scholarly journals Pregnancy in a diagnosed case of cauda equina syndrome and it’s management: a case report

2021 ◽  
Vol 10 (7) ◽  
pp. 2917
Author(s):  
Yashaswi Pandey ◽  
Kalyani Saidhandhapani
Keyword(s):  
Case Report ◽  
Cauda Equina Syndrome ◽  
Residual Disease ◽  
Burst Fracture ◽  
Cauda Equina ◽  
Lumbar Vertebrae ◽  
Lower Limbs ◽  
Autonomic Dysreflexia ◽  
Foot Drop ◽  
Cord Injury

As with many rare conditions, little is known about cauda equina syndrome (CES) and reproduction. Knowledge pertaining to complications during pregnancy and its management in a patient with diagnosed case of CES is even more scant. The information which we have is from attending on individual cases who presented with CES diagnosed during pregnancy. The following case report demonstrates pregnancy in a known case of CES, diagnosed after sustaining a burst fracture of lumbar vertebrae followed by surgical decompression at puberty. Patient conceived spontaneously with residual disease as symptoms of perineal numbness, sensory deficit in both lower limbs and persistent saddle hypoesthesia along with foot drop and gait abnormalities and presented at 30 weeks of gestation. CES is an unusual entity that appears in between 2-6% of all cases of disc herniation in the lumbar segment. Related post-traumatic presentations are extremely rare. Pregnancy exacerbates most problems associated with spinal cord injury. Autonomic dysreflexia may present as a complication in a case of pregnancy with CES which may be life threatening and requires immediate treatment. Antenatal management and complications of pregnancy in a diagnosed case of CES has not been documented till date.

An L-2 burst fracture and cauda equina syndrome due to tetanus

2012 ◽  
Vol 16 (1) ◽  
pp. 82-85 ◽  
Author(s):  
Thomas J. Wilson ◽  
Daniel A. Orringer ◽  
Stephen E. Sullivan ◽  
Parag G. Patil
Keyword(s):  
Cauda Equina Syndrome ◽  
Burst Fracture ◽  
Cauda Equina ◽  
Autonomic Dysreflexia ◽  
Vertebral Compression Fractures ◽  
Nerve Terminals ◽  
Bone Fragment ◽  
Compression Fractures ◽  
Natural Progression ◽  
Presynaptic Nerve Terminals

Thoracic vertebral compression fractures are a known complication of generalized tetanus. The authors report the first known case of an L-2 burst fracture leading to cauda equina syndrome, as a result of generalized tetanus. This 51-year-old man had generalized tetanus with a constellation of symptoms including compartment syndrome requiring fasciotomies, severe axial spasms and spasms of the extremities, autonomic dysreflexia, hypercarbic respiratory failure, and rhabdomyolysis. During the course of his illness, areflexic paraparesis developed in his lower extremities. He was found to have an L-2 burst fracture with retropulsion of a bone fragment resulting in cauda equina syndrome. Operative intervention was undertaken to decompress the cauda equina and stabilize the spine. The natural progression of tetanus can be complex, with a mixed picture ranging from spasms plus increased tone and reflexes to reduced tone and reflexes as presynaptic nerve terminals become damaged. The authors suggest that all sudden changes in the neurological examination should prompt consideration of diagnostic imaging before attributing such changes to natural progression of the disease.

scholarly journals Acute bilateral foot drop with or without cauda equina syndrome—a case series

2021 ◽  
Vol 163 (4) ◽  
pp. 1191-1198
Author(s):  
Andreas K. Demetriades ◽  
Marco Mancuso-Marcello ◽  
Asfand Baig Mirza ◽  
Joseph Frantzias ◽  
David A. Bell ◽  
...  
Keyword(s):  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Case Series ◽  
Foot Drop ◽  
Spinal Disease ◽  
Full Resolution ◽  
Degenerative Spinal Disease ◽  
The Mean ◽  
The One

