Spasticparaplegia secondary to cord constriction by the dura

1973 ◽  
Vol 39 (5) ◽  
pp. 645-647 ◽  
Author(s):  
M. Peter Heilbrun ◽  
David O. Davis

✓ A case of spastic paraplegia secondary to constriction of the upper thoracic spinal cord by the dura, which was associated with the juvenile onset of diabetes mellitus, is described.

1987 ◽  
Vol 66 (3) ◽  
pp. 447-452 ◽  
Author(s):  
Yutaka Naka ◽  
Toru Itakura ◽  
Kunio Nakai ◽  
Kazuo Nakakita ◽  
Harumichi Imai ◽  
...  

✓ The microangioarchitecture of corrosion casts of the cat spinal cord was studied by scanning electron microscopy. On the ventral surface of the spinal cord, the anterior spinal artery and the anterior spinal vein ran parallel along the anterior median fissure. Many central arteries branching from the anterior spinal artery coursed in a wavelike manner in the anterior median fissure. The number of central arteries was lowest in the thoracic spinal cord. Central arteries at some spinal cord levels revealed well-developed anastomoses with other central arteries in the anterior median fissure. These well-developed anastomotic central arteries were frequently observed in the thoracic spinal cord, in which the number of central arteries was lowest. On the dorsal surface of the spinal cord, the posterior spinal vein ran longitudinally at the midline and was drained by circumferential veins and posterior central veins. This vein formed a characteristic anastomotic plexus. Small arterioles (20 µm in diameter) in the spinal parenchyma revealed a ring-like compression at the branching site.


1992 ◽  
Vol 76 (2) ◽  
pp. 280-291 ◽  
Author(s):  
R. John Hurlbert ◽  
Charles H. Tator ◽  
Michael G. Fehlings ◽  
Greg Niznik ◽  
R. Dean Linden

✓ Although the assessment of spinal cord function by electrophysiological techniques has become important in both clinical and research environments, current monitoring methods do not completely evaluate all tracts in the spinal cord. Somatosensory and motor evoked potentials primarily reflect dorsal column and pyramidal tract integrity, respectively, but do not directly assess the status of the ventral funiculus. The present study was undertaken to evaluate the use of evoked potentials, elicited by direct cerebellar stimulation, in monitoring the ventral component of the rodent spinal cord. Twenty-nine rats underwent epidural anodal stimulation directly over the cerebellar cortex, with recording of evoked responses from the lower thoracic spinal cord, both sciatic nerves, and/or both gastrocnemius muscles. Stimulation parameters were varied to establish normative characteristics. The pathways conducting these “posterior fossa evoked potentials” were determined after creation of various lesions of the cervical spinal cord. The evoked potential recorded from the thoracic spinal cord consisted of five positive (P1 to P5) and five negative (N1 to N5) peaks. The average conduction velocity (± standard deviation) of the earliest wave (P1) was 53 ± 4 m/sec, with a latency of 1.24 ± 0.10 msec. The other components followed within 4 msec from stimulus onset. Unilateral cerebellar stimulation resulted in bilateral sciatic nerve and gastrocnemius muscle responses; there were no significant differences (p > 0.05) in the thresholds, amplitudes, or latencies of these responses elicited by right- versus left-sided stimulation. Recordings performed following creation of selective lesions of the cervical cord indicated that the thoracic response was carried primarily in the ventral funiculus while the sciatic and gastrocnemius responses were mediated through the dorsal half of the spinal cord. It is concluded that the posterior fossa evoked potential has research value as a method of monitoring pathways within the ventral spinal cord of the rat, and should be useful in the study of spinal cord injury.


2005 ◽  
Vol 2 (3) ◽  
pp. 308-318 ◽  
Author(s):  
Carlos E. Casas ◽  
Loren P. Herrera ◽  
Chad Prusmack ◽  
Gladys Ruenes ◽  
Alexander Marcillo ◽  
...  

