Trevor disease of the spine

2004 ◽  
Vol 1 (3) ◽  
pp. 342-346 ◽  
Author(s):  
Rudolph J. Schrot ◽  
Kee D. Kim ◽  
Mark Fedor
Keyword(s):  
Articular Cartilage ◽  
Nerve Root ◽  
Correct Diagnosis ◽  
Tumor Resection ◽  
Left Shoulder ◽  
Histological Findings ◽  
Imaging Studies ◽  
Content Type ◽  
Left Hand ◽  
Fine Print

✓ The authors report the case of a 15-year-old boy who presented with left shoulder pain and paresthesia of the left hand. Imaging studies revealed an osseous lesion compressing the C-8 nerve root. The patient underwent tumor resection followed by instrumentation-augmented fusion. Histological findings were consistent with osteochondroma. The tumor most likely originated from the articular cartilage between the first rib and T-1 or between C-7 and T-1. The correct diagnosis, therefore, was dysplasia epiphysialis hemimelica (DEH), also known as Trevor disease. To the authors' knowledge, this is the first report of DEH involving the spine.

Intradural sacral nerve root metastasis mimicking herniated disc

1978 ◽  
Vol 49 (5) ◽  
pp. 764-768 ◽  
Author(s):  
Leonard F. Hirsh ◽  
Bernard E. Finneson
Keyword(s):  
Nerve Root ◽  
Correct Diagnosis ◽  
Clinical Suspicion ◽  
Herniated Disc ◽  
Spinal Tumors ◽  
Content Type ◽  
Sacral Nerve Root ◽  
Sacral Nerve ◽  
Herniated Discs ◽  
Fine Print

✓ Spinal tumors may mimic herniated discs but the neurological findings and radiographs usually indicate the correct diagnosis. A case of metastasis to the S-1 intradural nerve rootlets is reported, with symptoms closely simulating a herniated disc. The correct diagnosis could not be made preoperatively in spite of clinical suspicion of a tumor.

Lateral exit-zone stenosis and lumbar radiculopathy

1999 ◽  
Vol 90 (1) ◽  
pp. 52-58 ◽  
Author(s):  
Cormac O. Maher ◽  
Fraser C. Henderson
Keyword(s):  
Nerve Root ◽  
Tertiary Care ◽  
Signs And Symptoms ◽  
Lumbar Spine Surgery ◽  
Care Hospital ◽  
Lumbar Radiculopathy ◽  
Imaging Studies ◽  
Content Type ◽  
Presenting Symptoms ◽  
Fine Print

Object. Hypertrophy of the superior facet of the inferior vertebra, resulting in a compression of the nerve root at the lateral foraminal exit, is a recognized cause of radicular symptoms, particularly in patients in whom previous lumbar spine surgery has failed. The lesion-specific presenting symptoms, imaging findings, and surgical treatment of this lesion, however, have received little attention. The authors prospectively studied a series of eight consecutive patients, in whom a diagnosis of lumbar stenosis at the lateral foraminal exit had been made, to elucidate the common presenting signs and symptoms of this disorder, as well as to evaluate the success of the operative treatment. Methods. The eight patients were selected from a group of 250 consecutive patients who presented to a tertiary-care hospital and in whom a diagnosis of long-standing lumbar radiculopathy had been made. In all cases the diagnosis was confirmed by imaging studies and by intraoperative findings. The authors performed decompressive procedures on the nerve root via a medial facet-sparing approach. Conclusions. The authors conclude that this lesion presents with characteristic physical findings and on imaging studies that distinguish it from other causes of radiculopathy, and they propose a lesion-specific, facet-sparing surgical technique that has yielded excellent results.

Spinal extradural schwannoma

2005 ◽  
Vol 2 (4) ◽  
pp. 447-456 ◽  
Author(s):  
Paolo Celli ◽  
Giuseppe Trillò ◽  
Luigi Ferrante
Keyword(s):  
Nerve Root ◽  
Pyramidal Tract ◽  
Tumor Resection ◽  
Spinal Nerve ◽  
Cervical Region ◽  
Nerve Roots ◽  
Content Type ◽  
Nerve Sheath Tumors ◽  
Nerve Sheath ◽  
Fine Print

Object. The authors endeavor to define the clinical and surgery-related profile of spinal nerve sheath tumors located in the extradural space outside both the dural sac and, apparently, the nerve roots' sleeve. Methods. A series of 24 extradural schwannomas was retrospectively selected after reviewing the notes of spinal nerve sheath tumors surgically treated at La Sapienza University of Rome. Clinical data, tumor-related characteristics, and outcome were analyzed. Women predominantly harbored these tumors. On admission sensory nerve root dysfunction was infrequently reported, whereas pyramidal tract deficits were often present. The tumor, generally large, was most frequently located in the intermediate thoracic segments and high cervical region; only one was reported in the lumbosacral region. Considerable erosion of vertebral bodies was reported in almost one third of the cases. In four patients eloquent nerve roots, that of C-5 in three and that of S-1 in one, were involved with the tumor. Radical tumor resection, with preservation of the nerve roots, was possible in several cases, whereas in two patients manipulation and resection of the C-5 root produced transient and permanent, respectively, root palsy. At follow-up examination patients for whom walking was impossible before surgery were now able to walk. Conclusions. Extradural schwannomas can be distinguished from other nerve sheath tumors growing inside the spinal canal by their clinicoradiological features and unlikely nerve root origin. After surgery, recovery from pyramidal tract deficits, even severe, is noteworthy; in the authors' experience, however, resection of an involved appendicular root is more likely to result in a permanent and significant radicular deficit.

