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https://www.readbyqxmd.com/read/28306628/pediatric-spinal-cord-injury-without-radiographic-abnormality-in-the-era-of-advanced-imaging
#1
Caitlin A Farrell, Megan Hannon, Lois K Lee
PURPOSE OF REVIEW: The current review describes the current evidence on pediatric spinal cord injury without radiographic abnormality (SCIWORA) with attention to the definition, epidemiology, and clinical presentation of the condition, as well as common MRI findings, management strategies, and outcomes. RECENT FINDINGS: Recent literature demonstrates that with more widespread MRI use, our understanding of SCIWORA has improved. The new literature, although still limited, provides a more granular conceptualization of patterns of injury as well as potential prognostic stratification of patients based on MRI findings...
March 16, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28298579/computed-tomography-of-thoracolumbar-spine-trauma
#2
Teresa G Odle
Thoracolumbar spine trauma typically occurs when high-energy forces damage bony and ligamentous spinal structures and, in severe cases, the spinal cord. These injuries often cause considerable neurological deficits as a result of the damage. Computed tomography (CT) is the imaging method of choice for determining injury severity in most victims of multiple trauma. In addition to describing various types of thoracolumbar trauma, this article discusses the role of CT in emergency diagnosis and management of thoracolumbar injuries...
January 2017: Radiologic Technology
https://www.readbyqxmd.com/read/28291403/a-rat-model-of-chronic-syringomyelia-induced-by-epidural-compression-of-the-lumbar-spinal-cord
#3
Ji Yeoun Lee, Shin Won Kim, Saet Pyoul Kim, Hyeonjin Kim, Jung-Eun Cheon, Seung-Ki Kim, Sun Ha Paek, Dachling Pang, Kyu-Chang Wang
OBJECTIVE There has been no established animal model of syringomyelia associated with lumbosacral spinal lipoma. The research on the pathophysiology of syringomyelia has been focused on Chiari malformation, trauma, and inflammation. To understand the pathophysiology of syringomyelia associated with occult spinal dysraphism, a novel animal model of syringomyelia induced by chronic mechanical compression of the lumbar spinal cord was created. METHODS The model was made by epidural injection of highly concentrated paste-like kaolin solution through windows created by partial laminectomy of L-1 and L-5 vertebrae...
February 17, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28283371/chiari-like-displacement-due-to-spontaneous-intracranial-hypotension-in-an-adolescent-successful-treatment-by-epidural-blood-patch
#4
Jan Schönberger, Markus Möhlenbruch, Angelika Seitz, Cornelia Bußmann, Heidi Bächli, Stefan Kölker
BACKGROUND: Spontaneous intracranial hypotension is a rarely diagnosed cause of headache, especially in children and adolescents. It is due to cerebrospinal fluid (CSF) leakage via spinal fistulae occurring without major trauma. CASE PRESENTATION: An adolescent patient presented with a 3-month history of strictly postural headache. Cranial magnetic resonance imaging (MRI) showed pronounced Chiari-like prolapse of the cerebellar tonsils, narrow ventricles and enlarged cerebral veins...
February 20, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28281001/acute-complete-paraplegia-of-8-year-old-girl-caused-by-spinal-cord-infarction-following-minor-trauma-complicated-with-longitudinal-signal-change-of-spinal-cord
#5
Kosei Nagata, Yuji Tanaka, Hiroyuki Kanai, Yasushi Oshima
INTRODUCTION: Spinal cord infarction followed by minor trauma in pediatric patients is rare and causes serious paralysis. Fibrocartilaginous embolism (FCE) is a possible diagnosis and there have been no consecutive magnetic resonance imaging (MRI) reports. Here, we report a case of an acute complete paraplegia with spinal cord infarction and longitudinal spinal cord signal change following minor trauma in an 8-year-old girl. CASE DESCRIPTION: An 8-year-old girl presented to our hospital emergency services with total paraplegia 2 h after she hit her back and neck after doing a handstand and falling down...
March 9, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28258287/-trisegmental-fusion-by-vertebral-body-replacement-outcome-following-traumatic-multisegmental-fractures-of-the-thoracic-and-lumbar-spine
#6
Michael Kreinest, Dorothee Schmahl, Paul A Grützner, Stefan Matschke
BACKGROUND: Around 5% of all trauma patients suffer from spinal trauma. Spinal fractures are mainly located in the thoracic and lumbar spine. For multisegmental vertebral fractures categorized as instable, combined dorsal instrumentation and ventral stabilization is recommended. Numerous vertebral body replacement systems are available for ventral stabilization. OBJECTIVES: The aim of the current study was to analyze radiological results following the implantation of a hydraulic expandable vertebral body replacement and the evaluation of patients' outcome three years after implantation...
