Case Reports of the Spinal Cord Tumor in the Upper Cervical Region

Abstract Neurological evaluation supplemented by myelography has been highly successful in diagnosing spinal cord tumors. Our experience shows that a widening of the cord on myelography is not always diagnostic of spinal cord tumors. Two patients who presented clinically with evidence of spinal cord tumor and had a widening of the cord on myelography were found to have severe cervical arachnoiditis without any evidence of intrinsic cord abnormality. Hence, cervical arachnoiditis should be considered in the differential diagnosis of spinal cord tumor on myelography.

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Treatment of Upper Cervical Spinal Cord Tumor

Orthopedics & Traumatology ◽

10.5035/nishiseisai.53.784 ◽

2004 ◽

Vol 53 (4) ◽

pp. 784-786

Author(s):

Yoshiya Arishima ◽

Kyoji Hayashi ◽

Katsuhiro Tofuku ◽

Shunji Matsunaga ◽

Kazunori Yone ◽

...

Keyword(s):

Spinal Cord ◽

Cervical Spinal Cord ◽

Spinal Cord Tumor ◽

Upper Cervical

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Mesenteric Paraganglioma

Archives of Pathology & Laboratory Medicine ◽

10.5858/2002-126-0362-mp ◽

2002 ◽

Vol 126 (3) ◽

pp. 362-364 ◽

Cited By ~ 2

Author(s):

Shabnam Jaffer ◽

Noam Harpaz

Keyword(s):

Nervous System ◽

Autonomic Nervous System ◽

Neural Crest ◽

Case Reports ◽

Neural Crest Cells ◽

Mesenteric Arteries ◽

Cervical Region ◽

Upper Cervical ◽

Embryologic Development ◽

Extra Adrenal Paraganglioma

Abstract Approximately 5% to 10% of paragangliomas occur in extra-adrenal sites, which can extend from the upper cervical region to the pelvis, parallel to the autonomic nervous system. This distribution corresponds to the embryologic development of the paraganglia from neural crest cells. Rarely, extra-adrenal paragangliomas can also occur aberrantly outside this distribution. We report such a case of extra-adrenal paraganglioma occurring in the anterior mesentery in a 76-year-old man. Two case reports exist in the literature describing extra-adrenal paragangliomas in the posterior mesentery. Normal paraganglionic tissue has been described at the roots of the superior and inferior mesenteric arteries, theoretically explaining the origin of the posterior mesenteric paragangliomas. Our case can best be attributed to the ventral migration of paraganglionic tissue through these vessels to reach the anterior mesentery, where they could potentially give rise to paragangliomas in this site.

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V.–Distribution of the Cells in the Intermedio-Lateral Tract of the Spinal Cord

Transactions of the Royal Society of Edinburgh ◽

10.1017/s0080456800011650 ◽

1906 ◽

Vol 45 (1) ◽

pp. 105-131 ◽

Cited By ~ 15

Author(s):

Alexander Bruce

Keyword(s):

