Steroid-responsive, cervical, pyogranulomatous pachymeningitis in a dog

1997 ◽  
Vol 33 (5) ◽  
pp. 461-468 ◽  
Author(s):  
PR Hess ◽  
RK Sellon
Keyword(s):  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Immunosuppressive Therapy ◽  
Dura Mater ◽  
Protein Concentration ◽  
Cord Compression ◽  
Inflammatory Disorder ◽  
Chronic Inflammatory Disorder ◽  
Elevated Protein

Syndromes of steroid-responsive meningitis have been described in the dog and typically are characterized by neutrophilic pleocytosis and an elevated protein concentration of the cerebrospinal fluid. In a minority of cases, histopathology has demonstrated suppurative leptomeningeal (i.e., arachnoid and pia) inflammation. A case of compressive, cervical, pyogranulomatous inflammation of undetermined cause affecting the dura mater (i.e., pachymeningitis), accompanied by fever and hyperpathia, is presented. The pachymeningitis ultimately regressed with long-term immunosuppressive therapy. This case shares features with hypertrophic spinal pachymeningitis of humans, an uncommon, frequently idiopathic, chronic inflammatory disorder causing dural hypertrophy, radiculopathy, and spinal cord compression.

scholarly journals Long-Term Follow-Up and Predictors of Functional Outcome after Surgery for Spinal Meningiomas: A Population-Based Cohort Study

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3244
Author(s):  
Jenny Pettersson-Segerlind ◽  
Alexander Fletcher-Sandersjöö ◽  
Charles Tatter ◽  
Gustav Burström ◽  
Oscar Persson ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Magnetic Resonance Images ◽  
Motor Deficit ◽  
Tumor Control ◽  
Time To Surgery ◽  
Spinal Meningiomas

Spinal meningiomas are the most common adult primary spinal tumor, constituting 24–45% of spinal intradural tumors and 2% of all meningiomas. The aim of this study was to assess postoperative complications, long-term outcomes, predictors of functional improvement and differences between elderly (≥70 years) and non-elderly (18–69 years) patients surgically treated for spinal meningiomas. Variables were retrospectively collected from patient charts and magnetic resonance images. Baseline comparisons, paired testing and regression analyses were used. In conclusion, 129 patients were included, with a median follow-up time of 8.2 years. Motor deficit was the most common presenting symptom (66%). The median time between diagnosis and surgery was 1.3 months. A postoperative complication occurred in 10 (7.8%) and tumor growth or recurrence in 6 (4.7%) patients. Surgery was associated with significant improvement of motor and sensory deficit, gait disturbance, bladder dysfunction and pain. Time to surgery, tumor area and the degree of spinal cord compression significantly predicted postoperative improvement in a modified McCormick scale (mMCs) in the univariable regression analysis, and spinal cord compression showed independent risk association in multivariable analysis. There was no difference in improvement, complications or tumor control between elderly and non-elderly patients. We concluded that surgery of spinal meningiomas was associated with significant long-term neurological improvement, which could be predicted by time to surgery, tumor size and spinal cord compression.

Fibreoptic intubation in ankylosing spondylitis patients

2021 ◽  
Vol 19 (1) ◽  
pp. 17-20
Author(s):  
Raghu K C ◽  
◽  
Nagesh R ◽  
Viswash G K ◽  
◽  
...  
Keyword(s):  
Spinal Cord ◽  
Ankylosing Spondylitis ◽  
Difficult Airway ◽  
Fibreoptic Intubation ◽  
Cardiovascular Complications ◽  
Inflammatory Disorder ◽  
Double Blind Study ◽  
Double Blind ◽  
Chronic Inflammatory Disorder ◽  
Group A

Background: Ankylosing spondylytes is a chronic inflammatory disorder characterized by inflammation in spines and spinal arthritis with a complex polygenic aetiology. The disease is more common in young males and risk factors include both genetic and environmental. Anesthesia management for ankylosing spondylitis is a challenge due to management of difficult airway, respiratory and cardiovascular complications, as well as the medications for disease and pain control. Both airway management and neuraxial access may prove to be difficult. Awake fibreoptic intubation is the safest option (²) in these patients with a potentially difficult airway as it allows continuous neurological monitoring while achieving a difficult airway. Methods: This is a Prospective Randomized Double-Blind Study conducted in Sri Sathya Sai Institute of Higher Medical Sciences; Total 70 Patients (Group A – 35, Group A – 35). All the subjects included after informed consent, blood samples and urine samples are collected from the all the subjects. Hb, RBCs, WBCs and Platelets was measured by laboratory standard methods. Along with Chest X- ray and ECG-for patients over 40 years of age. Results: This study was evaluated that in ankylosing spondylitis cases most of the physicians prefer to give general anaesthesia because to prevent trauma to the spinal cord but in these cases spine and surrounding tissues also it will involve at that time for maintain airway to the patient is challenge to the physicians by using fibreoptic intubation is good way to approach and maintain airway to the ankylosing patients. Conclusion: In this study suggest that in ankylosing spondylitis patients during surgery in place of tracheal intubation fibreoptic intubation is the best way to maintain airway to the patients and also we can prevent spinal cord damage.

