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https://www.readbyqxmd.com/read/29441246/spinal-cord-infarction-mimicking-acute-transverse-myelitis
#1
Nilesh H Pawar, Ealing Loke, Derrick C Aw
Spinal cord infarction (SCI) is a rare type of stroke. The initial magnetic resonance imaging (MRI) is usually normal and can mimic the presentation of the acute transverse myelitis (ATM), acute inflammatory demyelinating polyneuropathy, and compressive myelopathies from neoplasm, epidural or subdural hematoma, or abscess. The aim of this report is to describe and discuss the case of a patient with SCI presenting as a diagnostic confusion with acute transverse myelitis. A 64-year-old male with a medical history of hypertension presented with an acute onset of urinary retention with lower limb weakness...
December 6, 2017: Curēus
https://www.readbyqxmd.com/read/29437718/spinal-cord-compression-secondary-to-epidural-abscess-the-importance-of-prompt-diagnosis-and-management
#2
Chloe Thomson
A 66-year-old woman presented with a 4-day history of fever, lethargy, neck and lower back pain. Neurological examination revealed mild quadraparesis. In view of this, MRI whole spine with contrast was performed and showed extensive spinal epidural abscess extending from the cervical to lumbar region causing compression of the thecal sac, spinal cord and nerves. The patient received multiple laminectomies to decompress the spinal cord and required a prolonged course of intravenous flucloxacillin as Staphylococcus aureus was cultured from three sets of blood cultures...
February 7, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29416905/man-in-the-barrel-syndrome-case-report-of-ventral-epidural-abscess-and-review-of-the-literature
#3
Karam Asmaro, Aqueel H Pabaney, Richard Rammo, Rizwan Tahir, Max K Kole
Background: Man-in-the-barrel syndrome (MBS) is an uncommon clinical condition for which patients present with bilateral brachial diplegia but intact lower extremity strength. This syndrome is typically attributed to a cranial/cortical injury rather than a spinal pathology. Case Description: A 62-year-old diabetic male presented with bilateral upper extremity paresis attributed to a ventral cervical epidural abscess diagnosed on magnetic resonance imaging. Emergent cervical decompression resulted in slight improvement of upper extremity strength...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29406894/neurologic-illness-in-zambia-a-neurointensivist-s-experience
#4
Merritt W Brown, Katie Ellen Foy, Christopher Chanda, Jacqueline Mulundika, Igor J Koralnik, Omar K Siddiqi
INTRODUCTION: Management of critically ill patients in dedicated intensive care units (ICUs) is the standard of care in high income countries (HICs), but remains uncommon in low and middle-income countries (LMICs). We sought to determine the prevalence of neurologic disorders in the ICU of a LMIC and examine if resource appropriate specialized neurocritical care training could benefit these patients. METHODS: From February to March 2017, a trained neurocritical care intensivist recorded encounters in the sole ICU at the University Teaching Hospital (UTH) in Lusaka, Zambia...
February 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29395691/pott-s-disease-in-a-patient-with-subtle-red-flags
#5
Lauren M Cantwell, John C Perkins, David C V Keyes
BACKGROUND: Tuberculosis (TB) is now rare in developed countries; however, it is an important diagnosis for the Emergency Physician to be able to make. Classically thought of as a respiratory disease, TB can present in other ways, making it more challenging to recognize. CASE REPORT: We report the case of a 41-year-old woman who presented to the Emergency Department with a 4-week history of back pain. A diagnosis of T12 osteomyelitis and right psoas muscle abscess was made after magnetic resonance imaging...
January 26, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29386725/tubercular-spondylitis-a-review-of-mri-findings-in-80-cases
#6
Vinay K Maurya, Pankaj Sharma, R Ravikumar, J Debnath, Vivek Sharma, Satyabrat Srikumar, Mukul Bhatia
Background: Tuberculosis of spine is known as tubercular spondylitis or Pott's spine. The vertebral involvement leads to various pathological processes such as abscess formation, cord compression, and gibbus deformity. Magnetic Resonance Imaging (MRI) is the imaging modality of choice which not only helps in diagnosing a case of Pott's spine but also gives valuable information about its impending complications, thereby, aiding in management of these cases. Methods: In this study, MRI scans of 80 proven cases of tubercular spondylitis were studied retrospectively for the various pathological processes affecting the spine...
January 2018: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/29367221/severe-systemic-inflammatory-response-syndrome-immediately-after-spinal-surgery-in-a-patient-with-axial-gout
#7
Ricardo Gago, Salvador Vilá, Jonathan Vélez-Rivera, Luis M Vilá
We report a 55-year-old man with gouty arthritis who developed a 3-month history of low back pain, gradual lower extremities weakness and urinary incontinence. Lumbar MRI showed an exophytic lesion at L3-L4. Immediately after spinal decompression surgery, he developed fever, disorientation, polyarthritis, acute kidney injury and leucocytosis. He was treated with multiple antimicrobial agents for presumed spinal abscess but did not improve. Multiple body site cultures were negative. Aspiration of the sacroiliac joint revealed the presence of monosodium uric acid crystals...
