scholarly journals Intradural migration of bullet in vertebra corpus after meningitis

2020 ◽  
pp. 570-573
Author(s):  
Halil İbrahim Gündüz ◽  
Turan Kandemir
Keyword(s):  
Spinal Cord ◽  
Male Patient ◽  
Spinal Canal ◽  
The Body ◽  
Gunshot Injury ◽  
Diagnosis And Treatment ◽  
Thoracic Region ◽  
Neural Damage ◽  
Over Time

In a gunshot injury, the spinal cord of the thoracic region is usually the most affected and damaged part of the body. In most cases, the bullet cannot be removed without causing more damage to the injury. Over time, the bullet tends to travel in different areas of the body. Moreover, cases on bullet movements in the spinal canal were reported in the literature. In this study, we reviewed the diagnosis and treatment of a 27-year-old male patient with a bullet detected in his vertebra corpus, which is caused by a gunshot injury. During the follow-up period, an intradural migration of the bullet from the vertebra corpus was observed. Furthermore, we performed surgery to prevent any future neural damage. In this study, we focused on a case with a gunshot injury, presenting an intradural migration of a bullet from the vertebra corpus after meningitis.

A Sialolith and a Megalith: a Report of Two Cases

Dental Update ◽  
2020 ◽  
Vol 47 (1) ◽  
pp. 71-74
Author(s):  
Jawaad Ahmed Asif ◽  
Paras Ahmad ◽  
Tahir Yusuf Noorani
Keyword(s):  
Early Diagnosis ◽  
Salivary Glands ◽  
Submandibular Gland ◽  
Male Patient ◽  
Clinical Relevance ◽  
Diagnosis And Treatment ◽  
Normal Functioning ◽  
First Case ◽  
Free Swelling

Sialolithiasis is considered as one of the most frequently encountered diseases of the salivary glands. The most susceptible site is the submandibular gland and its duct. However, megaliths have been sparsely reported in the literature. This article portrays management of a sialolith and a megalith in a 26-year-old and a 59-year-old male patient, respectively. The sialolith in the first case case was 4 mm long, whereas the second case demonstrated a megalith measuring 46 mm at its greatest size. Follow-up revealed normal functioning and a painless gland in the first case, while the second case showed no eventful complications. It is interesting to know that both patients remained relatively pain-free, despite having such longstanding sialolith/megaliths. After removal of the small sialolith, the gland regained its normal functioning swiftly, whereas in the case of the megalith, the gland removal was mandatory because such a longstanding megalith led to irreversible functional injury to the gland. CPD/Clinical Relevance: A giant sialolith can be easily misdiagnosed as a submandibular infection or neoplasm, especially when the patient presents with a longstanding pain-free swelling. Hence, early and appropriate referral and investigation is necessary for early diagnosis and treatment.

scholarly journals Intramedullary Spinal Capillary Hemangioma: Case Report

2015 ◽  
Vol 36 (02) ◽  
pp. 125-127
Author(s):  
Leonardo Welling ◽  
Mariana Welling ◽  
Eberval Figueiredo
Keyword(s):  
Spinal Cord ◽  
Complete Removal ◽  
Conus Medullaris ◽  
Capillary Hemangioma ◽  
The Body ◽  
Accurate Information ◽  
Histopathological Diagnosis ◽  
Intramedullary Lesion ◽  
History Of

AbstractCapillary hemangiomas involving the neuraxis are very uncommon. In the spinal cord, they are located mainly intradural and extramedullary. To our knowledge, only four cases in conus medullaris have been previously described. In our case, a 46-year-old man was admitted with back pain, sphincter disturbances, as well as progressive weakness and numbness on the lower extremities. Magnetic resonance imaging revealed an undefined intramedullary lesion on the conus medullaris. The patient underwent microsurgery, which achieved complete removal. Histopathological diagnosis was compatible with capillary hemangioma. His postoperative course was uneventful and all symptoms, including bladder dysfunction clearly regressed. The treatment of intramedullary capillary hemangiomas is very critical in preventing unnecessary morbidity, providing accurate information with respect to prognosis, and establishes a regular outpatient follow-up. The natural history of this lesion involving the spinal cord is not well described, although they are common elsewhere in the body.

scholarly journals Intervertebral Disc Extrusion between T8 and T9 in a Dachshund

