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https://www.readbyqxmd.com/read/28537458/chiari-i-malformation-in-children-with-transverse-myelitis
#1
Sathya Vadivelu, Sudhakar Vadivelu, Maureen Mealy, Smurti Patel, Libby Kosnik-Infinger, Daniel Becker
PURPOSE: Transverse myelitis (TM) is an acute inflammatory spinal cord injury. Asymptomatic Chiari I malformation (CMI) management is highly controversial, particularly when associated with a spinal syrinx. Here, we assess the occurrence of CMI in the pediatric TM population and management outcomes. METHODS: We performed a retrospective cohort study based on 61 consecutively identified pediatric TM cases over an -8-year period. We reviewed demographic characteristics, radiographic findings, presenting symptoms, and long-term outcomes...
May 24, 2017: Developmental Neurorehabilitation
https://www.readbyqxmd.com/read/28428929/treatment-of-posttubercular-syringomyelia-not-responsive-to-antitubercular-therapy-case-report-and-review-of-literature
#2
Giuseppe Canova, Alessandro Boaro, Enrico Giordan, Pierluigi Longatti
Posttubercular adhesive arachnoiditis is a rare, late complication of tubercular meningitis. Syringomyelia can develop as a consequence of intramedullary cystic lesions and cerebrospinal fluid (CSF) flow disturbance around the spinal cord, even after successful chemotherapy. We reviewed the literature related to posttubercular syringomyelia treatment and suggest a new combined surgical approach. A 25-year-old Nigerian male patient presented with legs numbness, urinary disturbance, and legs weakness. Spinal magnetic resonance revealed a T5-T7 syringomyelia, secondary to adhesive spinal arachnoiditis related to a history of tuberculous meningitis...
April 2017: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/28291422/comparison-of-posterior-fossa-volumes-and-clinical-outcomes-after-decompression-of-chiari-malformation-type-i
#3
COMPARATIVE STUDY
Siri Sahib S Khalsa, Alan Siu, Tiffani A DeFreitas, Justin M Cappuzzo, John S Myseros, Suresh N Magge, Chima O Oluigbo, Robert F Keating
OBJECTIVE Previous studies have indicated an association of Chiari malformation Type I (CM-I) and a small posterior fossa. Most of these studies have been limited by 2D quantitative methods, and more recent studies utilizing 3D methodologies are time-intensive with manual segmentation. The authors sought to develop a more automated tool to calculate the 3D posterior fossa volume, and correlate its changes after decompression with surgical outcomes. METHODS A semiautomated segmentation program was developed, and used to compare the pre- and postoperative volumes of the posterior cranial fossa (PCF) and the CSF spaces (cisterna magna, prepontine cistern, and fourth ventricle) in a cohort of pediatric patients with CM-I...
May 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28291403/a-rat-model-of-chronic-syringomyelia-induced-by-epidural-compression-of-the-lumbar-spinal-cord
#4
Ji Yeoun Lee, Shin Won Kim, Saet Pyoul Kim, Hyeonjin Kim, Jung-Eun Cheon, Seung-Ki Kim, Sun Ha Paek, Dachling Pang, Kyu-Chang Wang
OBJECTIVE There has been no established animal model of syringomyelia associated with lumbosacral spinal lipoma. The research on the pathophysiology of syringomyelia has been focused on Chiari malformation, trauma, and inflammation. To understand the pathophysiology of syringomyelia associated with occult spinal dysraphism, a novel animal model of syringomyelia induced by chronic mechanical compression of the lumbar spinal cord was created. METHODS The model was made by epidural injection of highly concentrated paste-like kaolin solution through windows created by partial laminectomy of L-1 and L-5 vertebrae...
February 17, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28250632/treatment-of-idiopathic-syrinx-by-atlantoaxial-fixation-report-of-an-experience-with-nine-cases
#5
Abhidha Shah, Prashant Sathe, Manoj Patil, Atul Goel
OBJECTIVE: The authors evaluate the significance of atlantoaxial instability in the management of idiopathic syringomyelia. BACKGROUND: We recently observed that atlantoaxial dislocation can be present even when the atlantodental interval was within normal range. Atlantoaxial instability can be identified on the basis of facetal mal-alignment or even by direct observation of status of joint during surgery. Our observations are discussed in nine patients where we identified and treated atlantoaxial instability in cases that would otherwise be considered as having "idiopathic" syrinx...
