Acute herniated nucleus pulposus with cauda equina compression syndrome following chemonucleolysis

1987 ◽  
Vol 66 (4) ◽  
pp. 614-617 ◽  
Author(s):  
Samuel Smith ◽  
Lyal G. Leibrock ◽  
Benjamin R. Gelber ◽  
Eric W. Pierson
Keyword(s):  
Nucleus Pulposus ◽  
Disc Herniation ◽  
Therapeutic Intervention ◽  
Cauda Equina ◽  
Neurological Deficits ◽  
Content Type ◽  
Compression Syndrome ◽  
Cauda Equina Compression ◽  
Herniated Nucleus Pulposus ◽  
Fine Print

✓ Three cases of acute disc herniation causing cauda equina compression syndrome after chemonucleolysis are described. All three patients had myelographic blocks and, despite emergency decompression procedures, were left with residual neurological deficits. Recommendations are made regarding evaluation and therapeutic intervention, and possible etiologies of this problem are reviewed.

“Bicycle test” of van Gelderen in diagnosis of intermittent cauda equina compression syndrome

1977 ◽  
Vol 46 (5) ◽  
pp. 667-670 ◽  
Author(s):  
Peter Dyck ◽  
John B. Doyle
Keyword(s):  
Neurological Examination ◽  
Cauda Equina ◽  
Radicular Pain ◽  
Content Type ◽  
Compression Syndrome ◽  
Cauda Equina Compression ◽  
Vascular Insufficiency ◽  
Relationship Of ◽  
The Relationship ◽  
Fine Print

✓ The authors describe a simple clinical adjunct to the routine neurological examination of patients with intermittent cauda equina compression syndrome. The “bicycle test” helps exclude intermittent claudication due to vascular insufficiency and frequently confirms the relationship of posture to radicular pain.

Spinal meningioma arising from a lumbar nerve root

1989 ◽  
Vol 70 (4) ◽  
pp. 646-648 ◽  
Author(s):  
Thomas H. K. Ng ◽  
Kwan Hon Chan ◽  
Kirpal S. Mann ◽  
Ching F. Fung
Keyword(s):  
Nerve Root ◽  
Cauda Equina ◽  
Spinal Meningioma ◽  
Content Type ◽  
Cauda Equina Compression ◽  
Lumbar Nerve Root ◽  
Fine Print

✓ A case is reported of cauda equina compression from an intradural meningioma arising from the L-5 nerve root in a young man.

Spinal arterial malformation in a child with hereditary hemorrhagic telangiectasia

1976 ◽  
Vol 44 (5) ◽  
pp. 613-616 ◽  
Author(s):  
Glen S. Merry ◽  
D. Barry Appleton
Keyword(s):  
Spinal Cord ◽  
Family History ◽  
Hereditary Hemorrhagic Telangiectasia ◽  
Cauda Equina ◽  
Content Type ◽  
Cauda Equina Compression ◽  
History Of ◽  
Spinal Aneurysm ◽  
Arterial Malformation ◽  
Fine Print

✓ A case is reported of spinal aneurysm in a child with a family history of hereditary hemorrhagic telangiectasia causing spinal cord and cauda equina compression. The operative approach is discussed.

Risk of early closed reduction in cervical spine subluxation injuries

1999 ◽  
Vol 90 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Gerald A. Grant ◽  
Sohail K. Mirza ◽  
Jens R. Chapman ◽  
H. Richard Winn ◽  
David W. Newell ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Mr Imaging ◽  
Disc Herniation ◽  
Closed Reduction ◽  
Spinal Cord Injuries ◽  
Spinal Injury ◽  
Neurological Deterioration ◽  
Neurological Deficits ◽  
Content Type ◽  
Fine Print

Object. The authors retrospectively reviewed 121 patients with traumatic cervical spine injuries to determine the risk of neurological deterioration following early closed reduction. Methods. After excluding minor fractures and injuries without subluxation, the medical records and imaging studies (computerized tomography and magnetic resonance [MR] images) of 82 patients with bilateral and unilateral locked facet dislocations, burst fractures, extension injuries, or miscellaneous cervical fractures with subluxation were reviewed. Disc injury was defined on MR imaging as the presence of herniation or disruption: a herniation was described as deforming the thecal sac or nerve roots, and a disruption was defined as a disc with high T2-weighted signal characteristics in a widened disc space. Fifty-eight percent of patients presented with complete or incomplete spinal cord injuries. Thirteen percent of patients presented with a cervical radiculopathy, 22% were intact, and 9% had only transient neurological deficits in the field. Early, rapid closed reduction, using serial plain radiographs or fluoroscopy and Gardner—Wells craniocervical traction, was achieved in 97.6% of patients. In two patients (2.4%) closed reduction failed and they underwent emergency open surgical reduction. The average time to achieve closed reduction was 2.1 ± 0.24 hours (standard error of the mean). The incidence of disc herniation and disruption in the 80 patients who underwent postreduction MR imaging was 22% and 24%, respectively. However, the presence of disc herniation or disruption did not affect the degree of neurological recovery, as measured by American Spinal Injury Association motor score and the Frankel scale following early closed reduction. Only one (1.3%) of 80 patients deteriorated, but that occurred more than 6 hours following closed reduction. Conclusions. Although disc herniation and disruption can occur following all types of traumatic cervical fracture subluxations, the incidence of neurological deterioration following closed reduction in these patients is rare. The authors recommend early closed reduction in patients presenting with significant motor deficits without prior MR imaging.

