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Transverse Myelopathy

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https://www.readbyqxmd.com/read/29604979/hiv-and-spinal-cord-disease
#1
Seth N Levin, Jennifer L Lyons
The epidemiology of spinal cord disease in human immunodeficiency virus (HIV) infection is largely unknown due to a paucity of data since combination antiretroviral therapy (cART). HIV mediates spinal cord injury indirectly, by immune modulation, degeneration, or associated infections and neoplasms. The pathologies vary and range from cytotoxic necrosis to demyelination and vasculitis. Control of HIV determines the differential for all neurologic presentations in infected individuals. Primary HIV-associated acute transverse myelitis, an acute inflammatory condition with pathologic similarities to HIV encephalitis, arises in early infection and at seroconversion...
2018: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/29530383/high-resolution-magnetization-transfer-mri-in-patients-with-cervical-spondylotic-myelopathy
#2
Linda I Suleiman, Kenneth A Weber, Brett D Rosenthal, Surabhi A Bhatt, Jason W Savage, Wellington K Hsu, Alpesh A Patel, Todd B Parrish
Magnetization transfer (MT) contrast has been established as a marker of myelin integrity, and cervical spondylotic myelopathy is known to cause demyelination. Ten patients with clinical and magnetic resonance imaging (MRI) manifestations of cervical spondylotic myelopathy (CSM) were compared to the MRIs of seven historic healthy controls, using the magnetization transfer ratio (MTR) and Nurick scores as the primary metrics. Transverse slices through the intervertebral discs of the cervical spine were acquired using a gradient echo sequence (MEDIC) with and without an MT saturation pulse on a 3 Tesla Siemens Prisma scanner (TR = 300 ms, TEeff  = 17 ms, flip angle = 30°, in-plane resolution = 0...
March 9, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29518219/spontaneous-regression-of-a-retroodontoid-transverse-ligament-cyst-a-case-report
#3
Soliman Oushy, Lucas P Carlstrom, William E Krauss
BACKGROUND AND IMPORTANCE: Transverse ligament cysts (TLC) are rare, surgically complex lesions arising posterior to the odontoid process of C2. Direct compression of the cervicomedullary junction is a devastating consequence of untreated lesions. We report the first case of spontaneous TLC regression without surgical intervention. CLINICAL PRESENTATION: A 75-yr-old woman presented to an outside hospital with acute episodes of left face and upper extremity numbness...
March 5, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29449281/mri-features-of-aquaporin-4-antibody-positive-longitudinally-extensive-transverse-myelitis-insights-into-the-diagnosis-of-neuromyelitis-optica-spectrum-disorders
#4
C G Chee, K S Park, J W Lee, H W Ahn, E Lee, Y Kang, H S Kang
BACKGROUND AND PURPOSE: Longitudinally extensive transverse myelitis is a well-documented spinal manifestation of neuromyelitis optica spectrum disorders, however, other forms of nontumorous myelopathy can also manifest as longitudinally extensive transverse myelitis. Our aim was to evaluate the MR imaging features of aquaporin-4 antibody-positive longitudinally extensive transverse myelitis, which is strongly associated with neuromyelitis optica spectrum disorders. MATERIALS AND METHODS: We evaluated cervicomedullary junction involvement, cord expansion ratios, bright spotty lesions, the number of involved segments, skipped lesions, enhancement patterns, and axial distribution patterns using spinal MR imaging of 41 patients with longitudinally extensive transverse myelitis who underwent aquaporin-4 antibody testing...
February 15, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29441246/spinal-cord-infarction-mimicking-acute-transverse-myelitis
#5
Nilesh H Pawar, Ealing Loke, Derrick C Aw
Spinal cord infarction (SCI) is a rare type of stroke. The initial magnetic resonance imaging (MRI) is usually normal and can mimic the presentation of the acute transverse myelitis (ATM), acute inflammatory demyelinating polyneuropathy, and compressive myelopathies from neoplasm, epidural or subdural hematoma, or abscess. The aim of this report is to describe and discuss the case of a patient with SCI presenting as a diagnostic confusion with acute transverse myelitis. A 64-year-old male with a medical history of hypertension presented with an acute onset of urinary retention with lower limb weakness...
