Cruciate paralysis: a clinical and radiographic analysis of injuries to the cervicomedullary junction

1990 ◽  
Vol 73 (6) ◽  
pp. 850-858 ◽  
Author(s):  
Curtis A. Dickman ◽  
Mark N. Hadley ◽  
Conrad T. E. Pappas ◽  
Volker K. H. Sonntag ◽  
Fred H. Geisler
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Cervical Spinal Cord ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Lower Extremity Function ◽  
Rare Injury ◽  
Radiographic Findings ◽  
Content Type ◽  
Cervicomedullary Junction

✓ Fourteen patients with superior cervical spinal cord injuries and the clinical signs and symptoms of cruciate paralysis are presented. This rare injury pattern is characterized by weakness of the upper extremities with little or no compromise of lower-extremity function following trauma to the superior spinal cord. Anatomically, cruciate paralysis is thought to represent selective injury to descending corticospinal tracts as they decussate at the cervicomedullary junction. The clinical and radiographic findings of each patient are outlined and the incidence and natural history of the injury syndrome, including a review of the literature, are presented.

Identification and management of high-risk patients with Klippel-Feil syndrome

1984 ◽  
Vol 61 (3) ◽  
pp. 523-530 ◽  
Author(s):  
Mahmoud G. Nagib ◽  
Robert E. Maxwell ◽  
Shelley N. Chou
Keyword(s):  
Spinal Cord ◽  
High Risk ◽  
Cervical Spinal Cord ◽  
Neurological Injury ◽  
Content Type ◽  
High Risk Patients ◽  
Cervicomedullary Junction ◽  
Risk Patients ◽  
Salient Features ◽  
Fine Print

✓ Patients with Klippel-Feil syndrome are often at high risk for neurological injury. The cervicomedullary junction and cervical spinal cord are especially vulnerable. Twenty-one patients examined and treated over a 20-year period are reviewed. The salient features of the syndrome are identified, and an approach to management is proposed.

Prediction of mobility gains in patients with cervical spinal cord injuries

1976 ◽  
Vol 45 (6) ◽  
pp. 677-682 ◽  
Author(s):  
Robert L. Mason ◽  
Richard F. Gunst
Keyword(s):  
Spinal Cord ◽  
Motor Skills ◽  
Spinal Cord Injuries ◽  
Cervical Spinal Cord ◽  
Neurological Status ◽  
Prediction Equation ◽  
Predictor Variables ◽  
Content Type ◽  
Mobility Score ◽  
Fine Print

✓ A measure of mobility for patients with spinal cord injuries is introduced that is very useful in determining patient recovery. The index is used to obtain a prediction equation for motor skills 1 year after injury. Important predictor variables identified include the patient's sex, rectal status, total reflexes, two treatment combinations, motor and sensory neurological history since injury, neurological status, and initial mobility score. Interpretations are made to explain the meaning of the contributions of these variables and show the usefulness of the prediction equation.

Value of gas myelography in early management of acute cervical spinal cord injuries

1975 ◽  
Vol 42 (3) ◽  
pp. 330-337 ◽  
Author(s):  
Alain B. Rossier ◽  
Jean Berney ◽  
Arthur E. Rosenbaum ◽  
Jurg Hachen
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Cervical Spinal Cord ◽  
Cord Compression ◽  
Cervical Cord ◽  
Valuable Contribution ◽  
Early Management ◽  
Specific Patient ◽  
Content Type ◽  
Cord Injury

✓ Gas myelography was carried out in 22 patients with acute cervical spinal cord injuries in whom oily contrast media seemed contraindicated. The authors believe this technique makes a valuable contribution to the basic decision regarding the surgical versus medical treatment of a specific patient with a cervical cord injury. They emphasize the importance of visualizing cord compression due to disc herniation in these cases and conclude that gases are the optimal contrast agents for visualization of the entire circumference of the spinal cord.

