Spinal Cord Compression from a Thoracic Paraganglioma: Case Report

Neurosurgery ◽  
1991 ◽  
Vol 28 (2) ◽  
pp. 306-309 ◽  
Author(s):  
George R. Cybulski ◽  
Eduardo Nijensohn ◽  
Betty A. Brody ◽  
Paul R. Meyer ◽  
Bruce Cohen
Keyword(s):  
Spinal Cord ◽  
Spinous Process ◽  
Vascular Tumor ◽  
Cord Compression ◽  
Subtotal Resection ◽  
Recent Onset ◽  
Computed Tomographic ◽  
Second Stage ◽  
History Of ◽  
Probable Origin

Abstract A 34-year-old man with a 4-month history of midthoracic back pain sought treatment for a recent onset of lower extremity paresthesia and stiffness. A myelogram and computed tomographic myelogram disclosed an extradural block at the level of the 8th thoracic vertebral body with involvement of the pedicles, lamina, and spinous process. A posterior decompression of the spinal cord with subtotal resection of a highly vascular tumor was performed. The tumor was identified as a paraganglioma. In a second stage, the remainder of the tumor was embolized preoperatively, and gross total excision and sequential stabilization of the spine with a Luque rectangle and sublaminar wires were performed. The patient has been symptom free and without signs of a recurrence in the spine for over 13 months. A large abdominal paraganglioma was recently resected from its probable origin from the adventitia of the abdominal aorta.

scholarly journals Multiple spinal extradural cysts causing progressive paraparesia: case report and review of literature

2012 ◽  
Vol 31 (01) ◽  
pp. 46-49
Author(s):  
Elton Gomes da Silva ◽  
Vinícius Teixeira Ribeiro ◽  
Bruno Vieira Scarpim ◽  
Yvens Barbosa Fernandes
Keyword(s):  
Spinal Cord ◽  
Clinical Presentation ◽  
Cord Compression ◽  
Subtotal Resection ◽  
Review Of Literature ◽  
Partial Removal ◽  
Asymptomatic Patients ◽  
History Of ◽  
Progressive Paraparesis

AbstractMultiple meningeal extradural cysts are extremely rare. The clinical presentation varies from asymptomatic patients to important symptoms due to spinal cord compression. This article reports the case of a girl with multiple meningeal extradural cysts with progressive paraparesis and hypoesthesia on inferior limbs. The MRI showed multiple extradural cysts between C7 and L1. A partial resection was made at the cystis, reflecting a improve at the postoperative follow up of the patient. The management of asymptomatic cases is usually followed up clinical and radiologically. At the management of the symptomatic cases, the resection of the cysts is the most indicated treatment, even for patients with a long-standing history of compression. However the partial removal has as good results as the total one. The authors review the literature and show a subtotal resection of the cysts did not change the evolution of the presentation.

Epidural Lipomatosis Simulating an Epidural Abscess: Case Report and Literature Review

Neurosurgery ◽  
1987 ◽  
Vol 21 (5) ◽  
pp. 744-747 ◽  
Author(s):  
Regis W. Haid ◽  
Howard H. Kaufman ◽  
Sydney S. Schochet ◽  
Gary D. Marano
Keyword(s):  
Spinal Cord ◽  
Epidural Abscess ◽  
Cord Compression ◽  
Fatty Tissue ◽  
Epidural Lipomatosis ◽  
Neurological Improvement ◽  
Computed Tomographic ◽  
Dose Corticosteroid ◽  
Staphylococcus Aureus Pneumonia ◽  
And Staphylococcus Aureus

Abstract A case of epidural lipomatosis in a 49-year-old man presenting with paraparesis, midthoracic pain, and Staphylococcus aureus pneumonia is reported. The patient had been on low dose corticosteroid therapy for 7 years for rheumatoid arthritis. The clinical and myelographic findings suggested a diagnosis of epidural abscess, but the only abnormality discovered at operation was abundant fatty tissue in the dorsal epidural space significantly compressing the spinal cord, and this was partially removed. Postoperative neurological improvement suggested that the lipomatosis was responsible for the spinal cord compression and dysfunction. If this diagnosis had been suspected, it might have been confirmed by magnetic resonance imaging or postmyelography computed tomographic scanning. With such a diagnosis, an alternative treatment could have been to decrease the steroid dose, observe for clinical improvement, and perhaps avoid operation. (Neurosurgery 21:744-747, 1987)