December 6, 2017: Curēus
https://www.readbyqxmd.com/read/29388926/-the-role-of-the-neurophysiological-methods-in-the-assessment-of-the-effectiveness-of-the-rehabilitation-of-sensorimotor-disturbances-associated-with-the-lesions-of-the-central-nervous-system-at-the-spinal-cord-level
#6
E V Ekusheva, V B Voitenkov, N V Skripchenko, I G Samoilova, V A Filimonov
AIM: The objective of the present study was the evaluation and comparison of the effectiveness of the differential approaches to the neurorehabilitation of the somatosensory disturbances in the patients presenting with the spinal cord lesions. MATERIALS AND METHODS: A total of 68 patients with spinal cord lesions were enrolled in the study, including 38 suffering from vascular myelopathy, 18 with the consequences of extramedullar meningioma surgery, 12 with the sequelae of acute transverse myelitis...
December 28, 2017: Voprosy Kurortologii, Fizioterapii, i Lechebnoĭ Fizicheskoĭ Kultury
https://www.readbyqxmd.com/read/29382812/evaluation-and-management-of-spinal-subarachnoid-hemorrhage-in-a-patient-with-lupus-vasculitis
#7
Ryan M Glynn, Madeline R Garza, Franco M Campanella
BACKGROUND Isolated spinal artery subarachnoid hemorrhage is a rare occurrence in the general population, but occurs more commonly as one of many neurologic sequela of systemic lupus erythematosus (SLE). The etiology of a neurologic deficit in an SLE patient is often multifactorial. Comorbid conditions, such as antiphospholipid antibody syndrome, predispose to stroke. Other diagnoses, including transverse myelitis, may also be attributed to local inflammation. CASE REPORT A 37-year-old woman with SLE and antiphospholipid antibody syndrome experienced severe back pain followed by sudden paralysis and sensory loss below the T2 level...
January 31, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29332032/value-of-conventional-mri-and-diffusion-tensor-imaging-parameters-in-predicting-surgical-outcome-in-patients-with-degenerative-cervical-myelopathy
#8
Canghai Shen, Haiwei Xu, Baoshan Xu, Xiaoguang Zhang, Xiaofeng Li, Qiang Yang, Xinlong Ma
BACKGROUND: In addition to conventional magnetic resonance imaging (cMRI), diffusion tensor imaging (DTI) has been investigated as a potential diagnostic and prognostic tool for patients with degenerative cervical myelopathy (DCM). OBJECTIVE: To assess the efficacy of cMRI and DTI parameters in prediction of surgical outcome in DCM patients. METHODS: One hundred and forty-two patients with DCM who underwent presurgical cMRI and DTI of the cervical spine were included...
December 29, 2017: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/29322962/etiologic-spectrum-and-prognosis-in-noncompressive-acute-transverse-myelopathies-an-experience-of-80-patients-at-a-tertiary-care-facility
#9
Shuchit Pandey, Ravindra K Garg, Hardeep S Malhotra, Amita Jain, Kiran P Malhotra, Neeraj Kumar, Rajesh Verma, Praveen K Sharma
INTRODUCTION: We evaluated the spectrum of acquired demyelinating and inflammatory disorders in patients presenting with an acute transverse myelopathy. We also studied differences between an acute idiopathic transverse myelitis and myelitis resulting from other etiologies. MATERIALS AND METHODS: Eighty consecutive patients with acute transverse myelopathy were included. At inclusion, clinical profile, serum and cerebrospinal fluid parameters, brain and spinal cord magnetic resonance imaging, and visual evoked potentials were obtained...
January 2018: Neurology India
https://www.readbyqxmd.com/read/29247071/evaluation-of-idiopathic-transverse-myelitis-revealing-specific-myelopathy-diagnoses
#10
Nicholas L Zalewski, Eoin P Flanagan, B Mark Keegan
OBJECTIVE: To evaluate specific myelopathy diagnoses made in patients with suspected idiopathic transverse myelitis (ITM). METHODS: A total of 226 patients 18 years and older were referred to Mayo Clinic Neurology for suspected ITM from December 1, 2010, to December 31, 2015. Electronic medical records were reviewed for detailed clinical presentation and course, laboratory and electrophysiologic investigations, and neuroimaging to determine the etiology. Current diagnostic criteria for ITM and alternative myelopathy diagnoses were applied...
