Intramedullary Cervical Spine Germinoma: Case Report

Neurosurgery ◽  
2004 ◽  
Vol 55 (6) ◽  
pp. E1440-E1444 ◽  
Author(s):  
Jason H. Huang ◽  
Irena Tsui ◽  
Alexander R. Judkins ◽  
Erin Simon ◽  
John K. Birknes ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Cervical Spine ◽  
Magnetic Resonance ◽  
The Body ◽  
Pathological Examination ◽  
Magnetic Resonance Imaging Scan ◽  
Resonance Imaging ◽  
History Of ◽  
Resonance Imaging Scan

Abstract OBJECTIVE AND IMPORTANCE: We report an extremely rare case of primary intramedullary germinoma in the cervical spinal cord arising in an 18-year-old man who had not undergone previous surgery or irradiation. CLINICAL PRESENTATION: The patient had a 2-month history of intermittent neck pain and a 4-week history of bilateral hand paresthesias and weakness. A magnetic resonance imaging scan demonstrated a heterogeneous cervical spine lesion with marked contrast enhancement extending from C3 to C6. INTERVENTION: The patient underwent a cervical laminotomy with tumor resection, and pathological examination revealed the tumor to be a germinoma. He recovered well from the surgery with minimal neurological deficits. A postoperative magnetic resonance imaging scan of the brain and spinal cord did not show any other tumors. In addition, imaging studies of the mediastinum, testes, and the rest of the body also did not demonstrate any other tumors. The patient received local radiation as well as three courses of chemotherapy. CONCLUSION: To our knowledge, this is the first report of an intramedullary cervical spine germinoma with confirmed tissue diagnosis. Although extremely uncommon, the possibility of germinoma should be included in the differential diagnosis for primary intramedullary spinal cord tumors.

Modification of the ventral approach to the caudal cervical spine by resection of the manubrium in a dog

2009 ◽  
Vol 22 (06) ◽  
pp. 514-516 ◽  
Author(s):  
M. R. Owen ◽  
M. A. Bush
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Cervical Spine ◽  
Magnetic Resonance ◽  
Neurological Examination ◽  
Resonance Imaging ◽  
Successful Performance ◽  
Disc Material ◽  
History Of ◽  
Adverse Affects

SummaryA five-year-old neutered female Bassett Hound weighing 29 kg was presented with a two-day history of paraparesis. Neurological examination and magnetic resonance imaging confirmed the presence of extruded disc material ventral to the spinal cord, from the C7-T1 intervertebral disc. A ventral slot was performed to decompress the cord. In making the approach to the caudal cervical spine, the cranial aspect of the manubrium of the sternum was resected. This improved the exposure of a region normally difficult to expose via a conventional ventral approach to the cervical spine. The successful performance of the ventral slot procedure was greatly facilitated by this adaptation, which was quick and simple to perform, without any apparent adverse affects to the animal.

ECTOPIC RECURRENCE OF CRANIOPHARYNGIOMAS

Neurosurgery ◽  
2009 ◽  
Vol 64 (2) ◽  
pp. E382-E383 ◽  
Author(s):  
Kerem Bikmaz ◽  
Carlos A. Guerrero ◽  
Ruben Dammers ◽  
Ali F. Krisht ◽  
Muhammad M. Husain
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Cerebellopontine Angle ◽  
Magnetic Resonance Imaging Scan ◽  
Resonance Imaging ◽  
Postoperative Course ◽  
The Third ◽  
Ectopic Recurrence ◽  
History Of ◽  
Resonance Imaging Scan

