Intramedullary Cervical Tuberculoma: A Case Report With Note on Surgical Management

Abstract This study aims to report a relatively rare entity—intramedullary tuberculum of cervical spine—and describe its management and some key learning points. Intramedullary tuberculomas are rare entities. Intramedullary tuberculoma is most commonly found in the thoracic cord of a patient and is rarely seen in the cervical cord. We present an intramedullary cervical tuberculoma in a 21-year-old patient with finding of spinal cord compression. All 4 limbs were spastic, with grade 1 power on the right side and grade 3 power on the left side. Sensory deficit was found below the C6 level. Magnetic resonance imaging showed an intramedullary lesion at the C5 to C6 levels. Intramedullary tuberculoma was diagnosed based on clinical symptoms, physical examination, previous history, and magnetic resonance imaging. A C5 to C7 laminectomy was performed. Intramedullary tuberculoma was resected by microsurgery. One year after the surgery, strength returned to normal grade 5. Excellent clinical outcome was obtained with a combination of both medical and surgical treatments. Intramedullary cervical tuberculoma should be removed without delay to eliminate any mass effect on the neurons as soon as possible.

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Intramedullary Neurocysticercosis Mimicking Cord Tumor

Journal of Clinical Imaging Science ◽

10.25259/jcis_165_2019 ◽

2020 ◽

Vol 10 ◽

pp. 7

Author(s):

Kamlesh Jobanputra ◽

Karuna Raj ◽

Frank Yu ◽

Amit Agarwal

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Clinical Improvement ◽

Patient Population ◽

Cystic Lesion ◽

Cervical Cord ◽

Resonance Imaging ◽

Intramedullary Lesion ◽

Intracranial Lesions ◽

Cord Lesion

Isolated spinal intramedullary involvement by neurocysticercosis is extremely rare. We report a case of a Hispanic female with right-sided weakness, magnetic resonance imaging showing cervical intramedullary lesion. Surgery was performed due to the progressive nature of symptoms. The cervical cord lesion was completely removed; pathology was consistent with degenerated cysticercosis. Progressive clinical improvement with physiotherapy was achieved. Although rare, especially in the absence of intracranial lesions, the diagnosis should be considered in appropriate patient population as it usually presents a peripherally enhancing cystic lesion.

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Non-Ketotic Hyperglycemia Induced Hemichorea-Hemiballism May Represent Glioma-Like Pattern On Multimodal Magnetic Resonance Imaging: Can 1H Spectroscopy Help In The Differentiation?

10.21203/rs.3.rs-965143/v1 ◽

2021 ◽

Author(s):

Yu Lin ◽

Xiaoxiao Zhang ◽

Xin Yue ◽

Jinan Wang

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Mass Effect ◽

Resonance Spectroscopy ◽

Resonance Imaging ◽

Functional Changes ◽

Magnetic Resonance Imaging Mri ◽

T2 Hyperintensity ◽

The Right ◽

Ketotic Hyperglycemia

Abstract Background: Non-ketotic hyperglycemia (NKH) induced hemichorea-hemiballismus (HC-HB) is a rare reversible condition predominantly found in elderly patients with poorly controlled diabetics. Here, we describe two cases of NKH induced HC-HB with distinctive morphological and functional changes on conventional magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI) and 1H magnetic resonance spectroscopy (MRS).Case presentation: In case 1 with NKH induced HC-HB, computer tomography depicted increased attenuation in the left putamen and caudate nucleus. Focal T2-hyperintensity, obvious mass effect and ring-like enhancement were revealed on conventional MRI, suggesting the imaging findings of glioma. DWI indicated the lesion with unrestricted diffusion of water molecule. MRS further illustrated markedly increased lactate (Lac) and lipids (Lip), slightly elevated choline (Cho), and slightly decreased N-acetylaspartate (NAA) within the lesion. In case 2, baseline and follow-up MRI showed a lesion with typical reversible signal intensity in the right putamen without mass effect.Conclusions: This report emphasizes that NKH induced HC-HB may exhibit a unique appearance mimicking glioma. Slightly elevated Cho/NAA ratio with marked increased Lac peak on MRS may help to exclude neoplastic diseases.

