scholarly journals Constrictive Myelopathy in An Old Giant Dog

2021 ◽  
Keyword(s):  
Spinal Cord ◽  
Kidney Failure ◽  
Chronic Kidney Failure ◽  
Cord Compression ◽  
Spinal Cord Atrophy ◽  
Cerebrospinal Fluid Flow ◽  
Negative Results ◽  
First Case ◽  
Mixed Breed ◽  
Magnetic Resonance Imaging Mri

In pugs, West Highland white terriers and other small breeds, congenital or acquired malformations/deviations of the spine are commonly reported, resulting, amongst other complications, in chronic meningeal compression and fibrosis, and interference with cerebrospinal fluid flow into the sub-arachnoid space. This leads to constrictive myelopathy (CM) which involves the constriction and consequent reduced diameter of the spinal cord accompanied by parenchymal damage (mostly gliosis). A11-year-old giant mixed breed male dog presented with ataxia in the hindlimbs, paresis, reduced proprioception, and normal reflexes. Neurolocalization was to the thoracolumbar spinal cord (T3-L3). Myelographic computed tomography and magnetic resonance imaging (MRI) of this tract showed spondylosis, multiple disc protrusions with mild cord compression, and reduced spinal cord diameter. Genetic test for SOD1 mutations performed to evaluate predisposition to degenerative myelopathy negative results; although poorly compressive, the symptoms were attributed to multiple disc protrusions, leading to spinal cord atrophy. The dog underwent physiotherapy and 23 months later, was more ataxic and paretic however still ambulatory; repeated MRI confirmed the previous findings, however, the onset of concomitant megacolon and a chronic kidney failure, induced the owner to euthanasia. Histopathological assessment indicated diffused remodeling of the meninges with progressive constriction of the spinal cord of concomitant megacolon and a chronic kidney failure, induced the owner to euthanasia. Histopathological assessment indicated diffused remodeling of the meninges with progressive constriction of the spinal cord. Altered distribution of the mechanical forces among the meningeal layers with stiffening of the ventral pachymeninges, probably caused by the disc protrusions, was considered the most likely trigger. To our knowledge, this is the first case reporting clinical, MRI and histological findings resembling an acquired constrictive myelopathy in a large-breed dog.

scholarly journals Numbers of Axons in Spared Neural Tissue Bridges But Not Their Widths or Areas Correlate With Functional Recovery in Spinal Cord-Injured Rats

2020 ◽  
Vol 79 (11) ◽  
pp. 1203-1217
Author(s):  
Svenja Rink ◽  
Stoyan Pavlov ◽  
Aliona Wöhler ◽  
Habib Bendella ◽  
Marilena Manthou ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Functional Recovery ◽  
Neural Tissue ◽  
Cord Compression ◽  
Cresyl Violet ◽  
Spinal Cord Tissue ◽  
Class Iii ◽  
Morphological Findings ◽  
Cord Injury ◽  
Magnetic Resonance Imaging Mri

Abstract The relationships between various parameters of tissue damage and subsequent functional recovery after spinal cord injury (SCI) are not well understood. Patients may regain micturition control and walking despite large postinjury medullar cavities. The objective of this study was to establish possible correlations between morphological findings and degree of functional recovery after spinal cord compression at vertebra Th8 in rats. Recovery of motor (Basso, Beattie, Bresnahan, foot-stepping angle, rump-height index, and ladder climbing), sensory (withdrawal latency), and bladder functions was analyzed at 1, 3, 6, 9, and 12 weeks post-SCI. Following perfusion fixation, spinal cord tissue encompassing the injury site was cut in longitudinal frontal sections. Lesion lengths, lesion volumes, and areas of perilesional neural tissue bridges were determined after staining with cresyl violet. The numbers of axons in these bridges were quantified after staining for class III β-tubulin. We found that it was not the area of the spared tissue bridges, which is routinely determined by magnetic resonance imaging (MRI), but the numbers of axons in them that correlated with functional recovery after SCI (Spearman’s ρ > 0.8; p < 0.001). We conclude that prognostic statements based only on MRI measurements should be considered with caution.

scholarly journals IgG4-Related Sclerosing Disease Causing Spinal Cord Compression: The First Reported Case in Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Nooraldin Merza ◽  
Ahmed Taha ◽  
John Lung ◽  
Anthony W. Benderman ◽  
Stephen E. Wright
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Cervical Spinal Cord ◽  
Cord Compression ◽  
Neurological Deficits ◽  
Pathological Examination ◽  
Tissue Mass ◽  
Systemic Steroids ◽  
First Case