2016 ◽  
Vol 44 (1) ◽  
pp. 4
Author(s):  
Gabriel Antonio Covino Diamante ◽  
Paulo Vinicius Tertuliano Marinho ◽  
Carolina Camargo Zani ◽  
Bruno Cesar Elias ◽  
Mônica Vicky Bahr Arias
Keyword(s):  
Spinal Cord ◽  
Intervertebral Disc ◽  
Spinal Canal ◽  
Clinical Signs ◽  
Type I ◽  
Thoracic Region ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Rib Head ◽  
Disc Extrusion

Background: Intervertebral disc extrusion with consequent spinal compression or intervertebral disc disease (IVDD) is one of the most common causes of compressive myelopathy in dogs, and the thoracolumbar spine discs between T12 and L2 are most affected. Extrusions in cranial thoracic region are rare, and there is few cases in literature reporting this situations, this rarity is attributed to the presence of the intercapital ligament connecting the rib heads between T2 and T10, which strengthens this region both mechanically and anatomically. The aim of this article is report the clinical signs, diagnosis and treatment of a case of Type I Hansen IVDD between T8 and T9 in a Dachshund breed dog.Case: An 8-year-old Dachshund male dog was presented for investigation of pelvic limb incoordination and back pain, which started 10 days prior to the consultation. It had a history of a similar condition 3 months earlier that showed improvement after clinical treatment. On neurological examination was identified in both pelvic limbs proprioceptive ataxia, absence of proprioception, increased muscle tone, presence of interdigital reflex and increased patellar reflex. Cutaneous trunci reflex was absent below T11 on the left side, and pain was noted upon palpation of T7 through the T12 vertebrae. A grade II asymmetric thoracolumbar lesion with hyperesthesia was diagnosed. On suspicion of IVDD, cerebrospinal fluid (CSF) collection and CT scan analysis of the thoracolumbar region were performed. CT scan showed the presence of hyperattenuating and mineralized material, 1 cm long, on the floor of the spinal canal, mainly on the left side, occupying 80% of the diameter of the spinal canal between T8 and T9. The patient was then submitted to decompression surgery through hemilaminectomy and showed a good recovery. As the occurrence of disc extrusion in cranial thoracic region of chondrodystrophic breeds is rare, we report the clinical signs, diagnosis and treatment of a case of Type I Hansen intervertebral disc disease (IVDD) between T8 and T9 in a Dachshund breed dog.Discussion: All spinal discs can undergo a process of degeneration causing IVDD, in which the cervical and thoracolumbar regions are the most affected due to reasons not yet fully understood, however spinal cord compression between the T1 and T9 vertebrae is very rare, probably due to the strengthening provided by the intercapital ligament to the posterior annulus fibrosus. Disc extrusion in unusual locations in chondrodystrophic breeds is mainly reported as extrusion between vertebrae T1 and T2, and T9 and T10, with some cases was attributed to an anatomical abnormality of the intercapital ligament. The evaluation of intervertebral discs of the German shepherd breed dogs using MRI showed disc degeneration processes in thoracic vertebras. Disc extrusions often result in more severe clinical signs than protrusions, and occur acutely or subacutely, which was different from the case described here, maybe because the presence of the intercapital ligament permitted gradual extrusion allowing the spinal cord to adapt to the compression. Despite surgical access to this region being described as more complex due to the presence and proximity of the rib head to the vertebral body and the possibility of injuring the intercostal muscles causing pneumothorax, the hemilaminectomy and rib head excision at T9 could be performed without any complications. Thus, although unusual, the cranial thoracic region should not be overlooked as a possible site of occurrence of IVDD, since the diagnosis, treatment and prognosis are similar to those in patients with extrusions in the most common sites.Keywords: intervertebral disc degeneration, dogs, paresis, ataxia.

scholarly journals Postural deficiency in children with spinal stenosis

2018 ◽  
Vol 6 (4) ◽  
pp. 13-19
Author(s):  
Igor E. Nikityuk ◽  
Elizaveta L. Kononova ◽  
Sergei V. Vissarionov
Keyword(s):  
Spinal Cord ◽  
Regression Analysis ◽  
Spinal Stenosis ◽  
Thoracic Spine ◽  
Postural Balance ◽  
Spinal Canal ◽  
The Body ◽  
Congenital Deformity ◽  
Healthy Children ◽  
Mean Power

