Penetrating gunshot wounds of the cervical spine in civilians

1975 ◽  
Vol 42 (5) ◽  
pp. 575-579 ◽  
Author(s):  
James S. Heiden ◽  
Martin H. Weiss ◽  
Alan W. Rosenberg ◽  
Theodore Kurze ◽  
Michael L. J. Apuzzo
Keyword(s):  
Cervical Spine ◽  
Neurological Deficit ◽  
Surgical Intervention ◽  
Gunshot Wounds ◽  
Neurological Recovery ◽  
Content Type ◽  
Initial Injury ◽  
Progressive Neurological Deficit ◽  
Nonsurgical Therapy ◽  
Fine Print

✓ The authors present a series of 38 civilian patients with cervical gunshot injuries, and compare neurological recovery in patients with complete lesions and patients with incomplete lesions according to whether therapy was surgical or nonsurgical. In patients with incomplete injury, ultimate recovery was a function of the initial injury more than surgical or nonsurgical therapy; nor did patients with complete lesions show significant change in outcome with either mode of therapy. Cord pathology at laminectomy rarely provided a clue about neurological recovery, and dural decompression did not alter neurological outcome. The authors conclude that the sole indication for routine surgical intervention appears to be progressive neurological deficit.

Progressive neurological dysfunction secondary to postoperative cervical pseudomeningocele in a C-4 quadriplegic

1978 ◽  
Vol 48 (2) ◽  
pp. 289-291 ◽  
Author(s):  
Kenneth P. Burres ◽  
Frances K. Conley
Keyword(s):  
Neurological Deficit ◽  
Neurological Symptoms ◽  
Diagnostic Evaluation ◽  
Neurological Dysfunction ◽  
Previous Surgery ◽  
Content Type ◽  
Progressive Neurological Deficit ◽  
Operative Closure ◽  
Fine Print

✓ A case is detailed of a patient who developed progressive neurological deficit above a fixed quadriplegic level at C-4 18 years after posterior cervical decompression for trauma. Diagnostic evaluation revealed a pseudomeningocele at the site of his previous surgery. Subsequent operative closure resulted in reversal of his neurological symptoms.

Odontoid compression of the brain stem in a patient with rheumatoid arthritis

1980 ◽  
Vol 53 (6) ◽  
pp. 841-845 ◽  
Author(s):  
Harold P. Smith ◽  
Venkata R. Challa ◽  
Eben Alexander
Keyword(s):  
Rheumatoid Arthritis ◽  
Brain Stem ◽  
Neurological Deficit ◽  
Neurological Symptoms ◽  
Direct Compression ◽  
Content Type ◽  
Vertical Subluxation ◽  
Progressive Neurological Deficit ◽  
The Brain ◽  
Fine Print

✓ Cervical spine involvement by rheumatoid arthritis is common; brain-stem compression secondary to vertical subluxation of the odontoid in patients with rheumatoid arthritis is rare. Vertical subluxation results from 1) destruction of the transverse atlantal, apical, and alar ligaments of the atlas and odontoid, and 2) bone resorption in the occipital condyles, lateral masses of the atlas, and basilar processes of the skull. Neurological symptoms result from direct compression of the brain stem or from ischemia secondary to compression of vertebral arteries, anterior spinal arteries, or small perforating arteries of the brain stem and spinal cord. A case is reported in which a slowly progressive neurological deficit developed in a woman with rheumatoid arthritis following a fall from a stretcher. Neurological symptoms represented direct compression of the medulla by the dens, a mechanism confirmed at operation and autopsy. Recognition of progressive neurological deficit is often difficult in patients with rheumatoid arthritis because of their inactivity and their atrophic and immobile joints, but is essential if appropriate decompressive or stabilizing procedures are to be done. In patients with vertical subluxation of the dens, the transoral approach with removal of the odontoid is recommended. Decompression should be extensive, including the fibrous capsule around the odontoid and overlying synovial tissue as well as the odontoid itself.

