Low back pain due to spinal chronic subdural hematoma mimicking intradural tumor in the lumbar area: a case report and literature review

2003 ◽  
Vol 4 (8) ◽  
pp. 471-475 ◽  
Author(s):  
Serdar Kahraman ◽  
Sait Şirin ◽  
Hakan Kayali ◽  
Ilker Solmaz ◽  
Altay Bedük
2021 ◽  
Vol 26 (3) ◽  
pp. 599-602
Author(s):  
Nuri Serdar Bas ◽  
Azmi Tufan

Applications related to the use of leeches in medical therapies date back for centuries. We present here a case of self-administered leech application for chronic low back pain who subsequently developed complication of chronic subdural hematoma. We are not aware of similar report in the literature. This was a 34-year-old man who was admitted to our Emergency Department with headache, right side numbness, and intermittent difficulty in speaking. During the neurological examination, it was observed that the patient had difficulty in speaking and pronouncing words intermittently while taking his medical history. Motor examination was normal. The patient did not report any recent trauma. There was no known history of systemic or hereditary disease, drug or substance abuse. Cranial CT and MR imaging showed a left frontoparietal chronic subdural hematoma. Further history was obtained that leech was applied to the patient for low back pain in the last 45 days, two times at 15 days intervals. The patient’s drowsiness and speech difficulties improved after the surgical operation. On one month follow-up, neurological examinations were normal. Our patient shows that leech therapy can be complicated by subdural hematoma.


2016 ◽  
Vol 3;19 (3;3) ◽  
pp. 181-188 ◽  
Author(s):  
Mark C. Bicket

Background: Back mice, or episacroiliac lipoma, represent a potentially treatable cause of low back pain that may be under-recognized in clinical practice. Despite being well characterized based on clinical history and physical examination findings, implementation of appropriate treatment may be delayed or missed based on a lack of familiarity with the diagnosis. Objectives: In this case report and literature review, we describe a 47-year-old woman with history of persistent low back pain who presented with a pain exacerbation consistent with a back mouse. The history, epidemiology, clinical characteristics, differential diagnosis, potential mechanisms for pain, and treatment options for back mice were then reviewed. Study Design: Case report and literature review. Setting: Academic university-based pain management center. Results: Studies included one randomized clinical trial, 4 cross-sectional studies, 8 case reports or series, and 16 other publications prior to 1967. Limitations: A single case report. Conclusions: Firm, rubbery, mobile nodules that are located in characteristic regions of the sacroiliac, posterior superior iliac, and the lumbar paraspinal regions may represent fatty tissue that has herniated through fascial layers. When painful, these back mice may be confused with other causes of low back pain. In particular, the presence of point tenderness may mimic myofascial pain, and reports of radicular pain may imitate herniated nucleus pulposus. However, back mice may be distinguished from other entities based on findings from the history and physical examination such as absence of neurological deficit. Treatment consisting of injection of local anesthetic into the nodule with or without corticosteroid followed by repeated, direct needling has been reported to relieve pain in many case reports. The one clinical trial comparing injection of local anesthetic to normal saline, which did not include repeated needling, found only mild and transient benefit in the treatment group. Key words: Low back pain, back mice, back mouse, episacroiliac lipoma, lumbar subcutaneous nodules, multifidus triangle syndrome, subcutaneous fatty nodes, case report, review


Author(s):  
Dr. Rangarajan B. ◽  
Dr. Muralidhara .

