An unusual cause of polymorphic ventricular tachycardia: Acute cervical cord injury.

Cardiovascular disturbances are the leading causes of morbidity and mortality in patients of spinal cord particularly cervical cord injury accounting for approximately 30% of deaths. Most common cardiovascular dysfunctions are sinus bradycardia, hypotension, cardiac arrest, supraventricular tachycardia and all these occurs due to sympathetic withdrawal and unopposed vagal action. Here we are reporting a case of acute cervical cord injury with neurogenic shock in a 25 year young patient who developed polymorphic ventricular tachycardia, which degenerated to ventricular fibrillation and cardiac arrest. We described all possible mechanisms of development this arrythmia and its management.

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Hyperglycemia During Acute Spinal Cord Injury Is a Detrimental Factor That Impairs Functional Improvement in Acute C3-C4 Cervical Cord Injury Patients Without Any Bony Damages

Intensive Care Medicine Experimental ◽

10.1186/2197-425x-3-s1-a33 ◽

2015 ◽

Vol 3 (S1) ◽

Cited By ~ 1

Author(s):

K Kubota ◽

K Kobayakaya ◽

S Okada ◽

K Shiba ◽

Y Iwamoto

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Acute Spinal Cord Injury ◽

Functional Improvement ◽

Cervical Cord ◽

Cord Injury ◽

Cervical Cord Injury

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Electrophysiologic changes in lumbar spinal cord after cervical cord injury

Neurology ◽

10.1212/wnl.42.3.623 ◽

1992 ◽

Vol 42 (3) ◽

pp. 623-623 ◽

Cited By ~ 36

Author(s):

M. L. Aisen ◽

W. Brown ◽

M. Rubin

Keyword(s):

Spinal Cord ◽

Cervical Cord ◽

Lumbar Spinal Cord ◽

Cord Injury ◽

Lumbar Spinal ◽

Cervical Cord Injury

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Acute Cervical Cord Injury Associated with Ossification of the Posterior Longitudinal Ligament

Neurosurgery ◽

10.1227/01.neu.0000083590.84053.cc ◽

2003 ◽

Vol 53 (4) ◽

pp. 887-892 ◽

Cited By ~ 41

Author(s):

Izumi Koyanagi ◽

Yoshinobu Iwasaki ◽

Kazutoshi Hida ◽

Hiroyuki Imamura ◽

Shin Fujimoto ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Magnetic Resonance ◽

Posterior Longitudinal Ligament ◽

Cervical Cord ◽

Resonance Imaging ◽

Cord Injury ◽

Frankel Grade ◽

Cervical Cord Injury

Abstract OBJECTIVE Patients with ossification of the posterior longitudinal ligament (OPLL) sometimes present with acute spinal cord injury caused by only minor trauma. In the present study, we reviewed our experience of acute cervical cord injury associated with OPLL to understand the pathomechanisms and to provide clinical information for management of this disorder. METHODS Twenty-eight patients were retrospectively analyzed. There were 26 men and 2 women, aged 45 to 78 years (mean, 63.0 yr). Most patients experienced incomplete spinal cord injury (Frankel Grade A, 3; B, 1; C, 15; and D, 9). RESULTS Radiological studies revealed continuous- or mixed-type OPLL in 14 patients and segmental-type OPLL in 14 patients. The sagittal diameter of the spinal canal was reduced to 4.1 to 10 mm at the narrowest level as a result of OPLL. Developmental size of the spinal canal was significantly smaller in the group with segmental OPLL. Magnetic resonance imaging scans revealed that spinal cord injury occurred predominantly at the caudal edge of continuous-type OPLL or at the disc levels. Surgery was performed in 24 patients either by posterior (18 patients) or anterior (6 patients) decompression at various time intervals after the trauma. Twenty patients (71%) displayed improvement in Frankel grade. CONCLUSION The present study demonstrates the preexisting factors and pathomechanisms of acute spinal cord injury associated with cervical OPLL. Magnetic resonance imaging is useful to understand the level and mechanism of injury. Further investigation will be needed to elucidate the role of surgical decompression.