Introduction. Stenosis of the spinal canal can be accompanied by abnormalities of gait and body balance. At the same time, changes occurring in the postural control in children with spinal stenosis remain unexplored. Aim. To study postural stability in children with spinal stenosis and assess the imbalance of the body depending on the level of stenosis localization. Material and methods. This study investigated 14 patients, aged 10–17 years, with stenosis of the spinal canal. The first group consisted of seven patients with spinal stenosis due to congenital deformity of the thoracic spine with spinal cord compression at the stenosis level. The second group consisted of seven patients with spondylolisthesis of the L5 vertebra body of grades 3–4, accompanied with spinal cord root compression. The control group consisted of seven healthy children of the same age. We used stabilometry, and statistical study included correlation-regression analysis. Results. A significant deviation of the stabilometric parameters was noted only in the first group of patients (p < 0.05). In the same group, a strong correlation was found between the parameters of statokinesiogram: area S, length L, amplitude A, and mean power level of the spectrum of f 60%, which were much higher than those of healthy children, which may indicate a pathologically high synchronization of the vertical balance control system of the body. Other changes were revealed, such as a strong relationship between L/S and A at normal stabilometric parameters and a moderate force between L/A and f 60%, indicating postural deficiency in the group of patients with stenosis at the level of the lumbosacral spine. Correlation-regression analysis for assessing the postural balance in both groups of patients showed a correlation between parameters L, S, A, and f 60%, which were significantly higher than those in healthy children and most pronounced in the thoracic localization of stenosis. Conclusion. The system of maintaining vertical balance of the body in children with stenosis of the spinal canal at the level of the thoracic spine has a more pronounced deficiency than that in patients with stenosis of the canal at the lumbosacral level. To reveal hidden violations of the postural balance, the relationship between length, area, amplitude, and mean power of the statokinesiogram must be evaluated.

Maximum Medical Improvement

2014 ◽  
Vol 19 (1) ◽  
pp. 8-10
Author(s):  
Charles N. Brooks ◽  
Christopher R. Brigham
Keyword(s):  
Spinal Cord ◽  
Clinical Study ◽  
Soft Tissue Injuries ◽  
Severe Injuries ◽  
Acute Injuries ◽  
Study Results ◽  
Physical Findings ◽  
Severe Soft Tissue ◽  
Over Time

Abstract Most acute injuries and illnesses resolve, ie, reach maximum medical improvement (MMI), within days or weeks and without permanent impairment. Fractures, more severe soft tissue injuries and illness, and conditions that require surgery take longer to reach MMI, often about a year, with a range of six months to two years. Serious head, spinal cord, and other catastrophic injuries commonly take two or more years to reach MMI. These more severe injuries and illnesses understandably are more likely to result in permanent impairment. However, various parties to the claim process may request impairment rating prematurely: The claimant or plaintiff whose injury or illness has resulted in loss of income and financial hardship may push for an early impairment award or settlement. The surgeon who has operated and is done with postoperative follow-up may want to be rid of claim forms and move on to other patients. The overburdened adjuster may want to get the claim closed, thereby diminishing their workload. But rating impairment prior to MMI, ie, before it is permanent, often results in erroneously inflated ratings. In general, functional status, physical findings, and/or clinical study results improve over time, sometimes with and sometimes without treatment. This usually results in a concurrent decrease in, and sometimes even resolution of, impairment. With knowledge of the appropriate terminology and definitions, the evaluating physician should be able to render an opinion regarding MMI that is both understandable and legally sustainable in the applicable jurisdiction.

Decrease in incidence of sexually transmitted infections symptoms in men who have sex with men enrolled in a quarterly HIV prevention and care programme in West Africa (CohMSM ANRS 12324—Expertise France)

2021 ◽  
pp. sextrans-2020-054755
Author(s):  
Issifou Yaya ◽  
Fodié Diallo ◽  
Malan Jean-Baptiste Kouamé ◽  
Mawuényégan Kouamivi Agboyibor ◽  
Issa Traoré ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
West Africa ◽  
Total Duration ◽  
Diagnosis And Treatment ◽  
Trend Test ◽  
Mixed Effect ◽  
Care Programme ◽  
Sex With Men ◽  
Over Time

