scholarly journals Postoperative spinal subdural hygroma without incidental durotomy: illustrative cases

2021 ◽  
Vol 2 (23) ◽  
Author(s):  
Garrett Q. Barr ◽  
Peter L. Mayer
Keyword(s):  
Imaging Finding ◽  
Vascular Malformations ◽  
Anticoagulation Therapy ◽  
Leg Pain ◽  
Subdural Hygroma ◽  
Additional Surgery ◽  
Spinal Subdural Hematoma ◽  
Characteristic Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Incidental Durotomy

BACKGROUND Spinal subdural hygroma (SSH) is a rare pathological entity occurring as a complication of spinal surgery. It is different from spinal subdural hematoma due to blunt trauma, anticoagulation therapy, spinal puncture, and rupture of vascular malformations. OBSERVATIONS The authors presented five patients with SSH who received decompression for lumbar stenosis. None had incidental durotomy. All presented postoperatively with unexpectedly severe symptoms, including back and leg pain and weakness. Postoperative magnetic resonance imaging (MRI) revealed SSH with a characteristic imaging finding termed the “flying bat” sign. Four patients underwent evacuation of SSH, with immediate and complete resolution of symptoms in three patients and improvement in one patient. One patient improved without additional surgery. At surgery, subdural collections were found to be xanthochromic fluid in three patients and plain cerebrospinal fluid (CSF) in one patient. LESSONS Unexpectedly severe back and leg pain and weakness after lumbar or thoracic spine surgery should raise suspicion of SSH. MRI and/or computed tomography myelography shows the characteristic findings termed the flying bat sign. Surgical evacuation is successful although spontaneous resolution can also occur. The authors hypothesized that SSH is due to CSF entering the subdural space from the subarachnoid space via a one-way valve effect.

Posttraumatic Acute Spinal Subdural Hematoma of the Spine

2017 ◽  
Vol 14 (01) ◽  
pp. 053-055 ◽  
Author(s):  
Veldurti Kumar ◽  
Yashwanth Sandeep ◽  
Umamaheswara V. ◽  
Veda Samudrala ◽  
Amit Agrawal
Keyword(s):  
Subdural Hematoma ◽  
Spinal Injury ◽  
Cord Compression ◽  
Imaging Findings ◽  
Good Recovery ◽  
Resonance Imaging ◽  
Spinal Subdural Hematoma ◽  
Characteristic Imaging ◽  
Epidural Fat ◽  
Magnetic Resonance Imaging Mri

AbstractAcute spinal subdural hematoma (ASSH) is a rare cause of spinal cord compression and neurologic deficits. The authors report a case of 23-year-old male patient who developed ASSH following spinal injury and discuss the characteristic imaging findings of ASSH. Magnetic resonance imaging (MRI) of the spine showed hypointense collection on T2W images seen posteriorly extending from inferior endplate of C5 to superior endplate of D3 with preservation of the epidural fat signal. The patient underwent surgical evacuation of the hematoma and made a good recovery in his neurological functions.

scholarly journals A Case of Spontaneous Spinal Subdural Hematoma Complicated by Cranial Subarachnoid Hemorrhage and Spinal Adhesive Arachnoiditis

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Taihei Go ◽  
Toshiyuki Tsutsui ◽  
Yasuaki Iida ◽  
Katsunori Fukutake ◽  
Ryoichi Fukano ◽  
...  
Keyword(s):  
Back Pain ◽  
Subarachnoid Hemorrhage ◽  
Subdural Hematoma ◽  
Subarachnoid Space ◽  
Clinical Symptoms ◽  
Neurological Manifestation ◽  
Subdural Space ◽  
Spinal Subdural Hematoma ◽  
Magnetic Resonance Imaging Mri ◽  
To Come