Spinal Cord ◽

Grey Matter ◽

Central Canal ◽

Substantia Gelatinosa ◽

Lateral Margin ◽

Cervical Region ◽

Dorsal Region ◽

Lateral Column ◽

Upper Cervical ◽

Lateral Tract

The term intermedio-lateral tract was introduced in 1859 (Phil. Trans., 1859, p. 445) by Lockhart Clarke to designate a tract or column of nerve cells in the spinal cord, which he had previously described in 1851 (Phil. Trans., 1851, ii. p. 613) as occupying that portion of the lateral margin of the grey matter which is intermediate between the anterior and posterior cornua. According to Clarke's original account, the column in question was very transparent in appearance, and resembled somewhat the substantia gelatinosa of the posterior horn. It was found in the upper part of the lumbar enlargement, extended upwards through the dorsal region, where it distinctly increased in size, to the lower part of the cervical enlargement. Here it disappeared almost entirely. In the upper cervical region it was again seen, and could be traced upwards into the medulla oblongata, where, in the space immediately behind the central canal, it blended with its fellow of the opposite side. In the more complete account of the tract published in 1859 (p. 446), its component cells are described as in part oval, fusiform, pyriform, or triangular, and as being smaller and more uniform in size than those of the anterior cornua. In the mid-dorsal region, where they are least numerous, they are found only near the lateral margin of the grey matter, with the exception of some cells which lie among the white fibres beyond the margin of the grey substance. In the upper dorsal region the tract is larger, and not only projects further outwards into the lateral column of the white fibres, but also tapers inwards across the grey substance, almost to the front of Clarke's column. In the cervical enlargement it gradually disappears, although it seems to contain, in part at least, a few scattered cells resembling those of the intermedio-lateral tract of the dorsal region. In the upper cervical region, as already stated, it is again seen occupying a lateral horn similar to that found in the dorsal region. It is composed of the same kind of cells, and can be followed up into the medulla, where it is said to give origin to some of the fibres of the vagus and the spinal accessory.

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Infected congenital cervical dermal sinuses leading to spinal cord abscess: two case reports and a review of the literature

Child s Nervous System ◽

10.1007/s00381-020-04778-1 ◽

2020 ◽

Vol 37 (1) ◽

pp. 225-228

Author(s):

Rhian Bevan ◽

Paul Leach

Keyword(s):

Spinal Cord ◽

Case Reports ◽

Spinal Dysraphism ◽

Febrile Illness ◽

Surgical Excision ◽

Late Recurrence ◽

Cervical Region ◽

Developmental Defects ◽

Complete Surgical Excision

Abstract Purpose Congenital dermal sinuses are a rare form of spinal dysraphism. The developmental defects are located along the midline neuroaxis, with sinuses in the cervical region being the least common. Congenital dermal sinuses can be associated with intraspinal infection as they act as a direct route from the skin and subcutaneous tissues into the spinal cord. Methods The authors present two cases of cervical dermal sinuses complicated by intramedullary abscess. Both children presented with neurological decline and febrile illness. MRI showed intraspinal abscess. Both underwent prompt surgical excision of the sinus tract, exploration of the cord and intravenous antibiotics. Results Both patients demonstrated excellent neurological recovery. Conclusions Complete surgical excision of the sinus and tract in addition to long-term antimicrobials can yield excellent neurological outcomes. At surgery, do not expect to find pus when exploring the intramedullary component. Long-term follow-up is advocated due to potential late recurrence.

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Problems and Clinical Course after Operation of Spinal Cord Tumor at Upper Cervical Spine

Orthopedics & Traumatology ◽

10.5035/nishiseisai.59.656 ◽

2010 ◽

Vol 59 (3) ◽

pp. 656-658

Author(s):

Ichiro Kawamura ◽

Kosei Ijiri ◽

Takuya Yamamoto ◽

Michihisa Zenmyo ◽

Ryusaku Nagayoshi ◽

...

Keyword(s):

Spinal Cord ◽

Cervical Spine ◽

Clinical Course ◽

Spinal Cord Tumor ◽

Upper Cervical Spine ◽

Upper Cervical

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Intramedullary mature teratoma of the cervical spinal cord at C1–2 associated with occult spinal dysraphism in an adult

Journal of Neurosurgery Spine ◽

10.3171/spi.2007.6.6.12 ◽

2007 ◽

Vol 6 (6) ◽

pp. 579-584 ◽

Cited By ~ 31

Author(s):

Raafat Makary ◽

David Wolfson ◽

Victor Dasilva ◽

Amir Mohammadi ◽

Sania Shuja

Keyword(s):

Spinal Cord ◽

Cervical Spinal Cord ◽

Spinal Dysraphism ◽

Treatment Options ◽

Mature Teratoma ◽

Postoperative Outcome ◽

Complete Removal ◽

Cervical Region ◽

Upper Cervical ◽

Spinal Malformations

✓There is a well-recognized association between dysontogenetic tumors of the spinal cord (including teratomas and enterogenous cysts) and dysraphic congenital spinal malformations. The authors present a case of an adult with an intramedullary mature teratoma (IMMT) at the level of C1–2 of the cord associated with dysraphic congenital spinal malformations. Intramedullary mature teratomas of the cervical region of the spinal cord are very rare in adults; only four such lesions have been reported, two of which involved upper cervical segments. Despite the potentially critical location of the tumor, monitored microsurgery resulted in complete removal of the tumor with an intact surrounding capsule, associated fibrous tract, and ellipse of skin with a central dimple. There was an excellent postoperative neurological outcome. The clinical features, imaging studies, treatment options, postoperative outcome, and plausible pathological correlations of IMMTs are discussed.

