scholarly journals Evaluation and Management of Acute Myelopathy

2021 ◽  
Vol 41 (05) ◽  
pp. 511-529
Author(s):  
Elia Sechi ◽  
Eoin P. Flanagan
Keyword(s):  
Spinal Cord ◽  
Correct Diagnosis ◽  
Resonance Imaging ◽  
Spinal Cord Damage ◽  
Urgent Surgery ◽  
Acute Myelopathy ◽  
Imaging Characteristics ◽  
Appropriate Treatment ◽  
Spinal Cord Disorders ◽  
Unnecessary Procedures

AbstractAcute myelopathies are spinal cord disorders characterized by a rapidly progressive course reaching nadir within hours to a few weeks that may result in severe disability. The multitude of underlying etiologies, complexities in confirming the diagnosis, and often unforgiving nature of spinal cord damage have always represented a challenge. Moreover, certain slowly progressive myelopathies may present acutely or show abrupt worsening in specific settings and thus further complicate the diagnostic workup. Awareness of the clinical and magnetic resonance imaging characteristics of different myelopathies and the specific settings where they occur is fundamental for a correct diagnosis. Neuroimaging helps distinguish compressive etiologies that may require urgent surgery from intrinsic etiologies that generally require medical treatment. Differentiation between various myelopathies is essential to establish timely and appropriate treatment and avoid harm from unnecessary procedures. This article reviews the contemporary spectrum of acute myelopathy etiologies and provides guidance for diagnosis and management.

Magnetic Resonance Imaging of Spinal Cord Disease of Childhood

PEDIATRICS ◽  
1986 ◽  
Vol 78 (2) ◽  
pp. 251-256
Author(s):  
Roger J. Packer ◽  
Robert A. Zimmerman ◽  
Leslie N. Sutton ◽  
Larissa T. Bilaniuk ◽  
Derek A. Bruce ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Vertebral Body ◽  
Congenital Anomalies ◽  
Correct Diagnosis ◽  
Surface Coil ◽  
Resonance Imaging ◽  
Spinal Cord Disease ◽  
Magnetic Resonance Imaging Mri

Correct diagnosis of spinal cord disease in childhood is often delayed, resulting in irreversible neurologic deficits. A major reason for this delay is the lack of a reliable means to noninvasively visualize the spinal cord. Magnetic resonance imaging (MRI) should be useful in the evaluation of diseases of the spinal cord. A 1.5 Tesla MRI unit with a surface coil was used to study 41 children, including eight patients with intrinsic spinal cord lesions, eight patients with masses compressing the cord, 12 patients with congenital anomalies of the cord or surrounding bony structures, three patients with syrinxes, and three patients with vertebral body abnormalities. Intrinsic lesions of the cord were well seen in all cases as intrinsic irregularly widened, abnormally intense cord regions. MRI was helpful in following the course of disease in patients with primary spinal cord tumors. Areas of tumor were separable from syrinx cavities. Extrinsic lesions compressing the cord and vertebral body disease were also well visualized. Congenital anomalies of the spinal cord, including tethering and lipomatous tissue, were better seen on MRI than by any other radiographic technique. MRI is an excellent noninvasive "screening" technique for children with suspected spinal cord disease and may be the only study needed in many patients with congenital spinal cord anomalies. It is also an excellent means to diagnose and follow patients with other forms of intra- and extraspinal pathology.

scholarly journals Establishing the inter-rater reliability of spinal cord damage manual measurement using magnetic resonance imaging

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
David P. Cummins ◽  
Jordan R. Connor ◽  
Katherine A. Heller ◽  
Joshua S. Hubert ◽  
Megan J. Kates ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Rater Reliability ◽  
Manual Measurement ◽  
Spinal Cord Damage

Tumefactive demyelinating lesions: conventional and advanced magnetic resonance imaging

2005 ◽  
Vol 11 (2) ◽  
pp. 135-139 ◽  
Author(s):  
Christian Enzinger ◽  
Siegrid Strasser-Fuchs ◽  
Stefan Ropele ◽  
Peter Kapeller ◽  
Reinhold Kleinert ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Magnetization Transfer ◽  
Correct Diagnosis ◽  
Brain Biopsy ◽  
High Dose ◽  
Resonance Imaging ◽  
Neuronal Marker ◽  
Imaging Characteristics ◽  
Demyelinating Lesions