March 3, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28255506/spinal-epidural-hematoma-related-to-vertebral-fracture-in-an-atypical-rigid-diffuse-idiopathic-skeletal-hyperostosis-a-case-report
#7
José Ramírez Villaescusa, Marcela Restrepo Pérez, David Ruiz Picazo
INTRODUCTION: Spinal epidural hematoma (SEH) is a rare disease that causes cord compression and neurologic deficit. Spontaneous SEH is related to minor trauma, bleeding disorders, and anticoagulant medications. Posttraumatic SEH has been associated with low-energy spine hyperextension injuries in patients with ankylosing spinal disorders such as ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis (DISH). A variant named atypical DISH-like with SEH is reported. OBJECTIVE: To describe the management, diagnosis, and treatment of an unusual SEH case in a patient causing delayed neurologic deficit with rigid atypical DISH-like spine...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28254591/a-small-leak-will-sink-the-brain-targeted-c1-c2-patching
#8
Thomas Decramer, Pieter Jan Van Dyck-Lippens, Tom P Franken, Philippe Demaerel, Johannes van Loon, Tom Theys
BACKGROUND: Spontaneous intracranial hypotension (SIH) syndrome results from spontaneous spinal CSF leaks. The first treatment of choice consists of lumbar epidural blood patching. If this fails further imaging is mandatory to explore the possibility of targeted therapy. CASE DESCRIPTION: We describe a case of a 50-year old woman who developed spontaneous intracranial hypotension after minor blunt cervical trauma, complicated with bilateral subdural hematomas. Two lumbar epidural blood patches were unsuccessful...
February 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28242068/diffusion-tensor-mr-imaging-in-spinal-cord-injury
#9
Maria M D'souza, Ajay Choudhary, Mahesh Poonia, Pawan Kumar, Subash Khushu
BACKGROUND: The ability of diffusion tensor imaging (DTI) to complement conventional MR imaging by diagnosing subtle injuries to the spinal cord is a subject of intense research. We attempted to study change in the DTI indices, namely fractional anisotropy (FA) and mean diffusivity (MD) after traumatic cervical spinal cord injury and compared these with corresponding data from a control group of individuals with no injury. The correlation of these quantitative indices to the neurological profile of the patients was assessed...
February 21, 2017: Injury
https://www.readbyqxmd.com/read/28235527/a-patient-with-postpolio-syndrome-developed-cauda-equina-syndrome-after-neuraxial-anesthesia-a-case-report
#10
Wei-Cheng Tseng, Zhi-Fu Wu, Wen-Jinn Liaw, Su-Yang Hwa, Nan-Kai Hung
Combined spinal anesthesia and postoperative epidural analgesia is widely used in orthopedic surgery. Uncommon but serious neurologic complications of neuraxial anesthesia (NA) include direct trauma during needle or catheter insertion, central nervous system infections, and neurotoxicity of local anesthetics. Cauda equina syndrome (CES) is a rare complication after NA but can result in severe neurologic deterioration that may require surgical intervention. We present a case of a 69-year-old woman with postpolio syndrome who developed CES after combined spinal anesthesia and postoperative epidural analgesia...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28187806/diagnosis-and-management-of-spinal-cord-emergencies
#11
E P Flanagan, S J Pittock
Most spinal cord injury is seen with trauma. Nontraumatic spinal cord emergencies are discussed in this chapter. These myelopathies are rare but potentially devastating neurologic disorders. In some situations prior comorbidity (e.g., advanced cancer) provides a clue, but in others (e.g., autoimmune myelopathies) it may come with little warning. Neurologic examination helps distinguish spinal cord emergencies from peripheral nervous system emergencies (e.g., Guillain-Barré), although some features overlap...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28168635/imaging-of-post-surgical-treatment-and-of-related-complications-in-spinal-trauma
#12
REVIEW
F Caranci, G Leone, L Ugga, E Cesarano, R Capasso, S Schipani, A Bianco, P Fonio, F Briganti, L Brunese
Spinal trauma is a devastating event with a high morbidity and mortality. The rationale of imaging is to diagnose the traumatic abnormalities and characterize the type of injury, to estimate the severity of the lesions, to evaluate the potential spinal instability. In case of spinal instability, the goals of operative treatment are decompression of the spinal cord canal and stabilization of the disrupted vertebral column. Particularly, diagnostic imaging, mainly by CT and MR, has a main role in the post-treatment evaluation...
February 6, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28166934/spinal-cord-and-peripheral-nerve-abnormalities-of-the-ruminant
#13
REVIEW
Amanda K Hartnack
In food animals, spinal cord damage is most commonly associated with infection or trauma. Antemortem diagnosis is based on clinical signs, history, cerebrospinal fluid analysis, and imaging. As clinical signs are often severe, and prognosis is grave, necropsy may provide a postmortem diagnosis. Peripheral nerve abnormalities are most often the result of trauma. Calving paralysis or paresis is the most common condition affecting the sciatic or obturator nerve and often concurrently involves the peroneal branch of the sciatic...