Cervical spinal cord hemorrhages in experimental head injuries

1970 ◽  
Vol 33 (6) ◽  
pp. 640-645 ◽  
Author(s):  
Hank H. Gosch ◽  
Elwyn Gooding ◽  
Richard C. Schneider
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Cervical Spinal Cord ◽  
Head Injuries ◽  
Football Players ◽  
Content Type ◽  
Experimental Animals ◽  
Direct Head ◽  
Shear Strains ◽  
Flexion And Extension

✓ Petechial hemorrhages at the cervicomedullary junction have been noted in football players who sustained direct “head-on” or vertex impacts when they struck an opponent. Head and cervical spinal cord injuries were produced in experimental animals on an impact track simulating this mechanism. Severe cervical spinal cord destruction was obtained in the absence of cervical flexion and extension. Cord movement was enhanced by sectioning the dentate ligaments, which prevented these lesions. It is postulated that the transmission of shear strains along the axis of acceleration is responsible for the hemorrhages when the elastic deformation of the cervical spinal cord is exceeded.

Management of cervical spinal cord trauma in Southern California

1975 ◽  
Vol 43 (6) ◽  
pp. 732-736 ◽  
Author(s):  
James S. Heiden ◽  
Martin H. Weiss ◽  
Alan W. Rosenberg ◽  
Michael L. J. Apuzzo ◽  
Theodore Kurze
Keyword(s):  
Spinal Cord ◽  
Southern California ◽  
Spinal Cord Injuries ◽  
Cervical Spinal Cord ◽  
Surgical Decompression ◽  
Neurological Recovery ◽  
Spinal Cord Trauma ◽  
Content Type ◽  
Neurological Improvement ◽  
Similar Incidence

✓ Acute cervical spinal cord injuries were reviewed in 356 patients treated by the neurosurgical community in Southern California. Neurological recovery was compared in operated and nonoperated patients with complete and incomplete cervical myelopathies. The complications of nonsurgical and surgical therapy are identified. No neurological improvement was noted in any patient with a complete lesion who underwent early surgical decompression. In those with incomplete sensorimotor paralysis, it was difficult to document any effect of surgical decompression on neurological recovery. Patients with some degree of sensory preservation had a similar incidence of motor recovery in both surgical and nonsurgical groups. With complete sensorimotor paralysis, anterior cervical fusion within the first week of injury was associated with increased pulmonary morbidity.

Spinal epidural cavernous hemangiomas

1998 ◽  
Vol 88 (5) ◽  
pp. 903-908 ◽  
Author(s):  
Dimitris Zevgaridis ◽  
Andreas Büttner ◽  
Serge Weis ◽  
Christoph Hamburger ◽  
Hans-Jürgen Reulen
Keyword(s):  
Spinal Cord ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Surgical Excision ◽  
Content Type ◽  
Complete Surgical Excision ◽  
Imaging Characteristics ◽  
Cavernous Hemangiomas ◽  
Clinical Signs And Symptoms ◽  
Spinal Epidural

✓ Epidural cavernous hemangiomas are increasingly identified as a cause of acute or chronic progressive spinal cord syndrome and local back pain or radiculopathy. The authors present three cases of spinal epidural cavernous hemangiomas manifesting as spinal cord syndrome, thoracic radiculopathy, and lumbar radiculopathy. Based on the imaging characteristics of these three cases and a review of the literature, the clinical signs and symptoms and their implications, the role of preoperative neuroradiological diagnosis, and the need for complete surgical resection are discussed. Epidural cavernous hemangiomas display consistent magnetic resonance imaging properties: T1-weighted images most commonly show a homogeneous signal intensity similar to those of spinal cord and muscle, and contrast enhancement is homogeneous or slightly heterogeneous. On T2-weighted images the signal of the lesion is consistently high and slightly less intense than that of cerebrospinal fluid. Frequently, the lesion is characterized by its extension through the intervertebral foramen. Awareness of these characteristics facilitates diagnosis and treatment of the lesions. Despite the risk of bleeding, in all three cases complete surgical excision was achieved.

