Myelopathy due to epidural varicose veins of the cervicothoracic junction

1988 ◽  
Vol 69 (6) ◽  
pp. 940-941 ◽  
Author(s):  
Curtis A. Dickman ◽  
Joseph M. Zabramski ◽  
Volker K. H. Sonntag ◽  
Stephen Coons
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Varicose Veins ◽  
Signs And Symptoms ◽  
Cord Compression ◽  
Resonance Imaging ◽  
Cervicothoracic Junction ◽  
Content Type ◽  
Spinal Epidural ◽  
Fine Print

✓ A 30-year-old man presented with a subacute course of myelopathic signs and symptoms. Magnetic resonance imaging demonstrated an epidural mass lesion of the spinal canal at the cervicothoracic junction causing compression of the spinal cord. Laminectomy with resection of this lesion revealed a large varix with acute and chronic thrombus. Postoperatively, an improvement in neurological function occurred. Spinal epidural varicosities have been reported as an etiological factor in lumbar and sacral radiculopathies. This is the first reported case of spinal cord compression in association with spinal epidural varices. The diagnosis, pathophysiology, and management of this disorder are presented.

Spinal intramedullary cavernoma: clinical presentation and surgical outcome

2000 ◽  
Vol 93 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Harel Deutsch ◽  
George I. Jallo ◽  
Alina Faktorovich ◽  
Fred Epstein
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Signs And Symptoms ◽  
Acute Onset ◽  
Surgical Removal ◽  
Resonance Imaging ◽  
Content Type ◽  
Posterior Laminectomy ◽  
Fine Print

Object. Improved neuroimaging techniques have led to an increase in the reported cases of intramedullary cavernomas. The purpose of this study was to define the spectrum of presenting signs and symptoms in patients with spinal intramedullary cavernomas and to analyze the role of surgery as a treatment for these lesions. Methods. The authors reviewed the charts of 16 patients who underwent surgery for spinal intramedullary cavernomas. All patients underwent preoperative magnetic resonance imaging studies. Cavernomas represented 14 (5.0%) of 280 intramedullary lesions found in adults and two (1.1%) of 181 intramedullary lesions found in pediatric cases. A posterior laminectomy and surgical resection of the malformation were performed in all 16 patients. Conclusions. Magnetic resonance imaging is virtually diagnostic for spinal cavernoma lesions. Patients with spinal intramedullary cavernomas presented with either an acute onset of neurological compromise or a slowly progressive neurological decline. Acute neurological decline occurs secondary to hemorrhage within the spinal cord. Chronic progressive myelopathy occurs due to microhemorrhages and the resulting gliotic reaction to hemorrhagic products. There is no evidence that cavernomas increase in size. The rate of rebleeding is unknown, but spinal cavernomas appear to be clinically more aggressive than cranial cavernomas, probably because the spinal cord is less tolerant of mass lesions. Complete surgical removal of the cavernoma was possible in 15 of 16 of the authors' cases.

Angiographic demonstration of a spinal epidural arteriovenous malformation

1993 ◽  
Vol 79 (1) ◽  
pp. 119-120 ◽  
Author(s):  
William C. Olivero ◽  
William C. Hanigan ◽  
Kerry W. McCluney
Keyword(s):  
Magnetic Resonance Imaging ◽  
Arteriovenous Malformation ◽  
Epidural Hematoma ◽  
Spinal Angiography ◽  
Resonance Imaging ◽  
Thoracic Pain ◽  
Content Type ◽  
Angiographic Demonstration ◽  
Spinal Epidural ◽  
Fine Print

✓ A 16-year-old boy presented with acute midline thoracic pain followed by rapidly progressive paraplegia. The initial neurological examination demonstrated a complete sensory and motor paraplegia, which significantly improved spontaneously over the following 2 days. Magnetic resonance imaging revealed a posterior epidural hematoma extending from the T-4 to T-6 vertebrae, and spinal angiography demonstrated an arteriovenous malformation (AVM) with a nidus of abnormal epidural vessels at the level of the T-5 vertebra, which was confirmed surgically. This case represents one of the first reports of a spinal epidural AVM confirmed by angiography.