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Anatomy and clinical relevance of sub occipital soft tissue connections with the dura mater in the upper cervical spine

PeerJ ◽

10.7717/peerj.9716 ◽

2020 ◽

Vol 8 ◽

pp. e9716

Author(s):

Rob Sillevis ◽

Russell Hogg

Keyword(s):

Spinal Cord ◽

Cervical Spine ◽

Cadaver Study ◽

Cervicogenic Headache ◽

Passive Movement ◽

Cervical Region ◽

Upper Cervical Spine ◽

Posterior Aspect ◽

Upper Cervical ◽

Nuchal Ligament

Background The upper cervical region is a complex anatomical structure. Myodural bridges between posterior suboccipital muscles and the dura might be important explaining conditions associated with the upper cervical spine dysfunction such as cervicogenic headache. This cadaver study explored the upper cervical spine and evaluated the myodural bridges along with position of spinal cord in response to passive motion of upper cervical spine. Methods A total of seven adult cadavers were used in this exploratory study. The suboccipital muscles and nuchal ligament were exposed. Connections between the Rectus Capitis Posterior major/minor and the Obliquus Capitis minor, the nuchal ligament, posterior aspect of the cervical spine, flavum ligament and the dura were explored and confirmed with histology. The position of the spinal cord was evaluated with passive motions of the upper cervical spine. Outcomes In all cadavers connective tissues attaching the Rectus Capitis Posterior Major to the posterior atlanto-occipital membrane were identified. In the sagittal dissection we observed connection between the nuchal ligament and the dura. Histology revealed that the connection is collagenous in nature. The spinal cord moves within the spinal canal during passive movement. Discussion The presence of tissue connections between ligament, bone and muscles in the suboccipital region was confirmed. The nuchal ligament was continuous with the menigiovertebral ligament and the dura. Passive upper cervical motion results in spinal cord motion within the canal and possible tensioning of nerve and ligamentous connections.

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Percutaneous Computed Tomography-guided Radiofrequency Ablation of Upper Spinal Cord Pain Pathways for Cancer-Related Pain

Operative Neurosurgery ◽

10.1227/01.neu.0000317397.16089.f5 ◽

2008 ◽

Vol 62 (suppl_1) ◽

pp. ONS226-ONS234 ◽

Cited By ~ 21

Author(s):

Ahmed M. Raslan

Keyword(s):

Computed Tomography ◽

Spinal Cord ◽

Radiofrequency Ablation ◽

Pain Relief ◽

Cervical Spinal Cord ◽

The Body ◽

Cervical Region ◽

Spinothalamic Tract ◽

Upper Cervical ◽

Ablative Procedures

Abstract Objective: The author presents data to support the continued need for ablative procedures, particularly cordotomy, in the management of cancer-related pain. Methods: Fifty-one patients with cancer-related body or face pain were treated with computed tomography-guided radiofrequency ablation of the spinothalamic tract or trigeminal tract nucleus in the upper cervical region of the spinal cord. Forty-one patients underwent a unilateral cervical cordotomy, and 10 patients underwent a trigeminal tractotomy–nucleotomy. Three methods to assess patient pain were used: degree of pain relief, Visual Analog Scale, and total sleeping hours. The Karnofsky scale was used to measure the patient's level of function pre- and postprocedure. Results: After surgical intervention, patients reported initial and 6-months follow-up pain relief as 98 and 80%, respectively. Conclusion: Computed tomography-guided ablation of the upper cervical spinal cord is a safe and effective procedure to treat cancer pain involving the body or face. There remains a need for ablative procedures, in particular cordotomy, in the management of cancer-related pain.

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