Spinal and paraspinal giant cervical cavernous malformation with postpartum presentation

Cavernous malformations (CMs) are found throughout the CNS but are relatively uncommon in the spine. In this report, the authors describe a giant CM with the imaging appearance of an aggressive, invasive, expansive tumor in the cervical spine. The intradural extramedullary portion of the tumor originated from a cervical nerve root; histologically, the lesion was identified as an intraneural CM. Most of the tumor extended into the paraspinal tissues. The tumor was also epidural, intraosseous, and osteolytic and had completely encased cervical nerve roots, peripheral nerves, branches of the brachial plexus, and the vertebral artery on the right side. It became symptomatic during the puerperal period. Gross-total resection was achieved using staged operative procedures, complex dural reconstruction, spinal fixation, and fusion. Clinical, radiographic, and histological details, as well as a discussion of the relevant literature, are provided.

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Combined Effects of Thermotherapy along with Scapular Muscles Strenghtening in Cervical Radiculopathy: A Case Report

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/48979:15061 ◽

2021 ◽

Author(s):

Shaikh Mohammad Aeraj ◽

Tajuddin Chitapure

Keyword(s):

Spinous Process ◽

Cervical Radiculopathy ◽

Nerve Roots ◽

Cervical Nerve ◽

Future Studies ◽

Sensorimotor Deficits ◽

Forward Flexion ◽

Initial Hypothesis ◽

The Right ◽

Tissue Tension

Cervical radiculopathy is a syndrome in which the patient complains of pain along with sensorimotor deficits. This syndrome commonly develops due to compression of the cervical nerve roots. This report describes the case of 52-year-old histopathology laboratory technician who developed cervical radiculopathy due to prolonged cervical forward flexion while working on his table. The patient also complained of pain on the right scapular border. Radiographic analysis showed cervical spondylosis having osteophyte formation on spinous process of C2, C3, C4, C5 and C6 vertebras. Neural tissue tension test was positive for median nerve. He was treated consecutively with strengthening for shoulder abductors, shoulder adductors, scapula elevators and scapular protractors along with thermotherapy. His right medial border scapular pain and symptoms of cervical radiculopathy decreased in severity after the seventh day of treatment. Although the authors cannot suggest a cause-and effect relationship, this report allows for initial hypothesis development that thermotherapy approach may have clinical merit. Future studies in the form of well-designed, randomised clinical trials should be performed to evaluate the effectiveness of this approach in patients with cervical radiculopathy

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Accidental Strangulation with Cervical Nerve Root Injury Caused by the Entrapment of Clothing in a Soybean Milling Machine

Case Reports in Emergency Medicine ◽

10.1155/2019/4706278 ◽

2019 ◽

Vol 2019 ◽

pp. 1-3

Author(s):

Kazuhiko Omori ◽

Ikuto Takeuchi ◽

Youichi Yanagawa

Keyword(s):

Nerve Root ◽

Electrical Machine ◽

Milling Machine ◽

Cervical Nerve Root ◽

Cervical Nerve ◽

Pattern Of Injury ◽

Nerve Root Injury ◽

Root Injury ◽

Creatine Phosphokinase Level ◽

The Right

The clothing of a forty-five-year-old man became entrapped by the mixing rotator while he was operating a soybean milling machine. His clothing was wound around the rotator, and tightened around his neck and chest, causing strangulation and a loss of consciousness. He was rescued by his coworkers and transported to our hospital by helicopter. Upon arrival, he regained consciousness. A physiological examination revealed multiple petechiae on his face and strangulation marks with subcutaneous hemorrhage on his neck and upper trunk. In addition, he had motor weakness of the right upper extremity and bilateral paresthesia from C5 to Th1. All radiological studies were negative. He was admitted for observation. After the patient’s creatine phosphokinase level peaked and his focal neurological signs improved, he was discharged on foot on the 6th hospital day. Accidental ligature strangulation with cervical nerve root injury, in which an article of clothing is caught in an electrical machine and strangles the wearer, is very rare. This case is presented for its rarity and the unique pattern of injury.