Cerebrospinal fluid lactate and electrolyte levels following experimental spinal cord injury

1976 ◽  
Vol 44 (6) ◽  
pp. 715-722 ◽  
Author(s):  
Douglas K. Anderson ◽  
Leon D. Prockop ◽  
Eugene D. Means ◽  
Lawrence E. Hartley
Keyword(s):  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Spinal Cord Tissue ◽  
Post Injury ◽  
Content Type ◽  
Protein Levels ◽  
Cord Injury ◽  
Csf Lactate

✓ Cerebrospinal fluid (CSF) lactate, sodium (Na+), potassium (K+), calcium (Ca++), magnesium (Mg++), and chloride (Cl−) levels were determined for 17 to 21 days following experimental spinal cord compression in cats. Laminectomies were performed at L-2 under general anesthesia with aseptic techniques. Paraplegia was produced by applying a 170-gm weight transdurally for 5 minutes. Significant increases in CSF lactate levels were observed on the first through ninth days post injury with peak levels (50% above normal) occurring at Day 5. The only significant postinjury CSF electrolyte changes were elevation in Ca++ concentration on Days 3, 9, 11, 13, and 15, elevation in K+ concentration on Days 9 and 11 and decline in Cl− levels on the first day. The CSF K+ increase probably reflected cellular loss of K+ from damaged tissue whereas the Ca++ rise may have resulted from increased CSF protein levels. The prolonged elevation of CSF lactate indicates that tissue hypoxia plays a role in spinal cord compression paralysis, and that there is a continuing hypoxia of metabolically active spinal cord tissue for several days post injury.

Surgical treatment of the retethered spinal cord after repair of lipomyelomeningocele

1991 ◽  
Vol 74 (5) ◽  
pp. 709-714 ◽  
Author(s):  
Hiroaki Sakamoto ◽  
Akira Hakuba ◽  
Ken Fujitani ◽  
Shuro Nishimura
Keyword(s):  
Spinal Cord ◽  
Dura Mater ◽  
Conus Medullaris ◽  
Posterior Arch ◽  
Pia Mater ◽  
Dense Adhesion ◽  
Content Type ◽  
Dural Sac ◽  
Long Term Observation

✓ In a series of 75 patients with surgically treated lipomyelomeningoceles, the neurological condition of six patients deteriorated 6 months to 14 years after the operation due to repeat tethering of the spinal cord. The tethering resulted from postoperative dense adhesion between the cord and the overlying dura mater. Two of the six patients underwent conventional repeat untethering procedures, and the remaining four were successfully treated with a new surgical technique developed by the authors to prevent such dural adhesion. For this procedure, after complete untethering of the spinal cord, the lumbosacral cord is retained in the center of the dural sac by fine stay sutures between the pia mater of the conus medullaris and the ventral dura mater. In addition, the dura mater is tacked to the posterior arch which is reconstructed with bone grafts at one or two bifid vertebral levels. During a postoperative follow-up period of 1 to 3 years, no further deterioration has been observed and magnetic resonance studies have demonstrated a space filled with cerebrospinal fluid (CSF) around the lumbosacral cord. The authors conclude that long-term observation, both neurological and radiological, is essential even after successful repair of a lipomyelomeningocele. This new surgical procedure can maintain a CSF bath around the lumbosacral cord, thus preventing dural adhesion. Application of this technique will hopefully be beneficial in lipomyelomeningocele patients with a high risk of cord retethering after initial repair.

Long-Term Follow-Up of Patients with Metastatic Epidural Spinal Cord Compression from Solid Tumors Submitted for Surgery Followed by Radiation Therapy

2018 ◽  
Vol 115 ◽  
pp. e681-e687 ◽  
Author(s):  
Federico Pessina ◽  
Pierina Navarria ◽  
Giulio Alberto Carta ◽  
Giuseppe Roberto D'Agostino ◽  
Elena Clerici ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Radiation Therapy ◽  
Solid Tumors ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Long Term Follow Up

Spinal Cord Compression as a Primary Manifestation of Aggressive Malignant Lymphomas: Long-term Analysis of Treatments with Radiotherapy, Chemotherapy or Combined Therapy

