scholarly journals A Concomitant Occurrence of the Atlantoaxial Subluxation with Rare Vertebral Formation and Segmentation Defects

2021 ◽  
Vol 64 (5) ◽  
pp. 837-842
Author(s):  
Man Kyu Choi ◽  
Sung Bum Kim ◽  
Jun Ho Lee
Keyword(s):  
Vertebral Body ◽  
Congenital Anomalies ◽  
Clinical Signs ◽  
Atlantoaxial Subluxation ◽  
Neurological Deficits ◽  
Os Odontoideum ◽  
Vertebral Bodies ◽  
Multi Level ◽  
Preoperative Work Up ◽  
Work Up

An atlantoaxial subluxation from the unstable Os odontoideum by the failure of proper integrations between the embryological somites might be a commonly reported pathology. However, its suspicious origin or paralleled occurrence with other congenital anomalies of vertebral body might be a relatively rare phenomenon. The authors present two cases, who simply presented with clinical signs of prolonged, intractable cervicalgia without any neurological deficits, revealed this rare feature of C1–2 subluxation from the unstable, orthotropic type of Os odontoideum that coincide with congenitally fused cervical vertebral bodies between C2–3. Surprisingly, in one case, when traced from the lower cervical down to the thoracic-lumbar levels during the preoperative work-up process, was also compromised with multi-level butterfly vertebrae formations. Presented cases highlight the association of various congenital vertebrae anomalies and the rationale to fuse only affected joints.

Computed tomographic characterisation of vertebral osteomyelitis in a goat kid

2020 ◽  
Vol 8 (1) ◽  
pp. e001015
Author(s):  
Nicole Marie Szafranski ◽  
Aude Castel ◽  
Adrien-Maxence Hespel ◽  
Vincent Dore
Keyword(s):  
Vertebral Column ◽  
Histopathological Examination ◽  
Vertebral Osteomyelitis ◽  
Clinical Signs ◽  
Neurological Deficits ◽  
Computed Tomographic ◽  
Digital Radiographs ◽  
Microbiological Testing ◽  
History Of ◽  
Vertebral Bodies

A one-month-old male goat kid presented with a three weeks’ history of progressive neurological deficits and progressive tetraparesis. Initial therapeutic strategy with antimicrobial, anti-inflammatory and selenium supplementation only partly relieved clinical signs. Digital radiographs were performed antemortem and revealed a pathological fracture of the vertebral column. A CT scan was performed immediately postmortem. The imaging revealed lysis of the vertebral bodies of T8, T9, T12 and T13 and focal narrowing of the vertebral canal consistent with infectious osteomyelitis of the thoracic vertebral column. Histopathological examination and microbiological testing confirmed a multifocal discospondylitis and vertebral osteomyelitis of mixed bacterial origin.

Krónikus dialízis kapcsán kialakult destruktív cervicalis spondylarthropathia esete

2021 ◽  
Vol 74 (5-6) ◽  
pp. 211-215
Author(s):  
Balázs Berta ◽  
Hedvig Komáromy ◽  
Attila Schwarcz ◽  
Béla Kajtár ◽  
András Büki ◽  
...  
Keyword(s):  
Bone Graft ◽  
Vertebral Body ◽  
Posterior Instrumentation ◽  
Plate Fixation ◽  
Neurological Deficits ◽  
Pulmonary Insufficiency ◽  
Unstable Fracture ◽  
Pathologic Fractures ◽  
Vertebral Bodies

A case of a 61-year-old male patient suffered chronic renal failure and dialysed for 23 years with destructive cervical spondylarthropathy is presented. The patient presented with sudden onset of cervical pain radiating into his shoulders without neurological deficits. CT and MRI of the cervical and thoracic spine revealed severe destructive changes and compressive fractures of C6 and C7 vertebrae which caused the narrowing of the nerve root canals at these levels. A 360-degree fixation was performed to treat the unstable fracture and the patient’s pain (C6 and C7 corpectomy, autolog bone graft replacement of the two vertebral bodies, anterior plate fixation and posterior instrumentation with screws and rods). Postoperatively the patient had no significant pain, no neurological deficit and he was able to manage independent life himself. During the immediate follow-up CT of the neck showed the satisfactory position of the bone graft and the metal implantations. The 6 months follow-up CT revealed the anterior migration of the two screws from the Th1 vertebral body and 2 mm ventral elevation of the caudal end of the plate from the anterior surface of the Th1 vertebral body. The 1-year follow-up could not be performed because the patient died due to cardio-pulmonary insufficiency. This is the second Hungarian report of a chronic dialysis related severe spondylarthropathy which may cause pathologic fractures of the vertebral bodies. The typical radiological and histological findings are discussed. This disease affect patients’ quality of life and the conservative treatment alone seems to be ineffective in most cases. Based on the literature and personal experiences, the authors suggest 360-degree fixation of the spine to provide sufficient stability for the vertebrae of ”bad bone quality”, and early mobilisation of the patient can be achieved.

