A viable residual spinal hydatid cyst cured with albendazole

2000 ◽  
Vol 93 (1) ◽  
pp. 142-144 ◽  
Author(s):  
M. Kemali Baykaner ◽  
Fikret Doğulu ◽  
Gülyüz Öztürk ◽  
Naci Edali ◽  
Turgut Tali
Keyword(s):  
Hydatid Disease ◽  
Single Case ◽  
Cord Compression ◽  
Acute Onset ◽  
Neurological Deficits ◽  
Surgical Removal ◽  
Lower Extremity Weakness ◽  
Content Type ◽  
One Year ◽  
Fine Print

✓ Spinal hydatid disease is a rare entity that frequently yields to severe, acute-onset neurological deficits. Although the gold standard treatment is total surgical removal of the cysts without inducing any spillage, it may not be possible to perform this in patients with multiple and fragile cysts. In such cases, the neural structures should be adequately decompressed and albendazole should be administered promptly. The authors describe the case of a 13-year-old girl who was admitted with a history of back pain and acute-onset lower-extremity weakness. Magnetic resonance imaging scans demonstrated severe spinal cord compression caused by multiple cysts involving T-4 and the mediastinum. The patient underwent surgery, and the cysts were removed, except for one cyst that was hardly exposed. Following histopathological confirmation of spinal hydatid disease, she was treated with albendazole for 1 year. One year postoperatively, the residual cyst had gradually shrunk and had almost disappeared. Although a single case is not sufficiently promising, we believe that administration of albendazole is efficient to prevent recurrences in cases in which it is not possible to obtain total removal of the cysts without inducing spillage.

Intracerebral hemorrhage complicating cervical “hourglass” schwannoma removal

2001 ◽  
Vol 94 (1) ◽  
pp. 150-153 ◽  
Author(s):  
Xavier Morandi ◽  
Laurent Riffaud ◽  
Beatrice Carsin-Nicol ◽  
Yvon Guegan
Keyword(s):  
Intracerebral Hemorrhage ◽  
Surgical Procedure ◽  
Neurological Deficits ◽  
Surgical Removal ◽  
Neurosurgical Procedure ◽  
Content Type ◽  
Postoperative Course ◽  
First Case ◽  
Fine Print

✓ The authors report a case of infra- and supratentorial intracerebral hemorrhage complicating the postoperative course of a patient who had undergone surgical removal of a cervical schwannoma with an hourglass configuration. To their knowledge, this is the first case in which this neurosurgical procedure was followed by such a complication. Possible mechanisms are discussed; however, pathological events leading to this complication are unclear. The development of new neurological deficits not attributable to the surgical procedure should suggest this possibility.

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.

Spinal cord compression due to extramedullary hematopoiesis in homozygous thalassemia

1975 ◽  
Vol 42 (2) ◽  
pp. 212-216 ◽  
Author(s):  
Wlllem Luyendijk ◽  
Lodewijk Went ◽  
Hans D.G. Schaad
Keyword(s):  
Spastic Paraparesis ◽  
Extramedullary Hematopoiesis ◽  
Cord Compression ◽  
Surgical Removal ◽  
Pathological Findings ◽  
Hematopoietic Tissue ◽  
Content Type ◽  
Vertebral Canal ◽  
Direct Extension ◽  
Fine Print

✓ The authors report a case of homozygous thalassemia in which a mass of hematopoietic tissue in the vertebral canal caused spastic paraparesis. Surgical removal of the tissue plus radiotherapy were successful. The pathological findings indicated direct extension of hematopoietic tissue from the adjacent bone marrow into the epidural space of the vertebral canal.

Spinal cord concussion

1990 ◽  
Vol 72 (6) ◽  
pp. 894-900 ◽  
Author(s):  
Thomas J. Zwimpfer ◽  
Mark Bernstein
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Spinal Injury ◽  
Cord Compression ◽  
Neurological Deficits ◽  
Content Type ◽  
Young Males ◽  
Cord Injury ◽  
Sensory Disturbances ◽  
Fine Print