Discography and myelography in acute injuries of the cervical spine

1971 ◽  
Vol 35 (5) ◽  
pp. 529-535 ◽  
Author(s):  
Richard B. Raynor
Keyword(s):  
Cervical Spine ◽  
Neurological Deficit ◽  
Fracture Dislocation ◽  
Cervical Fracture ◽  
Content Type ◽  
Relative Safety ◽  
Acute Injuries ◽  
Fine Print

✓ Nineteen patients who suffered trauma to the cervical spine that resulted in moderate to severe neurological deficit were studied by discography. In 15 cases, myelography was also performed. When both tests were done there was good correlation of results. In the four cases where only discography was performed, the lesion was accurately localized. The danger of myelography in acute cervical fracture dislocation is emphasized and the relative safety, ease, and value of discography stressed.

Posterior cervical fusion in children

1976 ◽  
Vol 45 (2) ◽  
pp. 211-215 ◽  
Author(s):  
Joe M. McWhorter ◽  
Eben Alexander ◽  
Courtland H. Davis ◽  
David L. Kelly
Keyword(s):  
Cervical Spine ◽  
Neurological Deficit ◽  
The Other ◽  
Congenital Absence ◽  
Cervical Fusion ◽  
Content Type ◽  
Cervical Spine Injuries ◽  
Spine Injuries ◽  
Posterior Cervical Fusion ◽  
Fine Print

✓ Six cases of posterior cervical fusion with rib grafts in children are reported. Four of the children had sustained cervical spine injuries in accidents, and two had congenital absence of the odontoid. Three-level fusions (C1–3) were done in four children, and four-level fusions (C1–4) in two. One child died of unrelated causes 3 months after the operation. The other five children have been followed for 5 to 13 years. All are doing well and each has a remarkably supple, stable neck and no neurological deficit.

Analysis of 76 civilian craniocerebral gunshot wounds

1986 ◽  
Vol 65 (1) ◽  
pp. 9-14 ◽  
Author(s):  
W. Craig Clark ◽  
Michael S. Muhlbauer ◽  
Clarence B. Watridge ◽  
Morris W. Ray
Keyword(s):  
Mortality Rate ◽  
Management Practices ◽  
Surgical Intervention ◽  
Gunshot Wounds ◽  
Content Type ◽  
Multicenter Trials ◽  
Intracranial Hematomas ◽  
Gcs Score ◽  
Admission Glasgow Coma Scale ◽  
Fine Print

✓ A retrospective analysis of 76 civilian craniocerebral gunshot wounds treated over a 20-month period is presented. The authors report a 62% mortality rate and conclude that the admission Glasgow Coma Scale (GCS) score is a valuable prognosticator of outcome. Other important findings were: 1) patients with a GCS score of 3 invariably died, with or without surgical intervention; and 2) the presence of intracranial hematomas, ventricular injury, or bihemispheric wounding was associated with a poor outcome. Standardized methods of data reporting should be adopted in order to allow multicenter trials or comparisons that might lead to management practices that could improve results.

Malignant squamous degeneration of a cerebellopontine angle epidermoid tumor

2002 ◽  
Vol 97 (5) ◽  
pp. 1237-1243 ◽  
Author(s):  
Michael J. Link ◽  
Paul L. Cohen ◽  
John C. Breneman ◽  
John M. Tew
Keyword(s):  
Squamous Cell Carcinoma ◽  
Neurological Deficit ◽  
Epidermoid Cyst ◽  
Cerebellopontine Angle ◽  
External Beam Radiotherapy ◽  
Subtotal Resection ◽  
External Beam ◽  
Content Type ◽  
Progressive Neurological Deficit ◽  
Fine Print