January 9, 2018: Neurology
https://www.readbyqxmd.com/read/29201326/a-challenging-entity-multiple-sclerosis-or-collagen-tissue-disorders-a-case-series-of-6-patients
#11
Raida Ben Salah, Yosra Cherif, Faten Frikha, Dammak Chifaa, Mouna Snoussi, Moez Jallouli, Sameh Marzouk, Mhiri Chokri, Zouhir Bahloul
Background: Multiple sclerosis and other demyelinating processes are sometimes difficult to differentiate from the neurological involvement in autoimmune diseases. Distinguishing multiple sclerosis from other lesions due to autoimmune diseases is crucial to avoid unsuitable or delayed treatments. Methods: Charts of 6 patients diagnosed with mimicking multiple sclerosis between 1996 and 2014 were retrospectively assessed. Results: The mean age at diagnosis was 35±7 years...
2017: Caspian Journal of Internal Medicine
https://www.readbyqxmd.com/read/29196574/clinical-biomarkers-differentiate-myelitis-from-vascular-and-other-causes-of-myelopathy
#12
Paula Barreras, Kathryn C Fitzgerald, Maureen A Mealy, Jorge A Jimenez, Daniel Becker, Scott D Newsome, Michael Levy, Philippe Gailloud, Carlos A Pardo
OBJECTIVE: To assess the predictive value of the initial clinical and paraclinical features in the differentiation of inflammatory myelopathies from other causes of myelopathy in patients with initial diagnosis of transverse myelitis (TM). METHODS: We analyzed the clinical presentation, spinal cord MRI, and CSF features in a cohort of 457 patients referred to a specialized myelopathy center with the presumptive diagnosis of TM. After evaluation, the myelopathies were classified as inflammatory, ischemic/stroke, arteriovenous malformations/fistulas, spondylotic, or other...
January 2, 2018: Neurology
https://www.readbyqxmd.com/read/29166400/chronic-post-traumatic-intramedullary-lesions-in-dogs-a-translational-model
#13
Neringa Alisauskaite, Ingo Spitzbarth, Wolfgang Baumgärtner, Peter Dziallas, Sabine Kramer, Ricarda Dening, Veronika Maria Stein, Andrea Tipold
OBJECTIVES: Post-traumatic intramedullary myelopathies and cavitations are well described lesions following spinal cord injury (SCI) in humans and have been described in histopathological evaluations in dogs. Human intramedullary myelopathies/cavitations are associated with severe initial SCI and deterioration of clinical signs. Canine intervertebral disc extrusions share similarities with SCI in humans. In this descriptive study, magnetic resonance imaging (MRI) findings in spinal cords of dogs suffering from chronic post-traumatic myelopathies, including cavitations, are elucidated...
2017: PloS One
https://www.readbyqxmd.com/read/29110994/spinal-cord-involvement-in-primary-cns-lymphoma
#14
Arunmozhimaran Elavarasi, Deepa Dash, Anand R Warrier, Rohit Bhatia, Lalit Kumar, Deepali Jain, Manjari Tripathi
LETM is a common syndrome and the diagnosis of CNS lymphoma is not usually considered in the list of differentials. Primary CNS lymphoma can present as longitudinally extensive transverse myelopathy. Failure to suspect and evaluate leads to delay in diagnosis and treatment. PCNSL may be non contrast enhancing on gadolinium enhanced MRI. CSF analysis should be done preferably before starting corticosteroids as it is usual practice in treatment of transverse myelitis, as steroids may lead to transient improvement and mask the correct diagnosis...
