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https://www.readbyqxmd.com/read/29916956/surgical-treatment-of-cervical-spondylotic-myelopathy-in-the-elderly-outcomes-in-patients-aged-80-years-or-older
#1
Norihiro Isogai, Narihito Nagoshi, Akio Iwanami, Hitoshi Kono, Yoshiomi Kobayashi, Takashi Tsuji, Nobuyuki Fujita, Mitsuru Yagi, Kota Watanabe, Kazuya Kitamura, Yuta Shiono, Masaya Nakamura, Morio Matsumoto, Ken Ishii, Junichi Yamane
STUDY DESIGN: Retrospective multicenter study OBJECTIVE.: We aimed to assess the outcomes following posterior cervical decompression for cervical spondylotic myelopathy (CSM) in a large sample of patients older than 80 years. SUMMARY OF BACKGROUND DATA: Although age is a predictor of surgical outcomes for CSM, most previous studies have only investigated the effect of age for patients aged 65-75 years, and surgical outcomes remain unclear for older patients. METHODS: Patients older than 50 years who underwent posterior cervical decompression for CSM were enrolled from 17 institutions...
June 18, 2018: Spine
https://www.readbyqxmd.com/read/29907737/paradoxical-reaction-in-a-patient-with-co-occurring-tuberculous-meningitis-and-pott-s-disease
#2
Talia Robledo-Gil, Kaoru Harada, Ichiro Ikuta, Merceditas Villanueva
BACKGROUND Paradoxical reactions to tuberculosis (TB) are clinical or radiological worsening of prior tuberculous lesions or the development of new lesions upon treatment with appropriate anti-tuberculosis therapy (ATT). This phenomenon has been described in both HIV-seropositive and HIV-seronegative patients. Although historically estimated to occur in 6-30% of HIV-seronegative patients with TB, the phenomenon is often under-recognized in the current era, particularly in countries of low TB prevalence. We describe a case of a TB paradoxical reaction affecting the CNS and spine in an HIV-seronegative individual who received clinical care in the U...
June 16, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29907475/radiotherapy-for-langerhans-cell-histiocytosis-with-paraplegia-a-rare-oncologic-emergency-case-report-in-infancy-and-literature-review
#3
Kentaro Nakashima, Yuhki Koga, Yasunari Sakai, Hidetoshi Takada, Katsumi Harimaya, Saiji Ohga, Tomoaki Taguchi, Yoshinao Oda, Hiroshi Honda, Shouichi Ohga
BACKGROUND: Langerhans cell histiocytosis (LCH) is a clonal disease with focal or disseminated lesions that may compress the surrounding tissues, including the spinal cord. Because few reports have described the spinal symptoms as the first manifestation of pediatric LCH, the long-term neurological outcomes remain unclear. CASE REPORT AND LITERATURE REVIEW: We report a 21-month-old boy who presented with sudden-onset paraplegia. Imaging analyses revealed that osteolytic lesions and epidural tumors compressing the spinal cord at the T7-9 vertebrae...
June 12, 2018: Brain & Development
https://www.readbyqxmd.com/read/29896434/splenectomy-fails-to-provide-long-term-protection-against-ischemic-stroke
#4
Yuanyuan Ran, Zongjian Liu, Shuo Huang, Jiamei Shen, Fengwu Li, Wenxiu Zhang, Chen Chen, Xiaokun Geng, Zhili Ji, Huishan Du, Xiaoming Hu
Splenectomy before or immediately after stroke provides early brain protection. This study aims to explore the effect of splenectomy on long-term neurological recovery after stroke, which is currently lacking in the field. Adult male rats were randomized into splenectomy or sham groups and then subjected to 90 min of middle cerebral artery occlusion (MCAO). Spleen was removed right upon reperfusion or 3d after MCAO. Infarct volume, neurological functions, and peripheral immune cell populations were assessed up to 28d after stroke...
June 2018: Aging and Disease
https://www.readbyqxmd.com/read/29883818/successfully-conservative-management-of-delayed-cervical-spondylodiscitis-with-epidural-abscess-caused-by-esophageal-diverticulitis-a-case-report-and-review-of-literature
#5
Jinwei Ying, Shishen Pei, Linghao Su, Tianyong Wen, You Lv, Dike Ruan
BACKGROUND: Cervical spondylodiscitis with spinal epidural abscess (SEA) is not a rare medical condition that usually requires urgent decompression of neural structures and stabilization of the spine followed by antibiotic therapy for prevention from severe neurological deficits. CASE DESCRIPTION: In this report, we present a 43-year-old male patient with the chief complaint of neck pain and intermittent fever accompanying by slight dysphagia. After two weeks, he felt mild and transient numbness on the left upper limb...