January 24, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29340585/spinal-tuberculosis-clinicoradiological-findings-in-274-patients
#8
Suzaan Marais, Izanne Roos, Ayesha Mitha, Sepelong J Mabusha, Vinod Patel, Ahmed I Bhigjee
Background: Mycobacterium tuberculosis is a major cause of myelopathy and radiculopathy in high TB/HIV prevalent settings. However, a paucity of publications exists on the spectrum of neurological and magnetic resonance imaging (MRI) findings of spinal tuberculosis in these populations. Methods: A retrospective study of adults with spinal tuberculosis conducted at a referral center for patients with spinal disease without bony involvement on plain film radiography in South Africa...
January 11, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29339229/a-rare-case-of-c-glabrata-spondylodiscitis-case-report-and-literature-review
#9
REVIEW
Manfredi Gagliano, Costanza Marchiani, Giulia Bandini, Paolo Bernardi, Nicolas Palagano, Elisa Cioni, Martina Finocchi, Silvia Bellando Randone, Alberto Moggi Pignone
BACKGROUND: Spondylodiscitis are vertebral column infections whose incidence is rising due to an increase of the susceptible population and improved ascertainment. They have been associated with a wide range of microorganisms. Fungal spondylodiscitis is uncommon (0.5%-1.6%) and strongly associated with immunodepression and diabetes (Gouliouris et al., 2010). We present a rare case of Candida glabrata spondylodiscitis in a non neutropenic diabetic patient with the review of the literature...
January 12, 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29322981/expansile-manubriotomy-for-ventral-cervicothoracic-junction-disease
#10
Sudhir Dubey, Amit Agrawal
Cervicothoracic junction can be approached anteriorly, anterolaterally, posterolaterally, and posteriorly. The anterior approaches in this region best address the ventral vertebral body disease but may cause significant morbidity. Twelve patients with their disease process located ventral to the spinal cord in the cervicothoracic junction underwent expansile manubriotomy and corpectomy. Eleven patients underwent fusion. One patient underwent an oblique corpectomy. All patients had their disease process from T1 to T3 vertebral levels...
January 2018: Neurology India
https://www.readbyqxmd.com/read/29321098/spondylodiscitis-diagnosis-and-treatment-options
#11
Christian Herren, Norma Jung, Miguel Pishnamaz, Marianne Breuninger, Jan Siewe, Rolf Sobottke
BACKGROUND: A recent population-based study from Denmark showed that the incidence of spondylodiscitis rose from 2.2 to 5.8 per 100 000 persons per year over the period 1995-2008; the age-standardized incidence in Germany has been estimated at 30 per 250 000 per year on the basis of data from the Federal Statistical Office (2015). The early diagnosis and treatment of this condition are essential to give the patient the best chance of a good outcome, but these are often delayed because it tends to present with nonspecific manifestations, and fever is often absent...
December 25, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29313911/spinal-cord-injury-arising-in-anaesthesia-practice
#12
REVIEW
D W Hewson, N M Bedforth, J G Hardman
Spinal cord injury arising during anaesthetic practice is a rare event, but one that carries a significant burden in terms of morbidity and mortality. In this article, we will review the pathophysiology of spinal cord injury. We will then discuss injuries relating to patient position, spinal cord hypoperfusion and neuraxial techniques. The most serious causes of spinal cord injury - vertebral canal haematoma, spinal epidural abscess, meningitis and adhesive arachnoiditis - will be discussed in turn. For each condition, we draw attention to practical, evidence-based measures clinicians can undertake to reduce their incidence, or mitigate their severity...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29301178/epidural-metastasis-in-malignant-thymoma-mimicking-epidural-abscess-case-report-and-literature-review
#13
Ji Yoon Kim, Young Seok Lee, Dong Ho Kang, Min Hye Kim, Jeong Hee Lee, Chul Hee Lee, In Sung Park
Thymoma and thymic carcinoma are rare epithelial tumors that originate from the thymus gland. Extrathoracic metastases occur in the liver, kidney, and bone in 1% to 15% of patients. Although thymoma and thymic carcinoma exhibit highly aggressive biological behavior, spinal metastasis is rare. We describe a 78-year-old man with left wrist and grasp weakness that occurred 7 days before admission. The patient underwent thymoma surgery 7 years ago and was cured. Magnetic resonance images showed a rim-enhanced mass in the C6-7-T1 epidural space...
December 2017: Korean Journal of Spine
https://www.readbyqxmd.com/read/29282439/diffuse-nocardial-spinal-subdural-empyema-diagnostic-dilemma-and-treatment-options
#14
Zaid Aljuboori, Mayur Sharma, Thomas Altstadt
Nocardiosis of the central nervous system and spine, in particular, is a rare infection with significant morbidity and mortality. Treatment is usually with antibiotics and surgical drainage or biopsy. The authors report a case of a 49-year-old man who presented with chronic lower back pain and paraplegia. He was found to have spinal subdural empyema caused by Nocardia farcinica. Laminectomy and sampling of the subdural collection were performed, and the patient was treated with triple intravenous antibiotics (linezolid, amikacin and ciprofloxacin)...
