scholarly journals Acute Polyradiculomyelitis With Spinal Cord Gray Matter Lesions: A Report of Two Cases

2021 ◽  
Vol 12 ◽  
Author(s):  
Charidimos Tsagkas ◽  
Maria Janina Wendebourg ◽  
Matthias Mehling ◽  
Johannes Lorscheider ◽  
Philippe Lyrer ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Gray Matter ◽  
Case Reports ◽  
Motor Impairment ◽  
Bowel Dysfunction ◽  
Motor Deficits ◽  
Spinal Cord Lesions ◽  
Rare Presentation ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal

Objective: Inflammatory polyradiculomyelitis belongs to a rare group of immune-mediated diseases affecting both the central and peripheral nervous system. We aimed to describe an unusual presentation of acute polyradiculomyelitis with marked spinal cord lesions restricted to the gray matter.Methods: Thorough examination of two case reports including clinical, MRI, serologic, electrophysiologic and CSF examinations as well as short-term follow-up.Results: We present two adult patients with acute polyradiculomyelitis and unusual spinal cord lesions restricted to the gray matter on MRI. The clinical presentation, serologic, electrophysiologic and CSF features of the two patients varied, whereas both patients demonstrated severe, asymmetrical, predominantly distal, motor deficits of the lower extremities as well as bladder and bowel dysfunction. Both patients only partially responded to anti-inflammatory treatment. Severe motor impairment and bladder dysfunction persisted even months after symptom onset.Conclusions: To our best of knowledge, these are the first reports of acute polyradiculomyelitis with distinct involvement of the lower thoracic spinal cord gray matter. Currently, it remains unclear whether gray matter lesions reflect a separate pathophysiologic mechanism or an exceedingly rare presentation of spinal cord involvement in acute polyradiculomyelitis.

scholarly journals Association Between Thoracic Spinal Cord Gray Matter Atrophy and Disability in Multiple Sclerosis

2015 ◽  
Vol 72 (8) ◽  
pp. 897 ◽  
Author(s):  
Regina Schlaeger ◽  
Nico Papinutto ◽  
Alyssa H. Zhu ◽  
Iryna V. Lobach ◽  
Carolyn J. Bevan ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Gray Matter ◽  
Thoracic Spinal Cord ◽  
Gray Matter Atrophy ◽  
Thoracic Spinal

scholarly journals Central neuropathic pain in MS is due to distinct thoracic spinal cord lesions

2014 ◽  
Vol 1 (8) ◽  
pp. 554-561 ◽  
Author(s):  
Darin T. Okuda ◽  
Kara Melmed ◽  
Takashi Matsuwaki ◽  
Anders Blomqvist ◽  
Arthur D. Bud Craig
Keyword(s):  
Spinal Cord ◽  
Neuropathic Pain ◽  
Spinal Cord Lesions ◽  
Thoracic Spinal Cord ◽  
Central Neuropathic Pain ◽  
Thoracic Spinal

scholarly journals A pathway of NADPH diaphorase positivity between central canal and pial surface at anterior fissure in spinal cord: Supra fissure area with hypothesis configuring from dog, rat, monkey and pigeon

2020 ◽  
Author(s):  
Yunge Jia ◽  
Yinhua Li ◽  
Wei Hou ◽  
Fuhong Li ◽  
Haoran Sun ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Gray Matter ◽  
Anterior Commissure ◽  
Central Canal ◽  
Nadph Diaphorase ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Enzyme Histology ◽  
Aged Monkey ◽  
Anterior Median

ABSTRACTThe spinal cord is a cylinder structure in the vertebra and thought a simplified with the gray matter and white matter. Rexed lamination for the gray matter and regional sub-division for whiter matter are completely termed to date. Anterior commissure locates between the central canal and the anterior median fissure. However, some experimental data may still confront with new confined anatomical interpretation. By using NADPH diaphorase [N-d] enzyme histology, we found a vertical oriented neuronal pathway between the central canal and the anterior median fissure in the sacral spinal cord of young adult and aged dog. We used a term “supra fissure area” [SFA] to illustrate the region which consisted of the gray commissure and anterior white commissure. The N-d pathway was notably observable in aged animals. The vertical neurites revealed the cerebrospinal fluid [CSF] contacting neurites between the anterior median fissure and the central canal. We further examined the monkey, rat and pigeon in the region for better understanding of the structure and potential function. The neurodegeneration of N-d dystrophy was detected in the [SFA] in the thoracic spinal cord of the aged monkey. N-d positive fibers were detected in anterior fissure of the rat spinal cord. N-d fibrous structures were also detected in the pigeon spinal cord. These results suggested a new pathway of CSF contacting neurons and the neuronal communications about the central canal.

