scholarly journals Unexplained paraparesis following subarachnoid haemorrhage

2019 ◽  
Vol 12 (2) ◽  
pp. e227666
Author(s):  
Morgan J Bressington ◽  
Gulam Zilani ◽  
Dmitri Shastin ◽  
Chirag Patel
Keyword(s):  
Spinal Cord ◽  
Subarachnoid Haemorrhage ◽  
Chronic Back Pain ◽  
Relevant Literature ◽  
World Federation ◽  
Common Condition ◽  
Thoracic Region ◽  
Prompt Treatment ◽  
Structural Abnormalities ◽  
Congenital Cysts

Spinal arachnoid cysts (SAC) are rare in isolation and the exact aetiology is still debated. Primary (congenital) cysts are caused by structural abnormalities in the arachnoid layer and largely affect the thoracic region. Secondary cysts are induced by a multitude of factors, infection, trauma or iatrogenic response, and can affect any level of the spinal cord. While subarachnoid haemorrhage (SAH) is a relatively common condition with significant repercussions, it is extremely uncommonly associated with SAC. When present, it may develop in the months and years after the original bleed, giving rise to new neurological symptoms. Prompt treatment is needed to halt or reverse the worsening of symptoms and questions are still being asked about how best to approach this condition. A 42-year-old man presented with chronic back pain, severe worsening ataxia and numbness below the umbilicus, 7 months after treatment for a World Federation of Neurosurgical Societies grade five (WFNS V) SAH. Imaging revealed a SAC extending from T12 to L4 and causing thecal compression. This was treated with a L3 laminectomy andmarsupialisation. An improvement in neurological function was observed at 6 months. Aetiology of the SAC and its association with SAH are discussed and a review of the relevant literature is provided.

scholarly journals Aneurysm Arising at the Origin of a Duplicated Middle Cerebral Artery

2021 ◽  
pp. 446-450
Author(s):  
Jean Roch Alliez ◽  
Luis Manera
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Haemorrhage ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
World Federation ◽  
Treatment Procedure ◽  
3D Computed Tomography ◽  
Ruptured Aneurysms ◽  
Tomography Reconstruction ◽  
Computed Tomography Reconstruction

A duplicated middle cerebral artery (DMCA) is a common anomaly. However, aneurysms arising from the origin of a DMCA are extremely rare. A 22-year-old female was admitted to our hospital with a World Federation of Neurosurgical Societies grade 2 subarachnoid haemorrhage. Four-vessel angiography revealed a DMCA and an aneurysm arising from the origin of this artery. The aneurysm was successfully treated by embolization, and the patient was discharged 2 weeks later. Ruptured aneurysms arising from the origin of a DMCA can be successfully treated by embolization. These aneurysms are small and 3D-computed tomography reconstruction is mandatory to detect them. It is important to preserve the DMCA during the treatment procedure.

Spinal Cord Stimulation for the Treatment of Chronic Back Pain Patients: 500-Hz vs. 1000-Hz Burst Stimulation

2014 ◽  
Vol 18 (1) ◽  
pp. 9-12 ◽  
Author(s):  
Tony Van Havenbergh ◽  
Tim Vancamp ◽  
Pieter Van Looy ◽  
Sven Vanneste ◽  
Dirk De Ridder
Keyword(s):  
Spinal Cord ◽  
Back Pain ◽  
Spinal Cord Stimulation ◽  
Chronic Back Pain ◽  
Burst Stimulation ◽  
Pain Patients

scholarly journals Acute thoracic disc heralded by change in spinal cord stimulation pattern: illustrative case

2021 ◽  
Vol 2 (20) ◽  
Author(s):  
Faraz Behzadi ◽  
Edvin Telemi ◽  
Tarek R. Mansour ◽  
Thomas M. Zervos ◽  
Muwaffak M. Abdulhak ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Back Pain ◽  
Spinal Cord Stimulation ◽  
Chronic Back Pain ◽  
Cord Compression ◽  
Illustrative Case ◽  
Disc Protrusion ◽  
Stimulation Parameters ◽  
Spine Pathology ◽  
Thoracic Disc

BACKGROUND Spinal cord stimulation (SCS) uses unique electric stimulation parameters to selectively treat specific regions of chronic or refractory back pain. Changing these parameters can lead to spreading paresthesia and/or pain beyond the desired region. OBSERVATIONS A patient with a history of stable, successful SCS treatment presented with acute development of paresthesias that were relieved by reduction of stimulation parameters. The patient required paradoxically lower SCS settings for control of chronic back pain. This presentation prompted further investigation, which revealed a new disc protrusion and cord compression at the level of the paddle lead. LESSONS In patients with SCS, a new onset of back pain accompanied by acute paresthesia that is reversible by reducing the SCS amplitude warrants investigation for new spine pathology.

