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Traumatic central cord syndrome

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https://www.readbyqxmd.com/read/29844927/delayed-diagnosis-of-traumatic-gunshot-wound-brown-sequard-plus-syndrome-due-to-associated-brachial-plexopathy
#1
Raúl A Rosario-Concepción, Juan Carlos Pérez, Claudia Jiménez, Walter R Frontera, Carmen López-Acevedo
Introduction: Brown-Séquard Syndrome (BSS) is one of the rarest incomplete spinal cord syndromes. The combination of injuries to peripheral nerves and the central nervous system result in an array of symptoms that can result in overlapping clinical presentations and delayed diagnosis. Early detection of spinal cord injury in patients with peripheral nerve injury has been observed to have a positive effect on outcomes. Case presentation: This report discusses the case of a 29-year-old male patient with Brown-Sequard-Plus Syndrome (BSPS) and Brachial Plexopathy (BP) secondary to gunshot wound in the left inferior neck...
2018: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/29743771/cervical-myelopathy-in-a-child-a-rare-cause-of-hypoventilation-syndrome-presenting-with-type-2-respiratory-failure
#2
Alolika Mondal, Prabhas Prasun Giri
Hypoventilation syndrome leading to Type 2 respiratory failure is not a rare cause of Pediatric Intensive Care Unit admission and mechanical ventilation. Common causes in pediatric population are Guillain-Barre syndrome and various central nervous system disorders such as encephalitis, traumatic brain injury, and drugs. Any injury or disease in the cervical cord can also produce respiratory paralysis causing respiratory failure. Here, we present two cases of mixed cerebral palsy with cervical myelopathy due to compression effect of fractured segments of first and second cervical vertebrae...
April 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29666932/-complex-regional-pain-syndrome-crps-an-update
#3
V Dimova, F Birklein
The acute phase of complex regional pain syndrome (CRPS) is pathophysiologically characterized by an activation of the immune system and its associated inflammatory response. During the course of CRPS, central nervous symptoms like mechanical hyperalgesia, loss of sensation, and body perception disorders develop. Psychological factors such as pain-related anxiety and traumatic events might have a negative effect on the treatment outcome. While the visible inflammatory symptoms improve, the pain often persists...
June 2018: Der Schmerz
https://www.readbyqxmd.com/read/29361876/impact-of-admission-imaging-findings-on-neurological-outcomes-in-acute-cervical-traumatic-spinal-cord-injury
#4
H Francis Farhadi, Sunil Kukreja, Amy Minnema, Lohith Vatti, Meera Gopinath, Luciano Prevedello, Cheng Chen, Huiyun Xiang, Jan M Schwab
Variable and unpredictable spontaneous recovery can occur after acute cervical traumatic spinal cord injury (tSCI). Despite the critical clinical and interventional trial planning implications of this tSCI feature, baseline measures to predict neurologic recovery accurately are not well defined. In this study, we used data derived from 99 consecutive patients (78 male, 21 female) with acute cervical tSCIs to assess the sensitivity and specificity of various clinical and radiological factors in predicting recovery at one year after injury...
March 23, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29164024/a-clinical-practice-guideline-for-the-management-of-patients-with-acute-spinal-cord-injury-and-central-cord-syndrome-recommendations-on-the-timing-%C3%A2-24-hours-versus-24-hours-of-decompressive-surgery
#5
Michael G Fehlings, Lindsay A Tetreault, Jefferson R Wilson, Bizhan Aarabi, Paul Anderson, Paul M Arnold, Darrel S Brodke, Anthony S Burns, Kazuhiro Chiba, Joseph R Dettori, Julio C Furlan, Gregory Hawryluk, Langston T Holly, Susan Howley, Tara Jeji, Sukhvinder Kalsi-Ryan, Mark Kotter, Shekar Kurpad, Ralph J Marino, Allan R Martin, Eric Massicotte, Geno Merli, James W Middleton, Hiroaki Nakashima, Narihito Nagoshi, Katherine Palmieri, Anoushka Singh, Andrea C Skelly, Eve C Tsai, Alexander Vaccaro, Albert Yee, James S Harrop
Objective: To develop recommendations on the timing of surgical decompression in patients with traumatic spinal cord injury (SCI) and central cord syndrome. Methods: A systematic review of the literature was conducted to address key relevant questions. A multidisciplinary guideline development group used this information, along with their clinical expertise, to develop recommendations for the timing of surgical decompression in patients with SCI and central cord syndrome...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29138069/traumatic-fractures-of-the-cervical-spine-analysis-of-changes-in-incidence-cause-concurrent-injuries-and-complications-among-488-262-patients-from-2005-to-2013
#6
Peter G Passias, Gregory W Poorman, Frank A Segreto, Cyrus M Jalai, Samantha R Horn, Cole A Bortz, Dennis Vasquez-Montes, Bassel G Diebo, Shaleen Vira, Olivia J Bono, Rafael De La Garza-Ramos, John Y Moon, Charles Wang, Brandon P Hirsch, Peter L Zhou, Michael Gerling, Heiko Koller, Virginie Lafage
OBJECTIVE: The causes and epidemiology of traumatic cervical spine fracture have not been described with sufficient power or recency. Our goal is to describe demographics, incidence, cause, spinal cord injuries (SCIs), concurrent injuries, treatments, and complications of traumatic cervical spine fractures. METHODS: A retrospective review was carried out of the Nationwide Inpatient Sample. International Classification of Disease, Ninth Revision E-codes identified trauma cases from 2005 to 2013...
