Myelomeningocele before birth

1978 ◽  
Vol 49 (5) ◽  
pp. 711-724 ◽  
Author(s):  
Kunihiko Osaka ◽  
Takashi Tanimura ◽  
Akihiko Hirayama ◽  
Satoshi Matsumoto
Keyword(s):  
Spinal Cord ◽  
Chiari Malformation ◽  
Cervical Cord ◽  
Human Embryos ◽  
Content Type ◽  
Fetal Period ◽  
Arnold Chiari Malformation ◽  
Spina Bifida Cystica ◽  
Almost All ◽  
Fine Print

✓ The authors report a study of 92 human embryos and four fetuses with myeloschisis. The characteristics of embryonic myeloschisis compared with spina bifida cystica in infants are: 1) the lesion is often more diffuse, involving the whole spinal cord (12 embryos); 2) the cervical cord is more frequently affected (23 of the remaining 80 embryos); 3) holoprosencephaly is frequently associated (18 embryos); 4) meningocele is not found; and 5) hydrocephalus and Arnold-Chiari malformation are not yet developed. Hydrocephalus and Arnold-Chiari malformation are found in myeloschistic fetuses. Almost all embryos with diffuse and cervical myeloschisis or with holoprosencephaly are extruded before birth by spontaneous abortion. Absence of meningocele in the embryonic period implies that its appearance is deferred to the fetal period. The development of hydrocephalus and Arnold-Chiari malformation also seems to be delayed until the fetal period. Our observation implies that myelomeningocele is induced by non-closure of the neural tube, not by rupture once it was closed. “Neural overgrowth” and disturbed “recanalization process” are discussed in relation to the pathogenesis of myelomeningocele.

Deformation of the cervicomedullary junction and spinal cord in a surgically treated adult Chiari I hindbrain hernia associated with syringomyelia: a magnetic resonance microscopic and neuropathological study

1996 ◽  
Vol 85 (4) ◽  
pp. 701-708 ◽  
Author(s):  
Emile A. M. Beuls ◽  
Marie-Anne M. Vandersteen ◽  
Linda M. Vanormelingen ◽  
Peter J. Adriaensens ◽  
Gerard Freling ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Magnetic Resonance ◽  
Cervical Spinal Cord ◽  
Cervical Cord ◽  
Magnetic Resonance Microscopy ◽  
Type I ◽  
Additional Advantage ◽  
Content Type ◽  
Hindbrain Hernia ◽  
Fine Print

✓ The lower brainstem and cervical spinal cord from an ordinarily treated case of Chiari Type I hindbrain hernia associated with syringomyelia was examined using high-resolution magnetic resonance microscopy and standard neuropathological techniques. Magnetic resonance microscopy allows total screening and visualizes the disturbed internal and external microanatomy in the three orthogonal planes with the resolution of low-power optical microscopy. An additional advantage is the in situ visualization of the shunts. Afterwards the intact specimen is still available for microscopic examination. Part of the deformation of the medulla is caused by chronic tonsillar compression and molding inside the foramen magnum. Other anomalies, such as atrophy caused by demyelination, elongation, and unusual disturbances at the level of the trigeminal and solitary nuclear complexes contribute to the deformation. At the level of the syrinx-free upper part of the cervical cord, anomalies of the dorsal root and the dorsal horn are demonstrated.

Deterioration following spinal cord injury

1987 ◽  
Vol 66 (3) ◽  
pp. 400-404 ◽  
Author(s):  
Lawrence F. Marshall ◽  
Sharen Knowlton ◽  
Steven R. Garfin ◽  
Melville R. Klauber ◽  
Howard M. Eisenberg ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Cord ◽  
Skeletal Traction ◽  
Systemic Complications ◽  
Content Type ◽  
Management Procedures ◽  
Cord Injury ◽  
Specific Management ◽  
Fine Print

✓ The results are presented of a prospective study of the course of 283 spinal cord-injured patients who were consecutively admitted to five trauma centers participating in the Comprehensive Central Nervous System Injury Centers' program of the National Institutes of Health. Of the 283 patients, 14 deteriorated neurologically during acute hospital management. In 12 of the 14, the decline in neurological function could be associated with a specific management event, and in nine of these 12 the injury involved the cervical cord. Nine of the 14 patients who deteriorated had cervical injuries, three had thoracic cord injuries, and two had thoracolumbar junction injuries. Management intervention was identified as the cause of deterioration in four of 134 patients undergoing operative intervention, in three of 60 with skeletal traction application, in two of 68 with halo vest application, in two of 56 undergoing Stryker frame rotation, and in one of 57 undergoing rotobed rotation. Early surgery on the cervical spine when cord injury is present appears hazardous, since each of the three patients with a cervical cord injury who deteriorated was operated on within the first 5 days. No such deterioration was observed following surgery performed from the 6th day on. In two other patients, deterioration did not appear to be related to management but was a direct product of the underlying disease or of systemic complications. Deterioration following hospitalization for spinal cord injury is relatively uncommon — 4.9% in this large series. In most instances, decline in function could be attributed to specific management procedures. These changes must not be interpreted as representing failure to provide optimal care but rather should be seen as the inevitable product of an attempt to manage patients with spinal cord and column injuries, many of which are clearly unstable.