✓ The hallmark of concussion injuries of the nervous system is the rapid and complete resolution of neurological deficits. Cerebral concussion has been well studied, both clinically and experimentally. In comparison, spinal cord concussion (SCC) is poorly understood. The clinical and radiological features of 19 SCC injuries in the general population are presented. Spinal cord injuries were classified as concussions if they met three criteria: 1) spinal trauma immediately preceded the onset of neurological deficits; 2) neurological deficits were consistent with spinal cord involvement at the level of injury; and 3) complete neurological recovery occurred within 72 hours after injury. Most cases involved young males, injured during athletics or due to falls. Concussion occurred at the two most unstable spinal regions, 16 involving the cervical spinal and three the thoracolumbar junction. Fifteen cases presented with combined sensorimotor deficits, while four exhibited only sensory disturbances. Many patients showed signs of recovery with the first few hours after injury and most had completely recovered within 24 hours. Only one case involved an unstable spinal injury. There was no evidence of ligamentous instability, spinal stenosis, or canal encroachment in the remaining 18 cases. Two patients, both children, suffered recurrent SCC injuries. No delayed deterioration or permanent cord injuries occurred. Spinal abnormalities that would predispose the spinal cord to a compressive injury were present in only one of the 19 cases. This suggests that, as opposed to direct cord compression, SCC may be the result of an indirect cord injury. Possible mechanisms are discussed.

A novel dynamic model for experimental spinal cord compression

2005 ◽  
Vol 2 (4) ◽  
pp. 466-471 ◽  
Author(s):  
Gerhard Marquardt ◽  
Matthias Setzer ◽  
Alf Theisen ◽  
Edgar Dettmann ◽  
Volker Seifert
Keyword(s):  
Spinal Cord ◽  
Mr Imaging ◽  
Dynamic Model ◽  
Dura Mater ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Neurological Deficits ◽  
Content Type ◽  
Interlaminar Approach ◽  
Fine Print

Object. The goal of this study was to develop a novel dynamic model for experimental spinal cord compression that closely approximates neoplastic epidural compression of the spinal cord in humans. Methods. In 30 New Zealand white rabbits, the thoracic spine was exposed via a posterior approach. On each side of one vertebral lamina a small hole was drilled caudal to the articular process. A silicone band was passed through these holes, forming a loop. The spinal dura mater was exposed via an interlaminar approach. The loop was brought into contact with the dura mater and fixed in its position encircling 270° of the circumference of the spinal cord. Thereafter, the loop was gradually tightened at set times by pulling at the ends of the band and fixing them again in their new position. The spinal cord was thus increasingly compressed in a circular and dynamic manner. Neurological deficits of various degrees were created in all animals in the compression group, and the compressive effect of the loop was reliably demonstrated on MR imaging. After decompression of the spinal cord, the neurological deficits were reversible in the majority of animals, and MR imaging revealed either no signal changes or only circumscribed ones within the cord. In contrast, MR images obtained in animals that did not recover revealed the occurrence of extensive chronic myelopathy. Conclusions. This novel model features reproducibility of paresis and neurological recovery. It is a dynamic model simulating circular tumor growth and is characterized by its easy, straightforward, and cost-saving applicability.

Chondroma of the cervical spine

1987 ◽  
Vol 66 (1) ◽  
pp. 128-130 ◽  
Author(s):  
Gérald Lozes ◽  
Ahmad Fawaz ◽  
Harry Perper ◽  
Philippe Devos ◽  
Pascal Benoit ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Spinal Cord Compression ◽  
Vertebral Column ◽  
Cord Compression ◽  
Neurological Recovery ◽  
Surgical Removal ◽  
Content Type ◽  
Fine Print

✓ The authors report a case of cervical chondroma presenting with a syndrome of spinal cord compression in a 76-year-old woman. Total surgical removal of the lesion was followed by partial neurological recovery. Chondromas of the vertebral column are rarely reported in the literature.

Prolonged intrathecal baclofen withdrawal syndrome

2005 ◽  
Vol 102 (6) ◽  
pp. 1133-1136 ◽  
Author(s):  
Andrea F. Douglas ◽  
Howard L. Weiner ◽  
David R. Schwartz
Keyword(s):  
Withdrawal Syndrome ◽  
Direct Method ◽  
Intrathecal Baclofen ◽  
Acute Onset ◽  
Surgical Removal ◽  
Management Options ◽  
Content Type ◽  
Baclofen Withdrawal ◽  
Complete Reversal ◽  
Fine Print

✓ The authors describe a patient who experienced a prolonged course of intrathecal baclofen withdrawal syndrome after removal of an implantable baclofen pump for treatment of pump infection and meningitis. The current literature outlines management options for the acute management of this syndrome. In this report the authors discuss the long-term presentation of this syndrome and suggest a treatment strategy for management of the syndrome. A 37-year-old man who presented with a baclofen pump infection and meningitis experienced acute onset of intrathecal baclofen withdrawal syndrome 12 hours after the pump had been surgically removed. The patient's symptoms evolved into a severe, treatment-refractory withdrawal syndrome lasting longer than 1 month. Oral baclofen replacement with adjunctive administration of parenteral γ-aminobutyric acid agonists only served to stabilize the patient's critical condition throughout his hospital course. Replacement of the baclofen pump and restoration of intrathecal delivery of the medication was necessary to trigger the patient's dramatic recovery and complete reversal of the withdrawal syndrome within approximately 48 hours. These findings indicate that a more direct method of treating infected baclofen pumps than immediate surgical removal is necessary to prevent the onset of intrathecal baclofen withdrawal syndrome. Various options for preventing the onset of the syndrome while simultaneously treating the infection are discussed.

