Intradural tuberculomas of the spinal cord

1981 ◽  
Vol 55 (2) ◽  
pp. 289-292 ◽  
Author(s):  
Hamit Z. Gökalp ◽  
Ertuğ Özkal
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Medical Care ◽  
Review Of The Literature ◽  
Content Type ◽  
Antituberculous Treatment ◽  
Fine Print

✓ The incidence of intradural tuberculoma of the spinal cord is rare, and is becoming rarer as medical care improves. Two cases of surgically treated intradural tuberculomas are presented, with a brief review of the literature. The authors recommend surgical treatment, which carries almost no risk of meningitis if antituberculous treatment is given postoperatively.

Recurrent transient quadriparesis after minor cervical trauma associated with bilateral partial agenesis of the posterior arch of the atlas

1996 ◽  
Vol 84 (4) ◽  
pp. 663-665 ◽  
Author(s):  
Martijn Torreman ◽  
Ivo T. H. J. Verhagen ◽  
Menno Sluzewski ◽  
Alexander J. M. Kok ◽  
Willem Jan van Rooij
Keyword(s):  
Spinal Cord ◽  
Posterior Arch ◽  
Review Of The Literature ◽  
Cervical Trauma ◽  
Content Type ◽  
Causative Mechanism ◽  
Type D ◽  
Aggressive Management ◽  
Type C ◽  
Fine Print

✓ The case of a 33-year-old woman with bilateral partial agenesis (type D) of the posterior arch of the atlas and recurrent transient quadriparesis due to contusion of the spinal cord after minor cervical trauma is described. At least some patients with type C or D congenital anomalies of the posterior arch of the atlas are prone to transient quadriparesis; thus a more aggressive management is advocated for them. Radiological and surgical findings showing the possible causative mechanism are presented and a review of the literature is given.

Tethered cord syndrome from a choristoma of müllerian origin

1991 ◽  
Vol 74 (3) ◽  
pp. 497-500 ◽  
Author(s):  
Michael C. Molleston ◽  
Kevin A. Roth ◽  
Franz J. Wippold ◽  
Robert L. Grubb
Keyword(s):  
Spinal Cord ◽  
Tethered Cord ◽  
Tethered Cord Syndrome ◽  
Review Of The Literature ◽  
Lumbosacral Junction ◽  
Content Type ◽  
Fine Print

✓ The authors report a case of tethered cord syndrome due to a choristoma of müllerian origin located in the spinal cord at the lumbosacral junction. Two similar cases were found upon review of the literature. The embryology of this lesion is discussed.

Surgical treatment of irreducible atlanto-axial dislocation with spinal cord compression

1973 ◽  
Vol 38 (3) ◽  
pp. 374-378 ◽  
Author(s):  
Chikao Nagashima
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Spinal Cord Compression ◽  
Spinal Canal ◽  
Cord Compression ◽  
Foramen Magnum ◽  
Posterior Decompression ◽  
Content Type ◽  
Arthritic Changes ◽  
Fine Print

✓ The author reports the successful treatment of a case of irreducile atlantoaxial dislocation due to separation of the dens and secondary arthritic changes causing sagittal narrowing of the atlanto-axial spinal canal to 3 mm. Complete myelography obstruction was present. A one-stage posterior decompression of the foramen magnum and atlas was performed and occipito-cervical fixation accomplished by wire encased in acrylic plastic.

Outcome after surgical treatment of progressive posttraumatic cystic myelopathy

2000 ◽  
Vol 92 (2) ◽  
pp. 149-154 ◽  
Author(s):  
Thomas T. Lee ◽  
Gustavo J. Alameda ◽  
Erika B. Gromelski ◽  
Barth A. Green
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Treatment Protocol ◽  
Tethered Cord ◽  
Cyst Formation ◽  
Tethered Cord Syndrome ◽  
Intraoperative Ultrasonography ◽  
Cyst Size ◽  
Content Type ◽  
Fine Print