ObjectiveAlthough men who have sex with men (MSM) are at high risk of STI, their access to tailored healthcare services remains limited in West Africa. We assessed the change in STI symptoms incidence over time among MSM enrolled in a quarterly HIV prevention and care programme in four cities in Burkina Faso, Côte d’Ivoire, Mali and Togo.MethodsWe performed a prospective cohort study in MSM followed up between 2015 and 2019. Men aged over 18 who reported anal sex with another man within the previous 3 months were offered quarterly syndromic diagnosis and treatment for STI, as well as HIV testing, peer-led counselling and support. Condoms and lubricants were also provided. The change in STI symptoms incidence during follow-up was investigated using a non-parametric trend test and mixed-effect Poisson regression models.Results816 participants were followed for a total duration of 1479 person-years. 198 participants (24.3%) had at least one STI symptom during follow-up. Overall, STI symptoms incidence was 20.4 per 100 person-years (95% CI 18.4 to 22.6), ranging from 15.3 in Abidjan to 33.1 in Ouagadougou (adjusted incidence rate ratio (aIRR) 2.39, 95% CI 1.55 to 3.69, p<0.001). STI symptoms incidence was 16.8 and 23.0 per 100 person-years in HIV-positive and HIV-negative participants, respectively (aIRR 0.77, 95% CI 0.57 to 1.04, p=0.087). STI symptoms incidence decreased significantly from 29.9 per 100 person-years in the first 6 months to 8.6 at 30–35 months of follow-up (aIRR per 6-month increase 0.84, 95% CI 0.77 to 0.92, p<0.001).ConclusionSTI symptoms incidence decreased over time but the overall burden of STI appeared to be very high in MSM followed up in West Africa. STI services including counselling, diagnosis and treatment should be reinforced. Laboratory tests that allow accurate diagnosis of STI are required. Strengthening STI services will be critical for controlling the HIV and STI epidemics in this vulnerable population and in the general population.Trial registration numberNCT02626286.

scholarly journals Multiple meningiomas within the spinal canal: case report with 23 tumors

2005 ◽  
Vol 63 (1) ◽  
pp. 166-170 ◽  
Author(s):  
José Alberto Gonçalves da Silva ◽  
Maurus Marques de Almeida Holanda ◽  
Antônio Fernandes de Araújo ◽  
Roberto Vieira de Mello
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Spinal Canal ◽  
Thoracic Region ◽  
Multiple Meningiomas

In most series of neoplasms of the spinal canal, spinal cord and its leptomeninges, the incidence of meningioma group comprises approximately 25%. The incidence of multiple meningiomas is small when compared with the frequency of its single occurrence. In the majority of cases, their multiplicity is intracranial and spinal. Multiple meningiomas confined exclusively to the spinal canal are extremely rare. We report on a 33 years-old man, with 23 tumors located in the spinal thoracic region.

scholarly journals Changes in tonsillolith characteristics detected in a follow-up CT study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kouhei Yamashita ◽  
Masafumi Oda ◽  
Tatsurou Tanaka ◽  
Ikuko Nishida ◽  
Nao Wakasugi-Sato ◽  
...  
Keyword(s):  
Dynamic Change ◽  
Active Phase ◽  
The Body ◽  
Foreign Matter ◽  
The Mean ◽  
Almost All ◽  
Oral And Maxillofacial Regions ◽  
Over Time ◽  
Dynamic Fluctuation

Abstract Background Tonsilloliths are related clinically to halitosis and tonsillar abscess. However, the dynamics of tonsilloliths over time are unknown. The aim of the study was to evaluate change in the characteristics of tonsilloliths in a time-dependent fashion by follow-up computed tomography (CT). Methods Tonsilloliths were analyzed in 326 CT scan pair sets of initial and at least two follow-up CT examinations of patients with whole palatine tonsils and various diseases of the oral and maxillofacial regions. Results Over the follow-up period, 12.1% of tonsilloliths disappeared. Approximately 26.1% of tonsilloliths changed in size during follow-up, mostly increasing in size. In tonsilloliths that showed enlargement, the mean (± standard deviation) growth rate was 0.61 ± 0.41 mm per year. Approximately 37.3% of tonsilloliths changed position during the follow-up period; of these, movement was toward the respiratory tract in 92% at a mean rate of − 1.38 ± 1.59 mm per year. The calcification levels of almost all tonsilloliths showed dynamic change: HU number increased in 84.3% and decreased in 12.7% of tonsilloliths over the follow-up period. The mean rate of HU increase was 63.8 ± 96.3 HU/year, and the mean rate of HU decrease was − 38.4 ± 66.8 HU/year. Conclusions The calcification levels of all tonsilloliths showed dynamic fluctuation, and a tendency for excretion of tonsilloliths from the body. Their dynamics over time suggest that tonsilloliths may be in a permanently active phase which functions to remove foreign matter.

scholarly journals Delayed variations in the diagnostic accuracy of intraoperative neuromonitoring in the resection of intramedullary spinal cord tumors

