scholarly journals Idiopathic cervical spinal subdural haematoma: a case report and literature review

2019 ◽  
Vol 47 (3) ◽  
pp. 1365-1372
Author(s):  
Bingjin Wang ◽  
Weifang Liu ◽  
Xianlin Zeng

This report describes a case of idiopathic cervical spinal subdural haematoma (SSDH) in which the haematoma was spontaneously absorbed without any treatment. A 68-year-old male patient presented with persistent neck pain and no obvious cause. Magnetic resonance imaging (MRI) revealed a space-occupying lesion at the C4–T1 levels. The lesion was initially misdiagnosed as a tumour. An operation was arranged to remove the tumour, but a preoperative computed tomography scan showed no obvious abnormal soft tissue density in the cervical spinal canal. Repeat enhanced MRI showed degeneration of the cervical vertebrae, but no obvious abnormal soft tissue density and no obvious enhanced signals in the cervical spinal canal. Spontaneous resolution of an idiopathic cervical SSDH was considered. Idiopathic cervical SSDH without obvious neurological symptoms are difficult to diagnose, so suspected cases should be carefully monitored. If the neurological symptoms grow progressively more debilitating with time, emergency surgery might need to be considered. To avoid unnecessary surgery, conservative management should be an option for patients with minimal neurological deficits and re-examination with MRI could be the best way to observe the dynamic changes taking place in the idiopathic cervical SSDH.

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Lei Cao ◽  
Jin-Xu Wen ◽  
Shu-Man Han ◽  
Hui-Zhao Wu ◽  
Zhi-Gang Peng ◽  
...  

Abstract Background To investigate the imaging features of hemangiomas in long tabular bones for better diagnosis. Methods Twenty-four patients with long bone hemangiomas confirmed by pathology were enrolled. Nineteen patients had plain radiography, fourteen patients had computed tomography (CT) and eleven had magnetic resonance imaging (MRI). The hemangioma was divided into medullary [13], periosteal [6] and intracortical type [5]. Results Among 19 patients with plain radiography, eleven patients were medullary, three periosteal, and five intracortical. In the medullary type, the lesion was primarily osteolytic, including five cases with irregular and unclear rims and one lesion having osteosclerotic and unclear rims. In three patients with the periosteal type, the lesion had clear rims with involvement of the cortical bone in the form of bone defect, including two cases with local thickened bone periosteum and one case having expansile periosteum. Five intracortical hemangiomas had intracortical osteolytic lesions with clear margins. Among 14 patients with CT imaging, 8 cases were medullary, three periosteal, and three intracortical. Among 8 medullary hemangiomas, one had ground glass opacity, and seven had osteolytic, expansile lesions like soft tissue density with no calcification. In three periosteal cases, the lesion was osteolytic with thickened periosteum and narrowed medullary cavity. In three intracortical hemangiomas, the lesion was of even soft tissue density with no calcification. Among 11 patients with MRI imaging, seven were medullary, two periosteal, and two intracortical. Among 7 medullary lesions, six were of hypointense signal on T1WI and hyperintensesignal on T2 WI. In two periosteal cases, the periosteum was thickened, with one case being of equal signal, and the other having no signal. Two intracortical hemangiomas were both of slightly low signal on T1WI but hyperintense signal on T2WI. Conclusions The long bone hemangiomas had characteristic cystic honeycomb-like presentations in plain radiograph. CT and MRI imagings are helpful for diagnosis of hemangiomas in long bone.


2000 ◽  
Vol 114 (1) ◽  
pp. 76-80 ◽  
Author(s):  
V. J. Lund ◽  
G. Lloyd ◽  
L. Savy ◽  
D. Howard

Fungal infections in both their invasive and non-invasive forms can prove difficult to diagnose. The often characteristic appearances on imaging are of great assistance. CT is the primary imaging modality and is probably more accurate than MRI in diagnostic specificity and determining the extent of bone erosion. However this may require a modified scanning technique to adequately demonstrate the typical soft tissue density variations of fungi. MRI should be used to supplement CT when intra-cranial or intra-orbital extension is suspected.


1996 ◽  
Vol 37 (3P2) ◽  
pp. 927-932 ◽  
Author(s):  
G. Cittadini ◽  
F. Pozzi Mucelli ◽  
F. M. Danza ◽  
L. E. Derchi ◽  
R. S. Pozzi Mucelli