Immunoglobulin G4-related disease (IgG4-RD) is known for forming soft tissue mass lesions that may have compressive effects. It is an extremely rare disease that most frequently affects the pancreas causing autoimmune pancreatitis. It can also affect the gallbladder, salivary glands, and lacrimal glands causing respective organ-specific complications. In our report, we describe an IgG4-RD case that affected the spinal cord. A 60-year-old female presented with cervical spinal cord compression caused by IgG4-RD leading to several neurological deficits. Pathological examination of the excisional biopsy of the mass revealed dense lymphoplasmacytic cells infiltration and stromal fibrosis with IgG4 and plasma cells. The patient showed a dramatic response to the administration of systemic steroids with almost resolution of her neurological symptoms. This case highlights the first case in literature for IgG4-RD of the extradural tissue causing spinal compression. Hereby, we also demonstrate the dramatic response of IgG4-RD to the administration of systemic steroids as the patient had no recurrence after 5 years of close follow-up, the longest reported period of follow-up reported in the literature to date.

scholarly journals Kinematic MRI Analysis of Reducible Atlantoaxial Dislocation for Decompression

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Liang Dong ◽  
Chaoyuan Ge ◽  
Zhengwei Xu ◽  
Dongqi Wang ◽  
Honghui Sun ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Dynamic Mri ◽  
Cord Compression ◽  
Atlantoaxial Dislocation ◽  
Lower Percentage ◽  
Improvement Rate ◽  
Atlantoaxial Fixation ◽  
Magnetic Resonance Imaging Mri ◽  
Group B ◽  
Kinematic Magnetic Resonance Imaging

Background. Many doctors ignored the possibility that there is still a spinal cord compression (SCC) need for decompression after atlantoaxial reduction. Reduction can be achieved on kinematic magnetic resonance imaging (MRI); thus, we want to analyze the role of kinematic MRI in reducible atlantoaxial dislocation and make a preoperative decision whether to perform decompression. Methods. 36 patients with atlantoaxial reduction on preoperative kinematic MRI in extension postures were enrolled retrospectively. Grouping was based on the condition of SCC after atlantoaxial reduction preoperatively. Group A: patients with SCC after atlantoaxial reduction on dynamic cervical MRI were treated with C1 laminectomy for decompression and atlantoaxial fixation. Group B: patients with no significant SCC, according to dynamic MRI, underwent only atlantoaxial fixation. Clinical outcomes were evaluated using JOA score for spinal cord function. Radiological outcomes were assessed by measuring spinal cord diameter on MRI. Results. The mean follow-up time was 17.1 months. Postoperative JOA score and percentage of SCC in both groups were significantly better than its preoperative score. There were no significant statistical differences in the JOA score at 12 months after surgery and the JOA improvement rate between two groups. All patients in the two groups had a lower percentage of SCC on preoperative extension MRI, compared with neutral MRI. No significant statistical differences in the spinal decompression improvement rate were observed between the two groups. Conclusions. Decompression should be performed in patients who still have significant SCC on preoperative kinematic MRI. Kinematic MRI could be used to assess SCC and decide whether to perform decompression preoperatively.

scholarly journals Advances in spinal cord imaging in multiple sclerosis

2019 ◽  
Vol 12 ◽  
pp. 175628641984059 ◽  
Author(s):  
Marcello Moccia ◽  
Serena Ruggieri ◽  
Antonio Ianniello ◽  
Ahmed Toosy ◽  
Carlo Pozzilli ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Imaging Techniques ◽  
Quantitative Imaging ◽  
Automated Analysis ◽  
Spinal Cord Atrophy ◽  
Recent Developments ◽  
Magnetic Resonance Imaging Mri ◽  
Spinal Cord Imaging