January 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/28164059/neuropathic-knee-joint-a-complication-of-syrinx-following-spinal-anesthesia-a-rare-case-report-and-review-of-literature
#6
S Swaroop Chandra, J K Giriraj Harshavardhan, Ganesan G Ram, P V Vijayaraghavan
INTRODUCTION: Neurological complications due to spinal anesthesia are dysesthesia, paresthesia, cauda equina syndrome, and neuropathic joint. However, neurological complications are rare. We report a case of neuropathic joint of knee as a complication of syrinx following postspinal anesthesia. CASE REPORT: A 33-year-old female came with complaints of pain and instability of her left knee and left foot drop. She had developed weakness of her left lower limb following her cesarean section surgery done under spinal anesthesia...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/27712091/sustained-high-pressure-in-the-spinal-subarachnoid-space-while-arterial-expansion-is-low-may-be-linked-to-syrinx-development
#7
Elizabeth C Clarke, David F Fletcher, Lynne E Bilston
Syringomyelia (a spinal cord cyst) usually develops as a result of conditions that cause cerebrospinal fluid (CSF) obstruction. The mechanism of syrinx formation and enlargement remains unclear, though previous studies suggest that the fluid enters via the perivascular spaces (PVS) of the penetrating arteries of the spinal cord, and that alterations in the CSF pulse timing and pressure could contribute to enhanced PVS inflow. This study uses an idealised computational model of the PVS to investigate the factors that influence peri-arterial fluid flow...
April 2017: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/27448173/spinal-cord-anomalies-in-patients-with-anorectal-malformations-without-severe-sacral-abnormalities-or-meningomyelocele-outcomes-after-expectant-conservative-management
#8
Kristiina Kyrklund, Mikko P Pakarinen, Seppo Taskinen, Reetta Kivisaari, Risto J Rintala
OBJECTIVE The goal of this study was to determine the significance of spinal cord anomalies (SCAs) in patients with anorectal malformations (ARMs) by comparing the outcomes for bowel function, lower urinary tract symptoms (LUTS), and lower-limb neurological abnormalities to these outcomes in patients with similar ARMs and a normal spinal cord. METHODS The spinal cord MRI records of female patients treated for vestibular and perineal fistula (VF/PF) and male patients with rectourethral fistula (RUF) at a single center between 1983 and 2006 were reviewed...
December 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27114772/relationship-between-spinal-hemangioblastoma-location-and-age
#9
Tatsuya Yasuda, Tomohiko Hasegawa, Yu Yamato, Sho Kobayashi, Daisuke Togawa, Tomohiro Banno, Hideyuki Arima, Shin Oe, Yukihiro Matsuyama
STUDY DESIGN: Retrospective case series. PURPOSE: To investigate the relationship between tumor location and clinical characteristics. OVERVIEW OF LITERATURE: Hemangioblastoma is a rare disease that develops in the central nervous system. Magnetic resonance imaging (MRI) is useful to evaluate hemangioblastomas. Hemangioblastoma's location is designated as intramedullary, intramedullary+extramedullary, or extramedullary by MRI. METHODS: We analyzed 11 patients who underwent surgery for spinal hemangioblastoma...
April 2016: Asian Spine Journal
https://www.readbyqxmd.com/read/27082975/radiographic-predictors-of-deterioration-in-patients-with-lumbosacral-lipomas
#10
Albert Tu, Alexander R Hengel, D Douglas Cochrane
OBJECTIVE Although patients with lumbosacral lipomas may be asymptomatic at presentation, most develop neurological symptoms over time. Given the challenges in examining infants, the authors sought to determine whether MRI would be helpful in identifying patients who are more likely to deteriorate early in life and who would potentially benefit from early surgical intervention. METHODS A retrospective review of all patients with lumbosacral lipomas who were seen at the authors' institution between 1997 and 2013 and who were managed without prophylactic surgery was performed...
