scholarly journals Intramedullary Dermoid Cyst of the Cervical Spinal Cord – C5–C7 Level

2018 ◽  
Vol 37 (02) ◽  
pp. 140-144
Author(s):  
Palanisamy Seerangan ◽  
Aravinth Ashok ◽  
Jolarpettai Mahendran
Keyword(s):  
Spinal Cord ◽  
Dermoid Cyst ◽  
Histopathological Examination ◽  
Cervical Spinal Cord ◽  
Spinal Dysraphism ◽  
Operative Procedure ◽  
Hair Follicles ◽  
Cervical Region ◽  
Cervical Cord ◽  
Dermal Sinus

Introduction Inclusion cysts of the spinal cord are rarely intramedullary. Such cysts are commonly located in the lumbar and thoracic regions and are usually associated with congenital spinal dysraphism and dermal sinus. Intramedullary dermoid cysts in the cervical region without spinal dysraphism are extremely rare. To our knowledge, only seven such cases are reported in the literature to date. Materials and Methods An 18-year-old female patient presented with weakness in all four limbs, more distal than proximal muscle weakness, that had been progressing for 3 years. The magnetic resonance imaging (MRI) showed an intramedullary lesion from C5– C7 with peripheral ring enhancement. “Whorls” were observed within the lesion on T2 weighted image, with associated excavation of vertebral bodies C5– C7. Operative procedure and findings: partial laminectomy of C5– D1was performed. The dura was opened. A small myelotomy was made in the root entry zone. About 1.5 ml of yellowish colored fluid was drained. White shiny debris with hair, whitish pultaceous content and teeth were removed. Complete excision of cyst and its wall was performed. Results The histopathological examination revealed that the cyst wall was lined by stratified squamous epithelium with underlying dermis showing hair follicles, sebaceous glands, adipose tissue and cyst filled with keratin debris suggestive of dermoid cyst. Conclusion The intramedullary location of the dermoid cyst in the cervical cord and the absence of any congenital spinal dysraphism make this case a very unique and rare entity and warrants its inclusion in the reported cases of rare intramedullary space occupying lesions.

Intramedullary mature teratoma of the cervical spinal cord at C1–2 associated with occult spinal dysraphism in an adult

2007 ◽  
Vol 6 (6) ◽  
pp. 579-584 ◽  
Author(s):  
Raafat Makary ◽  
David Wolfson ◽  
Victor Dasilva ◽  
Amir Mohammadi ◽  
Sania Shuja
Keyword(s):  
Spinal Cord ◽  
Cervical Spinal Cord ◽  
Spinal Dysraphism ◽  
Treatment Options ◽  
Mature Teratoma ◽  
Postoperative Outcome ◽  
Complete Removal ◽  
Cervical Region ◽  
Upper Cervical ◽  
Spinal Malformations

✓There is a well-recognized association between dysontogenetic tumors of the spinal cord (including teratomas and enterogenous cysts) and dysraphic congenital spinal malformations. The authors present a case of an adult with an intramedullary mature teratoma (IMMT) at the level of C1–2 of the cord associated with dysraphic congenital spinal malformations. Intramedullary mature teratomas of the cervical region of the spinal cord are very rare in adults; only four such lesions have been reported, two of which involved upper cervical segments. Despite the potentially critical location of the tumor, monitored microsurgery resulted in complete removal of the tumor with an intact surrounding capsule, associated fibrous tract, and ellipse of skin with a central dimple. There was an excellent postoperative neurological outcome. The clinical features, imaging studies, treatment options, postoperative outcome, and plausible pathological correlations of IMMTs are discussed.

