scholarly journals Intramedullary Subependymoma of the Cervical Spinal Cord: A Case Report and Review of the Literature

2019 ◽  
Vol 08 (01) ◽  
pp. 064-068
Author(s):  
Eiralí Chapa ◽  
Juana González ◽  
Mauricio Morquecho ◽  
José Martínez ◽  
Mariana Flores ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Epithelial Membrane Antigen ◽  
Cervical Spinal Cord ◽  
Resonance Imaging ◽  
Nuclear Pleomorphism ◽  
Thoracic Spinal Cord ◽  
Intramedullary Lesion ◽  
Thoracic Spinal ◽  
The Central Nervous System ◽  
Diffuse Positivity

AbstractSubependymoma is a rare tumor of the central nervous system, representing 0.2 to 0.7% of all intracranial tumors. They are usually found in the fourth ventricle or in the walls of the lateral ventricles, often remaining asymptomatic. Subependymomas occur rarely in the cervical or thoracic spinal cord. Since its first description in the spinal cord by Boykin et al in 1954, only 47 cases have been reported. A 49-year-old man presented with a 4-year-long-lasting neck pain, which radiated to the upper right extremity for 4 years. It was insidious at onset and revealed gradual progression, difficulty in performing fine hand movements, and hyperalgesia. Magnetic resonance imaging revealed irregular hyperintensity of T2 and dilatation of the spinal cord from C4 to T1 with associated edema and an intramedullary lesion with central location. During the surgical event, a transoperative biopsy was performed that revealed loose fibrillary networks and groups of nuclei showing mild pleomorphism and microcystic formations. Histologically, we observed groups of cells with mild nuclear pleomorphism embedded in a dense, thin, glial fibrillar fundus, and microcystic formations. Immunohistochemical staining revealed diffuse positivity for the glial fibrillary acidic protein, and negative for the epithelial membrane antigen. Subependymoma accounts for 8.3% of all ependymal tumors. There are few descriptions of the cytologic features of the subependymoma because this neoplasm is rare and most commonly found incidentally in autopsies.

An extramedullary plasmacytoma originating from the thoracic spinal cord: magnetic resonance imaging findings

2007 ◽  
Vol 6 (1) ◽  
pp. 57-59 ◽  
Author(s):  
Bo Gao ◽  
Xuejian Wang
Keyword(s):  
Spinal Cord ◽  
Magnetic Resonance ◽  
Bone Marrow Involvement ◽  
Magnetic Resonance Images ◽  
Extramedullary Plasmacytoma ◽  
Rare Tumor ◽  
Histological Findings ◽  
Resonance Imaging ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal

✓Extramedullary plasmacytoma (EMP) is a rare tumor. The authors report a case of an EMP originating in the thoracic spinal cord. To their knowledge this is the first report in which an EMP originating in this location is described. Isointense and hyperintense signals were seen on T1-weighted and T2-weighted magnetic resonance images, respectively, with marked irregular contrast enhancement and extensive edema. No evidence of bone marrow involvement or multiple myeloma was noted. The histological findings were compatible with an EMP.

scholarly journals Combined medical and surgical treatment after acute spinal cord injury: results of a prospective pilot study to assess the merits of aggressive medical resuscitation and blood pressure management

1999 ◽  
Vol 6 (1) ◽  
pp. E6 ◽  
Author(s):  
Fernando L. Vale ◽  
Jennifer Burns ◽  
Amie B. Jackson ◽  
Mark N. Hadley
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Cervical Spinal Cord ◽  
Bladder Function ◽  
Thoracic Spinal Cord ◽  
Arterial Blood ◽  
Thoracic Spinal ◽  
Cord Injury

