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https://www.readbyqxmd.com/read/29471599/-acute-urinary-retention-caused-by-acute-disseminated-encephalomyelitis-a-case-report
#1
Shinji Fukui, Yusuke Iemura, Yoshiaki Matsumura, Yoriaki Kagebayashi, Yuki Hotta, Sayaka Yoshida, Shoji Samma
An 11-year-old boy was referred to our department with the chief complaint of acute urinary retention. He had had a history of viral enteritis a few days before the onset of dysuria. He presented with a slight fever, mild headache and weakness of the extremities. A cerebrospinal fluid examination showed the elevation of cell number (cell number : 158/3, polynuclear cells : 29/3, and mononuclear cells : 129/3). Although spinal magnetic resonance imaging (MRI) did not show abnormal findings, fluid attenuated inversion recovery (FLAIR) image of the brain MRI showed a high signal area on the cerebral cortex...
January 2018: Hinyokika Kiyo. Acta Urologica Japonica
https://www.readbyqxmd.com/read/29462057/segmental-spinal-myoclonus-complicating-lumbar-transforaminal-epidural-steroid-injection
#2
Stanley Sau Ching Wong, Qiu Qiu, Chi Wai Cheung
OBJECTIVE: Lumbar transforaminal epidural steroid injection is commonly used for treating lumbar radicular pain. We report a case of segmental spinal myoclonus that developed during lumbar transforaminal epidural injection with local anesthetic and steroid. CASE REPORT: A 58-year-old woman with failed back surgery syndrome presented with low back and right L3 and L4 radicular pain. As she had responded well previously to diagnostic selective nerve root injection with local anesthetic at the right L3 and L4 levels, lumbar transforaminal epidural steroid injection at the same levels was scheduled...
February 16, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29452319/-white-cord-syndrome-of-acute-hemiparesis-after-posterior-cervical-decompression-and-fusion-for-chronic-cervical-stenosis
#3
Prince Antwi, Ryan Grant, Gregory Kuzmik, Khalid Abbed
BACKGROUND: "White cord syndrome" is a very rare condition thought to be the result of acute reperfusion of chronically ischemic areas of the spinal cord. Its hallmark is the presence of intramedullary hyperintense signal on T2-weighted MRI sequences in a patient with unexplained neurologic deficits following a spinal cord decompression. The syndrome is rare and has been reported previously in two patients following anterior cervical decompression and fusion. CASE DESCRIPTION: Here, we report an additional case of this complication in a 68-year-old man who developed acute left-sided hemiparesis after posterior cervical decompression and fusion for cervical spondylotic myelopathy...
February 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29452285/risk-factors-for-perioperative-morbidity-in-spine-surgeries-of-different-complexities-a-multivariate-analysis-of-1009-consecutive-patients
#4
M Farshad, D E Bauer, C Wechsler, C Gerber, A Aichmair
BACKGROUND CONTEXT: There is a broad spectrum of complications during or after surgical procedures, with differing incidences reported in the published literature. Heterogeneity can be explained by the lack of an established evidence-based classification system for documentation and classification of complications in a standardized manner. PURPOSE: To identify predictive risk factors for peri- and early post-operative morbidities in spine surgeries of different complexities in a large cohort of consecutive patients...
February 13, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29449082/multiple-sclerosis-or-inflammatory-cadasil-case-report-and-review-of-the-literature
#5
N Schiess, K Huether, M Szolics, G Agarwal, A W El-Hattab, S Sathe
BACKGROUND: Multiple sclerosis (MS) and CADASIL presenting together is exceedingly rare. As more cases of "inflammatory" CADASIL emerge, diagnostic challenges for clinicians increase. We report an individual with MS and CADASIL presenting with cognitive decline at age 25. She presented with gadolinium enhancing lesions on MRI and inflammatory cerebrospinal fluid raising the question of whether these patients should be given a diagnosis of "inflammatory CADASIL" or both MS and CADASIL...
February 8, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29434480/a-rare-presentation-of-neuromyelitis-optica-spectrum-disorders
#6
Navneet K Singh, Alexander J Sweidan, Sarah Strube, Ignacio Carrillo-Nunez
Neuromyelitis optica spectrum disorders (NMOSDs) are a set of demyelinating disorders that primarily target the optic nerves and the spinal cord. Previously thought to be a subset of multiple sclerosis (MS), now is recognized as a distinct entity. We present a 59-year-old female patient who was admitted for acute upper and lower extremity weakness. The patient had woken up from sleep with sudden onset of weakness. Patient was initially diagnosed with a right hemispheric stroke; however, magnetic resonance imaging of the cervical spine later performed showed abnormal enhancement from C2-C4, representing transverse myelitis...