Delayed postoperative tethering of the cervical spinal cord

1994 ◽  
Vol 81 (2) ◽  
pp. 196-201 ◽  
Author(s):  
Kris A. Smith ◽  
Harold L. Rekate
Keyword(s):  
Spinal Cord ◽  
Cervical Spinal Cord ◽  
Severe Headache ◽  
Neurological Deficits ◽  
Cervical Region ◽  
Cervical Cord ◽  
Resonance Imaging ◽  
Content Type ◽  
Surgical Exploration ◽  
Spinal Cord Tethering

✓ Tethering of the spinal cord in the lumbar and sacral regions of children with congenital anomalies is a well-recognized problem; however, tethering in the cervical region has rarely been reported. A search of the literature revealed no reports of symptomatic postoperative cervical spinal cord tethering. The authors present five cases of delayed postoperative cervical spinal cord tethering and discuss the benefit of detethering in these patients. All five patients were young (16 to 42 years of age) at presentation. All had done well after an initial surgical procedure but returned between 1 and 31 years postoperatively with symptoms including severe headache, upper-extremity pain, and progressive neurological deficits. In each case, magnetic resonance imaging indicated dorsal tethering of the cord in the cervical region. Surgical exploration with microscopic sharp detethering of the cervical cord was performed on each patient with favorable results. To avoid retethering, wide Tutoplast duraplasty is recommended.

scholarly journals Schistosomal Cervical Myelopathy

2018 ◽  
Vol 37 (02) ◽  
pp. 151-153
Author(s):  
Ronald Farias ◽  
Kléver Oliveira ◽  
George Mendes ◽  
Ussânio Meira
Keyword(s):  
Spinal Cord ◽  
Inflammatory Diseases ◽  
Histopathological Examination ◽  
Cervical Spinal Cord ◽  
Cervical Cord ◽  
Illustrative Case ◽  
Mild Reduction ◽  
History Of ◽  
Magnetic Resonance Imaging Mri

AbstractSchistosomiasis is an infectious disease caused by trematode platyhelminths of the genus Schistosoma. The involvement of the cervical spinal cord is rare, with few cases reported in the literature. The management of such patients is particularly challenging, since clinical and radiological findings may be confounded with other inflammatory diseases and/ or spinal cord tumors. We describe a 20-year old male with a history of swimming outdoors. He first presented pain in the back of the neck extending to shoulders and upper limbs paresis associated with four limbs hyperreflexia. The magnetic resonance imaging (MRI) showed a hypointense T1-weighted lesion in the cervical spinal cord, which was hyperintense on T2 images. The serologic testing was negative for schistosomiasis. A cervical cord biopsy at the C5-C6 level showed Schistosoma eggs in the histopathological examination. The treatment was performed using a single dose of praziquantel 50 mg/kg, with prednisone 40 mg/day for 3 weeks. On the follow-up, 1 year later, the patient presented mild reduction of the vibratory sensitivity in the distal third of both legs. Our illustrative case strengthens that, in endemic regions, Schistosoma mansoni infestation should be included in the differential diagnosis of intramedullary expansive lesions.

scholarly journals Spinal neurenteric cysts and their relation to more common aspects of occult spinal dysraphism

2001 ◽  
Vol 10 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Michael J. Rauzzino ◽  
R. Shane Tubbs ◽  
Eben Alexander ◽  
Paul A. Grabb ◽  
W. Jerry Oakes
Keyword(s):  
Spinal Cord ◽  
Spinal Dysraphism ◽  
Postoperative Outcome ◽  
Cervical Region ◽  
Split Cord Malformation ◽  
Neurenteric Cyst ◽  
Dermal Sinus ◽  
Occult Spinal Dysraphism ◽  
Complete Excision ◽  
Thoracolumbar Region

Object Neurenteric cysts are infrequently reported congenital abnormalities believed to be derived from an abnormal connection between the primitive endoderm and ectoderm. The authors report a series of 13 patients treated over a 50-year period. Methods Of the 13 patients, seven were female and six were male. Their ages at presentation ranged widely from 5 weeks to 52 years of age. Children presented more commonly with cutaneous stigmata of occult spinal dysraphism (OSD) whereas adults presented primarily with pain. Neurological deficit as a presenting symptom was less common in our series, a finding that reflects the slow growth of these lesions. In all but one patient some form of vertebral anomaly was associated with the cystic lesions, including two patients with Klippel–Feil abnormalities. There was a high incidence of associated forms of OSD including split cord malformation, lipoma, dermal sinus tract, and tethered spinal cord. In previous reports the authors have suggested that neurenteric cysts are more common in the cervical region and in a position ventral to the cord. In the present series these cysts most commonly occurred as intradural, extramedullary masses in the thoracolumbar region, situated dorsal to the spinal cord. The median follow-up period was 7.5 years, and postoperative outcome reflected a patient's preoperative neurological status; in no patient was outcome worsened due to surgery. Conclusions Complete excision of the neurenteric cyst remains the treatment of choice, as subtotal excision is associated with recurrence.

