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https://www.readbyqxmd.com/read/29325956/rapid-onset-thoracic-myelopathy-due-to-an-epidural-sarcoid-like-lesion-in-a-pediatric-patient
#1
Michael A Galgano, Carlos R Goulart, Karen Chisholm, Melissa Hazen, Scellig Stone
Isolated intraspinal neurosarcoidosis is a rare clinical entity, with most reports describing intramedullary involvement in adults. We detail the case of a nine-year-old girl with rapid onset compressive myelopathy secondary to a thoracic epidural lesion. Although pathological diagnosis was challenging, a presumptive diagnosis of isolated extradural neurosarcoidosis was made in light of the patient's investigations and dramatic response to corticosteroids. Though less likely than neoplasia, rheumatologic processes such as inflammatory granulomatous disease warrant consideration in similar cases...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29316845/rho-inhibitor-vx-210-in-acute-traumatic-subaxial-cervical-spinal-cord-injury-design-of-the-spinal-cord-injury-rho-inhibition-investigation-spring-clinical-trial
#2
Michael G Fehlings, Kee D Kim, Bizhan Aarabi, Marco Rizzo, Lisa M Bond, Lisa McKerracher, Alexander Vaccaro, David O Okonkwo
Traumatic spinal cord injury (SCI) is associated with a lifetime of disability stemming from loss of motor, sensory, and autonomic functions; these losses, along with increased comorbid sequelae, negatively impact health outcomes and quality of life. Early decompression surgery after SCI can enhance patient outcomes but does not directly facilitate neural repair and regeneration. Currently, there are no FDA-approved pharmacologic therapies to augment motor function and functional recovery in individuals with traumatic SCI...
January 9, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29313091/intradural-cervical-chordoma-with-diffuse-spinal-leptomeningeal-spread-case-report-and-review-of-the-literature
#3
Jing Zhang, Chuan-Ping Gao, Xue-Jun Liu, Wen-Jian Xu
PURPOSE: Chordoma is a low-grade malignant bone tumor derived from embryonic notochord remnants along the axial skeleton. About 50% of chordomas occur in the sacral vertebrae and 35% in the skull base. Most chordomas are extradural and cause extensive bone destruction. Intradural spinal tumors without bone involvement are rare. METHODS: We herein describe the clinical features of a patient with a chordoma as well as the imaging and pathological manifestations of the tumor...
January 8, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29290904/primary-extradural-paraganglioma-of-the-thoracic-spine-a-case-report
#4
Alexander Reddy, Fanny Morón
Paragangliomas are rare, mostly benign neuroendocrine tumors arising from autonomic paraganglia. Spinal paragangliomas are uncommon, and among these, paragangliomas of the thoracic spine are distinctly unusual. We present the case of a primary paraganglioma of the extradural thoracic spine in a 34-year-old woman.
December 2017: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/29288844/primary-extradural-melanoma-arising-in-cervical-spinal-nerve-root
#5
Cunyi Zou, Wen Cheng, Chen Zhu, Qing Guo, Anhua Wu
BACKGROUND: Primary cervical melanoma is rare; this is especially true of extradural melanoma arising in the nerve root. Characterizing these cases can provide a basis for improved melanoma management. CASE DESCRIPTION: A 42-year-old female patient with numbness and pain in the right shoulder and arm persisting for 5 years was admitted. Preoperative magnetic resonance imaging revealed an epidural ladle-shaped mass shape beyond the C7-T1 intervertebral foramen that resembleda nerve sheath tumor...
December 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29285680/single-stage-total-resection-of-giant-dumbbell-shaped-hypoglossal-schwannoma-a-case-report
#6
Takuro Inoue, Yoichi Nonaka, Hisao Hirai, Ayako Shima, Fumio Suzuki, Masayuki Matsuda, Takanori Fukushima
Extensive large dumbbell-shaped hypoglossal schwannoma is extremely rare, and total resection is nearly impossible. We present a case of a 61-year-old male with a giant-size hypoglossal schwannoma with moderate tongue atrophy. The tumor extended from the enlarged hypoglossal canal to the brainstem intradurally and the high cervical region extradurally. Through the extreme lateral infrajugular transcondylar (ELITE) skull base approach, the tumor was totally removed in a single-stage operation. Single-stage total resection is feasible by an experienced skull base team utilizing transcondylar skull base techniques and high cervical dissection...
December 28, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29284599/spinal-arteriovenous-vascular-malformations-in-patients-with-neural-tube-defects
#7
E Giordan, C Bortolotti, G Lanzino, W Brinjikji
BACKGROUND AND PURPOSE: Neural tube defects, such as tethered cord, intradural lipoma, or myelomeningocele may coexist with spinal vascular malformations. The coexistence of these 2 rare entities is suggestive of a causal relationship between them, which may lead to further understanding of their pathogenesis. We present a series of 6 patients with epidural spinal arteriovenous fistulas associated with neural tube defects. MATERIALS AND METHODS: We retrieved cases of spinal vascular malformations associated with neural tube defects seen at our institution...