Multiple Subpial Transections in Eloquent Cortex for Refractory Epilepsy: 2-Dimensional Operative Video

2019 ◽  
Vol 19 (2) ◽  
pp. E167-E167
Author(s):  
Alexander C Whiting ◽  
Claudio Cavallo ◽  
Nicholas Rubel ◽  
Joshua S Catapano ◽  
Corey T Walker ◽  
...  
Keyword(s):  
Superior Temporal Gyrus ◽  
Neurological Deficits ◽  
Seizure Focus ◽  
Pars Opercularis ◽  
Eloquent Cortex ◽  
Surgical Treatments ◽  
Preoperative Work Up ◽  
Work Up ◽  
Neurologically Intact

Abstract Although the epilepsy refractory to medical therapy can potentially be cured by the resection of epileptogenic tissue, many patients do not qualify for surgery, because epileptogenic tissue can arise from eloquent areas of the brain, where surgical resection would result in severe neurological deficits. Palliative surgical treatments currently used in these situations include deep brain stimulation, responsive neurostimulation, and vagal nerve stimulation.1 A previously developed technique, multiple subpial transections (MSTs), although used infrequently, is another effective tool.2 Our patient, a 34-yr-old man, had epilepsy that was refractory to medical management. His preoperative work-up demonstrated a potential seizure focus in the left pars opercularis and left superior temporal gyrus, which was verified using invasive stereoelectroencephalography. Functional magnetic resonance imaging demonstrated a significant verbal and motor function in this region. After informed consent was obtained, the patient underwent a left-sided craniotomy. The central portion of the seizure focus was resected using the subpial technique. The surrounding presumed epileptogenic cortex, which was considered functionally eloquent, was then horizontally disconnected with MSTs. For each transection, a small puncture incision was made in the pia, and a vertical cut was completed using Morrell dissectors.2 MSTs were performed circumferentially around the entire resection cavity in 5-mm increments. All hemostasis was achieved with irrigation instead of electrocautery, although noncauterizing hemostatic agents are also acceptable. The patient was neurologically intact after the operation and was discharged home on postoperative day 2. He was free of seizures at 11-month follow-up. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.

Surgery for Skull Base Malignancies-Preoperative Work-Up to Minimize Complications

Skull Base ◽  
2008 ◽  
Vol 18 (S 01) ◽  
Author(s):  
Andrew King ◽  
Stephen MacNally ◽  
Jarod Homer ◽  
Richard Ramsden ◽  
Shakeel Saeed ◽  
...  
Keyword(s):  
Skull Base ◽  
Preoperative Work Up ◽  
Work Up

scholarly journals Investigation of an EHV-1 Outbreak in the United States Caused by a New H752 Genotype

Pathogens ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 747
Author(s):  
Nicola Pusterla ◽  
Samantha Barnum ◽  
Julia Miller ◽  
Sarah Varnell ◽  
Barbara Dallap-Schaer ◽  
...  
Keyword(s):  
Early Stage ◽  
Clinical Signs ◽  
Amino Acid Position ◽  
High Viral Load ◽  
The United States ◽  
Neurological Deficits ◽  
Diagnostic Challenge ◽  
Genotype I ◽  
Flunixin Meglumine ◽  
Nasal Secretions