Congenital Dermal Sinus Elements in Each Tethering Stalk of Coexisting Thoracic Limited Dorsal Myeloschisis and Retained Medullary Cord

2020 ◽  
pp. 1-8
Author(s):  
Takato Morioka ◽  
Nobuya Murakami ◽  
Masako Ichiyama ◽  
Takeshi Kusuda ◽  
Satoshi O. Suzuki
Keyword(s):  
Present Article ◽  
Dermoid Cyst ◽  
Spinal Dysraphism ◽  
Conus Medullaris ◽  
Dermal Sinus ◽  
Case Presentation ◽  
Upper Tract ◽  
Secondary Neurulation ◽  
Extradural Space ◽  
Congenital Dermal Sinus

<b><i>Introduction:</i></b> The embryogenesis of limited dorsal myeloschisis (LDM) likely involves impaired disjunction between the cutaneous and neural ectoderms during primary neurulation. Because LDM and congenital dermal sinus (CDS) have a shared origin in this regard, CDS elements can be found in the LDM stalk. Retained medullary cord (RMC) is a closed spinal dysraphism involving a robust, elongated, cord-like structure extending from the conus medullaris to the dural cul-de-sac. Because the RMC is assumed to be caused by impaired secondary neurulation, concurrent RMC and CDS cannot be explained embryologically. In the present article, we report a case in which CDS elements were noted in each tethering stalk of a coexisting LDM and RMC. <b><i>Case Presentation:</i></b> A 2.5-month-old boy with left clubfoot and frequent urinary and fecal leakage had 2 tethering tracts. The upper tract, which ran from the thoracic tail-like cutaneous appendage, had CDS elements in the extradural stalk and a tiny dermoid cyst in the intradural stalk immediately after the dural entry. In the lower tract, which ran from the lumbosacral dimple, the CDS as an extradural stalk continued to the RMC at the dural cul-de-sac. Both stalks were entirely resected through skip laminotomy/laminectomy at 1 stage to untether the cord and resect the CDS elements. <b><i>Conclusion:</i></b> Surgeons should be aware that CDS elements, in addition to LDM, may coexist with RMC that extends out to the extradural space.

scholarly journals Arrow-Shot Injury to Pediatric Spinal Cord

2021 ◽  
Author(s):  
Vijayveer Singh ◽  
Sharad Thanvi
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Pediatric Population ◽  
Cervical Region ◽  
Cervical Cord ◽  
Cord Injury ◽  
Dural Suturing ◽  
Stab Injuries ◽  
Early Surgical Intervention

AbstractPenetrating spinal cord injuries (PSCI) in cervical region are extremely rare in pediatric population. Most injuries in pediatric population are accidental due to gunshot or a stab injury with a sharp or pointed object. Gun shots may result into a severe wound which is usually fatal and may result in death, quadriplegia, or serious long-term disability. Stab injuries are less severe and may result in neurological sequalae. In this paper, an unusual case of pediatric arrow shot partial cervical cord injury is reported which was managed by aggressive neurosurgical management. The arrow lodged in the cervical cord was very near to the vertebral artery leading to parapariesis which recovered well without any complications. Diagnostic imaging at admission included radiographs, computed tomography (CT), and CT angiography of the cervical region. The patient underwent early surgical intervention with removal of foreign body from the cord and subsequent dural suturing.

scholarly journals MR diffusion tensor imaging of the spinal cord: can it help in early detection of cervical spondylotic myelopathy and assessment of its severity?

