Dramatic neurological recovery with delayed correction of traumatic lumbar spondyloptosis

2007 ◽  
Vol 6 (6) ◽  
pp. 606-610 ◽  
Author(s):  
Michael P. Bellew ◽  
Bradley J. Bartholomew
Keyword(s):  
Patient Outcome ◽  
English Literature ◽  
Cauda Equina ◽  
Neurological Function ◽  
Neurological Recovery ◽  
Delayed Treatment ◽  
First Case ◽  
Remarkable Recovery ◽  
Operative Decompression

✓The authors describe a 36-year-old woman with traumatic lateral spondyloptosis at L-2 and complete cauda equina injury who experienced a remarkable recovery after delayed treatment. To the authors' knowledge, this is the first case of traumatic spondyloptosis at L2–3 described in the English literature. A review of previous cases of lumbar spondyloptosis suggests that the degree of anatomical injury found at surgery is a better predictor of patient outcome than fracture severity assessed radiologically. Concomitant multisystem injury is common with spine disruptions of this magnitude and may mask clinical neurological function. Even when delayed, operative decompression of these severe lesions should be considered because dramatic neurological recovery is possible.

Effects of timing of methylprednisolone or naloxone administration on recovery of segmental and long-tract neurological function in NASCIS 2

1993 ◽  
Vol 79 (4) ◽  
pp. 500-507 ◽  
Author(s):  
Michael B. Bracken ◽  
Theodore R. Holford
Keyword(s):  
Clinical Management ◽  
Experimental Studies ◽  
Neurological Function ◽  
Neurological Recovery ◽  
Content Type ◽  
Naloxone Administration ◽  
Delayed Treatment ◽  
Cord Injury ◽  
Neurological Response ◽  
Fine Print

✓ Previous analyses of the National Acute Spinal Cord Injury Study (NASCIS) have not distinguished recovery of segmental function at the injury level from recovery of the long spinal tracts. Recovery at the injury level could be of considerable clinical significance, but long-tract recovery is the ultimate therapeutic goal. This analysis demonstrates that the greatest proportion of all neurological recovery and of recovery due to treatment with very high doses of methylprednisolone within 8 hours of injury occurs below the lesion. Methylprednisolone treatment administered early following injury has been found to improve recovery below the lesion in patients initially diagnosed as having complete or incomplete injuries; it also leads to greater (but still relatively small) improvement in the injury level. The analysis indicates that delayed treatment with methylprednisolone is associated with decreased neurological recovery. Naloxone administration also improved neurological function below the lesion in patients with incomplete injuries; these results support further experimental work with this drug. This observation of differential neurological response within a narrow treatment window has important implications for both experimental studies and clinical management. Early clinical management with highdose methylprednisolone is supported by this analysis.

scholarly journals A Case Series of Acute Painless Bilateral Foot Drop Without Cauda Equina Syndrome

2021 ◽  
Vol 11 (10) ◽  
Author(s):  
Manoj Kumar ◽  
Nikhil Jain ◽  
Nitin Adsul ◽  
Shankar Acharya ◽  
R. S. Chahal ◽  
...  
Keyword(s):  
Early Intervention ◽  
Case Reports ◽  
Lumbar Disc ◽  
Cauda Equina ◽  
Case Series ◽  
Foot Drop ◽  
Neurological Recovery ◽  
Rare Presentation ◽  
Duration Of Symptoms ◽  
First Case

Introduction:Acute painless bilateral foot drop without bowel/bladder involvement is a very rare presentation of lumbar degenerative disorders. Only a few cases have been published on it in the literature. An early intervention could prove to be very helpful for the neurological recovery. Case Report:We present three cases where patients developed acute onset bilateral foot drop without radiculopathy and without bowel/bladder involvement. The first case was due to acute lumbar disc herniation, the second was caused by acute disc prolapse in a pre-existing asymptomatic lumbar canal stenosis, and the third one precipitated in a progressive degenerative severe lumbar spinal stenosis. Two cases (case reports 1 and 3) underwent minimal invasive decompression while the other case (case report 2) underwent instrumentation+ decompression + fusion. Case 1 and 2 with a short duration of symptoms showed good neurological recovery, whileereas cCase 3 with longer duration of complaints did not improve. Conclusion:Patients presenting with painless bilateral foot drop without cauda equine syndrome should be evaluated for spinal causes besides central nervous systemCNS, peripheral nerve, metabolic and autoimmune causes. Any finding in support of lumbar degenerative disease as the cause after excluding other causes should prompt for surgical decompression of the spine as an early intervention might help patient recover back to a normal and active lifestyle. Keywords:Painless, bilateral, foot drop, acute.

scholarly journals An infertile female delivered a baby after removal of primary renal carcinoid tumor