A 76-year-old woman with a spinal subdural hematoma (SDH) was presented with severe back pain without headache. Magnetic resonance imaging (MRI) performed 4 days after onset showed SDH extending from Th2 to L3. She was diagnosed with spontaneous SDH without neurological manifestation, and conservative treatment was selected. Transient disturbance of orientation appeared 7 days after onset. Small subarachnoid hemorrhage (SAH) was detected on head CT, and strict antihypertensive therapy was started. Symptoms changed for the better. Back pain disappeared 4 weeks after onset. On follow-up MRI at 6 months after onset, the SDH had been resolved spontaneously. Although adhesive arachnoiditis was observed at Th4-6, the recurrence of clinical symptoms was not observed at one year and a half after onset. Spinal subdural space is almost avascular; a hematoma in a subdural space is considered to come from a subarachnoid space when it is a lot. A hemorrhage in subarachnoid space was flushed by cerebral spinal fluid; hematoma or arachnoiditis was not formed in general. In our case, hemorrhage was a lot and expansion of SDH was large enough to cause cranial SAH and arachnoiditis. But longitudinally expanded SDH did not show neurological manifestation and resolved spontaneously in our case.

scholarly journals An unusual case of unilateral limb hypertrophy: Lipoma of sacral roots

2012 ◽  
Vol 03 (01) ◽  
pp. 89-92 ◽  
Author(s):  
Archana B Netto ◽  
Sanjib Sinha ◽  
Arun B Taly ◽  
Chandrajit Prasad ◽  
A Mahadevan ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Unusual Case ◽  
Tethered Cord ◽  
Leg Pain ◽  
Lumbosacral Spine ◽  
Resonance Imaging ◽  
Chronic Denervation ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Progressive Enlargement

ABSTRACTWe report an unusual case of unilateral limb pseudo hypertrophy in a 21-year-old lady who developed progressive enlargement of the right calf followed by thigh in association with chronic leg pain. Magnetic resonance imaging (MRI) of the affected limb confirmed enlargement of various muscles. Electromyography revealed neurogenic features consistent with S1 radiculopathy. MRI of the lumbosacral spine showed tethered cord with a lipoma infiltrating multiple sacral roots. Our case illustrates that muscular pseudo hypertrophy may follow chronic denervation as a consequence of spinal neural compressive disease. The various mechanisms postulated for this distinct condition are outlined.

scholarly journals The Usefulness of Dual-Layer Spectral Computed Tomography for Myelography: A Case Report and Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Yuji Iyama ◽  
Takeshi Nakaura ◽  
Ayumi Iyama ◽  
Kazuhiro Katahira ◽  
Yasuyuki Yamashita
Keyword(s):  
Computed Tomography ◽  
Spectral Analysis ◽  
Spinal Canal ◽  
Leg Pain ◽  
Monochromatic Imaging ◽  
Canal Stenosis ◽  
Spectral Computed Tomography ◽  
Spectral Detector Ct ◽  
Magnetic Resonance Imaging Mri

We describe a case of lumbar stenosis in which retrospective spectral analysis using dual-layer spectral detector computed tomography (CT) had the ability to expand the evaluable region in the spinal canal. Spinal canal stenosis is a common condition whose symptoms (such as lower back and leg pain with walking) deteriorate the quality of life. Generally, magnetic resonance imaging (MRI) and CT myelography are performed to diagnose canal stenosis. Dual-layer spectral detector CT can yield virtual monochromatic imaging and retrospective on-demand spectral analysis without a prescan setting. Spectral analysis could expand the evaluable region in the spinal canal for increasing the contrast enhancement in the canal.

scholarly journals Isolated Spontaneous Midbrain Hemorrhage in a 14-Year-Old Boy

2017 ◽  
Vol 78 (01) ◽  
pp. e5-e8
Author(s):  
Kim-Long Nguyen ◽  
Hyunyoung Kim ◽  
Laszlo Nagy
Keyword(s):  
Endoscopic Third Ventriculostomy ◽  
Vascular Malformations ◽  
Third Ventriculostomy ◽  
Bleeding Diathesis ◽  
Resonance Imaging ◽  
Hyperactivity Disorder ◽  
Migraine Headaches ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Noncontrast Computed Tomography

AbstractIsolated spontaneous midbrain hemorrhages are rare because they are usually secondary to hemorrhages from inferior structures such as the pons and cerebellum, or superior structures such as the thalamus and putamen. While the etiologies are largely unidentified, the most common ones are vascular malformations and bleeding diathesis with hypertension being relatively uncommon. We report midbrain hemorrhage in a 14-year-old boy with a long-standing history of frequent migraine headaches and attention deficit/hyperactivity disorder (ADHD). Neurologic examinations, noncontrast computed tomography (CT) scans, and magnetic resonance imaging (MRI) suggested that the lesion likely affected the dorsal part of the midbrain. The neurologic symptoms improved following endoscopic third ventriculostomy (ETV) with the placement of external ventricular drains (EVDs). In this report, anatomical correlations to the case are discussed and previous reports of midbrain hemorrhages are reviewed.