Here we report on an EHV-1 outbreak investigation caused by a novel genotype H752 (histidine in amino acid position 752 of the ORF 30 gene). The outbreak involved 31 performance horses. Horses were monitored over a period of 35 days for clinical signs, therapeutic outcome and qPCR results of EHV-1 in blood and nasal secretions. The morbidity of the EHV-1 outbreak was 84% with 26 clinically infected horses displaying fever and less frequently anorexia and distal limb edema. Four horses showed mild transient neurological deficits. Clinically diseased horses experienced high viral load of EHV-1 in blood and/or nasal secretions via qPCR, while subclinically infected horses had detectable EHV-1 mainly in nasal secretions. The majority of infected horses showed a rise in antibody titers to EHV-1 during the outbreak. All 31 horses were treated with valacyclovir, while clinically infected horses further received flunixin meglumine and sodium heparin. This investigation highlights various relevant aspects of an EHV-1 outbreak caused by a new H752 genotype: (i) importance of early detection of EHV-1 infection; (ii) diagnostic challenge to assess H752 genotype; (iii) apparent benefit of valacyclovir use in the early stage of the outbreak; and (iv) weekly testing of blood and nasal secretions by qPCR in order to monitor individual infection status and lift quarantine.

scholarly journals Surgical Management of Sporadic Peripheral Nerve Schwannomas in Adults: Indications and Outcome in a Single Center Cohort

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1017
Author(s):  
Julian Zipfel ◽  
Meizer Al-Hariri ◽  
Isabel Gugel ◽  
Alexander Grimm ◽  
Volker Steger ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Clinical Signs ◽  
Complete Resection ◽  
Adult Patients ◽  
Neurological Deficits ◽  
Primary Tumors ◽  
Surgical Interventions ◽  
Nerve Sheath Tumors ◽  
Peripheral Nerve Sheath Tumors ◽  
Nerve Sheath

Most sporadic peripheral nerve sheath tumors in adults are schwannomas. These tumors usually present with significant pain but can also cause neurological deficits. Symptomatology is diverse, and successful surgical interventions demand interdisciplinarity. We retrospectively reviewed 414 patients treated between 2006 and 2017 for peripheral nerve sheath tumors. We analyzed clinical signs, symptoms, histology, and neurological function in the cohort of adult patients with schwannomas without a neurocutaneous syndrome. In 144 patients, 147 surgical interventions were performed. Mean follow-up was 3.1 years. The indication for surgery was pain (66.0%), neurological deficits (23.8%), significant tumor growth (8.8%), and suspected malignancy (1.4%). Complete tumor resection was achieved on 136/147 occasions (92.5%). The most common location of the tumors was intraspinal (49.0%), within the cervical neurovascular bundles (19.7%), and lower extremities (10.9%). Pain and neurological deficits improved significantly (p ≤ 0.003) after 131/147 interventions (89.1%). One patient had a persistent decrease in motor function after surgery. Complete resection was possible in 67% of recurrent tumors, compared to 94% of primary tumors. There was a significantly lower chance of complete resection for schwannomas of the cervical neurovascular bundle as compared to other locations. The surgical outcome of sporadic schwannoma surgery within the peripheral nervous system is very favorable in experienced peripheral nerve surgery centers. Surgery is safe and effective and needs a multidisciplinary setting. Early surgical resection in adult patients with peripheral nerve sheath tumors with significant growth, pain, neurological deficit, or suspected malignancy is thus recommended.

Magnetic Resonance Imaging of Spinal Cord Disease of Childhood

PEDIATRICS ◽  
1986 ◽  
Vol 78 (2) ◽  
pp. 251-256
Author(s):  
Roger J. Packer ◽  
Robert A. Zimmerman ◽  
Leslie N. Sutton ◽  
Larissa T. Bilaniuk ◽  
Derek A. Bruce ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Vertebral Body ◽  
Congenital Anomalies ◽  
Correct Diagnosis ◽  
Surface Coil ◽  
Resonance Imaging ◽  
Spinal Cord Disease ◽  
Magnetic Resonance Imaging Mri

Correct diagnosis of spinal cord disease in childhood is often delayed, resulting in irreversible neurologic deficits. A major reason for this delay is the lack of a reliable means to noninvasively visualize the spinal cord. Magnetic resonance imaging (MRI) should be useful in the evaluation of diseases of the spinal cord. A 1.5 Tesla MRI unit with a surface coil was used to study 41 children, including eight patients with intrinsic spinal cord lesions, eight patients with masses compressing the cord, 12 patients with congenital anomalies of the cord or surrounding bony structures, three patients with syrinxes, and three patients with vertebral body abnormalities. Intrinsic lesions of the cord were well seen in all cases as intrinsic irregularly widened, abnormally intense cord regions. MRI was helpful in following the course of disease in patients with primary spinal cord tumors. Areas of tumor were separable from syrinx cavities. Extrinsic lesions compressing the cord and vertebral body disease were also well visualized. Congenital anomalies of the spinal cord, including tethering and lipomatous tissue, were better seen on MRI than by any other radiographic technique. MRI is an excellent noninvasive "screening" technique for children with suspected spinal cord disease and may be the only study needed in many patients with congenital spinal cord anomalies. It is also an excellent means to diagnose and follow patients with other forms of intra- and extraspinal pathology.