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Ultrasonographic evaluation of cervical nerve roots and peripheral nerves in patients with spinal and bulbar muscular atrophy

Journal of the Neurological Sciences ◽

10.1016/j.jns.2017.08.2697 ◽

2017 ◽

Vol 381 ◽

pp. 958

Author(s):

D. Watanabe ◽

H. Tsukamoto ◽

T. Abe ◽

F. Tanaka ◽

T. Komori

Keyword(s):

Peripheral Nerves ◽

Muscular Atrophy ◽

Nerve Roots ◽

Cervical Nerve ◽

Cervical Nerve Roots

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Cervical Dumbbell Intra-extradural Hemangioblastoma: Total Removal through the Lateral Approach: Technical Case Report

Neurosurgery ◽

10.1227/01.neu.0000154134.83900.05 ◽

2005 ◽

Vol 56 (3) ◽

pp. E625-E625 ◽

Cited By ~ 13

Author(s):

Cédric Barrey ◽

Michel Kalamarides ◽

Marc Polivka ◽

Bernard George

Keyword(s):

Vertebral Artery ◽

Nerve Root ◽

Histopathological Examination ◽

Lateral Approach ◽

Primary Control ◽

Cervical Nerve Root ◽

Cervical Nerve ◽

Dumbbell Tumor ◽

Computed Tomographic ◽

The Right

Abstract OBJECTIVE AND IMPORTANCE: Extradural hemangioblastomas account for 8 to 12% of all spinal hemangioblastomas. Among them, intra-extradural forms with a dumbbell extension are extremely rare. We report a case of intra-extradural hemangioblastoma involving the C6 cervical nerve root. CLINICAL PRESENTATION: The patient was a 31-year-old woman presenting with signs of myelopathy and C6 radiculopathy on the right side. A computed tomographic scan and magnetic resonance imaging demonstrated a dumbbell tumor that had developed through the C5–C6 intervertebral foramen. Angiography revealed a well-circumscribed mass with feeders from the vertebral artery and the deep cervical artery. INTERVENTION: The tumor was totally removed through the lateral approach, with control of the vertebral artery and sacrifice of the C6 cervical nerve root. Limited bone drilling to enlarge the foramen permitted us to reach and resect the intradural component. Histopathological examination confirmed the diagnosis of hemangioblastoma. Follow-up was uneventful. CONCLUSION: This is the sixth reported case of a cervical dumbbell hemangioblastoma investigated by computed tomographic scanning and MRI but the first one resected via the lateral approach. The lateral approach seems appropriate for surgical resection because it provides primary control of the vascular feeders and access to the extradural and intradural components.

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Lateral Myelotomy for Resection of a Ruptured Intramedullary Cervico-Thoracic Cavernous Malformation

Operative Neurosurgery ◽

10.1093/ons/opaa417 ◽

2020 ◽

Author(s):

Elizabeth E Ginalis ◽

Yehuda Herschman ◽

Nitesh V Patel ◽

Fareed Jumah ◽

Zhenggang Xiong ◽

...

Keyword(s):

Spinal Cord ◽

Cavernous Malformation ◽

Lateral Approach ◽

Sudden Onset ◽

Sensory Loss ◽

Intramedullary Spinal Cord ◽

Cavernous Malformations ◽

Motor Weakness ◽

Left Lower Extremity ◽

The Right

Abstract BACKGROUND AND IMPORTANCE Intramedullary spinal cord cavernous malformations represent 5% to 12% of spinal vascular disease. Most patients present with acute or progressive neurological symptoms, including motor weakness or sensory loss. Surgical resection is the only definitive management and is recommended for symptomatic lesions that are surgically accessible. CLINICAL PRESENTATION A 35-yr-old woman presented with a sudden onset of pain and temperature sensation loss in the left lower extremity. Magnetic resonance imaging of the spine showed a hemorrhage located ventral and slightly lateral to the right of the midline of the spinal cord from C7 through T3. Ultimately, a right lateral myelotomy between the ventral and dorsal roots was performed, and the cavernous malformation was removed. Postoperative imaging confirmed gross total resection of the cavernous malformation. CONCLUSION In this article, we report a highly unusual case of a multisegment, ruptured intramedullary cavernous malformation that was ultimately resected through a lateral myelotomy approach. This case demonstrates that a lateral approach to the spinal cord substance can be utilized for ruptured cavernous malformation, especially if there is hemorrhage at the surface of the spinal cord. This can be used as an entry into the anterolateral compartment of the spinal cord, which would otherwise be regarded as a highly morbid approach due to the sensory deficits induced. We believe this entry point to the spinal cord is feasible in highly select cases such as this.

