Cervical conjoined nerve root variant: preoperative imaging and surgical confirmation

1994 ◽  
Vol 80 (3) ◽  
pp. 548-551 ◽  
Author(s):  
Constance R. Chu ◽  
Randall M. Chesnut
Keyword(s):  
Nerve Root ◽  
Cervical Radiculopathy ◽  
Preoperative Imaging ◽  
Neural Foramen ◽  
Cervical Nerve Root ◽  
Content Type ◽  
Contrast Enhanced ◽  
The Right ◽  
Tomography Scan ◽  
Conjoined Nerve Root

✓ A case of a nerve root anomaly in a patient presenting with cervical radiculopathy is presented. The patient was treated with posterolateral exploration and decompression, resulting in relief of pain and improvement in strength. Both the preoperative contrast-enhanced computerized tomography scan and the magnetic resonance image demonstrated an abnormality behind the C-4 body extending from the right C3–4 neural foramen to the neural foramen at C4–5. At surgery, a dural-encased structure was discovered connecting the C-4 and C-5 nerve roots within the spinal canal. This paper describes the first reported case of a cervical nerve root anomaly of this type, representing a variant of a conjoined nerve root. The occurrence of such nerve root anomalies in the cervical spine should be entered into the differential diagnosis and treatment of cervical radiculopathy.

Vascular decompression of a vertebral artery loop producing cervical radiculopathy

1998 ◽  
Vol 89 (3) ◽  
pp. 485-488 ◽  
Author(s):  
Paul W. Detwiler ◽  
Randall W. Porter ◽  
Timothy R. Harrington ◽  
Volker K. H. Sonntag ◽  
Robert F. Spetzler
Keyword(s):  
Vertebral Artery ◽  
Nerve Root ◽  
Cervical Radiculopathy ◽  
Vascular Structure ◽  
Loop Formation ◽  
Content Type ◽  
History Of ◽  
Radicular Symptoms ◽  
The Right ◽  
Vascular Decompression

✓ Vertebral artery tortuosity and loop formation are rare causes of cervical radiculopathy. The authors present the case of a 70-year-old man with 9 years of progressive right-sided cervical and scapular pain but no history of trauma. Computerized tomography myelography and magnetic resonance imaging revealed an ovoid mass in the right C3–4 intervertebral foramen. The patient underwent a right C-3 and C-4 hemilaminectomy and a complete C3–4 facetectomy. A pulsatile vascular structure was found compressing the right C-4 nerve root. The bone overlying the vascular structure was removed, producing decompression of the nerve root. Immediate postoperative angiography showed that this lesion was a focal vertebral artery loop. The patient's symptoms resolved after surgery, supporting the use of vascular decompression of a cervical nerve root compressed by a vertebral artery loop for the relief of radicular symptoms.

CERVICAL RADICULOPATHY

Neurosurgery ◽  
2007 ◽  
Vol 60 (suppl_1) ◽  
pp. S1-28-S1-34 ◽  
Author(s):  
Khalid M. Abbed ◽  
Jean-Valéry C.E. Coumans
Keyword(s):  
Physical Examination ◽  
Nerve Root ◽  
Cervical Spondylosis ◽  
Cervical Radiculopathy ◽  
Cervical Disc ◽  
Common Condition ◽  
Neural Foramen ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Entrapment Neuropathies

Abstract CERVICAL RADICULOPATHY IS a common condition that usually results from compression and inflammation of the cervical nerve root or roots in the region of the neural foramen. It is frequently caused by cervical disc herniation and cervical spondylosis. The diagnosis can be established by history and physical examination, but care should be taken, as diagnoses can mimic or coexist with cervical radiculopathy, such as entrapment neuropathies. The pathophysiology, presentation, and clinical evaluation of cervical radiculopathy are discussed.

Renal pseudoaneurysm after blunt trauma in a 10-year-old girl: A case report

2020 ◽  
pp. 039156031989615
Author(s):  
Simone Sforza ◽  
Giorgio Persano ◽  
Chiara Cini ◽  
Idanna Sforzi ◽  
Antonio Andrea Grosso ◽  
...  
Keyword(s):  
Renal Trauma ◽  
Angiographic Embolization ◽  
Computed Tomography Scan ◽  
Contrast Enhanced ◽  
Traumatic Pseudoaneurysm ◽  
Post Traumatic ◽  
The Right ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography ◽  
Tomography Scan

Introduction: Renal trauma is a relevant cause of morbidity in children older than 1 year. Most patients are currently managed conservatively, even in case of high-grade traumas; nevertheless, harmful complications may occur even in hemodynamically stable patients. We present a case of grade IV blunt renal trauma complicated by post-traumatic pseudoaneurysm. Case description: A 10-year-old girl was referred to our institution for grade IV trauma of the right kidney. During observation she had persistent hematuria that caused anemia. A second contrast-enhanced computed tomography scan revealed a posttraumatic pseudoaneurysm that was successfully treated by angiographic embolization. Conclusions: Although extremely rare after blunt renal trauma, post-traumatic renal pseudoaneurysm may cause severe blood loss and anemia, and angioembolization is therefore indicated. This condition should be suspected and move physicians to investigate further.

