Spontaneous migration of an intracranial bullet to the cervical spinal canal causing Lhermitte's sign

1982 ◽  
Vol 56 (1) ◽  
pp. 158-159 ◽  
Author(s):  
Ertekin Arasil ◽  
Ali O. Taşçioğlu
Keyword(s):  
Spinal Canal ◽  
Occipital Area ◽  
Vertebral Level ◽  
Content Type ◽  
X Ray ◽  
Cervical Spinal Canal ◽  
Spontaneous Migration ◽  
The Right ◽  
Neurologically Intact ◽  
Fine Print

✓ A case is presented of a woman who was shot in the left occipital area with a .32 caliber automatic pistol. She was neurologically intact on admission, and skull x-ray films revealed the bullet in the right suboccipital area. On the 2nd day of her admission she developed Lhermitte's sign. Repeat films showed that the bullet had migrated to the C-4 vertebral level. The bullet was subsequently removed via a total laminectomy at C3–4.

Cervical myelopathy caused by developmental stenosis of the spinal canal

1979 ◽  
Vol 51 (3) ◽  
pp. 362-367 ◽  
Author(s):  
Joseph A. Epstein ◽  
Robert Carras ◽  
Roger A. Hyman ◽  
Sergio Costa
Keyword(s):  
Spinal Canal ◽  
Cervical Spondylotic Myelopathy ◽  
Transverse Plane ◽  
Intramedullary Tumor ◽  
Neural Arch ◽  
Decompressive Laminectomy ◽  
Content Type ◽  
Significant Evidence ◽  
X Ray ◽  
Fine Print

✓ The authors present six patients with myelopathy caused by developmental stenosis of the cervical spine. Hyperextension injuries precipitated the onset of symptoms in two patients, aged 19 and 20 years. In four, 41 to 69 years of age, symptoms were gradual in onset, progressing to severe disability. X-ray films revealed narrowing of the dorsoventral diameter of the spinal canal to as little as 1.0 cm. The myelograms showed widening of the cord in the transverse plane strongly suggestive of an intramedullary tumor. A unique finding was maldevelopment with flattening of the neural arch often hidden by the posterior portions of the articular facets when seen in the lateral views. These patients showed no significant evidence of spondylosis, arthrosis, or any of the structural stigmata usually observed in cervical spondylotic myelopathy. When indicated, decompressive laminectomy is the treatment of choice.

Neurenteric cyst in the cervical spinal canal of a 10-week-old boy

1971 ◽  
Vol 35 (4) ◽  
pp. 472-476 ◽  
Author(s):  
Thomas E. Klump
Keyword(s):  
Spinal Canal ◽  
Neurological Symptoms ◽  
Neurenteric Cyst ◽  
Content Type ◽  
Cervical Spinal Canal ◽  
Fine Print

✓ A 10-week-old infant was found to have a cervicothoracic intradural neurenteric cyst which was operated on with resolution of the neurological symptoms. The discussion centers on the nature of the lesion and its possible pathogenesis.

Extraspinal meningioma

1986 ◽  
Vol 64 (2) ◽  
pp. 328-330 ◽  
Author(s):  
A. Wahab Ibrahim ◽  
Mohamed B. Satti ◽  
E. Mustafa Ibrahim
Keyword(s):  
Nerve Root ◽  
Spinal Canal ◽  
Total Resection ◽  
Content Type ◽  
The Right ◽  
Two Stages ◽  
Fine Print ◽  
Considerable Size

✓ A case of ectopic extraspinal meningioma is reported which presented as a tumor at the back of the neck of a 51-year-old woman. This neoplasm was of considerable size and arose extradurally in the region of the C-2 nerve root, with its main bulk lying almost totally outside the spinal canal in the right suboccipital region. Total resection was accomplished in two stages, with no evidence of recurrence after 1 year. The rarity of such cases prompted this report.

Spinal epidural leiomyoma occurring in an HIV-infected man

1993 ◽  
Vol 79 (3) ◽  
pp. 442-445 ◽  
Author(s):  
Timothy R. Steel ◽  
Malcolm F. Pell ◽  
Jennifer J. Turner ◽  
Gerald H. K. Lim
Keyword(s):  
Soft Tissue Tumors ◽  
Radicular Pain ◽  
Pediatric Hiv ◽  
Hiv Positive ◽  
Vertebral Level ◽  
Content Type ◽  
Immunodeficiency Virus ◽  
The Right ◽  
Spinal Epidural ◽  
Fine Print

✓ A case of spinal epidural leiomyoma is reported in a 52-year-old man infected with the human immunodeficiency virus (HIV). The tumor arose in the epidural region at the T-3 vertebral level, and the patient presented with radicular pain in the right T-3 dermatome. While soft-tissue tumors such as Kaposi's sarcoma and lymphomas have been well documented in association with HIV infection, this is the first reported case of primary spinal leiomyoma. Isolated cases of leiomyomas and leiomyosarcomas in unusual locations have been reported, notably in pediatric HIV-positive patients, perhaps indicating a causal relationship. This case may represent further evidence of such an association.

