scholarly journals A Case Report: The Challenging Diagnosis of Spontaneous Cervical Epidural Hematoma

2020 ◽  
Vol 4 (3) ◽  
pp. 428-431
Author(s):  
Francis Counselman ◽  
Julie Tondt ◽  
Harry Lustig
Keyword(s):  
Magnetic Resonance Imaging ◽  
Emergency Department ◽  
Case Report ◽  
Neck Pain ◽  
Epidural Hematoma ◽  
Correct Diagnosis ◽  
Sudden Onset ◽  
Resonance Imaging ◽  
History Of ◽  
Leg Weakness

Introduction: We present the case of a patient with a spontaneous cervical epidural hematoma that presented with neck pain and mild, left arm parasthesia. Case Report: A 59-year old man presented with sudden onset of severe neck pain, without history of injury or trauma. The patient also complained of associated left arm parasthesias that progressed to left arm and leg weakness while in the emergency department. Multiple diagnoses were considered and worked up; eventually the correct diagnosis was made with magnetic resonance imaging of the cervical spine. Conclusion: Spontaneous cervical epidural hematoma typically presents with neck pain, and variable neurologic complaints. This case illustrates the challenge in making this uncommon but serious diagnosis.

scholarly journals Diagnosis and Spontaneous Resolution of an Epidural Hematoma in a Patient Presenting after Cervical Epidural Steroid Injection

2018 ◽  
pp. 213-219
Author(s):  
Ivan Urits
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Neck Pain ◽  
Epidural Hematoma ◽  
Steroid Injection ◽  
Spontaneous Resolution ◽  
Resonance Imaging ◽  
Radiographic Findings ◽  
History Of ◽  
Epidural Steroid

While not a cure for the underlying spinal pathology, cervical epidural steroid injections (CESI) are an important minimally invasive treatment for neck pain with radiculopathy. Although CESIs are considered safe, cervical epidural hematoma (CEH) is a major complication and has previously been reported. Patients, who develop CEH, present with acute neck pain and upper extremity radiculopathy. A prolonged time to treatment may lead to worsened neurological outcome. Diagnostic magnetic resonance imaging and surgical decompression is the mainstay of treatment. This report presents a patient with a history of chronic neck pain and repeat cervical injections, who presented with increased neck pain and upper extremity weakness after undergoing a CESI. Initial radiographic findings were complicated and inconclusive of a definitive epidural hematoma. With conservative management, the patient showed signs of clinical improvement and ultimately had spontaneous resolution of his CEH. Though CEH are frequently rapidly progressing and most often surgically decompressed, some acutely presenting cases may be approached conservatively. Though MRI is an important diagnostic tool for CEH, interpretation of radiographic findings, following a recent CESI, may be challenging due to distortion of the epidural space anatomy. Patients with a history of multiple cervical epidural injections may have an increased risk for the development of CEH. Key words: Cervical epidural steroid injection, cervical epidural hematoma, spontaneous resolution, conservative management, magnetic resonance imaging, complication

scholarly journals Non traumatic spinal epidural haematoma

2019 ◽  
Vol 18 (4) ◽  
pp. 255-258
Author(s):  
Naureen Abdul Khalid ◽  
◽  
Nainal Shah ◽  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Trauma Surgery ◽  
Epidural Haematoma ◽  
Rare Condition ◽  
Sudden Onset ◽  
Resonance Imaging ◽  
Spinal Epidural Haematoma ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Spinal Epidural

Spinal epidural haematoma is a rare condition, which may be due to trauma, surgery, epidural catheterisation or disorders of coagulation. We report a case of 60 year old lady who was on warfarin for Atrial fibrillation (AF) presented with history of non-traumatic sudden onset pain in both legs and difficulty in walking. Magnetic resonance imaging (MRI) spine demonstrated epidural haematoma which was treated conservatively. Another dilemma was anticoagulation for AF. We examine the options to manage such case.

