Diffuse Necrotizing Myelitis following Intracystic Bleomycin Chemotherapy for Craniopharyngioma

Neurographics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 275-278
Author(s):  
N. Pham ◽  
L. Hacein-Bey
Keyword(s):  
Spinal Cord ◽  
Urinary Incontinence ◽  
Mr Imaging ◽  
Lower Extremity ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Proven Case ◽  
T2 Hyperintensity ◽  
Adamantinomatous Craniopharyngioma

A child with recurrent adamantinomatous craniopharyngioma was treated with surgery and radiosurgery followed by 12 cycles of intracystic bleomycin injections. One month after treatment, he developed progressive lower extremity paresthesia, pain, wide-based gait, and urinary incontinence. MR imaging showed extensive T2 hyperintensity, enlargement, and enhancement extending from the medulla to the lower thoracic spinal cord. Spinal cord biopsy showed necrotizing myelitis. To our knowledge, this is the first histologically proven case of bleomycin spinal cord neurotoxicity.

MR imaging features of idiopathic thoracic spinal cord herniations using combined 3D-fiesta and 2D-PC cine techniques

2005 ◽  
Vol 32 (2) ◽  
pp. 125-130 ◽  
Author(s):  
J.C. Ferré ◽  
B. Carsin-Nicol ◽  
A. Hamlat ◽  
M. Carsin ◽  
X. Morandi
Keyword(s):  
Spinal Cord ◽  
Mr Imaging ◽  
Imaging Features ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal

scholarly journals Role of Multimodality Intraoperative Neurophysiological Monitoring during Embolisation of a Spinal Cord Arteriovenous Malformation

2000 ◽  
Vol 6 (3) ◽  
pp. 223-234 ◽  
Author(s):  
F. Sala ◽  
Y. Niimi ◽  
A. Berenstein ◽  
V. Deletis
Keyword(s):  
Spinal Cord ◽  
Mr Imaging ◽  
General Anesthesia ◽  
Endovascular Procedures ◽  
Motor Evoked Potentials ◽  
Neurological Deficits ◽  
Neurophysiological Monitoring ◽  
Thoracic Spinal Cord ◽  
Lower Extremity Weakness ◽  
Thoracic Spinal

The decision whether or not to embolise during endovascular procedures for arteriovenous malformations (AVMs) of the spinal cord under general anesthesia, relies primarily on neurophysiological results of provocative tests with Lidocaine and short-acting barbiturates. Because of the complex haemodynamics of spinal AVMs, when either sensory (CSEPs) or muscle motor evoked potentials (mMEPs) are used independently, they can mislead the interpretation of provocative tests. This report illustrates the specific but complementary role played by provocative tests using CSEPs and mMEPs during embolisation of a low thoracic spinal cord AVM. We present the case of a 46 year old male with six year history of right lower extremity weakness. At that time, Magnetic Resonance (MR) imaging of the spine disclosed an intramedullary AVM at T11. He remained neurologically stable up to seven months before admission, when he developed sudden onset of low back pain, followed by progressive paraparesis, numbness in lower extremities, urinary retention and fecal incontinence. A new MR imaging study indicated venous thrombosis of the AVM. A two-stage embolisation was performed. During the first procedure, after provocative tests did not affect either CSEPs or mMEPs, an embolisation was performed through a sulco-commisure feeder from the anterior spinal artery (ASA) at T9. Conversely, provocative tests with Lidocaine performed from a right posterior spinal artery (PSA) feeder to the AVM nidus resulted in a significant (>50%) decrease of CSEPs, while mMEPs remained unchanged. The repeatedly positive tests warranted further investigation of the vascular anatomy which disclosed a normal right PSA distal to the nidus; the distal normal PSA was protected with coils. A repeated Lidocaine test was negative and the posterior feeder was embolised with no subsequent changes in CSEPs or mMEPs. After the procedure, the patient experienced only a mild transitory increase in right leg numbness, but no additional motor deficits. Five days later, the embolisation through the ASA feeder at T9 was completed on the basis of negative provocative tests. No additional neurological deficits were observed. Favoring either CSEPs or MEPs during endovascular procedures in the spinal cord is not justified by a solid scientific background. This case report illustrates that monitoring both CSEPs and mMEPs combined with provocative tests allows the safest and most effective embolisation of spinal cord AVMs under general anesthesia.

