Brain, Spinal Cord and Labyrinthine Concussion in Sports

In this paper, we discuss the 3 types of concussion that occur in sports; brain concussion, spinal concussion (spinal cord neurapraxia), and labyrinthine (inner ear) concussion. Brain concussion data was collected from professional ice hockey players (Tohoku Free Blades, Japan) during 9 consecutive seasons. Spinal cord concussion and Labyrinthine concussion data was collected from athletes who sustained the injury in various sports including ice hockey. Material and methods The average incidence of brain concussion in professional ice hockey players was 2.0 per season. All 13 cases of spinal cord concussion were cervical cord concussion. Seven cases showed evidence of spinal cord compression; six cases had no radiological abnormality observed. All cases of labyrinthine concussion were sustained through a traumatic blow to the lateral aspect of the head. Results In any sports injury, all three of these concussions can co-exist and requires the team doctor to be at the site in order to fully assess the injury.

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Cardiovascular response to experimental spinal cord compression

Journal of Neurosurgery ◽

10.3171/jns.1973.38.3.0326 ◽

1973 ◽

Vol 38 (3) ◽

pp. 326-331 ◽

Cited By ~ 45

Author(s):

Eduardo E. Eidelberg

Keyword(s):

Spinal Cord ◽

Spinal Cord Compression ◽

Cardiovascular Response ◽

Pressor Response ◽

Blocking Agent ◽

Cord Compression ◽

Left Ventricular ◽

Cervical Cord ◽

Content Type ◽

Ectopic Beats

✓ Anesthetized, and unanesthetized decerebrate, cats were used to study the arterial pressor response to spinal cord compression. To produce a cervical compression it was necessary that the cervical cord be functionally connected to the thoracic cord, pressor response by the reverse was not true. A pressor response above 200 mm Hg systolic was associated with electrocardiographic (EKG) signs of left ventricular overload and ventricular ectopic beats. These changes were not prevented by atropine, hexamethonium, or propanolol. Both the pressor response and the EKG abnormalities were prevented by an alpha-adrenergic blocking agent. The authors conclude that alpha-adrenergically mediated arterial vasoconstriction is the effector mechanism in the pressor response to increased intracranial pressure or cord compression.

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Cilostazol, a selective Type III phosphodiesterase inhibitor: prevention of cervical myelopathy in a rat chronic compression model

Journal of Neurosurgery Spine ◽

10.3171/2013.9.spine121136 ◽

2014 ◽

Vol 20 (1) ◽

pp. 93-101 ◽

Cited By ~ 17

Author(s):

Shinji Yamamoto ◽

Ryu Kurokawa ◽

Phyo Kim

Keyword(s):

Spinal Cord ◽

Grip Strength ◽

Motor Neurons ◽

Cervical Myelopathy ◽

Cervical Spondylotic Myelopathy ◽

Phosphodiesterase Inhibitor ◽

Cord Compression ◽

Anterior Horn ◽

Cervical Cord ◽

Forced Running

Object Regional blood flow is decreased in experimental models of chronic spinal cord compression, and the alteration presumably contributes to the development of myelopathy. Cilostazol (Otsuka Pharmaceuticals Co.), a selective Type III phosphodiesterase inhibitor, has been shown to be neuroprotective in cerebral hypoperfusion animal models and clinically effective in preventing the recurrence of cerebral infarction. To investigate the neuroprotective effect of cilostazol on cervical spondylotic myelopathy, the preventive effect against progressive motor dysfunction and the loss of anterior horn motor neurons were assessed using a chronic cord compression model in rats. Methods To produce chronic cervical cord compression in male Wistar rats, thin polyurethane sheets (3 × 5 × 0.7 mm) that gradually expand over 48–72 hours by absorbing water were implanted under the C5–6 laminae. In sham operations, the sheets were momentarily placed and then immediately removed. This model has been shown to reproduce characteristic features of clinical cervical myelopathy, with progressive motor disturbances after a latency period and insidious neuronal loss preceding the onset of symptoms. In the treatment group, cilostazol (30 mg/kg/day) was orally administered to the rats once a day, starting the day after surgery and continuing through the entire observation period of 25 weeks. In the control group, vehicle solution was administered under the same protocol. Changes in motor function were monitored by measuring bilateral forepaw grip strength and the duration of forced running on a treadmill. Twenty-five weeks after surgery, cervical spinal cords were examined histopathologically. Results Cilostazol preserved both forepaw grip strength and forced running capability. The drug also preserved anterior horn motor neurons in the C5–6 spinal cord segment, which diminished in number in the untreated chronic compression group. The drug decreased the number of TUNEL-positive apoptotic cells. Conclusions These results indicate that cilostazol is neuroprotective in the chronically compressed cervical cord and is potentially useful in the treatment of cervical spondylotic myelopathy.