2002 ◽  
Vol 43 (2) ◽  
pp. 355-359 ◽  
Author(s):  
Agustin Avilés ◽  
Raúl Fernández ◽  
José Luis González ◽  
Edna L. GarcÍa ◽  
Natividad Neri ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Combined Therapy ◽  
Cord Compression ◽  
Malignant Lymphomas ◽  
Term Analysis

Acute Disseminated Encephalomyelitis

2017 ◽  
Author(s):  
Benjamin M. Greenberg ◽  
Allen Desena
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Supportive Care ◽  
Acute Disseminated Encephalomyelitis ◽  
Autoimmune Response ◽  
Inflammatory Disorder ◽  
The Central Nervous System ◽  
The Brain

Acute disseminated encephalomyelitis (ADEM) is a rare inflammatory disorder of the central nervous system (CNS) that can be fatal or lead to long-term disability. Various triggers have been identified in children and adults, which presumably cause an autoimmune response targeting myelin. The resulting inflammation causes demyelination and edema of the brain, spinal cord, and optic nerves. Depending on which portion of the CNS is affected, patients will experience a variety of symptoms including weakness, numbness, ataxia, encephalopathy, and seizures. Treatment is currently focused on reducing the amount of inflammation and supportive care.

scholarly journals Study protocol for an observational study of cerebrospinal fluid pressure in patients with degenerative cervical myelopathy undergoing surgical deCOMPression of the spinal CORD: the COMP-CORD study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037332
Author(s):  
Carl Moritz Zipser ◽  
Nikolai Pfender ◽  
Jose Miguel Spirig ◽  
Michael Betz ◽  
Jose Aguirre ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Spinal Cord Compression ◽  
Study Protocol ◽  
Cervical Myelopathy ◽  
Fluid Pressure ◽  
Cord Compression ◽  
Surgical Decompression ◽  
Degenerative Cervical Myelopathy

IntroductionDegenerative cervical myelopathy (DCM) is a disabling spinal disorder characterised by sensorimotor deficits of upper and lower limbs, neurogenic bladder dysfunction and neuropathic pain. When suspected, cervical MRI helps to reveal spinal cord compression and rules out alternative diagnoses. However, the correlation between radiological findings and symptoms is weak. Cerebrospinal fluid pressure (CSFP) analysis may complement the appreciation of cord compression and be used for intraoperative and postoperative monitorings in patients undergoing surgical decompression.Methods and analysisTwenty patients diagnosed with DCM undergoing surgical decompression will receive standardised lumbar CSFP monitoring immediately before, during and 24 hours after operation. Rest (ie, opening pressure, CSF pulsation) and stimulated (ie, Valsalva, Queckenstedt’s) CSFP—findings in DCM will be compared with 20 controls and results from CSFP monitoring will be related to clinical and neurophysiological findings. Arterial blood pressure will be recorded perioperatively and postoperatively to calculate spinal cord perfusion pressure and spinal vascular reactivity index. Furthermore, measures of CSFP will be compared with markers of spinal cord compression by means of MR imaging.Ethics and disseminationThe study protocol conformed to the latest revision of the Declaration of Helsinki and was approved by the local Ethics Committee of the University Hospital of Zurich (KEK-ZH number PB-2016-00623). The main publications from this study will cover the CSFP fluid dynamics and pressure analysis preoperative, perioperative and postoperative correlated with imaging, clinical scores and neurophysiology. Other publications will deal with preoperative and postoperative spinal perfusion. Furthermore, we will disseminate an analysis on waveform morphology and the correlation with blood pressure and ECG. Parts of the data will be used for computational modelling of cervical stenosis.Trial registration numberClinicalTrials.gov Registry (NCT02170155).

Treatment of scar endometriosis with elagolix

2020 ◽  
Vol 12 (1) ◽  
pp. 56-58
Author(s):  
Timothy A D’Amico ◽  
Lisa Bystry ◽  
Sean M Kandel
Keyword(s):  
Rare Complication ◽  
High Rate ◽  
Attractive Potential ◽  
Inflammatory Disorder ◽  
Invasive Treatment ◽  
Scar Endometriosis ◽  
Chronic Inflammatory Disorder ◽  
Non Invasive ◽  
Long Term Follow Up

Endometriosis is a chronic inflammatory disorder that affects approximately 5%–10% of women and is a major contributor to chronic pelvic pain. It can result in a significant impact on a woman’s quality of life with a high rate of reoccurrence throughout the woman’s reproductive years. Medical treatment is available but often surgical intervention is required. Scar endometriosis is a rare complication of this disease, mostly involving cesarean section scars. Our case demonstrates a possible new, non-invasive treatment for scar endometriosis with elagolix. The ability to avoid the potential morbidity of surgical scar revision makes this a very attractive potential option. Further studies with larger cohorts and long-term follow up are needed to confirm efficacy.

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