Recurrent transient quadriparesis after minor cervical trauma associated with bilateral partial agenesis of the posterior arch of the atlas

1996 ◽  
Vol 84 (4) ◽  
pp. 663-665 ◽  
Author(s):  
Martijn Torreman ◽  
Ivo T. H. J. Verhagen ◽  
Menno Sluzewski ◽  
Alexander J. M. Kok ◽  
Willem Jan van Rooij
Keyword(s):  
Spinal Cord ◽  
Posterior Arch ◽  
Review Of The Literature ◽  
Cervical Trauma ◽  
Content Type ◽  
Causative Mechanism ◽  
Type D ◽  
Aggressive Management ◽  
Type C ◽  
Fine Print

✓ The case of a 33-year-old woman with bilateral partial agenesis (type D) of the posterior arch of the atlas and recurrent transient quadriparesis due to contusion of the spinal cord after minor cervical trauma is described. At least some patients with type C or D congenital anomalies of the posterior arch of the atlas are prone to transient quadriparesis; thus a more aggressive management is advocated for them. Radiological and surgical findings showing the possible causative mechanism are presented and a review of the literature is given.

Intradural tuberculomas of the spinal cord

1981 ◽  
Vol 55 (2) ◽  
pp. 289-292 ◽  
Author(s):  
Hamit Z. Gökalp ◽  
Ertuğ Özkal
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Medical Care ◽  
Review Of The Literature ◽  
Content Type ◽  
Antituberculous Treatment ◽  
Fine Print

✓ The incidence of intradural tuberculoma of the spinal cord is rare, and is becoming rarer as medical care improves. Two cases of surgically treated intradural tuberculomas are presented, with a brief review of the literature. The authors recommend surgical treatment, which carries almost no risk of meningitis if antituberculous treatment is given postoperatively.

Tethered cord syndrome from a choristoma of müllerian origin

1991 ◽  
Vol 74 (3) ◽  
pp. 497-500 ◽  
Author(s):  
Michael C. Molleston ◽  
Kevin A. Roth ◽  
Franz J. Wippold ◽  
Robert L. Grubb
Keyword(s):  
Spinal Cord ◽  
Tethered Cord ◽  
Tethered Cord Syndrome ◽  
Review Of The Literature ◽  
Lumbosacral Junction ◽  
Content Type ◽  
Fine Print

✓ The authors report a case of tethered cord syndrome due to a choristoma of müllerian origin located in the spinal cord at the lumbosacral junction. Two similar cases were found upon review of the literature. The embryology of this lesion is discussed.

Microsurgical anatomy of the artery of Adamkiewicz and its segmental artery

1998 ◽  
Vol 89 (5) ◽  
pp. 791-795 ◽  
Author(s):  
Cargill H. Alleyne ◽  
C. Michael Cawley ◽  
George G. Shengelaia ◽  
Daniel L. Barrow
Keyword(s):  
Spinal Cord ◽  
Blood Supply ◽  
Anatomical Study ◽  
Microsurgical Anatomy ◽  
Review Of The Literature ◽  
Content Type ◽  
Segmental Artery ◽  
Artery Of Adamkiewicz ◽  
Segmental Arteries ◽  
Fine Print

Object. The blood supply of the lower spinal cord is heavily dependent on the artery of Adamkiewicz, which characteristically originates from one of the thoracolumbar segmental arteries. The aforementioned artery is of enormous clinical, surgical, and radiological importance, and the goal of this study was to elucidate the course and branches of the segmental artery that gives rise to this important vessel. Methods. In this cadaveric, microsurgical anatomical study, the authors investigate and describe the course and branches of the artery of Adamkiewicz and the segmental branch from which it ultimately originates. A review of the literature is provided. Conclusions. By documenting the microsurgical anatomy of these important vessels, this study facilitates an understanding of the anatomy that will aid in treatment planning for surgery of various lesions in this area.

Anomaly of the axis causing cervical myelopathy

1999 ◽  
Vol 91 (1) ◽  
pp. 121-123 ◽  
Author(s):  
Hiroyuki Asakawa ◽  
Kiyoyuki Yanaka ◽  
Kiyoshi Narushima ◽  
Kotoo Meguro ◽  
Tadao Nose
Keyword(s):  
Spinal Cord ◽  
Cervical Myelopathy ◽  
Craniovertebral Junction ◽  
Posterior Arch ◽  
Cervical Canal ◽  
Decompressive Laminectomy ◽  
Content Type ◽  
Canal Stenosis ◽  
Remarkable Recovery ◽  
Fine Print

✓ Although the craniovertebral junction is one of the most common sites at which anomalies develop, spina bifida occulta of the axis (C-2) associated with cervical myelopathy is extremely rare. The authors present the case of a 46-year-old man who developed progressive tetraparesis caused by a cervical canal stenosis at the level of the axis. The spinal cord was compressed by an invaginated bifid lamina of the axis. The patient made a remarkable recovery after undergoing decompressive laminectomy of C-3 and removal of the bifid posterior arch of the axis.