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Integrative treatment of paralytic small intestine following acute cervical cord injury: A case report

Surgical Neurology International ◽

10.25259/sni_62_2020 ◽

2020 ◽

Vol 11 ◽

pp. 80

Author(s):

Yoshitaka Hirano ◽

Hideya Isai ◽

Akinori Onuki ◽

Kazuo Watanabe

Keyword(s):

Spinal Cord ◽

Small Intestine ◽

Spinal Injury ◽

Cervical Spinal Cord ◽

Posterior Longitudinal Ligament ◽

Neurological Status ◽

Sensory Loss ◽

Cervical Cord ◽

Cord Injury ◽

Cervical Cord Injury

Background: A patient developed paralysis of the small intestine following an acute traumatic hyperextension cervical spinal cord injury attributed to the ossification of the posterior longitudinal ligament (OPLL) C3–C6. The persistent ileus finally resolved utilizing Kampo medications (traditional Chinese therapy) consisting of both bukuryoin (TJ-69) and hangekobokuto (TJ-16). Case Description: A 63-year-old male became acutely quadriplegic secondary to a hyperextension injury incurred during a fall. Radiographic studies confirmed mixed OPLL extending from C3–C6 resulting in marked cord compression, there was a clear spinal cord contusion. His neurological status using the American Spinal Injury Association (ASIA) Scale was Grade “A;” there were was complete motor and sensory loss below the C5 level. After a C3–C6 expansive laminoplasty, the ASIA scale improved to Grade B. However, he then developed a persistent small intestine ileus resulting in marked abdominal distention. When conventional therapies failed to resolve the problem, Kampo medicines, consisting of both bukuryoin (TJ-69) and hangekobokuto (TJ-16), were administered. The ileus improved within 2 days and fully resolved within the 1st postoperative week. Conclusion: The utilization of Kampo medications, consisting of both bukuryoin (TJ-69) and hangekobokuto (TJ-16), or the combined bukuryoingohangekobokuto (TJ-116) effectively resolved a postoperative paralytic small bowel ileus following a cervical laminoplasty performed in a quadriplegic patient. Keywords: Acute cervical cord injury, Cervical ossification of the posterior longitudinal ligamentOPLL, Complication management, Integrative medicine, Paralytic small intestine

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Acute cervical cord injury without fracture or dislocation of the spinal column

Journal of Neurosurgery Spine ◽

10.3171/spi.2000.93.1.0015 ◽

2000 ◽

Vol 93 (1) ◽

pp. 15-20 ◽

Cited By ~ 29

Author(s):

Izumi Koyanagi ◽

Yoshinobu Iwasaki ◽

Kazutoshi Hida ◽

Minoru Akino ◽

Hiroyuki Imamura ◽

...

Keyword(s):

Spinal Cord ◽

Cervical Spine ◽

Spinal Canal ◽

Spinal Column ◽

Cord Compression ◽

Cervical Cord ◽

Content Type ◽

Cord Injury ◽

Cervical Cord Injury ◽

Fine Print

Object. It is known that the spinal cord can sustain traumatic injury without associated injury of the spinal column in some conditions, such as a flexible spinal column or preexisting narrowed spinal canal. The purpose of this study was to characterize the clinical features and to understand the mechanisms in cases of acute cervical cord injury in which fracture or dislocation of the cervical spine has not occurred. Methods. Eighty-nine patients who sustained an acute cervical cord injury were treated in our hospitals between 1990 and 1998. In 42 patients (47%) no bone injuries of the cervical spine were demonstrated, and this group was retrospectively analyzed. There were 35 men and seven women, aged 19 to 81 years (mean 58.9 years). The initial neurological examination indicated complete injury in five patients, whereas incomplete injury was demonstrated in 37. In the majority of the patients (90%) the authors found degenerative changes of the cervical spine such as spondylosis (22 cases) or ossification of the posterior longitudinal ligament (16 cases). The mean sagittal diameter of the cervical spinal canal, as measured on computerized tomography scans, was significantly narrower than that obtained in the control patients. Magnetic resonance (MR) imaging revealed spinal cord compression in 93% and paravertebral soft-tissue injuries in 58% of the patients. Conclusions. Degenerative changes of the cervical spine and developmental narrowing of the spinal canal are important preexisting factors. In the acute stage MR imaging is useful to understand the level and mechanisms of spinal cord injury. The fact that a significant number of the patients were found to have spinal cord compression despite the absence of bone injuries of the spinal column indicates that future investigations into surgical treatment of this type of injury are necessary.