Gridhrasi (Sciatica) is a disorder in which low back pain is found, that spreads through the hip, to the back of the thigh and down the inside of the leg. Mechanical low back pain (LBP) remains the second most common symptom related reason for seeing a physician. 85% of total population will experience an episode of mechanical LBP at some point during their lifetime. Fortunately, the LBP resolves for the vast majority within 2-4 weeks. There are many causes for low back pain, however true sciatica is a symptom of inflammation or compression of the sciatica nerve. The sciatica nerve carries impulses between nerve roots in the lower back and the muscles and nerve of the buttocks, thighs and lower legs. Compression of a nerve root often occurs as a result of damage to one of the discs between the vertebrae. In some cases, sciatic pain radiate from other nerves in the body. This is called referred pain. Pain associated with sciatica often is severe, sharp and shooting. It may be accompanied by other symptom, such as numbness, tingling, weakness and sensitivity to touch. There is only conservative treatment giving short term relief in pain or surgical intervention with side effect. But these are not successful and therefore those who are suffering from this are always in search of result oriented remedy. Walking distance and SLR test were taken for assessment parameter, VAS score was adopted for pain. Before treatment patient was not able to walk even 4 to 5 steps due to severe pain, was brought on stretcher and his SLR was 30° of right side. After 22 days of treatment he was able to walk up to 500 meters without any difficulty, SLR was changed to 60° and patient had got 80 % relief in pain. This case report showed that Ayurvedic protocol is potent and safe in the treatment of Gridhrasi.


Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 658
Author(s):  
Tsubasa Kawasaki ◽  
Takuya Yada ◽  
Masahiro Ohira

The cognitive–evaluative (C–E) dimension of pain is commonly observed in patients with a relatively long duration of pain. However, little is known about the effects of pain relapse on the C–E dimension of pain. Moreover, the improvement process of the C–E dimension of pain following treatment is unknown. The objective of this case report was to (a) demonstrate that the C–E dimension was affected in the acute phase of neuropathic pain in cases of pain relapse, and (b) demonstrate the improvement process of the C–E dimension of pain. A woman was diagnosed with low back pain (LBP) and sciatica. The patient had previously experienced symptoms of LBP and sciatica; thus, this episode was a case of pain relapse. At the beginning of rehabilitation, the C–E dimension of pain was present in addition to the sensory–discriminative (S–D) dimension of pain. It was observed that improvement of the C–E dimension of pain was delayed in comparison with that of the S–D dimension of pain. The C–E dimension of pain was observed with pain relapse even though it was in the acute phase of pain. This case provides a novel insight into the C–E dimension of pain. Moreover, the delay in improving the C–E dimension of pain indicates a difference in the improvement process for each pain dimension.


PM&R ◽  
2018 ◽  
Vol 10 ◽  
pp. S104-S104
Author(s):  
Ashley Michael ◽  
Vandana Sood ◽  
Brian M. Bruel ◽  
Kenneth Kemp

2008 ◽  
Vol 3;11 (5;3) ◽  
pp. 333-338
Author(s):  
Asokumar Buvanendran

Background: Failed back surgery syndrome is a common clinical entity for which spinal cord stimulation has been found to be an effective mode of analgesia, but with variable success rates. Objective: To determine if focal stimulation of the dorsal columns with a transverse tripolar lead might achieve deeper penetration of the electrical stimulus into the spinal cord and therefore provide greater analgesia to the back. Design: Case report. Methods: We describe a 42-year-old female with failed back surgery syndrome that had greater back pain than leg pain. The tripolar lead configuration was achieved by placing percutaneously an octapolar lead in the spinal midline followed by 2 adjacent quadripolar leads, advanced to the T7-T10 vertebral bodies. Results: Tripolar stimulation pattern resulted in more than 70% pain relief in this patient during the screening trial, while stimulation of one or 2 electrodes only provided 20% pain relief. After implantation of a permanent tripolar electrode system with a single rechargeable battery, the pain relief was maintained for one year. Conclusion: This is case report describing a case of a patient with chronic low back pain with a diagnosis of failed back surgery syndrome in which transverse tripolar stimulation using an octapolar and 2 quadripolar leads appeared to be beneficial. The transverse tripolar system consists of a central cathode surrounded by anodes, using 3 leads. This arrangement may contribute to maximum dorsal column stimulation with minimal dorsal root stimulation and provide analgesia to the lower back. Key words: Epidural, low back pain, spinal cord stimulation, failed back surgery syndrome, tripolar stimulation


2013 ◽  
Vol 1 (3) ◽  
pp. 209-210
Author(s):  
R Supraja ◽  
R Vidyanath
Keyword(s):  

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