2018: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/29428181/why-is-this-auntminnie-a-diagnostic-conundrum-a-knowledge-based-approach-to-balo-s-concentric-sclerosis-from-reports-of-3-cases-and-pooled-data-from-68-other-patients-in-the-literature
#7
REVIEW
Mohit Agarwal, John L Ulmer, Andrew P Klein, Leighton P Mark
INTRODUCTION: We came across 3 cases of Balo's concentric sclerosis (BCS). The first of these patients presented to an outside hospital and was transferred to our institution due to complications resulting from a biopsy. The other 2 patients, despite having a characteristic imaging appearance and despite insistence on our part on the diagnosis of BCS, underwent a surgical procedure, which could have been prevented. This led us to review the available literature on BCS. MATERIAL AND METHODS: A total of 68 patients diagnosed with BCS between 1995 and 2015 were studied and the data collected for the clinical presentation and course, imaging, spinal fluid analysis, treatment, and clinical and imaging outcome...
January 6, 2018: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/29422845/myointimal-hyperplasia-in-a-patient-with-neuromyelitis-optica-devic-s-disease-after-the-creation-of-an-arteriovenous-graft
#8
Christina Rao, Stephanie Fox, Sapan S Desai
Neuromyelitis optica, also known as Devic's disease, is an autoimmune disorder that leads to the inflammation and demyelination of nerves. Devic's disease primarily affects the optic nerve and spinal cord, but can lead to a significant loss of function throughout the body if not treated with steroid therapy or plasmapheresis. We recently saw a 62-year-old patient who received plasmapheresis for Devic's disease through a PTFE arteriovenous graft in her left arm. Her graft clotted without warning, and percutaneous thrombolysis was not successful...
September 2017: Case Reports in Neurology
https://www.readbyqxmd.com/read/29419657/neuroinflammation-of-the-spinal-cord-and-nerve-roots-in-chronic-radicular-pain-patients
#9
Daniel Albrecht, Shihab Ahmed, Norman Kettner, Ronald Borra, Julien Cohen-Adad, Hao Deng, Timothy Houle, Arissa Opalacz, Sarah Roth, Marcos Vidal Melo, Lucy Chen, Jianren Mao, Jacob Hooker, Marco L Loggia, Yi Zhang
Numerous preclinical studies support the role of spinal neuroimmune activation in the pathogenesis of chronic pain, and targeting glia (e.g., microglia/astrocyte)- or macrophage-mediated neuroinflammatory responses effectively prevents or reverses the establishment of persistent nocifensive behaviors in laboratory animals. However, thus far the translation of those findings into novel treatments for clinical use has been hindered by the scarcity of data supporting the role of neuroinflammation in human pain...
February 5, 2018: Pain
https://www.readbyqxmd.com/read/29408878/the-endocannabinoid-system-in-canine-steroid-responsive-meningitis-arteritis-and-intraspinal-spirocercosis
#10
Jessica Freundt-Revilla, Franciska Heinrich, Alexander Zoerner, Felix Gesell, Martin Beyerbach, Merav Shamir, Anna Oevermann, Wolfgang Baumgärtner, Andrea Tipold
Endocannabinoids (ECs) are involved in immunomodulation, neuroprotection and control of inflammation in the central nervous system (CNS). Activation of cannabinoid type 2 receptors (CB2) is known to diminish the release of pro-inflammatory factors and enhance the secretion of anti-inflammatory cytokines. Furthermore, the endocannabinoid 2-arachidonoyl glycerol (2-AG) has been proved to induce the migration of eosinophils in a CB2 receptor-dependent manner in peripheral blood and activate neutrophils independent of CB activation in humans...
