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Caudas medullaris

E Brouwers, H van de Meent, A Curt, B Starremans, A Hosman, R Bartels
STUDY DESIGN: A systematic review. OBJECTIVES: Conus medullaris syndrome (CMS) and cauda equina syndrome (CES) are well-known neurological entities. It is assumed that these syndromes are different regarding neurological and functional prognosis. However, literature concerning spinal trauma is ambiguous about the exact definition of the syndromes. METHODS: A MEDLINE, EMBASE and Cochrane literature search was performed. We included original articles in which clinical descriptions of CMS and/or CES were mentioned in patients following trauma to the thoracolumbar spine...
May 23, 2017: Spinal Cord
Kentaro Naito, Toru Yamagata, Atsufumi Nagahama, Shinichi Kawahara, Kenji Ohata, Toshihiro Takami
The objective of this retrospective case analysis was to evaluate the surgical impact on neurological functional recovery in cases of solitary spinal nerve sheath tumors (NSTs) originating around the epiconus, conus medullaris, or cauda equina and not associated with neurofibromatosis. This 10-year surgical study included 30 cases of spinal NSTs originating around the spine level of T12-L1 (epiconus-to-conus medullaris: Epi-CM group), and 15 cases of spinal NSTs originating below the spine level of L2 (cauda equina: CE group)...
April 3, 2017: Neurosurgical Review
N Hadiji, R Mieusset, J G Previnaire, E Castel-Lacanal, J M Soler
STUDY DESIGN: Retrospective. OBJECTIVES: The objective of the study was to describe the type of ejaculation in patients with cauda equina (CE) and conus medullaris (CM) lesions, and to analyse sperm quality. SETTING: France. METHODS: One hundred sixty-six patients with CE and CM lesions were included. Diagnosis was based on clinical (no motor responses, sensation or sacral reflexes) and urodynamic assessments (no detrusor activity)...
June 2017: Spinal Cord
Mohammadreza Shahmohammadi, Reza Jalil Khoshuod, Alireza Zali, Amir Saied Seddeghi, Nima Mohseni Kabir
BACKGROUND: Cauda equina syndrome is a rare disorder that causes loss of Lumbar plexus function (nerve roots) lower than conus medullaris. No risk factor has been defined for this disease yet. Due to the high morbidity of Cauda equina syndrome and lack of sufficient information about the connection between the disease and urodynamic findings and EMG (Electromyography) findings, the need for this comprehensive study is felt. OBJECTIVE: The aim is to determine the predictive power of findings resulted from urodynamics and electromyography of perineal region and around sphincter in the clinical cure rate of urination in patients with urinary retention followed by Cauda equina syndrome...
October 2016: Acta Informatica Medica: AIM
Basant K Misra, Saurav K Samantray, Omkar N Churi
We present our recent experience with fluorescein sodium videoangiography (FLVA) in the intra-operative evaluation of a patient with conus medullaris arteriovenous malformation (AVM). To our knowledge this is the first report in the literature of use of FLVA in the surgery of spinal AVM. Intra-operative FLVA was done to identify an early filling vessel and to obliterate the site of fistulous connection. This was correlated and confirmed with simultaneous indocyanine green videoangiography (ICGVA). The conus and cauda equina roots could be appreciated and manipulated in relation to this fluorescence...
April 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Nickalus R Khan, Matthew VanLandingham, Thomas O'Brien, Frederick A Boop, Kenan Arnautović
Myxopapillary ependymoma (MPE) is a slow-growing tumor, occurring most often in adults. It originates from the filum terminale in the area of the conus medullaris and cauda equina and is considered a benign lesion. Despite this classification, however, recurrence after both partial and gross total resection is well known. In the pediatric population, primary MPE seeding and generally more aggressive clinical course is well documented and treated through gross total resection, if possible, followed by irradiation...
March 2017: World Neurosurgery
Ali Babashahi, Morteza Taheri, Arash Fattahi
BACKGROUND: Dermoid tumors are slow growing, benign CNS lesions. CASE DESCRIPTION: This case study concerns a 29-year-old female with a 6-year history of lower extremity paresthesias attributed to magnetic resonance (MR)/computed tomography (CT) documented intradural dermoid tumor that extended from L1 to S1. On MR, it was hypointense on T1, hyperintense on T2, and did not enhance with gadolinium. CT showed hyperdensity at the L1-L2 levels. The craniocervical MR imaging showed small hyperintense foci in the cisternal space favoring "fat dissemination...