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 146-148
Author(s):  
Syu Jhang ◽  
Allen W. Chiu
Keyword(s):  
Carcinoid Tumor ◽  
English Literature ◽  
Carcinoid Tumors ◽  
Primary Infertility ◽  
First Case

Abstract Primary renal carcinoid tumors are exceedingly rare. We report a 37-year-old woman with primary infertility, who was found to have a primary renal carcinoid tumor. She became pregnant and gave birth to a baby after removal of the tumor. This is the first case in the English literature of primary renal carcinoid tumor related with primary infertility.

scholarly journals A rare benign genitourinary tumor in a Japanese male: urinary retention owing to aggressive angiomyxoma of the prostate

Rare Tumors ◽  
2010 ◽  
Vol 2 (1) ◽  
pp. 43-45 ◽  
Author(s):  
Yugo Sawada ◽  
Fumio Ito ◽  
Hayakazu Nakazawa ◽  
Nobuhiko Tsushima ◽  
Hikaru Tomoe ◽  
...  
Keyword(s):  
Renal Dysfunction ◽  
Urinary Retention ◽  
Bladder Neck ◽  
English Literature ◽  
Pathological Examination ◽  
Aggressive Angiomyxoma ◽  
Urethral Meatus ◽  
First Case ◽  
Japanese Male ◽  
Old Japanese

Close examination of a 67-year-old Japanese man, who complained of persistent nocturia, revealed that a semitransparent polypoid tumor had developed from the bladder neck to the prostatic urethra obstructing the internal urethral meatus, which resulted in excessive urinary retention and post-renal dysfunction. The tumor was resected by a transurethral procedure and a pathological examination of specimens revealed aggressive angiomyxoma (AAM) of the prostate. AAM usually develops in the intrapelvic and perineal organs of females. So far as we know, this is the second case of primary prostatic AAM reported in the English literature, and is the first case where the patient encountered urethral obstruction.

scholarly journals Neurological Recovery in Two Patients with Cauda Equina Syndrome Secondary to L5 Lumbar Spine Giant Cell Tumour after Treatment with Denosumab without Surgery

2016 ◽  
Vol 10 (5) ◽  
pp. 945 ◽  
Author(s):  
Simret Singh Randhawa ◽  
Angel Khor Nee Kwan ◽  
Chee Kidd Chiu ◽  
Chris Yin Wei Chan ◽  
Mun Keong Kwan
Keyword(s):  
Lumbar Spine ◽  
Giant Cell ◽  
Cauda Equina Syndrome ◽  
Giant Cell Tumour ◽  
Cauda Equina ◽  
Cell Tumour ◽  
Neurological Recovery

scholarly journals Anaplastic pilocytic astrocytoma of the cerebellum presenting with conus medullaris drop metastasis

2021 ◽  
Vol 8 (1) ◽  
pp. 10
Author(s):  
Jared F. Sweeney ◽  
Vaibhav Chumbalkar ◽  
Michael D. Staudt ◽  
Pouya Entezami ◽  
Jiang Qian ◽  
...  
Keyword(s):  
Pilocytic Astrocytoma ◽  
Cauda Equina ◽  
Conus Medullaris ◽  
Complete Understanding ◽  
First Case ◽  
Spine Imaging ◽  
Drop Metastasis ◽  
Cerebellar Mass ◽  
Definition Of ◽  
Staged Operations

Due to its rarity, a complete understanding of the clinical behavior, pathogenesis, and diagnostic definition of anaplastic pilocytic astrocytoma (APA) is currently lacking. The optimal clinical management and use of adjuvant therapies has yet to be defined. We present a 64 year-old-female with progressive headaches, dysarthria, and ataxia, who was found to have right cerebellar mass. A gross total resection was achieved through two staged operations. Pathology demonstrated focal areas of necrosis, tumor infiltration, and increased mitotic activity most consistent with APA. Adjuvant chemotherapy and stereotactic radiosurgery were administered. Approximately two years later, the patient presented with symptoms of cauda equina syndrome, and lumbar spine imaging demonstrated a large intradural mass at the conus medullaris with diffuse leptomeningeal enhancement. A biopsy was performed and was consistent with metastatic APA. APA may rarely progress to metastatic disease, most frequently involving the leptomeninges of the posterior fossa and cervical spine. This report represents the first case of metastases distal to the cervicomedullary junction.