December 28, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29276623/feline-vertebral-angiomatosis-two-cases
#8
Massimo Frizzi, Nicola Ottolini, Claudia Spigolon, Giovanna Bertolini
Case series summary: Two cats aged between 1 and 2 years were presented for paraparesis, general discomfort, back pain and urinary retention. Extradural spinal cord compression at the level of T4 and T8 was evident on CT examination and on MRI. Hemilaminectomy and partial corpectomy were performed to achieve spinal cord decompression. Histopathology of the abnormal bone tissue was suggestive of vertebral angiomatosis. After initially worsening, both cats recovered their normal gait and functional urination...
July 2017: JFMS Open Reports
https://www.readbyqxmd.com/read/29243997/transdural-approach-to-resection-of-retro-odontoid-cysts-in-elderly-patients-report-of-3-cases
#9
Karthik Madhavan, Lee Onn Chieng, Brandon G Gaynor, Allan D Levi
Retro-odontoid cysts that arise from the tectorial membrane are uncommon lesions that can occur in elderly patients. They arise secondary to degenerative changes, including calcium pyrophosphate deposition within the ligaments. Surgical treatment is indicated when these lesions result in intractable pain, instability, and/or myelopathy. Several surgical techniques to treat this condition exist, but the optimal approach in elderly patients with comorbidities remains controversial. Here, the authors present a case series of 3 patients who underwent successful resection of a retro-odontoid lesion performed through a transdural approach...
December 15, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29192876/posterior-inferior-cerebellar-artery-with-an-extradural-origin-from-the-v3-segment-higher-incidence-on-the-nondominant-vertebral-artery
#10
Taiki Isaji, Muneyoshi Yasuda, Reo Kawaguchi, Masahiro Aoyama, Aichi Niwa, Takahiro Nakura, Naoki Matsuo, Masakazu Takayasu
OBJECTIVE The posterior inferior cerebellar artery (PICA) and the vertebral artery (VA) often exhibit anatomical variations at the craniovertebral junction (CVJ). An example of this is the PICA originating extradurally from the V3 segment of the VA. To date, some cadaveric investigations have been reported, but the incidence and relationship of this variation to the VA and the atlas as observed on clinical imaging have not been discussed. This study evaluated the prevalence of PICAs originating from the V3 on CT scanning...
December 1, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29192875/circumferential-dural-resection-technique-and-reconstruction-for-the-removal-of-giant-calcified-transdural-herniated-thoracic-discs
#11
Corey T Walker, M Yashar S Kalani, Mark E Oppenlander, Jakub Godzik, Nikolay L Martirosyan, Robert J Standerfer, Nicholas Theodore
OBJECTIVE The authors report a novel paradigm for resection of the disc or dural complex to treat giant calcified transdural herniated thoracic discs, and they describe a technique for the repair of dural defects. These herniated thoracic discs are uncommon, complicated lesions that often require a multidisciplinary team for effective treatment. The intradural component must be removed to effectively decompress the spinal cord. The opening of the friable dura mater, which frequently adheres to the extradural component of the disc, can result in large defects and difficult-to-manage CSF leaks...
December 1, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29191541/subtemporal-interdural-surgical-approach-for-giant-facial-nerve-neurinomas
#12
Atul Goel, Shashi Ranjan, Abhidha Shah, Survendra Rai, Sandeep Gore, Pralhad Dharurkar
OBJECTIVE: The management issues of 15 cases of giant and dumbbell shaped facial neurinomas that extended both in the middle and in the posterior cranial fossa is reported. MATERIAL AND METHODS: During the period 2002 to June 2017, 15 cases of giant and dumbbell shaped facial neurinomas were surgically treated. There were 10 males and 5 females and their ages ranged from 17 to 59 years (average 34.2 years). Average duration of facial nerve weakness prior to seeking surgical relief was 49...
November 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29179597/spontaneous-extradural-hematoma-a-rare-entity
#13
Khursheed Alam Khan, Sachin Chhabra, Somnath Sharma, Devendra Purohit
Spontaneous onset extradural hematoma (EDH) is a very rare entity and has been seen mostly to be associated with adjacent infective pathologies, dural vascular malformations, extradural metastasis, or coagulopathies. We report a series of two such cases and review the literature. One case presented with spontaneous EDH that was managed conservatively and was diagnosed to have chronic kidney disease later; the other had deranged coagulation profile and liver function secondary to drug induced hepatitis and was operated...