2016: Surgical Neurology International
Satoko Kojima, Junichi Yoshimura, Tetsuro Takao, Tetsuro Tamura, Kenichi Nishiyama, Shigeru Maruyama, Masashi Suda, Yukihiko Fujii
The authors report the case of a mobile spinal enterogenous cyst in a 2-year-old boy, who was admitted to the hospital several times for intermittent paraplegia. Magnetic resonance imaging and CT revealed an isolated cyst in the lumbar spinal canal. The symptoms were caused by transient myelopathy of the conus medullaris and radiculopathy of the cauda equina due to the changing size and location of the cyst. The cyst was surgically extirpated, after which the symptoms resolved. The histopathological diagnosis was enterogenous cyst...
October 2016: Journal of Neurosurgery. Pediatrics
Huiyi H Chang, Leif A Havton
Detrusor underactivity (DU) is defined as a contraction of reduced strength and/or duration during bladder emptying and results in incomplete and prolonged bladder emptying. The clinical diagnosis of DU is challenging when present alone or in association with other bladder conditions such as detrusor overactivity, urinary retention, detrusor hyperactivity with impaired contractility, aging, and neurological injuries. Several etiologies may be responsible for DU or the development of an underactive bladder (UAB), but the pathobiology of DU or UAB is not well understood...
November 2016: Experimental Neurology
Misun Hwang, Giulio Zuccoli, Ashok Panigrahy, David Rodriguez, Michele D Poe, Maria L Escolar
OBJECTIVES: Evaluation of Krabbe disease burden and eligibility for hematopoietic stem cell transplantation are often based on neuroimaging findings using the modified Loes scoring system, which encompasses central but not peripheral nervous system changes. We show that quantitative evaluation of thickened cauda equina nerve roots may improve the evaluation of Krabbe disease and therapeutic guidance. METHODS: Lumbar spine MRI scans of patients obtained between March 2013 and September 2013 were retrospectively evaluated and compared to those of controls...
October 2016: European Radiology
Ali A Al-Omari, Rishabh D Phukan, Dana A Leonard, Tyler L Herzog, Kirkham B Wood, Christopher M Bono
Overgrowth of epidural fat, known as spinal epidural lipomatosis (SEL), can cause symptomatic compression of the spinal cord, conus medullaris, or cauda equina. Suggested predisposing factors such as obesity, steroid use, and diabetes mellitus have been based on a few reported cases, many of which were not surgically confirmed. There is a paucity of epidemiological data in surgically confirmed cases for this disorder. The purpose of this independently reviewed, retrospective, matched cohort analysis was to compare the demographics and incidence of comorbidities of patients who underwent lumbar decompression for SEL vs degenerative stenosis without SEL...
May 1, 2016: Orthopedics
Daijiro Morimoto, Toyohiko Isu, Kyongsong Kim, Masanori Isobe, Tatsuro Takahashi, Yusuke Ishida, Hidehiro Takei, Akio Morita
PURPOSE: Symptoms of cauda equina syndrome due to ependymoma in the conus medullaris or filum terminale develop slowly. However, hemorrhagic change inside spinal tumors can induce acute neurologic decline. Here, we report a case of posttraumatic hemorrhage inside a filum terminale myxopapillary ependymoma presenting as acute neurologic decline, which had a positive prognosis after surgical resection. METHODS: A 28-year-old man presented with buttock pain, sensory disturbance, and motor weakness of bilateral lower extremities after falling on ice during smelt fishing...
May 2016: European Spine Journal
Norihiro Nishida, Tsukasa Kanchiku, Junji Ohgi, Kazuhiko Ichihara, Xian Chen, Toshihiko Taguchi
No reports have described experiments designed to determine the strength characteristics of spinal nerve roots and rami radiculares for the purpose of explaining the complexity of symptoms of medullary cone lesions and cauda equina syndrome. In this study, to explain the pathogenesis of cauda equina syndrome, monoaxial tensile tests were performed to determine the strength characteristics of spinal nerve roots and rami radiculares, and analysis was conducted to evaluate the stress-strain relationship and strength characteristics...
November 2015: Neural Regeneration Research
Ashraf Youssef Nasr
Anatomical orientation of the caudal space and termination level of conus medullaris (CMT) and dural sac (DST) has great significance for anesthetists and neurosurgeons. This study aimed to explore the anatomical landmarks important to perform save spinal anaesthesia, lumber puncture and caudal analgesia through the correlation between the vertebral level of CMT, DST and sacral hiatus apex (SHA) in human cadavers and by using MR images. 60 adult cadavers (40 male and 20 females) and 200 (100 female & 100 male) MR lumbosacral images of 16 to 69 years-old persons were used in this study...