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Talaat Ahmed Abd El Hameed Hassan ◽  
Ramy Edward Assad ◽  
Shaimaa Atef Belal
Keyword(s):  
Spinal Cord ◽  
Diffusion Tensor Imaging ◽  
Early Detection ◽  
Cervical Spondylotic Myelopathy ◽  
Diffusion Tensor ◽  
Cervical Spinal Cord ◽  
Cervical Cord ◽  
Mr Diffusion ◽  
Compressive Myelopathy ◽  
Mr Diffusion Tensor Imaging

Abstract Background The aim of this study is to evaluate the potential application of MR diffusion tensor imaging (with calculation of fractional anisotropy (FA) values) in assessment of the spondylotic cervical spinal canal compromise and comparison with the information issued from conventional MR sequences for early detection of cervical spondylotic myelopathy (CSM). Thirty patients (11 males and 19 females) were included in this study; age ranged from 22 to 70 years (mean age = 44). All patients had conventional and diffusion tensor imaging (DTI) examinations of the cervical spine for detection and assessment of degree of cervical cord myelopathy. FA values of the whole cord circumference and at 3, 6, 9, 12 o’clock positions of the normal cord (opposite to C2), opposite to the most affected disc, and below the level of the most affected disc were measured. Results High statistically significant P values were obtained when comparing the FA values of the normal cord with the cord opposite to the most affected disc, the normal cord with the cord below the affected disc and the cord at the level of the most affected disc with the cord below the level of the most affected disc. Conclusions DTI of the cervical spinal cord with FA measurement in patients with cervical spondylosis helps in early detection of cervical cord compressive myelopathy prior to appearance of changes in conventional MRI, which can improve the clinical outcome and help in treatment plans.

Deformation of the cervicomedullary junction and spinal cord in a surgically treated adult Chiari I hindbrain hernia associated with syringomyelia: a magnetic resonance microscopic and neuropathological study

1996 ◽  
Vol 85 (4) ◽  
pp. 701-708 ◽  
Author(s):  
Emile A. M. Beuls ◽  
Marie-Anne M. Vandersteen ◽  
Linda M. Vanormelingen ◽  
Peter J. Adriaensens ◽  
Gerard Freling ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Magnetic Resonance ◽  
Cervical Spinal Cord ◽  
Cervical Cord ◽  
Magnetic Resonance Microscopy ◽  
Type I ◽  
Additional Advantage ◽  
Content Type ◽  
Hindbrain Hernia ◽  
Fine Print

✓ The lower brainstem and cervical spinal cord from an ordinarily treated case of Chiari Type I hindbrain hernia associated with syringomyelia was examined using high-resolution magnetic resonance microscopy and standard neuropathological techniques. Magnetic resonance microscopy allows total screening and visualizes the disturbed internal and external microanatomy in the three orthogonal planes with the resolution of low-power optical microscopy. An additional advantage is the in situ visualization of the shunts. Afterwards the intact specimen is still available for microscopic examination. Part of the deformation of the medulla is caused by chronic tonsillar compression and molding inside the foramen magnum. Other anomalies, such as atrophy caused by demyelination, elongation, and unusual disturbances at the level of the trigeminal and solitary nuclear complexes contribute to the deformation. At the level of the syrinx-free upper part of the cervical cord, anomalies of the dorsal root and the dorsal horn are demonstrated.

scholarly journals A feather cyst causing vertebral bone lysis and spinal cord compression in a Lohmann Brown layer

2020 ◽  
Vol 91 ◽  
Author(s):  
Alaster Samkange ◽  
Borden Mushonga ◽  
Erick Kandiwa ◽  
Alec S. Bishi ◽  
Basiamisi V.E. Segwagwe ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cervical Spinal Cord ◽  
Cervical Vertebra ◽  
Cord Compression ◽  
Cervical Region ◽  
Subsequent Growth ◽  
Spinal Cord Segment ◽  
Normal Diameter ◽  
Bone Lysis ◽  
Exerted Pressure

A feather cyst in the cervical region which, through complications of inward growth, resulted in compression of the cervical spinal cord of a Lohmann Brown layer is described. It is postulated that expansion of the cyst exerted pressure on the adjacent cervical vertebra and through bone lysis created an opening through which the cyst protruded, thereby exerting pressure on the spinal cord. The affected spinal cord segment was reduced to a fifth of its normal diameter. The bird most likely died of starvation because of limb and neck paralysis and disorientation. Although the cause of the feather cyst was not conclusively identified, moulting and trauma could have triggered its formation and subsequent growth.

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