scholarly journals Holocord spontaneous pneumorrhachis in the setting of refractory emesis

2021 ◽  
Vol 12 ◽  
pp. 602
Author(s):  
Rebecca Houston ◽  
Brian Fiani ◽  
Brian Musch ◽  
Emilio Tayag
Keyword(s):  
Thoracic Spine ◽  
Case Description ◽  
Past Medical History ◽  
Severe Dehydration ◽  
Upper Limit ◽  
Common Location ◽  
Spinal Axis ◽  
Hands And Feet ◽  
Secondary Causes ◽  
Refractory Emesis

Background: Pneumorrhachis (PNR) is the presence of air within the spinal canal and may be either intramedullary or extramedullary in location. The etiology is most commonly iatrogenic or traumatic in nature. Treatment is dependent on underlying cause and physical exam. Case Description: Herein, we describe the second case in the literature of spontaneous holocord PNR in a young patient without risk factors. A 22-year-old male with no past medical history presented to the hospital for 2 days of vomiting and cramping in his hands and feet secondary to severe dehydration. He recently started a new job as a manual laborer and had to leave work early 2 days prior due to overexertion working outside in heat ranging from 100 to 120 degrees Fahrenheit. CT abdomen and pelvis demonstrated spontaneous pneumomediastinum and extramedullary PNR extending upward from L3 throughout the thoracic spine to the upper limit of the scan. Subsequent CT cervical and thoracic spine showed the full length of the extradural air from C2-T12 and again at L3. Conclusion: Spontaneous PNR is an uncommon, typically self-limited condition in which air is introduced into the spinal axis. Anatomic predisposition makes the extradural, dorsal cord in the cervicothoracic region the most common location. Patients are rarely symptomatic, and treatment is supportive in nature once secondary causes with high rates of morbidity and mortality are ruled out.

scholarly journals Extradural Glomus Tumor of the Thoracic Spine: Case Report and Literature Review

2021 ◽  
Author(s):  
Jihui Zheng ◽  
Xinxing Li
Keyword(s):  
Literature Review ◽  
Thoracic Spine ◽  
Glomus Tumor ◽  
Glomus Tumors ◽  
Spinal Axis ◽  
Incomplete Removal ◽  
Long Term Prognosis ◽  
Male To Female

Abstract Objective Glomus tumors are rare lesions that can arise anywhere along the spinal axis. Only thirteen cases have been reported. We report a case of a patient with a rare glomangioma of the thoracic spine. Following a review of the twelve previous cases is a discussion of a spinal glomus tumor with regard to clinical presentation, diagnosis, and treatment. Methods A single, recent case arising from the extradural space of the thoracic spine is described, followed by a literature review of spinal glomus tumors. Results Including our case, thirteen cases of a glomus tumor have been reported. The mean age at the time of diagnosis was 44.6 years (range: 22–73 years) and the male-to-female (M:F) ratio was 1.17:1. The lesion was located in the cervical spine in 1 patient, the thoracic spine in 7 patients, the lumbar spine in 4 patients, and the sacrum in 1 patient. All the tumors were benign; however, there was one report of local recurrence because of incomplete removal. There were no malignant transformations, metastases, or deaths reported with a mean follow-up of 20.09 ± 28.43 months (range: 2–90 months). Conclusions Spinal glomus tumor are rare, and the preoperative diagnosis is difficult. An overwhelming majority of glomus tumors are benign and are cured by simple local excision. Patients undergoing complete resection have an excellent long-term prognosis.

scholarly journals Spinal Extradural Arachnoid cyst: Review of Literature

2020 ◽  
Vol 3 (2) ◽  
pp. 01-03
Author(s):  
Siddharth Verma
Keyword(s):  
Arachnoid Cyst ◽  
Thoracic Spine ◽  
Rare Condition ◽  
Arachnoid Cysts ◽  
Spinal Tumors ◽  
Review Of Literature ◽  
Common Location ◽  
Extradural Arachnoid Cyst