Magnetic resonance imaging findings in ossification of the posterior longitudinal ligament of the cervical spine

1998 ◽  
Vol 88 (2) ◽  
pp. 247-254 ◽  
Author(s):  
Izumi Koyanagi ◽  
Yoshinobu Iwasaki ◽  
Kazutoshi Hida ◽  
Hiroyuki Imamura ◽  
Hiroshi Abe
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Posterior Longitudinal Ligament ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Disc Protrusion ◽  
Content Type ◽  
Fine Print

Object. Because of the lack of magnetic resonance (MR) signal from cortical bones, MR imaging is inadequate for diagnosing ossified lesions in the spinal canal. However, MR imaging provides important information on spinal cord morphology and associated soft-tissue abnormality. The purpose of this study is to determine the role of MR imaging in the diagnosis and treatment of patients with ossification of the posterior longitudinal ligament (OPLL) of the cervical spine. Methods. The authors reviewed MR imaging findings in 42 patients with cervical OPLL who were examined with a superconducting MR imaging system. The types of OPLL reviewed included eight cases of continuous, 21 cases of segmental, and 13 cases of the mixed type. All patients were treated surgically either by anterior (26 cases) or posterior decompression (16 cases). Conclusions. The T1-weighted images clearly demonstrated the spinal cord deformity caused by OPLL. Associated disc protrusion was found to be present at the maximum compression level in 60% of the patients in this series. The highest incidence of disc protrusion (81%) was found in patients with segmental OPLL. Intramedullary hyperintensity on T2*-weighted imaging was noted in 18 patients (43%). The neurological deficits observed in these 18 patients were significantly more severe than those observed in the other 24 patients. Postoperative MR imaging revealed improvement in the spinal cord deformity, although the intramedullary hyperintensity was still observed in most cases. The present study demonstrates the importance of associated disc protrusion in the development of myelopathy in patients with cervical OPLL. Magnetic resonance imaging findings may be used to help determine the actual levels of spinal cord compression and to suggest the method of surgical treatment.

Magnetic resonance imaging of spinal meningiomas and neurinomas

1987 ◽  
Vol 66 (5) ◽  
pp. 695-700 ◽  
Author(s):  
Gerhard Schroth ◽  
Armin Thron ◽  
Lothar Guhl ◽  
Karsten Voigt ◽  
Hans-Peter Niendorf ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Spinal Tumors ◽  
Resonance Imaging ◽  
Content Type ◽  
Spinal Cord Diseases ◽  
Spinal Meningiomas ◽  
Magnetic Resonance Imaging Mri ◽  
Fine Print

The detection and delineation of spinal tumors by magnetic resonance imaging (MRI) after intravenous administration of gadolinium (Gd)-diethylenetriaminepenta-acetic acid (DTPA) is demonstrated in eight cases of neurinoma or meningioma. The advantages of Gd-DTPA-enhanced MRI over other MRI techniques used in more than 100 cases of spinal cord diseases are described.

Trichinoechinococcosis T-5

2000 ◽  
Vol 92 (2) ◽  
pp. 225-228 ◽  
Author(s):  
H. S. Bhatoe ◽  
S. S. Bakshi ◽  
G. L. N. Swamy
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cystic Lesion ◽  
Histopathological Examination ◽  
Cord Compression ◽  
Resonance Imaging ◽  
Thoracic Spinal Cord ◽  
Content Type ◽  
Remarkable Improvement ◽  
Thoracic Spinal ◽  
Fine Print

✓ Echinococcosis affecting the spine is rare. The authors present the case of a 23-year-old man in whom features of thoracic spinal cord compression were demonstrated. Magnetic resonance imaging of the thoracic spine revealed an extradural cystic lesion involving the spine and paraspinal musculature. At surgery echinococcosis was confirmed, and subsequent histopathological examination also revealed Trichinella infestation of the paraspinal musculature. After undergoing decompressive surgery and albendazole therapy, the patient made a remarkable improvement. Although primary echinococcosis can affect the spine, concomitant infestation with Trichinella has not been reported. Surgery has to be followed by albendazole therapy.

Direct convective delivery of macromolecules to the spinal cord

1998 ◽  
Vol 89 (4) ◽  
pp. 616-622 ◽  
Author(s):  
Russell R. Lonser ◽  
Nitin Gogate ◽  
Paul F. Morrison ◽  
J. David Wood ◽  
Edward H. Oldfield
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Histological Analysis ◽  
Quantitative Autoradiography ◽  
Homogeneous Distribution ◽  
Outer Diameter ◽  
Resonance Imaging ◽  
Content Type ◽  
Fine Print