The optimal management of acute spinal cord injuries remains to be defined. The authors prospectively applied resuscitation principles of volume expansion and blood pressure maintenance to 77 patients who presented with acute neurological deficits as a result of spinal cord injuries occurring from C-1 through T-12 in an effort to maintain spinal cord blood flow and prevent secondary injury. According to the Intensive Care Unit protocol, all patients were managed by Swan-Ganz and arterial blood pressure catheters and were treated with immobilization and fracture reduction as indicated. Intravenous fluids, colloid, and vasopressors were administered as necessary to maintain mean arterial blood pressure above 85 mm Hg. Surgery was performed for decompression and stabilization, and fusion in selected cases. Sixty-four patients have been followed at least 12 months postinjury by means of detailed neurological assessments and functional ability evaluations. Sixty percent of patients with complete cervical spinal cord injuries improved at least one Frankel or American Spinal Injury Association (ASIA) grade at the last follow-up review. Thirty percent regained the ability to walk and 20% had return of bladder function 1 year postinjury. Thirty-three percent of the patients with complete thoracic spinal cord injuries improved at least one Frankel or ASIA grade. Approximately 10% of the patients regained the ability to walk and had return of bladder function. As of the 12-month follow-up review, 92% of patients demonstrated clinical improvement after sustaining incomplete cervical spinal cord injuries compared to their initial neurological status. Ninety-two percent regained the ability to walk and 88% regained bladder function. Eighty-eight percent of patients with incomplete thoracic spinal cord injuries demonstrated significant improvements in neurological function 1 year postinjury. Eighty-eight percent were able to walk and 63% had return of bladder function. The authors conclude that the enhanced neurological outcome that was observed in patients after spinal cord injury in this study was in addition to, and/or distinct from, any potential benefit provided by surgery. Early and aggressive medical management (volume resuscitation and blood pressure augmentation) of patients with acute spinal cord injuries optimizes the potential for neurological recovery after sustaining trauma.

Multiple Aneurysms of Thoracic Spinal Cord Arteries Presenting With Spinal Infarction and Subarachnoid Hemorrhage

Neurosurgery ◽  
2012 ◽  
Vol 71 (5) ◽  
pp. E1053-E1058 ◽  
Author(s):  
Kenichi Sato ◽  
Luca Roccatagliata ◽  
Sebastien Depuydt ◽  
Georges Rodesch
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Back Pain ◽  
Subarachnoid Hemorrhage ◽  
Magnetic Resonance ◽  
Arterial Aneurysm ◽  
Spinal Angiography ◽  
Resonance Imaging ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal

Abstract BACKGROUND AND IMPORTANCE: Arterial aneurysms of the spinal cord are rare. Their pathogenesis is variable, and the therapeutic strategies remain controversial, because their natural history is unclear. We report a case of multiple dissecting aneurysms of radiculomedullary and radiculopial arteries presenting with spinal infarction and subarachnoid hemorrhage, which spontaneously resolved. CLINICAL PRESENTATION: A 67-year-old woman was hospitalized owing to sudden onset of severe back pain with discomfort in the lower extremities. Two days later, she again experienced sudden back pain accompanied by paraparesis and sphincter disturbance. Magnetic resonance imaging of the thoracic spinal cord showed 2 intradural masses of heterogeneous intensity at the levels of T-8 and T-10, spinal infarction, and subarachnoid hemorrhage. Spinal angiography revealed a “pearls and strings” aspect of a radiculomedullary artery arising from the left T-11 and a fusiform aneurysm of a radiculopial artery arising from the left T-8. Infectious and immunological evaluations failed to show any anomaly. Spontaneous dissections were suspected. Conservative treatment was proposed, and the patient's clinical course remained uneventful. Follow-up magnetic resonance imaging and spinal angiography performed 2 months after onset showed disappearance of both arterial lesions. CONCLUSION: Arterial dissections of spinal radicular arteries can resolve spontaneously and be managed conservatively. We propose a classification of the pathogenesis of spinal arterial aneurysm to clarify appropriate treatment strategies by a literature review.

scholarly journals Syringomyelia in demyelinating disease of the central nervous system: Report of two cases

2011 ◽  
Vol 139 (9-10) ◽  
pp. 657-660 ◽  
Author(s):  
Dejan Savic ◽  
Slobodan Vojinovic ◽  
Mirjana Spasic ◽  
Zoran Peric ◽  
Stevo Lukic
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Magnetic Resonance ◽  
Demyelinating Disease ◽  
Clinical Signs ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
The Central Nervous System

Introduction. Syringomyelia is a cavitary extension inside the spinal cord which can be either symptomatic or congenitally-idiopathic. Syringomyelia during the course of the disease in patients presenting with clinically definite multiple sclerosis was described earlier. Syringomyelia in patients presenting with a clinically isolated syndrome suggestive of multiple sclerosis is unusual. Case Outline. We present two patients presenting with demy-elinating disease of the central nervous system with syringomyelia in the cervical and thoracic spinal cord. We did not find classical clinical signs of syringomyelia in our patients, but we disclosed syringomyelia incidentally during magnetic resonance exploration. Magnetic resonance exploration using the gadolinium contrast revealed the signs of active demyelinating lesions in the spinal cord in one patient but not in the other. Conclusion. Syringomyelia in demyelinating disease of the central nervous system opens the question whether it is a coincidental finding or a part of clinical features of the disease. Differentiation of the significance of syringomyelia finding in these patients plays a role in the choice of treatment concept in such patients.