Atlantoaxial epidural abscess secondary to grass awn migration in a dog

2014 ◽  
Vol 27 (02) ◽  
pp. 155-158 ◽  
Author(s):  
U. Geissbühler ◽  
P. Karli ◽  
F. Forterre ◽  
E. Linon
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Epidural Abscess ◽  
Cervical Vertebrae ◽  
Clinical Signs ◽  
Resonance Imaging ◽  
Mri Findings ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Grass Awn

SummaryA two-year-old female Lucerne Hound was presented with a one-week history of signs of progressive neck pain, inappetence, apathy, and an elevated rectal temperature. Findings of magnetic resonance imaging (MRI) were consistent with a foreign body abscess in the epidural space at the level of the first and second cervical vertebrae. A leftsided dorso-lateral atlantoaxial approach was performed, revealing an epidural abscess containing a grass awn. The clinical signs resolved within three days of surgery and the dog made a full recovery. This case report shows that grass awns can migrate to the atlantoaxial region in dogs and MRI findings lead to a suspicion of caudo-cranial migration within the spinal canal.

Acquired megaesophagus in a dog – case report

2021 ◽  
Vol XXVI (150) ◽  
pp. 46-55
Author(s):  
Bruna Dias Fagundes ◽  
Mariana C. H. Rondelli ◽  
Eduarda A. N. L. D. Cavalcanti ◽  
Arthur de Lima Espinosa ◽  
Carina Burkert da Silva ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Magnetic Resonance ◽  
Barium Sulphate ◽  
Effective Alternative ◽  
Resonance Imaging ◽  
Esophageal Dilatation ◽  
Pet Food ◽  
Alternative Method ◽  
History Of

Acquired megaesophagus is an uncommon cause of regurgitation in dogs. Diagnosis is confirmed by simple or contrast radiographs, endoscopy, tomography, scintigraphy, or magnetic resonance imaging. Esophagography with barium sulphate contrast is the most commonly used method, however, it may be inconclusive if dilation marking does not occur. This paper reports the case of a 9-year-old female dog, with a history of regurgitation over six months, simple and contrast radiographic exams showing no evidence of megaesophagus. The esophagography exam was repeated with the addition of barium contrast mixed with commercial dry pet food, which verified esophageal dilatation and confirmed megaesophagus. Although this technique is not widely used, it is an effective alternative method for diagnosis of canine megaesophagus, particularly when other radiographic approaches are inconclusive.

Multiple Spinal Cavernous Malformations with Atypical Phenotype after Prior Irradiation: Case Report

Neurosurgery ◽  
2004 ◽  
Vol 55 (6) ◽  
pp. E1435-E1439 ◽  
Author(s):  
Pascal Jabbour ◽  
Judith Gault ◽  
Steven E. Murk ◽  
Issam A. Awad
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Magnetic Resonance ◽  
Wilms Tumor ◽  
Incidental Finding ◽  
Resonance Imaging ◽  
Cavernous Malformations ◽  
Drop Metastasis ◽  
History Of ◽  
Radiation Induced

Abstract OBJECTIVE AND IMPORTANCE: This is the first reported case of histologically proven multiple spinal cavernous malformations (CMs) associated with previous irradiation. There are only two cases reported in the literature of solitary spinal CM after irradiation. In addition, the lesions in our patient had an atypical magnetic resonance imaging appearance mimicking intraspinal drop metastasis. CLINICAL PRESENTATION: A 33-year-old man had an incidental finding of multiple enhancing intraspinal lesions as revealed by magnetic resonance imaging during staging tests for hepatocellular carcinoma. He had a history of Wilms' tumor at a young age with irradiation to the abdomen and pelvis. His family history included a paternal cousin with multiple cerebral CMs. The diagnosis of spinal drop metastasis was made, and further intervention was undertaken for confirmation. INTERVENTION: The patient underwent a lumbar laminectomy with durotomy and excision of two of the lesions. Macroscopic analysis revealed mulberry-like appearance with nerve root involvement, and pathological analysis confirmed the diagnosis of CM. Genetic testing of the patient and his affected cousin was negative for the CCM1 gene. CONCLUSION: The occurrence of multiple spinal lesions in the context of known neoplasia indicates a diagnosis of metastasis. Spinal CMs were not suspected preoperatively because of the atypical appearance revealed by magnetic resonance imaging scans, with uniform contrast enhancement and absence of hemosiderin rim. This case report is discussed relative to previous literature regarding radiation-induced CMs and other known causes of the disease.

scholarly journals Retroperitoneal Ectopic Pregnancy: Diagnosis and Therapeutic Challenges

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Salma Ouassour ◽  
Abdelhai Adib Filali ◽  
Mohamed Raiss ◽  
Rachid Bezad ◽  
Zakia Tazi ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Ectopic Pregnancy ◽  
Management Strategy ◽  
Clinical Signs ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Life Threatening ◽  
History Of ◽  
Ectopic Pregnancies

