scholarly journals Two cases of retained medullary cord running parallel to a terminal lipoma

2021 ◽  
Vol 12 ◽  
pp. 112
Author(s):  
Ai Kurogi ◽  
Nobuya Murakami ◽  
Takato Morioka ◽  
Nobutaka Mukae ◽  
Takafumi Shimogawa ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Histopathological Examination ◽  
Contralateral Side ◽  
Central Canal ◽  
Neurophysiological Monitoring ◽  
Case Description ◽  
Histopathological Feature ◽  
Secondary Neurulation ◽  
Surprising Finding ◽  
Untethering Surgery

Background: Retained medullary cord (RMC) is a newly defined entity believed to originate from the late arrest of secondary neurulation. Some RMCs contain varying amounts of lipomatous tissues, which need to be differentiated from spinal lipomas, such as filar and caudal lipomas (terminal lipomas). Case Description: We surgically treated two patients with a nonfunctional cord-like structure (C-LS) that was continuous from the cord and extended to the dural cul-de-sac, and ran parallel to the terminal lipoma. In both cases, untethering surgery was performed by resecting the C-LS with lipoma as a column, under intraoperative neurophysiological monitoring. Histopathological examination confirmed that the central canal-like ependyma-lined lumen with surrounding neuroglial and fibrocollagenous tissues, which is the central histopathological feature of an RMC, was located on the unilateral side of the resected column, while the fibroadipose tissues of the lipoma were located on the contralateral side. Conclusion: Our findings support the idea proposed by Pang et al. that entities such as RMC and terminal lipomas are members of a continuum of regression failure occurring during late secondary neurulation, and the coexistence of RMC and terminal lipoma is not a surprising finding. Therefore, it may be difficult in clinical practice to make a distinct diagnosis between these two entities.

scholarly journals Surgical histopathology of a filar anomaly as an additional tethering element associated with closed spinal dysraphism of primary neurulation failure

2021 ◽  
Vol 12 ◽  
pp. 373
Author(s):  
Takato Morioka ◽  
Nobuya Murakami ◽  
Satoshi O. Suzuki ◽  
Nobutaka Mukae ◽  
Takafumi Shimogawa ◽  
...  
Keyword(s):  
Spinal Dysraphism ◽  
Central Canal ◽  
Morphological Features ◽  
Neurophysiological Monitoring ◽  
Filum Terminale ◽  
Histopathological Findings ◽  
Secondary Neurulation ◽  
Tight Filum Terminale ◽  
Untethering Surgery ◽  
Made In

Background: Closed spinal dysraphism of primary neurulation failure could be associated with filar anomalies, such as filar lipoma or thickened and tight filum terminale (TFT), resulting from impaired secondary neurulation. Retained medullary cord (RMC) is a remnant of the cavitary medullary cord originating from the secondary neurulation failure. Some filar lipomas are known to contain a central canal-like ependyma-lined lumen with surrounding neuroglial tissues (E-LC w/NGT), that is, a characteristic histopathology of RMC. To clarify the embryological background of these filar anomalies, we evaluated the histopathological findings. Methods: Among 41 patients with lesions of primary neurulation failure who underwent initial untethering surgery, the filum including cord-like structure (C-LS) was additionally resected in 10 patients (five dorsal and transitional lipomas; five limited dorsal myeloschisis). We retrospectively analyzed the clinical, neuroradiological, intraoperative, and histopathological findings. Results: Among 10 patients, two patients were diagnosed with RMC based on morphological features and intraoperative neurophysiological monitoring. The diagnosis of filar lipoma was made in six patients, since various amounts of fibroadipose tissue were histopathologically noted in the filum. Two patients were diagnosed with TFT, since the filum was composed solely of fibrocollagenous tissue. E-LC w/NGT was noted not only in both C-LSs of RMCs but also in two out of six fila both with filar lipomas and fila with TFTs. Conclusion: These findings provide further evidence for the idea that entities, such as filar lipoma, TFT, and RMC, can be considered consequences of a continuum of regression failure occurring during late secondary neurulation.

scholarly journals Clinical practice guideline for intraoperative neurophysiological monitoring : 2020 update

2020 ◽  
Vol 2 (1) ◽  
pp. 1-10
Author(s):  
◽  
Korean Neurological Association ◽  
Korean Academy of Rehabilitation Medicine ◽  
Korean Society of Clinical Neurophysiology ◽  
Korean Association of EMG Electrodiagnostic Medicine
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Intraoperative Neurophysiological Monitoring ◽  
Neurophysiological Monitoring

Morphological study of experimental syringomyelia with kaolin-induced hydrocephalus in a canine model