Object. Regionally delivered hypothermia has advantages over systemic hypothermia for clinical application following spinal cord injury (SCI). The effects of local hypothermia on tissue sparing, neuronal preservation, and locomotor outcome were studied in a moderate thoracic spinal cord contusion model. Methods. Rats were randomized to four treatment groups and data were collected and analyzed in a blinded fashion. Chilled saline was perfused into the epidural space 30 minutes postcontusion to achieve the following epidural temperatures: 24 ± 2.3°C (16 rats), 30 ± 2.4°C (13 rats), and 35 ± 0.9°C (13 rats). Hypothermia was continued for 3 hours when a 45-minute period of rewarming was instituted. In a fourth group a moderate contusion only was induced in 14 animals. Rectal (core) and T9–10 (epidural) temperatures were measured continuously. Locomotor testing, using the Basso-Beattie-Bresnahan (Ba-Be-Br) scale, was performed for 6 weeks, and rats were videotaped for subsequent analysis. The lesion/preserved tissue ratio was calculated throughout the entire lesion cavity and the total lesion, spinal cord, and spared tissue volumes were determined. The rostral and caudal extent of gray matter loss was also measured. At 6 weeks locomotor recovery was similar in all groups (mean Ba-Be-Br Scale scores 14.88 ± 3.71, 14.83 ± 2.81, 14.50 ± 2.24, and 14.07 ± 2.39 [p = 0.77] for all four groups, respectively). No significant differences in spared tissue volumes were found when control and treatment groups were compared, but gray matter preservation was reduced in the infusion-treated groups. Conclusions. Regional cooling applied 30 minutes after a moderate contusive SCI was not beneficial in terms of tissue sparing, neuronal preservation, or locomotor outcome. This method of cooling may reduce blood flow in the injured spinal cord and exacerbate secondary injury.


1982 ◽  
Vol 56 (1) ◽  
pp. 143-144
Author(s):  
Jose Berciano ◽  
Jaime Gutierrez ◽  
Mariano Rebollo ◽  
Guillermo Dierssen

✓ A case of thoracic spinal cord ependymoma presenting with ejaculatory failure is described. This mode of onset has not previously been reported in patients with thoracic intraspinal tumors.


1970 ◽  
Vol 33 (5) ◽  
pp. 554-563 ◽  
Author(s):  
David L. Kelly ◽  
Kenneth R. L. Lassiter ◽  
John A. Calogero ◽  
Eben Alexander

✓ A controlled series of adult mongrel dogs were rendered paraplegic by traumatizing the thoracic spinal cord. Those animals treated with local hypothermia, whether immediately or after a delay, recovered to a significantly greater degree than the untreated group. Spinal cord pO2 studies revealed a marked fall in the pO2 at the area of maximal injury over a 30-min period. The severe hypoxia lasted at least 7 hours. Pathological studies showed the varying degrees of injury produced. It is postulated that local hypothermia may be effective in altering the clinical recovery by decreasing the tissue metabolism at the site of injury.


2003 ◽  
Vol 99 (3) ◽  
pp. 306-309 ◽  
Author(s):  
Victor R. Dasilva ◽  
Mubarak Al-Gahtany ◽  
Rajiv Midha ◽  
Dipanka Sarma ◽  
Perry Cooper

✓ Transdural herniation of the spinal cord, a rare but well-documented entity, has been reported sporadically for more than 25 years as a possible cause for various neurological signs and symptoms ranging from isolated sensory or motor findings to myelopathy and Brown—Séquard syndrome. The authors report, to the best of their knowledge, the first case of upper thoracic spinal cord herniation occurring after traumatic nerve root avulsion.


