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Conus medullaris

Husam A AlTahan, Roaa R Amer, Areej A Madani, Eman A Bakhsh
BACKGROUND Epidural venous plexus (EVP) engorgement occurs due to many conditions, so it can be easily misdiagnosed. This becomes problematic when the diagnosis requires prompt treatment for a good outcome, especially when it results in cauda equina syndrome (CES). We report a case of extensive iliocaval thrombosis leading to epidural venous plexus and ascending lumbar vein engorgement as an outcome of deep venous thrombosis (DVT) due to probable adverse effects of oral combined contraceptive pills (OCCP). CASE REPORT A 42-year-old woman presented to a rural medical facility with bilateral lower-limb swelling and skin darkening for 2 days...
June 15, 2018: American Journal of Case Reports
Evan Luther, Timur Urakov, Steven Vanni
BACKGROUND AND STUDY OBJECTIVE:  Complex traumatic lumbar spine fractures are difficult to manage and typically occur in younger patients. Surgical immobilization for unstable fractures is an accepted treatment but can lead to future adjacent-level disease. Furthermore, large variations in fracture morphology create significant difficulties when attempting fixation. Therefore, a surgical approach that considers both long-term outcomes and fracture type is of utmost importance. We present a novel technique for percutaneous fixation without interbody or posterolateral fusion in a young patient with bilateral pedicle dissociations and an acute-onset incomplete neurologic deficit...
June 11, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Rohan Bhimani, Fardeen Bhimani, Preeti Singh
Introduction: Intracranial hypotension may occur when CSF leaks from the subarachnoid space. Formation of intracranial, subdural, and subarachnoid hemorrhage has been observed after significant CSF leak as seen in lumbar puncture or ventricular shunt placement. However, very few cases, referring to these remote complications following spine surgery, have been described in literature. We present a case of a 10-year-old male child operated for idiopathic scoliosis with low-lying conus medullaris who postoperatively developed subdural hemorrhage...
2018: Case Reports in Medicine
Ronghua Yu, Chunlin Hou, Haodong Lin, Jianguo Zhao, Haiyang Zong, Yaofa Lin
Objective: To observe the structural changes of urinary center and the expression of Bcl-2 after conus medullaris injury in rats brain so as to explore the possible influence factors of degeneration in brain. Methods: Thirty-six adult Sprague-Dawley rats were randomly divided into experimental group ( n =30) and control group ( n =6). In the experimental group, the conus medullaris injury model was established by cutting off the spinal nerve below L 4 , and no treatment was done in the control group...
January 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Ashraf Youssef Nasr, Adel Mostafa Hussein, Said Ahmed Zaghloul
BACKGROUND: Morphology and histology of filum terminale (FT) has a role in the pathophysiology of TCS. OBJECTIVE: This research was implemented to investigate the morphometric parameters and histological structure of normal FT in adult human cadavers and MRI scans to correlate them with the pathophysiology of tethered cord syndrome (TCS). MATERIALS AND METHODS: twenty five adult human cadavers (15 males &10 females) and 100 MR echo scans of lumbosacral region (50 males and 50 females), were used for this study...
May 26, 2018: Folia Morphologica (Warsz)
Mayank Patel, Marc Vetter, Emily Simonds, Maia Schumacher, Tyler Laws, Joe Iwanaga, Rod Oskouian, R Shane Tubbs
INTRODUCTION: Intradural transection of the filum terminale (FTI) is often used to treat tethered cord syndrome. Recently, some have proposed that the extradural part of the filum terminale (FTE) can be sectioned with equal results but with fewer complications. Therefore, the present cadaveric study aimed to evaluate the anatomical foundation of such procedures. METHODS: A posterior lumbosacral approach was performed on five fresh-frozen cadaveric specimens to expose both the FTI and FTE...
May 24, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Iraj Lotfinia, Ata Mahdkhah
CONTEXT: The ventriculus terminalis (VT) is a very small ependymal-lined residual lumen in the conus medullaris. It is normally present in all subjects during fetal development. VT in adults appears as an unusual pathology with an uncertain pathogenesis. FINDINGS: In this paper, we described three case reports of symptomatic fifth ventricle cystic dilations. All of them were female and their mean age was 59 years. We treated them surgically and all three patients were improved based on clinical and imaging assessments...
May 23, 2018: Journal of Spinal Cord Medicine
Suraj Sajeev, R Krishnakumar
No abstract text is available yet for this article.
May 2018: Neurology India
Daniel S Yanni, Aurora S Cruz, Alexander Y Halim, Amandip S Gill, Michael G Muhonen, Robert F Heary, Ira M Goldstein
Pediatric spinal trauma can present a surgeon with difficult management decisions given the rarity of these cases, pediatric anatomy, and a growing spine. The need to stabilize a traumatically unstable pediatric spine can be an operative challenge given the lack of instrumentation available. The authors present a surgical technique and an illustrative case that may offer a novel, less disruptive method of stabilization. A 2-year-old girl presented after an assault with an L1-2 fracture subluxation with lateral listhesis and fractured jumped facets exhibited on CT scans...
May 4, 2018: Journal of Neurosurgery. Pediatrics
Charidimos Tsagkas, Anna Altermatt, Ulrike Bonati, Simon Pezold, Julia Reinhard, Michael Amann, Philippe Cattin, Jens Wuerfel, Dirk Fischer, Katrin Parmar, Arne Fischmann
OBJECTIVE: To validate the precision and accuracy of the semi-automated cord image analyser (Cordial) for lumbar spinal cord (SC) volumetry in 3D T1w MRI data of healthy controls (HC). MATERIALS AND METHODS: 40 3D T1w images of 10 HC (w/m: 6/4; age range: 18-41 years) were acquired at one 3T-scanner in two MRI sessions (time interval 14.9±6.1 days). Each subject was scanned twice per session, allowing determination of test-retest reliability both in back-to-back (intra-session) and scan-rescan images (inter-session)...
