Primary spinal syringomyelia

2005 ◽  
Vol 3 (6) ◽  
pp. 429-435 ◽  
Author(s):  
Ulrich Batzdorf
Keyword(s):  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Fluid Flow ◽  
Craniovertebral Junction ◽  
Arachnoid Cysts ◽  
Spinal Cord Tumors ◽  
Content Type ◽  
Cerebrospinal Fluid Flow ◽  
Different Types ◽  
Fine Print

✓ In the present review the author describes the different types of syringomyelia that originate from abnormalities at the level of the spinal cord rather than at the craniovertebral junction. These include posttraumatic and postinflammatory syringomyelia, as well as syringomyelia associated with arachnoid cysts and spinal cord tumors. The diagnosis and the principles of managing these lesions are discussed, notably resection of the entity restricting cerebrospinal fluid flow. Placement of a shunt into the syrinx cavity is reserved for patients in whom other procedures have failed or who are not candidates for other procedures.

Spinal arachnoid cysts

1974 ◽  
Vol 41 (6) ◽  
pp. 728-735 ◽  
Author(s):  
Jacques J. Palmer
Keyword(s):  
Spinal Cord ◽  
Early Diagnosis ◽  
Arachnoid Cysts ◽  
Definitive Treatment ◽  
Spinal Cord Tumors ◽  
Content Type ◽  
Precise Diagnosis ◽  
Fine Print

✓ Six cases of symptomatic spinal arachnoid cysts are presented. All lesions but one were intradural. Although these cysts are frequently indistinguishable clinically from spinal cord tumors, their correct early diagnosis by myelography and treatment by excision or marsupialization gives gratifying results. The authors emphasize that precise diagnosis and definitive treatment are sometimes delayed because of intermittent symptoms.

Management of proximal shunt obstruction

1988 ◽  
Vol 68 (5) ◽  
pp. 817-819 ◽  
Author(s):  
Charles C. Duncan
Keyword(s):  
Cerebrospinal Fluid ◽  
Fluid Flow ◽  
Intracranial Pressure ◽  
Signs And Symptoms ◽  
Ventricular Catheter ◽  
Shunt Failure ◽  
Content Type ◽  
Cerebrospinal Fluid Flow ◽  
Shunt Obstruction ◽  
Fine Print

✓ Proximal shunt obstruction or obstruction of the ventricular catheter may present with signs and symptoms of shunt failure with either no cerebrospinal fluid flow or a falsely low intracranial pressure (ICP) upon shunt tap. The author reports a technique for lowering the ICP and for measuring the pressure in patients with such obstruction by cannulation of the reservoir and ventricular catheter to penetrate into the ventricle with a 3½-in. No. 22 spinal needle. The findings in 20 cases in which this approach was utilized are summarized.

Audible cerebrospinal fluid flow through a ventriculoperitoneal shunt

1987 ◽  
Vol 67 (3) ◽  
pp. 460-462 ◽  
Author(s):  
Joe I. Ordia ◽  
Ronald W. Mortara ◽  
Edward L. Spatz
Keyword(s):  
Cerebrospinal Fluid ◽  
Fluid Flow ◽  
Ventriculoperitoneal Shunt ◽  
Content Type ◽  
Cerebrospinal Fluid Flow ◽  
Ventriculoperitoneal Shunting ◽  
Flow Through ◽  
Fine Print

✓ An audible, noisy cerebrospinal fluid flow is an uncommon sequela of ventriculoperitoneal shunting. Two cases presenting this phenomenon are described.

Evaluation of the central canal of the spinal cord in experimentally induced hydrocephalus

1978 ◽  
Vol 48 (6) ◽  
pp. 970-974 ◽  
Author(s):  
A. Everette James ◽  
William J. Flor ◽  
Gary R. Novak ◽  
Ernst-Peter Strecker ◽  
Barry Burns
Keyword(s):  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Experimental Model ◽  
Alternative Pathway ◽  
Central Canal ◽  
Communicating Hydrocephalus ◽  
Csf Flow ◽  
Content Type ◽  
Histological Appearance ◽  
Fine Print

✓ The central canal of the spinal cord has been proposed as a significant compensatory alternative pathway of cerebrospinal fluid (CSF) flow in hydrocephalus. Ten dogs were made hydrocephalic by a relatively atraumatic experimental model that simulates the human circumstance of chronic communicating hydrocephalus. The central canal was studied by histopathology and compared with 10 normal control dogs. In both groups the central canal of the spinal cord was normal in size, configuration, and histological appearance. In this experimental model dilatation of the canal and increased movement of CSF does not appear to be a compensatory alternative pathway.