Mesencephalic spur (beaking deformity of the tectum) in Arnold-Chiari malformation

1976 ◽  
Vol 45 (3) ◽  
pp. 315-320 ◽  
Author(s):  
Adelola Adeloye
Keyword(s):  
Chiari Malformation ◽  
Type Ii ◽  
Content Type ◽  
Arnold Chiari Malformation ◽  
Degrees Of Severity ◽  
Fine Print

✓ The beaking deformity of the tectum, referred to in this paper as the mesencephalic spur, is regularly present in the Type II variety of the Arnold-Chiari malformation in varying degrees of severity. When the mesencephalic spur is related to associated myelomeningocele, it was found that the more extensive the myelomeningocele, and the older the affected children, the more prominent was the mesencephalic spur.

Symptomatic hydrocephalus and reversible spinal cord compression in Listeria monocytogenes meningitis

1989 ◽  
Vol 71 (4) ◽  
pp. 620-622 ◽  
Author(s):  
Eric C. Raps ◽  
David H. Gutmann ◽  
James R. Brorson ◽  
Michael O'Connor ◽  
Howard I. Hurtig
Keyword(s):  
Spinal Cord ◽  
Listeria Monocytogenes ◽  
Cord Compression ◽  
Cervical Cord ◽  
Communicating Hydrocephalus ◽  
Ventricular Drainage ◽  
Central Nervous System Infections ◽  
Content Type ◽  
Clinical Syndromes ◽  
Fine Print

✓ Central nervous system infections with Listeria monocytogenes result in varied clinical syndromes ranging from meningitis to rhomboencephalitis. A case of Listeria meningitis complicated by symptomatic communicating hydrocephalus and hydrostatic cervical cord compression is presented which clinically and radiographically improved with aggressive ventricular drainage.

Experience with Arnold-Chiari malformation, 1960 to 1970

1976 ◽  
Vol 45 (4) ◽  
pp. 416-422 ◽  
Author(s):  
Ruben J. Saez ◽  
Burton M. Onofrio ◽  
Takehiko Yanagihara
Keyword(s):  
Retrospective Study ◽  
Neurological Deficit ◽  
Chiari Malformation ◽  
Prognostic Significance ◽  
Cerebellar Dysfunction ◽  
Content Type ◽  
Arnold Chiari Malformation ◽  
Clinical Syndromes ◽  
Suboccipital Decompression ◽  
Fine Print

✓ A retrospective study of 60 adult patients with Arnold-Chiari malformation revealed that certain presenting clinical syndromes, although not pathognomonic, seemed to have definite prognostic significance. Surgical management by suboccipital decompression led to remarkable and enduring improvement in 65% of patients followed for as long as 14 years. In some patients, however, the initial postoperative benefit tended to fade into an insidious progression of neurological deficit. Despite operation, 18.6% of patients eventually experienced progressive neurological deterioration. Patients who presented with paroxysmal intracranial hypertension or cerebellar dysfunction had the best prognosis. Evidence of central cord involvement was the single most detrimental factor to neurological recovery.

Spinal cord meningioma

1982 ◽  
Vol 57 (6) ◽  
pp. 804-812 ◽  
Author(s):  
Walter J. Levy ◽  
Janet Bay ◽  
Donald Dohn
Keyword(s):  
Spinal Cord ◽  
Surgical Approach ◽  
Clinical Presentation ◽  
Tumor Location ◽  
Spinal Meningioma ◽  
Content Type ◽  
High Incidence ◽  
Almost All ◽  
Cervical Tumors ◽  
Fine Print

✓ The authors present a retrospective analysis of 97 cases of spinal meningioma. Age, sex, tumor location, and clinical presentation are similar to that reported by others. Importantly, even among paraplegic patients, one-third eventually walked. Other findings of note were poor results among those with calcified or recurrent tumors, and a high incidence of invasiveness among the rare epidural lesions. Males do not show the preference for a thoracic location that is found among females, and cervical tumors are almost all anterior to the cord. This last point suggests a different surgical approach in some cases. A large percentage of cases carried other diagnoses before tumor was recognized.

