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caudal equina syndrome

Kiona Sharon de Nies, Ralph Alexander Edwards, Niklas Bergknut, Martijn Beukers, Björn Petrus Meij
BACKGROUND: Spinal cysts are rare findings in veterinary medicine, but they are increasingly recognized due to the availability of advanced imaging techniques. Extradural meningeal cysts in French Bulldogs have not been reported previously and arachnoid cysts (diverticula) have not been reported at the caudal lumbar (L6-L7) region in dogs. CASE PRESENTATION: Two French Bulldogs, aged 5 and 8 years, were referred for evaluation of lower back pain and bilateral hind limb neurological deficits...
March 1, 2018: Acta Veterinaria Scandinavica
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
Nina S Korse, Mark C Kruit, Wilco C Peul, Carmen L A Vleggeert-Lankamp
INTRODUCTION: Correlation between magnetic resonance imaging (MRI) and clinical features in cauda equina syndrome (CES) is unknown; nor is known whether there are differences in MRI spinal canal size between lumbar herniated disc patients with CES versus lumbar herniated discs patients without CES, operated for sciatica. The aims of this study are 1) evaluating the association of MRI features with clinical presentation and outcome of CES and 2) comparing lumbar spinal canal diameters of lumbar herniated disc patients with CES versus lumbar herniated disc patients without CES, operated because of sciatica...
2017: PloS One
Young Tak Seo, Hyun Ho Kong, Goo Joo Lee, Heui Je Bang
Caudal epidural injection (CEI) is one of the most common treatments for low-back pain with sciatica. CEI rarely leads to neurologic complications. We report a case of persistent cauda equina syndrome after CEI. A 44-year-old male patient with severe L4 and L5 spinal ste-nosis underwent CEI for low-back pain and sciatica. The CEI solution consisted of bupivacaine, hyaluronidase, triamcinolone acetonide, and normal saline. He experienced motor weakness and sensory loss in both lower extremities and neurogenic bladder for more than 1 year after the procedure...
2017: Journal of Pain Research
Sachin Baldawa, Vijay Shivpuje
BACKGROUND: Migration of the bullet within the spinal subarachnoid space has long been recognized as unusual complication of spinal gunshot injury. OBJECTIVE: We report a case of migratory low velocity intradural lumbosacral spinal bullet causing cauda equina syndrome. The relevant literature is reviewed and all cases of migratory spinal bullet are summarised, and management strategies are discussed. STUDY DESIGN: Literature review. METHODS: A 32-year-old male suffered abdominal gunshot injury for which emergency laparotomy and repair of colonic perforation were performed...
May 2017: European Spine Journal
Daniele Starnoni, John Michael Duff, Gopalakrishnan Chittur Viswanathan
CONTEXT: Anatomical variations of the filum terminale (FT) have been described in association with split cord malformations (SCM) but they appear to be a rare finding in its absence. We report the first case in literature of a duplicated FT in a patient presenting with tethered cord syndrome (TCS) without any radiological evidence of SCM. FINDINGS: A 47-year-old man presented with invalidating back pain radiating to both legs. Magnetic resonance imaging revealed an intradural dorsal lipoma in a low-lying conus...
July 2017: Journal of Spinal Cord Medicine
Tristan P C van Doormaal, Fred van Ruissen, Kai J Miller, Jessica E Hoogendijk
Two siblings with Charcot-Marie-Tooth (CMT) 1B due to a c.517G>C (p.Gly173Arg) mutation in the MPZ gene both developed an acute cauda syndrome with unbearable back pain radiating to both legs, progressive muscle weakness of the legs, and saddle hypesthesia with fecal and urinary incontinence. MRI showed in both patients a lumbar spinal canal totally filled with hypertrophic caudal nerve roots. We performed acute decompression. Postoperatively, in both patients, the back pain resolved immediately, there was a significant improvement of both the paresis of the legs and the hypesthesia, and there was a full return of continence...
December 2016: Neuromuscular Disorders: NMD
Winward Choy, Ryan Khanna, Thomas C Ortmeier, Gino G Tapia-Zegarra, Timothy E Lindley, Zachary A Smith, Nader S Dahdaleh
Although schwannomas are common spinal tumors with insidious presentations, acute neurological deterioration is an extremely rare manifestation that can occur in the setting of tumor torsion and infarction. The present case reports an unusual presentation of a spinal schwannoma that underwent torsion and infarction. A 65-year-old male presented initially with acute radicular pain progressing to cauda equina syndrome and confusion. MRI of the lumbar spine revealed an intradural extramedullary lesion at the level of L1/L2 measuring 1...
2016: Curēus
Kadalur Thimmegowda Puneeth, Ankur Goyal, Manisha Jana
No abstract text is available yet for this article.
2014: BMJ Case Reports
Eric M Thompson, Michael J Strong, Garth Warren, Randy L Woltjer, Nathan R Selden
OBJECT: The pathophysiology of tethered cord syndrome (TCS) is uncertain; however, it has been suggested that fibrous and fatty elements within the filum terminale (FT) play a role. The objective of this study was to describe the radiological and histological features of the FT in TCS and determine if there are associations between those features and clinical outcomes, complications, and urodynamics. METHODS: In this retrospective study, histological, MRI, and clinical data obtained in 293 patients with TCS who underwent FT transection were reviewed and analyzed in a multivariate analysis...
March 2014: Journal of Neurosurgery. Pediatrics
Nam Chull Paik, Chun Soo Lim, Ho Suk Jang
STUDY DESIGN: A case report and review of the literature. OBJECTIVE: To present a rare case, and its treatment, of cauda equina syndrome (CES) caused by epidural pneumorrhachis after repeated caudal epidural injections. SUMMARY OF BACKGROUND DATA: Pneumorrhachis is defined as the presence of air in the epidural or subarachnoid space. Epidural pneumorrhachis is usually asymptomatic and managed conservatively, but rare cases of lumbar radiculopathy resulting from epidural air have been reported...