Object. Because of the limited penetration of macromolecules across the blood—spinal cord barrier, numerous therapeutic compounds with potential for treating spinal cord disorders cannot be used effectively. The authors have developed a technique to deliver and distribute macromolecules regionally in the spinal cord by using convection in the interstitial space. Methods. The authors designed a delivery system connected to a “floating” silica cannula (inner diameter 100 µm, outer diameter 170 µm) that provides for constant volumetric inflow to the spinal cord. A solution containing albumin that was either unlabeled or labeled with carbon-14 or gadolinium was infused at various volumes (3, 6, 10, 20, 40, or 50 µl) at a rate of 0.1 µl/minute into the spinal cord dorsal columns of nine swine and into the lateral columns of three primates (Macaca mulatta). Volume of distribution (Vd), concentration homogeneity, and percentage of recovery were determined using scintillation analysis, kurtosis calculation (K), and quantitative autoradiography (six swine), magnetic resonance imaging (one swine and three primates), and histological analysis (all animals). Neurological function was observed for up to 3 days in four of the swine and up to 16 weeks in the three primates. The Vd of 14C-albumin was linearly proportional (R2 = 0.97) to the volume of infusion (Vi) (Vd/Vi = 4.4 ± 0.5; [mean ± standard deviation]). The increases in Vd resulting from increases in Vi were primarily in the longitudinal dimension (R2 = 0.83 in swine; R2 = 0.98 in primates), allowing large segments of spinal cord (up to 4.3 cm; Vi 50 µl) to be perfused with the macromolecule. The concentration across the area of distribution was homogeneous (K = −1.1). The mean recovery of infused albumin from the spinal cord was 85.5 ± 5.6%. Magnetic resonance imaging and histological analysis combined with quantitative autoradiography revealed the albumin infusate to be preferentially distributed along the white matter tracts. No animal exhibited a neurological deficit as a result of the infusion. Conclusions. Regional convective delivery provides reproducible, safe, region-specific, and homogeneous distribution of macromolecules over large longitudinal segments of the spinal cord. This delivery method overcomes many of the obstacles associated with current delivery techniques and provides for research into new treatments of various conditions of the spinal cord.

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.

Cervical epidural actinomycosis

2001 ◽  
Vol 95 (1) ◽  
pp. 132-134
Author(s):  
Behzad Eftekhar ◽  
Ebrahim Ketabchi ◽  
Mohammad Ghodsi ◽  
Ali Ahmadi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cord Compression ◽  
Clinical Entity ◽  
Rare Clinical Entity ◽  
Upper Limbs ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Radiological Findings ◽  
Content Type ◽  
Fine Print

✓ Cervical actinomycosis causing spinal cord compression is a rare clinical entity. In a review of the literature, the authors found only 13 cases with actinomycosis-related spinal neurological deficit. The authors describe the case of a 26-year-old man who presented with neck pain and partial paresis of the upper limbs. Magnetic resonance imaging revealed a long cervical epidural enhancing lesion that extended from C-1 to T-2. The radiological findings resembled metastasis and other epidural infections. The patient was treated medically with penicillin and amoxicillin for 7 months and recovered neurologically. The authors conclude that although cervical epidural actinomycosis is a rare clinical entity resembling metastasis and other infections in this region, it should be considered so that this unique infection can be diagnosed in the least invasive fashion and, whenever possible, unnecessary surgery can be avoided.

Vertebral metastatic chemodectoma: imaging and therapeutic octreotide

2002 ◽  
Vol 97 (1) ◽  
pp. 106-109 ◽  
Author(s):  
Jean Marie U-King-Im ◽  
Thomas A. Carroll ◽  
Kevin Morris
Keyword(s):  
Magnetic Resonance Imaging ◽  
External Beam Radiotherapy ◽  
Somatostatin Receptors ◽  
Cord Compression ◽  
External Beam ◽  
Spinal Angiography ◽  
Current Investigation ◽  
Resonance Imaging ◽  
Content Type ◽  
Fine Print

✓ The authors report on the use of external-beam radiotherapy and octreotide in a 32-year-old woman who presented with spinal cord compression secondary to metastatic chemodectoma. Scintigraphy studies were used to confirm the presence of somatostatin receptors. Magnetic resonance imaging, and in particular spinal angiography, were performed to define the extent of spinal metastatic disease. The literature on current investigation and management of vertebral metastatic chemodectoma is reviewed.

Intramedullary hemorrhage in spinal cord hemangioblastoma

1994 ◽  
Vol 81 (6) ◽  
pp. 937-940 ◽  
Author(s):  
John S. Yu ◽  
M. Priscilla Short ◽  
James Schumacher ◽  
Paul H. Chapman ◽  
Griffith R. Harsh
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Histopathological Examination ◽  
Resonance Imaging ◽  
Content Type ◽  
First Case ◽  
Surgical Evacuation ◽  
Acute Paraplegia ◽  
Spinal Hemangioblastoma ◽  
Fine Print

✓ The authors describe two cases of intramedullary hemorrhage caused by thoracic hemangioblastoma. Both patients presented with acute paraplegia. The lesion in the first case was diagnosed by myelography and in the second by magnetic resonance imaging. Emergency surgical evacuation of the intramedullary hematoma and tumor was performed in these patients. Hemangioblastoma was confirmed by histopathological examination in both cases. Both patients remain paraplegic after 7 and 1 years, respectively. Intramedullary hemorrhage is a rare and devastating effect of spinal hemangioblastoma.

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