scholarly journals Cerebellar peduncle abscess secondary to disseminated strangles in a six-week-old miniature foal

2011 ◽  
Vol 1 (1) ◽  
pp. 12
Author(s):  
Brianne Henderson
Keyword(s):  
Animal Health ◽  
Clinical Signs ◽  
Acute Onset ◽  
Abscess Formation ◽  
Neurological Deficits ◽  
Post Mortem ◽  
Streptococcus Equi ◽  
The Central Nervous System ◽  
Cerebellar Peduncle ◽  
The Right

During a strangles outbreak within a herd of minature horses, a six week old foal developed acute onset clinical signs of sepsis and neurological deficits. The foal was euthanized and submitted for post-mortem at the Animal Health Laboratories, Guelph Ontario. Gross <em>post-mortem</em> examination noted severe bronchopneumonia, hypopyon of the right eye and a singular cerebellar peduncle abscess. Culture of the lungs and cerebellum produced a pure growth of <em>Streptococcus equi</em> ssp. <em>equi</em>. <em>Streptococcus equi</em> ssp. <em>equi</em>, the causative agent of equine strangles, produces an acute pyrexia, purulent lymphadenopathy of submandibular and retropharyngeal lymph nodes. Commonly, lymph node abscesses rupture and resolve without complication. Rarely, complications may include: dissemination of the bacteria with diffuse abscess formation, immune mediated disease (purpura haemorrhagica), rarely abscess formation within the central nervous system (CNS) can occur. These can be managed medically with appropriate antibiotics and drugs to reduce intra-cranial pressure, however surgical drainage and debulking of the abscess has been attempted successfully in a few cases.

scholarly journals Comparison of MRI and colonoscopy in determining tumor height in rectal cancer

2017 ◽  
Vol 6 (1) ◽  
pp. 131-137 ◽  
Author(s):  
Lotte Jacobs ◽  
David B Meek ◽  
Joost van Heukelom ◽  
Thomas L Bollen ◽  
Peter D Siersema ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Intraclass Correlation ◽  
Rectal Tumor ◽  
Height Measurement ◽  
Treatment Allocation ◽  
Large Variability ◽  
Magnetic Resonance Imaging Mri ◽  
Preoperative Work Up ◽  
Work Up

Background and aim Endoscopy and magnetic resonance imaging (MRI) are used routinely in the diagnostic and preoperative work-up of rectal cancer. We aimed to compare colonoscopy and MRI in determining rectal tumor height. Methods Between 2002 and 2012, all patients with rectal cancer with available MRIs and endoscopy reports were included. All MRIs were reassessed for tumor height by two abdominal radiologists. To obtain insight in techniques used for endoscopic determination of tumor height, a survey among regional endoscopists was conducted. Results A total of 211 patients with rectal cancer were included. Tumor height was significantly lower when assessed by MRI than by endoscopy with a mean difference of 2.5 cm (95% CI: 2.1–2.8). Although the agreement between tumor height as measured by MRI and endoscopy was good (intraclass correlation coefficient (ICC) 0.7 (95% CI: 0.7–0.8)), the 95% limits of agreement varied from –3.0 cm to 8.0 cm. In 45 patients (21.3%), tumors were regarded as low by MRI and middle–high by endoscopy. MRI inter- and intraobserver agreements were excellent with an ICC of 0.8 (95% CI: 0.7–0.9) and 0.9 (95% CI: 0.9–1.0), respectively. The survey showed no consensus among endoscopists as to how to technically measure tumor height. Conclusion This study showed large variability in rectal tumor height as measured by colonoscopy and MRI. Since MRI measurements showed excellent inter- and intraobserver agreement, we suggest using tumor height measurement by MRI for diagnostic purposes and treatment allocation.

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