Fatal outcome of cervical myelopathy caused by fibrocartilaginous embolism. Rare cause of spinal vascular damage

2021 ◽  
Vol 74 (5-6) ◽  
pp. 207-210
Author(s):  
András Folyovich ◽  
László Havas ◽  
Gizella Vadász ◽  
Ágnes Fehér ◽  
Károly Vadasdi ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Fatal Outcome ◽  
Upper Extremities ◽  
Definite Diagnosis ◽  
Resonance Imaging ◽  
Intramedullary Lesion ◽  
Fibrocartilaginous Embolism ◽  
Complex Therapy ◽  
Neuropathological Examination

Fibrocartilaginous embolism is a rare cause of ischemic myelopathy. Authors report a case of a 39-year-old woman with progressive tetraparesis and severe autonomic dysfunction. Despite of the detailed examinations, the definite diagnosis was verified by autopsy. The patient was admitted because of progressive pain and numbness of the upper extremities and tetraparesis. Hypotonic muscles of the lower extremities with mild tetraparesis were observed. Magnetic resonance imaging showed an intramedullary lesion at the level of the cervical V-VII vertebral. Patient’s tetraparesis worsened gradually to plegia with urinary retention. Expansive, rapidly progressing multiple decubiti developed, which were resistant to therapy. In spite of the complex therapy, the patient died. No internal disease was found to explain the death by autopsy. Multiple subacute infarctions of the cervical myelon (involving the lateral columns as well) in the territory of the anterior spinal artery were verified by neuropathological examination. The occluded vessels were filled by a material containing cartilaginous cells, while signs of atherosclerosis or thrombosis were not present. Cartilaginous embolism of spinal arteries was diagnosed.

scholarly journals Post-Mortem 7.0-Tesla Magnetic Resonance Imaging of the Hippocampus in Progressive Supranuclear Palsy with and without Cerebral Amyloid Angiopathy

NeuroSci ◽  
2020 ◽  
Vol 1 (2) ◽  
pp. 115-120
Author(s):  
Jacques De Reuck ◽  
Florent Auger ◽  
Nicolas Durieux ◽  
Claude-Alain Maurage ◽  
Vincent Deramecourt ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Progressive Supranuclear Palsy ◽  
Cerebral Amyloid Angiopathy ◽  
Amyloid Angiopathy ◽  
Post Mortem ◽  
Resonance Imaging ◽  
Cerebral Amyloid ◽  
Magnetic Resonance Imaging Mri ◽  
Neuropathological Examination

Introduction and Purpose: Cerebral amyloid angiopathy (CAA) can be observed in patients with progressive supranuclear palsy (PSP), though to a lesser degree than in Alzheimer’s disease. The present post-mortem 7.0-tesla magnetic resonance imaging (MRI) evaluates whether CAA has an influence on the degree of hippocampal atrophy (HA) and on the incidence of associated micro-infarcts (HMIs) and cortical micro-bleeds (HMBs). Material and Methods: Eight brains with PSP-CAA were compared to 20 PSP brains without CAA. In addition to the neuropathological examination, the hippocampus was evaluated on the most representative coronal section with T2 and T2*-weighted MRI sequences. The average degree of HA was determined in both groups. The incidence of HMIs and HMBs was also compared as well as the frequency of cortical micro-infarcts (CoMIs) and cortical micro-bleeds (CoMBs) in the hemispheric neocortex. Results: The neuropathological examination showed a higher incidence of lacunar infarcts in the PSP-CAA brains compared to the PSP ones. With magnetic resonance imaging (MRI), the severity of HA and the incidence of HMIs and HMBs was similar between both groups. Additionally, the frequency of CoMIs and CoMBs in the neocortex was comparable. Conclusions: The association of CAA in PSP brains has no influence on the degree of HA and on the incidence of the small cerebrovascular lesions in the hippocampus as well as in the neocortex.

Post-mortem Magnetic Resonance Imaging as an Additional Tool of the Neuropathological Examination of Neurodegenerative and Cerebrovascular Diseases

2016 ◽  
Vol 11 (1) ◽  
pp. 22 ◽  
Author(s):  
Jacques L De Reuck ◽  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Cerebral Hemisphere ◽  
Small Samples ◽  
Post Mortem ◽  
Resonance Imaging ◽  
Cerebrovascular Lesions ◽  
Additional Tool ◽  
Neuropathological Examination