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Spinal Injuries in Canadian Ice Hockey: Documentation of Injuries Sustained from 1943-1999

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100003632 ◽

2004 ◽

Vol 31 (4) ◽

pp. 460-466 ◽

Cited By ~ 23

Author(s):

C.H. Tator ◽

C.F. Provvidenza ◽

L. Lapczak ◽

J. Carson ◽

D. Raymond

Keyword(s):

Spinal Cord ◽

Spinal Cord Injuries ◽

Spinal Injury ◽

Spinal Injuries ◽

Ice Hockey ◽

Common Mechanism ◽

Cord Injury ◽

Hockey Players ◽

Rules Changes ◽

Type Of Fracture

Objectives:Study objectives were: (a) to examine the causes and incidence of major spinal cord injuries sustained by ice hockey players; and (b) to add recently reported Canadian cases to the Canadian Ice Hockey Spinal Injury Registry to determine the effectiveness of prevention efforts.Methods:The study was a review of questionnaires returned retrospectively by physicians and other sources reporting ice hockey related spinal injuries in Canada. Physicians reported on the mechanism of injury, vertebral level of injury, presence of neurologic deficit, type of event, and type of fracture.Results:Between 1943 and 1999, 271 major spinal injuries were reported in Canadian ice hockey players, of which 49.0% occurred to players 16-20 years of age. Ontario has had a disproportionately large number of injuries compared to some provinces, especially Quebec. Of the spinal cord injuries, 65.8% resulted from colliding with the boards, and 36.6% were due to players being pushed or checked from behind. The recent survey shows that there has been a decline in the number of major spinal cord injuries in Canadian ice hockey, especially those causing paralysis due to checking or pushing from behind.Conclusion:Impact of the head with the boards after being checked or pushed from behind was the most common mechanism of spinal cord injury. Injury prevention programs are becoming effective in reducing the overall number of injuries, especially those due to checking from behind. Greater awareness of the occurrence and mechanisms of injury through educational programs and rules changes by organized hockey have reduced the annual incidence of catastrophic spinal injuries in Canadian ice hockey.

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Epidemiological study of cervical cord compression and its clinical symptoms in community-dwelling residents

PLoS ONE ◽

10.1371/journal.pone.0256732 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0256732

Author(s):

Toru Hirai ◽

Koji Otani ◽

Miho Sekiguchi ◽

Shin-ichi Kikuchi ◽

Shin-ichi Konno

Keyword(s):