Risk of Injury From Baseball and Softball in Children 5 to 14 Years of Age

PEDIATRICS ◽  
1994 ◽  
Vol 93 (4) ◽  
pp. 690-692
Author(s):  
Keyword(s):  
United States ◽  
Complete Resolution ◽  
Relevant Literature ◽  
The United States ◽  
Overuse Injuries ◽  
Little League ◽  
Risk Of Injury ◽  
Structural Abnormalities ◽  
Catastrophic Impact ◽  
Radiologic Evidence

Baseball is one of the most popular sports in the United States, with estimates of 4.8 million children 5 to 14 years of age participating annually in organized and recreational baseball and softball. Interest in and fascination with the sport have grown since the beginning of the 20th century, but it was not until 1965 that the issue of "Little League elbow" raised concern about the safety of the game. Recently, highly publicized catastrophic impact injuries from contact with a ball or bat have raised new safety concerns. These injuries provided the impetus for this review of the safety of baseball for 5- to 14-year-old participants. The discussion focuses principally on baseball, but softball is considered in accord with the availability of relevant literature. This statement mainly concerns injuries during practices and games in organized settings; players and bystanders also can be injured in casual play. The term Little League elbow was used in 1965 to denote radiologic evidence of fragmentation of the medial epicondylar apophysis and osteochondrosis of the head of the radius and capitellum.1,2 Subsequent studies of children 12 years old and younger3,4 have found a substantially lower incidence of abnormalities than originally described.1,2 Early detection and intervention seem to permit the complete resolution of symptoms and underlying structural abnormalities.5 More serious abnormalities become more common after the age of 13 years.6-8 The role that repetitive throwing in 5- to 14-year-old children may play in the evolution of elbow overuse injuries at an older age remains to be determined.

scholarly journals Bilateral lower limb paralysis as initial symptom of neurofibromatosis type 2: A case report

2017 ◽  
Vol 4 (1) ◽  
pp. 24
Author(s):  
Mitsuru Yamagishi ◽  
Masaya Takahashi ◽  
Masahiro Nonaka ◽  
Yumiko Someno ◽  
Yoko Nakai ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Lower Limb ◽  
Neurofibromatosis Type ◽  
Spinal Tumor ◽  
Spinal Tumors ◽  
Thoracic Region ◽  
Lower Limb Paralysis ◽  
Bilateral Lower Limb ◽  
Tendon Reflexes

Neurofibromatosis type 2 (NF2) is an autosomal dominant disorder characterized by multiple tumors including schwannomas, meningiomas and ependymomas of the central nervous system. Although paresthesias, muscle weakness, muscle atrophy, and gait unsteadiness have been reported as clinical symptoms of spinal tumors, there are no reports of patients with NF2 who developed paralysis. A 7-year-old female consulted with our hospital because of sudden bilateral lower limb paralysis. She had not recognized the abnormalities, including paralysis, paraplegia and muscle weakness of bilateral lower limb before administration. Because of the aggravated bilateral patellar tendon reflexes, Achilles tendon reflexes, and the positive bilateral Babinski reflexes, a magnetic resonance imaging (MRI) of the spinal cord was performed. MRI revealed multiple spinal tumors in the cervical, thoracic, lumbar, and sacral regions. In particular, a 12 mm ×  33 mm spinal tumor was present in the thoracic region and was pressing against the spinal cord. Surgery was urgently performed to remove the spinal tumor in the thoracic region. Histopathological examination revealed that the tumor was a schwannoma. Gadolinium-enhanced MRI of the head was performed to explore the intra-cranial lesions: bilateral vestibular schwannomas and tumors in the left oculomotor nerve and right glossopharyngeal nerve were also discovered. Auditory brainstem response was performed to evaluate the bilateral VSs, and the results were normal. Nine months after the surgery, MRI of the head and spinal cord showed that her tumors had not increased in size. This represents the first reported case of NF2 complicated bilateral lower limb paralysis as initial neurological symptom.

scholarly journals Spinal epidural angiolipoma: A rare cause of spinal cord compression

2012 ◽  
Vol 03 (03) ◽  
pp. 341-343 ◽  
Author(s):  
Rajesh K Ghanta ◽  
Kalyan Koti ◽  
Srinivas Dandamudi
Keyword(s):  
Spinal Cord ◽  
Blood Vessels ◽  
Spinal Cord Compression ◽  
Surgical Excision ◽  
Cord Compression ◽  
Benign Tumors ◽  
Thoracic Region ◽  
Spinal Angiolipomas ◽  
Spinal Epidural

ABSTRACTSpinal epidural angiolipomas are rare, benign tumors composed of mature lipocytes admixed with abnormal blood vessels. Only 128 cases of spinal epidural angiolipomas have been reported in literature till now. Spinal angiolipomas are predominantly located in the mid-thoracic region. We report a case of dorsal epidural angiolipoma in a 56-year-old male who presented with paraparesis and was diagnosed to have D4-5 epidural angiolipoma. Total surgical excision of the epidural angiolipoma was done and his paraparesis gradually improved.

Intramedullary inclusion cysts of the cervicothoracic junction

2007 ◽  
Vol 7 (2) ◽  
pp. 236-242 ◽  
Author(s):  
Alfred T. Ogden ◽  
Alexander G. Khandji ◽  
Paul C. McCormick ◽  
Michael G. Kaiser
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Surgical Treatment ◽  
Dermoid Cyst ◽  
Clinical Features ◽  
Epidermoid Cyst ◽  
Relevant Literature ◽  
Literature Discussion ◽  
Cervicothoracic Junction

✓Intramedullary inclusion cysts are extremely rare within the rostral spinal cord. In this case report the authors outline the clinical features and surgical treatment of one dermoid cyst and one epidermoid cyst of the cervicothoracic junction. The authors also include a relevant literature discussion regarding the treatment and the embryological origin of these lesions.

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