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spinal shock

Chien Yew Kow, Patrick Chan, Greg Etherington, Lu Ton, Susan Liew, Allen C Cheng, Jeffrey V Rosenfeld
BACKGROUND: Panspinal infection usually presents with fever, back pain, neurological deficit, and in advanced cases multi-organ failure and septic shock. The choice of treatment for panspinal infection is challenging because these patients are usually medically unstable with severe neurological compromise. The objective of this study is to review management and long term outcomes for patients with panspinal infection. METHODS: A retrospective review of patients with panspinal infection treated in our center over a 5-year period [Jan 2010-Dec 2014] and a review of the current published literatures was undertaken...
September 2016: J Spine Surg
Matthew Harris, Grigoris V Karamasis, Shayna Chotai, Kare H Tang, Gerald J Clesham, Paul A Kelly
Intra-aortic balloon pump (IABP) is commonly used as a cardiac assist device in various clinical situations: cardiogenic shock, mechanical complications of acute myocardial infarction, high risk percutaneous coronary interventions, coronary artery bypass graft surgery and refractory unstable angina and ventricular arrhythmias as bridge to therapy. Although current data support its safety, there is limited or no support for its efficacy. We present the case of spinal cord infarction after IABP use in a patient who presented with ST elevation myocardial infarction and cardiac arrest and we discuss the potential mechanism of such a devastating complication...
October 13, 2016: Acute Cardiac Care
Guoyang Huang, Jiale Diao, Hongjie Yi, Li Xu, Jiajun Xu, Weigang Xu
Spinal cord injury (SCI) is a debilitating disease, effective prevention measures are in desperate need. Our previous work found that hyperbaric oxygen (HBO) preconditioning significantly protected rats from SCI after stimulated diving, and in vitro study further testified that HBO protected primary cultured rat spinal neurons from oxidative insult and oxygen glucose deprivation injury via heat shock protein (HSP) 32 induction. In this study, underlying molecular mechanisms were further investigated. The results showed that a single exposure to HBO significantly increased intracellular levels of reactive oxygen species (ROS) and nitric oxide (NO) and activated MEK1/2, ERK1/2, p38 MAPK, CREB, Bach1 and Nrf2...
September 24, 2016: Redox Biology
Matthew Pritam Taylor, Paul Wrenn, Andrew David O'Donnell
BACKGROUND: Injury to the spinal cord can result in loss of sympathetic innervation causing a drop in BP and HR, this condition is known as neurogenic shock. There is debate among the literature on how and when neurogenic shock presents and what values of HR and BP should be used to define it. Previous studies do not take into account multiple prehospital and emergency department recordings. OBJECTIVE: To improve understanding of how neurogenic shock presents in humans, allowing better identification and treatment...
October 3, 2016: Emergency Medicine Journal: EMJ
Nissar Shaikh, M A Rhaman, Ali Raza, Adel Shabana, Mahommad Faisal Malstrom, Ghanem Al-Sulaiti
BACKGROUND: High spinal cord injury (HSCI) is one of the devastating traumatic injuries. 80% of these patients are young male, and 93% will have major neurological disabilities. There is a paucity of literature about prolonged bradycardia in HSCI patients. The aim of this study was to know the prevalence, risk factors, precipitating factors for prolonged bradycardia in the HSCI patients. MATERIALS AND METHODS: All patients who were admitted to the Intensive Care Unit (ICU) of a tertiary hospital, with spinal cord injury above level of dorsal (D4) were enrolled in this study prospectively...
October 2016: Asian Journal of Neurosurgery
Lei Wang, Yuquan Jiang, Zheng Jiang, Lizhang Han
BACKGROUND: Latest studies show that low-energy extracorporeal shock wave therapy (ESWT) can upregulate levels of vascular endothelial growth factor (VEGF). VEGF can ease nervous tissue harm after spinal cord injury (SCI). This study aims to explore whether low-energy ESWT can promote expression of VEGF, protect nervous tissue after SCI, and improve motor function. METHODS: Ninety adult female rats were divided into the following groups: Group A (simple laminectomy), Group B (laminectomy and low-energy ESWT), Group C (spinal cord injury), and Group D (spinal cord injury and low-energy ESWT)...