October 24, 2017: Curēus
https://www.readbyqxmd.com/read/29276230/disseminated-nontuberculous-mycobacterial-infection-in-a-patient-with-anti-ifn-%C3%AE-autoantibodies
#15
Masakuni Tanimizu, Kenji Mizuno, Masayuki Hashimoto
We treated a 72-year-old Japanese female with sustained high fever and overall body exhaustion. An infectious liver cyst and right lung pneumonia were suspected causes. Hepatic cystectomy and various antibiotics did not resolve symptoms. Pneumonia exacerbation and ascitic fluid retention, left lumbar spinal osteomyelitis, and peri-gastric lymph node abscess penetrating the stomach were observed. Mycobacterium avium was identified in sputum, ascites, vertebral body abscess puncture specimen, and pus mucus secretion in the stomach...
December 2017: Acta Medica Okayama
https://www.readbyqxmd.com/read/29218392/unusual-circumstances-to-diagnose-cervical-pott-s-disease
#16
Mohamed Ali Kedous, Ahmed Msakni, Wael Chebbi, Mourad Zaraa, Mohsen Trabelsi
Tuberculous spondylodiscitis usually affects the dorso-lumbar spine, and its cervical location is a rare condition that can mimic other diseases and consequently cause treatment delays. We report a case of tuberculous spondylodiscitis of the lower cervical spine discovered under unusual circumstances in a patient with severe polytrauma involving a cranio-cerebral trauma, a non-displaced fracture of the two laminæ and the spinous process of the C6 vertebrae as well as fibular and tibial shaft fractures. The patient underwent static tibial nailing, and a collar with occipital and chin supports was applied...
December 7, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/29208449/surgical-treatment-of-thoracic-spinal-tuberculosis-a-multicenter-retrospective-study
#17
Wenjie Wu, Jingtong Lyu, Xun Liu, Fei Luo, TianYong Hou, Qiang Zhou, Zhilin Li, Yuan Chen, Li Tao Li, Yonghong Zheng, Gaoju Wang, Jianzhong Xu, Zehua Zhang
OBJECTIVE: The aim of the present multicenter, retrospective study was to assess the safety and effectiveness of different surgery strategies for the treatment of thoracic tuberculosis and to provide a reference for surgical treatment of thoracic tuberculosis. MATERIALS AND METHODS: This study reviewed 394 patients with thoracic tuberculosis who were treated in 6 institutions between January 2000 and January 2015. There were 208 men and 186 women with an average age of 34...
December 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29189305/rehabilitation-outcomes-in-spinal-abscess-patients-with-and-without-a-history-of-intravenous-substance-abuse
#18
Namrata Raut, Vittal R Nagar, Sara Salles, Joe E Springer, Lumy Sawaki
OBJECTIVE: To compare functional outcomes of acute inpatient rehabilitation for spinal epidural abscess (SEA) patients with and without history of intravenous substance abuse (IVSA). DESIGN: Retrospective case series study in freestanding rehabilitation hospital. METHODS: Charts of 28 SEA patients admitted from 01/2012 to 9/2015: 13 with IVSA and 15 without IVSA were reviewed. Both groups received standard-of-care rehabilitation. Statistical analyses of Functional Independence Measure (FIM) scores were conducted using individual 2 (substance use) X 2 (rehabilitation status) repeated measures analysis of variance (ANOVA)...
November 20, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29174228/rare-concurrent-retroclival-and-pan-spinal-subdural-empyema-review-of-literature-with-an-uncommon-illustrative-case
#19
REVIEW
Martin M Mortazavi, Syed A Quadri, Sajid S Suriya, Salman A Fard, Shahram Hadidchi, Farzad H Adl, Ian Armstrong, Richard Goldman, R Shane Tubbs
BACKGROUND: Subdural empyema can present as a spinal subdural empyema (SSE) or a cranial subdural empyema (CSE). Though they differ somewhat in epidemiology, etiology, pathophysiology, and symptomatology and occur separately, they rarely manifest together. The aim of this article is to review the literature concerning the clinical presentation, clinical course and treatment options for managing concurrently-occurring SSE and CSE. METHODS: The literature in the Medline database was reviewed with keywords including but not limited to subdural empyema, retroclival empyema, and Streptococcus mitis...
November 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29151570/a-case-report-of-refractory-notalgia-paresthetica-treated-with-lidocaine-infusions
#20
Yaroslava Chtompel, Marzieh Eghtesadi, Grisell Vargas-Schaffer
BACKGROUND Notalgia paresthetica is a neuropathic condition that manifests as a chronic itch in the thoraco-dorsal region. It is often resistant to treatment, and specific guidelines for its management are lacking. As such, we present a treatment approach with intravenous lidocaine infusions. CASE REPORT The case involves a 50-year-old woman with spinal cord injury caused by an epidural abscess. The patient developed notalgia paresthetica and sublesional neuropathic pain following its drainage. In the course of her pain management, she was treated with intravenous lidocaine which resulted in profound relief of notalgia paresthetica...
November 20, 2017: American Journal of Case Reports
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