Posttraumatic lumbar epidural true synovial cyst

1973 ◽  
Vol 39 (2) ◽  
pp. 246-248 ◽  
Author(s):  
George W. Sypert ◽  
Richard W. Leech ◽  
A. Basil Harris
Keyword(s):  
Surgical Therapy ◽  
Cauda Equina ◽  
Synovial Cyst ◽  
Content Type ◽  
Cauda Equina Compression ◽  
Satisfactory Recovery ◽  
Fine Print

✓ A case is reported of posttraumatic epidural true synovial cyst causing cauda equina compression. Surgical therapy resulted in satisfactory recovery.

Nerve root compression by herniated intradiscal gas

1990 ◽  
Vol 72 (2) ◽  
pp. 282-284 ◽  
Author(s):  
Gregory F. Ricca ◽  
James T. Robertson ◽  
Robert S. Hines
Keyword(s):  
Nucleus Pulposus ◽  
Nerve Root ◽  
Intervertebral Disc Degeneration ◽  
Disc Space ◽  
Content Type ◽  
Connective Tissue Capsule ◽  
Symptoms And Signs ◽  
Herniated Nucleus Pulposus ◽  
Tissue Capsule ◽  
Fine Print

✓ Intervertebral disc degeneration of any etiology may be associated with the formation of spaces or clefts within the disc. Gas collects within these spaces and can be seen roentgenographically. A case is presented in which intradiscal gas herniated into a connective tissue capsule, displacing the left S-1 nerve root and producing symptoms and signs identical to those of a herniated nucleus pulposus. The pathophysiology of gas within a disc space and the possibility that it may herniate much like the nucleus pulposus is discussed.

Subarachnoid hematoma following lumbar puncture causing compression of the cauda equina

1974 ◽  
Vol 41 (2) ◽  
pp. 252-254 ◽  
Author(s):  
Setti S. Rengachary ◽  
Daniel Murphy
Keyword(s):  
Lumbar Puncture ◽  
Cauda Equina ◽  
Content Type ◽  
Cauda Equina Compression ◽  
Fine Print

✓ A case of conus and cauda equina compression caused by a subarachnoid hematoma is reported which was probably due to needle trauma during an attempted lumbar puncture.

A fatal, chronically growing basilar artery: a new type of dissecting aneurysm

1996 ◽  
Vol 84 (6) ◽  
pp. 962-971 ◽  
Author(s):  
Tohru Mizutani
Keyword(s):  
Mr Imaging ◽  
Basilar Artery ◽  
Dissecting Aneurysm ◽  
Neurological Deficits ◽  
Vertebrobasilar Insufficiency ◽  
Content Type ◽  
Asymptomatic Patients ◽  
Basilar Arteries ◽  
Fine Print

✓ A long-term follow-up study (minimum duration 2 years) was made of 13 patients with tortuous dilated basilar arteries. Of these, five patients had symptoms related to the presence of such arteries. Symptoms present at a very early stage included vertebrobasilar insufficiency in two patients, brainstem infarction in two patients, and left hemifacial spasm in one patient. Initial magnetic resonance (MR) imaging in serial slices of basilar arteries obtained from the five symptomatic patients showed an intimal flap or a subadventitial hematoma, both of which are characteristic of a dissecting aneurysm. In contrast, the basilar arteries in the eight asymptomatic patients did not show particular findings and they remained clinically and radiologically silent during the follow-up period. All of the lesions in the five symptomatic patients gradually grew to fantastic sizes, with progressive deterioration of the related clinical symptoms. Dilation of the basilar artery was consistent with hemorrhage into the “pseudolumen” within the laminated thrombus, which was confirmed by MR imaging studies. Of the five symptomatic patients studied, two died of fatal subarachnoid hemorrhage (SAH) and two of brainstem compression; the fifth patient remains alive without neurological deficits. In the three patients who underwent autopsy, a definite macroscopic double lumen was observed in both the proximal and distal ends of the aneurysms within the layer of the thickening intima. Microscopically, multiple mural dissections, fragmentation of internal elastic lamina (IEL), and degeneration of media were diffusely observed in the remarkably extended wall of the aneurysms. The substantial mechanism of pathogenesis and enlargement in the symptomatic, highly tortuous dilated artery might initially be macroscopic dissection within a thickening intima and subsequent repetitive hemorrhaging within a laminated thrombus in the pseudolumen combined with microscopic multiple mural dissections on the basis of a weakened IEL. The authors note and caution that symptomatic, tortuous dilated basilar arteries cannot be overlooked because they include a group of malignant arteries that may grow rapidly, resulting in a fatal course.

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