Evaluation of acute nonpenetrating cervical spinal cord injuries with CT metrizamide myelography

1985 ◽  
Vol 63 (4) ◽  
pp. 510-520 ◽  
Author(s):  
Robert L. Allen ◽  
Phanor L. Perot ◽  
Steven K. Gudeman
Keyword(s):  
Spinal Cord ◽  
Computerized Tomography ◽  
Spinal Cord Compression ◽  
Spinal Canal ◽  
Spinal Cord Injuries ◽  
Cervical Spinal Cord ◽  
Cord Compression ◽  
Surgical Decompression ◽  
Content Type ◽  
Fine Print

✓ Computerized tomography metrizamide myelography was performed in 46 patients with acute, nonpenetrating cervical spinal cord injuries. By visualizing the spinal canal, spinal cord, and any compressive lesion, the study proved valuable in the decision as to whether surgical decompression was indicated and what approach should be used. Eleven patients were found to have significant spinal cord compression, 10 of whom were treated surgically. The technique, results, and complications resulting from the study are discussed.

Spinal cord involvement with Schistosoma mansoni

1972 ◽  
Vol 36 (4) ◽  
pp. 494-498 ◽  
Author(s):  
Allan Herskowitz
Keyword(s):  
Spinal Cord ◽  
Schistosoma Mansoni ◽  
Laboratory Data ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Leg Pain ◽  
Low Back ◽  
Pertinent Literature ◽  
Content Type ◽  
Clinical Signs And Symptoms

✓ A case of Schistosoma mansoni involving the spinal cord is reported and the pertinent literature reviewed. The epidemiology, pathology, clinical signs and symptoms, and laboratory data that frequently occur in this disease are presented. Low back or leg pain associated with sphincter disturbance and eosinophilia in a patient from an endemic area should alert the physician to the diagnosis. Early institution of specific therapy and decompressive surgery are the major determinants for a favorable prognosis in this potentially curable neurological disease.

Evaluation of cervical spinal cord injuries with metrizamide myelography-CT scanning

1984 ◽  
Vol 61 (2) ◽  
pp. 281-289 ◽  
Author(s):  
Paul R. Cooper ◽  
Wendy Cohen
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Subarachnoid Space ◽  
Spinal Cord Injuries ◽  
Cervical Spinal Cord ◽  
Ct Scanning ◽  
Posterior Longitudinal Ligament ◽  
Radiographic Evaluation ◽  
Exact Nature ◽  
Content Type

✓ In the past, patients with injuries of the cervical spine and spinal cord have been diagnosed by means of myelography and polytomography. In an attempt to improve the radiographic evaluation of patients with cervical spinal cord injuries the authors performed computerized tomography (CT) scanning of the cervical spine following injection of metrizamide into the spinal subarachnoid space. In 23 patients with cervical spinal cord injuries, metrizamide myelography was performed via a C1–2 puncture. Myelography was used only for localization of the lesion and to determine the site of CT scanning. After myelography, CT scanning of the cervical spine in the transaxial plane was effective in determining the exact nature of compressive lesions and distinguishing the etiology among hematoma, disc, bone fragments, osteophytes, or ossification of the posterior longitudinal ligament. In several patients, metrizamide could be seen entering the spinal cord and was indicative of anatomical spinal cord disruption. In patients with fractures, CT scanning identified the site and nature of the injury without the need for turning the patient to the lateral position. In several patients with an apparently stable cervical spine, the CT scan showed apophyseal joint widening indicative of instability. The authors conclude that CT scanning of the cervical spine after the introduction of metrizamide into the subarachnoid space provides a definitive evaluation of the cervical spinal cord, the bone structures of the cervical spine, and their relationship to each other.

Metrizamide Myelography for Cervical Spinal Cord Injuries

Radiology ◽  
1978 ◽  
Vol 129 (3) ◽  
pp. 707-711 ◽  
Author(s):  
Jin S. Leo ◽  
R. Thomas Bergeron ◽  
Irvin I. Kricheff ◽  
M. Vallo Benjamin
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Cervical Spinal Cord
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