Posttraumatic spinal cord tethering

1993 ◽  
Vol 78 (1) ◽  
pp. 120-121 ◽  
Author(s):  
Neil R. Berrington
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Cervical Cord ◽  
Resonance Imaging ◽  
Tonsillar Herniation ◽  
Content Type ◽  
Bulbar Symptoms ◽  
Initial Injury ◽  
Spinal Cord Tethering ◽  
Fine Print

✓ A 53-year-old woman with a complete C-7 traumatic quadriplegia developed progressive neurological deterioration, including bulbar symptoms, 3 years after her initial injury. Magnetic resonance imaging showed tethering of the spinal cord at the level of her injury, with marked stretching of the cervical cord associated with medullary and tonsillar herniation. Following transection of the spinal cord, there was some improvement in her condition. Possible etiological factors accounting for this unique presentation are discussed.

Malignant hyperthermia

1977 ◽  
Vol 46 (3) ◽  
pp. 385-390 ◽  
Author(s):  
Jeffery L. Rush ◽  
Eldon L. Foltz
Keyword(s):  
Metabolic Acidosis ◽  
Malignant Hyperthermia ◽  
Chiari Malformation ◽  
Tissue Hypoxia ◽  
Content Type ◽  
Arnold Chiari Malformation ◽  
Noncommunicating Hydrocephalus ◽  
Unusual Problem ◽  
Fine Print

✓ The authors report the case of an infant with noncommunicating hydrocephalus, Arnold-Chiari malformation, and a lumbar myelomeningocele, in whom malignant hyperthermia occurred. The genetics and presumed etiology of this unusual problem are reviewed. The management is directed toward establishing effective cooling measures, reversing tissue hypoxia, and correcting respiratory and metabolic acidosis.

Direction of blood flow in the primate cervical spinal cord

1970 ◽  
Vol 33 (3) ◽  
pp. 325-330 ◽  
Author(s):  
Larry C. Fried ◽  
John L. Doppman ◽  
Giovanni Di Chiro
Keyword(s):  
Spinal Cord ◽  
Blood Flow ◽  
Cervical Spinal Cord ◽  
Cervical Cord ◽  
Content Type ◽  
Vertebral Arteries ◽  
Cast Doubt ◽  
Thoracic Cord ◽  
Cervical Level ◽  
Fine Print

✓ The direction of blood flow in the cervical spinal cord of monkeys was studied by direct cinematic observation of the results of dye injections, plus separate angiographic studies. The studies indicated that in monkeys blood enters the cervical spinal cord mainly from radicular arteries that are usually derived from branches of the costo-cervical trunk. Although some blood entering at the low cervical level flows toward the thoracic cord, the major component flows up to the C-2 level. The findings cast doubt on the established assumption that the vertebral arteries provide the main blood supply of the cervical cord.

Effects of cervical spinal cord stimulation on cerebral blood flow in the rat

2000 ◽  
Vol 93 (1) ◽  
pp. 71-76 ◽  
Author(s):  
Oren Sagher ◽  
Dah-Luen Huang
Keyword(s):  
Spinal Cord ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Spinal Cord Stimulation ◽  
Cervical Spinal Cord ◽  
Cervical Cord ◽  
Peripheral Vasculature ◽  
Doppler Flowmetry ◽  
Content Type ◽  
Fine Print

Object. Spinal cord stimulation (SCS) is frequently used for the treatment of chronic pain. Although the mechanisms by which SCS alleviates pain are unclear, they are believed to involve changes within the dorsal horn of the spinal cord. Spinal cord stimulation has also been found to cause significant vasodilation in the peripheral vasculature. The mechanisms underlying this effect are thought to involve sympathetic blockade. A rostral vasodilatory effect has also been described, but changes in cerebral blood flow (CBF) have been poorly delineated. Using laser Doppler flowmetry (LDF), the authors examined the effects of cervical SCS on CBF in rats. Methods. Cervical SCS was found to result in a significant increase in cortical LDF values (83 ± 11% [mean ± standard error of the mean]). The increase in cortical LDF values was not accompanied by a significant increase in systemic blood pressure. Stimulation of the upper cervical spinal cord was more effective in inducing LDF changes than was that of the lower cervical cord. Changes in SDS-induced LDF values were significantly attenuated after spinal cord transection at the cervicomedullary junction and by the administration of the sympathetic blocker hexamethonium. Conclusions. These results indicate that cervical SCS may induce cerebral vasodilation and that this effect may involve indirect effects on vasomotor centers in the brainstem as well as an alteration in sympathetic tone.

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