Spinal arachnoid cysts are mostly intradural. Spinal extradural arachnoid cyst (SEAC) is very rare condition accounting for only 1% cases of spinal tumors. [1,2,3] SEAC is mostly found in males in their second to fifth decades. Most common location of SEAC is thoracic spine

scholarly journals EFFECTIVENESS OF FIXED DOSES OF PROPRANOLOL IN THE TREATMENT OF HEMANGIOMAS REGARDLESS OF CHILD’S WEIGHT GAIN: A CASE REPORT

2019 ◽  
Vol 37 (3) ◽  
pp. 392-395
Author(s):  
Jaime Anger ◽  
Eduardo Mesquita de Oliveira ◽  
José Gabel
Keyword(s):  
Case Report ◽  
Weight Gain ◽  
Complete Remission ◽  
Rebound Effect ◽  
Oral Solution ◽  
Maximum Amount ◽  
Fixed Dose ◽  
Case Description ◽  
Upper Limit ◽  
Weight Gains

ABSTRACT Objective: To present the outcomes of fixed doses of propranolol tablets for the treatment of hemangiomas. Case description: Two illustrative cases of hemangioma in infant patients younger than six months old are described. Treatments were started in 2010 and 2011 and were monitored until August 2017. Patients were treated with fixed doses, initially calculated based on the upper limit of 3 mg/kg/day and administrated in two daily doses rounded down to the nearest multiple of five milligrams. Dosage was not adjusted to patients’ weight gain. The tablets were crushed and then diluted in a maximum amount of 3 mL of water. This procedure was necessary because propranolol was not available in oral solution in 2009, when dosages available in the Brazilian market were 10, 40 and 80 mg. Both patients presented significative improvement in the first 60 days and were in complete remission by the end of the treatment. Comments: It is possible to treat patients with Propranolol 10 mg tablets, even though the dosage is not as precise as when calculated according to patients’ weight. The maintenance of a fixed dose, ignoring the patient’s progressive weight gains, helps avoiding the rebound effect and decreases complications.

Congenital Hypoparathyroidism Associated With Elevated Circulating Nonfunctional Parathyroid Hormone Due to Novel PTH Mutation

2020 ◽  
Vol 105 (7) ◽  
pp. 2408-2412
Author(s):  
Matti L Gild ◽  
Martyn Bullock ◽  
Catherine Luxford ◽  
Michael Field ◽  
Roderick J Clifton-Bligh
Keyword(s):  
Parathyroid Hormone ◽  
Elevated Serum ◽  
Gene Mutations ◽  
Homozygosity Mapping ◽  
Case Description ◽  
Biochemical Phenotype ◽  
Upper Limit ◽  
Codon Change ◽  
Serum Pth ◽  
Pth Resistance

Abstract Context Familial hypoparathyroidism has a heterogeneous presentation where patients usually have low parathyroid hormone (PTH) levels due to impaired production or secretion. This contrasts with pseudohypoparathyroidism, in which PTH resistance is usually associated with an elevated serum PTH. High levels of circulating PTH can also be due to bioinactive PTH, which is difficult to distinguish from pseudohypoparathyroidism on biochemical grounds. Case Description We report on 2 sisters from consanguineous parents who presented with tetany at birth and were diagnosed with congenital hypocalcemia. Serum PTH levels were normal for many years, but progressively increased in midadulthood to greater than 100x the upper limit of normal on multiple assays. Homozygosity mapping was performed on 1 sister that demonstrated loss of heterozygosity (LOH) around PTH. Sequencing revealed a previously unreported variant, c.94T>C, predicting a codon change of p.Ser32Pro that is biologically inactive. Conclusions This case report shows a previously unreported unusual biochemical phenotype of a rising PTH in the context of a novel PTH mutation. This expands the evolving genotypes associated with hypoparathyroidism without established gene mutations.

scholarly journals An unexpected cause of sepsis in a patient with dental decay

2013 ◽  
Vol 12 (1) ◽  
pp. 34-34
Author(s):  
Rob LJ Zwinkels ◽  
◽  
Simone van der Sar – van der Brugge ◽  
Steven J Sleeswijk Visser ◽  
◽  
...  
Keyword(s):  
Emergency Department ◽  
Medical History ◽  
Thoracic Spine ◽  
Sudden Onset ◽  
Past Medical History ◽  
Significant Past Medical History ◽  
Dental Decay