Spinal Cord ◽

Spinal Cord Compression ◽

Clinical Symptoms ◽

Cord Compression ◽

Community Dwelling ◽

Gait Disturbance ◽

Cervical Cord ◽

Cervical Cord Compression ◽

The Relationship ◽

Disc Level

Background Degenerative compressive myelopathy (DCM) is caused by cervical cord compression. The relationship between the magnitude and clinical findings of cervical cord compression has been described in the literature, but the details remain unclear. This study aimed to clarify the relationship between the magnitude and clinical symptoms of cervical cord compression in community-dwelling residents. Methods The present study included 532 subjects. The subjective symptoms and the objective findings of one board-certified spine surgeon were assessed. The subjective symptoms were upper extremity pain and numbness, clumsy hand, fall in the past 1 year, and subjective gait disturbance. The objective findings were: Hoffmann, Trömner, and Wartenberg signs; Babinski’s and Chaddock’s signs; hyperreflexia of the patellar tendon and Achilles tendon reflexes; ankle clonus; Romberg and modified Romberg tests; grip and release test; finger escape sign; and grip strength. Using midsagittal T2-weighted magnetic resonance imaging, the anterior–posterior (AP) diameters (mm) of the spinal cord at the C2 midvertebral body level (DC2) and at each intervertebral disc level from C2/3 to C7/T1 (DC2/3-C7/T1) were measured. The spinal cord compression ratio (R) for each intervertebral disc level was defined and calculated as DC2/3-C7/T1 divided by DC2. The lowest R (LR) along C2/3 to C7/T1 of each individual was divided into 3 grades by the tertile method. The relationship between LR and clinical symptoms was investigated by trend analysis. Results The prevalence of subjective gait disturbance increased significantly with the severity of spinal cord compression (p = 0.002812), whereas the other clinical symptoms were not significantly related with the severity of spinal cord compression. Conclusions The magnitude of cervical cord compression had no relationship with any of the neurologic findings. However, subjective gait disturbance might be a better indicator of the possibility of early stage cervical cord compression.

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Cervical Cord Compression With Lower Limbs Sensory Disturbance Presentation: Three Case Reports and Literature Review

10.21203/rs.3.rs-1037842/v1 ◽

2021 ◽

Author(s):

Yafei Cao ◽

Yihong Wu ◽

Weiji Yu ◽

Weidong Liu ◽

Shufen Sun ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Compression ◽

Lower Limb ◽

Cord Compression ◽

Lower Limbs ◽

Anterior Cervical Discectomy ◽

Cervical Cord ◽

Sensory Disturbance ◽

Cervical Discectomy ◽

Sensory Disturbances

Abstract Background: Lower limb sensory disturbance presentation can be a false localizing cervical cord compressive myelopathy (CSM). It may lead to delayed or missed diagnosis, resulting in the wrong management plan, especially in the presence of concurrent lumbar lesions.Case presentation:Three Asian patients with lower limb sensory disturbances presentation were treated ineffectively in the lumbar. Magnetic resonance imaging (MRI) showed cervical disc herniation and cervical level spinal cord compression. Anterior cervical discectomy surgery and zero-p interbody fusion were performed. After operations, imagings showed that the spinal cord compression were relieved, and the lower limbs sensory disturbances were also relieved. Three-months follow-up after operation showed good recovery.Conclusions:These three cervical cord compression cases of lower limb sensory disturbance presentation were easily misdiagnosed with lumbar spondylosis. Anterior cervical discectomy and fusion operation had a good therapeutic effect. Therefore, cases that present with lower limb sensory disturbance, but in a non-radicular classical pattern, should always alert a suspicion of a possible cord compression cause at a higher level.

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Osteolysis and Cervical Cord Compression Secondary to Silicone Granuloma Formation around a Dorsal Spinal Cord Stimulator: A Case Report

Journal of Neurological Surgery Reports ◽

10.1055/s-0036-1579631 ◽

2016 ◽

Vol 77 (02) ◽

pp. e67-e72 ◽

Cited By ~ 5

Author(s):

John Dimar ◽

David Endriga ◽

Leah Carreon

Keyword(s):

Spinal Cord ◽

Case Report ◽

Cord Compression ◽

Granuloma Formation ◽

Cervical Cord ◽

Spinal Cord Stimulator ◽

Dorsal Spinal Cord ◽

Cervical Cord Compression ◽

Dorsal Spinal ◽

Silicone Granuloma

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Pediatric spinal injury: review of 174 hospital admissions

Journal of Neurosurgery ◽

10.3171/jns.1992.77.5.0700 ◽

1992 ◽

Vol 77 (5) ◽

pp. 700-704 ◽

Cited By ~ 176

Author(s):