2016: Neuropsychiatric Disease and Treatment
Shunyi Wang, Dongliang Ren
Allicin is a major component of garlic, extracted as an oily liquid. The present study was designed to investigate the beneficial effects of allicin on traumatic spinal cord injury (TSCI) in mice, and whether the effects are mediated via regulation of the heat shock protein 70 (HSP70), v‑akt murine thymoma viral oncogene homolog 1 (Akt) and inducible nitric oxide synthase (iNOS) pathways. Adult BALB/c mice (30‑40 g) received a laminectomy at the T9 vertebral level as a model of TSCI. In the present study, treatment of the TSCI mice with allicin significantly increased their Basso, Beattie and Bresnahan (BBB) scores (P<0...
October 2016: Molecular Medicine Reports
Veronica La Padula, Ori Staszewski, Sigrun Nestel, Hauke Busch, Melanie Boerries, Eleni Roussa, Marco Prinz, Kerstin Krieglstein
The human small heat shock proteins (HSPBs) form a family of molecular chaperones comprising ten members (HSPB1-HSPB10), whose functions span from protein quality control to cytoskeletal dynamics and cell death control. Mutations in HSPBs can lead to human disease and particularly point mutations in HSPB1 and HSPB8 are known to lead to peripheral neuropathies. Recently, a missense mutation (R7S) in yet another member of this family, HSPB3, was found to cause an axonal motor neuropathy (distal hereditary motor neuropathy type 2C, dHMN2C)...
August 24, 2016: Experimental Neurology
Rafael De la Garza Ramos, C Rory Goodwin, Nancy Abu-Bonsrah, Amit Jain, Emily K Miller, Nicole Huang, Khaled M Kebaish, Paul D Sponseller, Daniel M Sciubba
OBJECTIVE The aim of this study was to investigate the incidence of and factors associated with complications following idiopathic scoliosis surgery in adolescents. METHODS The Nationwide Inpatient Sample database was used to identify patients 10-18 years of age who had undergone spinal fusion for adolescent idiopathic scoliosis (AIS) from 2002 to 2011. Twenty-three unique in-hospital postoperative complications, including death, were examined. A series of logistic regressions was used to determine if any demographic, comorbid, or surgical parameter was associated with complication development...
August 26, 2016: Journal of Neurosurgery. Pediatrics
Adán Pérez-Arredondo, Eduardo Cázares-Ramírez, Paul Carrillo-Mora, Marina Martínez-Vargas, Noemí Cárdenas-Rodríguez, Elvia Coballase-Urrutia, Radamés Alemón-Medina, Aristides Sampieri, Luz Navarro, Liliana Carmona-Aparicio
Traumatic brain injury (TBI) is an alteration in brain function, caused by an external force, which may be a hit on the skull, rapid acceleration or deceleration, penetration of an object, or shock waves from an explosion. Traumatic brain injury is a major cause of morbidity and mortality worldwide, with a high prevalence rate in pediatric patients, in which treatment options are still limited, not available at present neuroprotective drugs. Although the therapeutic management of these patients is varied and dependent on the severity of the injury, general techniques of drug types are handled, as well as physical and surgical...
August 25, 2016: Clinical Neuropharmacology
Samiul Muquit, Ahmad Abdelhai Moussa, Surajit Basu
Failure of spinal cord stimulation (SCS) may be due to hardware problems, migration of electrodes and, in the long-term, plasticity in the spinal cord with habituation to the stimulation current. We describe a series of seven patients who experienced acute therapeutic loss of SCS effects following an acute nociceptive event unrelated to primary pathology. There were no hardware problems. We called this 'Pseudofailure', as the effective stimulation returned in all patients following a period off stimulation or reprogramming...
May 2016: British Journal of Pain
George I Mataliotakis, Nikolaos Bounakis, Enrique Garrido-Stratenwerth
There is still no consensus on the management of severe intracanal RH dislocation in neurofibromatosis type 1 dystrophic kyphoscoliosis. This study notes the early cord function impairment signs, reports a serious complication in a susceptible cord, identifies possible mechanisms of injury, and discusses the management of intracanal RH dislocation presented in the literature. First report is as follows: a 12-year-old female with cord compromise and preoperative neurology that underwent thoracotomy and anterior release...
2016: Case Reports in Orthopedics
Kazutoyo Ogino, Hiromi Hirata
Glycine mediates fast inhibitory synaptic transmission. Physiological importance of the glycinergic synapse is well established in the brainstem and the spinal cord. In humans, the loss of glycinergic function in the spinal cord and brainstem leads to hyperekplexia, which is characterized by an excess startle reflex to sudden acoustic or tactile stimulation. In addition, glycinergic synapses in this region are also involved in the regulation of respiration and locomotion, and in the nociceptive processing. The importance of the glycinergic synapse is conserved across vertebrate species...