Primary Intradural Extraosseous Ewing Sarcoma of the Spine: Case Report and Literature Review

Neurosurgery ◽  
2011 ◽  
Vol 69 (4) ◽  
pp. E995-E999 ◽  
Author(s):  
Isaac O Karikari ◽  
Ankit I Mehta ◽  
Shahid Nimjee ◽  
Tiffany R Hodges ◽  
June Tibaleka ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Ewing Sarcoma ◽  
Correct Diagnosis ◽  
Immunohistochemical Analysis ◽  
Leg Pain ◽  
Treatment Modalities ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Extraosseous Ewing Sarcoma

Abstract BACKGROUND AND IMPORTANCE: To report a rare case of spinal intradural extraosseous Ewing sarcoma in an adult and review current literature. Although Ewing sarcoma belongs to the family, the treatment modalities are different, and thus the correct diagnosis is very important despite its rare occurrence. CLINICAL PRESENTATION: A 56-year-old woman presented with nocturnal bilateral buttock and leg pain. Magnetic resonance imaging (MRI) showed an enhancing intradural extramedullary extraosseous tumor at L1. INTERVENTION: A T12-L2 laminectomy was performed to resect the tumor. Immunohistochemical analysis confirmed the diagnosis of Ewing sarcoma. A thorough diagnostic workup did not reveal any bony origin of the tumor. Primary intradural central nervous system Ewing sarcoma is infrequently encountered and shares imaging and histopathological features with central primitive neuroectodermal tumors. Establishment of the right diagnosis is crucial because it mandates a distinct workup and treatment modality different from that for central primitive neuroectodermal tumor. Although osseous Ewing sarcoma predominantly occurs in children and young adults, extraosseous central nervous system Ewing sarcoma is not uncommon in adults and should therefore be considered in the differential diagnosis of extraosseous small blue cell tumors in adult patients.

scholarly journals Metronidazole-Induced Encephalopathy: Case Report and Review of MRI Findings

2011 ◽  
Vol 38 (3) ◽  
pp. 512-513 ◽  
Author(s):  
Jamsheed A. Desai ◽  
Jessica Dobson ◽  
Michel Melanson ◽  
Giovanna Pari ◽  
Albert Yongwon Jin
Keyword(s):  
Imaging Finding ◽  
Sensory Loss ◽  
Mri Findings ◽  
Axonal Polyneuropathy ◽  
Large Fibre ◽  
History Of ◽  
Impaired Balance ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Vibration Threshold

A 74-year-old man presented with a four week history of behavioural disturbances, upper and lower extremity numbness and impaired balance. He had been treated with metronidazole for six months for osteomyelitis of the right hallux. Examination revealed encephalopathy, and glove-and-stocking sensory loss to pinprick with reduced vibration threshold at the toe. The gait was wide based and ataxic. Nerve conduction studies showed a large fibre sensory-motor axonal polyneuropathy. Magnetic resonance imaging (MRI) revealed a solitary restricted diffusion lesion in the splenium of the corpus callosum (Figure A, B) with subtle prolongation of T2 (Figure C). The radiographic differential diagnosis included hypoglycaemia, viral encephalitis, antiepileptic drug toxicity/withdrawal and metronidazole toxicity. The combination of the imaging finding with the history of prolonged metronidazole use suggested metronidazole induced encephalopathy.

scholarly journals Therapeutic challenges after successful thrombectomy in a patient with an antiphospholipid syndrome associated M1-occlusion: A case report

