scholarly journals Pediatric pathology all grown up – An interesting case of adult tethered spinal cord

2020 ◽  
Vol 11 ◽  
pp. 362
Author(s):  
Dimitri Laurent ◽  
Olgert Bardhi ◽  
Jason Gregory ◽  
Anthony Yachnis ◽  
Lance S. Governale
Keyword(s):  
Surgical Repair ◽  
Symptomatic Patient ◽  
Neck Surgery ◽  
Interesting Case ◽  
Cervical Cord ◽  
Pediatric Pathology ◽  
Lower Back ◽  
Subcutaneous Tissues ◽  
T2 Hyperintensity ◽  
Lower Extremity Dysfunction

Background: Cervical myelopathy in an adult is typically the result of degenerative disease or trauma. Dysraphism is rarely the cause. Case Description: The authors report the case of a 35-year-old male drywall installer who presented with 2 years of progressive left upper extremity weakness, numbness, and hand clumsiness. Only upon detailed questioning did he mention that he had neck surgery just after birth, but he did not know what was done. He then also reported that he routinely shaved a patch of lower back hair, but denied bowel, bladder, or lower extremity dysfunction. Magnetic resonance imaging of the cervical spine demonstrated T2 hyperintensity at C4-C5 with dorsal projection of the neural elements into the subcutaneous tissues concerning for a retethered cervical myelomeningocele. Lumbar imaging revealed a diastematomyelia at L4. He underwent surgical intervention for detethering and repaired of the cervical myelomeningocele. Four months postoperatively, he had almost complete resolution of symptoms, and imaging showed a satisfactory detethering. The diastematomyelia remained asymptomatic and is being observed. Conclusion: Tethered cervical cord is a rare cause for myelopathy in the adult patient. In the symptomatic patient, surgical repair with detethering is indicated to prevent disease progression and often results in clinical improvement.

Duplicated left pulmonary artery: an unknown disease? Three case reports and review of the literature

2015 ◽  
Vol 26 (2) ◽  
pp. 340-346 ◽  
Author(s):  
Valentina Giudici ◽  
Mazyar Kanani ◽  
Nagarajan Muthialu ◽  
Michelle Carr ◽  
Alistair D. Calder ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Surgical Repair ◽  
Case Reports ◽  
Vascular Ring ◽  
Symptomatic Patient ◽  
Left Pulmonary Artery ◽  
Kabuki Syndrome ◽  
Cross Sectional ◽  
Abnormal Finding ◽  
Pulmonary Sling

AbstractWe report three cases of an abnormal finding of duplicated left pulmonary artery: two of these occurring in children with Kabuki syndrome and configuring the setting of a pseudo-pulmonary sling without any clinical or cardiac cross-sectional evidence of tracheal compression. The other case instead represents duplicated left pulmonary artery with pulmonary sling caused by the retro-tracheal course of the lower left pulmonary artery associated with “Christmas Tree” arrangement of the tracheo-bronchial system.In both patients with pseudo-pulmonary sling and Kabuki syndrome, the abnormal finding was incidental during echocardiographic examination and neither of the patients required surgical repair for the condition. To the best of our knowledge, they represent the third and fourth cases in which such an anomaly of the pulmonary artery branches not forming a sling is seen in association with Kabuki syndrome. Another case represents our second experience and the second case reported in literature with duplicated left pulmonary artery in the setting of a complex tracheal anatomy. In this symptomatic patient, surgical repair of atrial septal defect and relief of the vascular ring were indicated, and the surgical repair was performed successfully at the age of 3 years.

scholarly journals Message

2020 ◽  
Vol 35 (1) ◽  
pp. 2
Author(s):  
Cecilia Gretchen Navarro-Locsin
Keyword(s):  
Head And Neck ◽  
Case Reports ◽  
Surgical Techniques ◽  
Neck Surgery ◽  
Editorial Staff ◽  
Evidence Base ◽  
Interesting Case ◽  
Head And Neck Surgery ◽  
The Past ◽  
Good Reading