Effects of epidural hypothermic saline infusion on locomotor outcome and tissue preservation after moderate thoracic spinal cord contusion in rats

2005 ◽  
Vol 2 (3) ◽  
pp. 308-318 ◽  
Author(s):  
Carlos E. Casas ◽  
Loren P. Herrera ◽  
Chad Prusmack ◽  
Gladys Ruenes ◽  
Alexander Marcillo ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Gray Matter ◽  
Thoracic Spinal Cord ◽  
Content Type ◽  
Treatment Groups ◽  
Thoracic Spinal ◽  
Cord Injury ◽  
Spinal Cord Contusion ◽  
Tissue Sparing ◽  
Fine Print

Object. Regionally delivered hypothermia has advantages over systemic hypothermia for clinical application following spinal cord injury (SCI). The effects of local hypothermia on tissue sparing, neuronal preservation, and locomotor outcome were studied in a moderate thoracic spinal cord contusion model. Methods. Rats were randomized to four treatment groups and data were collected and analyzed in a blinded fashion. Chilled saline was perfused into the epidural space 30 minutes postcontusion to achieve the following epidural temperatures: 24 ± 2.3°C (16 rats), 30 ± 2.4°C (13 rats), and 35 ± 0.9°C (13 rats). Hypothermia was continued for 3 hours when a 45-minute period of rewarming was instituted. In a fourth group a moderate contusion only was induced in 14 animals. Rectal (core) and T9–10 (epidural) temperatures were measured continuously. Locomotor testing, using the Basso-Beattie-Bresnahan (Ba-Be-Br) scale, was performed for 6 weeks, and rats were videotaped for subsequent analysis. The lesion/preserved tissue ratio was calculated throughout the entire lesion cavity and the total lesion, spinal cord, and spared tissue volumes were determined. The rostral and caudal extent of gray matter loss was also measured. At 6 weeks locomotor recovery was similar in all groups (mean Ba-Be-Br Scale scores 14.88 ± 3.71, 14.83 ± 2.81, 14.50 ± 2.24, and 14.07 ± 2.39 [p = 0.77] for all four groups, respectively). No significant differences in spared tissue volumes were found when control and treatment groups were compared, but gray matter preservation was reduced in the infusion-treated groups. Conclusions. Regional cooling applied 30 minutes after a moderate contusive SCI was not beneficial in terms of tissue sparing, neuronal preservation, or locomotor outcome. This method of cooling may reduce blood flow in the injured spinal cord and exacerbate secondary injury.

scholarly journals Endocrine signaling mediates asymmetric motor deficits after unilateral brain injury

2020 ◽  
Author(s):  
Nikolay Lukoyanov ◽  
Hiroyuki Watanabe ◽  
Liliana S. Carvalho ◽  
Olga Nosova ◽  
Daniil Sarkisyan ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Brain Injury ◽  
Neural Control ◽  
Expression Patterns ◽  
Lumbar Spinal Cord ◽  
Motor Deficits ◽  
Postural Asymmetry ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Unilateral Brain

AbstractA paradigm in neurology is that brain injury-induced motor deficits (e.g. hemiparesis and hemiplegia) arise due to aberrant activity of descending neural pathways. We discovered that a unilateral injury of the hindlimb sensorimotor cortex of rats with completely transected thoracic spinal cord produces hindlimb postural asymmetry with contralateral flexion, and asymmetric changes in nociceptive hindlimb withdrawal reflexes and gene expression patterns in lumbar spinal cord. The injury-induced postural effects were abolished by prior hypophysectomy and were mimicked by transfusion of serum from animals with unilateral brain injury. Antagonists of the opioid and vasopressin receptors blocked formation of hindlimb postural asymmetry suggesting that these neurohormones mediate effects of brain injury on lateralized motor responses. Our data indicate that descending neural control of spinal circuits is complemented by a previously unknown humoral signaling from injured brain to the contra- and ipsilesional hindlimbs, and suggest the existence of a body side-specific neuroendocrine regulation in bilaterally symmetric animals.

Regression of Recurrent Spinal Cord High-Grade Glioma After Convection-Enhanced Delivery of Nimustine Hydrochloride: Case Reports and Literature Review

2019 ◽  
Author(s):  
Toshiki Endo ◽  
Tomoo Inoue ◽  
Shinichiro Sugiyama ◽  
Ryuta Saito ◽  
Teiji Tominaga
Keyword(s):  
Spinal Cord ◽  
Case Reports ◽  
High Grade Glioma ◽  
Chemotherapeutic Agents ◽  
High Grade ◽  
Convection Enhanced Delivery ◽  
Thoracic Spinal Cord ◽  
Lower Extremity Weakness ◽  
Thoracic Spinal ◽  
Nimustine Hydrochloride