Extradural Thoracic Arteriovenous Malformation in a Patient with Klippel-Trenaunay-Weber Syndrome: Case Report

Neurosurgery ◽  
2002 ◽  
Vol 51 (5) ◽  
pp. 1275-1279 ◽  
Author(s):  
Michael J. Alexander ◽  
Peter M. Grossi ◽  
Robert F. Spetzler ◽  
Cameron G. McDougall
Keyword(s):  
Spinal Cord ◽  
Cord Compression ◽  
Magnetic Resonance Imaging Scan ◽  
Lower Extremity Weakness ◽  
Thyrocervical Trunk ◽  
Weber Syndrome ◽  
History Of ◽  
Cutaneous Hemangioma ◽  
The Right ◽  
Upper Thoracic

Abstract OBJECTIVE AND IMPORTANCE Spinal cord involvement in Klippel-Trenaunay-Weber (KTW) syndrome is rare. Cases of intradural spinal cord arteriovenous malformations (AVMs) have been associated with this syndrome. Likewise, cases of epidural hemangioma and angiomyolipoma have been reported to occur at the same segmental level as cutaneous hemangioma in KTW syndrome. This report details a rare case of an extradural thoracic AVM in a patient with KTW syndrome. CLINICAL PRESENTATION A 30-year-old man presented with a 10-month history of progressive myelopathy, bilateral lower-extremity weakness, and numbness, with the right side affected more than the left. His symptoms had progressed to the point that he was unable to walk. The patient had the characteristic manifestations of KTW syndrome, including numerous cutaneous angiomas and cavernomas, limb hypertrophy and syndactyly, and limb venous malformations. A magnetic resonance imaging scan and subsequent angiogram demonstrated a large extradural AVM causing cord compression at the T3–T4 levels. INTERVENTION The patient underwent two separate endovascular procedures, including embolization of upper thoracic and thyrocervical trunk feeders. Subsequently, he underwent T1–T4 laminectomy and microsurgical excision of the AVM. Clinically, the patient improved such that he could walk without assistance. CONCLUSION KTW syndrome represents a spectrum of clinical presentations. Although involvement of the spinal cord is uncommon, the manifestations of this syndrome may include both intradural and extradural AVMs in addition to various tumors.

scholarly journals Initial presentation of Hodgkin’s Lymphoma as Extradural Spinal Cord Compression: A case report

2020 ◽  
Vol 11 (2) ◽  
pp. 101-103
Author(s):  
Rishav Mukherjee ◽  
Sampurna Chowdhury
Keyword(s):  
Spinal Cord ◽  
Hodgkin Lymphoma ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Acute Onset ◽  
Initial Presentation ◽  
Classical Hodgkin Lymphoma ◽  
Night Sweats ◽  
History Of ◽  
Mediastinal Widening

A 23 year old female presented with acute onset paraparesis. She denied any history of fever, weight loss or drenching night sweats. Neither did she have any obvious lymphadenopathy on general examination. Chest Xray was however suggestive of mediastinal widening and her MRI spine showed metastases with superior mediastinal SOL. Biopsy of this SOL ultimately revealed classical Hodgkin lymphoma. Thus this was a very unusual initial presentation of Hodgkin lymphoma presenting as Epidural Spinal Cord Compression. Hasenclever IPS score was 2. Patient was treated with radiotherapy followed by ABVD chemotherapy and achieved remission in 3months.

Primary polymorphous hemangioendothelioma of the spinal cord

2001 ◽  
Vol 95 (1) ◽  
pp. 93-95 ◽  
Author(s):  
Federico Roncaroli ◽  
Bernd W. Scheithauer ◽  
Savvas Papazoglou
Keyword(s):  
Spinal Cord ◽  
Vascular Tumor ◽  
Nerve Roots ◽  
Content Type ◽  
Sensorimotor Deficit ◽  
History Of ◽  
Intradural Extramedullary ◽  
Borderline Malignancy ◽  
Current Experience

✓ A case of polymorphous hemangioendothelioma of the spinal cord is described. This 55-year-old woman presented with an 18-month history of lower-extremity sensorimotor deficit. A magnetic resonance image revealed an enhancing, intradural, extramedullary nodule at the T1–2 level. On gross inspection, the lesion measured 3.5 cm and was firmly attached to spinal cord parenchyma and adjacent nerve roots. It was completely removed. Fourteen months after surgery the patient's neurological deficit had resolved. Polymorphous hemangioendothelioma is a rare vascular tumor of borderline malignancy. Most occur in lymph nodes. None has been reported to occur in the central and peripheral nervous system. Based on current experience, resection and close follow up seems the best therapeutic approach.