August 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27035547/severe-holocord-syrinx-in-a-child-with-megalencephaly-capillary-malformation-syndrome
#11
Devorah Segal, Robert F Heary, Sanjeev Sabharwal, Maureen T Barry, Xue Ming
The authors present the case of a child with megalencephaly-capillary malformation syndrome who developed a rapidly progressive holocord syringomyelia that was treated surgically. A 3-year-old boy with megalencephaly-capillary malformation-polymicrogyria (MCAP) syndrome presented with several months of right leg weakness, worsening scoliosis, and increased seizures. An MRI study of the brain demonstrated a Chiari I malformation and massively dilated syringomyelia extending from C-2 to the conus medullaris. The patient underwent an urgent suboccipital craniectomy with C1-3 laminectomies to relieve the CSF outflow obstruction with significant clinical improvement...
July 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/26824588/direct-trauma-model-of-posttraumatic-syringomyelia-with-a-computer-controlled-motorized-spinal-cord-impactor
#12
Johnny H Y Wong, Xin Song, Sarah J Hemley, Lynne E Bilston, Shaokoon Cheng, Marcus A Stoodley
OBJECTIVE The pathogenesis of posttraumatic syringomyelia remains enigmatic and is not adequately explained by current theories. Experimental investigations require a reproducible animal model that replicates the human condition. Current animal models are imperfect because of their low reliability, severe neurological deficits, or dissimilar mechanism of injury. The objective of this study was to develop a reproducible rodent model of posttraumatic syringomyelia using a spinal cord impactor that produces an injury that more closely mimics the human condition and does not produce severe neurological deficits...
May 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/26771680/a-case-of-spinal-epidural-venous-malformation-with-mediastinal-extension-management-with-combined-surgery-and-percutaneous-sclerotherapy
#13
Gurpreet S Gandhoke, Sabri Yilmaz, Lorelei Grunwaldt, Ronald L Hamilton, David J Salvetti, Stephanie Greene
While spinal epidural arteriovenous malformations, fistulas, and shunts are well reported, the presence of a venous malformation in the spinal epidural space is a rare phenomenon. Herein, the authors report the clinical presentation, imaging findings, pathological features, and the outcome of surgical and percutaneous interventional management of a mediastinal and spinal epidural venous malformation in a young woman who presented clinically with neurogenic claudication from presumed venous hypertension precipitating the formation of a syrinx...
May 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/26768400/inwardly-rectifying-potassium-channel-4-1-expression-in-post-traumatic-syringomyelia
#14
E Najafi, M A Stoodley, L E Bilston, S J Hemley
Post-traumatic syringomyelia (PTS) is a serious neurological disorder characterized by fluid filled cavities that develop in the spinal cord. PTS is thought to be caused by an imbalance between fluid inflow and outflow in the spinal cord, but the underlying mechanisms are unknown. The ion channel Kir4.1 plays an important role in the uptake of K(+) ions from the extracellular space and release of K(+) ions into the microvasculature, generating an osmotic gradient that drives water movement. Changes in Kir4...
March 11, 2016: Neuroscience
https://www.readbyqxmd.com/read/26743916/cerebrospinal-fluid-disturbance-in-overweight-women-after-occipitocervical-decompression-in-chiari-malformation-type-i
#15
Fawaz S Almotairi, Magnus Tisell
BACKGROUND: Cerebrospinal fluid disturbance (CSFD) is a well-known complication after occipitocervical decompression (OCD) in patients with Chiari malformation type I (CMI). There is scarce data focusing on preoperative patients' factors predisposing to development of CSF disturbance. The aim of this study is to evaluate a prognostic value of some patients' factors in the prediction of CSFD after OCD in CMI patients. MATERIALS AND METHODS: We undertook a 10-year (2003-2013) retrospective study of all OCD in patients with CMI performed at Sahlgrenska IC, Sahlgrenska University Hospital, Sweden...
