scholarly journals The Need for a Broad Differential: Intramedullary Neurosarcoidosis Case Report

2021 ◽  
Author(s):  
Diego Dereck Luy ◽  
Daniel Tonetti ◽  
Peter Carlos Gerszten
Keyword(s):  
Spinal Cord ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Spinal Cord Lesion ◽  
Inflammatory Disorder ◽  
Pathological Findings ◽  
Thoracic Spinal Cord ◽  
Case Presentation ◽  
Thoracic Spinal ◽  
Immunosuppressant Treatment

Abstract BackgroundSarcoidosis, an idiopathic multisystem inflammatory disorder, involves the nervous system in as few as 5-15% of cases. We aim to detail how a rare case of intramedullary neurosarcoidosis spinal-cord lesion, present in less than 1% of sarcoidosis cases, presented with features mimicking a neoplasm. MethodsRetrospective chart review was performed to obtain pertinent details regarding history and examination, pathological findings, and treatment course.Case PresentationWe report a case of intramedullary sarcoidosis involving the cervical and thoracic spinal cord with syringomyelia, which presented as subacute neck pain, intermittent leg paresthesias, and difficult micturition. Historically, a spinal syrinx with concern for neoplasm has led surgeons to decompress the spinal cord for certain enhancing intramedullary lesions, which is unnecessary for neurosarcoidosis. Immunosuppressant treatment resulted in symptomatic resolution without the need for spinal cord biopsy or syrinx decompression in this case.Conclusions Expansile contrast-enhancing intramedullary lesions, most commonly neoplastic, may instead be non-neoplastic etiologies mimicking neoplastic features; therefore, it is the responsibility of any surgeon to maintain a broad differential diagnosis in the absence of a confirmed pathology.

scholarly journals A CASE OF LATELY RECURRENT BREAST CANCER RECOVERED FROM TRANSVERSAL UPPER THORACIC SPINAL CORD LESION

1992 ◽  
Vol 53 (12) ◽  
pp. 2934-2937
Author(s):  
Masahiro KIMURA ◽  
Shunzo KOBAYASHI ◽  
Hirotaka IWASE ◽  
Hideki FUKUOKA ◽  
Yukashi ITO ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Spinal Cord ◽  
Recurrent Breast Cancer ◽  
Spinal Cord Lesion ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Recurrent Breast ◽  
Upper Thoracic ◽  
Cord Lesion

scholarly journals Functional plasticity in the respiratory drive to thoracic motoneurons in the segment above a chronic lateral spinal cord lesion

2016 ◽  
Vol 115 (1) ◽  
pp. 554-567 ◽  
Author(s):  
T. W. Ford ◽  
N. P. Anissimova ◽  
C. F. Meehan ◽  
P. A. Kirkwood
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Lesion ◽  
Similar Distribution ◽  
Respiratory Drive ◽  
Functional Plasticity ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Spike Triggered Averaging ◽  
The Right ◽  
Cord Lesion

A previous neurophysiological investigation demonstrated an increase in functional projections of expiratory bulbospinal neurons (EBSNs) in the segment above a chronic lateral thoracic spinal cord lesion that severed their axons. We have now investigated how this plasticity might be manifested in thoracic motoneurons by measuring their respiratory drive and the connections to them from individual EBSNs. In anesthetized cats, simultaneous recordings were made intracellularly from motoneurons in the segment above a left-side chronic (16 wk) lesion of the spinal cord in the rostral part of T8, T9, or T10 and extracellularly from EBSNs in the right caudal medulla, antidromically excited from just above the lesion but not from below. Spike-triggered averaging was used to measure the connections between pairs of EBSNs and motoneurons. Connections were found to have a very similar distribution to normal and were, if anything (nonsignificantly), weaker than normal, being present for 42/158 pairs, vs. 55/154 pairs in controls. The expiratory drive in expiratory motoneurons appeared stronger than in controls but again not significantly so. Thus we conclude that new connections made by the EBSNs following these lesions were made to neurons other than α-motoneurons. However, a previously unidentified form of functional plasticity was seen in that there was a significant increase in the excitation of motoneurons during postinspiration, being manifest either in increased incidence of expiratory decrementing respiratory drive potentials or in an increased amplitude of the postinspiratory depolarizing phase in inspiratory motoneurons. We suggest that this component arose from spinal cord interneurons.

Nondysraphic pediatric intramedullary spinal cord lipomas

2010 ◽  
Vol 5 (2) ◽  
pp. 172-178 ◽  
Author(s):  
Karen L. Fleming ◽  
Laurence Davidson ◽  
Ignacio Gonzalez-Gomez ◽  
J. Gordon McComb
Keyword(s):  
Spinal Cord ◽  
Los Angeles ◽  
Retrospective Chart Review ◽  
Thoracic Spinal Cord ◽  
Intramedullary Spinal Cord ◽  
Institutional Review ◽  
Thoracic Spinal ◽  
Stabilization Procedure