Abstract Introduction Isolated acute bilateral foot drop due to degenerative spine disease is an extremely rare neurosurgical presentation, whilst the literature is rich with accounts of chronic bilateral foot drop occurring as a sequela of systemic illnesses. We present, to our knowledge, the largest case series of acute bilateral foot drop, with trauma and relevant systemic illness excluded. Methods Data from three different centres had been collected at the time of historic treatment, and records were subsequently reviewed retrospectively, documenting the clinical presentation, radiological level of compression, timing of surgery, and degree of neurological recovery. Results Seven patients are presented. The mean age at presentation was 52.1 years (range 41–66). All patients but one were male. All had a painful radiculopathic presentation. Relevant discopathy was observed from L2/3 to L5/S1, the commonest level being L3/4. Five were treated within 24 h of presentation, and two within 48 h. Three had concomitant cauda equina syndrome; of these, the first two made a full motor recovery, one by 6 weeks follow-up and the second on the same-day post-op evaluation. Overall, five out of seven cases had full resolution of their ankle dorsiflexion pareses. One patient with 1/5 power has not improved. Another with 1/5 weakness improved to normal on the one side and to 3/5 on the other. Conclusion When bilateral foot drop occurs acutely, we encourage the consideration of degenerative spinal disease. Relevant discopathy was observed from L2/3 to L5/S1; aberrant innervation may be at play. Cauda equina syndrome is not necessarily associated with acute bilateral foot drop. The prognosis seems to be pretty good with respect to recovery of the foot drop, especially if partial at presentation and if treated within 48 h.

Cauda Equina Syndrome After Percutaneous Endoscopic Discectomy At L5-S1 -A case Report-

2005 ◽  
Vol 12 (4) ◽  
pp. 365
Author(s):  
Byung-Joon Shin ◽  
Jae-Chul Lee ◽  
Jun-Seo Nam ◽  
Je-Pil Eom ◽  
Young-Il Cho ◽  
...  
Keyword(s):  
Case Report ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Endoscopic Discectomy

scholarly journals Late presentation of a cauda equina lesion with a vulval abscess: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Chanil Deshan Ekanayake ◽  
Deepal Weerasekera ◽  
Dilini Dissanayake ◽  
Ranga Wickramarachchi ◽  
Saman Pushpakumara ◽  
...  
Keyword(s):  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Late Presentation ◽  
Surgical Decompression ◽  
Lower Limbs ◽  
Sensory Loss ◽  
Postoperative Rehabilitation ◽  
Indwelling Catheter ◽  
Distended Bladder ◽  
Tract Infections

Abstract Background Cauda equina syndrome is a rare clinical condition that requires prompt diagnosis and timely surgical decompression with postoperative rehabilitation to prevent devastating complications. Case presentation A 55-year-old Sinhalese woman presented with a vulval abscess, with a history of involuntary leakage of urine for the last 7 years. Her sexual activity has been compromised due to coital incontinence, and she had also been treated for recurrent urinary tract infections during the last 7 years. On examination, a distended bladder was found. Neurological examination revealed a saddle sensory loss of S2–S4 dermatomes. There was no sensory loss over the lower limbs. Bladder sensation was absent, but there was some degree of anal sphincter tone. Motor functions and reflexes were normal in the limbs. Magnetic resonance imaging revealed L5–S1 spondylolisthesis. Ultrasound imaging confirmed the finding of a distended bladder, in addition to bilateral hydroureters with hydronephrosis. An incision and drainage with concomitant intravenous antibiotics were started for the vulval abscess. An indwelling catheter was placed to decompress the bladder and to reduce vulval excoriations due to urine. Bilateral ureteric stenting was performed later for persistent hydronephrosis and hydroureter despite an empty bladder. Conclusion This is a tragic case that illustrates the devastating long-term sequelae that ensues if cauda equina syndrome is left undiagnosed. It reiterates the importance of prompt referral and surgical decompression.

scholarly journals Cauda equina syndrome after spinal anesthesia in a patient with severe spinal stenosis - A case report -

2009 ◽  
Vol 57 (3) ◽  
pp. 364
Author(s):  
Kyu Don Chung ◽  
Sung Jun Yu ◽  
Sang Mook Lee ◽  
Hyun Sook Cho ◽  
Youn Suk Son ◽  
...  
Keyword(s):  
Case Report ◽  
Spinal Anesthesia ◽  
Spinal Stenosis ◽  
Cauda Equina Syndrome ◽  
Cauda Equina
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