2018: PloS One
https://www.readbyqxmd.com/read/29403257/idiopathic-hypertrophic-pachymeningitis-as-a-rare-cause-of-cervical-compressive-myelopathy
#11
Aya Fukuda, Elizabete Punaro, Fábio Rogério, Luciano de Souza Queiroz, Fabiano Reis
The spinal form of idiopathic hypertrophic pachymeningitis (IHP) is a rare condition characterized by a chronic progressive diffuse inflammatory fibrosis of the dura mater, which may evolve to the compression of the spinal cord. We present a case report about IHP focusing on its features in magnetic resonance imaging, which are determined by an intradural extramedullary mass in the cervical spine showing hypointensity on T2-weighted images and peripheral enhancement, causing compression of the spinal cord. Histological analysis showed a nonspecific chronic inflammatory process in dense fibrous tissue...
October 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/29394207/systemic-effects-of-epidural-steroid-injections-for-spinal-stenosis
#12
Janna L Friedly, Bryan A Comstock, Patrick J Heagerty, Zoya Bauer, Micol S Rothman, Pradeep Suri, Ryan Hansen, Andrew L Avins, Srdjan S Nedeljkovic, David R Nerenz, Venu Akuthota, Jeffrey G Jarvik
This analysis of the Lumbar Epidural steroid injections for Spinal Stenosis (LESS) multi-center randomized controlled trial data identifies the degree of and risk factors for cortisol suppression following epidural steroid injections in older adults with spinal stenosis. 400 patients aged > 50 years with back or leg pain and central lumbar spinal stenosis completed baseline demographic and psychosocial measures. Morning serum cortisol levels were measured at baseline and 3 weeks after initial injection. Patients were randomized to receive epidural injections of either local anesthetic with corticosteroid (n = 200) or local anesthetic only (n = 200)...
January 30, 2018: Pain
https://www.readbyqxmd.com/read/29385888/andrographolide-relieved-pathological-pain-generated-by-spared-nerve-injury-model-in-mice
#13
Huang-Chi Wang, Hsin-Sheng Tsay, Hui-Nung Shih, Yi-An Chen, Kai-Ming Chang, Dinesh Chandra Agrawal, Siendong Huang, Yi-Lo Lin, Meng-Jen Lee
CONTEXT: Andrographolide (Andro), found in large quantities in Andrographis paniculata Nees (Acanthaceae), is anti-inflammatory, especially in the central nervous system (CNS) glia. OBJECTIVE: The objective of this study is to test Andro's ability to reduce allodynia in a spared nerve injury model. MATERIAL AND METHODS: Male 30 g BalbC mice were divided into four groups: (1) Sham-operated control (Sham-group); (2) nerve injured and treated with saline (Saline-group); (3) nerve injured and treated with Andro (Andro-group); (4) nerve injured and treated with non-steroidal anti-inflammatory drugs (NSAIDS) (NSAIDS-group)...
December 2018: Pharmaceutical Biology
https://www.readbyqxmd.com/read/29382812/evaluation-and-management-of-spinal-subarachnoid-hemorrhage-in-a-patient-with-lupus-vasculitis
#14
Ryan M Glynn, Madeline R Garza, Franco M Campanella
BACKGROUND Isolated spinal artery subarachnoid hemorrhage is a rare occurrence in the general population, but occurs more commonly as one of many neurologic sequela of systemic lupus erythematosus (SLE). The etiology of a neurologic deficit in an SLE patient is often multifactorial. Comorbid conditions, such as antiphospholipid antibody syndrome, predispose to stroke. Other diagnoses, including transverse myelitis, may also be attributed to local inflammation. CASE REPORT A 37-year-old woman with SLE and antiphospholipid antibody syndrome experienced severe back pain followed by sudden paralysis and sensory loss below the T2 level...
January 31, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29374352/image-guidance-technologies-for-interventional-pain-procedures-ultrasound-fluoroscopy-and-ct
#15
REVIEW
Dajie Wang
Chronic pain is a common medical condition. Patients who suffer uncontrolled chronic pain may require interventions including spinal injections and various nerve blocks. Interventional procedures have evolved and improved over time since epidural injection was first introduced for low back pain and sciatica in 1901. One of the major contributors in the improvement of these interventions is the advancement of imaging guidance technologies. The utilization of image guidance has dramatically improved the accuracy and safety of these interventions...