Object. Progressive posttraumatic cystic myelopathy (PPCM) can occur after an injury to the spinal cord. Traditional treatment of PPCM consists of inserting a shunt into the cyst. However, some authors have advocated a more pathophysiological approach to this problem. The authors of the present study describe their surgical treatment protocol and outcome in a series of patients with syringomyelia. Methods. Medical records of 34 patients undergoing surgical treatment for PPCM were reviewed. Laminectomies and intraoperative ultrasonography were performed. In patients without focal tethering of the spinal cord and in whom only a confluent cyst had been revealed on ultrasonography, a syringosubarachnoid shunt was inserted; in those with both tethering and a confluent cord cyst, an untethering procedure was performed first. When a significant reduction (> 50%) in the size of the cyst was shown after the untethering procedure, no shunt was inserted. When no changes in cyst size were demonstrated on ultrasonography, a short syringosubarachnoid shunt was used. The mean follow-up period was 28.7 months (range 12–102 months). The interval between the mechanism of injury and the operation ranged from 5 months to 37 years (mean 11 years). Pain was the most frequent symptom, which was followed by motor deterioration and spasticity. Postoperative improvement was noted in 55% of patients who experienced motor function deterioration and in 53% of those who demonstrated worsening spasticity. In 14 of 18 patients with an associated tethered spinal cord, tethering alone caused significant collapse of the cyst. Postoperative magnetic resonance imaging demonstrated cyst collapse in 92% of patients who had undergone untethering alone and in 93% of those who underwent syringosubarachnoid shunt placement. Treatment failure was observed in 7% of the former group and in 13% of the latter. Conclusions. Posttraumatic cystic myelopathy can occur with or without the presence of tethered cord syndrome. Intraoperative ultrasonography can readily demonstrate this distinction to aid in surgical decision making. Untethering alone in patients with tethered cord syndrome and cyst formation can reduce the cyst size and alleviate symptoms and signs of posttraumatic cystic myelopathy in the majority of these cases. Untethering procedures in which duraplasty is performed to expand the subarachnoid space may be a more physiologically effective way of treating tethered cord with associated syringomyelia.

Microsurgical anatomy of the artery of Adamkiewicz and its segmental artery

1998 ◽  
Vol 89 (5) ◽  
pp. 791-795 ◽  
Author(s):  
Cargill H. Alleyne ◽  
C. Michael Cawley ◽  
George G. Shengelaia ◽  
Daniel L. Barrow
Keyword(s):  
Spinal Cord ◽  
Blood Supply ◽  
Anatomical Study ◽  
Microsurgical Anatomy ◽  
Review Of The Literature ◽  
Content Type ◽  
Segmental Artery ◽  
Artery Of Adamkiewicz ◽  
Segmental Arteries ◽  
Fine Print

Object. The blood supply of the lower spinal cord is heavily dependent on the artery of Adamkiewicz, which characteristically originates from one of the thoracolumbar segmental arteries. The aforementioned artery is of enormous clinical, surgical, and radiological importance, and the goal of this study was to elucidate the course and branches of the segmental artery that gives rise to this important vessel. Methods. In this cadaveric, microsurgical anatomical study, the authors investigate and describe the course and branches of the artery of Adamkiewicz and the segmental branch from which it ultimately originates. A review of the literature is provided. Conclusions. By documenting the microsurgical anatomy of these important vessels, this study facilitates an understanding of the anatomy that will aid in treatment planning for surgery of various lesions in this area.

Diaphyseal aclasis with spinal cord compression

1996 ◽  
Vol 84 (3) ◽  
pp. 518-521 ◽  
Author(s):  
Emmanuel K. Labram ◽  
J. Mohan
Keyword(s):  
Spinal Cord ◽  
Clinical Features ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Long Bones ◽  
Review Of The Literature ◽  
Content Type ◽  
First Case ◽  
Fine Print

✓ In diaphyseal aclasis, the exostoses usually involve long bones, although occasionally the spine is also affected. Very few cases of osteochondroma causing spinal cord compression have been cited. The authors report their experience with two cases of diaphyseal aclasis. In the first case spinal cord compression caused by an exostosis of the lamina of C-2 occurred in a 9-year-old boy; in the second case a large osteochondroma of C-5 occurred in a 45-year-old man. Also included in this report is a review of the literature highlighting the incidence of diaphyseal aclasis, its clinical features and its excellent prognosis in treated cases.

