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https://www.readbyqxmd.com/read/28644112/susac-syndrome-misdiagnosed-as-multiple-sclerosis-with-exacerbation-by-interferon-beta-therapy
#1
Hussein Algahtani, Bader Shirah, Muhammad Amin, Eyad Altarazi, Hashem Almarzouki
Susac syndrome is a rare autoimmune disorder characterised by the clinical triad of encephalopathy, retinopathy (branch retinal artery occlusions) and hearing loss. The diagnosis of Susac syndrome may be difficult initially, and it is not uncommon for patients with Susac syndrome to be misdiagnosed with multiple sclerosis. In this case report, we describe a patient who was diagnosed as having multiple sclerosis for three years, with further deterioration after starting treatment with interferon beta-1a. The patient had the triad of encephalopathy, branch retinal artery occlusions and sensorineural hearing loss...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28637118/asymptomatic-chiari-type-i-malformation-should-patients-be-advised-against-participation-in-contact-sports
#2
Robert Spencer, Paul Leach
BACKGROUND: Chiari type I malformation (CM-I) is characterised by caudal displacement of the cerebellar tonsils through the foramen magnum, crowding the craniocervical junction. It is being increasingly diagnosed in asymptomatic patients due to the widespread availability of MRI, and there are case reports of these patients suffering sudden death or neurological injury following head or neck trauma, raising the issue of whether they should be prohibited from contact sport participation, given the likelihood of frequent trauma...
March 2, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28622902/a-critical-analysis-of-sagittal-plane-deformity-correction-with-minimally-invasive-adult-spinal-deformity-surgery-a-2-year-follow-up-study
#3
Gregory M Mundis, Jay D Turner, Vedat Deverin, Juan S Uribe, Pierce Nunley, Praveen Mummaneni, Neel Anand, Paul Park, David O Okonkwo, Michael Y Wang, Shay Bess, Adam S Kanter, Richard Fessler, Stacie Nguyen, Behrooz A Akbarnia
INTRODUCTION: Sagittal plane realignment is important to achieve desirable clinical outcomes after adult spinal deformity (ASD) surgery. This study evaluates the impact of minimally invasive (MIS) techniques on sagittal plane alignment and clinical outcomes in ASD patients. METHODS: A retrospective, multi-center review of ASD patients (age ≥18 years, and with one of the following: coronal Cobb ≥20°, sagittal vertical axis [SVA] >5 cm, and/or pelvic tilt >25°), MIS surgery, and four or more levels instrumented...
July 2017: Spine Deformity
https://www.readbyqxmd.com/read/28616883/treatment-for-thoracic-ossification-of-posterior-longitudinal-ligament-with-posterior-circumferential-decompression
#4
Zhao-Wan Xu, Yong-Cheng Hu, Chui-Guo Sun, Xiao-Peng Shang, Deng-Xing Lun, Feng Li, Xu-Bin Ji, Da-Yong Liu, Nai-Wang Chen, Qing-Shan Zhuang
OBJECTIVE: To report the results of the posterior approach for thoracic ossification of posterior longitudinal ligament (TOPLL) by using a special "L" osteotome. METHODS: The present study enrolled 16 consecutive patients (9 men and 7 women) between May 2009 and September 2013. All patients underwent a posterior circumferential decompression osteotomy and segmental instrumentation with interbody fusion. The mean age at surgery was 57.3 years (range, 37-68 years)...
June 14, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28614233/discordant-lumbar-epidural-hematoma-after-caudal-steroid-injection-a-case-report-care-compliant
#5
Jung Ju Choi, Young Jin Chang, Wol Seon Jung, Kyung Cheon Lee, Ju Ho Kim, Youn Yi Jo
RATIONALE: Caudal epidural injection is one of the conventional treatments of chronic back pain. Even though spinal epidural hematoma after caudal epidural injection is rare but it can cause serious neurologic complication. PATIENT CONCERNS: An 83-year-old woman taking cilostazol received caudal epidural steroid injection because of her chronic back pain. Six hours later, she experienced an acute hip pain which worsened with time. DIAGNOSIS: Magnetic resonance image showed acute cord compression due to a spinal epidural hematoma at L2-S1 level with concomitant central canal compromise at L2/3, L3/4 level...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28599909/anterior-transthoracic-surgery-with-motor-evoked-potential-monitoring-for-high-risk-thoracic-disc-herniations-technique-and-results
#6
Erwin Cornips, Jeroen Habets, Vivianne van Kranen-Mastenbroek, Herman Bos, Paul Bergs, Alida Postma
OBJECTIVE: We present our experience with anterior transthoracic surgery for high-risk thoracic disc herniations (TDHs) using motor evoked potential monitoring (MEPm). METHODS: We estimated surgical risk based on clinical and radiological characteristics, including antero-posterior (AP) spinal canal occupation (SCO), AP spinal cord compression (SCC), residual AP spinal cord diameter (RSCD), and intramedullary signal changes (ISC). We analyzed Anand, ASIA, and Nurick scores, anesthesiological, neurophysiological, and surgical reports...