February 2018: World Neurosurgery
https://www.readbyqxmd.com/read/28993290/spinal-cord-injury-associated-with-cervical-spinal-canal-stenosis-outcomes-and-prognostic-factors
#7
Y Ronzi, B Perrouin-Verbe, O Hamel, R Gross
OBJECTIVES: To specify outcomes and identify prognostic factors of neurologic and functional recovery in patients with an acute traumatic spinal cord injury (SCI) associated with cervical spinal canal stenosis (SCS), without spinal instability. METHODS: A retrospective study was conducted using data from a Regional Department for SCI rehabilitation in France. A description of the population characteristics, clinical data and neurological and functional outcomes of all patients treated for acute SCI due to cervical trauma associated with SCS was performed...
January 2018: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28816870/spinal-cord-injury-what-are-the-controversies
#8
REVIEW
Christopher S Ahuja, Gregory D Schroeder, Alexander R Vaccaro, Michael G Fehlings
Traumatic spinal cord injuries have a tremendous impact on individuals, families, and society as a whole. Substantial heterogeneity in the patient population, their presentation and underlying pathophysiology has sparked debates along the care spectrum from initial assessment to definitive treatment. This article reviews spinal cord injury (SCI) management followed by a discussion of the salient controversies in the field. Current care practices modeled on the American Association of Neurological Surgeons/Congress of Neurological Surgeons joint section guidelines are highlighted including key recommendations regarding immobilization, avoidance of hypotension, early International Standards for Neurological Classification of SCI examination and intensive care unit treatment...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28673827/the-impact-of-spine-stability-on-cervical-spinal-cord-injury-with-respect-to-demographics-management-and-outcome-a-prospective-cohort-from-a-national-spinal-cord-injury-registry
#9
Jérôme Paquet, Carly S Rivers, Dilnur Kurban, Joel Finkelstein, Jin W Tee, Vanessa K Noonan, Brian K Kwon, R John Hurlbert, Sean Christie, Eve C Tsai, Henry Ahn, Brian Drew, Christopher S Bailey, Daryl R Fourney, Najmedden Attabib, Michael G Johnson, Michael G Fehlings, Stefan Parent, Marcel F Dvorak
BACKGROUND CONTEXT: Emergent surgery for patients with a traumatic spinal cord injury (SCI) is seen as the gold standard in acute management. However, optimal treatment for those with the clinical diagnosis of central cord syndrome (CCS) is less clear, and classic definitions of CCS do not identify a unique population of patients. PURPOSE: The study aimed to test the authors' hypothesis that spine stability can identify a unique group of patients with regard to demographics, management, and outcomes, which classic CCS definitions do not...
January 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28580859/isolated-spinal-cord-compression-syndrome-revealing-delayed-extensive-superficial-siderosis-of-the-central-nervous-system-secondary-to-cervical-root-avulsion
#10
Amina Nasri, Imen Kacem, Youssef Sidhom, Mouna Ben Djebara, Amina Gargouri, Riadh Gouider
CONTEXT: Cervical root avulsion secondary to traumatic plexus injury is a rare etiology of superficial siderosis (SS) of the central nervous system (CNS). We describe the case of an isolated progressive compressive myelopathy revealing this complication and discuss the pathogenesis of such a presentation, its clinical and imaging peculiarities with a literature review. FINDINGS: We report on the case of a 48-year-old man with history of left brachial plexus injury at the age of 2 years...