Object Intramedullary spinal cord lipomas not associated with dysraphism are infrequently reported. When present, they typically occur in children and have a predilection for the cervical and thoracic spinal cord. The authors review the presentation, treatment, and disease course in 5 pediatric patients, and compare the outcomes with previously reported cases. Methods With institutional review board approval, a retrospective chart review was undertaken at Childrens Hospital Los Angeles. Results Four patients with intramedullary spinal cord lipomas and 1 patient with a lipoblastoma, none associated with dysraphism, were retrospectively reviewed. There were 2 boys and 3 girls ranging in age from 2 months to 4 years. Four patients underwent a laminectomy or laminoplasty with one or more subtotal resections. One patient initially underwent a decompressive laminoplasty without debulking. The median follow-up was 8 years (range 12 months–11 years). Two patients had regrowth of their lipoma, necessitating a second surgery in one patient and 3 debulking surgeries in the other. Postoperatively, 3 patients developed mild kyphosis, none significant enough to require orthopedic intervention. One patient underwent a stabilization procedure at the time of the initial laminectomy and tumor debulking. No patient received chemotherapy or radiation. At the most recent follow-up visit, patients demonstrated improved neurological function when compared with preoperative status. Conclusions In addition to a decompressive laminectomy, debulking of the lipoma provides the best long-term neurological outcome. Gross-total excision is not warranted and usually is not possible. Long-term follow-up is needed, and repeat debulking of the lipoma is indicated if there is an increase in tumor size due to hyperplasia of residual adipocytes, when tumor growth is associated with neurological deterioration.

Spontaneous Herniation of the Thoracic Spinal Cord: A Case Report

2001 ◽  
Vol 45 (4) ◽  
pp. 353 ◽  
Author(s):  
Sung Chan Jin ◽  
Seoung Ro Lee ◽  
Dong Woo Park ◽  
Kyung Bin Joo
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Spontaneous Herniation

Lipomeningocele associated with diplomyelia in a dog

2018 ◽  
Vol 46 (05) ◽  
pp. 323-329 ◽  
Author(s):  
Nele Ondreka ◽  
Sara Malberg ◽  
Emma Laws ◽  
Martin Schmidt ◽  
Sabine Schulze
Keyword(s):  
Spinal Cord ◽  
Neurological Status ◽  
Split Cord Malformation ◽  
Lumbar Spinal Cord ◽  
Histopathological Diagnosis ◽  
Type I ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Subcutaneous Mass ◽  
Lumbar Spinal

SummaryA 2-year-old male neutered mixed breed dog with a body weight of 30 kg was presented for evaluation of a soft subcutaneous mass on the dorsal midline at the level of the caudal thoracic spine. A further clinical sign was intermittent pain on palpation of the area of the subcutaneous mass. The owner also described a prolonged phase of urination with repeated interruption and re-initiation of voiding. The findings of the neurological examination were consistent with a lesion localization between the 3rd thoracic and 3rd lumbar spinal cord segments. Magnetic resonance imaging revealed a spina bifida with a lipomeningocele and diplomyelia (split cord malformation type I) at the level of thoracic vertebra 11 and 12 and secondary syringomyelia above the aforementioned defects in the caudal thoracic spinal cord. Surgical resection of the lipomeningocele via a hemilaminectomy was performed. After initial deterioration of the neurological status postsurgery with paraplegia and absent deep pain sensation the dog improved within 2 weeks to non-ambulatory paraparesis with voluntary urination. Six weeks postoperatively the dog was ambulatory, according to the owner. Two years after surgery the owner recorded that the dog showed a normal gait, a normal urination and no pain. Histopathological diagnosis of the biopsied material revealed a lipomeningocele which confirmed the radiological diagnosis.

scholarly journals The Histopathology of Severe Graded Compression in Lower Thoracic Spinal Cord Segment of Rat, Evaluated at Late Post-injury Phase

2021 ◽  
Author(s):  
Fedorova Jana ◽  
Kellerova Erika ◽  
Bimbova Katarina ◽  
Pavel Jaroslav
Keyword(s):  
Spinal Cord ◽  
Spontaneous Recovery ◽  
Traumatic Injury ◽  
Blue Dye ◽  
Post Injury ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Severe Traumatic Injury ◽  
Spinal Cord Segment ◽  
Cord Injury

AbstractSpontaneous recovery of lost motor functions is relative fast in rodent models after inducing a very mild/moderate spinal cord injury (SCI), and this may complicate a reliable evaluation of the effectiveness of potential therapy. Therefore, a severe graded (30 g, 40 g and 50 g) weight-compression SCI at the Th9 spinal segment, involving an acute mechanical impact followed by 15 min of persistent compression, was studied in adult female Wistar rats. Functional parameters, such as spontaneous recovery of motor hind limb and bladder emptying function, and the presence of hematuria were evaluated within 28 days of the post-traumatic period. The disruption of the blood-spinal cord barrier, measured by extravasated Evans Blue dye, was examined 24 h after the SCI, when maximum permeability occurs. At the end of the survival period, the degradation of gray and white matter associated with the formation of cystic cavities, and quantitative changes of glial structural proteins, such as GFAP, and integral components of axonal architecture, such as neurofilaments and myelin basic protein, were evaluated in the lesioned area of the spinal cord. Based on these functional and histological parameters, and taking the animal’s welfare into account, the 40 g weight can be considered as an upper limit for severe traumatic injury in this compression model.

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