The spinal cord is frequently affected in multiple sclerosis (MS), causing motor, sensory and autonomic dysfunction. A number of pathological abnormalities, including demyelination and neuroaxonal loss, occur in the MS spinal cord and are studied in vivo with magnetic resonance imaging (MRI). The aim of this review is to summarise and discuss recent advances in spinal cord MRI. Advances in conventional spinal cord MRI include improved identification of MS lesions, recommended spinal cord MRI protocols, enhanced recognition of MRI lesion characteristics that allow MS to be distinguished from other myelopathies, evidence for the role of spinal cord lesions in predicting prognosis and monitoring disease course, and novel post-processing methods to obtain lesion probability maps. The rate of spinal cord atrophy is greater than that of brain atrophy (−1.78% versus −0.5% per year), and reflects neuroaxonal loss in an eloquent site of the central nervous system, suggesting that it can become an important outcome measure in clinical trials, especially in progressive MS. Recent developments allow the calculation of spinal cord atrophy from brain volumetric scans and evaluation of its progression over time with registration-based techniques. Fully automated analysis methods, including segmentation of grey matter and intramedullary lesions, will facilitate the use of spinal cord atrophy in trial designs and observational studies. Advances in quantitative imaging techniques to evaluate neuroaxonal integrity, myelin content, metabolic changes, and functional connectivity, have provided new insights into the mechanisms of damage in MS. Future directions of research and the possible impact of 7T scanners on spinal cord imaging will be discussed.

scholarly journals Cervical Osteomyelitis with Thoracic Myelitis and Meningitis in a Diabetic Patient

2015 ◽  
Vol 8 ◽  
pp. CCRep.S21678
Author(s):  
Yu-ichiro Ohnishi ◽  
Koichi Iwatsuki ◽  
Shiromaru Ishida ◽  
Toshiki Yoshimine
Keyword(s):  
Spinal Cord ◽  
Pathogenic Bacteria ◽  
Epidural Abscess ◽  
Cervical Spinal Cord ◽  
Cord Compression ◽  
Care Physician ◽  
Mri Findings ◽  
Sensorimotor Disturbances ◽  
Magnetic Resonance Imaging Mri ◽  
Csf Examination

A 45-year-old man with a history of untreated diabetes mellitus had a persisting fever, back pain, and diarrhea. The primary care physician diagnosed the patient with the flu and gastroenteritis. The patient developed paraplegia for two weeks and was admitted to another hospital. The physician in this hospital suspected infectious meningitis and myelitis, and administered piperacillin and steroids without cerebrospinal fluid (CSF) examination. On referral to our hospital, he presented a high fever and complete paraplegia. The lumbar puncture revealed a yellowish CSF, polynucleosis, and hypoglycorrhachia. Bacteria were not detected on Gram's staining and were not confirmed by CSF culture. Magnetic resonance imaging (MRI) showed no thoracolumbar lesion and suggested a cervical epidural abscess without any spinal cord compression. He was diagnosed as having osteomyelitis with meningitis and thoracic myelitis. The infection subsided with broadspectrum antibiotics. After two weeks, bilateral sensorimotor disturbances of the upper extremities appeared. MRI findings showed the epidural abscess compressing the cervical spinal cord. We performed debridement of the epidural abscess. The infection was clinically controlled by using another antibiotic. One month after the infection subsided, a 360° reconstruction was performed. In this case, the misdiagnosis and the absence of CSF examination and culture to detect the pathogenic bacteria at an earlier stage in the patient's disease course might have led to the exacerbation of the pathology.

Evaluation of a proposed therapeutic protocol in 12 dogs with tentative degenerative myelopathy

2008 ◽  
Vol 56 (3) ◽  
pp. 293-301 ◽  
Author(s):  
Zoe Polizopoulou ◽  
Alexander Koutinas ◽  
Michael Patsikas ◽  
Nektarios Soubasis
Keyword(s):  
Spinal Cord ◽  
Aminocaproic Acid ◽  
Cord Compression ◽  
Attractive Alternative ◽  
Neurological Signs ◽  
Therapeutic Protocol ◽  
Vaccination History ◽  
History Of ◽  
Degenerative Myelopathy ◽  
Magnetic Resonance Imaging Mri

