scholarly journals Management and outcome of spontaneous cervical epidural hematoma: Case report and review of the literature

2021 ◽  
Vol 12 (3) ◽  
pp. 094-097
Author(s):  
Yao Christian Hugues DOKPONOU ◽  
Adil BELHACHMI ◽  
Fernand Nathan IMOUMBY ◽  
Alngar DJIMRABEYE ◽  
Brahim El MOSTARCHID ◽  
...  

Spontaneous spinal epidural hematomas are rare and potentially disabling neurological emergencies. Its lead to devastating neurologic outcomes and most patient does not recover completely. The clinical presentation is diverse and includes a severe acute attack, radiating pain at the back, interscapular, or neurological deficits. We report a case of a young woman, 24-year-old, that was admitted to our department for sudden non-traumatic cervical spinal cord compression syndrome (Type A of the American Spinal Cord Injury Association “ASIA A”) including intense cervical back pain, sensory loss, and tetraplegia. Her past medical history was unremarkable. The MRI confirmed a cervical mass responsible for the spinal cord compression and the emergent surgical intervention allow us to evacuate acute C3-C7 hematoma. The patient never recovers from the neurologic deficit despite the emergent management of her case followed by functional musculoskeletal rehabilitation for two years.

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Nooraldin Merza ◽  
Ahmed Taha ◽  
John Lung ◽  
Anthony W. Benderman ◽  
Stephen E. Wright

Immunoglobulin G4-related disease (IgG4-RD) is known for forming soft tissue mass lesions that may have compressive effects. It is an extremely rare disease that most frequently affects the pancreas causing autoimmune pancreatitis. It can also affect the gallbladder, salivary glands, and lacrimal glands causing respective organ-specific complications. In our report, we describe an IgG4-RD case that affected the spinal cord. A 60-year-old female presented with cervical spinal cord compression caused by IgG4-RD leading to several neurological deficits. Pathological examination of the excisional biopsy of the mass revealed dense lymphoplasmacytic cells infiltration and stromal fibrosis with IgG4 and plasma cells. The patient showed a dramatic response to the administration of systemic steroids with almost resolution of her neurological symptoms. This case highlights the first case in literature for IgG4-RD of the extradural tissue causing spinal compression. Hereby, we also demonstrate the dramatic response of IgG4-RD to the administration of systemic steroids as the patient had no recurrence after 5 years of close follow-up, the longest reported period of follow-up reported in the literature to date.


2011 ◽  
Vol 15 (1) ◽  
pp. 97-106 ◽  
Author(s):  
Marina Boido ◽  
Diego Garbossa ◽  
Alessandro Vercelli

Object Spinal cord injury (SCI) often results in irreversible and permanent neurological deficits below the injury site and is considered a pathological state of functional damage to local neurons and axon fibers. There are several experimental treatments to minimize tissue damage, and recently cell transplantation has emerged as a promising approach in spinal cord repair. The authors undertook this study to evaluate grafting of neural tube precursors as a possible therapeutic strategy in a model of spinal cord compression in the mouse. Methods Compression SCI was induced at the T-13 level in adult male mice. Immediately after injury, neural precursor cells (NPs) were transplanted into the SCI lesion cavity in 18 mice; the remaining 19 mice received saline injections into the lesion cavity and were used as controls. Spinal cords were examined 12, 19, and 26 days postinjury to investigate the survival of the NPs and their effects on the cellular environment, glial scar and glial cyst formation, astrogliosis, and microglial activation. Results Grafted NPs survived well and integrated into the host spinal cord tissue. Some NPs had differentiated into cells expressing glial and neuronal markers at all 3 end points. Analysis of glial cyst volume showed a lesion volume reduction of 63.2% in the NP-treated mice compared with volume in the injured but untreated mice. There appeared to be no difference in astroglial and microglial activation between untreated mice and treated ones. Sensory and motor tests demonstrated that transplantation of NPs promoted improvement in injured and treated animals compared with controls. Conclusions These results support the therapeutic potential of NPs, demonstrating that they can survive for a long time, differentiate, integrate into the injured spinal cord, and promote functional recovery after SCI.


2008 ◽  
Vol 25 (5) ◽  
pp. E9 ◽  
Author(s):  
Bizhan Aarabi ◽  
Michael Koltz ◽  
David Ibrahimi

Traumatic central cord syndrome (TCCS), regardless of its biomechanics, is the most frequently encountered incomplete spinal cord injury. Patients with TCCS present with disproportionate weakness of the upper extremities, and variable sensory loss and bladder dysfunction. Fractures and/or subluxations, forced hyperextension, and herniated nucleus pulposus are the main pathogenetic mechanisms of TCCS. Nearly 50% of patients with TCCS suffer from congenital or degenerative spinal stenosis and sustained their injuries during hyperextension as originally described by Schneider in 1954. Immunohistochemical and imaging studies indicate mild to moderate insult to axons and their ensheathing myelin in the lateral funiculi culminating in cytoskeletal injury and impaired conduction. More than one-half of these patients enjoy spontaneous recovery of motor weakness; however, as time goes on, lack of manual dexterity, neuropathic pain, spasticity, bladder dysfunction, and imbalance of gait render their activities of daily living nearly impossible. Based on the current level of evidence, there is no clear indication of the timing of decompression for relief of sustained spinal cord compression in hyperextension injuries. Future research, taking advantage of validated digital imaging data such as maximum canal compromise, maximum spinal cord compression, and lesion length on the CT and MR images, as well as more sensitive measures of bladder and hand function, spasticity, and neuropathic pain may help tailor surgery for a specific group of these patients.


2005 ◽  
Vol 63 (3a) ◽  
pp. 666-669 ◽  
Author(s):  
Marcos R.G. de Freitas ◽  
Osvaldo J.M. Nascimento ◽  
Cristiane N. Soares ◽  
Adriana Rocha Brito ◽  
Romeu Cortes Domingues

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a peripheral nerve disorder probably due to an immunological disturb. It evolves either in a steadily progressive or in a relapsing and fluctuating course. Weakness is mainly in the lower limbs proximally and distally. The electromyography is demyelinating. The cerebral spinal fluid protein is most of times elevated. Sometimes enlarged nerves are found. There are few cases described with spinal cord compression due to hypertrophic spinal nerve roots. Two patients (females, 66 and 67 years old) with diagnosis of a long standing CIDP are described. In the first one, the evolution was characterized by remission and relapsing course. The second patient had a chronic and progressive course. These patients presented after a long evolution a cervical spinal cord compression syndrome due to hypertrophic cervical roots. Neurologists must be aware of the possibility of development of spinal cord compression by enlarged spinal roots in patients with a long standing CIDP.


Sign in / Sign up

Export Citation Format

Share Document