Effect of impounder contact area on experimental spinal cord injury

1979 ◽  
Vol 51 (4) ◽  
pp. 539-542 ◽  
Author(s):  
Arthur M. Gerber ◽  
W. Stephen Corrie
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Contact Area ◽  
Dorsal Surface ◽  
Posterior Arch ◽  
Content Type ◽  
Experimental Spinal Cord Injury ◽  
Cord Injury ◽  
Fine Print

✓ The spinal cords of two groups of dogs were subjected to 500 gm-cm impacts using two different configurations of impounders. The impounders varied only in area of contact with the dural surface. All other parameters were kept constant. With one impounder all of the dogs injured were totally paraplegic. The impounder consistently producing total paraplegia straddled the entire width of the dorsal surface of the spinal cord in a manner corresponding to the posterior arch of a vertebra. The injury produced with this impounder is not only consistently reproducible but bears a closer resemblance to clinical injury such as anterior vertebral dislocation than that produced with a smaller impounder.

Diaphyseal aclasis with spinal cord compression

1996 ◽  
Vol 84 (3) ◽  
pp. 518-521 ◽  
Author(s):  
Emmanuel K. Labram ◽  
J. Mohan
Keyword(s):  
Spinal Cord ◽  
Clinical Features ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Long Bones ◽  
Review Of The Literature ◽  
Content Type ◽  
First Case ◽  
Fine Print

✓ In diaphyseal aclasis, the exostoses usually involve long bones, although occasionally the spine is also affected. Very few cases of osteochondroma causing spinal cord compression have been cited. The authors report their experience with two cases of diaphyseal aclasis. In the first case spinal cord compression caused by an exostosis of the lamina of C-2 occurred in a 9-year-old boy; in the second case a large osteochondroma of C-5 occurred in a 45-year-old man. Also included in this report is a review of the literature highlighting the incidence of diaphyseal aclasis, its clinical features and its excellent prognosis in treated cases.

Tuberculous meningitis presenting as an obstructive myelopathy

1984 ◽  
Vol 60 (1) ◽  
pp. 196-199 ◽  
Author(s):  
Brien Vlcek ◽  
Kim J. Burchiel ◽  
Thomas Gordon
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Tuberculous Meningitis ◽  
Cord Compression ◽  
Review Of The Literature ◽  
Content Type ◽  
X Ray ◽  
Normal Chest ◽  
Chest X Ray ◽  
Fine Print

✓ Subacute paraplegia progressing over 3 months due to spinal cord compression was the presenting symptom of tuberculous meningitis in this patient with a normal chest x-ray film and no radiological or autopsy evidence of Pott's vertebral tuberculosis. The obstructive myelopathy was the result of proliferative granulomatous meningitis. A review of the literature indicates that this is a very unusual presentation of tuberculous meningitis.

Safety and efficacy of stereotactic radiosurgery for tumors of the spine

2004 ◽  
pp. 413-418 ◽  
Author(s):  
Deborah L. Benzil ◽  
Mehran Saboori ◽  
Alon Y. Mogilner ◽  
Ronald Rocchio ◽  
Chitti R. Moorthy
Keyword(s):  
Spinal Cord ◽  
Single Dose ◽  
Pain Relief ◽  
Total Dose ◽  
Stereotactic Radiosurgery ◽  
Medical Center ◽  
Primary Tumors ◽  
Content Type ◽  
Increased Risk ◽  
Fine Print