2021 ◽  
Vol 50 (5) ◽  
pp. E21
Author(s):  
Gil Kimchi ◽  
Nachshon Knoller ◽  
Akiva Korn ◽  
Yahel Eyal-Mazuz ◽  
Yechiam Sapir ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Diagnostic Accuracy ◽  
Postoperative Period ◽  
Intraoperative Neuromonitoring ◽  
Spinal Cord Tumors ◽  
Intramedullary Spinal Cord ◽  
Over Time ◽  
D Wave

OBJECTIVE The use of intraoperative neuromonitoring (IONM) has become an imperative adjunct to the resection of intramedullary spinal cord tumors (IMSCTs). While the diagnostic utility of IONM during the immediate postoperative period has been previously studied, its long-term diagnostic accuracy has seldom been thoroughly assessed. The aim of this study was to evaluate long-term variations in the diagnostic accuracy of transcranial motor evoked potentials (tcMEPs), somatosensory evoked potentials (SSEPs), and D-wave recordings during IMSCT excision. METHODS The authors performed a retrospective evaluation of imaging studies, patient charts, operative reports, and IONM recordings of patients who were operated on for gross-total or subtotal resection of IMSCTs at a single institution between 2012 and 2018. Variations in the specificity, sensitivity, positive predictive value (PPV), and negative predictive value (NPV) for postoperative functional outcome (McCormick Scale) were analyzed at postoperative day 1 (POD1), 6 weeks postoperatively (PO-6 weeks), and at the latest follow-up. RESULTS Overall, 28 patients were included. The mean length of follow-up was 19 ± 23.4 months. Persistent motor attenuations occurred in 71.4% of the cohort. MEP was the most sensitive modality (78.6%, 87.5%, and 85.7% sensitivity at POD1, PO-6 weeks, and last follow-up, respectively). The specificity of the D-wave was the most consistent over time (100%, 83.35%, and 90% specificity at the aforementioned time points). The PPV of motor recordings decreased over time (58% vs 33% and 100% vs 0 for tcMEP and D-wave at POD1 and last follow-up, respectively), while their NPV consistently increased (67% vs 89% and 70% vs 100% for tcMEP and D-wave at POD1 and last follow-up, respectively). CONCLUSIONS The diagnostic accuracy of IONM in the resection of IMSCTs varies during the postoperative period. The decrease in the PPV of motor recordings over time suggests that this method is more predictive of short-term rather than long-term neurological deficits. The increasing NPV of motor recordings indicates a higher diagnostic accuracy in the identification of patients who preserve neurological function, albeit with an increased proportion of false-negative alarms for the immediate postoperative period. These variations should be considered in the surgical decision-making process when weighing the risk of resection-associated neurological injury against the implications of incomplete tumor resection.

scholarly journals Longitudinal Associations between Anatomical Regions of Pain and Work Conditions: A Study from The SwePain Cohort

2019 ◽  
Vol 16 (12) ◽  
pp. 2167 ◽  
Author(s):  
Elena Dragioti ◽  
Björn Gerdle ◽  
Britt Larsson
Keyword(s):  
Linear Models ◽  
Mechanical Strain ◽  
Job Demands ◽  
Work Conditions ◽  
The Body ◽  
Parameter Estimates ◽  
Psychosocial Work ◽  
Work Stressors ◽  
Over Time

We investigated the time-based associations between workload (physical and mechanical), psychosocial work stressors (demands, control, and support), and the number of anatomical regions with pain (ARP). This population-based study with a two-year follow-up included 11,386 responders (5125 men, 6261 women; mean age: 48.8 years; SD: 18.5) living in south-eastern Sweden. Predictive associations were assessed through generalised linear models, and changes over time were examined using a generalised estimating equation. The results of both models were reported as parameter estimates (B) with 95% confidence interval (CIs). Mean changes in the number of ARP, workload, and psychosocial work stressors were stable over time. High mechanical workload and job demands were likely associated with the number of ARP at the two-year follow-up. In the reverse prospective model, we found that the number of ARP was also associated with high physical and mechanical workload and low job control and support. In the two time-based models of changes, we found a reciprocal association between number of ARP and mechanical workload. Our results add epidemiological evidence to the associations between work conditions and the extent of pain on the body. Components of work conditions, including job demands and mechanical strain, must be considered when organisations and health policy makers plan and employ ergonomic evaluations to minimise workplace hazards in the general population.

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