Monophasic Synovial Sarcoma Arising in the Vulva: A Case Report and Review of the Literature

2008 ◽  
Vol 132 (4) ◽  
pp. 698-702
Author(s):  
Beverly E. White ◽  
Alan Kaplan ◽  
Dolores H. Lopez-Terrada ◽  
Jae Y. Ro ◽  
Robert S. Benjamin ◽  
...  
Keyword(s):  
Synovial Sarcoma ◽  
Soft Tissues ◽  
English Literature ◽  
Review Of The Literature ◽  
First Case ◽  
Additional Surgery ◽  
Synovial Sarcomas ◽  
The Right ◽  
Disease Free ◽  
Vulvar Mass

Abstract Synovial sarcomas most commonly arise in the soft tissue of the extremities. Less commonly, these tumors present in the head and neck, abdominal wall, and other sites. However, synovial sarcoma occurring in the vulvar area is extremely rare. Only 2 previous cases of biphasic synovial sarcoma of the vulva have been reported, but no case of vulvar monophasic synovial sarcoma has been described in the English literature. We report the third case of synovial sarcoma and apparently the first case of monophasic synovial sarcoma arising in soft tissues of the vulva. The patient was a 33-year-old woman who presented for evaluation of a painless vulvar mass. The tumor was located in the deep fibroadipose tissue of the right vulva (6.5 × 4.2 × 3.5 cm). The histology of the lesion was that of a monophasic synovial sarcoma with a hemangiopericytic vascular pattern. A subsequent molecular analysis revealed SYT-SSX2 gene fusion, which confirmed the diagnosis of synovial sarcoma. After an initial wide local excision, the patient developed a recurrence in the right groin and received chemotherapy and additional surgery. The patient is currently disease free, on adjuvant chemotherapy, and being followed up closely.

scholarly journals Restoration of Neurological Function Following Peripheral Nerve Trauma

2020 ◽  
Vol 21 (5) ◽  
pp. 1808 ◽  
Author(s):  
Damien P. Kuffler ◽  
Christian Foy
Keyword(s):  
Peripheral Nerve ◽  
Functional Recovery ◽  
Recovery Of Function ◽  
Sensory Nerve ◽  
Standard Technique ◽  
Neurological Function ◽  
Neurological Recovery ◽  
Nerve Grafts ◽  
Peripheral Nerve Trauma ◽  
Nerve Trauma

Following peripheral nerve trauma that damages a length of the nerve, recovery of function is generally limited. This is because no material tested for bridging nerve gaps promotes good axon regeneration across the gap under conditions associated with common nerve traumas. While many materials have been tested, sensory nerve grafts remain the clinical “gold standard” technique. This is despite the significant limitations in the conditions under which they restore function. Thus, they induce reliable and good recovery only for patients < 25 years old, when gaps are <2 cm in length, and when repairs are performed <2–3 months post trauma. Repairs performed when these values are larger result in a precipitous decrease in neurological recovery. Further, when patients have more than one parameter larger than these values, there is normally no functional recovery. Clinically, there has been little progress in developing new techniques that increase the level of functional recovery following peripheral nerve injury. This paper examines the efficacies and limitations of sensory nerve grafts and various other techniques used to induce functional neurological recovery, and how these might be improved to induce more extensive functional recovery. It also discusses preliminary data from the clinical application of a novel technique that restores neurological function across long nerve gaps, when repairs are performed at long times post-trauma, and in older patients, even under all three of these conditions. Thus, it appears that function can be restored under conditions where sensory nerve grafts are not effective.

scholarly journals Acquired smooth muscle hamartoma: A case report on the lower extremity with hidrosis

2019 ◽  
Vol 7 ◽  
pp. 2050313X1989383
Author(s):  
Malika A Ladha ◽  
Todd Remington
Keyword(s):  
Smooth Muscle ◽  
Case Report ◽  
Lower Extremity ◽  
Smooth Muscle Cells ◽  
English Literature ◽  
Surgical Excision ◽  
Muscle Cells ◽  
Clinical Spectrum ◽  
Rare Entity ◽  
First Case

Smooth muscle hamartomas are benign dermal proliferations of smooth muscle cells. Smooth muscle hamartomas are sub-divided into congenital or acquired; the latter is a rare entity with less than 20 cases being reported in the English literature. Most often asymptomatic, acquired smooth muscle hamartomas follow an indolent course. Treatment in the form of surgical excision can be utilized for symptomatic or cosmetic purposes. Here, we report the first case of an acquired smooth muscle hamartomas of the shin which also uniquely presented with hidrosis. This case highlights the varied clinical spectrum of acquired smooth muscle hamartomas.

scholarly journals Endoscopic Repair of a Colonic Perforation following Polypectomy Using an Endoclip

2004 ◽  
Vol 18 (2) ◽  
pp. 105-106 ◽  
Author(s):  
Sonny S Dhalla
Keyword(s):  
Case Report ◽  
English Literature ◽  
Colonic Perforation ◽  
Endoscopic Repair ◽  
First Case

Endoscopic repair using an endoclip device for colonic perforation following polypectomy is described. This is the first case report of a repair following a regular polypectomy-induced perforation described in the English literature.

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