A 42-year old man attended our emergency department with sudden onset of nausea, fever and cold sweats. In the days prior to presentation, he had developed a radiating pain in the thoracic spine. Furthermore, he had been suffering from dyspnoea on exertion for several weeks. He was a smoker, but had no significant past medical history.

scholarly journals Spinal intramedullary epidermoid cysts: Three case presentations and literature review

2020 ◽  
Vol 11 ◽  
pp. 17 ◽  
Author(s):  
Abolfazl Rahimizadeh ◽  
Guive Sharifi
Keyword(s):  
Literature Review ◽  
Thoracic Spine ◽  
Congenital Anomalies ◽  
Spastic Paraparesis ◽  
Partial Resection ◽  
Case Description ◽  
Review Of The Literature ◽  
Epidermoid Cysts ◽  
Case Presentations

Background: True intramedullary epidermoid cysts (IECs) not associated with congenital anomalies or previous spinal procedures are extremely rare. In a review of the literature since 1992, only 29 such cases have been reported. Here, we add three new cases in this category. Case Description: Three adults presented with spastic paraparesis attributed to thoracic IECs. Gross total microsurgical removal was achieved in two cases, while one case was a partial resection due to capsular adherence to the cord. In all three cases, patients sustained complete recoveries of neurological function and remained symptom free for an average of 5 years follow-up. Conclusion: IECs are rare lesions; here, the three located in the thoracic spine, contributed to slow, progressive spastic paraparesis with/without incontinence, and resolved following total (2 patients) and partial (1 patient) resection.

scholarly journals Extradural Glomus Tumor of the Thoracic Spine: Case Report and Literature Review

2021 ◽  
Author(s):  
Jihui Zheng ◽  
Xinxing Li
Keyword(s):  
Literature Review ◽  
Thoracic Spine ◽  
Glomus Tumor ◽  
Glomus Tumors ◽  
Spinal Axis ◽  
Incomplete Removal ◽  
Long Term Prognosis ◽  
Male To Female

Abstract Background: Glomus tumors are rare lesions that can arise anywhere along the spinal axis. Only thirteen cases have been reported. We report a case of a patient with a rare glomangioma of the thoracic spine. Following a review of the twelve previous cases is a discussion of a spinal glomus tumor with regard to clinical presentation, diagnosis, and treatment. Methods: A single, recent case arising from the extradural space of the thoracic spine is described, followed by a literature review of spinal glomus tumors.Results: Including our case, thirteen cases of a glomus tumor have been reported. The mean age at the time of diagnosis was 44.6 years (range: 22–73 years) and the male-to-female (M:F) ratio was 1.17:1. The lesion was located in the cervical spine in 1 patient, the thoracic spine in 7 patients, the lumbar spine in 4 patients, and the sacrum in 1 patient. All the tumors were benign; however, there was one report of local recurrence because of incomplete removal. There were no malignant transformations, metastases, or deaths reported with a mean follow-up of 20.09 ± 28.43 months (range: 2–90 months).Conclusions: Spinal glomus tumor are rare, and the preoperative diagnosis is difficult. An overwhelming majority of glomus tumors are benign and are cured by simple local excision. Patients undergoing complete resection have an excellent long-term prognosis.Trial registration: Not applicable.

scholarly journals Circumferential intradural meningioma of the thoracic spine: Case report and literature review

2021 ◽  
Vol 12 ◽  
pp. 120
Author(s):  
Sneha Bisht ◽  
Raphael Laurente ◽  
K Joshi George
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Literature Review ◽  
Thoracic Spine ◽  
Neurological Deficit ◽  
Malignant Potential ◽  
Spinal Tumors ◽  
Case Description ◽  
Intradural Extramedullary ◽  
Spine Case