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De Novo Development of a Cavernous Malformation of the Brain: Significance of Factors with Paracrine and Endocrine Activity: Case Report

Neurosurgery ◽

10.1097/00006123-200203000-00042 ◽

2002 ◽

Vol 50 (3) ◽

pp. 646-650 ◽

Cited By ~ 1

Author(s):

Wolf Lüdemann ◽

Verena Ellerkamp ◽

Alexandru C. Stan ◽

Sami Hussein

Keyword(s):

Hormone Receptors ◽

De Novo ◽

Cavernous Malformation ◽

Pituitary Hormones ◽

Surrounding Tissue ◽

Endocrine Activity ◽

Cavernous Malformations ◽

Computed Tomographic ◽

The Right ◽

The Brain

Abstract OBJECTIVE AND IMPORTANCE: De novo development of cavernous malformations is poorly documented in the literature. CLINICAL PRESENTATION: We report the case of a 37-year old woman with de novo growth of a cavernous malformation of the brain. The patient presented with a 12-month history of nonspecific headaches and paresthesias after two pregnancies. After computed tomographic scanning of the cranium, a cavernous malformation located parieto-occipitally within the right brain hemisphere was diagnosed. Control magnetic resonance imaging scans obtained 12 years earlier did not reveal a similar lesion. INTERVENTION: Surgery was performed, and the specimen was analyzed histopathologically. CONCLUSION: Immunohistochemistry demonstrated lack of expression of pituitary hormones as well as of androgen, estrogen, and progesterone hormone receptors. However, strong expression of both basic fibroblast growth factor and CD44 was detected in surrounding tissue, and expression of CD44 was noted within the matrix of the cavernous malformation.

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Vascular Evaluation around the Cervical Nerve Roots during Ultrasound-Guided Cervical Nerve Root Block

Spine Surgery and Related Research ◽

10.22603/ssrr.2019-0006 ◽

2020 ◽

Vol 4 (1) ◽

pp. 18-22

Author(s):

Shizumasa Murata ◽

Hiroshi Iwasaki ◽

Yuta Natsumi ◽

Hiroshi Minagawa ◽

Hiroshi Yamada

Keyword(s):

Nerve Root ◽

Ultrasound Guided ◽

Nerve Roots ◽

Cervical Nerve Root ◽

Cervical Nerve ◽

Nerve Root Block ◽

Cervical Nerve Root Block ◽

Cervical Nerve Roots

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Cerebral Glioblastoma Mimicking a Cavernous Malformation: A Case Report and Literature Review

Translational Neuroscience and Clinics ◽

10.18679/cn11-6030_r.2017.005 ◽

2017 ◽

Vol 3 (1) ◽

pp. 35-39

Author(s):

Jiefei Li ◽

Yuqi Zhang ◽

Huancong Zuo

Keyword(s):

Autosomal Dominant ◽

Cavernous Malformation ◽

Vascular Diseases ◽

Cerebral Cavernous Malformations ◽

Imaging Features ◽

Cavernous Malformations ◽

History Of ◽

Vascular Dysplasia ◽

The Right ◽

Dominant Condition

Glioblastomas are highly malignant and invasive brain tumors. Cerebral cavernous malformations (CCMs) are vascular diseases of congenital and occult vascular dysplasia, which may arise sporadically or may be inherited due to autosomal dominant condition. To the best of our knowledge, cases of glioblastoma in the cerebral hemisphere mimicking cavernous malformation have not been reported in the literature. We reported a case of glioblastoma mimicking CCM. The patient was admitted at our hospital in July 2015 due to a 9-day history of intermittent dizziness. The present study reports a case of a glioblastoma on the right temporal lobe mimicking CCM, which was confirmed by postoperative pathology. The diagnosis of glioblastoma was not determined even during surgery, and the lesion was totally resected with no complications. During the surgical procedure, the lesion was very similar to a CCM. In conclusion, it is difficult to distinguish between glioblastoma and CCM. Therefore, when a lesion is present with hemorrhage and the imaging features are very similar to a vascular disease, a tumor must be considered in the differential diagnosis.

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