Neuropathological examination of post-mortem brains of patients with dementia due to neurodegenerative and cerebrovascular changes remains important, as the family wants to be sure about the clinical diagnosis and the risk of a hereditary disease. 7.0-tesla magnetic resonance imaging (MRI) can be applied as an additional tool to examine post-mortem brains of patients with neurodegenerative and cerebrovasular diseases. It allows examination of serial coronal sections of a cerebral hemisphere and horizontal sections of brainstem and cerebellum and comparison with the neuropathological lesions. Post-mortem MRI can show the degree and the distribution of the cerebral atrophy. Additional small cerebrovascular lesions can be quantified. The degree of iron load, not due to microbleeds, can be evaluated in different basal ganglia and brainstem structures. Three to six serial sections of a cerebral hemisphere and one section of brainstem and cerebellum allow the evaluation of the most important brain changes and to select the small samples to be used for histological diagnostic purposes. These correlation studies are extremely important for the future, when more 7.0-tesla MRI machines will be available forin vivoclinical-radiological diagnosis. This article is a review of post-mortem MRI data in the brains of patients with neurodegenerative and vascular dementias.

scholarly journals Intramedullary Blastomycosis in a Child: Case Report

2004 ◽  
Vol 31 (2) ◽  
pp. 282-285 ◽  
Author(s):  
A.M. Parr ◽  
D. Fewer
Keyword(s):  
Magnetic Resonance Imaging ◽  
Differential Diagnosis ◽  
Case Report ◽  
Magnetic Resonance ◽  
Clinical Presentation ◽  
Substantial Improvement ◽  
Pathological Examination ◽  
Resonance Imaging ◽  
Total Resection ◽  
Intramedullary Lesion

AbstractObjective:To report a case of spinal intramedullary blastomycosis causing myelopathy. This is the first published case of a pediatric patient with intramedullary blastomycosis and compromised function.Clinical presentation:An otherwise healthy 13-year-old patient was diagnosed with respiratory North American blastomycosis. She subsequently received a five-month course of itraconazole with presumed resolution of the infection. The patient presented again at 14 years of age with a lumbar myelopathy. Magnetic resonance imaging revealed an intramedullary lesion of 1 cm diameter at the level of T12-L1.Intervention:AT12-L1 laminectomy was performed with a gross total resection of the lesion. Pathological examination and microbiological culture of the specimen was consistent with blastomycosis. Postoperatively, the patient was placed on a five week course of amphotericin B. The patient showed substantial improvement in neurological function.Conclusion:Blastomycosis can present as an isolated intramedullary lesion causing compromised function. It should be considered in the differential diagnosis of a patient with a myelopathy and previously recognized blastomycosis. The prognosis is good with surgical resection.

scholarly journals Intramedullary Cervical Tuberculoma: A Case Report With Note on Surgical Management

2015 ◽  
Vol 100 (1) ◽  
pp. 133-136 ◽  
Author(s):  
Hong-Bin Ju ◽  
Dong-Ming Guo ◽  
Fan-Fan Chen
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Symptoms ◽  
Previous History ◽  
Mass Effect ◽  
Cord Compression ◽  
Cervical Cord ◽  
Resonance Imaging ◽  
Intramedullary Lesion ◽  
The Right

Abstract This study aims to report a relatively rare entity—intramedullary tuberculum of cervical spine—and describe its management and some key learning points. Intramedullary tuberculomas are rare entities. Intramedullary tuberculoma is most commonly found in the thoracic cord of a patient and is rarely seen in the cervical cord. We present an intramedullary cervical tuberculoma in a 21-year-old patient with finding of spinal cord compression. All 4 limbs were spastic, with grade 1 power on the right side and grade 3 power on the left side. Sensory deficit was found below the C6 level. Magnetic resonance imaging showed an intramedullary lesion at the C5 to C6 levels. Intramedullary tuberculoma was diagnosed based on clinical symptoms, physical examination, previous history, and magnetic resonance imaging. A C5 to C7 laminectomy was performed. Intramedullary tuberculoma was resected by microsurgery. One year after the surgery, strength returned to normal grade 5. Excellent clinical outcome was obtained with a combination of both medical and surgical treatments. Intramedullary cervical tuberculoma should be removed without delay to eliminate any mass effect on the neurons as soon as possible.

scholarly journals Intramedullary Neurocysticercosis Mimicking Cord Tumor

2020 ◽  
Vol 10 ◽  
pp. 7
Author(s):  
Kamlesh Jobanputra ◽  
Karuna Raj ◽  
Frank Yu ◽  
Amit Agarwal
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Improvement ◽  
Patient Population ◽  
Cystic Lesion ◽  
Cervical Cord ◽  
Resonance Imaging ◽  
Intramedullary Lesion ◽  
Intracranial Lesions ◽  
Cord Lesion