January 26, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29361915/neuromyelitis-optica-spectrum-disorder-secondary-to-treatment-with-anti-pd-1-antibody-nivolumab-the-first-report
#16
Yoshitsugu Narumi, Ryohei Yoshida, Yoshinori Minami, Yasushi Yamamoto, Shiori Takeguchi, Kohei Kano, Kae Takahashi, Tsukasa Saito, Jun Sawada, Hiroya Terui, Takayuki Katayama, Takaaki Sasaki, Yoshinobu Ohsaki
BACKGROUND: Immune checkpoint blockade is developed as standard treatment for non-small cell lung cancer. However immune-related adverse events (irAE) have still unknown complications. Here, we report a patient with lung squamous cell carcinoma who developed neuromyelitis optica spectrum disorder with nivolumab. CASE PRESENTATION: A 75-year-old Japanese man with lung squamous cell carcinoma was administered nivolumab as second-line treatment. Two months after treatment with nivolumab, he presented acute paralysis in the bilateral lower limbs, sensory loss...
January 24, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29357335/outcome-of-transforaminal-epidural-steroid-injection-according-to-the-severity-of-lumbar-foraminal-spinal-stenosis
#17
Min Cheol Chang, Dong Gyu Lee
BACKGROUND: Lumbar foraminal spinal stenosis (LFSS) is a common cause of radicular pain in the lower extremities. Transforaminal epidural steroid injection (TFESI) is being used widely for controlling radicular pain induced by LFSS. The efficacy of TFESI has been demonstrated in previous studies. However, no study has evaluated the outcome of TFESI according to the severity of LFSS. OBJECTIVE: In this study, we evaluated the outcome of TFESI in patients with chronic lumbar radicular pain due to LFSS according to the severity of LFSS by using magnetic resonance imaging (MRI)...
January 2018: Pain Physician
https://www.readbyqxmd.com/read/29353736/mitochondrial-leukoencephalopathies-a-border-zone-between-acquired-and-inherited-white-matter-disorders-in-children
#18
Parayil Sankaran Bindu, Kothari Sonam, Shwetha Chiplunkar, Periyasamy Govindaraj, Madhu Nagappa, Chetan Chandrakanth Vekhande, Hanumanthapura R Aravinda, Jn Jessiena Ponmalar, Anita Mahadevan, Narayanappa Gayathri, Mm Srinivas Bharath, Sanjib Sinha, Arun B Taly
BACKGROUND: There is emerging evidence implicating mitochondrial dysfunction in the pathogenesis of acquired demyelinating disorders such as multiple sclerosis. On the other hand, some of the primary mitochondrial disorders such as mitochondrial leukoencephalopathies exhibit evidence of neuroinflammation on MRI. The inter-relationship between mitochondrial disorders and episodic CNS inflammation needs exploration because of the therapeutic implications. OBJECTIVE: We sought to analyze the clinical course and MRI characteristics in a cohort of patients with mitochondrial leukoencephalopathy to determine features, if any, that mimic primary demyelinating disorders...
January 6, 2018: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/29350608/acute-transverse-myelitis-following-scrub-typhus-a-case-report-and-review-of-the-literature
#19
Hyun-Seung Ryu, Bong Ju Moon, Jae-Young Park, Sang-Deok Kim, Seung-Kwon Seo, Jung-Kil Lee
Context Scrub typhus is an acute febrile disease caused by Orientia tsutsugamushi. The disease can usually involve the lungs, heart, liver, spleen and brain through hematogenous dissemination. However, very rarely, acute transverse myelitis in the spinal cord develops from scrub typhus. We present a case of acute transverse myelitis following scrub typhus with a review of the literature. Findings A 66-year-old male visited a hospital for general myalgia, mild headache, and fever in October. He was noted to have thick, black papule skin on his abdomen, which was highly suggestive of scrub typhus...
January 19, 2018: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29339316/diagnosis-and-management-of-neuromyelitis-optica-spectrum-disorders-an-update
#20
REVIEW
Alice Bruscolini, Marta Sacchetti, Maurizio La Cava, Magda Gharbiya, Massimo Ralli, Alessandro Lambiase, Armando de Virgilio, Antonio Greco
Neuromyelitis optica (NMO) and Neuromyelitis optica spectrum disorders (NMOSD) are a group of autoimmune conditions characterized by inflammatory involvement of the optic nerve, spinal cord and central nervous system. Novel evidence showed a key role of autoantibodies against aquaporin-4 immunoglobulin G (AQP4 IgG) in the pathogenesis of NMOSD and, recently, new classification and diagnostic criteria have been adopted to facilitate an earlier identification and improve the management of these conditions. Diagnosis of NMOSD is currently based on clinical, neuroimaging and laboratory features...
January 12, 2018: Autoimmunity Reviews
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