scholarly journals A Case of Acute Aortoiliac Occlusive Disease Presenting as Cauda Equina Syndrome and Fournier´s Gangrene

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Rosalba Paone ◽  
Pekka Romsi
Keyword(s):  
Spinal Cord ◽  
Erectile Dysfunction ◽  
Spinal Cord Ischemia ◽  
Cauda Equina ◽  
Cord Compression ◽  
Occlusive Disease ◽  
Lower Limbs ◽  
Careful Examination ◽  
Diagnostic Challenge ◽  
Aortoiliac Occlusive Disease

Aortoiliac occlusive disease presents itself more frequently as chronic claudication, erectile dysfunction, and absent femoral pulses. Its acute manifestation is less frequently encountered in a clinical practice; hence, it presents sometimes as a diagnostic challenge. We illustrate a case of acute aortoiliac occlusive disease presenting with spinal cord ischemia and gluteal and scrotal necroses, which was initially diagnosed and treated as spinal cord compression. In order to avoid misdiagnosis, careful examination of peripheral pulses of both lower limbs should always be part of the initial evaluation of cauda syndrome and paraplegia and when Fournier’s gangrene is suspected.

scholarly journals Is there a right time for surgery in paraplegic patients secondary to non traumatic spinal cord compression?

2012 ◽  
Vol 10 (4) ◽  
pp. 508-511 ◽  
Author(s):  
Leonardo Giacomini ◽  
Roger Neves Mathias ◽  
Andrei Fernandes Joaquim ◽  
Mateus Dal Fabbro ◽  
Enrico Ghizoni ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Prognostic Factor ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Lower Limbs ◽  
Motor Deficit ◽  
Indication For Surgery ◽  
Sensory Deficits ◽  
Sensory Involvement ◽  
Spinal Cord Decompression

Paraplegia is a well-defined state of complete motor deficit in lower limbs, regardless of sensory involvement. The cause of paraplegia usually guides treatment, however, some controversies remain about the time and benefits for spinal cord decompression in nontraumatic paraplegic patients, especially after 48 hours of the onset of paraplegia. The objective of this study was to evaluate the benefits of spinal cord decompression in such patients. We describe three patients with paraplegia secondary to non-traumatic spinal cord compression without sensory deficits, and who were surgically treated after more than 48 hours of the onset of symptoms. All patients, even those with paraplegia during more than 48 hours, had benefits from spinal cord decompression like recovery of gait ability. The duration of paraplegia, which influences prognosis, is not a contra-indication for surgery. The preservation of sensitivity in this group of patients should be considered as a positive prognostic factor when surgery is taken into account.

scholarly journals Acute-onset paraplegia as an unexpected complication under general anesthesia in supine position during abdominal endovascular aneurysm repair: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Atsushi Morio ◽  
Hirotsugu Miyoshi ◽  
Noboru Saeki ◽  
Yukari Toyota ◽  
Yasuo M. Tsutsumi
Keyword(s):  
Spinal Cord ◽  
General Anesthesia ◽  
Supine Position ◽  
Spinal Cord Ischemia ◽  
Endovascular Aneurysm Repair ◽  
Acute Onset ◽  
Lower Limbs ◽  
Canal Stenosis ◽  
Cord Injury ◽  
Aneurysm Repair

Abstract Background Acute onset paraplegia after endovascular aneurysm repair (EVAR) is a rare but well-known complication. We here show a 79-year-old woman with paraplegia caused by static and dynamic spinal cord insult not by ischemia after EVAR. Case presentation The patient underwent EVAR for abdominal aortic aneurism under general anesthesia in the supine position. She had a medical history of lumbar canal stenosis. After the surgery, we recognized severe paraplegia and sensory disorder of lower limbs. Although the possibility of spinal cord ischemia was considered at that time, postoperative magnetic resonance imaging (MRI) revealed burst fracture of vertebra and compressed spinal cord. Conclusions Patients with spinal canal stenosis can cause extrinsic spinal cord injury even with weak external forces. Thus, even after EVAR, it is important to consider extrinsic factors as the cause of paraplegia.