✓ The authors present the case of a woman with a cerebellopontine angle (CPA) epidermoid cyst that degenerated into a squamous cell carcinoma. Malignant degeneration of an epidermoid cyst is an extremely rare occurrence. Malignant transformation must be considered in the differential diagnosis when new contrast enhancement on imaging studies and progressive neurological deficit are seen in a patient harboring an epidermoid cyst. The patient initially presented with a 10-year history of left trigeminal neuralgia, subacute left-sided hearing loss, and with facial weakness of 3 weeks' duration. Initial magnetic resonance (MR) imaging revealed a left CPA mass, consistent with an epidermoid. There was faint contrast enhancement where the tumor was in contact with the lateral brainstem. A subtotal resection was performed. Histopathological findings were consistent with an epidermoid tumor. One year after initial presentation, the patient's neurological deficit had increased, and follow-up MR imaging demonstrated a large contrast-enhancing tumor filling the left CPA and compressing the brainstem. At repeated surgery a squamous cell carcinoma arising from the previous epidermoid was found. The patient was subsequently treated with external-beam radiotherapy and stereotactic radiosurgery. Her tumor stabilized. Three years and 8 months after the patient's initial presentation, a new area of tumor developed at the torcular Herophili. The patient died shortly thereafter. Malignant squamous degeneration is a rare cause of enhancement on MR images, as is progressive neurological deficit in a patient with an epidermoid. The combination of subtotal resection, external-beam radiotherapy, and stereotactic radiosurgery may be useful for local tumor control but the long-term prognosis is guarded.

Chondroma of the cervical spine

1987 ◽  
Vol 66 (1) ◽  
pp. 128-130 ◽  
Author(s):  
Gérald Lozes ◽  
Ahmad Fawaz ◽  
Harry Perper ◽  
Philippe Devos ◽  
Pascal Benoit ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Spinal Cord Compression ◽  
Vertebral Column ◽  
Cord Compression ◽  
Neurological Recovery ◽  
Surgical Removal ◽  
Content Type ◽  
Fine Print

✓ The authors report a case of cervical chondroma presenting with a syndrome of spinal cord compression in a 76-year-old woman. Total surgical removal of the lesion was followed by partial neurological recovery. Chondromas of the vertebral column are rarely reported in the literature.

Pitfalls of bungee jumping

1998 ◽  
Vol 89 (6) ◽  
pp. 1040-1042 ◽  
Author(s):  
Deon Louw ◽  
Kesava K. V. Reddy ◽  
Carl Lauryssen ◽  
Gideon Louw
Keyword(s):  
Cervical Spine ◽  
Cervical Spine Injury ◽  
Surgical Intervention ◽  
Spine Injury ◽  
Content Type ◽  
Serious Injury ◽  
Fine Print

✓ A case of cervical spine injury related to bungee jumping is presented. Surgical intervention resulted in resolution of the patient's quadriparesis. The incidence of serious injury connected with this pastime is not inconsiderable, and it is recommended that safer jumping practices be followed. Inspection of bungee equipment and certification of instructors is now voluntary but should be mandated. Jumping heights should be limited and the use of air cushions encouraged.

Spinal cord sarcoidosis

1972 ◽  
Vol 36 (4) ◽  
pp. 490-493 ◽  
Author(s):  
Timir Banerjee ◽  
William E. Hunt
Keyword(s):  
Spinal Cord ◽  
Physical Therapy ◽  
Steroid Therapy ◽  
Neurological Deficit ◽  
Surgical Intervention ◽  
Intramedullary Tumor ◽  
Content Type ◽  
Spinal Cord Sarcoidosis ◽  
The Common ◽  
Fine Print

✓ A case of spinal cord sarcoidosis simulating an intramedullary tumor is presented. Surgical intervention increased the neurological deficit which was subsequently decreased by steroid therapy. The common complications are discussed and the need for extensive physical therapy emphasized.

Traumatic epidural hematoma of the cervical spine: diagnosis with magnetic resonance imaging

1988 ◽  
Vol 68 (5) ◽  
pp. 798-801 ◽  
Author(s):  
Golden Pan ◽  
Madan Kulkarni ◽  
David J. MacDougall ◽  
Michael E. Miner
Keyword(s):  
Cervical Spine ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Epidural Hematoma ◽  
Surgical Intervention ◽  
Resonance Imaging ◽  
Content Type ◽  
Cord Injury ◽  
Spinal Epidural ◽  
Fine Print

✓ A traumatic epidural hematoma of the cervical spine is reported in a 13-year-old girl. The patient recovered spontaneously over several days without surgical intervention. The diagnosis was made on magnetic resonance (MR) imaging, which also demonstrated subsequent resolution of the hematoma. The etiological factors of spinal epidural hematomas are reviewed and the utility of MR imaging in differentiating other causes of acute spinal cord injury is emphasized.

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