1997 ◽  
Vol 87 (2) ◽  
pp. 239-246 ◽  
Author(s):  
Fernando L. Vale ◽  
Jennifer Burns ◽  
Amie B. Jackson ◽  
Mark N. Hadley

✓ The optimal management of acute spinal cord injuries remains to be defined. The authors prospectively applied resuscitation principles of volume expansion and blood pressure maintenance to 77 patients who presented with acute neurological deficits as a result of spinal cord injuries occurring from C-1 through T-12 in an effort to maintain spinal cord blood flow and prevent secondary injury. According to the Intensive Care Unit protocol, all patients were managed by using Swan—Ganz and arterial blood pressure catheters and were treated with immobilization and fracture reduction as indicated. Intravenous fluids, colloid, and vasopressors were administered as necessary to maintain mean arterial blood pressure above 85 mm Hg. Surgery was performed for decompression and stabilization, and fusion in selected cases. Sixty-four patients have been followed at least 12 months postinjury by means of detailed neurological assessments and functional ability evaluations. Sixty percent of patients with complete cervical spinal cord injuries improved at least one Frankel or American Spinal Injury Association (ASIA) grade at the last follow-up review. Thirty percent regained the ability to walk and 20% had return of bladder function 1 year postinjury. Thirty-three percent of the patients with complete thoracic spinal cord injuries improved at least one Frankel or ASIA grade. Approximately 10% of the patients regained the ability to walk and had return of bladder function. As of the 12-month follow-up review, 92% of patients demonstrated clinical improvement after sustaining incomplete cervical spinal cord injuries compared to their initial neurological status. Ninety-two percent regained the ability to walk and 88% regained bladder function. Eighty-eight percent of patients with incomplete thoracic spinal cord injuries demonstrated significant improvements in neurological function 1 year postinjury. Eighty-eight percent were able to walk and 63% had return of bladder function. The authors conclude that the enhanced neurological outcome that was observed in patients after spinal cord injury in this study was in addition to, and/or distinct from, any potential benefit provided by surgery. Early and aggressive medical management (volume resuscitation and blood pressure augmentation) of patients with acute spinal cord injuries optimizes the potential for neurological recovery after sustaining trauma.


1982 ◽  
Vol 56 (2) ◽  
pp. 267-269 ◽  
Author(s):  
Yvon Guegan ◽  
Raeph Fardoun ◽  
Bernard Launois ◽  
Jean Pecker

✓ This young man was operated on twice for thoracic spinal cord compression. He had been on corticosteroid therapy for the last 2 years subsequent to a renal transplant. The only anomaly discovered during the operation was a large quantity of extradural fat that did not present the characteristics of lipoma. The remarkable postoperative clinical improvement suggested that the fat deposit was responsible for the spinal cord compression.


1976 ◽  
Vol 44 (3) ◽  
pp. 331-336 ◽  
Author(s):  
Bruce J. Ammerman ◽  
James M. Henry ◽  
Umberto De Girolami ◽  
Kenneth M. Earle

✓ Nine original cases of intradural spinal cord lipomas have been examined from a clinical and pathological standpoint. These tumors occur more commonly in men in the second to fourth decade and are found most frequently in the thoracic spinal cord. Paraparesis, sensory changes, urinary incontinence, and pain are frequent presenting complaints. Myelography is the diagnostic study of choice. All lipomas in this series were located primarily within the cord; four of these also presented an extramedullary extension. Admixed nerve bundles were present in five cases with associated hypertrophic onion-bulb formations in three. Decompression with biopsy or subtotal resection is the operative procedure of choice.


1998 ◽  
Vol 89 (4) ◽  
pp. 659-666 ◽  
Author(s):  
Francesco M. Salpietro ◽  
Concetta Alafaci ◽  
Olga Gervasio ◽  
Giovanni La Rosa ◽  
Ambrogia Baio ◽  
...  

✓ Primary intramedullary melanoma is a very rare tumor that occurs most frequently in the middle or lower thoracic spinal cord. The authors present a case of primary cervical cord melanoma that developed in a 62-year-old man who was surgically treated and subsequently underwent radiation therapy. Clinical and histogenetic features of this neoplasm and results of chemo-, radio-, and immunotherapy are reported. Both “dysembryogenetic” and “mesodermal” hypotheses on the origin of primary spinal melanoma are discussed.


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