Abstract OBJECTIVE Craniopharyngiomas are benign tumors that originate from squamous cell rests of the embryonal hypophyseal-pharyngeal duct located along the pituitary stalk. After their surgical resection, recurrence usually occurs in the region of the original tumor bed. Ectopic recurrence of craniopharyngiomas is extremely rare. It usually occurs either along the surgical route, because of direct surgical seeding, or at a distal location in the subarachnoid space, because of seeding along the cerebrospinal fluid pathways. We present 3 examples of ectopic recurrences of craniopharyngiomas. CLINICAL PRESENTATION The first patient was a 52-year-old woman with a history of resected suprasellar craniopharyngioma presenting 15 years later with a history of balance problems and new onset of double vision. Her magnetic resonance imaging scan revealed a tumor in the prepontine cistern. The second patient was a 41-year-old man with a history of a resected suprasellar craniopharyngioma presenting 9 years later with headache, dizziness, and disequilibrium. He was noted by his family to have an altered behavior with progressively increasing indifference. His magnetic resonance imaging scan showed a right frontal lesion in the vicinity of the sylvian fissure. The third patient was a 24-year-old man with a history of suprasellar craniopharyngioma resection, followed by conventional radiotherapy 12 years before his recent presentation with headache, numbness of the right side of his face, and increased drowsiness. His magnetic resonance imaging scan showed a bilateral cystic cerebellopontine angle lesion. INTERVENTION The first patient underwent operation via a petrosal approach with subtotal resection of the tumor and decompression of the brainstem; this patient had an uneventful postoperative course. The tumor in the second patient was surgically resected through a pterional craniotomy, with an uneventful postoperative course. The third patient's right-sided cerebellopontine angle lesion was microsurgically resected, and the patient was given a single-dose gamma knife for the left-side and residual small right-side tumor. The histological diagnosis of all 3 lesions was craniopharyngioma. CONCLUSION Although ectopic recurrence of a craniopharyngioma is very rare, it should always be considered in the differential diagnosis of what appears to be a new tumor in a patient with a history of previously resected craniopharyngiomas. Long-term follow-up of patients with resected craniopharyngioma is very important.

Minimally Invasive Insertion of Syringosubarachnoid Shunt for Posttraumatic Syringomyelia: Technical Case Report

2007 ◽  
Vol 61 (suppl_5) ◽  
pp. ONSE331-ONSE332 ◽  
Author(s):  
John E. O’Toole ◽  
Kurt M. Eichholz ◽  
Richard G. Fessler
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Invasive Technique ◽  
Magnetic Resonance Imaging Scan ◽  
Resonance Imaging ◽  
Posttraumatic Syringomyelia ◽  
Resonance Imaging Scan

Abstract Objective: Symptomatic posttraumatic syringomyelia affects up to 10% of patients with spinal cord injuries and manifests in a delayed manner as progressive sensorimotor changes below the level of the syrinx. Syrinx shunting, and in particular syringosubarachnoid shunting (SSAS), provides neurological improvement or stabilization in at least 50% of these patients. Given the debilitated condition of many of these patients, a minimally invasive approach to the insertion of these devices is desirable. We provide the first report of an SSAS inserted in a minimally invasive fashion through a tubular retractor. Patients and Methods: A 27-year-old woman presented 4 years after C6 to C7 fracture dislocation and incomplete spinal cord injury with increasing pain and spasticity below the midthoracic region. Magnetic resonance imaging scan revealed a midthoracic syrinx that had enlarged on serial imaging. SSAS was inserted using a minimally invasive technique via the X-Tube retractor (Medtronic Sofamor Danek, Memphis, TN). Through a 2.5-cm incision, hemilaminotomy was performed, and a midline durotomy and myelotomy were opened for SSAS insertion under microscopic visualization. Results: Intraoperative ultrasonography revealed successful syrinx decompression after SSAS insertion. The operative time was 150 minutes and estimated blood loss was less than 100 mL. The patient was mobilized on postoperative Day 1 and was discharged 38.5 hours after surgery with resolution of her preoperative symptoms. Postoperative magnetic resonance imaging scan revealed excellent decompression of the syrinx, and through 1 year of follow-up, the patient has had no recurrence of her syrinx-related symptoms. Conclusion: This is the first report of minimal-access insertion of an SSAS. The minimally invasive technique appears to be a safe and effective means of implanting an SSAS. This approach allows for diminished blood loss and early mobilization and transfer to rehabilitation units for these patients.

Intradural Dirofilariasis in a Dog with Chronic Cervical Pain

2017 ◽  
Vol 53 (1) ◽  
pp. 59-63
Author(s):  
Kathleen Ann Bonawandt ◽  
Jason M. Berg ◽  
Richard J. Joseph ◽  
Joseph D. Stefanacci
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cervical Spine ◽  
Magnetic Resonance ◽  
Spinal Pain ◽  
Resonance Imaging ◽  
Male Adult ◽  
Normal Limits ◽  
History Of ◽  
C2 Vertebra ◽  
Intradural Extramedullary

ABSTRACT A 7 yr old female spayed Yorkshire terrier was referred to the author's institute for a 5 mo history of recurrent cervical spinal pain. Neurologic examination did not reveal any deficits. Hematologic and serum analyses were within normal limits. Thoracic radiographs that incorporated the cervical spine did not show structural abnormalities. Magnetic resonance imaging of the cervical spine demonstrated a contrast enhancing, intradural extramedullary lesion at the level of the C2 vertebra. Hemilaminectomy was performed, during which a long, narrow nematode was visualized upon opening of the dura mater. The parasite was alive when removed during surgery, and the dog recovered with complete resolution of symptoms. The parasite was submitted and confirmed as a male adult Dirofilaria immitis. This is a novel case of an intradural D. immitis infection in the dog with a magnetic resonance imaging description of spinal D. immitis.