Purpose: We describe the US and CT examinations of 4 patients with renal angiomyolipoma with an “aggressive” appearance, and review the literature. Material and Methods: The imaging findings in 4 patients with benign renal angiomyolipomas associated with thrombosis of the renal vein and/or inferior vena cava are presented. In one case, enlarged lymph nodes at the renal hilum were found. Results: CT demonstrated fat densities within both tumor and thrombus. In one patient, small lymph nodes with low density internal areas were detected in the para-aortic region. When considering our patients together with those reported in the literature, we found that most angiomyolipomas with venous invasion were large and centrally located within the kidney. Venous thrombosis was observed in 9 lesions of the right kidney, and in only 4 of the left one; detection of the site of origin was impossible in one case. One patient only had symptoms due to the thrombus; 10 had problems due to the tumor; and 3 were asymptomatic. Only 4 patients with pararenal enlarged lymph nodes have been reported on in the imaging literature. Fat-containing nodes were detected by CT in one case only; the others had enlarged nodes of soft-tissue density. In one patient the diagnosis of hamartomatous lymph node invasion was established by angiography. Conclusion: In patients with renal angiomyolipoma, demonstration of both fatty thrombus and the fatty infiltration of lymph nodes of the renal hilum cannot be regarded as an indication of malignancy, but only of local aggressive behavior. Although surgery is commonly contemplated to prevent symptoms from venous thrombosis, conservative treatment seems possible. Detection of enlarged lymph nodes of soft tissue density may cause difficult diagnostic problems, with the diagnosis addressed only by the presence of associated lesions. Increased awareness that renal angiomyolipoma can sometimes appear “aggressive” could help to prevent such lesions from being considered malignant, and thus avoid surgical confirmation of their nature.


1985 ◽  
Vol 26 (6) ◽  
pp. 689-692 ◽  
Author(s):  
N. Izumi ◽  
W. Koyama ◽  
T. Irie ◽  
H. Miyakawa ◽  
Y. Ito ◽  
...  

Ultrasonography and computed tomography were performed in 4 patients with adenomyomatosis of the gallbladder of segmental or diffuse type. Cholecystectomy was performed in all cases, and the diagnosis of adenomyomatosis was confirmed histopathologically. Ultrasonography revealed diffuse or segmental thickening of the gallbladder wall with small intramural diverticula. Small stones were also found. The characteristic findings of adenomyomatosis at computed tomography were soft tissue density masses in the gallbladder fossa, associated with a well-delineated, distinct tumor-free space between the mass and the liver, and with small intramural diverticula and calcified stones within the mass. Ultrasonography and computed tomography demonstrate a characteristic appearance of adenomyomatosis.


1971 ◽  
Vol 35 (4) ◽  
pp. 472-476 ◽  
Author(s):  
Thomas E. Klump

✓ A 10-week-old infant was found to have a cervicothoracic intradural neurenteric cyst which was operated on with resolution of the neurological symptoms. The discussion centers on the nature of the lesion and its possible pathogenesis.


2012 ◽  
Vol 25 (04) ◽  
pp. 337-341 ◽  
Author(s):  
A. Danielski ◽  
A. Vanhaesebrouck ◽  
R. Yeadon

SummaryThis report describes the management of clinically significant, single level cervical spinal canal stenosis associated with articular facet hypertrophy in a three-year-old Great Dane dog, by combined surgical decompression and spinal stabilization. Spinal column stabilization was achieved by ventral application of two String of Pearls locking plates and subsequent decompression was accomplished by unilateral facetectomy. The six-month postoperative reassessment examination confirmed satisfactory clinical outcome with a complete return to normal activity, resolution of neurological deficits and maintenance of implant positioning.


Author(s):  
Nikki Gajjar ◽  
Neena Bhalodiya ◽  
Simple Bhadania

<p><strong>Background: </strong>High resolution computed tomography (HRCT) provides information about anatomy and pathology of temporal bone and middle ear cleft, thus becoming important imaging modality in diagnosis and pre-operative planning in patients of chronic suppurative otitis media (attico-antral) CSOM (AA) type. The aim of study was to study disease extension and plan surgery accordingly in patients of CSOM (AA) and to study correlation between the HRCT findings and intra-operative findings of CSOM (AA) like soft tissue density mass, ossicular chain erosion, facial canal dehiscence, semi-circular canal erosion.</p><p><strong>Methods: </strong>Study of 70 patients clinically diagnosed of having CSOM (AA) in period between August 2018 to March 2020 was done at Sola civil hospital, Ahmedabad. All patients were advised HRCT temporal bone except those who had contraindications to CT scan, analysed and operated. Pre-operative CT-scan findings and intra-operative findings were compared for statistical analysis.</p><p><strong>Results: </strong>Soft tissue density was found in 100% of cases on HRCT temporal bone. Bony erosion seen in 25% of cases. 90% showed ossicular erosion. Lateral semi-circular canal fistula was observed in 10% of cases with facial canal dehiscence in 10% of cases. Intra-operative findings showed accuracy of HRCT in detecting soft tissue density to be 100%; bony erosion was observed in 25% cases. 10% patients had lateral semi-circular canal fistula. Facial canal dehiscence was seen in 15% cases.</p><strong>Conclusion: </strong>HRCT has proved quite useful and reliable to identify the disease extension before surgery and plan surgery accordingly.<p> </p>


Sign in / Sign up

Export Citation Format

Share Document