Mark G. Hamilton ◽

S. Terence Mylks

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Hospital Admissions ◽

Spinal Injury ◽

Neurological Injury ◽

Cervical Cord ◽

Mature Adult ◽

Younger Patients ◽

Cord Injury ◽

Radiological Abnormality

✓ Injury to the spinal column and spinal cord occurs relatively infrequently in the pediatric population. A review of 174 pediatric patients is presented, representing 5.4% of all patients admitted with spinal injury, Spinal cord injury was present in 45% of patients. A distinct injury profile, explained by anatomical and biomechanical features, distinguishes the young patient with an immature spine from older adolescents with a more mature, adult-like spine. The younger patients, while less likely to have spinal injury, had a higher incidence of neurological injury, in addition to a higher frequency of both spinal cord injury without radiological abnormality and upper cervical cord injury. In addition, younger patients with spinal cord injury and no radiological abnormality were more likely to have complete or severe cord injury. Prognosis was determined by the severity of spinal cord injury. Patients with complete cord injuries showed little improvement, while patients with incomplete injuries generally fared much better, with 74% showing significant improvement and 59% experiencing a complete recovery of neurological functions. There were six deaths, but none was attributed solely to spinal injury. The authors conclude that outcome is quite good after pediatric spinal cord injury that does not produce a physiologically complete cord deficit.

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The Role of Dynamic Magnetic Resonance Imaging in Cervical Spondylotic Myelopathy

Asian Spine Journal ◽

10.4184/asj.2017.11.6.1008 ◽

2017 ◽

Vol 11 (6) ◽

pp. 1008-1015 ◽

Cited By ~ 9

Author(s):

John Paul Kolcun ◽

Lee Onn Chieng ◽

Karthik Madhavan ◽

Michael Y. Wang

Keyword(s):

Spinal Cord ◽

Cervical Spondylotic Myelopathy ◽

English Language ◽

Case Reports ◽

Preoperative Evaluation ◽

Case Series ◽

Dynamic Mri ◽

Cord Compression ◽

Cervical Cord ◽

Dynamic Changes

<p>Dynamic spinal cord compression has been investigated for several years, but until the advent of open MRI, the use of dynamic MRI (dMRI) did not gain popularity. Several publications have shown that cervical cord compression is both static and dynamic. On many occasions the evaluation of cervical spondylotic myelopathy (CSM) is straightforward, but patients are frequently encountered with a significantly worse clinical examination than would be suggested by radiological images. In this paper, we present an extensive review of the literature in order to describe the importance of dMRI in various settings and applications. A detailed literature review was performed in the Medline and Pubmed databases using the terms “cervical spondylotic myelopathy”, “dynamic MRI”, “kinetic MRI”, and “myelomalalcia” for the period of 1980-2016. The study was limited to English language, human subjects, case series, retrospective studies, prospective reports, and clinical trials. Reviews, case reports, cadaveric studies, editorials, and commentaries were excluded. The literature search yielded 180 papers, 19 of which met inclusion criteria. However, each paper had evaluated results and outcomes in different ways. It was not possible to compile them for meta-analysis or pooled data evaluation. Instead, we evaluated individual studies and present them for discussion. We describe a number of parameters evaluated in 2661 total patients, including dynamic changes to spinal cord and canal dimensions, transient compression of the cord with changes in position, and the effects of position on the intervertebral disc. dMRI is a useful tool for understanding the development of CSM. It has found several applications in the diagnosis and preoperative evaluation of many patients, as well as certain congenital dysplasias and Hirayama disease. It is useful in correlating symptoms with the dynamic changes only noted on dMRI, and has reduced the incidence of misdiagnosis of myelopathy.</p>

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Symptomatic hydrocephalus and reversible spinal cord compression in Listeria monocytogenes meningitis

Journal of Neurosurgery ◽

10.3171/jns.1989.71.4.0620 ◽

1989 ◽

Vol 71 (4) ◽

pp. 620-622 ◽

Cited By ~ 6

Author(s):

Eric C. Raps ◽

David H. Gutmann ◽

James R. Brorson ◽

Michael O'Connor ◽

Howard I. Hurtig

Keyword(s):

Spinal Cord ◽

Listeria Monocytogenes ◽

Cord Compression ◽

Cervical Cord ◽

Communicating Hydrocephalus ◽

Ventricular Drainage ◽

Central Nervous System Infections ◽

Content Type ◽

Clinical Syndromes ◽

Fine Print

✓ Central nervous system infections with Listeria monocytogenes result in varied clinical syndromes ranging from meningitis to rhomboencephalitis. A case of Listeria meningitis complicated by symptomatic communicating hydrocephalus and hydrostatic cervical cord compression is presented which clinically and radiographically improved with aggressive ventricular drainage.

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