In rare instances, demyelinating disorders present with radiological features that mimic a brain tumour. This often leads to biopsy, which-apart from carrying significant morbidity-frequently turns out as nondiagnostic or dispensable. We therefore set out to assess the contribution of repeated conventional magnetic resonance imaging (MRI), 1H-MR spectroscopy and magnetization transfer imaging in establishing a correct diagnosis of tumefactive demyelinating lesions (TDLs). We studied two females and one male, who presented with TDLs that led to brain biopsy in two cases, for up to three years. TDLs were characterized by the following features: (a) delayed or absent response to high-dose steroids together with progressive lesion growth over several weeks; (b) late or sparse enhancement, ill-defined borders, signal inhomogeneity and considerable concomitant oedema; and (c) normalization of initial increases in lipid and lactate peaks within three to four weeks, followed by persistent, marked reductions of the neuronal marker NAA and MTR values around or below 30%. These imaging characteristics reflected the histological correlate of marked demyelination in the absence of significant inflammation. MRI techniques thus appear to have the potential to establish a correct diagnosis of this subtype of TDLs. Awareness of these possibilities might obviate the need for biopsy at least in some cases in future.

scholarly journals Surgical Approaches to Intramedullary Cavernous Malformations of the Spinal Cord

2011 ◽  
Vol 68 (suppl_2) ◽  
pp. ons317-ons324 ◽  
Author(s):  
Alim P. Mitha ◽  
Jay D. Turner ◽  
Robert F. Spetzler
Keyword(s):  
Spinal Cord ◽  
Significant Risk ◽  
Definitive Treatment ◽  
Surgical Approaches ◽  
Clinical Aspects ◽  
Anatomical Location ◽  
Resonance Imaging ◽  
Intramedullary Spinal Cord ◽  
Cavernous Malformations ◽  
Imaging Characteristics

Abstract Background: Resection of intramedullary spinal cord cavernous malformations is associated with a significant risk of morbidity because of the high density of eloquent tissue within the spinal cord. Despite this risk, surgery remains the definitive treatment for symptomatic lesions. Objective: To review the clinical aspects of surgical approaches for spinal cord cavernous malformations. Methods: This article reviews the epidemiology, pathophysiology, clinical and imaging characteristics, and indications for surgical resection. Surgical issues and operative approaches by anatomical location are also detailed, drawing from evidence in the literature and from the senior author’s clinical experience. Results: The 3 primary approaches to spinal cord cavernous malformations—the posterior, posterolateral, and lateral approaches—are described and illustrated. Magnetic resonance imaging and intraoperative photographs of representative cases are included. Conclusion: Intramedullary spinal cord cavernous malformations are complex entities, and it is our hope that this article will improve readers’ understanding of their clinical characteristics, their indications for treatment, and the surgical pathways through which these lesions can be safely resected.

Central neurocytomas of the cervical spinal cord

1994 ◽  
Vol 81 (2) ◽  
pp. 288-293 ◽  
Author(s):  
Stephen B. Tatter ◽  
Lawrence F. Borges ◽  
David N. Louis
Keyword(s):  
Spinal Cord ◽  
Cervical Spinal Cord ◽  
Correct Diagnosis ◽  
Central Neurocytoma ◽  
Neurological Deficits ◽  
Resonance Imaging ◽  
Spinal Cord Tumors ◽  
Intramedullary Spinal Cord ◽  
Content Type ◽  
Fine Print

✓ Central neurocytoma is a neuronal neoplasm that occurs supratentorially in the lateral or third ventricles. The authors report the clinical, neuroradiological, and neuropathological features of two neurocytomas arising in the spinal cord of two men, aged 65 and 49 years. The patients presented with progressive neurological deficits referable to the cervical spinal cord. Magnetic resonance imaging revealed isodense intramedullary spinal cord tumors at the C3–4 level. Both tumors were initially misdiagnosed as gliomas. In Case 1 the correct diagnosis was made after electron microscopy revealed neuronal features. Immunostaining in Case 2 revealed that tumor cells were positive for synaptophysin and negative for glial fibrillary acidic protein, strongly indicating a neuronal tumor. It is suggested that this spinal cord neoplasm be included under the designation “central neurocytoma.”

scholarly journals Magnetic resonance imaging of the spine and spinal cord disorders.

1987 ◽  
Vol 35 (4) ◽  
pp. 1391-1395
Author(s):  
Eisaku Nakasone ◽  
Hiroaki Takara ◽  
Tomohiro Nakasone ◽  
Shinya Kuniyoshi ◽  
Yukio Kinjo ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Spinal Cord Disorders

Bioelectrodes for Neural Prostheses

1985 ◽  
Vol 55 ◽  
Author(s):  
F. Terry Hambrecht
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Urinary Bladder ◽  
Cochlear Implants ◽  
Neural Prostheses ◽  
The Future ◽  
Spinal Cord Disorders ◽  
The Central Nervous System ◽  
Auditory Prostheses

ABSTRACTNeural prostheses which are commercially available include cochlear implants for treating certain forms of deafness and urinary bladder evacuation prostheses for individuals with spinal cord disorders. In the future we can anticipate improvements in bioelectrodes and biomaterials which should permit more sophisticated devices such as visual prostheses for the blind and auditory prostheses for the deaf based on microstimulation of the central nervous system.

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