Deformation of the cervicomedullary junction and spinal cord in a surgically treated adult Chiari I hindbrain hernia associated with syringomyelia: a magnetic resonance microscopic and neuropathological study

1996 ◽  
Vol 85 (4) ◽  
pp. 701-708 ◽  
Author(s):  
Emile A. M. Beuls ◽  
Marie-Anne M. Vandersteen ◽  
Linda M. Vanormelingen ◽  
Peter J. Adriaensens ◽  
Gerard Freling ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Magnetic Resonance ◽  
Cervical Spinal Cord ◽  
Cervical Cord ◽  
Magnetic Resonance Microscopy ◽  
Type I ◽  
Additional Advantage ◽  
Content Type ◽  
Hindbrain Hernia ◽  
Fine Print

✓ The lower brainstem and cervical spinal cord from an ordinarily treated case of Chiari Type I hindbrain hernia associated with syringomyelia was examined using high-resolution magnetic resonance microscopy and standard neuropathological techniques. Magnetic resonance microscopy allows total screening and visualizes the disturbed internal and external microanatomy in the three orthogonal planes with the resolution of low-power optical microscopy. An additional advantage is the in situ visualization of the shunts. Afterwards the intact specimen is still available for microscopic examination. Part of the deformation of the medulla is caused by chronic tonsillar compression and molding inside the foramen magnum. Other anomalies, such as atrophy caused by demyelination, elongation, and unusual disturbances at the level of the trigeminal and solitary nuclear complexes contribute to the deformation. At the level of the syrinx-free upper part of the cervical cord, anomalies of the dorsal root and the dorsal horn are demonstrated.

Direction of blood flow in the primate cervical spinal cord

1970 ◽  
Vol 33 (3) ◽  
pp. 325-330 ◽  
Author(s):  
Larry C. Fried ◽  
John L. Doppman ◽  
Giovanni Di Chiro
Keyword(s):  
Spinal Cord ◽  
Blood Flow ◽  
Cervical Spinal Cord ◽  
Cervical Cord ◽  
Content Type ◽  
Vertebral Arteries ◽  
Cast Doubt ◽  
Thoracic Cord ◽  
Cervical Level ◽  
Fine Print

✓ The direction of blood flow in the cervical spinal cord of monkeys was studied by direct cinematic observation of the results of dye injections, plus separate angiographic studies. The studies indicated that in monkeys blood enters the cervical spinal cord mainly from radicular arteries that are usually derived from branches of the costo-cervical trunk. Although some blood entering at the low cervical level flows toward the thoracic cord, the major component flows up to the C-2 level. The findings cast doubt on the established assumption that the vertebral arteries provide the main blood supply of the cervical cord.

Effects of cervical spinal cord stimulation on cerebral blood flow in the rat

2000 ◽  
Vol 93 (1) ◽  
pp. 71-76 ◽  
Author(s):  
Oren Sagher ◽  
Dah-Luen Huang
Keyword(s):  
Spinal Cord ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Spinal Cord Stimulation ◽  
Cervical Spinal Cord ◽  
Cervical Cord ◽  
Peripheral Vasculature ◽  
Doppler Flowmetry ◽  
Content Type ◽  
Fine Print

Object. Spinal cord stimulation (SCS) is frequently used for the treatment of chronic pain. Although the mechanisms by which SCS alleviates pain are unclear, they are believed to involve changes within the dorsal horn of the spinal cord. Spinal cord stimulation has also been found to cause significant vasodilation in the peripheral vasculature. The mechanisms underlying this effect are thought to involve sympathetic blockade. A rostral vasodilatory effect has also been described, but changes in cerebral blood flow (CBF) have been poorly delineated. Using laser Doppler flowmetry (LDF), the authors examined the effects of cervical SCS on CBF in rats. Methods. Cervical SCS was found to result in a significant increase in cortical LDF values (83 ± 11% [mean ± standard error of the mean]). The increase in cortical LDF values was not accompanied by a significant increase in systemic blood pressure. Stimulation of the upper cervical spinal cord was more effective in inducing LDF changes than was that of the lower cervical cord. Changes in SDS-induced LDF values were significantly attenuated after spinal cord transection at the cervicomedullary junction and by the administration of the sympathetic blocker hexamethonium. Conclusions. These results indicate that cervical SCS may induce cerebral vasodilation and that this effect may involve indirect effects on vasomotor centers in the brainstem as well as an alteration in sympathetic tone.