Background: Meningiomas are common intradural extramedullary spinal tumors with a predilection for the thoracic spine. They are mostly benign (90%), with only a few showing malignant potential. However, circumferential intradural meningiomas surrounding the spinal cord are exceptionally rare. Here, we present a 40-year-old patient with a T6-T7 circumferential lesion who underwent surgery. In addition, we reviewed three similar cases previously reported in the literature. Case Description: A 40-year-old female presented with paraparesis. Imaging demonstrated a T6-T7 thoracic circumferential intradural lesion, considered to most likely be a meningioma. At surgery, the posterolateral portion of the tumor was removed, but there was residual ventral disease. The tumor recurred several years later, and was again partially removed, now leaving her with a residual neurological deficit. Three similar cases of circumferential meningiomas, one cervical and two thoracic, were reported from the literature. Conclusion: Circumferential meningiomas pose unique and significant surgical challenges, particularly since resection of the posterolateral components is feasible, but some tumor may have to be left ventrally to avoid injury to the anterior spinal artery, that may recur.

Imaging features and atypical signs of symptomatic vertebral haemangioma: a retrospective single-centre analysis of 118 patients

2021 ◽  
Vol 94 (1121) ◽  
pp. 20201250
Author(s):  
Lihua Zhang ◽  
Ben Wang ◽  
Songbo Han ◽  
Shaomin Yang ◽  
Liang Jiang ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Thoracic Spine ◽  
Compression Fracture ◽  
Imaging Features ◽  
Single Centre ◽  
Vertebral Haemangioma ◽  
Common Location ◽  
Spinal Segments ◽  
Mri Characteristics ◽  
Ct And Mri

Objectives: Symptomatic vertebral haemangioma (SVH) can present with atypical imaging features. Thus, this study analysed the imaging features of SVH using CT and MRI to improve SVH awareness. Methods: We retrospectively analysed CT and MRI characteristics of 118 patients with clinically and pathologically confirmed SVH. Results: Overall, 118 patients were diagnosed with SVH, including 79 females and 39 males (mean age, 45.76 ± 16.36 years). The thoracic spine (n = 86) was the most common location of SVH, followed by the lumbar spine (n = 17). Involvement of multiple spinal segments was observed in 15 patients (12.71%). A total of 101 lesions (85.59%) were centred in the vertebral body, 15 lesions (12.71%) were centred in the posterior attachment, and two lesions (2%) were centred in the paraspinal region. CT showed 39 lesions (33.05%) without a typical honeycomb or polka-dot pattern. Compression fracture was observed in 23 patients (19.49%). Extraosseous extension was present in 111 patients (94.1%), and 17 lesions (14.41%) presented with foraminal extension. Epidural bony compression was observed in 46 patients (38.98%). 20 lesions (16.95%) had atypical T2 weighted MRI signals, and 8 lesions (10.26%) showed atypical enhancement. Conclusion: SVH was predominantly located in the thoracic spine. Involvement of multiple segments, posterior attachment localisation, absence of honeycomb or polka-dot signs, compression fracture, and atypical T2 weighted imaging signals and enhancement were uncommon. Epidural bony compression was not uncommon and has important clinical significance. Advances in knowledge: The imaging features of SVHs are not fully understood. We examined the largest series of SVH cases reported to date.

scholarly journals Intrathecal pump catheter-tip granuloma recurrence with associated myelomalacia – How safe is intrathecal analgesic infusion therapy? A case report

2019 ◽  
Vol 10 ◽  
pp. 62 ◽  
Author(s):  
Moritz Haering ◽  
Christian Saleh ◽  
Phillip Jaszczuk ◽  
Markus Koehler ◽  
Margret Hund-Georgiadis
Keyword(s):  
Case Report ◽  
Surgical Decompression ◽  
Infusion Therapy ◽  
High Grade ◽  
Case Description ◽  
Pump Therapy ◽  
Neurological Sequelae ◽  
Spinal Axis ◽  
Catheter Tip ◽  
Rule Out

Background: A serious complication of intrathecal (IT) infusion therapy for pain management is catheter-tip-associated granuloma. Catheter-tip granulomas can lead to permanent severe neurological sequelae if not promptly detected. Case Description: We report a patient with a recurrence of a catheter-tip granuloma causing a high-grade paresis of the lower extremities and we review briefly the literature. Conclusion: Patients with IT pump therapy presenting new neurological findings need prompt imaging of the spinal axis to rule out a catheter-tip granuloma. In case of catheter-tip granuloma, early surgical decompression is important.

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