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Recovery patterns of spinal cord injury after traumatic cervical cord injury in a developing country

Saudi Journal of Sports Medicine ◽

10.4103/1319-6308.180178 ◽

2016 ◽

Vol 16 (2) ◽

pp. 128

Author(s):

Arunima Chaudhuri ◽

Indrajeet Kumar ◽

Sankhadeb Acharya ◽

PradipKumar Ghosh ◽

PurnimaPrasad Acharya ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Developing Country ◽

Cervical Cord ◽

Cord Injury ◽

Cervical Cord Injury

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Are subjects with spondylotic cervical cord encroachment at increased risk of cervical spinal cord injury after minor trauma?

Yearbook of Neurology and Neurosurgery ◽

10.1016/j.yneu.2011.12.006 ◽

2012 ◽

Vol 2012 ◽

pp. 282-283

Author(s):

R. Riesenburger

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Cervical Spinal Cord ◽

Cervical Spinal Cord Injury ◽

Cervical Cord ◽

Minor Trauma ◽

Increased Risk ◽

Cord Injury

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Catecholaminergic polymorphic ventricular tachycardia complicated by dilated cardiomyopathy: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytaa299 ◽

2020 ◽

Author(s):

Granitz Christina ◽

Jirak Peter ◽

Strohmer Bernhard ◽

Pölzl Gerhard

Keyword(s):

Heart Failure ◽

Ventricular Tachycardia ◽

Dilated Cardiomyopathy ◽

Sinus Bradycardia ◽

Clinical Care ◽

Structural Heart Disease ◽

Catecholaminergic Polymorphic Ventricular Tachycardia ◽

Polymorphic Ventricular Tachycardia ◽

Myocardial Inflammation ◽

As Stress

Abstract Background Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a severe genetic arrhythmogenic disorder characterized by adrenergically induced ventricular tachycardia manifesting as stress-induced syncope and sudden cardiac death. While CPVT is not associated with dilated cardiomyopathy (DCM) in most cases, the combination of both disease entities poses a major diagnostic and therapeutic challenge. Case summary We present the case of a young woman with CPVT. The clinical course since childhood was characterized by repetitive episodes of exercise-induced ventricular arrhythmias and a brady-tachy syndrome due to rapid paroxysmal atrial fibrillation and sinus bradycardia. Medical treatment included propranolol and flecainide until echocardiography showed a dilated left ventricle with severely depressed ejection fraction when the patient was 32 years old. Cardiac magnetic resonance imaging revealed non-specific late gadolinium enhancement. Myocardial inflammation, however, was excluded by subsequent endomyocardial biopsy. Genetic analysis confirmed a mutation in the cardiac ryanodine receptor but no pathogenetic variant associated with DCM. Guideline-directed medical therapy for HFrEF was limited due to symptomatic hypotension. Over the next months, the patient developed progressive heart failure symptoms that were finally managed by heart transplantation. Discussion Management in patients with CPVT and DCM is challenging, as Class I antiarrhythmic drugs are not recommended in structural heart disease and prophylactic internal cardioverter-defibrillator implantation without adjuvant antiarrhythmic therapy can be detrimental. Regular echocardiographic screening for DCM is recommendable in patients with CPVT. A multidisciplinary team of heart failure specialists, electrophysiologists, geneticists, and imaging specialists is needed to collaborate in the delivery of clinical care.

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