Greetings! This year marks the 64th year of the Philippine Society of Otolaryngology-Head and Neck Surgery. It is a defining year, marked by both national and international events that changed and will most likely continue to change medical practice, public health policy, socio-economic concepts and structures. The SARS-coronavirus-2 (COVID-19) pandemic crashed into the first quarter of 2020 unannounced and with great fury. This great unknown served as the impetus for a flurry of research into every aspect of the disease – its origins, biology, clinical course, and treatment. It initiated an unprecedented interest in research, not just among scientists and clinicians, but most especially amongst the general population. But what is RESEARCH? Re-search - to look again at the past with spectacles, to look at the past with new eyes, to look at the present with a microscope, and to look at the far distance with binoculars – all to better see & perhaps to find answers to our questions. Research fuels the evidence base of our understanding of diseases and the principles of our clinical and surgical practice. Our specialty of Otolaryngology, during this time of the pandemic, will be at the forefront of an exciting time for a renewed quest for knowledge. And what better vehicle to transport us into this new and uncharted world than the Philippine Journal of Otolaryngology Head and Neck Surgery? It is a testament to the unparalleled dedication of the editor-in-chief and editorial staff and the enthusiasm of the contributors, that every year the PJOHNS publishes interesting case reports, relevant descriptive and analytical studies, papers on surgical techniques & instrument innovations, and insightful commentaries. The journal is a platform for our questions and hypotheses. The journal is a venue for our discoveries. But most importantly, the journal is a celebration of our passion for Otolaryngology.                 Good reading to all!   Cecilia Gretchen S. Navarro – Locsin, MD President Philippine Society of Otolaryngology – Head and Neck Surgery

scholarly journals Successful open surgical repair of an infrarenal, abdominal aortic aneurysm (AAA) in a young Malawian female: A case report

2019 ◽  
Vol 31 (4) ◽  
pp. 256-258
Author(s):  
Geoffrey Manda
Keyword(s):  
Abdominal Pain ◽  
Spinal Surgery ◽  
Surgical Repair ◽  
Central Hospital ◽  
Open Surgical Repair ◽  
Infrarenal Abdominal Aortic Aneurysm ◽  
Lower Back ◽  
Abdominal Aortic ◽  
History Of ◽  
Queen Elizabeth Central Hospital

A 39-year-old woman presented to Queen Elizabeth Central Hospital in Blantyre, Malawi  with a 3-week history of worsening peri-umbilical abdominal pain radiating to the lower back associated with anorexia, nausea and vomiting. There was no history of trauma, diarrhoea, obstipation, fevers, or urinary symptoms. She reported history of ‘spinal surgery’ performed 6 years prior due to a herniated intervertebral lumbar disk.

Significance of T2 Hyperintensity on Magnetic Resonance Imaging After Cervical Cord Injury and Return to Play in Professional Athletes

Neurosurgery ◽  
2015 ◽  
Vol 77 (1) ◽  
pp. 23-31 ◽  
Author(s):  
Zachary J. Tempel ◽  
Jeffrey W. Bost ◽  
John A. Norwig ◽  
Joseph C. Maroon
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Return To Play ◽  
Professional Athletes ◽  
Cervical Cord ◽  
Cervical Canal ◽  
Resonance Imaging ◽  
Cord Injury ◽  
T2 Hyperintensity

Abstract BACKGROUND: Cervical cord magnetic resonance imaging (MRI) T2 hyperintensity is used as evidence of cord trauma in the evaluation and management of athletes in contact sports. The long-term pathophysiologic and prognostic value of this finding is poorly understood, especially in return to play (RTP). OBJECTIVE: To examine the significance of T2 hyperintensity in the cervical spinal cord of professional athletes. METHODS: Retrospective review of MRI T2 hyperintensity findings between 2007 and 2014 in 5 professional athletes. Pertinent examination and demographics, including mechanism of injury, surgical intervention, radiographs, MRI studies, long-term outcomes, and RTP recommendations were collected. RESULTS: Four National Football League players and 1 professional wrestler had prior traumatic neurapraxia that at the time of initial consultation had resolved. MRIs showed congenitally small cervical canal (1) and multilevel spondylosis/stenosis/disc herniation (4) along with focal cord T2 hyperintensity (5). The signal abnormalities were at C3/C4 (3), C4 mid-vertebral body (1), and C5/C6 (1). Four athletes had single-level anterior cervical discectomy and fusion, and 1 was nonoperative. Serial MRI imaging at 3 months after surgery showed hyperintensity partially resolved (4) and unchanged (1), and at 9-months 3 of the 5 completely resolved. Based on the author's RTP criteria, 4 of 5 were released to return to their sport. Clearance for RTP preceded complete resolution of MRI T2 hyperintensity in 3 of 4 athletes. The 2 athletes that have returned to profession sport have not had any additional episodes of neurapraxia or any cervical spine-related complications. CONCLUSION: MRI T2 hyperintensity in contact sport athletes who are symptom-free with normal examination and no evidence of spinal instability may not be a contraindication to RTP. Additional observations are needed to confirm this observation.