Intrathecal phenol and glycerin in metrizamide for treatment of intractable spasms in paraplegia

1985 ◽  
Vol 63 (1) ◽  
pp. 125-127 ◽  
Author(s):  
Brett A. Scott ◽  
Zelig Weinstein ◽  
Robert Chiteman ◽  
Morris W. Pulliam
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cerebrospinal Fluid ◽  
Intrathecal Injection ◽  
Fluoroscopic Guidance ◽  
Content Type ◽  
Therapeutic Modalities ◽  
Comparative Review ◽  
Cord Injury ◽  
Fine Print

✓ Intractable lower extremity spasms after spinal cord injury is a significant source of morbidity. A case of refractory spasticity in paraplegia was successfully converted to flaccid paraplegia by intrathecal injection of phenol and glycerin in metrizamide. This chemical rhizolysis is simple and effective, and the presence of metrizamide allows both fluoroscopic guidance for accurate intrathecal phenol placement and good miscibility with cerebrospinal fluid. A brief comparative review of alternative therapeutic modalities is presented.

The development of techniques for resection of spinal cord tumors by Harvey W. Cushing

2005 ◽  
Vol 2 (1) ◽  
pp. 92-97 ◽  
Author(s):  
Aaron A. Cohen-Gadol ◽  
Dennis D. Spencer ◽  
William E. Krauss
Keyword(s):  
Spinal Cord ◽  
Surgical Techniques ◽  
Spinal Tumors ◽  
Spinal Cord Tumors ◽  
Content Type ◽  
Improved Outcomes ◽  
Peter Bent Brigham Hospital ◽  
Operative Notes ◽  
Natural Histories ◽  
Fine Print

✓ Harvey Cushing's refinement of Halsted's meticulous surgical techniques facilitated safe resection of intradural spinal tumors. Although Cushing focused his attention on brain tumors at the Peter Bent Brigham Hospital, his numerous contributions to the treatment of intradural spinal tumors include the description of these tumors' natural histories and their histological classifications. The application of his experienced intracranial techniques to the resection of spinal tumors improved outcomes. The authors review selected operative notes and sketches to demonstrate his technique in the excision of the spinal cord tumors.

Intramedullary spinal cord tumors in patients older than 50 years of age: management and outcome analysis

2005 ◽  
Vol 2 (3) ◽  
pp. 249-255 ◽  
Author(s):  
Raj K. Shrivastava ◽  
Fred J. Epstein ◽  
Noel I. Perin ◽  
Kalmon D. Post ◽  
George I. Jallo
Keyword(s):  
Spinal Cord ◽  
Older Adult ◽  
Adult Population ◽  
Spinal Cord Tumors ◽  
Intramedullary Spinal Cord ◽  
Content Type ◽  
The Mean ◽  
Older Adult Population ◽  
Fine Print

Object. Intramedullary spinal cord tumors (IMSCTs) in the older-age adult population pose complex management issues regarding the extent of resection and functional outcome, especially in terms of quality of life. Historically, IMSCTs in the older adult population were treated with irradiation alone because it was assumed that functional recovery would be poor. The authors examined their IMSCT database and report the first large series of IMSCTs in patients older than 50 years of age. Methods. In this retrospective clinical and chart review there were 30 cases meeting inclusion criteria drawn from databases at three different institutions. A modified McCormick Scale was used to assess functional levels in all 30 patients pre- and postoperatively. The mean age of patients in this cohort was 59.8 years (range 50–78 years), and the mean follow- up period was 10.6 years (range 2–16 years). Ependymoma was the most common tumor (83%), and 55% were located in the thoracic spine. The most common presenting symptom was sensory dysesthesia, with rare motor loss. The prodromal period to treatment was 19.4 months. Based on the McCormick Scale score at last follow-up examination 67% of patients were clinically functionally the same, 9% were worse, and 24% were improved after surgery. There were two deaths due tumor progression (both malignant tumors) and one recurrence (anaplastic astrocytoma). All three patients in whom malignant astrocytomas were diagnosed underwent postoperative radiation therapy. Conclusions. In the population of patients older than age 50 years, thoracic ependymomas are the most common IMSCTs that present characteristically with sensory symptoms. The longer prodromal period in the older adult population may reflect the fact that their diagnosis and workup is inadequate. There was no significant increase in the length of stay in the neurosurgical ward. The authors recommend motor evoked potential-guided aggressive microsurgical resection, because the long-term outcome of benign lesions is excellent (good functional recovery and no tumor recurrence).

Spinal intramedullary metastatic medulloblastoma

1978 ◽  
Vol 48 (4) ◽  
pp. 632-635 ◽  
Author(s):  
B. Joseph Zumpano
Keyword(s):  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Metastatic Spread ◽  
Intramedullary Spinal Cord ◽  
Content Type ◽  
Documented Case ◽  
Leptomeningeal Seeding ◽  
Extracranial Metastases ◽  
Fine Print

✓ Metastatic spread of medulloblastoma along the neuraxis by leptomeningeal seeding through the cerebrospinal fluid pathways is well known. The occurrence of extracranial metastases outside the neuraxis has been well established, but the occurrence of intramedullary spinal cord metastases not related to surface seeding is rare. A histologically documented case of the latter type is described.

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