June 5, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28072744/posterior-arthrodesis-of-c1-c3-for-the-stabilization-of-multiple-unstable-upper-cervical-fractures-with-spinal-cord-compromise-a-case-report-and-literature-review
#11
Deting Xue, Qixin Chen, Gang Chen, Wenhai Zhuo, Fangcai Li
BACKGROUND: Multiple fractures of the atlas and axis are rare. The management of multiple fragment axis fractures and unstable atlas fractures is still challenging for the spinal surgeon. There are no published reports of similar fractures with 3-part fracture of axis associated with an unstable atlas fracture. CASE SUMMARY: We present a patient with concurrent axis and atlas fractures, which have not been reported. The patient suffered hyperextension injury with neck pain and numbness of the bilateral upper extremity associated with weakness after a 2-m fall...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27842476/recurrent-neurological-deterioration-after-conservative-treatment-for-acute-traumatic-central-cord-syndrome-without-bony-injury-seventeen-operative-case-reports
#12
Wenjie Jin, Xin Sun, Kangping Shen, Jia Wang, Xingzhen Liu, Xiushuai Shang, Hairong Tao, Tong Zhu
The mechanisms of late recurrent neurological deterioration after conservative treatment for acute traumatic central cord syndrome (ATCCS) remain unclear. Seventeen operative cases sustaining late recurrent neurological deterioration after conservative treatment for ATCCS were reviewed to investigate the mechanisms. The assessment of neurological status was based on International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). Gender, age, cause of injury, results of image, conservative treatment and operative data, and neurological status at different time points were recorded...
November 1, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27635608/-the-efficacy-of-botulinum-toxin-therapy-in-patients-with-upper-limb-spasticity-due-to-traumatic-brain-injury
#13
REVIEW
M A Akulov, S E Hat'kova, O A Mokienko, O R Orlova, D Yu Usachev, V O Zakharov, A S Orlova, A A Tomskiy
Spasticity is a type of muscle hyperactivity that occurs in patients after focal lesions of the Central nervous system due to various diseases: stroke, traumatic brain injury or spinal cord injury, neurosurgical intervention, as well as multiple sclerosis and other diseases of the Central nervous system and is the most disability manifestation of the syndrome of upper motor neuron (UMNS). Focal spasticity of the upper limb requires a complex treatment. Botulinum toxin therapy is an effective treatment for focal/multifocal spasticity in reducing muscle tone and improving function with the highest level of evidence according to the latest American and European guidelines for treatment of spasticity...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/27466236/scissor-spinal-cord-injury-study-on-small-molecule-derived-rho-inhibition-a-clinical-study-protocol
#14
Marcel A Kopp, Thomas Liebscher, Ralf Watzlawick, Peter Martus, Stefan Laufer, Christian Blex, Ralf Schindler, Gerhard J Jungehulsing, Sven Knüppel, Martin Kreutzträger, Axel Ekkernkamp, Ulrich Dirnagl, Stephen M Strittmatter, Andreas Niedeggen, Jan M Schwab
INTRODUCTION: The approved analgesic and anti-inflammatory drugs ibuprofen and indometacin block the small GTPase RhoA, a key enzyme that impedes axonal sprouting after axonal damage. Inhibition of the Rho pathway in a central nervous system-effective manner requires higher dosages compared with orthodox cyclooxygenase-blocking effects. Preclinical studies on spinal cord injury (SCI) imply improved motor recovery after ibuprofen/indometacin-mediated Rho inhibition. This has been reassessed by a meta-analysis of the underlying experimental evidence, which indicates an overall effect size of 20...
July 26, 2016: BMJ Open
https://www.readbyqxmd.com/read/27399460/181-guidelines-for-the-management-of-patients-with-spinal-cord-injury-the-optimal-timing-of-decompression
#15
Jefferson R Wilson, Lindsay Tetreault BSc, Bizhan Aarabi, Paul A Anderson, Paul M Arnold, Darrel S Brodke, Anthony Burns, Robert Chen, Kazuhiro Chiba, Joseph Dettori, Julio C Furlan, James S Harrop, Langston T Holly, Tara Jeji, Sukhvinder Kalsi-Ryan, Mark Kotter, Shekar N Kurpad, Brian K Kwon, Ralph Marino, Allen R Martin, Eric M Massicotte, Geno Merli, James Middleton, Hiroaki Nakashima, Narihito Nagoshi, Katherine Palmieri, Mohammed F Shamji, Anoushka Singh, Andrea Skelly, Albert Yee, Michael Fehlings
INTRODUCTION: The objective of this study is to develop guidelines that outline the optimal timing of decompression in patients with traumatic spinal cord injury (SCI) and central cord syndrome. METHODS: A systematic review of the literature was conducted to address the following key questions: (1) What is the efficacy of early decompression (=24 hours) compared with late decompression (>24 hours) based on clinically important change in neurological status? (2) Does timing of decompression influence functional or administrative outcomes? (3) What is the safety profile of early decompression compared with late decompression? (4) What is the evidence that early decompression has differential efficacy or safety in subpopulations? (5) What is the comparative cost-effectiveness of early vs late decompression? A multidisciplinary guideline development group used this information, in combination with their clinical expertise, to develop recommendations for the optimal timing of SCI...