Background. Retroperitoneal ectopic pregnancy is extremely rare. This unusual location represents a great challenge for clinicians due to the difficulties of diagnosis and high risk of life-threatening complications. Case Report. We report the case of a spontaneous early pregnancy of undetermined location in a patient with a history of previous laparoscopic surgery. Diagnosis steps using clinical examination, ultrasound, and magnetic resonance imaging led to the localization of the pregnancy, in the left side of the para-aortic region, in the retroperitoneal space. Conclusion. Retroperitoneal ectopic pregnancy is an uncommon entity with rather complex pathogenesis. Clinicians should carefully interpret clinical signs, biological findings, and imaging features and be aware of unusual locations such as the retroperitoneum for ectopic pregnancies. Early diagnosis and appropriate management strategy are conditio sine qua non for successful treatment outcomes.

scholarly journals Symptomatic Cerebral Ependymal Cyst : A Case Report

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Rauf P ◽  
Aidil MN ◽  
Chan KH ◽  
Saufi A ◽  
Fadli M
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Status Epilepticus ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Neuroepithelial Cyst ◽  
Ependymal Cyst ◽  
History Of ◽  
Occipital Headache ◽  
The Brain

Cerebral ependymal cyst is a rare benign neuroepithelial cyst. We report a case of cerebral ependymal cyst in a 62-year-old lady who presented with status epilepticus. She gave history of progressive right occipital headache over a year. Magnetic Resonance Imaging of the brain showed a large occipital cyst. She underwent a right craniotomy, deroofing of the cyst and insertion of Ommaya catheter. The clinicopathological aspects of the cyst are discussed.

scholarly journals Metronidazole, an Uncommon Cause of Dizziness and Ataxia in the Emergency Department: A Case Report

2021 ◽  
Vol 2 (5) ◽  
pp. 239-241
Author(s):  
Mary Starrs ◽  
Onur Yenigun
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Adverse Reactions ◽  
Clinical Presentation ◽  
Use Case ◽  
Resonance Imaging ◽  
Cerebellar Dysfunction ◽  
History Of ◽  
The Central Nervous System ◽  
Local Emergency Department

Introduction: Metronidazole, a nitroimidazole antibiotic, is a well-known antibacterial and antiprotozoal agent that is generally well tolerated without many serious side effects. Most adverse reactions affect the gastrointestinal or genitourinary system, but the central nervous system may also be afflicted. In addition to headache and dizziness, cerebellar dysfunction can occur with metronidazole use. Case Report: We discuss the clinical presentation and imaging findings of metronidazole-induced encephalopathy in a 12-year-old male. The patient had a history of Crohn’s disease and chronic Clostridium difficile infection for which he had received metronidazole for approximately 75 days prior to arrival to a local emergency department (ED). He presented with five days of progressive vertigo, nausea, vomiting, and ataxia. Subsequent magnetic resonance imaging showed symmetric hyperintense dentate nuclei lesions, characteristic of metronidazole-induced encephalopathy. The patient’s symptoms improved rapidly after cessation of metronidazole, and his symptoms had completely resolved by discharge on hospital day two. Conclusion: Metronidazole-induced encephalopathy is a rare cause of vertigo and ataxia that can lead to permanent sequela if not identified and treated promptly. Thus, it is important for physicians to keep this diagnosis in mind when evaluating patients on metronidazole who present to the ED with new neurologic complaints.

Lupus Cerebellitis Presenting With Ataxia: A Case Report

2021 ◽  
pp. 194187442110212
Author(s):  
Tyler J. Kristoff ◽  
Aaron Shoskes ◽  
Benjamin Claytor
Keyword(s):  
Magnetic Resonance Imaging ◽  
Systemic Lupus Erythematosus ◽  
Case Report ◽  
Lupus Erythematosus ◽  
Mass Effect ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Systemic Lupus ◽  
History Of ◽  
The Brain

We report a case of a woman with a history of systemic lupus erythematosus who developed persistent ataxia and was diagnosis with lupus cerebellitis. Magnetic resonance imaging of the brain showed T2/FLAIR signal hyperintensity within the cerebellar vermis without mass effect. The patient’s condition improved with pulse IV methylprednisolone. This case highlights unique imaging findings within the cerebellum, our diagnostic and treatment regimen, and compares this case to previous literature on similar cases.

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