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Cervical Cord Compression and Whole-Spine Sagittal Balance: Retrospective Study Using Whole-Spine Magnetic Resonance Imaging and Cervical Cord Compression Index

World Neurosurgery ◽

10.1016/j.wneu.2019.06.198 ◽

2019 ◽

Vol 130 ◽

pp. e709-e714

Author(s):

Chang Duk Yuk ◽

Tae Hwan Kim ◽

Moon Soo Park ◽

Seok Woo Kim ◽

Ho Geun Chang ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Retrospective Study ◽

Magnetic Resonance ◽

Cord Compression ◽

Cervical Cord ◽

Compression Index ◽

Resonance Imaging ◽

Cervical Cord Compression ◽

Whole Spine ◽

Spine Magnetic Resonance Imaging

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Cervical cord compression caused by a pillow in a postlaminectomy patient undergoing magnetic resonance imaging

Journal of Neurosurgery Spine ◽

10.3171/spi.1999.90.1.0145 ◽

1999 ◽

Vol 90 (1) ◽

pp. 145-147 ◽

Cited By ~ 2

Author(s):

Fumio Suzuki ◽

Masayuki Nakajima ◽

Masayuki Matsuda

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Cord Compression ◽

Cervical Cord ◽

Resonance Imaging ◽

Neck Extension ◽

Content Type ◽

Deep Wound ◽

Extended Position ◽

Cord Injury

✓ A 66-year-old man, who had undergone osteoplastic laminectomy for posttraumatic cervical myelopathy, underwent a second operation in which the replaced laminae were removed because of postoperative deep wound infection. Follow-up dynamic magnetic resonance imaging with flexion and extension views of the neck 1 year postsurgery demonstrated that the cervical cord was markedly compressed from behind in the extended position, although a wide subarachnoid space was observed in this region when the neck was in the flexed position. The cause of cord compression was the pillow that was placed underneath the patient's neck for maintaining the extended position, not the neck extension itself. This finding indicates that care must be taken during neuroradiological examination not to place a pillow under the neck of a patient who has undergone laminectomy. Nuchal compression could lead to cervical cord injury after laminectomy. Laminoplasty benefits the patient by protecting the cervical cord from secondary injury.

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Dynamic Cervical Cord Compression Post-laminectomy Visualized by Flexion-extension Magnetic Resonance Imaging: Case Report

Cureus ◽

10.7759/cureus.3878 ◽

2019 ◽

Author(s):

Adam Y Li ◽

Jennifer B Dai ◽

Alexander F Post ◽

Tanvir F Choudhri

Keyword(s):

Magnetic Resonance Imaging ◽

Case Report ◽

Magnetic Resonance ◽

Cord Compression ◽

Cervical Cord ◽

Resonance Imaging ◽

Cervical Cord Compression ◽

Flexion Extension

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MIDTERM CLINICAL AND MAGNETIC RESONANCE IMAGING FOLLOW-UP OF LARGE AND GIANT CAROTID ARTERY ANEURYSMS AFTER THERAPEUTIC CAROTID ARTERY OCCLUSION

Neurosurgery ◽

10.1227/01.neu.0000255468.30011.aa ◽

2007 ◽

Vol 60 (6) ◽

pp. 1025-1031 ◽

Cited By ~ 22

Author(s):

Anjob N. de Gast ◽

Marieke E. Sprengers ◽

Willem Jan van Rooij ◽

Cristina Lavini ◽

Menno Sluzewski ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Carotid Artery ◽

Clinical Symptoms ◽

Incidental Finding ◽

Mass Effect ◽

Artery Occlusion ◽

Carotid Artery Occlusion ◽

Resonance Imaging

Abstract OBJECTIVE The purpose of this study was to evaluate aneurysm size and clinical symptoms midterm after therapeutic carotid artery occlusion in 39 patients with large or giant carotid artery aneurysms. METHODS Between January 1996 and August 2004, 39 patients with large or giant carotid artery aneurysms were treated with therapeutic carotid artery occlusion and had clinical and magnetic resonance imaging follow-up of at least 3 months (mean, 35.9 mo; median, 29 mo; range, 3–107 mo; 117 patient-yr). Initial clinical presentation was mass effect caused by the aneurysm in 32 (82%) of the 39 patients. Three patients presented with subarachnoid hemorrhage and one presented with epistaxis; two aneurysms were an incidental finding and one was additional to another ruptured aneurysm. RESULTS There were no early or late complications of therapeutic carotid artery occlusion. All aneurysms seemed to have thrombosed completely after carotid artery occlusion as observed on early and late magnetic resonance imaging and magnetic resonance angiographic follow-up studies. At the time of the most recent magnetic resonance imaging follow-up study, 29 (74%) of the 39 aneurysms involuted totally, two aneurysms decreased to 25% of the original diameter, two aneurysms decreased to 50%, and five aneurysms decreased to 75%. Two aneurysms remained unchanged in size after 49 and 58 months, respectively. At the most recent clinical follow-up evaluation, symptoms of mass effect were cured in 19 (60%), improved in 10 (31%), and remained unchanged in three (9%) of the 32 patients. CONCLUSION Therapeutic carotid artery occlusion was a simple, safe, and effective treatment for large and giant carotid artery aneurysms. Almost all aneurysms involute completely or substantially decrease in size. Alleviation of symptoms of mass effect was achieved in most patients.