Isolated spinal intramedullary involvement by neurocysticercosis is extremely rare. We report a case of a Hispanic female with right-sided weakness, magnetic resonance imaging showing cervical intramedullary lesion. Surgery was performed due to the progressive nature of symptoms. The cervical cord lesion was completely removed; pathology was consistent with degenerated cysticercosis. Progressive clinical improvement with physiotherapy was achieved. Although rare, especially in the absence of intracranial lesions, the diagnosis should be considered in appropriate patient population as it usually presents a peripherally enhancing cystic lesion.

scholarly journals Brain Magnetic Resonance Imaging Reveals Different Courses of Disease in Pediatric and Adult Cerebral Malaria

2020 ◽  
Author(s):  
Praveen K Sahu ◽  
Angelika Hoffmann ◽  
Megharay Majhi ◽  
Rajyabardhan Pattnaik ◽  
Catriona Patterson ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Cerebral Malaria ◽  
Brain Volume ◽  
Fatal Outcome ◽  
Brain Magnetic Resonance Imaging ◽  
Quantitative Mri ◽  
Resonance Imaging ◽  
Brain Swelling ◽  
Brain Volumes

Abstract Background Cerebral malaria is a common presentation of severe Plasmodium falciparum infection and remains an important cause of death in the tropics. Key aspects of its pathogenesis are still incompletely understood, but severe brain swelling identified by magnetic resonance imaging (MRI) was associated with a fatal outcome in African children. In contrast, neuroimaging investigations failed to identify cerebral features associated with fatality in Asian adults. Methods Quantitative MRI with brain volume assessment and apparent diffusion coefficient (ADC) histogram analyses were performed for the first time in 65 patients with cerebral malaria to compare disease signatures between children and adults from the same cohort, as well as between fatal and nonfatal cases. Results We found an age-dependent decrease in brain swelling during acute cerebral malaria, and brain volumes did not differ between fatal and nonfatal cases across both age groups. In nonfatal disease, reversible, hypoxia-induced cytotoxic edema occurred predominantly in the white matter in children, and in the basal ganglia in adults. In fatal cases, quantitative ADC histogram analyses also demonstrated different end-stage patterns between adults and children: Severe hypoxia, evidenced by global ADC decrease and elevated plasma levels of lipocalin-2 and microRNA-150, was associated with a fatal outcome in adults. In fatal pediatric disease, our results corroborate an increase in brain volume, leading to augmented cerebral pressure, brainstem herniation, and death. Conclusions Our findings suggest distinct pathogenic patterns in pediatric and adult cerebral malaria with a stronger cytotoxic component in adults, supporting the development of age-specific adjunct therapies.

Abnormalities of the upper extremities on fetal magnetic resonance imaging

2011 ◽  
Vol 38 (5) ◽  
pp. 559-567 ◽  
Author(s):  
S. F. Nemec ◽  
G. Kasprian ◽  
P. C. Brugger ◽  
D. Bettelheim ◽  
G. Amann ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Upper Extremities ◽  
Resonance Imaging ◽  
Fetal Magnetic Resonance Imaging

scholarly journals Fibrocartilaginous Embolism of the Spinal Cord Diagnosed by Characteristic Clinical Findings and Magnetic Resonance Imaging in 26 Dogs

2009 ◽  
Vol 71 (2) ◽  
pp. 171-176 ◽  
Author(s):  
Yuya NAKAMOTO ◽  
Tsuyoshi OZAWA ◽  
Kengo KATAKABE ◽  
Koichi NISHIYA ◽  
Nobuhiro YASUDA ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Clinical Findings ◽  
Resonance Imaging ◽  
Fibrocartilaginous Embolism

Aortic Arch Abnormality in a Patient with Klippel-Feil Syndrome

Vascular ◽  
2006 ◽  
Vol 14 (1) ◽  
pp. 43-46 ◽  
Author(s):  
Jihad Abbas ◽  
Munier Nazzal ◽  
Pablo Serrano ◽  
Lawrence Elmer
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Aortic Arch ◽  
Internal Carotid ◽  
Upper Extremities ◽  
Left Internal Carotid Artery ◽  
Complete Fusion ◽  
Resonance Imaging ◽  
The Third ◽  
Magnetic Resonance Imaging Mri

We present a case of a 43-year-old female with headaches, progressive paresthesias of the upper extremities, and vertigo. Ultrasonography could not visualize the left internal carotid artery (ICA). Magnetic resonance imaging (MRI) showed complete fusion of the C5, C6, and C7 levels, representing Klippel-Feil deformity. Angiography showed a unique abnormality of the aortic arch with complete absence of the left ICA. An embryologic defect associated with this type of abnormality is proposed, with defects of development of the third aortic arch and the aortic sac secondarily.

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