1996 ◽  
Vol 84 (6) ◽  
pp. 999-1005 ◽  
Author(s):  
Haruyuki Yamada ◽  
Akira Yokota ◽  
Joji Haratake ◽  
Akio Horie
Keyword(s):  
Morphological Study ◽  
Histopathological Examination ◽  
Foramen Magnum ◽  
Central Canal ◽  
Chiari I Malformation ◽  
Hydrodynamic Theory ◽  
Cervical Cord ◽  
Content Type ◽  
Vascular Insufficiency ◽  
Fine Print

✓ In this morphological study the authors investigated whether spinal cord cavitation, produced in young mongrel dogs that had been rendered hydrocephalic by cisternal injection of kaolin, consists of a dilated central canal or intramedullary cavities. Hydrocephalus was noted in 50 of 56 dogs treated with kaolin. Of the 50 hydrocephalic young dogs, 29 were shown to have central canal dilation that was prominent at the thoracic level and 21 to have cervical intramedullary cavities in the posterior column and/or the posterior horn. In 11 dogs from the latter group these cavities were demonstrated to have no communication with the central canal. This finding could not be explained by the hydrodynamic theory. On histopathological examination, myelomalacia and hemorrhagic infarction following ventricular shunting were noted adjacent to the cervical cavities, which suggested vascular impairment. A perfusion study revealed insufficient blood flow within the cervical cord at the level of the intramedullary cavities. A close correlation between the vascular insufficiency of the cervical cord and the pressure cone resulting from significant hydrocephalus was observed. The latter may cause cervicomedullary compression at the foramen magnum, affecting the venous drainage of the cervical cord below that level, resulting in intramedullary cavitation. Accordingly, vascular impairment was thought to play a significant role in the development of cervical syrinx formation in our kaolin model. The current results may provide a reasonable explanation for the formation of noncommunicating cervical syringomyelia in Chiari I malformation.

scholarly journals Fetal HDlive Silhouette Mode in Clinical Practice

2015 ◽  
Vol 9 (4) ◽  
pp. 413-419
Author(s):  
Hiroshi Masaoka ◽  
Akira Ejiri
Keyword(s):  
Clinical Practice ◽  
Congenital Anomalies ◽  
Congenital Malformations ◽  
Obstet Gynecol ◽  
Inner Core ◽  
Contralateral Side ◽  
Normal Anatomy ◽  
Fetal Anomalies ◽  
Novel Technology ◽  
Shadowing Effect

ABSTRACT Many rendering modes and types of software have been introduced as tools to aid in the prenatal detection of fetal anomalies. They aim at facilitating the diagnosis, increasing physicians’ confidence, and achieving a better understanding of these anomalies. The HDlive silhouette mode is a novel technology, which provides vitreous-like clarity of the fetus and placenta. Through using a shadowing effect, the outlines of structures of interest can be delineated clearly with a simultaneous display of the inner core and structure. It is more beneficial for identifying a normal anatomy and diagnosing complex congenital malformations. Moreover, the shadowing effect allows the operator to observe structures present behind the directly visualized structure, making it more advantageous than the recent advanced rendering modes, such as three-/fourdimensional ultrasound and HDlive. The contralateral side of the same structure and contralateral limbs can also be displayed. In this article, we highlight this rendering mode, focusing on its merits for the visualization of normal fetal structures as well as some congenital anomalies. How to cite this article AboEllail MAM, Kanenishi K, Marumo G, Masaoka H, Ejiri A, Hata T. Fetal HDlive Silhouette Mode in Clinical Practice. Donald School J Ultrasound Obstet Gynecol 2015;9(4):413-419.

scholarly journals Rabies in bovine: First case report of rabies in Al Jabal Al Akhdar, Libya

2021 ◽  
Vol 11 (1) ◽  
pp. 96-99
Author(s):  
Monier Sharif ◽  
Aiman Arhaiem ◽  
Osama Giadan ◽  
Abdulkarim Adam ◽  
Fawzia Abdalla ◽  
...  
Keyword(s):  
Case Report ◽  
North Africa ◽  
Clinical Symptoms ◽  
Histopathological Examination ◽  
Neglected Diseases ◽  
Case Description ◽  
Cerebellar Neurons ◽  
First Case ◽  
Al Jabal Al Akhdar ◽  
Veterinary Pathology