Object. The extension of stereotactic radiosurgery treatment of tumors of the spine has the potential to benefit many patients. As in the early days of cranial stereotactic radiosurgery, however, dose-related efficacy and toxicity are not well understood. The authors report their initial experience with stereotactic radiosurgery of the spine with attention to dose, efficacy, and toxicity. Methods. All patients who underwent stereotactic radiosurgery of the spine were treated using the Novalis unit at Westchester Medical Center between December 2001 and January 2004 are included in a database consisting of demographics on disease, dose, outcome, and complications. A total of 31 patients (12 men, 19 women; mean age 61 years, median age 63 years) received treatment for 35 tumors. Tumor types included 26 metastases (12 lung, nine breast, five other) and nine primary tumors (four intradural, five extradural). Thoracic tumors were most common (17 metastases and four primary) followed by lumbar tumors (four metastases and four primary). Lesions were treated to the 85 to 90% isodose line with spinal cord doses being less than 50%. The dose per fraction and total dose were selected on the basis of previous treatment (particularly radiation exposure), size of lesion, and proximity to critical structures. Conclusions. Rapid and significant pain relief was achieved after stereotactic radiosurgery in 32 of 34 treated tumors. In patients treated for metastases, pain was relieved within 72 hours and remained reduced 3 months later. Pain relief was achieved with a single dose as low as 500 cGy. Spinal cord isodoses were less than 50% in all patients except those with intradural tumors (mean single dose to spinal cord 268 cGy and mean total dose to spinal cord 689 cGy). Two patients experienced transient radiculitis (both with a biological equivalent dose (BED) > 60 Gy). One patient who suffered multiple recurrences of a conus ependymoma had permanent neurological deterioration after initial improvement. Pathological evaluation of this lesion at surgery revealed radiation necrosis with some residual/recurrent tumor. No patient experienced other organ toxicity. Stereotactic radiosurgery of the spine is safe at the doses used and provides effective pain relief. In this study, BEDs greater than 60 Gy were associated with an increased risk of radiculitis.

Posterior approach for cervical intramedullary arteriovenous malformation with diffuse-type nidus

1999 ◽  
Vol 91 (1) ◽  
pp. 105-111 ◽  
Author(s):  
Kenji Ohata ◽  
Toshihiro Takami ◽  
Alaa El-Naggar ◽  
Michiharu Morino ◽  
Akimasa Nishio ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Poor Prognosis ◽  
Posterior Approach ◽  
The Other ◽  
Anterior Spinal Artery ◽  
Neural Element ◽  
Feeding Artery ◽  
Diffuse Type ◽  
Content Type ◽  
Fine Print

✓ The treatment of spinal intramedullary arteriovenous malformations (AVMs) with a diffuse-type nidus that contains a neural element poses different challenges compared with a glomus-type nidus. The surgical elimination of such lesions involves the risk of spinal cord ischemia that results from coagulation of the feeding artery that, at the same time, supplies cord parenchyma. However, based on evaluation of the risks involved in performing embolization, together with the frequent occurrence of reperfusion, which necessitates frequent reembolization, the authors consider surgery to be a one-stage solution to a disease that otherwise has a very poor prognosis. Magnetic resonance (MR) imaging revealed diffuse-type intramedullary AVMs in the cervical spinal cords of three patients who subsequently underwent surgery via the posterior approach. The AVM was supplied by the anterior spinal artery in one case and by both the anterior and posterior spinal arteries in the other two cases. In all three cases, a posterior median myelotomy was performed up to the vicinity of the anterior median fissure that divided the spinal cord together with the nidus, and the feeding artery was coagulated and severed at its origin from the anterior spinal artery. In the two cases in which the posterior spinal artery fed the AVM, the feeding artery was coagulated on the dorsal surface of the spinal cord. Neurological outcome improved in one patient and deteriorated slightly to mildly in the other two patients. Postoperative angiography demonstrated complete disappearance of the AVM in all cases. Because of the extremely poor prognosis of patients with spinal intramedullary AVMs, this surgical technique for the treatment of diffuse-type AVMs provides acceptable operative outcome. Surgical intervention should be considered when managing a patient with a diffuse-type intramedullary AVM in the cervical spinal cord.

Progressive neurological deficits with benign intracerebral cysts

1986 ◽  
Vol 65 (5) ◽  
pp. 706-709 ◽  
Author(s):  
Yoko Nakasu ◽  
Jyoji Handa ◽  
Kazuyoshi Watanabe
Keyword(s):  
Histological Examination ◽  
Computerized Tomography ◽  
Cyst Wall ◽  
Benign Lesion ◽  
Ct Scanning ◽  
Neurological Deficits ◽  
Review Of The Literature ◽  
Content Type ◽  
Ct Findings ◽  
Fine Print

✓ Two patients with benign intracerebral cysts are reported and a brief review of the literature is given. Although computerized tomography (CT) scanning is useful in detecting a variety of intracerebral cysts, the CT findings are not specific for any lesion. An exploratory operation with establishment of an adequate route of drainage and a histological examination of the cyst wall are mandatory in the management of patients with a progressive but benign lesion.

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