March 2017: Veterinary Clinics of North America. Food Animal Practice
https://www.readbyqxmd.com/read/28165875/multidetector-ct-of-surgically-proven-blunt-bowel-and-mesenteric-injury
#14
David D B Bates, Michael Wasserman, Anita Malek, Varun Gorantla, Stephan W Anderson, Jorge A Soto, Christina A LeBedis
Blunt traumatic injury is one of the leading causes of morbidity and mortality in the United States. Unintentional injury represents the leading cause of death in the United States for all persons between the ages of 1 and 44 years. In the setting of blunt abdominal trauma, the reported rate of occurrence of bowel and mesenteric injuries ranges from 1% to 5%. Despite the relatively low rate of blunt bowel and mesenteric injury in patients with abdominal and pelvic trauma, delays in diagnosis are associated with increased rates of sepsis, a prolonged course in the intensive care unit, and increased mortality...
March 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28165638/anatomical-complications-of-epidural-anesthesia-a-comprehensive-review
#15
REVIEW
Prasanthi Maddali, Marc Moisi, Jeni Page, Parthasarathi Chamiraju, Christian Fisahn, Rod Oskouian, R Shane Tubbs
Epidural anesthesia is a versatile technique widely used in treating lumbar spinal pain syndromes. Complications during these procedures can arise either from needle placement or from administration of medication. Potential risks include infection, hematoma, intravascular or subdural injections of medication, direct nerve trauma, air embolism, entry into a disc space, urinary retention, radiation exposure, and hypersensitivity reactions. The objective of this article is to review the complications of lumbar epidural injections and discuss the potential pitfalls related to these procedures...
April 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28164000/spinal-dural-arteriovenous-fistula-and-cecal-arteriovenous-malformation-in-a-boy
#16
Vimlesh Soni, Pankaj C Vaidya, Jitendra Kumar Sahu, Mukesh Yadav, Pratibha Singhi
Concurrent spinal dural arteriovenous fistula (AVF) and cecal arteriovenous malformation (AVM) are very rare. A 6-year old boy presented with lower limb paresis after trauma. On imaging work-up spinal dural AVF was found. It was managed with endovascular glue embolization. After two years, the boy presented with severe anemia and occult gastrointestinal tract (GIT) bleed. Cecal AVM was diagnosed and managed with embolization.
January 2017: APSP Journal of Case Reports
https://www.readbyqxmd.com/read/28151882/modified-posterior-vertebral-column-resection-for-k%C3%A3-mmell-disease-case-report
#17
Feng-Yu Liu, Li-Shuang Huo, Sen Liu, Hui Wang, Li-Jun Zhang, Da-Long Yang, Wen-Yuan Ding
RATIONALE: Kümmell's disease is defined as delayed traumatic vertebral collapse disease in which patients develop a kyphosis after asymptomatic minor spinal trauma. Both anterior approach and posterior approach have been reported, however, there is no standard treatment for Kümmell's disease. PATIENT CONCERNS: We described a successful modified posterior vertebral column resection in a patient with Kümmell's disease. A 65-year-old woman reported persistent back pain for almost three months...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28151094/spontaneous-resolution-of-ruptured-intracranial-pial-arteriovenous-fistula-following-spinal-surgery
#18
Mark K Lyons, Joseph M Hoxworth, Jamal McClendon, Chandan X Krishna, Naresh P Patel
Pial arteriovenous fistulae (AVFs) are rare vascular abnormalities that are distinct from arteriovenous malformations and dural AVFs. These vascular lesions have been linked with trauma, ischemic syndromes, venous thrombotic diseases, and intracranial surgical procedures. In this report we describe a case of an intracranial ruptured pial AVF immediately following uneventful spinal surgery in an elderly patient with subsequent spontaneous resolution. He was a previous heavy smoker with a 60-pack-year history and alcohol abuse...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28150118/clinical-outcomes-following-spinal-fracture-in-patients-with-ankylosing-spondylitis
#19
M Nugent, M J Berney, S Morris
BACKGROUND: Ankylosing spondylitis is a seronegative rheumatoid condition mainly affecting the axial skeleton. It leads to progressive deformity and stiffening of the spine with an increased risk of vertebral fractures and significant neurological deficits compared to the general population. AIM: This study aimed to evaluate the outcomes of patients with ankylosing spondylitis who sustained acute vertebral fractures over a 10-year period. METHODS: A retrospective review of patient records and radiographic images was performed...
February 1, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28102813/intramedullary-amputation-neuroma-a-case-report-and-review-of-the-literature
#20
REVIEW
Laura Stone McGuire, Mandana Behbahini, Sumit Das, David Loeffler, Peter Burger, Herbert Engelhard, Tibor Valyi-Nagy, Ankit Mehta
BACKGROUND AND IMPORTANCE: Amputation neuromas consist of non-neoplastic collections of myelinated axons and Schwann cells and typically arise in injured peripheral nerves. Rarely, however, neuromas occur within the spinal cord. Intramedullary amputation neuromas have been described both with and without a history of trauma within the peripheral nervous system. We report a rare case of an isolated intramedullary spinal cord amputation neuroma. CLINICAL PRESENTATION: This 43-year-old man presented with progressive and severe gait deterioration for ~ 7 years...
March 2017: Clinical Neuropathology
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