Detailed anatomy of the intracranial segment of the hypoglossal nerve: neurovascular relationships and landmarks on magnetic resonance imaging sequences

2002 ◽  
Vol 96 (6) ◽  
pp. 1113-1122 ◽  
Author(s):  
Indra Yousry ◽  
Bernhard Moriggl ◽  
Urs D. Schmid ◽  
Martin Wiesman ◽  
Gunther Fesl ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Nerve Root ◽  
Cranial Nerve ◽  
Hypoglossal Nerve ◽  
Posterior Inferior Cerebellar Artery ◽  
Content Type ◽  
Contrast Enhanced ◽  
Ciss Sequence ◽  
12Th Cranial Nerve ◽  
Fine Print

Object. The thin hypoglossal nerve can be very difficult to distinguish on magnetic resonance (MR) images. The authors used a combination of sequences to increase the reliability of MR imaging in its demonstration of the 12th cranial nerve as well as to assess the course of the nerve, display its relationships to adjacent vessels, and provide landmarks for evaluating the nerve in daily practice. Methods. The study group consisted of 34 volunteers (68 nerves) in whom a three-dimensional (3D) Fourier-transformation constructive interference in steady-state (CISS) sequence and a 3D T1-weighted contrast-enhanced magnetization-prepared rapid-acquisition gradient-echo (MPRAGE) sequence were applied. Two trained neuroradiologists collaboratively identified the hypoglossal trigone, preolivary sulcus, 12th cranial nerve, posterior inferior cerebellar artery, vertebral artery, 12th nerve root sleeve, and the hypoglossal canal on each side. The 3D CISS sequence successfully demonstrated the hypoglossal trigone (100% of images), 12th nerve root bundles (100% of images), and 12th nerve sleeves (88.2% of images). The canalicular segment was exhibited with the aid of plain 3D CISS sequences in 74% of images and by using contrast-enhanced 3D CISS sequences and contrast-enhanced MPRAGE sequences in 100% of images. The landmarks that proved useful to identify the cisternal segment of the 12th cranial nerve included the hypoglossal trigone, preolivary sulcus, and 12th nerve root sleeve. Neurovascular contact was identified in 61% of root bundles. The roots were distorted in 44% of these contacts. Conclusions. The contrast-enhanced 3D CISS sequence consistently displayed the cisternal segment as well as the canalicular segments of the hypoglossal nerve and is, therefore, the best sequence to visualize the complete cranial course of this nerve. Landmarks such as the 12th nerve sleeves can assist in the identification of this nerve.

scholarly journals A novel sling technique for microvascular decompression of a rare anomalous vertebral artery causing cervical radiculopathy

2013 ◽  
Vol 35 (3) ◽  
pp. E2 ◽  
Author(s):  
Adesh Tandon ◽  
Sid Chandela ◽  
David Langer ◽  
Chandranath Sen
Keyword(s):  
Conservative Management ◽  
Microvascular Decompression ◽  
Nerve Root ◽  
Treatment Options ◽  
Cervical Radiculopathy ◽  
Occipital Neuralgia ◽  
Nerve Root Compression ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Vertebral Arteries

Cervical radiculopathy secondary to compression from congenital anomalous vertebral arteries (VAs) is a known entity. Patients present with a variety of symptoms ranging from upper-extremity numbness to true occipital neuralgia. Treatment options for extracranial tortuous VAs include conservative management or some form of surgical microvascular decompression (MVD). The authors report on a patient with a congenital anomalous VA loop causing cervical nerve root compression. Successful MVD was conducted with relief of the patient's symptoms. A novel sling technique was used for mobilization of the VA. To the authors' knowledge, this is the first MVD described utilizing this technique.