Radiation Necrosis of the Optic Chiasm, Optic Tract, Hypothalamus, and Upper Pons after Radiotherapy for Pituitary Adenoma, Detected by Gadolinium-Enhanced, T1-Weighted Magnetic Resonance Imaging: Case Report

Neurosurgery ◽  
1990 ◽  
Vol 27 (4) ◽  
pp. 640-643 ◽  
Author(s):  
Osamu Tachibana ◽  
Narihito Yamaguchi ◽  
Tetsumori Yamashima ◽  
Junkoh Yamashita
Keyword(s):  
Magnetic Resonance Imaging ◽  
Pituitary Adenoma ◽  
Magnetic Resonance ◽  
Radiation Necrosis ◽  
Optic Tract ◽  
Optic Chiasm ◽  
Magnetic Resonance Imaging Scan ◽  
Resonance Imaging ◽  
Weighted Magnetic Resonance Imaging ◽  
Resonance Imaging Scan

Abstract A 26-year-old woman was treated for a prolactin secreting pituitary adenoma by surgery and radiotherapy (5860 rads). Fourteen months later, she developed right hemiparesis and dysarthria. A T1-weighted magnetic resonance imaging scan using gadolinium contrast showed a small, enhanced lesion in the upper pons. Seven months later, she had a sudden onset of loss of vision, and radiation optic neuropathy was diagnosed. A T1-weighted magnetic resonance imaging scan showed widespread gadolinium-enhanced lesions in the optic chiasm, optic tract, and hypothalamus. Magnetic resonance imaging is indispensable for the early diagnosis of radiation necrosis, which is not visualized by radiography or computed tomography.

Congenital Cervical Spine Stenosis in a Multicenter Global Cohort of Patients With Degenerative Cervical Myelopathy: An Ambispective Report Based on a Magnetic Resonance Imaging Diagnostic Criterion

Neurosurgery ◽  
2018 ◽  
Vol 83 (3) ◽  
pp. 521-528 ◽  
Author(s):  
Aria Nouri ◽  
Lindsay Tetreault ◽  
Satoshi Nori ◽  
Allan R Martin ◽  
Anick Nater ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Cervical Spine ◽  
Magnetic Resonance ◽  
Surgical Outcomes ◽  
Cervical Myelopathy ◽  
Spinal Canal ◽  
Resonance Imaging ◽  
Baseline Severity ◽  
Degenerative Cervical Myelopathy

Abstract BACKGROUND Congenital spinal stenosis (CSS) of the cervical spine is a risk factor for acute spinal cord injury and development of degenerative cervical myelopathy (DCM). OBJECTIVE To develop magnetic resonance imaging (MRI)-based criteria to diagnose preexisting CSS and evaluate differences between patients with and without CSS. METHODS A secondary analysis of international prospectively collected data between 2005 and 2011 was conducted. We examined the data of 349 surgical DCM patients and 27 controls. Spinal canal and cord anteroposterior diameters were measured at noncompressed sites to calculate spinal cord occupation ratio (SCOR). Torg–Pavlov ratios and spinal canal diameters from radiographs were correlated with SCOR. Clinical and MRI factors were compared between patients with and without CSS. Surgical outcomes were also assessed. RESULTS Calculation of SCOR was feasible in 311/349 patients. Twenty-six patients with CSS were identified (8.4%). Patients with CSS were younger than patients without CSS (P = .03) and had worse baseline severity as measured by the modified Japanese Orthopedic Association score (P = .04), Nurick scale (P = .05), and Neck Disability Index (P < .01). CSS patients more commonly had T2 cord hyperintensity changes (P = .09, ns) and worse SF-36 Physical Component scores (P = .06, ns). SCOR correlated better with Torg–Pavlov ratio and spinal canal diameter at C3 than C5. Patients with SCOR ≥ 65% were also younger but did not differ in baseline severity. CONCLUSION SCOR ≥ 70% is an effective criterion to diagnose CSS. CSS patients develop myelopathy at a younger age and have greater impairment and disability than other patients with DCM. Despite this, CSS patients have comparable duration of symptoms, MRI presentations, and surgical outcomes to DCM patients without CSS.

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