June 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28596039/assessment-of-aortic-wall-thrombus-predicts-outcomes-of-endovascular-repair-of-complex-aortic-aneurysms-using-fenestrated-and-branched-endografts
#7
Mauricio Ribeiro, Gustavo S Oderich, Thanila Macedo, Terri J Vrtiska, Jan Hofer, Julia Chini, Bernardo Mendes, Stephen Cha
OBJECTIVE: The goal of this study was to investigate the correlation between atherothrombotic aortic wall thrombus (AWT) and clinical outcomes in patients treated by fenestrated-branched endovascular aortic repair (F-BEVAR) and present a new classification system for assessment of AWT burden. METHODS: The clinical data of 301 patients treated for pararenal and thoracoabdominal aortic aneurysms (TAAAs) by F-BEVAR was reviewed. The study excluded 89 patients with extent I to III TAAA because of extensive laminated thrombus within the aneurysm sac...
June 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28588757/identification-of-neuron-selective-androgen-receptor-inhibitors
#8
Maya Otto-Duessel, Ben Yi Tew, Steven Vonderfecht, Roger Moore, Jeremy O Jones
AIM: To identify neuron-selective androgen receptor (AR) signaling inhibitors, which could be useful in the treatment of spinal and bulbar muscular atrophy (SBMA), or Kennedy's disease, a neuromuscular disorder in which deterioration of motor neurons leads to progressive muscle weakness. METHODS: Cell lines representing prostate, kidney, neuron, adipose, and muscle tissue were developed that stably expressed the CFP-AR-YFP FRET reporter. We used these cells to screen a library of small molecules for cell type-selective AR inhibitors...
May 26, 2017: World Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28574882/surgical-outcomes-of-posterior-spinal-fusion-alone-using-cervical-pedicle-screw-constructs-for-cervical-disorders-associated-with-athetoid-cerebral-palsy
#9
Kei Watanabe, Toru Hirano, Keiichi Katsumi, Masayuki Ohashi, Hirokazu Shoji, Akiyoshi Yamazaki, Tomohiro Izumi, Kazuhiro Hasegawa, Takui Ito, Naoto Endo
STUDY DESIGN: Retrospective case series. OBJECTIVE: To investigate clinical outcomes after posterior spinal fusion (PSF) using cervical pedicle screw (CPS) constructs for cervical disorders associated with athetoid cerebral palsy (CP). SUMMARY OF BACKGROUND DATA: Traditionally, most patients with cervical myelopathy associated with CP have required combined anterior and posterior fusion to achieve solid stability against severe involuntary movement...