March 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/26728365/retrocerebellar-arachnoid-cyst-resulting-in-syringomyelia-in-a-patient-without-tonsillar-herniation-successful-surgical-treatment-with-reconstruction-of-csf-flow-in-the-foramen-magnum-region
#16
Liyong Sun, Stephan Emich, Wenzhuo Fu, Zan Chen, Wu Hao, Feng Ling, Fengzeng Jian
A retrocerebellar arachnoid cyst causing syringomyelia is extremely rare without tonsillar herniation. The authors present a 44-year-old woman with symptoms of foramen magnum compression and syringomyelia. Magnetic resonance imaging demonstrated a large retrocerebellar arachnoid cyst with a large cervicothoracic syrinx but no signs of tonsillar herniation or hydrocephalus. The patient underwent a foramen magnum decompression with C1 laminectomy, microsurgical fenestration of the cyst, and duraplasty. After successful reconstruction of CSF flow, the patient experienced a relief of symptoms and a significant reduction of the syrinx...
April 2016: Neurosurgical Review
https://www.readbyqxmd.com/read/26704196/complicated-pseudomeningocele-repair-after-chiari-decompression-case-report-and-review-of-the-literature
#17
REVIEW
Claudio De Tommasi, Aaron E Bond
BACKGROUND: Pseudomeningocele is a recognised complication after posterior fossa decompression for Chiari malformation. Its management can be challenging and treatment options vary in literature. CASE DESCRIPTION: A difficult-to-treat case of a pseudomeningocele after posterior fossa decompression for a Chiari I malformation is presented. A 34-year-old woman underwent an initial decompression followed by multiple revision surgeries after the development of a symptomatic pseudomeningocele and a low-grade infection...
April 2016: World Neurosurgery
https://www.readbyqxmd.com/read/26679889/radiological-features-of-scoliosis-in-chiari-i-malformation-without-syringomyelia
#18
Zezhang Zhu, Huang Yan, Xiao Han, Mengran Jin, Dingding Xie, Shifu Sha, Zhen Liu, Bangping Qian, Feng Zhu, Yong Qiu
STUDY DESIGN: A retrospective radiographic analysis. OBJECTIVE: The aim of this study was to investigate the scoliosis curve patterns/features and magnetic resonance imaging (MRI) tonsillar ectopia characteristics in Chiari I malformation without syringomyelia (CMI-only). SUMMARY OF BACKGROUND DATA: The development of scoliosis associated with a CMI typically has been ascribed to the presence of syringomyelia. However, a subset of CMI patients with scoliosis may not have a concomitant syrinx...
March 2016: Spine
https://www.readbyqxmd.com/read/26675625/post-hemorrhagic-hydrocephalus-presenting-as-cauda-equina-syndrome-in-a-patient-with-spinal-dysraphism
#19
Matthew T Bender, Geoffrey P Colby, Judy Huang
Hydrocephalus has varied presentations in patients with a history of spinal dysraphism. This is a unique case of post-subarachnoid hemorrhage hydrocephalus presenting as cauda equina syndrome. We report on a 32-year-old woman with remotely repaired spinal defect who experienced subarachnoid hemorrhage and underwent anterior communicating artery aneurysm clipping. Post-operatively, she developed urinary and fecal incontinence as the sole presenting symptom of communicating post-hemorrhagic hydrocephalus. New neurological deficits in this population can also be attributed to recurrent cord tethering or syrinx, both of which were demonstrated on her lumbar spine MRI, but her incontinence resolved with external ventricular drain placement and cerebrospinal fluid diversion...
April 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/26588459/natural-and-surgical-history-of-chiari-malformation-type-i-in-the-pediatric-population
#20
I Jonathan Pomeraniec, Alexander Ksendzovsky, Ahmed J Awad, Francis Fezeu, John A Jane
OBJECT The natural and surgical history of Chiari malformation Type I (CM-I) in pediatric patients is currently not well described. In this study the authors discuss the clinical and radiological presentation and outcomes in a large cohort of pediatric CM-I patients treated with either conservative or surgical management. METHODS The authors retrospectively reviewed 95 cases involving pediatric patients with CM-I who presented between 2004 and 2013. The patients ranged in age from 9 months to 18 years (mean 8 years) at presentation...
March 2016: Journal of Neurosurgery. Pediatrics
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