Brown-Séquard syndrome, or quadriparesis deteriorating to quadriplegia. Emergent magnetic resonance imaging (MRI) scans and emergent decompression and fusion for acute soft disk herniation were performed in all cases. All patients recovered to excellent functional status with Frankel score improvement from B (one patient)/C (three patients) to E (three patients)/D (one patient). Conclusions Acute cervical disk herniation with acute neurologic deterioration is a medical emergency necessitating emergent MRI and surgical decompression. Clinical presentation varies. In patients with rapid-onset neurologic deterioration, a high level of suspicion for this rare entity is indicated.

scholarly journals Malignant priapism due to penile metastases: Case series and literature review

2016 ◽  
Vol 88 (2) ◽  
pp. 150 ◽  
Author(s):  
Francesco De Luca ◽  
Evangelos Zacharakis ◽  
Majed Shabbir ◽  
Angela Maurizi ◽  
Emy Manzi ◽  
...  
Keyword(s):  
Case Reports ◽  
Case Series ◽  
Rare Condition ◽  
Medical Emergency ◽  
Palliative Intent ◽  
Patient Reported ◽  
Malignant Priapism ◽  
Carcinoma Of The Bladder ◽  
Organ Site ◽  
Penile Metastases

Malignant priapism secondary to penile metastases is a rare condition. This term was originally used by Peacock in 1938 to describe a condition of painful induration and erection of the penis due to metastatic infiltration by a neoplasm. In the current literature there are 512 case reports. The primary tumor sites are bladder, prostate and rectum. The treatment has only palliative intent and consists of local tumor excision, penectomy, radiotherapy and chemotherapy. We present one case of malignant priapism originated from prostate cancer, and two from urothelial carcinoma of the bladder. Different approaches in diagnosis and therapy were performed. The entire three patient reported a relief of the pain following the treatment, with an improvement of their quality of life, even though it was only temporary as a palliative. Malignant priapism is a rare medical emergency. Penile/pelvis magnetic resonance imaging (MRI) scan and corporal biopsies are considered an effective method of diagnosis of the primary organ site.

High resolution CT of cervical disk herniation: the value of intravenous contrast enhancement

1991 ◽  
Vol 27 (2) ◽  
pp. 213
Author(s):  
Heoung Keun Kang ◽  
Yong Yeun Jeong ◽  
Won Jee Lee ◽  
Jae Kyu Kim ◽  
Jin Gyoon Park ◽  
...  
Keyword(s):  
High Resolution ◽  
Contrast Enhancement ◽  
Disk Herniation ◽  
Intravenous Contrast ◽  
High Resolution Ct ◽  
Cervical Disk Herniation ◽  
Cervical Disk

scholarly journals Fixation of Traumatic Chondral-Only Fragments of the Knee in Pediatric and Adolescent Athletes: A Retrospective Multicenter Report

2018 ◽  
Vol 6 (2) ◽  
pp. 232596711775314 ◽  
Author(s):  
Peter D. Fabricant ◽  
Yi-Meng Yen ◽  
Dennis E. Kramer ◽  
Mininder S. Kocher ◽  
Lyle J. Micheli ◽  
...  
Keyword(s):  
Case Reports ◽  
Femoral Condyle ◽  
Tertiary Care ◽  
Case Series ◽  
Return To Sports ◽  
Adolescent Athletes ◽  
Patient Registries ◽  
Level Of Evidence ◽  
Bioabsorbable Implants ◽  
Clinical And Radiological Results

Background: While traditional biological principles have suggested that fragments consisting of cartilage alone cannot be reaffixed to bone with expectable long-term healing, case reports of successful healing after fixation in younger patients indicate that this concept remains incompletely explored. Purpose: To evaluate the presenting features, techniques, healing rates, and clinical and radiological results in a cohort of pediatric and adolescent athletes who underwent fixation of traumatic chondral-only fragments in the knee. Study Design: Case series; Level of evidence, 4. Methods: Patient registries at 2 tertiary care children’s hospitals were reviewed to identify patients ≤18 years old who underwent fixation of a “chondral-only” fragment in the knee, defined as the inability to visualize the fragment on injury radiographs or discern bone on the articular portion of a fragment intraoperatively. The mechanism of injury, fragment features, fixation technique, and postoperative clinical course, including timing of sports clearance, healing on postoperative magnetic resonance imaging (MRI), and any complications or reoperations, were assessed. Results: Fifteen patients with a median age at surgery of 12.7 years (interquartile range [IQR], 11.7-14.2 years) and median follow-up of 12.0 months (IQR, 6.0-19.2 months) were analyzed. All patients sustained an acute knee injury before surgery. The injured sites, as assessed on MRI, were the patella (n = 6), trochlea (n = 5), and lateral femoral condyle (n = 4). The median fragment surface area was 492.0 mm2 (IQR, 400.0-787.5 mm2). Fixation with bioabsorbable implants was performed in all patients at a median of 1.6 weeks (IQR, 1.0-2.6 weeks) after the injury. One patient (7%) sustained a fall 8 weeks postoperatively, requiring secondary surgery for excision of a dislodged fragment, and 1 patient (7%) underwent unrelated patellar stabilization surgery 3.4 years postoperatively, at which time the fragment was found to be stable. MRI was performed in 9 of 14 patients with retained fragments (median, 12.0 months postoperatively), with 5 patients (56%) showing restoration of the cartilage contour and the resolution of subchondral edema; 2 patients showed thinning but intact cartilage, 1 had cartilage thickening, and 1 had subchondral edema, fissuring, and cystic changes. The median time to return to sports for all 15 patients was 26.0 weeks (IQR, 22.8-40.9 weeks), including 2 patients who required second surgery and returned to sports at 26.1 and 191.1 weeks. Conclusion: Fixation of traumatic chondral-only fragments using bioabsorbable implants may result in successful short-term healing in the majority of pediatric and adolescent athletes.

scholarly journals Percutaneous Nucleoplasty for the Treatment of a Contained Cervical Disk Herniation

2017 ◽  
Vol 30 (9) ◽  
pp. 389-391 ◽  
Author(s):  
Judith D. de Rooij ◽  
Pravesh S. Gadjradj ◽  
John S. Soria van Hoeve ◽  
Frank J. Huygen ◽  
Hans A. Aukes ◽  
...  
Keyword(s):  
Disk Herniation ◽  
Cervical Disk Herniation ◽  
Cervical Disk
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