Imaging Findings in Dorsal Thoracic Arachnoid Web and the Differential Diagnosis of “Scalpel Sign”

Neurographics ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 96-102
Author(s):  
P.M. Brasil ◽  
L.P. Pereira ◽  
D.G.F. Távora ◽  
A.C.F. Camara ◽  
C.L. Macedo Filho ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Mr Imaging ◽  
Correct Diagnosis ◽  
Dural Defect ◽  
Imaging Findings ◽  
Thoracic Spinal Cord ◽  
Ventral Cord ◽  
Thoracic Spinal ◽  
Spinal Cord Herniation ◽  
Idiopathic Spinal Cord Herniation

A dorsal thoracic arachnoid web represents an intradural extramedullary transverse band of arachnoid tissue that causes mass effect and dorsal cord indentation, and can or cannot be associated with spinal cord altered signal. On sagittal MR imaging, this focal dorsal indentation of the thoracic spinal cord resembles a scalpel with its blade pointing posteriorly (called a “scalpel sign”). Although very suggestive of dorsal thoracic arachnoid web, this sign is not specific and should be differentiated from other ventral cord displacement causes (eg, idiopathic spinal cord herniation and spinal arachnoid cyst). In idiopathic spinal cord herniation, cord tissue protrudes through a ventral dural defect, and the focal deformity can be seen along the ventral aspect of the cord on spinal axial MR imaging and with a characteristic “C sign” on sagittal MR imaging; in spinal arachnoid cysts, the marginated walls and the presence of smooth, wide scalloping of the cord surface can be identified. Recognition of these imaging findings, especially the scalpel sign, can help radiologists and clinicians make a correct diagnosis of ventral cord displacement causes and allow subsequent prompt treatment for the patient.

Symptomatic hamartoma of the spinal cord associated with neurofibromatosis type 1

1998 ◽  
Vol 88 (6) ◽  
pp. 1099-1103 ◽  
Author(s):  
Richard D. Brownlee ◽  
Arthur W. Clark ◽  
Robert J. Sevick ◽  
S. Terence Myles
Keyword(s):  
Spinal Cord ◽  
Mr Imaging ◽  
Neurofibromatosis Type 1 ◽  
Ganglion Cells ◽  
Neurofibromatosis Type ◽  
Conus Medullaris ◽  
Thoracic Spinal Cord ◽  
Content Type ◽  
Thoracic Spinal

✓ The authors present a case in which a symptomatic hamartoma was found in the spinal cord of a patient with neurofibromatosis type 1 (NF-1). This 52-year-old woman presented with painful urinary incontinence. Magnetic resonance (MR) imaging revealed an intramedullary lesion within the lower thoracic spinal cord and conus medullaris, which was surgically removed. Pathological investigation showed a hamartomatous lesion consisting of glial cells, ganglion cells, abundant disoriented axons, and thin-walled vessels. This case provides a pathological correlate to the hamartomatous lesions demonstrated on MR imaging in patients with NF-1 and illustrates that these benign lesions may become symptomatic and require neurosurgical intervention.

Intramedullary spinal cord ganglioglioma presenting as hyperhidrosis: unique symptoms and magnetic resonance imaging findings

2013 ◽  
Vol 18 (2) ◽  
pp. 184-188 ◽  
Author(s):  
Tomohiro Murakami ◽  
Izumi Koyanagi ◽  
Takahisa Kaneko ◽  
Akihiro Yoneta ◽  
Yoshiko Keira ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Lower Extremity ◽  
Initial Symptom ◽  
Resonance Imaging ◽  
Thoracic Spinal Cord ◽  
Intramedullary Spinal Cord ◽  
Thoracic Spinal ◽  
The Right

Hyperhidrosis is caused by a sympathetic dysfunction of the central or peripheral nervous system. Intramedullary spinal cord lesions can be a cause of hyperhidrosis. The authors report a rare case of intramedullary thoracic spinal cord ganglioglioma presenting as hyperhidrosis. This 16-year-old boy presented with abnormal sweating on the right side of the neck, chest, and the right arm that had been occurring for 6 years. Neurological examination revealed mild motor weakness of the right lower extremity and slightly decreased sensation in the left lower extremity. Hyperhidrosis was observed in the right C3–T8 dermatomes. Magnetic resonance imaging showed an intramedullary tumor at the right side of the spinal cord at the T2–3 level. The tumor showed partial enhancement after Gd administration. The patient underwent removal of the tumor via hemilaminectomy of T2–3. Only subtotal resection was achieved because the margins of the tumor were unclear. Histopathological examination revealed ganglioglioma. Hyperhidrosis gradually improved after surgery. Hyperhidrosis is a rare clinical manifestation of intramedullary spinal cord tumors, and only a few cases have been reported in the literature. The location of the tumor origin, around the right gray matter of the lateral spinal cord, may account for the hyperhidrosis as the initial symptom in this patient. Physicians should examine the spinal cord using MRI studies when a patient has hyperhidrosis with some motor or sensory symptoms of the extremities.