Outpatient surgical treatment of cervical radiculopathy

1997 ◽  
Vol 87 (1) ◽  
pp. 41-43 ◽  
Author(s):  
Christopher R. Tomaras ◽  
J. Bob Blacklock ◽  
Warren D. Parker ◽  
Richard L. Harper
Keyword(s):  
Surgical Treatment ◽  
Cervical Radiculopathy ◽  
Preoperative Imaging ◽  
Anesthetic Techniques ◽  
Workers Compensation ◽  
General Anesthetic ◽  
Content Type ◽  
Good Outcome ◽  
Compensation Claims

✓ A series of 200 patients who underwent outpatient surgical treatment for cervical radiculopathy is presented. The patients were selected on the basis of their willingness to undergo surgery in the outpatient setting and the absence of serious underlying medical conditions. All operations were performed using general anesthetic techniques with limited posterior dissections. A laminoforaminotomy was performed at each affected level, which had been determined by preoperative imaging and clinical examination. After being observed for several hours, the patients were discharged if they met specific criteria. No patient required subsequent hospital admission in the immediate postoperative period. Follow-up review in 183 patients ranged from 3 to 43 months, with a mean of 19 months. In cases in which Workers' Compensation claims were not involved, 92.8% of patients reported an excellent or good outcome and returned to work or comparable duties at a mean of 2.9 weeks. In cases in which Workers' Compensation claims were involved, 77.8% of patients reported excellent or good outcome and returned to work at a mean of 7.6 weeks postoperatively. Two patients whose cases involved Workers' Compensation claims did not return to work. There were seven patients (3.8%) who had a poor outcome. Two of these patients underwent a second posterior procedure and reported a good outcome at the time of follow-up review. The results of this study show that outpatient surgical treatment of cervical radiculopathy can be safely provided in selected patients with outcomes similar to the inpatient surgical management of these individuals.

Microsurgical Cervical Nerve Root Decompression by Anterolateral Approach

2006 ◽  
Vol 58 (suppl_1) ◽  
pp. ONS-103-ONS-107 ◽  
Author(s):  
Michaël Bruneau ◽  
Jan Frédérick Cornelius ◽  
Bernard George
Keyword(s):  
Minimally Invasive ◽  
Nerve Root ◽  
Cervical Radiculopathy ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Anterolateral Approach ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Neurosurgical Procedure ◽  
Nerve Root Decompression

Abstract OBJECTIVE: Cervical radiculopathy caused by a posterolateral soft disc herniation or spondylosis is a common pathology. METHODS: Decompression of a stressed cervical nerve root is a routine neurosurgical procedure. Most of the time it is achieved through an anterior approach and, less frequently, through a posterior approach in specific indications. RESULTS: According to the principles that an anterolateral compression must directly be reached and that working in the vicinity of the vertebral artery is safe under visual control, we developed the anterolateral approach to the cervical intervertebral foramen and the nerve root using a minimally invasive technique to remove the offending process. CONCLUSION: Microsurgical cervical nerve root decompression by anterolateral approach is a minimally invasive technique, permitting one to remove the offending process staightforwardly. The disc and bone resections are minimal. This method avoids osteoarthrodesis or arthroplasty with disc prosthesis. This technique is efficient with good results and low morbidity.

Mechanisms of cervical nerve root avulsion in injuries of the neck and shoulder

1974 ◽  
Vol 41 (6) ◽  
pp. 705-714 ◽  
Author(s):  
Sydney Sunderland
Keyword(s):  
Nerve Root ◽  
Spinal Nerve ◽  
Spinal Nerve Root ◽  
Root Avulsion ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Content Type ◽  
Nerve Root Avulsion ◽  
New Interpretation ◽  
Fine Print

✓ The author reviews the mechanisms of traumatic spinal nerve root avulsion and proposes a new interpretation.

scholarly journals Accidental Strangulation with Cervical Nerve Root Injury Caused by the Entrapment of Clothing in a Soybean Milling Machine

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Kazuhiko Omori ◽  
Ikuto Takeuchi ◽  
Youichi Yanagawa
Keyword(s):  
Nerve Root ◽  
Electrical Machine ◽  
Milling Machine ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Pattern Of Injury ◽  
Nerve Root Injury ◽  
Root Injury ◽  
Creatine Phosphokinase Level ◽  
The Right

The clothing of a forty-five-year-old man became entrapped by the mixing rotator while he was operating a soybean milling machine. His clothing was wound around the rotator, and tightened around his neck and chest, causing strangulation and a loss of consciousness. He was rescued by his coworkers and transported to our hospital by helicopter. Upon arrival, he regained consciousness. A physiological examination revealed multiple petechiae on his face and strangulation marks with subcutaneous hemorrhage on his neck and upper trunk. In addition, he had motor weakness of the right upper extremity and bilateral paresthesia from C5 to Th1. All radiological studies were negative. He was admitted for observation. After the patient’s creatine phosphokinase level peaked and his focal neurological signs improved, he was discharged on foot on the 6th hospital day. Accidental ligature strangulation with cervical nerve root injury, in which an article of clothing is caught in an electrical machine and strangles the wearer, is very rare. This case is presented for its rarity and the unique pattern of injury.

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.

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