Background: Rabies is still one of the most neglected diseases in developing countries. It is endemic to North Africa, although rabies incidence in North Africa is certainly underestimated. Case Description: On 18 December 2018 in the region of Al-Jabal Al-Akhdar, an 8-month-old calf died after a period of characteristic clinical symptoms of rabies. This is the first case of rabies in bovine which is confirmed through histopathological examination in the Laboratory of Veterinary Pathology, Omar Al-Mukhtar University. Microscopic examination clearly revealed encephalitis with the pathognomonic Negri bodies in the cerebellar neurons. Conclusion: Since the characteristic lesions in the histopathological examination are sufficient to confirm the diagnosis and report infected cases, we recommend that the next version of the OIE Terrestrial Manual should add and clarify that the results of the use of histopathological techniques in the diagnosis of rabies are significant.

scholarly journals Artificial Intelligence in medicine: today and tomorrow

2020 ◽  
Author(s):  
Giovanni Briganti ◽  
Olivier Le Moine
Keyword(s):  
Artificial Intelligence ◽  
Atrial Fibrillation ◽  
Medical Education ◽  
Clinical Practice ◽  
Scientific Literature ◽  
Medical Curriculum ◽  
Histopathological Examination ◽  
Medical Technologies ◽  
Digital Medicine ◽  
Medicine Today

Artificial intelligence-powered medical technologies are rapidly evolving into applicable solutions for clinical practice. Deep learning algorithms can deal with increasing amounts of data provided by wearables, smartphones and other mobile monitoring sensors in different areas of medicine.Currently, only very specific settings in clinical practice benefit from the application of artificial intelligence, such as the detection of atrial fibrillation, epilepsy seizures, and hypoglycemia, or the diagnosis of disease based on histopathological examination or medical imaging. The implementation of augmented medicine is long-awaited by patients because it allows for a greater autonomy and a more personalized treatment, however, it is met with resistance from physicians which were not prepared for such an evolution of clinical practice.This phenomenon also creates the need to validate these modern tools with traditional clinical trials, debate the educational upgrade of the medical curriculum in light of digital medicine as well as ethical consideration of the ongoing connected monitoring. The aim of this paper is to discuss recent scientific literature and provide a perspective on the benefits, future opportunities and risks of established artificial intelligence applications in clinical practice on physicians, healthcare institutions, medical education and bioethics.

Chronic urine retention secondary to peripheral neuropathy with widespread vegetative involvement. Case description

1996 ◽  
Vol 63 (3) ◽  
pp. 335-337
Author(s):  
G. Giusti ◽  
D. Schiavone ◽  
R. Pianon ◽  
C. Tallarigo
Keyword(s):  
Clinical Practice ◽  
Surgical Treatment ◽  
Urinary Retention ◽  
Correct Diagnosis ◽  
Case Description ◽  
Urine Retention ◽  
Sympathetic Response ◽  
Therapeutic Measures ◽  
Cardiovascular Tests ◽  
Diagnostic Framework

In clinical practice it is common to find patients in whom urinary retention is not secondary to cervicourethral obstruction. Therapeutic measures, surgical or otherwise, do not live up to expectations in these patients. The Authors describe the case of a 54-year-old patient who presented with urinary retention. Neuro-urological exams excluded the presence of a cervicourethral obstruction and instead revealed probable parasympathetic denervation, subsequently confirmed by the Cutaneous Sympathetic Response recording and Cardiovascular Tests. In such cases correct diagnosis relies on close co-operation between the urodynamics and the neurophysiology doctors. These are undoubtedly particular cases, but an incorrect diagnostic framework could lead to inappropriate surgical treatment.

scholarly journals Multiple extradural spinal arachnoid cysts: A case report

2021 ◽  
Vol 12 ◽  
pp. 101
Author(s):  
Joaquim Francisco Cavalcante-Neto ◽  
Lúcio Soares e Silva-Neto ◽  
Paulo Roberto Lacerda Leal ◽  
Cláudio Henrique Souza Moreira ◽  
Espártaco Moraes Lima Ribeiro ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Histopathological Examination ◽  
Sensory Function ◽  
Lower Limbs ◽  
Arachnoid Cysts ◽  
Type I ◽  
Case Description ◽  
Resonance Imaging ◽  
Complete Surgical Resection ◽  
History Of

Background: Extradural spinal arachnoid cysts (SACs) rarely cause neural compression and disability. Case Description: A 38-year-old female presented with a history of two episodes of falling due to transient weakness in the lower limbs. The neurological examination showed normal motor and sensory function, but hyperreflexia. The thoracic magnetic resonance imaging revealed multiple extradural SACs between the T3-L1 levels. Following complete surgical resection of the most symptomatic cyst, she did well. The histopathological examination confirmed a Type I extradural SAC. Conclusion: Here, we discussed one case and reviewed the literature on the diagnosis and treatment of multiple extradural SACs.

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