The objective of this work was to evaluate the long-term efficacy of a proposed therapeutic protocol in 12 dogs with a tentative diagnosis of degenerative myelopathy, followed-up for a 6-month period. Twelve dogs fulfilling the antemortem inclusion criteria (breed, age, adequate vaccination, history of progressive posterior ataxia and/or paraparesis, no radiographic and myelographic abnormalities in the spinal cord and vertebral column) were allocated. All these dogs presented signs of thoracolumbar syndrome (T3-L3), scored as grade I (mild to moderate ataxia and paraparesis) in 10 and grade II (severe ataxia and ambulatory paraparesis) in 2 cases. Treatment included the use of ɛ-aminocaproic acid and N-acetylcysteine, supplemented with vitamins B, C and E. Prednisolone was given for the first two weeks and upon worsening of neurological signs. Daily exercise, performed as walking or swimming, was strongly recommended. Clinicopathological evaluation was normal in all 12 dogs, and survey radiographs and myelograms did not show spinal cord compression. Magnetic resonance imaging (MRI), performed only in 4 dogs, did not disclose compressive disorders or intramedullary lesions. Neurological signs were progressively worsening in all 12 animals, eventually resulting in severe paraparesis (grade III) or paraplegia (grade IV). The applied medications do not appear to be an attractive alternative to conservative management (physiotherapy) or euthanasia in canine degenerative myelopathy, irrespective of its chronicity.

scholarly journals Neurobrucellosis with ischemic stroke and spinal cord involvement: a case report

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hongfeng Wen ◽  
Di Jin ◽  
Lina Cai ◽  
Tao Wu ◽  
Haichao Liu
Keyword(s):  
Spinal Cord ◽  
Ischemic Stroke ◽  
Clinical Manifestations ◽  
Transverse Myelitis ◽  
Lower Limbs ◽  
Spinal Cord Atrophy ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Next Generation Sequencing Ngs

Abstract Background Brucellosis is a common zoonotic disease that may have a variety of clinical manifestations when it affects the nervous system. Ischemic stroke is a rare clinical symptom, but if it is not diagnosed and treated early, it may cause more severe consequences. Case presentation We report a 38-year-old man presenting with hearing impairment for four years and sudden weakness of the right limb for two years, recurrent aphasia, and gradual weakness of bilateral lower limbs for nine months. He had bilateral positive Babinski’s sign. Cerebrospinal fluid (CSF) showed raised protein and pleocytosis. Magnetic resonance imaging (MRI) showed ischemic infarcts in the pons and extensive enhancement of spinal meninges combined with spinal cord atrophy and ischemia. The tests revealed Brucella Rose Bengal positive in serum and CSF. Brucella culture in CSF was also positive. Next-generation sequencing (NGS) of CSF revealed positive for Brucella with 105 species were detected. He showed significant improvement with antibiotics at five months follow-up. Conclusions Neurobrucellosis may mimic stroke and transverse myelitis like syndromes. NB is a treatable infectious condition and should always be considered in the differentials, especially if there are risk factors, as in our case.

scholarly journals Snake-Eyes Appearance on MRI Occurs during the Late Stage of Hirayama Disease and Indicates Poor Prognosis

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Haocheng Xu ◽  
Minghao Shao ◽  
Fan Zhang ◽  
Cong Nie ◽  
Hongli Wang ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Late Stage ◽  
Poor Prognosis ◽  
Close Association ◽  
Pathological Process ◽  
Spinal Cord Atrophy ◽  
Duration Of Symptoms ◽  
Hirayama Disease ◽  
Magnetic Resonance Imaging Mri ◽  
New Perspective

Purpose. Because Hirayama disease is stereotyped as a self-limited disease in the absence of a definite pathology, we investigated the potential relationship between snake-eyes appearance (SEA) and Hirayama disease to bring a new perspective in the pathological process of Hirayama disease based on relevant radiological and clinical evidence. Methods. A total of 30 cases observed SEA were selected from 293 patients with Hirayama disease to constitute the SEA group, and an equal number of cases were randomly selected from the remaining patients to form the non-SEA group. Cervical magnetic resonance imaging (MRI) was performed and subsequently used to measure the anteroposterior diameter and anterior shifting of the spinal cord. Additionally, clinical data, such as age, sex, duration of symptoms, symptoms, and signs, were collected and analyzed. Results. Of 293 patients, 10.6% appeared with the SEA, which was mainly multisegmental (86.7%), particularly at the C5-6 segment (73.3%), and intense with a well-defined border (70.0%). The SEA group was an older population (p < 0.0001) with a longer duration (p < 0.0001) and a higher incidence of Hoffmann signs and knee hyperreflexia (p < 0.0001, p = 0.0038, respectively). The degree of spinal cord atrophy demonstrated a close association with the SEA, as it was significantly worse in the SEA group and SEA segment (p = 0.0008, p < 0.0001, respectively). The degree of spinal cord atrophy was positively related to both age and duration (p = 0.0095, p = 0.0176, respectively). Conclusions. Confirmed as an irreversible lesion and an indication of poor prognosis, SEA appears during the late stage of Hirayama disease and is closely related to pyramidal signs and spinal cord atrophy.