scholarly journals Open Achilles Tendon Rerupture: A Case Report and Review of the Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Michael E. Doany ◽  
Megan C. Paulus
Keyword(s):  
Achilles Tendon ◽  
Soft Tissues ◽  
Surgical Repair ◽  
Rare Complication ◽  
Tendon Repair ◽  
Review Of The Literature ◽  
Open Wound ◽  
Surgical Incision ◽  
Repair Technique ◽  
Subcutaneous Tissues

In this report, we describe a rare case of open rerupture of an Achilles tendon following primary surgical repair. The rerupture occurred 12 weeks postoperatively and was associated with a transverse open wound perpendicular to the original surgical incision. This complication was successfully managed utilizing the preexisting transverse wound and a minimally invasive repair technique, minimizing further risk to the soft tissues overlying the tendon. This rare complication has only been described a few times in the literature and is likely associated with adhesions between the tendon repair and the subcutaneous tissues.

scholarly journals A rare presentation of perioperative myocardial infarction as a consequence of stent thrombosis in non-cardiac surgery

2021 ◽  
Vol 9 (7) ◽  
pp. 2125
Author(s):  
Aditi P. Kadakia ◽  
Deepak C. Koli ◽  
Hemant H. Mehta
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Surgery ◽  
Neck Surgery ◽  
Interesting Case ◽  
Drug Eluting Stent ◽  
Perioperative Myocardial Infarction ◽  
Rare Presentation ◽  
Coronary Artery Stent ◽  
History Of ◽  
Drug Eluting

Perioperative myocardial infarction (PMI) is a major cause of long term morbidity and mortality associated with non-cardiac surgery. In patients with recent coronary artery stent placement undergoing non-cardiac surgery perioperative management is always challenging. We reported an interesting case of a 67 year old man posted for head neck surgery with recent history of angioplasty with drug eluting stent developing perioperative MI and the challenges faced by an anaesthesiologist.

scholarly journals Salmonella Typhi dorsolumbar spondylodiscitis mimicking tuberculosis – An interesting case report

2020 ◽  
Vol 11 ◽  
pp. 184
Author(s):  
Shailesh Hadgaonkar ◽  
Pradhyumn Rathi ◽  
Bharat Purandare ◽  
Ashok Shyam ◽  
Parag Sancheti ◽  
...  
Keyword(s):  
Spinal Surgery ◽  
Spinal Tuberculosis ◽  
Salmonella Typhi ◽  
Interesting Case ◽  
Healthy Individuals ◽  
Gastrointestinal Infections ◽  
Pyogenic Spondylodiscitis ◽  
Lower Back ◽  
Gastrointestinal Pathology ◽  
Spinal Infections

Background: Salmonella rarely causes spinal infections in patients other than those who are immunocompromised or have sickle cell anemia. Further, most cases occurring in healthy individuals have preexisting gastrointestinal infections. Here, we present a case of pyogenic spondylodiscitis attributed to Salmonella Typhi, in an immunologically normal patient without gastrointestinal pathology. Case Description: A 58-year-old diabetic female complained of lower back pain and malaise. The workup for spinal tuberculosis was negative, but her MRI revealed findings consistent with pyogenic spondylodiscitis (e.g., destruction and instability) for which she required posterior spinal surgery. The organism proved to be S. Typhi; she was treated for 2 months and followed-up for 2 years. Conclusion: Salmonella spondylodiscitis should be considered among the differential diagnoses for patients with features of infective spondylodiscitis. Culture-specific antibiotics are the cornerstone of treatment, along with appropriate and timely surgery.