Abstract BACKGROUND Spinal cord high-grade glioma has poor prognosis. Especially, no treatment protocols have been established for recurrent cases. OBJECTIVE To apply a novel treatment method, convection-enhanced delivery (CED), for recurrent high-grade glioma. CED can deliver chemotherapeutic agents directly into the intramedullary lesion and possibly lead to remarkable regression of enlarging tumors that are, otherwise, difficult to control. METHODS Two patients developed high-grade glioma in the thoracic spinal cord. Partial resection and chemotherapy and radiotherapy induced remission of the disease. However, following the initial treatment, recurrence was noted in the spinal cord at 6 and 12 mo, respectively. No effective treatment was available for these recurrent lesions. Therefore, the authors decided to use CED to infuse nimustine hydrochloride (ACNU) directly into the spinal cord. During the procedure, the infusion cannula was inserted into the spinal cord lesion under intraoperative computed tomography scan. RESULTS After ACNU CED, successive magnetic resonance imaging confirmed remarkable shrinkages of the tumors in both cases. However, the patient's preinfusion symptoms, including bilateral lower extremity weakness, did not change after the treatment. Importantly, overall survivals of the 2 patients were as long as 67 and 33 mo. CONCLUSION The authors report the first 2 cases of recurrent spinal cord high-grade glioma. ACNU CED dramatically regressed enhanced mass lesions and provided local tumor controls in the spinal cord.

scholarly journals Thoracic spinal cord lesions are influenced by the degree of cervical spine involvement in multiple sclerosis

Spinal Cord ◽  
2015 ◽  
Vol 53 (7) ◽  
pp. 520-525 ◽  
Author(s):  
L H Hua ◽  
S L Donlon ◽  
M J Sobhanian ◽  
S M Portner ◽  
D T Okuda
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Cervical Spine ◽  
Spinal Cord Lesions ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal

Cardiovascular responses to arm static exercise in men with thoracic spinal cord lesions

2011 ◽  
Vol 112 (2) ◽  
pp. 661-666 ◽  
Author(s):  
Keiko Sakamoto ◽  
Takeshi Nakamura ◽  
Yasunori Umemoto ◽  
Yumi Koike ◽  
Yusuke Sasaki ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cardiovascular Responses ◽  
Static Exercise ◽  
Spinal Cord Lesions ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal

Progressive motor impairment from a critically located lesion in highly restricted CNS-demyelinating disease

2018 ◽  
Vol 24 (11) ◽  
pp. 1445-1452 ◽  
Author(s):  
B Mark Keegan ◽  
Timothy J Kaufmann ◽  
Brian G Weinshenker ◽  
Orhun H Kantarci ◽  
William F Schmalstieg ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Demyelinating Disease ◽  
Cervical Spinal Cord ◽  
Motor Impairment ◽  
Subcortical White Matter ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Demyelinating Lesions ◽  
Magnetic Resonance Imaging Mri

Objective: To report progressive motor impairment from a critically located central nervous system (CNS) demyelinating lesion in patients with restricted magnetic resonance imaging (MRI)-lesion burden. Methods: We identified 38 patients with progressive upper motor-neuron impairment for >1 year, 2–5 MRI CNS-demyelinating lesions, with one seemingly anatomically responsible for progressive motor impairment. Patients with any alternative etiology for progressive motor impairment were excluded. A neuroradiologist blinded to clinical evaluation reviewed multiple brain and spinal-cord MRI, selecting a candidate critically located demyelinating lesion. Lesion characteristics were determined and subsequently compared with clinical course. Results: Median onset age was 47.5 years (24–64); 23 (61%) women. Median follow-up was 94 months (18–442); median Expanded Disability Status Scale Score (EDSS) at last follow-up was 4.5 (2–10). Clinical presentations were progressive: hemiparesis/monoparesis 31; quadriparesis 5; and paraparesis 2; 27 patients had progression from onset; 11 progression post-relapse. Total MRI lesions were 2 ( n = 8), 3 ( n = 12), 4 ( n = 12), and 5 ( n = 6). Critical lesions were located on corticospinal tracts, chronically atrophic in 26/38 (68%) and involved cervical spinal cord in 27, cervicomedullary/brainstem region in 6, thoracic spinal cord in 4, and subcortical white matter in 1. Conclusion: Progressive motor impairment may ascribe to a critically located CNS-demyelinating lesion in patients with highly restricted MRI burden. Motor progression from a specific demyelinating lesion has implications for understanding multiple sclerosis (MS) progression.

Case reports

Neurosurgery ◽  
1991 ◽  
Vol 29 (6) ◽  
pp. 893-898 ◽  
Author(s):  
Cheryl P. Harris ◽  
Mark S. Dias ◽  
Douglas L. Brockmeyer ◽  
Jeannette J. Townsend ◽  
Brian K. Willis ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cerebellopontine Angle ◽  
Case Reports ◽  
Primitive Streak ◽  
Jugular Foramen ◽  
Thoracic Spinal Cord ◽  
Prepontine Cistern ◽  
Thoracic Spinal ◽  
Upper Thoracic ◽  
4Th Ventricle

Abstract Neurenteric cysts are endothelium-lined structures most commonly encountered in the lower cervical or upper thoracic spinal cord. The occurrence of neurenteric cysts within the cranial vault is unusual. We present three patients with neurenteric cysts located within the posterior fossa: one near the jugular foramen deforming the 4th ventricle, a second in the cerebellopontine angle, and a third in the prepontine cistern. Several different theories have been advanced to explain the embryogenesis of neurenteric cysts. We review these theories and conclude that cranial neurenteric cysts may arise from a disturbance of early gastrulation, shortly after the onset of primitive streak regression.

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