scholarly journals Spontaneous Spinal Epidural Hematoma: Report of Two Cases and Literature Review

2021 ◽  
Vol 8 (4) ◽  
pp. 198-204
Author(s):  
Duc Duy Tri Tran ◽  
Quoc Bao Nguyen ◽  
Van Tri Truong ◽  
Thai Duong Truong ◽  
Dinh Thanh Phan ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Epidural Hematoma ◽  
Cord Compression ◽  
Neurological Deficits ◽  
Spinal Epidural Hematoma ◽  
Spontaneous Spinal Epidural Hematoma ◽  
Hematoma Evacuation ◽  
First Case ◽  
Spinal Epidural

Spontaneous spinal epidural hematoma (SSEH) is a rare disease but may lead to life-threatening consequences if not timely diagnosed and managed. Emergent hematoma evacuation is indicated before neurological deficits become irreversible. We report two cases. The first case was a 45-year-old man brought to hospital because of an acute onset of quadriparesis and urinary incontinence. His cervical magnetic resonance imaging (MRI) showed an epidural hematoma at the C5-C6 level with severe spinal cord compression. He underwent an emergency C5-C6 right hemi-laminotomy to remove the clot and decompress the cord. Postoperatively, his left-sided deficits immediately resolved. His urinary function returned to normal two weeks after the surgery. He could independently walk two months later. The second case was a 57-year-old man admitted to the hospital because of severe neck pain and paresthesia in both arms. He had been using an antiplatelet for two months. His MRI revealed an epidural hematoma from C2 to C4 with spinal cord compression on the right. This patient was successfully treated with conservative treatment. If SSEH is left undiagnosed and untreated, the neurological deficits may be permanent. Early emergent hematoma evacuation contributes to a favorable outcome. Conservative management is reasonable if neurological deficits are not severe.

scholarly journals Segmental neurofibromatosis with compression of the spinal cord at the cervical level. Literature review and case report

2022 ◽  
Vol 20 (6) ◽  
pp. 158-163
Author(s):  
D. A. Gulyaev ◽  
I. Yu. Belov ◽  
D. V. Nizolin ◽  
L. B. Mitrofanova ◽  
N. A. Primak ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Morphological Characteristics ◽  
Cord Compression ◽  
Point Of View ◽  
Rare Type ◽  
Cutaneous Manifestations ◽  
First Case ◽  
Type V ◽  
Karnofsky Index

Background. Neurofibromatosis is a fairly rare disease (1/3000). In 1992, V. Riccardi described seven types of neurofibromatosis. Segmental neurofibromatosis (sh), also known as type V neurofibromatosis, is an extremely rare variant characterized by the development of typical cutaneous manifestations or one body segment neurofibromas. Clinical case. Currently, the literature describes about 100 cases of sh and only one of them with compression of the spinal cord. We present our first case of this nosological form with spinal cord compression in a Russian patient. A 70-year-old patient, due to an increasing paresis in the left extremities, underwent mri of the cervical spine, which revealed solid tumors located extramedullary intra-extradurally at the level of c2-c3 vertebrae with pronounced compression of the spinal cord. At the time of hospitalization, clinical presentation was characterized by deep spastic tetraparesis (1–2 points), impairment of all types of sensitivity from the c4 level by the conductive type, and dysfunction of the pelvic organs by the type of delay. Karnofsky index was 50 %, 2 points on the Fim scale. Standard c2-c3 vertebrae laminectomy was performed. Spinal cord compression was eliminated due to the removal of intradural tumors. Subsequently, extradural tumors were removed step by step. On histological examination, tumors were represented by intertwining bundles of elongated schwann cells with wavy nuclei with pointed ends and ileogenic fibers. Mucin present in the stroma separated cells and fibers. Conclusion. Sn is a rare type of neurofibromatosis. However, from the point of view of genetics, it is most likely incorrect to attribute it to a separate type of neurofibromatosis, since the cause of its development is mosaicism of somatic cells due to mutation of the NF 1 gene. Sn is rarely manifested by the development of spinal nerves multiple neurofibromas, however, it can be accompanied by a gross neurological deficit caused by compression of the spinal cord such neurofibromas. Surgical treatment is based on basic and special surgical principles that determine the anatomical and morphological characteristics of the area of intervention, the compliance of which allows for good treatment results.

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