August 2016: Neurosurgery
https://www.readbyqxmd.com/read/27399447/168%C3%A2-impact-of-initial-clinical-and-imaging-parameters-on-long-term-neurological-outcomes-in-acute-traumatic-cervical-spinal-cord-injury
#16
Sunil Kukreja, Jan Schwab, Francis Farhadi
INTRODUCTION: The influence of initial clinical and imaging parameters on long-term outcomes following spinal cord injury (SCI) has been examined in previous studies, often with inconsistent or contradictory findings. In this study, we evaluated a comprehensive set of admission parameters and analyzed their relationships with long-term neurological recovery. METHODS: Institutional databases were used to retrospectively identify consecutive patients with cervical SCI admitted between 2008 and 2015...
August 2016: Neurosurgery
https://www.readbyqxmd.com/read/27020670/traumatic-central-cord-syndrome-neurological-and-functional-outcome-at-3-years
#17
C M Stevenson, D P Dargan, J Warnock, S Sloan, R Espey, S Maguire, N Eames
STUDY DESIGN: Retrospective cohort analysis with prospective follow-up. OBJECTIVES: To evaluate neurological and functional recovery following central cord syndrome. SETTING: Northern Ireland, population 1.8 million. METHODS: Twenty-seven cords were identified in 1 year. Five managed conservatively and 22 with surgery. American Spinal Injury Association (ASIA) motor scores (AMS) were calculated to assess neurological recovery...
November 2016: Spinal Cord
https://www.readbyqxmd.com/read/26999797/experimental-cannabinoid-2-receptor-inhibition-in-cns-injury-induced-immunodeficiency-syndrome
#18
Ian Burkovskiy, Juan Zhou, Christian Lehmann
OBJECTIVE: Severe CNS injury, such as stroke, traumatic brain injury, or spinal cord injury, is known to increase susceptibility to infections. The increased susceptibility to infection is due to an impaired immune response and is referred to as CIDS. The CB2 receptor on immune cells presents a potential therapeutic target in CIDS as activation of this receptor has been shown to be involved in immunosuppression. The main purpose of this study was to determine the impact of CB2 receptor inhibition on leukocyte activation within the microcirculation following endotoxin challenge in an experimental stroke model...
May 2016: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://www.readbyqxmd.com/read/26633781/fungal-infections-of-the-central-nervous-system
#19
REVIEW
Anil A Panackal, Peter R Williamson
PURPOSE OF REVIEW: This article summarizes current knowledge on the epidemiology, clinical presentations, diagnosis, and management of selected fungal infections of the central nervous system (CNS). Key syndromes, differential diagnoses, and therapeutic interventions according to host immune status and exposure are reviewed. RECENT FINDINGS: Advancements in imaging of the brain and spinal cord, and molecular DNA and antigen-based laboratory diagnostics afford improved sensitivity for CNS mycoses...
December 2015: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/26378353/optimal-timing-of-surgical-decompression-for-acute-traumatic-central-cord-syndrome-a-systematic-review-of-the-literature
#20
REVIEW
Karen K Anderson, Lindsay Tetreault, Mohammed F Shamji, Anoushka Singh, Rachel R Vukas, James S Harrop, Michael G Fehlings, Alexander R Vaccaro, Alan S Hilibrand, Paul M Arnold
BACKGROUND: Traumatic central cord syndrome (TCCS) is an incomplete spinal cord injury defined by greater weakness in upper versus lower extremities, variable sensory loss, and variable bladder, bowel, and sexual dysfunction. The optimal timing of surgery for TCCS remains controversial. OBJECTIVE: To determine whether timing of surgery for TCCS predicts neurological outcomes, length of stay, and complications. METHODS: Five databases were searched through March 2015...
October 2015: Neurosurgery
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