April 1, 2013: Spine
Sunita Arvind Athavale
BACKGROUND: A number of syndromes÷associations involving the caudal region have been described in the literature. Each of them is characterized by a set of morphological features. Reports on difficulties in delineation and an ever-increasing constellation of defects in recent past call for a comprehensive study into the morphologic presentations and pathogenesis of caudal embryonic defects. MATERIALS AND METHODS: The present article describes a case of the OEIS complex--a combination of omphalocele, exstrophy of bladder, imperforate anus and spinal defects...
2012: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Kazuyoshi Nakanishi, Nobuhiro Tanaka, Naosuke Kamei, Toshio Nakamae, Bun-Ichiro Izumi, Ryo Ohta, Yuki Fujioka, Mitsuo Ochi
OBJECT: The pathophysiology of occult tethered cord syndrome (OTCS) with no anatomical evidence of a caudally shifted conus and a normal terminal filum is hard to understand. Therefore, the diagnosis of OTCS is often difficult. The authors hypothesized that the posterior displacement of the terminal filum may become prominent in patients with OCTS who are in a prone position if filum inelasticity exists, and they investigated prone-position MRI findings. METHODS: Fourteen patients with OTCS and 12 control individuals were examined using T2-weighted axial MRI with the patients in a prone position on a flat table...
January 2013: Journal of Neurosurgery. Spine
Ayse Banu Sarifakioglu, Oya Umit Yemisci, Seniz Akcay Yalbuzdag, Pinar Oztop Ciftkaya, Nur Saracgil Cosar
This report describes a case of cauda equina syndrome possibly caused by arachnoiditis due to levobupivacaine after spinal-epidural anesthesia. A 39-yr-old woman delivered by cesarean section under a combined spinal-epidural anesthesia. After an uneventful procedure and surgery, she complained of weakness in her lower extremities, which increased in a few hours. Neurologic examination revealed severe weakness in both her lower extremities, perianal anesthesia, and absence of muscle stretch reflexes. She was unable to urinate...
February 2013: American Journal of Physical Medicine & Rehabilitation
J D Bartleson, Gary M Miller, Giuseppe Lanzino
BACKGROUND: This study sought to describe a patient with a slowly progressive cauda equina syndrome (CES) who had imaging findings of the CES that occurs as a rare complication of ankylosing spondylitis (AS), but whose spinal fusion was due to thoracolumbosacral instrumentation, not spondyloarthropathy. METHODS: A 53-year-old woman presented with a 5-year history of slowly progressive CES affecting sensory and sphincter more than motor function many years after sequential instrumented fusions of her thoracic and then lumbosacral spine...
March 2013: World Neurosurgery
Trond Iversen, Tore K Solberg, Bertil Romner, Tom Wilsgaard, Jos Twisk, Audny Anke, Oystein Nygaard, Toralf Hasvold, Tor Ingebrigtsen
OBJECTIVE: To assess the efficacy of caudal epidural steroid or saline injection in chronic lumbar radiculopathy in the short (6 weeks), intermediate (12 weeks), and long term (52 weeks). DESIGN: Multicentre, blinded, randomised controlled trial. SETTING: Outpatient multidisciplinary back clinics of five Norwegian hospitals. PARTICIPANTS: Between October 2005 and February 2009, 461 patients assessed for inclusion (presenting with lumbar radiculopathy >12 weeks)...
September 13, 2011: BMJ: British Medical Journal
Luca Massimi, Simone Peraio, Elisabetta Peppucci, Gianpiero Tamburrini, Concezio Di Rocco
A section of the filum terminale (SFT) is used for the surgical treatment of isolated tethered cord or that resulting from neurulation disorders. More recently, it has been proposed for the management of the occult tethered cord syndrome (OTCS), though it is still under debate. Even more controversial appears to be the use of SFT in patients with Chiari type I malformation (CIM), which is based on the possible presence of OTCS. This review shows that: (1) there are issues both in favor and against the occurrence of OTCS, (2) there is no significant correlation between CIM and tethered cord, the old "caudal traction theory" being not supported by clinical or experimental evidences...
December 2011: Neurological Sciences
Kamal R M Woods, Austin R T Colohan, Shokei Yamada, Shoko M Yamada, Daniel J Won
OBJECT: Tethered cord syndrome (TCS) is being diagnosed in an increasing number of adults and late teens. Before referral to neurosurgeons, however, the majority of patients in this group suffers back and leg pain for a long period without a definitive diagnosis. The diagnostic difficulty derives from 2 factors: the signs and symptoms are subtle and easily overlooked, and the combination of an elongated cord and a thickened filum is lacking in 65% of patients. When a patient presents with signs and symptoms typical for TCS but demonstrates no elongated cord or thickened filum on MR imaging, one must search for a more reliable finding to establish a diagnosis of TCS...
October 2010: Journal of Neurosurgery. Spine
Aristotelis S Filippidis, M Yashar Kalani, Nicholas Theodore, Harold L Rekate
OBJECT: The definition of tethered cord syndrome (TCS) relies mainly on radiological criteria and clinical picture. The presence of a thickened filum terminale and a low-lying conus medullaris in symptomatic patients is indicative of TCS. The radiological definition of TCS does not take into account cases that involve a normal-lying conus medullaris exhibiting symptoms of the disease. METHODS: The authors performed a MEDLINE search using the terms "tethered cord" and "pathophysiology...
July 2010: Neurosurgical Focus
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