Impact of Myelography on the Radiotherapeutic Management of Malignant Spinal Cord Compression

Neurosurgery ◽  
1986 ◽  
Vol 19 (4) ◽  
pp. 614-616 ◽  
Author(s):  
Alison R. Calkins ◽  
Margaret A. Olson ◽  
James H. Ellis
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Additional Information ◽  
Compression Syndrome ◽  
Plain Films ◽  
Port Design ◽  
Bony Lesions ◽  
History Of ◽  
Spinal Cord Compression Syndrome

Abstract From December 1981 through August 1984, 24 patients with spinal cord compression syndrome due to epidural neoplasms were evaluated for radiotherapy with clinical examination, radiographs of the spine, and myelography. All plain films were reviewed, and mock radiotherapy fields designed using specific criteria for margins. The same patients were reviewed a second time considering the additional information provided by myelography. The initial treatment fields were found to be inadequate in 69% of the patients. Even in patients with discrete bony lesions, the results of myelography affected the treatment 45% of the time. A history of previous spinal irradiation significantly influenced port design in only 1 of the 7 patients who had received previous radiotherapy. Although invasive, myelography is essential in planning the treatment of spinal cord compression.

Spinal Cord Compression by Heterotopic Ossification Associated with Pseudohypoparathyroidism

1997 ◽  
Vol 25 (6) ◽  
pp. 364-368 ◽  
Author(s):  
Y Yamamoto ◽  
Y Noto ◽  
M Saito ◽  
H Ichizen ◽  
H Kid a
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Spastic Paraparesis ◽  
Cyclic Adenosine Monophosphate ◽  
Adenosine Monophosphate ◽  
Cord Compression ◽  
Ectopic Ossification ◽  
Computed Tomographic ◽  
Type Ia ◽  
Physical Findings

This report describes a 37-year-old man presenting with a gait disturbance due to spastic paraparesis. Physical findings showed typical features of Albright's hereditary osteodystrophy, including short stature, obesity, brachydactyly and dental hypoplasia. He was diagnosed as having pseudohypoparathyroidism type Ia, on the basis of his hypocalcaemia, hyperphosphataemia, increased plasma level of parathyroid hormone (PTH), and the unresponsiveness to exogenous PTH loading of his urinary excretion of both nephrogenous cyclic adenosine monophosphate and phosphate. Magnetic resonance imaging and myelographic computed tomographic scans clearly demonstrated severe compression of the spinal cord at T 9/10 by tumour-like ossifications of the paravertebral ligaments. Neurosurgical decompression therapy was, therefore, performed to alleviate his spastic paraparesis. This was a rare case of pseudohypoparathyroidism complicated with spinal cord compression caused by ectopic ossification of the ligaments.

HISTORY OF EVOLUTION OF POSTERO-LATERAL APPROACHES TO THE THORACIC SPINE: FROM CURE OF POTT’S DISEASE TO EPIDURAL TUMOR RESECTION

2022 ◽  
Author(s):  
Filippo Gagliardi ◽  
Edoardo Pompeo ◽  
Pierfrancesco De Domenico ◽  
Silvia Snider ◽  
Francesca Roncelli ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Tumor Resection ◽  
Cord Compression ◽  
Target Area ◽  
Pott’S Disease ◽  
History Of ◽  
The One ◽  
Optimal Approach ◽  
Surgical Manipulation ◽  
First Time

Since the end of the nineteenth century, the wide dissemination of Pott’s disease has ignited debates about which should be the ideal route to perform ventrolateral decompression of the dorsal rachis in case of paraplegia due to spinal cord compression in tuberculosis spondylitis. It was immediately clear that the optimal approach should be the one minimizing the surgical manipulation on both neural and extra-neural structures, while optimizing the exposure and surgical maneuverability on the target area. The first attempt was reported by Victor Auguste Menard in 1894, who described, for the first time, a completely different route from traditional laminectomy, called costotransversectomy. The technique was conceived to drain tubercular paravertebral abscesses causing paraplegia without manipulating the spinal cord. Over the following decades many other routes have been described all over the world, thus demonstrating the wide interest on the topic. Surgical development has been marked by the new technical achievements and by instrumental/technological advancements, until the advent of portal surgery and endoscopy-assisted techniques. Authors retraced the milestones of this history up to the present days, through a systematic review on the topic.

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