June 1, 2017: Spine
https://www.readbyqxmd.com/read/28571193/recurrent-longitudinally-extensive-myelitis-and-aquaporin-4-seronegativity-the-expanding-spectrum-of-neuromyelitis-optica
#10
Ravi Anadure, Coimbatore Sivasubramanian Narayanan, Govindaraj Varadraj
Neuromyelitis Optica Spectrum Disorder (NMOSD) is a recently proposed unifying term for Neuromyelitis Optica (NMO), also known as Devic's disease and related syndromes. It is a relapsing inflammatory demyelinating disease that most commonly affects optic nerves and the spinal cord, leading to sudden vision loss or weakness in one or both eyes, and loss of sensation and bladder function. Though inflammation may also involve the brain, the lesions seen in NMO are different from Multiple Sclerosis (MS) which has a similar clinical course...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28552154/spinal-cavernous-malformations
#11
Aaron J Clark, Doris D Wang, Michael T Lawton
Spinal cavernous malformations are rare intramedullary vascular lesions of the central nervous system. Most are located in the thoracic spine. Patients present with either acute neurologic deficit or gradual deterioration. Weakness is the most common presenting symptom. The annual hemorrhage risk is 2.1%. Diagnosis is made by magnetic resonance imaging as these lesions are occult on angiography. Surgical removal is indicated in patients with hemorrhage and neurologic deficit. All lesions are approached posteriorly by laminectomy...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28552031/the-hybrid-assistive-limb%C3%A2-intervention-for-a-postoperative-patient-with-spinal-dural-arteriovenous-fistula-and-chronic-spinal-cord-injury-a-case-study
#12
Yukiyo Shimizu, Kei Nakai, Hideki Kadone, Shunsuke Yamauchi, Shigeki Kubota, Tomoyuki Ueno, Aiki Marushima, Kayo Hiruta, Ayumu Endo, Hiroaki Kawamoto, Akira Matsumura, Yoshiyuki Sankai, Yasushi Hada, Masashi Yamazaki
CONTEXT: The purpose of this report was to describe the improvement in walking ability using the Hybrid Assistive Limb® (HAL®) intervention in the case of a patient with paraplegia after spinal cord injury whose condition deteriorated because of a spinal dural arteriovenous fistula (SDAVF). FINDINGS: A 48-year-old man started the HAL® intervention twice per week (total 10 sessions), after his neurologic improvement had plateaued from 3 to 6 months postoperatively for an SDAVF...
May 29, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28546874/acute-paraparesis-and-sensory-loss-following-intravenous-corticosteroid-administration-in-a-case-of-longitudinally-extensive-transverse-myelitis-caused-by-spinal-dural-arteriovenous-fistula-case-report-and-review-of-literature
#13
Michael A DiSano, Russell Cerejo, MaryAnn Mays
INTRODUCTION: The underlying causes of longitudinally extensive transverse myelitis (LETM) are broad and include inflammatory processes, compression and spinal dural arteriovenous fistula (SDAVF). Presenting symptoms of SDAVF are nonspecific and often go misdiagnosed. Acute clinical deterioration from SDAVF has been described following exertion or valsalva. However, deterioration has been recently recognized following steroid administration and may contribute to increased morbidity. CASE PRESENTATION: We describe a 63-year-old woman with a 2-year history of intermittent lower extremity numbness and back pain, lumbar stenosis, who presented with subacute worsening of symptoms following a course of oral steroids for an upper respiratory infection...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28546044/endovascular-repair-of-thoraco-abdominal-and-arch-aneurysms-in-patients-with-connective-tissue-disease-using-branched-and-fenestrated-devices
#14
Rachel E Clough, Teresa Martin-Gonzalez, Katrien Van Calster, Adrien Hertault, Rafaëlle Spear, Richard Azzaoui, Jonathan Sobocinski, Stéphan Haulon
INTRODUCTION: Prophylactic open surgery is the standard practice in patients with connective tissue and thoraco-abdominal (TAAA) and aortic arch disease. Branched and fenestrated devices offer a less invasive alternative but there are concerns regarding the durability of the repair and the effect of the stent graft on the fragile aortic wall. The aim of this study was to evaluate mid-term outcomes of fenestrated and/or branched endografting in patients with connective tissue disease. METHODS: All patients with connective tissue disease that underwent TAAA or arch aneurysm repair using a fenestrated and/or branched endograft in a single high volume centre between 2004 and 2015 were included...