Effects of various lesions on crossed and uncrossed descending inspiratory pathways in the cervical spinal cord of the cat

1973 ◽  
Vol 39 (5) ◽  
pp. 589-595 ◽  
Author(s):  
Fred L. Cohen
Keyword(s):  
Spinal Cord ◽  
Cervical Spinal Cord ◽  
Cervical Cord ◽  
Spinal Cord Lesions ◽  
Content Type ◽  
Level 3 ◽  
High Cervical ◽  
Cervical Level ◽  
Fine Print ◽  
Made In

✓ Various cervical spinal cord lesions interrupting portions of the descending respiratory pathways were made in 12 cats. Results suggest: 1) that the descending inspiratory pathways lie in the ventrolateral portion of the high cervical spinal cord; 2) that a decussation of these pathways exists between the low medullary and high cervical level; 3) that fibers descend via both crossed and uncrossed pathways along the length of the cervical cord to innervate phrenic nuclei bilaterally; 4) that activity in the crossed pathway running along the length of the cervical cord is related to the level of PaCO2.

Sarcoidosis of the spinal cord

1976 ◽  
Vol 44 (6) ◽  
pp. 740-743 ◽  
Author(s):  
Robert Snyder ◽  
Javad Towfighi ◽  
Nicholas K. Gonatas
Keyword(s):  
Spinal Cord ◽  
Lymph Nodes ◽  
Cervical Spinal Cord ◽  
Cervical Cord ◽  
Content Type ◽  
Spinal Cord Sarcoidosis ◽  
Fine Print

✓ A case of intramedullary sarcoidosis simulating a tumor of the cervical spinal cord is presented. Autopsy showed that the disease was limited to the cervical cord and hilar lymph nodes. The literature is reviewed and six cases of histologically documented spinal cord sarcoidosis are discussed.

Symptomatic subependymoma of the cervical spinal cord

1987 ◽  
Vol 67 (1) ◽  
pp. 128-131 ◽  
Author(s):  
K. Stuart Lee ◽  
Jean N. Angelo ◽  
Joe M. McWhorter ◽  
Courtland H. Davis
Keyword(s):  
Spinal Cord ◽  
Fourth Ventricle ◽  
Cervical Spinal Cord ◽  
Cervical Cord ◽  
Common Site ◽  
Content Type ◽  
Histological Appearance ◽  
Fine Print

✓ Subependymomas are relatively unusual tumors with a distinctive histological appearance. They are generally considered to be benign, and they are often found incidentally at autopsy. Most are located intracranially, and the most common site of origin is the fourth ventricle. Only two cases of subependymoma of the spinal cord have been reported previously. The authors present two additional cases of subependymoma of the cervical cord; both were symptomatic, and both were treated by microsurgical removal.

Gowers intrasyringal hemorrhage

2005 ◽  
Vol 3 (6) ◽  
pp. 477-481 ◽  
Author(s):  
Abderrahmane Hamlat ◽  
Mahmoudreza Adn ◽  
Mourad Ben Yahia ◽  
Xavier Morandi ◽  
Gilles Brassier ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rapid Development ◽  
Neurological Dysfunction ◽  
Cervical Cord ◽  
Type I ◽  
Resonance Imaging ◽  
Content Type ◽  
Hyperintense Signal ◽  
Fine Print

✓ The concept of hemorrhage in a preexisting syringomyelic cavity was first described by Gowers in 1904. Since its first description only 13 cases have been reported. The aims of this report are to describe a new case, bring this entity to wider attention, and summarize the existing literature on the subject. This 36-year-old woman presented with progressive gait disturbance and unsteadiness. Physical examination revealed incomplete quadriparesis, predominantly on the left side, and hypesthesia below C-7. Magnetic resonance imaging revealed hematomyelia characterized by a heterogeneous hyperintense signal within the central cervical cord. A liquefied well-limited hematoma was evacuated. The postoperative course was uneventful; a near-complete recovery was observed at the 7-year follow-up examination. Most cases of intrasyringal hemorrhage (ISH) have occurred in syringomyelic cavities associated with scoliosis or Chiari malformation Type I. Although there is no specific clinical picture associated with this entity, it can be characterized by three neurological forms: 1) sudden onset or rapid development of signs and symptoms, 2) acute worsening of symptoms that may improve but leaving greater neurological dysfunction than before the previous episode, and 3) ISH may initiate progressive deterioration in a patient with known syringomyelia. Intrasyringal bleeding is most probably caused by a sudden dilation of the syringomyelic cavity, which may provoke rupture of the intrasyringal vessels by an acute distension of the accompanying strands. Magnetic resonance imaging is the most accurate diagnostic modality, and recognition of ISH can lead to early, safe, and efficient surgical treatment.