2016: Frontiers in Molecular Neuroscience
Kamal Kant Sahu, Pankaj Malhotra, Preithy Uthamalingam, Gaurav Prakash, Amanjit Bal, Neelam Varma, Subhash Chandar Varma
Extramedullary blast crisis (EBC) in chronic myeloid leukemia (CML) is a rare phenomenon and represents infiltration of leukemic blasts in areas other than bone marrow. Lymph node is the most common site of involvement by EBC. We herein present a case of CML who suffered from two discrete episodes of EBC at atypical locations (scalp and paravertebral) within an interval duration of nine months. A-38-year-old female was diagnosed as a case of CML with extramedullary blast crisis in scalp at presentation. She received treatment with imatinib 600 mg once daily through Novartis Oncology Access Program (NOA)...
June 2016: Indian Journal of Hematology & Blood Transfusion
Kenichiro Yahata, Haruo Kanno, Hiroshi Ozawa, Seiji Yamaya, Satoshi Tateda, Kenta Ito, Hiroaki Shimokawa, Eiji Itoi
OBJECTIVE Extracorporeal shock wave therapy (ESWT) is widely used to treat various human diseases. Low-energy ESWT increases expression of vascular endothelial growth factor (VEGF) in cultured endothelial cells. The VEGF stimulates not only endothelial cells to promote angiogenesis but also neural cells to induce neuroprotective effects. A previous study by these authors demonstrated that low-energy ESWT promoted expression of VEGF in damaged neural tissue and improved locomotor function after spinal cord injury (SCI)...
July 1, 2016: Journal of Neurosurgery. Spine
Arifumi Matsumoto, Hiroyoshi Suzuki, Muneshige Tobita, Kinya Hisanaga
A 74-year-old female patient, who was diagnosed with neurofibromatosis type 1 (NF1) at the age of 40, was admitted with complaints of flickering vision and gait disturbance for the last 2 years. On admission, neurological examination revealed mild bilateral hearing loss and ataxia in the limb and trunk. Laboratory tests revealed anti-hepatitis C virus (HCV) antibody positivity and elevated HCV RNA by real-time polymerase chain reaction. The cerebrospinal fluid examination revealed a slightly yellowish appearance with elevated total protein levels...
July 28, 2016: Rinshō Shinkeigaku, Clinical Neurology
Mohammed H Alanazy
Absent F wave in the stage of spinal shock has been described in cases of traumatic spinal cord injury. The role of F wave in predicting prognosis after conus medullaris infarct has not been described. We describe herein a middle aged-man with a conus medullaris infarct. Both tibial and peroneal F waves were absent on day 4. The left tibial F wave reappeared in the following study on day 18. All F waves reappeared on day 56 at which time the patient was still wheelchair bound. He regained walking on day 105...
July 2016: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
Changiz Gholipour, Bahram Samadi Rad, Samad Shams Vahdati, Amir Ghaffarzad, Armita Masoud
BACKGROUND: Trauma is considered as a worldwide problem despite socio-economic development. Motor vehicle accidents (MVAs) are the most important cause of trauma. Trauma related deaths are mostly preventable. This study aimed to investigate the causes and prevention of death in trauma patients. METHODS: This retrospective, descriptive-analytic study assessed 100 trauma patients referred to our emergency department (ED) from January 2013 to Januanry 2015. The included patients were those with trauma died after arrival at our ED...
2016: World Journal of Emergency Medicine
Lauren A Raff, Holly Waller, Russell L Griffin, Jeffrey D Kerby, Patrick L Bosarge
PURPOSE: To present information about a study of risk factors for development of pressure ulcers (PrUs) in trauma patients. TARGET AUDIENCE: This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant should be better able to:1. Describe the previous PrU research, scope of the problem, and methodology of the study...
July 2016: Advances in Skin & Wound Care
Kotaro Sorimachi, Yuko Ono, Hideo Kobayashi, Kazuyuki Watanabe, Kazuaki Shinohara, Koji Otani
BACKGROUND: Penetrating neck injury is an important trauma subset but is relatively rare, especially when involving the posterior cervical column. Rupture of the neck restraints, including the interspinous and flavum ligaments, can create serious cervical instability that requires special consideration when managing the airway. However, no detailed information regarding airway management in patients with profound posterior neck muscle laceration and direct cervical ligament disruption by an edged weapon is yet available in the literature...
2016: Journal of Medical Case Reports
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