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Alteration within the Hippocampal Volume in Patients with LHON Disease—7 Tesla MRI Study

Journal of Clinical Medicine ◽

10.3390/jcm10010014 ◽

2020 ◽

Vol 10 (1) ◽

pp. 14

Author(s):

Cezary Grochowski ◽

Kamil Jonak ◽

Marcin Maciejewski ◽

Andrzej Stępniewski ◽

Mansur Rahnama-Hezavah

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Molecular Layer ◽

Three Dimensional ◽

Hippocampal Volume ◽

7 Tesla ◽

Diagnostic Process ◽

Resonance Imaging ◽

The Right

Purpose: The aim of this study was to assess the volumetry of the hippocampus in the Leber’s hereditary optic neuropathy (LHON) of blind patients. Methods: A total of 25 patients with LHON were randomly included into the study from the national health database. A total of 15 patients were selected according to the inclusion criteria. The submillimeter segmentation of the hippocampus was based on three-dimensional spoiled gradient recalled acquisition in steady state (3D-SPGR) BRAVO 7T magnetic resonance imaging (MRI) protocol. Results: Statistical analysis revealed that compared to healthy controls (HC), LHON subjects had multiple significant differences only in the right hippocampus, including a significantly higher volume of hippocampal tail (p = 0.009), subiculum body (p = 0.018), CA1 body (p = 0.002), hippocampal fissure (p = 0.046), molecular layer hippocampus (HP) body (p = 0.014), CA3 body (p = 0.006), Granule Cell (GC) and Molecular Layer (ML) of the Dentate Gyrus (DG)–GC ML DG body (p = 0.003), CA4 body (p = 0.001), whole hippocampal body (p = 0.018), and the whole hippocampus volume (p = 0.023). Discussion: The ultra-high-field magnetic resonance imaging allowed hippocampus quality visualization and analysis, serving as a powerful in vivo diagnostic tool in the diagnostic process and LHON disease course assessment. The study confirmed previous reports regarding volumetry of hippocampus in blind individuals.

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Substantia nigra neuromelanin magnetic resonance imaging in patients with different subtypes of Parkinson disease

Journal of Neural Transmission ◽

10.1007/s00702-020-02295-8 ◽

2021 ◽

Author(s):

Lu Wang ◽

Yayun Yan ◽

Liyao Zhang ◽

Yan Liu ◽

Ruirui Luo ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Substantia Nigra ◽

Parkinson Disease ◽

Clinical Symptoms ◽

Dopamine Neurons ◽

Substantia Nigra Pars Compacta ◽

Resonance Imaging ◽

Mean Values

AbstractNeuromelanin (NM) is a dark pigment that mainly exists in neurons of the substantia nigra pars compacta (SNc). In Parkinson disease (PD) patients, NM concentration decreases gradually with degeneration and necrosis of dopamine neurons, suggesting potential use as a PD biomarker. We aimed to evaluate associations between NM concentration in in vivo SN and PD progression and different motor subtypes using NM magnetic resonance imaging (NM-MRI). Fifty-four patients with idiopathic PD were enrolled. Patients were divided into groups by subtypes with different clinical symptoms: tremor dominant (TD) group and postural instability and gait difficulty (PIGD) group. Fifteen healthy age-matched volunteers were enrolled as controls. All subjects underwent clinical assessment and NM-MRI examination. PD patients showed significantly decreased contrast-to-noise ratio (CNR) values in medial and lateral SN (P < 0.05) compared to controls. CNR values in lateral SN region decreased linearly with PD progression (P = 0.001). PIGD patients showed significant decreases in CNR mean values in lateral SN compared to TD patients (P = 0.004). Diagnostic accuracy of using lateral substantia nigra (SN) in TD and PIGD groups was 79% (sensitivity 76.5%, specificity 78.6%). NM concentration in PD patients decreases gradually during disease progression and differs significantly between PD subtypes. NM may be a reliable biomarker for PD severity and subtype identification.

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