Split spinal cord malformations in children

1998 ◽  
Vol 88 (1) ◽  
pp. 57-65 ◽  
Author(s):  
Yusuf Ersşahin ◽  
Saffet Mutluer ◽  
Sevgül Kocaman ◽  
Eren Demirtasş
Keyword(s):  
Spinal Cord ◽  
Neurological Deficits ◽  
Single Type ◽  
Type I ◽  
Type Ii ◽  
Content Type ◽  
Spinal Lesion ◽  
The Mean ◽  
Fine Print

Object. The authors reviewed and analyzed information on 74 patients with split spinal cord malformations (SSCMs) treated between January 1, 1980 and December 31, 1996 at their institution with the aim of defining and classifying the malformations according to the method of Pang, et al. Methods. Computerized tomography myelography was superior to other radiological tools in defining the type of SSCM. There were 46 girls (62%) and 28 boys (38%) ranging in age from less than 1 day to 12 years (mean 33.08 months). The mean age (43.2 months) of the patients who exhibited neurological deficits and orthopedic deformities was significantly older than those (8.2 months) without deficits (p = 0.003). Fifty-two patients had a single Type I and 18 patients a single Type II SSCM; four patients had composite SSCMs. Sixty-two patients had at least one associated spinal lesion that could lead to spinal cord tethering. After surgery, the majority of the patients remained stable and clinical improvement was observed in 18 patients. Conclusions. The classification of SSCMs proposed by Pang, et al., will eliminate the current chaos in terminology. In all SSCMs, either a rigid or a fibrous septum was found to transfix the spinal cord. There was at least one unrelated lesion that caused tethering of the spinal cord in 85% of the patients. The risk of neurological deficits resulting from SSCMs increases with the age of the patient; therefore, all patients should be surgically treated when diagnosed, especially before the development of orthopedic and neurological manifestations.

Herniation of the spinal cord into an iatrogenic meningocele

1973 ◽  
Vol 39 (4) ◽  
pp. 533-536 ◽  
Author(s):  
Cully Cobb ◽  
George Ehni
Keyword(s):  
Spinal Cord ◽  
Cervical Spinal Cord ◽  
Content Type ◽  
Fine Print

✓ The authors describe a case in which the cervical spinal cord became incarcerated in the mouth of an iatrogenic meningocele or “pseudocyst.”

Cruciate paralysis

1986 ◽  
Vol 65 (1) ◽  
pp. 108-110 ◽  
Author(s):  
Daniel Dumitru ◽  
James E. Lang
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Rare Case ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Cervical Spinal Cord ◽  
Content Type ◽  
Vehicle Accident ◽  
Cord Injury ◽  
Fine Print

✓ A rare case of cruciate paralysis is reported in a 39-year-old man following a motor-vehicle accident. The differentiation of this syndrome from a central cervical spinal cord injury is delineated.

Bladder function after incomplete spinal cord injury in mice: quantifiable outcomes associated with bladder function and efficiency of dehydroepiandrosterone as a therapeutic adjunct

2004 ◽  
Vol 100 (1) ◽  
pp. 56-61
Author(s):  
Pierre-Yves Mure ◽  
Mark Galdo ◽  
Nathalie Compagnone
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Mouse Model ◽  
Collagen Type ◽  
Neurological Recovery ◽  
Bladder Function ◽  
Type I ◽  
Content Type ◽  
Cord Injury ◽  
Fine Print

Object. The authors conducted a study to establish outcomes associated with bladder function in a mouse model of spinal cord injury (SCI) and to assess the sensitivity of these outcomes in determining the efficacy of pharmacological treatments. Methods. A mouse model of moderate contusive SCI was used. Outcome parameters included physiological, behavioral, and morphological measurements. To test the sensitivity of these outcomes, the authors used a dehydroepiandrosterone (DHEA) treatment that they had previously shown to promote neurological recovery effectively after SCI. A behavioral scale was used to identify the day at which autonomic function of the bladder was recovered. The reduction in the daily volume of urine during the period of functional recovery paralleled this scale. They then determined the day postinjury at which the functional differences between the vehicle- and DHEA-treated mice exhibited the maximal amplitude. Changes were measured in the composition of the extracellular matrix relative to collagen expression in the layer muscularis of the detrusor at this time point. They found that SCI increases the ratio of collagen type III to collagen type I in the detrusor. Moreover, in the DHEA-treated group, this ratio was similar to that demonstrated in sham-operated mice, establishing the sensitivity of this outcome to assess therapeutic benefits to the bladder function. They next examined the relationship between measurements of neurological recovery and controlled voiding by using cluster analysis. Conclusions. The authors found that early recovery of controlled voiding is predictive of motor recovery.

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