Recurrences of cerebellar astrocytomas: a violation of Collins' Law

1988 ◽  
Vol 68 (1) ◽  
pp. 41-47 ◽  
Author(s):  
Everett J. Austin ◽  
Ellsworth C. Alvord
Keyword(s):  
Radiation Therapy ◽  
Surgical Treatment ◽  
Brain Stem ◽  
Malignant Tumors ◽  
Surgical Excision ◽  
Review Of The Literature ◽  
Content Type ◽  
Cerebellar Astrocytoma ◽  
Incomplete Excision ◽  
Fine Print

✓ Cerebellar astrocytomas generally carry an excellent prognosis when managed with surgical treatment alone. However, these tumors may violate Collins' Law in two opposite ways: by recurring late or by being “cured” with incomplete excision. In a study of 41 cases of cerebellar astrocytoma and a review of the literature, no gross or microscopic factors that correlated with either of these two outcomes could be identified other than brain-stem involvement. The effect of radiation therapy in the treatment of primary or recurrent cerebellar astrocytomas was not detectable when analyzed the same way. Malignant recurrence of cerebellar astrocytoma and primary malignant tumors of the cerebellum are so rare that the possibility should not be taken as a reason to substitute radiation therapy for surgical excision repeated as necessary.

Cavernous angioma of the tentorium cerebelli

1989 ◽  
Vol 71 (6) ◽  
pp. 935-937 ◽  
Author(s):  
Keith B. Quattrocchi ◽  
Phillip Kissel ◽  
William G. Ellis ◽  
Edmund H. Frank
Keyword(s):  
Magnetic Resonance Imaging ◽  
Surgical Treatment ◽  
Magnetic Resonance ◽  
Clinical Presentation ◽  
Cavernous Angioma ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Content Type ◽  
Tentorium Cerebelli ◽  
Fine Print

✓ The case of a cavernous angioma of the tentorium cerebelli is described. This is the seventh reported case of a cavernous angioma in this unusual location and the first of a dural cavernous angioma demonstrated by magnetic resonance imaging. The clinical presentation, radiographic features, and surgical treatment of these rare tumors are discussed, along with a review of the literature.

Tuberculous meningitis presenting as an obstructive myelopathy

1984 ◽  
Vol 60 (1) ◽  
pp. 196-199 ◽  
Author(s):  
Brien Vlcek ◽  
Kim J. Burchiel ◽  
Thomas Gordon
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Tuberculous Meningitis ◽  
Cord Compression ◽  
Review Of The Literature ◽  
Content Type ◽  
X Ray ◽  
Normal Chest ◽  
Chest X Ray ◽  
Fine Print

✓ Subacute paraplegia progressing over 3 months due to spinal cord compression was the presenting symptom of tuberculous meningitis in this patient with a normal chest x-ray film and no radiological or autopsy evidence of Pott's vertebral tuberculosis. The obstructive myelopathy was the result of proliferative granulomatous meningitis. A review of the literature indicates that this is a very unusual presentation of tuberculous meningitis.

Surgical treatment of cryptic AVM's and associated hematoma in the brain stem and spinal cord

1986 ◽  
Vol 65 (2) ◽  
pp. 188-193 ◽  
Author(s):  
Richard J. Veerapen ◽  
Ibrahim Abdeaziz Sbeih ◽  
Sean A. O'Laoire
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Brain Stem ◽  
Arteriovenous Malformations ◽  
Vascular Tissue ◽  
Content Type ◽  
The Third ◽  
The Brain ◽  
Fine Print

✓ Most surgically treated cases of brain-stem hematomas have been attributed to rupture of cryptic arteriovenous malformations (AVM's); however, very few cases have been histologically proven. Similarly, there are very few reports of surgically treated spontaneous hematomyelia, in which the hemorrhage has been histologically confirmed as being due to a purely intramedullary AVM. The authors report three cases with surgically treated, histologically confirmed AVM's, of which two were in the brain stem and the third was in the spinal cord. In all these cases, abnormal vascular tissue in the wall of the hematoma cavity was recognized at operation and excised.

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