Transuncodiscal approach to dumbbell tumors of the cervical spinal canal

1984 ◽  
Vol 61 (6) ◽  
pp. 1100-1106 ◽  
Author(s):  
Akira Hakuba ◽  
Masaki Komiyama ◽  
Takeshi Tsujimoto ◽  
Myung Soo Ahn ◽  
Shuro Nishimura ◽  
...  
Keyword(s):  
Spinal Canal ◽  
Lateral Approach ◽  
Lateral Part ◽  
Anterolateral Approach ◽  
Large Tumor ◽  
Content Type ◽  
Cervical Spinal Canal ◽  
Iliac Bone Graft ◽  
Vertebral Bodies ◽  
Fine Print

✓ A combined anterior and lateral approach to the anterior cervical spinal canal with fusion was performed on five patients with cervical dumbbell-shaped tumors. The procedure consists of anterior discectomy and ipsilateral uncectomy, and removal of the posterolateral corners and posterior transverse ridges of the upper and lower vertebral bodies at the level of the tumor. In the case of a large tumor in the spinal canal, additional removal of a limited segment from the lateral part of the vertebral body was performed. The bone defect was filled with a T-shaped iliac bone graft. Two vertebral bodies were fused in each case. The highest level of the operation was C-2 and the lowest was T-1. The authors believe that any cervical dumbbell-shaped tumor below the C-2 level can be removed via an anterolateral approach as long as no more than three levels of the spine are involved.

Sacral agenesis

1973 ◽  
Vol 38 (1) ◽  
pp. 92-95 ◽  
Author(s):  
Herbert Lourie
Keyword(s):  
Fecal Incontinence ◽  
Content Type ◽  
X Ray ◽  
Sacral Agenesis ◽  
Neurological Defect ◽  
Neurologically Intact ◽  
Fine Print

✓ A case of partial sacral agenesis is reported and the possible relationship to diabetes discussed. The commonest neurological defect relates to urinary and fecal incontinence, and many cases have been otherwise neurologically intact. The condition should be suspected when bone cannot be felt in the region of the coccyx and sacrum; close scrutiny of the x-ray films will confirm the diagnosis.

Cystic cerebral cavernous angioma with dense calcification

1980 ◽  
Vol 52 (2) ◽  
pp. 259-262 ◽  
Author(s):  
Ricardo Ramina ◽  
William Ingunza ◽  
Dimitrios Vonofakos
Keyword(s):  
Preoperative Diagnosis ◽  
Cavernous Angioma ◽  
Occipital Area ◽  
Large Area ◽  
Content Type ◽  
Cystic Formation ◽  
The Right ◽  
Fine Print

✓ A case of cavernous angioma in the right temporoparieto-occipital area is reported. The unusually large area of calcification and cystic formation presented problems in preoperative diagnosis. The tumor was treated successfully by subtotal excision.

Traumatic thoracic spinal fracture dislocation with minimal or no cord injury

2002 ◽  
Vol 96 (3) ◽  
pp. 333-337 ◽  
Author(s):  
Scott Shapiro ◽  
Todd Abel ◽  
Richard B. Rodgers
Keyword(s):  
Spinal Cord ◽  
Spinal Canal ◽  
Neurological Status ◽  
Neurological Deficits ◽  
Fracture Dislocation ◽  
Content Type ◽  
Intercostal Neuralgia ◽  
Neurologically Intact ◽  
Anatomical Alignment ◽  
Fine Print