January 25, 2016: Folia Morphologica (Warsz)
Joonchul Lee, Seong-Eun Koh, Heeyoune Jung, Hye Yeon Lee, In-Sik Lee
OBJECTIVE: To evaluate the usefulness of various magnetic resonance imaging (MRI) findings in the prognosis of neurological recovery in paraplegics with thoracolumbar fracture using association analysis with clinical outcomes and electrodiagnostic features. METHODS: This retrospective study involved 30 patients treated for paraplegia following thoracolumbar fracture. On axial and sagittal T2-weighted MRI scans, nerve root sedimentation sign, root aggregation sign, and signal intensity changes in the conus medullaris were independently assessed by two raters...
December 2015: Annals of Rehabilitation Medicine
I J Pomeraniec, R F Dallapiazza, H M Sumner, M B Lopes, C I Shaffrey, J S Smith
We present a rare extramedullary ependymoma with diffuse spinal metastatic disease, and review the previous reports of extramedullary spinal ependymomas. Ependymomas are the most common intramedullary spinal cord tumor in adults. These tumors rarely present as extramedullary masses. We treated a 23-year-old man with a history of progressive neck, shoulder and arm pain, with sensory and motor symptoms in the C7 dermatome. MRI of the cervical spine demonstrated a ventral contrast-enhancing lesion with evidence of enhancement along the dura and spinal cord of the upper cervical spine, thoracic spine, and cauda equina...
December 2015: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Shutaro Fujimoto, Motoyuki Iwasaki, Masaki Ito, Yoshimasa Niiya, Hiroyuki Itosaka, Shouji Mabuchi, Takeshi Nishioka, Hayato Echizenya, Kiyoshi Kasai
Leptomeningeal metastasis is a rare entity and its diagnosis is often difficult. Moreover, evidence-based therapeutic strategies have not yet been established. A 52-year-old woman presented with high fever and was diagnosed with bacterial meningitis at first examination;although her fever was alleviated, she experienced motor weakness in both of her lower extremities. Ga scintigraphy highlighted the hot-spot areas of the disease in the cranial bone. She was then transferred to our department. Open biopsy of the skull showed metastasis of the cancer...
September 2015: No Shinkei Geka. Neurological Surgery
Ana C Siquara De Sousa, Stepan Capek, Kimberly K Amrami, Robert J Spinner
Endometriosis (EM) is an infrequent cause of peripheral neuropathy, most commonly sciatic. Perineural spread has recently been introduced as an alternate explanation for cases of lumbosacral or sciatic nerve EM. We performed a literature review to collect all reported cases of peripheral and central nervous system EM in search of anatomic patterns of involvement; potentially to support the perineural spread theory. If available, intraneural invasion and presence of peritoneal EM were recorded. The search revealed 83 articles describing 365 cases of somatic peripheral nervous EM and 13 cases of central nervous EM...
November 2015: Clinical Anatomy
Helen K Könnecke, Elisabeth J Rushing, Marian Christoph Neidert, Regina Reimann, Luca Regli, Oliver Bozinov, Jan-Karl Burkhardt
Involvement of the central nervous system (CNS) is rarely described in malignant mixed Müllerian tumors (MMMTs). Only four intracranial and two spinal cases have been published to date. Here we report two more cases with heterogeneous clinical, radiologic and pathologic features and summarize the available contemporary literature. One patient presented with aphasia due to an intra-axial contrast-enhanced left temporal lesion with marked perifocal edema. After surgical resection, histology showed collections of small uniform tumor cells embedded in a myxoid matrix and compartmentalized by connective tissue septations, consistent with an MMMT...
September 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Takuya Konno, Tatsuya Suwabe, Sou Kasahara, Yoshitaka Umeda, Mutsuo Oyake, Nobuya Fujita
A 77-year-old woman presented with conus medullaris and cauda equina syndrome following a sudden pain in the bilateral lower abdomen and right buttock. Lumbar magnetic resonance imaging (MRI) showed not only a conus medullaris lesion, but also several lesions in the vertebral bodies (L1, L2), right major psoas muscle, right multifidus muscle and bilateral erector spinae muscles. As these areas receive blood supply from each branch of the same segmental artery, we considered all of the lesions as infarctions that were a result of a single parent vessel occlusion...
2015: Rinshō Shinkeigaku, Clinical Neurology
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