Surveillance neuroimaging of intracranial medulloblastoma in children: how effective, how often, and for how long?

2003 ◽  
Vol 99 (2) ◽  
pp. 280-286 ◽  
Author(s):  
Dawn E. Saunders ◽  
Richard D. Hayward ◽  
Kim P. Phipps ◽  
Wui Khean Chong ◽  
Angela M. Wade
Keyword(s):  
Survival Time ◽  
Tumor Recurrence ◽  
Tumor Resection ◽  
Imaging Studies ◽  
Content Type ◽  
Surveillance Imaging ◽  
First Recurrence ◽  
The Impact ◽  
Reduced Time ◽  
Fine Print

Object. The goal of this paper was to review brain and spine images obtained in children with medulloblastomas to determine the risk factors for tumor recurrence and to assess the impact of surveillance imaging on patient outcomes among patients who remain alive 1 month postsurgery. Methods. Imaging studies and clinical data obtained in children with medulloblastomas, who presented between January 1987 and August 1998, were retrospectively reviewed. Images were termed surveillance if they were follow-up studies and symptom prompted if they were obtained to investigate new symptoms. One hundred seven patients (mean age 6 years and 3 months, range 2 months–15 years and 6 months) were entered into the study. Fifty-three children experienced tumor recurrence; 41 had one recurrence, nine had two, and three had three recurrences. Surveillance imaging revealed 10 of the first 53 recurrences and 15 of all 68 recurrences. When the first recurrence was identified by the emergence of symptoms (42 patients), the children tended to survive for a shorter time (hazard ratio 3.72, 95% confidence interval 1.42–9.76, p = 0.008) than children in whom the first recurrence was detected before symptoms occurred (10 patients). The median survival time following symptomatic tumor recurrence was 4 months and that after surveillance-detected tumor recurrence was 17 months. The median increased survival time among patients whose recurrence was asymptomatic and identified by imaging studies was 13 months, more than half the mean time between surveillance imaging sessions. Incomplete tumor resection was associated with a significantly reduced time to recurrence (p = 0.048) and to death (p = 0.002). The number of recurrences that were experienced was associated with a reduced time to death (p < 0.001). Conclusions. Surveillance imaging is associated with an increase in survival in children with medulloblastomas. More frequent surveillance imaging in children with incomplete tumor excision and recurrent disease may further improve the length of survival.

The contrast-enhanced CT scan in the diagnosis of isodense subdural hematoma

1979 ◽  
Vol 50 (1) ◽  
pp. 64-69 ◽  
Author(s):  
Fong Y. Tsai ◽  
James E. Huprich ◽  
Hervey D. Segall ◽  
James S. Teal
Keyword(s):  
Cerebral Cortex ◽  
Ct Scan ◽  
Subdural Hematoma ◽  
Correct Diagnosis ◽  
Content Type ◽  
Subdural Hematomas ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Fine Print

✓ The authors review 29 cases of surgically-proven isodense subdural hematomas examined by non-contrast and contrast-enhanced computerized tomography scans. Three types of isodense collections were noted: homogeneous isodense collections, mixed-density collections, and gravitational layering within subdural collections. Contrast enhancement within the cerebral cortex, cortical vessels, and subdural membranes led to the correct diagnosis in each case. Contrast-enhanced scans are essential for the evaluation of isodense subdural hematomas.

Retrosigmoid intradural suprameatal approach to Meckel's cave and the middle fossa: surgical technique and outcome

2000 ◽  
Vol 92 (2) ◽  
pp. 235-241 ◽  
Author(s):  
Madjid Samii ◽  
Marcos Tatagiba ◽  
Gustavo A. Carvalho
Keyword(s):  
Tumor Resection ◽  
Neurological Deficits ◽  
Subtotal Resection ◽  
Middle Fossa ◽  
Meckel’S Cave ◽  
Content Type ◽  
Simpson Grade ◽  
Petroclival Meningiomas ◽  
Meckel's Cave ◽  
Fine Print