Osteochondroma with spinal cord compression

1980 ◽  
Vol 52 (6) ◽  
pp. 842-845 ◽  
Author(s):  
F. John Palmer ◽  
Peter W. Blum
Keyword(s):  
Spinal Cord ◽  
Clinical Result ◽  
Neurological Complications ◽  
Cord Compression ◽  
Surgical Removal ◽  
Neural Arch ◽  
Content Type ◽  
Bone Dysplasias ◽  
The Relationship ◽  
Fine Print

✓ Multiple osteochondromatosis is the most common of the bone dysplasias, but neurological complications are rare. Osteochondromas of the spine usually arise from the neural arch. Tomography and myelography are useful in determining the site of origin and the relationship to the spinal cord. The tumor is benign, and surgical removal produces an excellent clinical result. Three cases are described illustrating the clinical and radiological manifestations of these tumors.

Intention-to-treat analysis of Spetzler—Martin Grades IV and V arteriovenous malformations: natural history and treatment paradigm

2003 ◽  
Vol 98 (1) ◽  
pp. 3-7 ◽  
Author(s):  
Patrick P. Han ◽  
Francisco A. Ponce ◽  
Robert F. Spetzler
Keyword(s):  
Natural History ◽  
Arteriovenous Malformations ◽  
Neurological Deficits ◽  
Surgical Removal ◽  
Content Type ◽  
Intention To Treat ◽  
Complete Treatment ◽  
Risk Of Hemorrhage ◽  
Treat Analysis ◽  
Fine Print

Object. In this study the authors quantified a subgroup of patients with Spetzler—Martin Grades IV and V arteriovenous malformations (AVMs) recommended for complete, partial, or no treatment, and calculated the retrospective hemorrhage rate for these lesions. Methods. Between July 1997 and May 2000, 73 consecutive patients with Grades IV and V AVMs were evaluated prospectively by the cerebrovascular team at Barrow Neurological Institute. Treatment recommendations given to the patients or referring physicians were classified as complete treatment, partial treatment, and no treatment. Retrospectively, the hemorrhage rates associated with these treatment groups were also calculated. In the prospective portion of the study (the intention-to-treat analysis), no treatment of the AVM, was recommended for 55 patients (75%) and partial treatment was recommended for seven patients (10%). Aneurysms associated with an AVM were obliterated by surgical or endovascular treatment in seven patients (10%), and complete surgical removal was recommended for four patients (5%). The overall hemorrhage rate for Grades IV and V AVMs was 1.5% per year. The annual risk of hemorrhage was 10.4% among patients who previously had received incomplete treatment, compared with patients without previous treatment. Conclusions. The hemorrhage risk of 1.5% per year, which was associated with Grades IV and V AVMs appears to be lower than that reported for Grades I through III AVMs. The authors recommend that no treatment be given for most Grades IV and V AVMs. No evidence indicates that partial treatment of an AVM reduces a patient's risk of hemorrhage. In fact, partial treatment may worsen the natural history of an AVM. The authors do not support palliative treatment of AVMs, except in the specific circumstances of arterial or intranidal aneurysms or progressive neurological deficits related to vascular steal. Complete treatment is warranted for patients with progressive neurological deficits caused by hemorrhage of the AVM. This selection process plays a significant role in the relatively low combined morbidity and mortality rates for Grade IV and Grade V AVMs (17 and 22%, respectively) reported by the cerebrovascular group in both retrospective and prospective studies.

Spinal cord compression in a new homozygous variant of beta-thalassemia

1982 ◽  
Vol 57 (6) ◽  
pp. 846-848 ◽  
Author(s):  
Willem F. Luitjes ◽  
Reinder Braakman ◽  
Johannes Abels
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Genetic Variant ◽  
Cord Compression ◽  
Beta Thalassemia ◽  
Surgical Removal ◽  
Hematopoietic Tissue ◽  
Content Type ◽  
Cord Lesion ◽  
Fine Print

✓ A patient is reported with a new genetic variant of beta-thalassemia, who suffered from a progressive partial transverse cord lesion caused by epidural hematopoietic tissue. He recovered after partial surgical removal of this tissue and subsequent radiotherapy.

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