Correlation of Postmortem 9.4 Tesla Magnetic Resonance Imaging and Immunohistopathology of the Human Thoracic Spinal Cord 7 Months after Traumatic Cervical Spine Injury

Neurosurgery ◽  
2006 ◽  
Vol 59 (3) ◽  
pp. 671-678 ◽  
Author(s):  
Felix Scholtes ◽  
Peter Adriaensens ◽  
Liesbet Storme ◽  
Armin Buss ◽  
Byron A. Kakulas ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Spinal Cord Injuries ◽  
Spine Injury ◽  
Resonance Imaging ◽  
Thoracic Spinal Cord ◽  
Human Spinal Cord ◽  
Thoracic Spinal ◽  
Mri Scans

Abstract OBJECTIVE: To correlate high-resolution magnetic resonance imaging (MRI) with immunohistopathology in the injured human spinal cord. METHODS: Postmortem MRI scans at a field strength of 9.4 T, as well as standard histology and immunohistochemistry, were performed on an excised specimen of human high thoracic spinal cord, obtained 7 months after the initial trauma, several segments below a severe spinal cord lesion (C5). RESULTS: A precise correlation is described between MRI and immunohistochemistry of the long white matter tracts undergoing Wallerian degeneration and of an extension of the cervical lesion into the high thoracic cord. CONCLUSION: MRI, the only imaging technique that currently provides useful information on the spinal cord parenchyma after trauma, is rapidly evolving. High-field scanners of up to 9.4 T are being clinically tested. The present postmortem investigation of an isolated spinal cord specimen demonstrates the precise correlation that can be achieved between imaging and pathology. In future investigations, this type of technique can lead to a more precise description of spinal cord injuries and their consequences in remote tissue. Translation into the clinical setting will improve diagnosis and follow-up of spinal cord injured patients.

scholarly journals Sulcal artery syndrome presenting as an incomplete Brown–Sequard syndrome – Report of an unusual case and review of the literature

2020 ◽  
Vol 29 (1) ◽  
pp. 59-63
Author(s):  
May Myat Win ◽  
Monica Saini ◽  
Shrikant Digambarrao Pande ◽  
Kappaganthu Venkatesh Prasanna
Keyword(s):  
Spinal Cord ◽  
Cervical Spinal Cord ◽  
Vertebral Artery Dissection ◽  
Artery Occlusion ◽  
Sudden Onset ◽  
Artery Dissection ◽  
Spinal Cord Infarction ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Brown Sequard Syndrome

Sulcal arteries perfuse the anterior two-thirds of the spinal cord, and spinal cord infarction as a result of sulcal artery occlusion is rare. Most reported cases are associated with vertebral artery dissection, and commonly involve the cervical spinal cord. A 74-year-old man presented with sudden onset weakness and numbness after a brief bout of abdominal pain. Further investigations concluded that this was sulcal artery syndrome. We report a case of sulcal artery syndrome affecting the thoracic spinal cord presenting as Brown–Sequard syndrome. Sulcal artery syndrome usually has good prognoses, unlike anterior spinal artery infarction.

scholarly journals Magnetic resonance imaging in HTLV-I associated myelopathy

1993 ◽  
Vol 51 (3) ◽  
pp. 329-332 ◽  
Author(s):  
Aílton Melo ◽  
Luciana Moura ◽  
Solana Rios ◽  
Marcos Machado ◽  
Gersonita Costa
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Central Nervous System ◽  
Magnetic Resonance ◽  
Brain Lesions ◽  
Resonance Imaging ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Brain And Spinal Cord ◽  
The Brain

Magnetic resonance imaging of the brain and spinal cord were carried out for seventeen consecutive patients with HTLV-1 associated myelopathy (HAM). Eight patients had brain abnormalities and four had decreased thoracic spinal cord diameter. Brain lesions were mostly located in subcortical and periventricular areas. Our data suggest that diffuse central nervous system lesions are present in patients with HAM.

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