January 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28991665/spinal-cord-anteroposterior-atrophy-in-ham-tsp-magnetic-resonance-imaging-and-neuropathological-analyses
#15
Akitoshi Taniguchi, Hitoshi Mochizuki, Atsushi Yamashita, Kazutaka Shiomi, Yujiro Asada, Masamitsu Nakazato
To evaluate the spinal cord atrophy that occurs in HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), we conducted magnetic resonance imaging (MRI) and pathological analyses. In the MRI study, 15 patients with HAM/TSP and 20 age-matched normal control subjects were enrolled. Anteroposterior and transverse distances and cross-sectional areas were measured and calculated at the C2, C4, C6, T2, and T6 vertebral levels. In the pathological study, spinal cord autopsy specimens were compared between a HAM/TSP case and an adult T cell leukemia/lymphoma case...
October 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28894681/preoperative-computed-tomography-myelography-parameters-as-predictors-of-outcome-in-patients-with-degenerative-cervical-myelopathy-results-of-a-systematic-review
#16
Feras J Waly, Fahad H Abduljabbar, Maryse Fortin, Anas Nooh, Michael Weber
STUDY DESIGN: Systematic review. OBJECTIVES: To determine the preoperative computed tomography (CT) myelogram imaging parameters in patients diagnosed with degenerative cervical myelopathy (DCM) that correlate with severity of DCM and predict postoperative patients' functional outcome. METHODS: An electronic database search was performed using Ovid Medline and Embase. CT myelogram studies investigating the correlation between imaging characteristics and DCM severity or postoperative outcomes were included...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28798719/fulminant-acute-ascending-hemorrhagic-myelitis-treated-with-eculizumab
#17
Nang Boe Ohnmar Hsam, Klemens Angstwurm, Sebastian Peters, Kornelius Fuchs, Gerhard Schuierer, Ulrich Bogdahn, Robert Weissert
We describe an 18-year-old patient who developed back pain, rapidly ascending sensomotory deficits, bladder dysfunction, Lhermitte's sign, absent abdominal reflexes of all three levels, brisk tendon reflexes, and positive Babinski's sign. Magnetic resonance imaging of the spinal cord showed a long segment of cervical and thoracic intramedullary signal hyperintensity suggesting a longitudinally extensive transverse myelitis possibly within the course of a fast progressing ascending immune-mediated hemorrhagic myelopathy...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28797832/subacute-progressive-myelopathy-transverse-myelitis-or-subacute-combined-degeneration-a-case-report
#18
Daniel Goldish, Teresa L Massagli
Evolving subacute myelopathies have many possible etiologies. This is a report of a patient who presented with progressive paresthesias, proprioceptive loss, and gait disturbance with acute myelitis seen on magnetic resonance imaging initially concerning for transverse myelitis. However, she also had vitamin B12 deficiency, and her clinical course ultimately suggested a diagnosis more compatible with subacute combined degeneration. The clinical features, laboratory, and imaging findings and prognosis of the 2 disorders are compared...
March 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28721000/roentgenographic-and-computerized-tomography-based-morphometric-analysis-of-cervical-spinal-canal-diameters-to-establish-normative-measurements-in-an-indian-population
#19
Kapil A Pawar, Arya S Mishra, Gokul Bandagi, Sudhir K Srivastava
Compressive cervical myelopathy secondary to degenerative changes in the cervical spine is a common cause of neurologic morbidity in the elderly. Identification of canal stenosis and addressing it surgically in addition to the obvious compressive lesions is essential to obtain satisfactory results. We attempt to define the saggital and transverse diameters in a normal adult population presenting at our centre with head injuries. We found that the values were lower than those reported in comparable studies for a western population, and also that the dimensions in women are significantly lower than in men...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28667382/magnetic-resonance-imaging-and-clinical-features-in-acute-and-subacute-myelopathies
#20
REVIEW
Stefan Weidauer, Marlies Wagner, Michael Nichtweiß
Differential diagnosis of acute and subacute transverse myelopathy includes inflammatory, infectious, vascular, metabolic and paraneoplastic etiologies. Information on the diagnostic approach to transverse myelopathy with regard to daily clinical practice is provided. The differentiation between five lesion patterns on magnetic resonance imaging (MRI) in myelitis may be helpful: (1) longitudinal extensive transverse myelitis, (2) short segment ovoid or peripherally located, (3) "polio-like", (4) granulomatous and (5) segmental with rash...
December 2017: Clinical Neuroradiology
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