2015 ◽  
Vol 21 (5) ◽  
pp. 598-602 ◽  
Author(s):  
Katharina Stadler ◽  
Johannes S Mutzenbach ◽  
Gudrun Kalss ◽  
Johann Sellner ◽  
Abdul R Al-Schameri ◽  
...  
Keyword(s):  
Case Report ◽  
Antiphospholipid Syndrome ◽  
Stent Implantation ◽  
New Left ◽  
Anticoagulation Therapy ◽  
Blood Parameters ◽  
Left Middle Cerebral Artery ◽  
Systemic Thrombolysis ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Backround Stroke is a frequent disorder in patients with an antiphospholipid syndrome (APS). Due to a high risk for further thromboembolic events, appropriate anticoagulation therapy in patients with an APS-associated stroke seems mandatory but drug eluting and duration is a matter of debate. Case A 48-year-old female patient presented with Broca’s aphasia and mild hemiparesis on the right side. Diagnostic work-up revealed left middle cerebral artery (MCA) occlusion yet without diffusion-weighted lesions. Due to a thrombocytopenia (67.00 g/l) systemic thrombolysis was not indicated and endovascular treatment was initiated 150 min after symptom onset. After successful clot retrieval, recurrent re-occlusions lead to the necessity of stent implantation and anticoagulation, respectively. On day 5 she developed a new severe right-sided hemiparesis. The magnetic resonance imaging (MRI) showed a subtotal restenosis of the left MCA despite the regular anticoagulation regime leading to a new left MCA ischaemic stroke. In the meantime, the unknown aetiology, the patients’ age and the thrombocytopenia let to further diagnostic workup. Elevated blood parameters such as lupus anticoagulant (LA)-1, LA-ratio, positive anti-nuclear antibody (ANA), p-anti-neutrophil cytoplasmic antibodies (ANCA), c-ANCA confirmed the diagnosis of APS. Conclusion This case report showed the feasibility of mechanical clot retrieval and stent implantation in patients with APS. Due to the elevated risk of in-stent thrombosis a prolonged therapy with glycoprotein (GP)IIb/IIIa receptor antagonists in the initial postoperative period and further anticoagulation with coumarin derivate might be needed.

scholarly journals Cervical Intramedullary Cavernoma in Children: Case report and literature review

2019 ◽  
Vol 29 (4) ◽  
pp. 690-696
Author(s):  
Catarine Cavalcante Ary ◽  
Sebastião Carlos de Sousa Oliveira ◽  
Joaquim Francisco Cavalcante Neto ◽  
Mateus Aragão Esmeraldo ◽  
Francisco Abdoral Brito Júnior ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Vascular Malformations ◽  
Pediatric Population ◽  
Single Layer ◽  
Complete Regression ◽  
Resonance Imaging ◽  
Case Presentation ◽  
Vascular Channels ◽  
Magnetic Resonance Imaging Mri ◽  
Spinal Cavernomas

Case presentation: A 10-year-old male patient was admitted due to posterior cervicalgia, vomiting and progressive generalized weakness. Physical examination showed difficulty in ambulation and tetraparesis. Magnetic resonance imaging (MRI) of the cervical medulla enhanced by the contrast agent, gadolinium, showed a poorly contrasted mass with a hemorrhagic center. We undertook a posterior cervicotomy (C1-C3). Post-operative evolution was satisfactory with complete regression of the deficits 90 days after surgery. Control MRI at intervals of 1 and 4 years confirmed absence of the tumor. Discussion: Cavernomas are vascular malformations, consisting of coarsely dilated vascular channels and coated by a single layer of endothelial cells, devoid of endothelium and myothelium. They represent only 5-12% of all vascular pathologies of the medulla, with only 10% affecting the pediatric population. There are only thirty cases of pediatric intramedullary spinal cavernomas in the literature, with predominance among males (2.1:1). Thoracic and cervical spinal cavernomas consist in 55% and 45% of the cases, respectively. In six cases (20%) cavernomatous lesions were associated with synchronic intracranial cavernoma. Among the reported cases, only one had poor evolution after surgery, whereas six patients persisted with prior symptoms. Conclusion: Spinal intramedullary cavernomas are rare entities, especially in the pediatric population, and are treated with surgery which improves prior neurologic deficits, besides preventing rebleeding

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