Object. Thoracic fracture dislocations reportedly lead to complete paraplegia in 80% of cases. It is rare for these dislocations not to cause neurological deficits, as evidenced by the mere 11 well-documented neurologically intact cases in the English-language literature. Methods. The authors report four cases of thoracic fracture dislocation that remained neurologically intact and discuss 11 other previously published well-documented cases. Overall there were 10 men and five women with a mean age of 34 years (range 17–66 years). Mechanisms of injury included car crash in six, motorcycle crash in seven, plane crash in one, and fall from a horse in one. On admission, neurological deficits were absent in 11 patients, intercostal neuralgia was present in two, and mild lower-extremity weakness/numbness was demonstrated in two. All suffered significant thoracic pain, with 14 patients having sustained rib fractures and eight a hemothorax. The levels of dislocation were T3–4 in two, T5–6 in four, T6–7 in four, T7–8 in two, T8–9 in one, and T9–10 in two. All suffered some degree of lateral translation (mean 12 mm, range 3–27 mm). There were six cases of well-documented anterior subluxation in addition to translation (mean 12 mm, range 4–23 mm), and all involved some degree of fracture imploding of one vertebral body (VB) into an adjacent VB. There were six cases of burst fracture with translation (mean kyphotic angle 38°, range 28–50°). Bilateral pedicle shear fractures were present in all 15 cases at the site of subluxation, thus separating the anterior from the posterior elements and preserving the spinal canal. Only two of the 15 patients suffered complete spondylolisthesis. Five patients underwent successful nonoperative management with prolonged bed rest; at follow-up examination, neurological status remained normal in all five, lesions were radiographically unchanged in three, and there was less subluxation but not anatomical alignment in two. Ten patients underwent successful internal fixation via anterior approaches (two cases), posterior approaches (five cases), and combined approaches (three cases). Neurological status either improved to normal or remained normal except in one case with persistent intercostal neuralgia. Surgery resulted in no change in alignment in three, improved but not anatomical alignment in 11, and normal alignment in one patient. All patients ambulated unassisted by 6 months. Conclusions. In cases in which bilateral pedicle fractures occur at the site of significant thoracic subluxation and/or translation, preservation of the spinal canal and spinal cord neurological function can rarely occur when both the lamina and spinal cord do not dislocate along with the anterior VBs. In these instances, perfect anatomical reduction may require forces that unnecessarily put neurological function at risk and the results appear to justify internal fixation with some or no reduction of deformity.

Malignant astrocytoma following radiotherapy of a craniopharyngioma

1978 ◽  
Vol 48 (4) ◽  
pp. 622-627 ◽  
Author(s):  
Richard L. Sogg ◽  
Sarah S. Donaldson ◽  
Craig H. Yorke
Keyword(s):  
Experimental Evidence ◽  
Temporal Lobe ◽  
Malignant Astrocytoma ◽  
Content Type ◽  
Suprasellar Region ◽  
The Right ◽  
Fine Print

✓ A 9-year-old schoolgirl received 6007 rads to the suprasellar region for craniopharyngioma. Five years later, a malignant astrocytoma developed in the right temporal lobe. We cite clinical and experimental evidence to support our suspicion that the glioma may have been induced by radiation.

A new rat model of chronic cerebral hypoperfusion associated with arteriovenous malformations

2002 ◽  
Vol 97 (5) ◽  
pp. 1198-1202 ◽  
Author(s):  
Jian Hai ◽  
Meixiu Ding ◽  
Zhilin Guo ◽  
Bingyu Wang
Keyword(s):  
Electron Microscopy ◽  
Animal Model ◽  
Arteriovenous Malformations ◽  
Perfusion Pressure ◽  
Chronic Cerebral Hypoperfusion ◽  
Cerebral Hypoperfusion ◽  
Model Group ◽  
Content Type ◽  
The Right ◽  
Fine Print

Object. A new experimental model of chronic cerebral hypoperfusion was developed to study the effects of systemic arterial shunting and obstruction of the primary vessel that drains intracranial venous blood on cerebral perfusion pressure (CPP), as well as cerebral pathological changes during restoration of normal perfusion pressure. Methods. Twenty-four Sprague—Dawley rats were randomly assigned to either a sham-operated group, an arteriovenous fistula (AVF) group, or a model group (eight rats each). The animal model was readied by creating a fistula through an end-to-side anastomosis between the right distal external jugular vein (EJV) and the ispilateral common carotid artery (CCA), followed by ligation of the left vein draining the transverse sinus and bilateral external carotid arteries. Systemic mean arterial pressure (MAP), draining vein pressure (DVP), and CPP were monitored and compared among the three groups preoperatively, immediately postoperatively, and again 90 days later. Following occlusion of the fistula after a 90-day interval, blood—brain barrier (BBB) disruption and water content in the right cortical tissues of the middle cerebral artery territory were confirmed and also quantified with transmission electron microscopy. Formation of a fistula resulted in significant decreases in MAP and CPP, and a significant increase in DVP in the AVF and model groups. Ninety days later, there were still significant increases in DVP and decreases in CPP in the model group compared with the other groups (p < 0.05). Damage to the BBB and brain edema were noted in animals in the model group during restoration of normal perfusion pressure by occlusion of the fistula. Electron microscopy studies revealed cerebral vasogenic edema and/or hemorrhage in various amounts, which correlated with absent astrocytic foot processes surrounding some cerebral capillaries. Conclusions. The results demonstrated that an end-to-side anastomosis between the distal EJV and CCA can induce a decrease in CPP, whereas a further chronic state of cerebral hypoperfusion may be caused by venous outflow restriction, which is associated with perfusion pressure breakthrough. This animal model conforms to the basic hemodynamic characteristics of human cerebral arteriovenous malformations.

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