April 30, 2018: European Radiology
Noritoshi Shirozu, Takato Morioka, Satoshi Inoha, Naoyuki Imamoto, Takakazu Sasaguri
BACKGROUND: A retained medullary cord (RMC) is a rare closed spinal dysraphism with a robust elongated neural structure continuous from the conus and extending to the dural cul-de-sac. Four cases of RMC extending down to the base of an associated subcutaneous meningocele at the sacral level have been reported. CLINICAL PRESENTATION: We report an additional case of RMC, in whom serial MRI examination revealed an enlargement of the meningocele associated with RMC over a 3-month period between 8 and 11 months of age, when he began to stand...
April 27, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Tatsuya Nishii, Yoshiro Hori, Atsushi Omura, Atsushi K Kono, Hitoshi Matsuda, Tetsuya Fukuda
No abstract text is available yet for this article.
March 29, 2018: Annals of Thoracic Surgery
Jayson Lian, Nicole Levine, Woojin Cho
PURPOSE: To review the current literature on methods of accurate numeration of vertebral segments in patients with Lumbosacral transitional vertebrae (LSTVs). LSTVs are a common congenital anomaly of the L5-S1 junction. While their clinical significance has been debated, unquestionable is the need for their identification prior to spinal surgery. We hypothesize that there are no reliable landmarks by which we can accurately number transitional vertebrae, and thus a full spinal radiograph is required...
May 2018: European Spine Journal
D Diaz-Aguilar, T Niu, S Terterov, R Scharnweber, A Tucker, J Woodard, H Brara, C Merna, H Shah, S Wang, S Rahman
Background: Neurenteric cysts (NECs) are rare developmental malformations of the central nervous system (CNS) which originate as benign congenital lesions. They originate from developmental foregut precursors, and are presumed to be the result of abnormal partitioning of the embryonic notochord plate. Such NECs predominantly arise in the cervical region in patients around 6 years of age or in their twenties or thirties. Notably, NECs of the conus medullaris are exceedingly rare, especially in patients of advanced age...
2018: Surgical Neurology International
Thiébaud Picart, Timothée Jacquesson, Emmanuel Jouanneau, Moncef Berhouma
BACKGROUND: Traumatic spinal subarachnoid hematoma, associated or not with a concurrent subdural hematoma, has rarely been described. The evolution of such hematomas is heterogeneous. This study aims at defining the most accurate management, which is currently not standardized. CASE DESCRIPTION: A 20-year-old man, victim of a high-kinetic road accident 5 days before and with several nonneurologic nonsurgical vertebral fractures, experienced a sudden dorsolumbar pain radiating to his lower limbs...
May 2018: World Neurosurgery
Layton Lamsam, Jennifer Quon, Nancy Fischbein, Michael Iv, Robert Dodd, John Ratliff
No abstract text is available yet for this article.
February 10, 2018: Operative Neurosurgery (Hagerstown, Md.)
Salah G Aoun, Mary Ashley Liu, Megan Still, Tarek Y El Ahmadieh, Mazin Al Tamimi, Wayne Gluf
BACKGROUND: The management of dermoid cysts can be tedious as they have a tendency to recur, and respond poorly to chemotherapy and radiation. Management is especially difficult for tumors involving highly eloquent areas such as the conus medullaris. OBJECTIVE: We aim to provide a summary of the pathology, clinical presentation, and operative management strategies of dermoid cysts involving the conus medullaris. METHODS: Two clinical cases of dermoid cysts of the conus are presented, as well as a commented surgical video...
April 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Jean Gabriel Previnaire
The BCR consists of the contraction of the bulbocavernosus muscle in response to squeezing the glans penis or clitoris, and is mediated through the pudendal nerve. In case of a complete lesion, the presence of BCR is indicative of intact S2-S4 spinal reflex arcs and loss of supraspinal inhibition, determining an upper motor neuron (UMN) lesion, its absence a lower motor neuron (LMN) lesion. The BCR further helps distinguish conus medullaris from cauda equina syndromes. Sensory or motor function in the most caudal sacral segments, not BCR, defines the sacral sparing as part of the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI)...
2018: Spinal Cord Series and Cases
Chamara Jayamanne, Lakkumar Fernando, Sachith Mettananda
BACKGROUND: Foot drop is a disabling clinical condition with multiplicity of causes, which requires detailed evaluation to identify the exact aetiology. Here, we report an extremely rare cause of foot drop in a child, which if not recognized early, could lead to multiple complications. CASE PRESENTATION: A 6-year-old girl presented with difficulty in walking and left sided foot droop for1-month duration. On examination she had reduced muscle power in dorsiflexors and plantar flexors and diminished knee and absent ankle jerk in the left side...
February 7, 2018: BMC Pediatrics
Romulus Emmanuel H Cruz, Ranhel C De Roxas, Carmela Concepcion A Sales-Callangan, Roland Dominic G Jamora
Widespread primary spinal oligodendrogliomas are a rare variety of tumors that usually affect children. Currently, there are only two adult cases reported worldwide. We report the first case of primary holocord oligodendroglioma with intracranial extension in a young adult female. The patient presented with a 4-month history of fluctuating hemiparesis of the left upper extremity eventually becoming quadriplegic after 1 month. Imaging findings revealed a contrast-enhancing holocord neoplasm spanning from the cervical region to the conus medullaris and with extension to the lower medulla...
January 2018: CNS Oncology
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