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caudal equina syndrome

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https://www.readbyqxmd.com/read/27735228/duplicated-filum-terminale-in-non-split-cord-malformations-an-underrecognized-cause-for-treatment-failure-in-tethered-cord-syndrome
#1
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...
October 13, 2016: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/27614573/effective-cauda-equina-decompression-in-two-siblings-with-charcot-marie-tooth-disease-type-1b
#2
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...
August 22, 2016: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/27226945/acute-presentation-of%C3%A2-lumbar-spinal-schwannoma-due-to-torsion-a-case-report
#3
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
https://www.readbyqxmd.com/read/24473424/high-abrupt-cord-termination-a-hallmark-of-caudal-regression-syndrome
#4
Kadalur Thimmegowda Puneeth, Ankur Goyal, Manisha Jana
No abstract text is available yet for this article.
2014: BMJ Case Reports
https://www.readbyqxmd.com/read/24404969/clinical-significance-of-imaging-and-histological-characteristics-of-filum-terminale-in-tethered-cord-syndrome
#5
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
https://www.readbyqxmd.com/read/23324943/cauda-equina-syndrome-caused-by-epidural-pneumorrhachis-treatment-with-percutaneous-computed-tomography-guided-translaminar-trephination
#6
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
https://www.readbyqxmd.com/read/23303026/deciphering-caudal-embryonic-defects-embryological-analysis-and-reviewing-literature-data
#7
REVIEW
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
https://www.readbyqxmd.com/read/23140126/use-of-prone-position-magnetic-resonance-imaging-for-detecting-the-terminal-filum-in-patients-with-occult-tethered-cord-syndrome
#8
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
https://www.readbyqxmd.com/read/23044703/cauda-equina-syndrome-after-cesarean-section
#9
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
https://www.readbyqxmd.com/read/22381300/cauda-equina-syndrome-associated-with-longstanding-instrumented-spinal-fusion
#10
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
https://www.readbyqxmd.com/read/21914755/effect-of-caudal-epidural-steroid-or-saline-injection-in-chronic-lumbar-radiculopathy-multicentre-blinded-randomised-controlled-trial
#11
RANDOMIZED CONTROLLED TRIAL
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)...
2011: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/21800080/section-of-the-filum-terminale-is-it-worthwhile-in-chiari-type-i-malformation
#12
REVIEW
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
https://www.readbyqxmd.com/read/21512203/-congenital-anomalies-in-the-central-nervous-system-6-occult-spinal-dysraphism-other-than-spinal-lipoma-congenital-dermal-sinus-tight-filum-terminale-neurenteric-cyst-split-cord-malformation-and-caudal-regression-syndrome
#13
REVIEW
https://www.readbyqxmd.com/read/20887145/intrathecal-endoscopy-to-enhance-the-diagnosis-of-tethered-cord-syndrome
#14
COMPARATIVE STUDY
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
https://www.readbyqxmd.com/read/20594007/spinal-cord-traction-vascular-compromise-hypoxia-and-metabolic-derangements-in-the-pathophysiology-of-tethered-cord-syndrome
#15
REVIEW
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
https://www.readbyqxmd.com/read/17968797/crossed-fused-renal-ectopia-with-segmental-fusion-of-bilateral-ureters-and-abdominal-aortic-anomalies-in-a-patient-with-caudal-regression-syndrome
#16
Y-C Duh, S-T Chia, J-C Sheu, C-C Peng
Caudal regression syndrome consists of multiple congenital anomalies, mainly caudal segment defects. We describe a preterm baby born to a healthy mother with typical caudal regression picture, including imperforated anus with rectovesical fistula, sacral agenesis, multiple rib and vertebral anomalies, and club feet. Crossed fused renal ectopia with fused ureters resulting in urinary obstruction was managed with transureteroureterostomy and cutaneous vesicostomy. We also found a single large umbilical artery with high abdominal aortic insertion which usually presents in sirenomelia...
October 2007: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/17961011/pathophysiology-of-tethered-cord-syndrome-and-similar-complex-disorders
#17
REVIEW
Shokei Yamada, Daniel J Won, Gholam Pezeshkpour, Brian S Yamada, Shoko M Yamada, Javed Siddiqi, Alexander Zouros, Austin R T Colohan
Tethered cord syndrome (TCS) is a stretch-induced functional disorder of the spinal cord due to the fact that its caudal portion is anchored by an inelastic structure. The functional lesion of TCS is generally situated in the lumbosacral cord, and many authors have shown that the syndrome is reversible via surgery to untether the cord. To clarify the expressions relevant to TCS, such as "cord tethering" and "tethered cord," the authors have formulated three categories. These categories include cases that show the anatomical appearance of spinal cord stretching...
2007: Neurosurgical Focus
https://www.readbyqxmd.com/read/17422145/intramedullary-spinal-glioblastoma-in-a-cat-presented-as-a-cauda-equina-syndrome
#18
J M Parent, C Isler, D L Holmberg, C S Farrow
A ten year old castrated male domestic short haired cat, was presented with clinical signs related to the cauda equina. The results of the neurological examination, diagnostic procedures, and clinical course are presented. At necropsy a glioblastoma of the caudal spinal cord was present. The difficulties in distinguishing between neoplasms arising in the cauda equina and the caudal spinal cord are discussed. A comparative discussion of the cauda equina syndrome is presented.
May 1982: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
https://www.readbyqxmd.com/read/17226037/what-is-the-true-tethered-cord-syndrome
#19
Shokei Yamada, Daniel J Won
INTRODUCTION: The tethered cord syndrome (TCS) is a stretch-induced functional disorder of the spinal cord with its caudal part anchored by an inelastic structure. DISCUSSION: This article clarifies the reversible lesions that occur in the cord segments above any of the inelastic abnormalities. These lesions are found mostly in the lumbosacral cord, occasionally in the cervical cord and closely correlate with clinical findings. Imaging studies alone do not allow accurate diagnosis of the TCS...
April 2007: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/16945660/treatment-of-the-occult-tethered-spinal-cord-for-neuropathic-bladder-results-of-sectioning-the-filum-terminale
#20
P D Metcalfe, T G Luerssen, S J King, M Kaefer, K K Meldrum, M P Cain, R C Rink, A J Casale
PURPOSE: Occult tethered cord syndrome applies to patients with signs and symptoms consistent with a caudal spinal cord malformation despite normal neuroimaging. Although several reports of successful surgical treatment exist, controversy remains with respect to patient selection and efficacy. We present a large series with excellent clinical followup, neuroimaging and urodynamic characterization. MATERIALS AND METHODS: We present our experience with 36 patients at a single institution with preoperative clinical findings, neuroimaging and urodynamics available...
October 2006: Journal of Urology
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