Rosai-Dorfman disease with spinal cord compression: a diagnostic challenge

2014 ◽  
Vol 24 (S4) ◽  
pp. 529-535 ◽  
Author(s):  
Sara Sciacca ◽  
Kostantinos Barkas ◽  
Lauren Heptinstall ◽  
Christopher McNamara ◽  
Rohit Shetty
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Diagnostic Challenge ◽  
Rosai Dorfman Disease

Thoracic spinal cord compression masquerading as cauda equina syndrome

2016 ◽  
Vol 34 (4) ◽  
pp. 756.e3-756.e5 ◽  
Author(s):  
Katherine Stolper ◽  
Erin R. Hanlin ◽  
Michael D. April ◽  
John L. Ritter ◽  
Curtis J. Hunter ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Cord Compression ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal

Four cases of spinal cord compression: The need for early diagnosis

1985 ◽  
Vol 71 (2) ◽  
pp. 92-95
Author(s):  
R. K. Bradley ◽  
S. H. Murch
Keyword(s):  
Spinal Cord ◽  
Early Diagnosis ◽  
Clinical Diagnosis ◽  
Spinal Cord Compression ◽  
Cauda Equina ◽  
Cord Compression ◽  
Symptoms And Signs

SummaryFour cases of spinal cord compression, with symptoms and signs evolving over several years or as quickly as two days, are presented. The symptoms and signs of extrinsic cord compression are described and briefly contrasted with those of intrinsic cord or cauda equina lesions. The need for early clinical diagnosis is emphasised.

Dermoid tumors of the spinal cord

1970 ◽  
Vol 33 (6) ◽  
pp. 676-681 ◽  
Author(s):  
Ian C. Bailey
Keyword(s):  
Spinal Cord ◽  
Low Back Pain ◽  
Back Pain ◽  
Cauda Equina ◽  
Complete Removal ◽  
Cord Compression ◽  
Conus Medullaris ◽  
Low Back ◽  
Content Type ◽  
Fine Print

✓ This is an analysis of 10 cases of dermoid tumor occurring in the spinal canal (8 lumbar and 2 thoracic). Low-back pain was the commonest presenting symptom, especially if the tumor was adherent to the conus medullaris. Other complaints included urinary dysfunction and motor and sensory disturbances of the legs. Clinical and radiological evidence of spina bifida was found in about half of the cases and suggested the diagnosis of a developmental type of tumor when patients presented with progressive spinal cord compression. At operation, the tumors were often found embedded in the conus medullaris or firmly adherent to the cauda equina, thus precluding complete removal. Evacuation of the cystic contents, however, gave lasting relief of the low-back pain and did not cause any deterioration in neurological function. In a follow-up study, ranging from 1 to 15 years, virtually no improvement in the neurological signs was observed. On the other hand, only one case has deteriorated due to recurrence of tumor growth.

Radiation-Sensitive Spine Tumor

2018 ◽  
pp. 159-174
Author(s):  
Adam M. Robin ◽  
Ilya Laufer
Keyword(s):  
Spinal Cord ◽  
Multiple Myeloma ◽  
Spinal Cord Compression ◽  
Cauda Equina ◽  
Spinal Metastases ◽  
Cord Compression ◽  
External Beam Radiation ◽  
Spinal Instability ◽  
Mechanical Instability

A decision-making framework called NOMS (neurologic, oncologic, mechanical and systemic) facilitates and guides therapeutic decisions for patients with spinal metastases. Patients should be evaluated for signs of myelopathy or cauda equina syndrome. The Epidural Spinal Cord Compression (ESCC) scale facilitates reporting of the degree of radiographic spinal cord compression. A determination of the expected histology-specific tumor response to conventionally fractionated external beam radiation (cEBRT) and systemic therapy should be made. Radiation therapy effectively treats biologic pain for radiosensitive tumors such as multiple myeloma. Patients should undergo a careful evaluation of movement-associated pain as tumor-induced spinal instability is an independent indication for surgery. Determination of tumor-associated mechanical instability can be facilitated by the Spinal Instability Neoplastic Score (SINS). Herein, the authors present a case of spinal multiple myeloma managed using the NOMS framework and in consideration of current evidence and treatment paradigms.

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