November 28, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29173435/pathophysiology-of-calcification-and-ossification-of-the-ligamentum-flavum-in-the-cervical-spine
#14
REVIEW
Toshiyuki Takahashi, Junya Hanakita, Manabu Minami
Calcification of the ligamentum flavum (CLF) and ossification of the ligamentum flavum (OLF) in the cervical spine are differential diagnoses in patients with posterior extradural compressive lesions related to cervical degenerative disease. Preoperative computed tomography can facilitate the detection of characteristic findings and help to distinguish between CLF and OLF. Although these are rare entities in the cervical spine, adequately timed surgical decompression is required in most patients who present with radiculomyelopathy...
January 2018: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/29146635/antibiotic-use-and-bacterial-complications-following-upper-respiratory-tract-infections-a-population-based-study
#15
Thomas Cars, Irene Eriksson, Anna Granath, Björn Wettermark, Jenny Hellman, Christer Norman, Anders Ternhag
OBJECTIVES: To investigate if use of antibiotics was associated with bacterial complications following upper respiratory tract infections (URTIs). DESIGN: Ecological time-trend analysis and a prospective cohort study. SETTING: Primary, outpatient specialist and inpatient care in Stockholm County, Sweden. All analyses were based on administrative healthcare data on consultations, diagnoses and dispensed antibiotics from January 2006 to January 2016...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29145656/refining-operative-strategies-for-optic-nerve-decompression-a-morphometric-analysis-of-transcranial-and-endoscopic-endonasal-techniques-using-clinical-parameters
#16
Steven L Gogela, Lee A Zimmer, Jeffrey T Keller, Norberto Andaluz
BACKGROUND: Various approaches can be considered for decompression of the intracanalicular optic nerve. Although clinical experience has been reported, no quantitative study has yet compared the extent of decompression achieved by an endoscopic endonasal versus transcranial approach. OBJECTIVE: Toward this aim, our morphometric analysis compared both approaches by quantifying the circumferential degree of optic canal decompression that is possible before any meningeal violation, which would result in cerebrospinal fluid (CSF) leak...
May 3, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29142793/a-ruptured-extra-dural-spinal-arterio-venous-malformation-presenting-as-horner-s-syndrome-the-first-case-report
#17
Sunil Munakomi
We report the first case of a young patient who presented with the features of Horner's syndrome following a spinal extradural hematoma resulting from a ruptured arterio-venous malformation (AVM). Since there were features of early compressive myelopathy as well, urgent magnetic resonance imaging (MRI) scan of the spine revealed features suggestive of an extradural hematoma in the cervico-thoracic junction. The patient underwent an emergent laminectomy with an evacuation of the hematoma. The histological features were consistent with that of an AVM...
September 3, 2017: Curēus
https://www.readbyqxmd.com/read/29142772/rare-case-of-an-extraosseous-cervical-chordoma-with-both-intradural-and-extensive-extraspinal-involvement
#18
Victor Awuor, Christopher E Stewart, Albert Camma, Julie Renner, J M Tongson
Background: Chordomas must be considered among the differential diagnoses for extradural spinal tumors, especially involving the clival or sacrococcygeal regions. They are often locally invasive and destructive to the osseous structures from which they arise, but rarely extend intradurally. Here, we report a unique chordoma that was intradural and spanned nearly four subaxial cervical vertebral levels. Case Description: We report the case of an atypical intradural chordoma that spanned four subaxial levels of the cervical spine in an 81-year-old female...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29131823/prevalence-of-extracranial-carotid-artery-aneurysms-in-patients-with-an-intracranial-aneurysm
#19
V E C Pourier, C J H C M van Laarhoven, M D I Vergouwen, G J E Rinkel, Gert J de Borst
BACKGROUND AND PURPOSE: Aneurysms in various arterial beds have common risk- and genetic factors. Data on the correlation of extracranial carotid artery aneurysms (ECAA) with aneurysms in other vascular territories are lacking. We aimed to investigate the prevalence of ECAA in patients with an intracranial aneurysm (IA). METHODS: We used prospectively collected databases of consecutive patients registered at the University Medical Center Utrecht with an unruptured intracranial aneurysm (UIA) or aneurysmal Subarachnoid hemorrhage (SAH)...
2017: PloS One
https://www.readbyqxmd.com/read/29131102/a-case-of-a-4-year-old-female-with-a-primary-spinal-malignancy-presenting-with-froin-s-syndrome
#20
Andrew T Hale, Gregory P Fricker, Travis W Crook
We report the case of a 4-year-old female with a primary extradural intramedullary atypical teratoid/rhabdoid tumor (AT/RT) leading to a middle cerebral artery (MCA) infarct and Froin's syndrome. She presented with a 6-pound weight loss over the previous week, as well as a decreased urinary output and an altered mental status. She underwent a brain MRI that revealed a left MCA infarct, mild ventriculomegaly, and bilateral internal carotid artery, M1, and A1 stenosis. An external ventricular drain (EVD) was placed due to increased intracranial pressure...
2018: Pediatric Neurosurgery
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