Spontaneous Herniation of the Thoracic Spinal Cord: A Case Report

2001 ◽  
Vol 45 (4) ◽  
pp. 353 ◽  
Author(s):  
Sung Chan Jin ◽  
Seoung Ro Lee ◽  
Dong Woo Park ◽  
Kyung Bin Joo
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Spontaneous Herniation

Lipomeningocele associated with diplomyelia in a dog

2018 ◽  
Vol 46 (05) ◽  
pp. 323-329 ◽  
Author(s):  
Nele Ondreka ◽  
Sara Malberg ◽  
Emma Laws ◽  
Martin Schmidt ◽  
Sabine Schulze
Keyword(s):  
Spinal Cord ◽  
Neurological Status ◽  
Split Cord Malformation ◽  
Lumbar Spinal Cord ◽  
Histopathological Diagnosis ◽  
Type I ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Subcutaneous Mass ◽  
Lumbar Spinal

SummaryA 2-year-old male neutered mixed breed dog with a body weight of 30 kg was presented for evaluation of a soft subcutaneous mass on the dorsal midline at the level of the caudal thoracic spine. A further clinical sign was intermittent pain on palpation of the area of the subcutaneous mass. The owner also described a prolonged phase of urination with repeated interruption and re-initiation of voiding. The findings of the neurological examination were consistent with a lesion localization between the 3rd thoracic and 3rd lumbar spinal cord segments. Magnetic resonance imaging revealed a spina bifida with a lipomeningocele and diplomyelia (split cord malformation type I) at the level of thoracic vertebra 11 and 12 and secondary syringomyelia above the aforementioned defects in the caudal thoracic spinal cord. Surgical resection of the lipomeningocele via a hemilaminectomy was performed. After initial deterioration of the neurological status postsurgery with paraplegia and absent deep pain sensation the dog improved within 2 weeks to non-ambulatory paraparesis with voluntary urination. Six weeks postoperatively the dog was ambulatory, according to the owner. Two years after surgery the owner recorded that the dog showed a normal gait, a normal urination and no pain. Histopathological diagnosis of the biopsied material revealed a lipomeningocele which confirmed the radiological diagnosis.

scholarly journals The Histopathology of Severe Graded Compression in Lower Thoracic Spinal Cord Segment of Rat, Evaluated at Late Post-injury Phase

2021 ◽  
Author(s):  
Fedorova Jana ◽  
Kellerova Erika ◽  
Bimbova Katarina ◽  
Pavel Jaroslav
Keyword(s):  
Spinal Cord ◽  
Spontaneous Recovery ◽  
Traumatic Injury ◽  
Blue Dye ◽  
Post Injury ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Severe Traumatic Injury ◽  
Spinal Cord Segment ◽  
Cord Injury

AbstractSpontaneous recovery of lost motor functions is relative fast in rodent models after inducing a very mild/moderate spinal cord injury (SCI), and this may complicate a reliable evaluation of the effectiveness of potential therapy. Therefore, a severe graded (30 g, 40 g and 50 g) weight-compression SCI at the Th9 spinal segment, involving an acute mechanical impact followed by 15 min of persistent compression, was studied in adult female Wistar rats. Functional parameters, such as spontaneous recovery of motor hind limb and bladder emptying function, and the presence of hematuria were evaluated within 28 days of the post-traumatic period. The disruption of the blood-spinal cord barrier, measured by extravasated Evans Blue dye, was examined 24 h after the SCI, when maximum permeability occurs. At the end of the survival period, the degradation of gray and white matter associated with the formation of cystic cavities, and quantitative changes of glial structural proteins, such as GFAP, and integral components of axonal architecture, such as neurofilaments and myelin basic protein, were evaluated in the lesioned area of the spinal cord. Based on these functional and histological parameters, and taking the animal’s welfare into account, the 40 g weight can be considered as an upper limit for severe traumatic injury in this compression model.

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