Object. The goal of this study was to determine whether some petroclival tumors can be safely and efficiently treated using a modified retrosigmoid petrosal approach that is called the retrosigmoid intradural suprameatal approach (RISA).Methods. The RISA was introduced in 1983, and since that time 12 patients harboring petroclival meningiomas have been treated using this technique. The RISA includes a retrosigmoid craniotomy and drilling of the suprameatus petrous bone, which is located above and anterior to the internal auditory meatus, thus providing access to Meckel's cave and the middle fossa.Radical tumor resection (Simpson Grade I or II) was achieved in nine (75%) of the 12 patients. Two patients underwent subtotal resection (Simpson Grade III), and one patient underwent complete resection of tumor at the posterior fossa with subtotal resection at the middle fossa. There were no deaths or severe complications in this series; all patients did well postoperatively, being independent at the time of their last follow-up examinations (mean 5.6 years). Neurological deficits included facial paresis in one patient and worsening of hearing in two patients.Conclusions. Theapproach described here is a useful modification of the retrosigmoid approach, which allows resection of large petroclival tumors without the need for supratentorial craniotomies. Although technically meticulous, this approach is not time-consuming; it is safe and can produce good results. This is the first report on the use of this approach for petroclival meningiomas.

Traumatic lumbar nerve root meningocele

1973 ◽  
Vol 39 (4) ◽  
pp. 528-532 ◽  
Author(s):  
James E. McLennan ◽  
William T. McLaughlin ◽  
Stanley A. Skillicorn
Keyword(s):  
Functional Recovery ◽  
Nerve Root ◽  
Surgical Intervention ◽  
Nerve Roots ◽  
Content Type ◽  
Lumbar Nerve Root ◽  
Fine Print

✓ A patient is described who developed an acute, occult, lumbosacral nerve root meningocele following a partial traumatic avulsion of the L-4 and L-5 nerve roots accompanied by fracture of the pelvis and fibula. Almost total functional recovery ensued. The differences between acute and chronic nerve root meningoceles are discussed, as well as the possibility of surgical intervention.

Spinal intradural schwannoma without attachment to a nerve root

1982 ◽  
Vol 57 (5) ◽  
pp. 701-702 ◽  
Author(s):  
Angelo Bollati ◽  
Giuseppe Galli ◽  
Massimo Gandolfini ◽  
Giovanni Marini ◽  
Gabriele Pizzoli
Keyword(s):  
Nerve Root ◽  
Unusual Case ◽  
Content Type ◽  
Fine Print ◽  
Root Connection

✓ The authors report an unusual case of intradural schwannoma, without demonstrable nerve root connection. An original explanation is given.

Recovery from complete hemiplegia following resection of a retrocentral metastasis: the prognostic value of intraoperative cortical stimulation

2001 ◽  
Vol 95 (6) ◽  
pp. 1050-1052 ◽  
Author(s):  
Hugues Duffau
Keyword(s):  
Tumor Resection ◽  
Prognostic Indicator ◽  
Acute Onset ◽  
Motor Area ◽  
Primary Motor Area ◽  
Content Type ◽  
Motor Responses ◽  
Motor Mapping ◽  
Intraoperative Electrical Stimulation ◽  
Fine Print

✓ The goal in this study was to determine if intraoperative electrical stimulation mapping is useful during surgical resection of lesions located in the central region, even in cases of preoperative hemiplegia. This 45-year-old man with a retrocentral metastasis from an embryonal carcinoma of the testis suffered an acute complete hemiplegia after intratumoral bleeding. Emergency surgery was performed with the aid of intraoperative motor mapping despite the preoperative deficit. Cortical stimulations (CSs) elicited motor responses, allowing the detection and hence preservation of the primary motor area during tumor removal. Postoperatively, the patient recovered almost completely within 1 week; the tumor resection was total. It is possible that CSs give an early and valuable prognostic indicator of motor recovery in cases of complete hemiplegia, at least in patients with acute onset and short duration of the deficit. Consequently, if motor responses can be elicited by CSs, it becomes mandatory for the surgeon to respect the primary motor area despite the preoperative hemiplegia, with the aim of preserving the chances of an eventual recovery.

Primary diffuse leptomeningeal oligodendroglioma

1995 ◽  
Vol 83 (4) ◽  
pp. 724-728 ◽  
Author(s):  
Robert Chen ◽  
David R. Macdonald ◽  
David A. Ramsay
Keyword(s):  
High Dose Chemotherapy ◽  
Postmortem Examination ◽  
High Dose ◽  
Imaging Studies ◽  
Neoplastic Cells ◽  
Content Type ◽  
Suprasellar Cistern ◽  
Brain And Spinal Cord ◽  
The Brain ◽  
Fine Print

✓ The authors describe a case of a diffuse primary leptomeningeal oligodendroglioma in a 17-year-old girl who presented with raised intracranial pressure and hydrocephalus. She underwent imaging studies and a left frontotemporal craniotomy that revealed a cystic oligodendroglioma in the suprasellar cistern and spread of neoplastic cells to the spinal leptomeninges. The tumor showed little response to maximum radiotherapy and chemotherapy, and the patient died from complications of high-dose chemotherapy 2 years after diagnosis. Postmortem examination of the brain and spinal cord revealed diffuse meningeal infiltration by neoplastic cells and no evidence of an intraparenchymal origin. Glial heterotopias were noted at several sites along the brain base, adding circumstantial support to the theory that leptomeningeal gliomas are derived from ectopic glial tissue in the subarachnoid space.

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