May 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28538361/characteristics-of-and-risk-factors-for-severe-neurological-deficit-in-patients-with-pyogenic-vertebral-osteomyelitis-a-case-control-study
#15
RANDOMIZED CONTROLLED TRIAL
Adrien Lemaignen, Idir Ghout, Aurélien Dinh, Guillaume Gras, Bruno Fantin, Virginie Zarrouk, Robert Carlier, Jean-Edouard Loret, Eric Denes, Alix Greder, François-Xavier Lescure, David Boutoille, Pierre Tattevin, Bertrand Issartel, Jean-Philippe Cottier, Louis Bernard
Severe neurological deficit (SND) is a rare but major complication of pyogenic vertebral osteomyelitis (PVO). We aimed to determine the risk factors and the variables associated with clinical improvement for SND during PVO.This case-control study included patients without PVO-associated SND enrolled in a prospective randomized antibiotic duration study, and patients with PVO-associated SND managed in 8 French referral centers. Risk factors for SND were determined by logistic regression.Ninety-seven patients with PVO-associated SND cases, and 297 controls were included...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28536800/causes-and-preventive-measures-of-symptomatic-spinal-epidural-haematoma-after-spinal-surgery
#16
Xiao-Jun Zeng, Wei Wang, Zhou Zhao, Ming Li
STUDY DESIGN: This was a retrospective study to evaluate clinical characteristics of patients who developed symptomatic spinal epidural haematoma (SSEH) after spinal surgery. OBJECTIVE: The objective was to determine clinical parameters associated with the development of SSEH after spinal surgery, and to discuss clinical management and possible preventive measures. Although the incidence rate of SSEH is low, the neurological sequelae are devastating. There are limited reports which identify risk factors for SSEH because of the rarity of the condition...
May 24, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28534220/is-decompressive-surgery-the-only-treatment-option-a-case-series-of-patients-with-spinal-tuberculosis-in-advanced-pregnancy
#17
Ashok K Rathod, Vishwajeet Singh, Prateek Patil, Hemant Singh
PURPOSE: To present cases of spinal tuberculosis in advanced pregnancy treated on anti-tuberculous drug regimen with successful outcome and proposing alternative paradigm to surgical decompression. A case series of five patients in stages of advanced pregnancy with neurologic deterioration and spinal tuberculosis were reported and treated. METHODS: Five patients with backache in advanced stages of pregnancy were reported. Patients were diagnosed as cases of spinal tuberculosis on further imaging studies...
May 22, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28533943/etiology-and-treatment-of-amyotrophic-lateral-sclerosis
#18
Hernando Rafael, Juan Oscar David, Antonio Santiago Vilca
BACKGROUND: To date all researchers conclude that the etiology of Amyotrophic lateral sclerosis (ALS) is not known. On the contrary, since August 2009, we believe that disease is of ischemic origin in the anterior surface of the medulla oblongata. MATERIAL AND METHOD: We present our surgical experience into 45 patients with ALS (bulbar form in 36 cases and spinal form in 9). Preoperative MRI scans revealed microinfarcts in the medulla oblongata and/or cervical cord...
2017: American Journal of Neurodegenerative Disease
https://www.readbyqxmd.com/read/28516804/spinal-cord-atrophy-as-a-primary-outcome-measure-in-phase-ii-trials-of-progressive-multiple-sclerosis
#19
Niamh Cawley, Carmen Tur, Ferran Prados, Domenico Plantone, Hugh Kearney, Khaled Abdel-Aziz, Sebastian Ourselin, Claudia Am Gandini Wheeler-Kingshott, David H Miller, Alan J Thompson, Olga Ciccarelli
OBJECTIVES: To measure the development of spinal cord (SC) atrophy over 1 year in patients with progressive multiple sclerosis (PMS) and determine the sample sizes required to demonstrate a reduction in spinal cord cross-sectional area (SC-CSA) as an outcome measure in clinical trials. METHODS: In total, 44 PMS patients (26 primary progressive multiple sclerosis (PPMS), 18 secondary progressive multiple sclerosis (SPMS)) and 29 healthy controls (HCs) were studied at baseline and 12 months...
May 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28515929/clinical-outcome-of-posterior-fixation-surgery-in-patients-with-vertebral-metastasis-of-lung-cancer
#20
Tomoyuki Igarashi, Keigo Okamoto, Koji Teramoto, Ryosuke Kaku, Keiko Ishida, Keiko Ueda, Yo Kawaguchi, Tetsuo Hori, Masayuki Hashimoto, Shoji Kitamura, Noriaki Tezuka, Jun Hanaoka
Vertebral metastasis of non-small-cell lung cancer (NSCLC) often leads to neurological paralysis, with deterioration of the patients' activities of daily living (ADL). Surgical treatments for the symptoms are unlikely to be recommended due to the poor prognosis of patients with advanced NSCLC. The aim of the present study was to retrospectively evaluate the clinical outcome of posterior spinal fixation surgery in patients with neurological paralysis resulting from vertebral metastasis of NSCLC. Between April, 2007 and March, 2012, 4 patients (3 men and 1 woman; median age, 56...
May 2017: Molecular and Clinical Oncology
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