282 Skull base dural AVF mistaken as cervical myelitis: a series

2018 ◽  
Vol 89 (10) ◽  
pp. A42.2-A42
Author(s):  
Whittam Dan ◽  
Huda Saif ◽  
Pulicino Richard ◽  
Chandran Arun ◽  
Puthuran Mani ◽  
...  
Keyword(s):  
Skull Base ◽  
Protein Concentration ◽  
Cervical Cord ◽  
Surface Vessels ◽  
Elevated Protein ◽  
Life Threatening ◽  
Low Threshold ◽  
T2 Hyperintensity ◽  
Case Note Review ◽  
Csf Examination

BackgroundCervico-medullary spinal cord lesions are usually inflammatory (or rarely neoplastic). Dural arteriovenous fistula (DAVF) is considered very unlikely in the cervical cord, particularly if the history is of an acute myelopathy.MethodCase note review of five patients with skull base DAVF.ResultsAll were men aged 60–69 years. Four were symptomatic for a month or less, followed by acute deterioration over hours-7days, mimicking myelitis. MRIs showed extensive T2-hyperintensity and swelling in the cervico-medullary region. Worsening after corticosteroids occurred in 3/4 patients and one needed ventilation. Conspicuous and unambiguous cord-surface vessels were present in only one patient. Clinical suspicion prompted digital subtraction angiography (DSA) in the other four patients. Median time from initial MRI to diagnostic DSA and embolization was 28 days (7–91 days). All patients survived with good clinical recovery.Systematic retrospective review of MRIs showed lack of gadolinium enhancement in 4/5. CSF examination (n=4) showed normal leucocyte count in all cases and elevated protein concentration in 3/4 (0.6–1.2 g/L).ConclusionSkull base DAVF can mimic acute cervical myelitis. Steroids may prompt life-threatening clinical deterioration mistaken for ascending myelitis. A low threshold for angiography in the context of non-enhancing lesions and acellular CSF will facilitate earlier diagnosis and improve outcomes.

scholarly journals Work-Related Musculoskeletal Symptoms in Otorhinolaryngology-Head and Neck Surgery Residents

2020 ◽  
Vol 20 (2) ◽  
pp. 202
Author(s):  
Abdulmajeed Bin Dahmash ◽  
Feras Alkholaiwi ◽  
Abdussalam Alahmari ◽  
Asem M. Shadid ◽  
Abdulrahman M. Alharbi ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Head And Neck ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Musculoskeletal Symptoms ◽  
Musculoskeletal Symptom ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Work Related ◽  
Lower Back

Objectives: Work-related musculoskeletal disorders in Saudi Arabia are not often reported in the literature. This study aimed to identify musculoskeletal symptoms among otorhinolaryngology residents in Saudi Arabia. Methods: This cross-sectional survey-based study was conducted in May 2018 and included residents registered in the Saudi Otorhinolaryngology-Head and Neck Surgery Board Training programme, Riyadh, Saudi Arabia. The Nordic Musculoskeletal Questionnaire was used to assess musculoskeletal symptoms in addition to demographic and occupational factors, including operating position and the average number of operating hours. Results: A total of 45 residents (response rate: 68.2%) completed the survey, including 33 males (73.3%) and 12 females (26.7%). Most residents (91.1%) reported at least one musculoskeletal symptom. The most commonly reported musculoskeletal over the previous 12 months were shoulder complaints (64.4%) followed by neck complaints (60%). In the short term (i.e. within seven days preceding the survey), neck complaints were more common than shoulder complaints (28.9% versus 20%). Lower back complaints were the most common cause of activity limitation (24.4%) followed by shoulder complaints (13.3%), while those with neck complaints reported it as a cause for visiting a physician (8.9%). Hip and thigh complaints were significantly more frequent among residents with operation times of eight hours or more compared to those who operating for less than eight hours (42.9% versus 5.9%; P = 0.021). Conclusion: A high incidence of shoulder, neck and lower back complaints was found in this study. Residency is an ideal time in an otorhinolaryngologist’s career to implement programmes in ergonomic best practices before bad habits are developed.Keywords: Otorhinolaryngology; Musculoskeletal Abnormalities; Symptoms and Signs; Workplace; Ergonomics; Saudi Arabia.

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