June 5, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29880554/similar-outcomes-for-contact-aspiration-and-stent-retriever-use-according-to-the-admission-clot-burden-score-in-aster
#6
François Zhu, Bertrand Lapergue, Maéva Kyheng, Raphael Blanc, Julien Labreuche, Malek Ben Machaa, Alain Duhamel, Gautier Marnat, Suzana Saleme, Vincent Costalat, Serge Bracard, Sébastien Richard, Hubert Desal, Mikael Mazighi, Arturo Consoli, Michel Piotin, Benjamin Gory
BACKGROUND AND PURPOSE: The clot burden score (CBS) at admission reliably evaluates the thrombus burden in acute ischemic stroke patients with anterior circulation large vessel occlusion. Mechanical thrombectomy has been diversified, especially with contact aspiration technique, and its efficiency with respect to the thrombus burden is not known. We compared reperfusion, adverse events, neurological recovery, and 90-day functional outcome of stent retriever use versus contact aspiration according to the admission CBS...
June 7, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29874553/effect-of-detection-time-interval-for-out-of-hospital-cardiac-arrest-on-outcomes-in-dispatcher-assisted-cardiopulmonary-resuscitation-a-nationwide-observational-study
#7
Seo Young Ko, Sang Do Shin, Young Sun Ro, Kyoung Jun Song, Ki Jeong Hong, Jeong Ho Park, Seung Chul Lee
INTRODUCTION: The association between the detection time interval (DTI) from the call for ambulance to the detection of out-of-hospital cardiac arrest (OHCA) by the dispatcher and the neurological outcome in dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) is unclear. METHODS: Adults who sustained OHCA with cardiac etiology received DA-CPR between 2013 and 2016 were analyzed. The main predictor was DTI defined as the time interval from the beginning of the emergency call to identification of OHCA by the dispatcher...
June 3, 2018: Resuscitation
https://www.readbyqxmd.com/read/29871886/risk-factors-and-outcomes-of-rapid-correction-of-severe-hyponatremia
#8
Jason C George, Waleed Zafar, Ion Dan Bucaloiu, Alex R Chang
BACKGROUND AND OBJECTIVES: Rapid correction of severe hyponatremia can result in serious neurologic complications, including osmotic demyelination. Few data exist on incidence and risk factors of rapid correction or osmotic demyelination. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In a retrospective cohort of 1490 patients admitted with serum sodium <120 mEq/L to seven hospitals in the Geisinger Health System from 2001 to 2017, we examined the incidence and risk factors of rapid correction and osmotic demyelination...
June 5, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29870419/neurological-outcome-after-traumatic-transverse-sacral-fractures-a-systematic-review-of-521-patients-reported-in-the-literature
#9
D H R Kempen, D Delawi, M C Altena, M C Kruyt, M P J van den Bekerom, F C Oner, R W Poolman
BACKGROUND: The purpose of this study was to determine the neurological outcome after transverse sacral fractures in patients with neurological impairment. METHODS: A systematic review of the English, French, German, and Dutch literature was conducted. All study designs, including retrospective cohort studies and case reports, describing transverse sacral fractures were included. Two authors independently extracted the predefined data and scored the neurological impairment according to the Gibbons classification after the trauma and at the time of follow-up...
June 5, 2018: JBJS Reviews
https://www.readbyqxmd.com/read/29859357/short-term-outcomes-of-anterior-fusion-nonfusion-hybrid-surgery-versus-posterior-cervical-laminoplasty-in-the-treatment-of-multilevel-cervical-spondylotic-myelopathy
#10
Hua Chen, Hao Liu, Yang Meng, Beiyu Wang, Quan Gong, Yueming Song
OBJECTIVE: To compare short-term clinical and radiological outcomes of anterior fusion-nonfusion hybrid surgery (cervical discectomy or corpectomy and fusion combine with cervical disc replacement) and posterior cervical laminoplasty for multilevel cervical spondylotic myelopathy (CSM). METHODS: From January 2014 to December 2015, 105 patients who underwent anterior fusion-nonfusion hybrid surgery (AHS group, n=48) or posterior cervical laminoplasty (PCL group, n=57) for ≥3 disc levels CSM were included...
May 30, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29851658/drainage-of-cerebrospinal-fluid-and-blood-pressure-augmentation-as-rescue-therapies-for-ischemic-myelitis-after-bronchial-embolization-a-case-report
#11
Pierre-Alexis Lépine, Jean-François Naud, Philippe Boisvert
A 62-year-old man presented to the emergency department with massive hemoptysis. After bronchial artery embolization, he developed ischemic myelitis, a rare complication in this setting for which no specific therapy is currently recommended. The symptoms were managed with lumbar drainage of cerebrospinal fluid and blood pressure augmentation therapy. To our knowledge, this is the first report of using lumbar drainage of cerebrospinal fluid and blood pressure augmentation in the treatment of anterior medullary ischemia after bronchial artery embolization for massive hemoptysis...
June 1, 2018: A&A practice
https://www.readbyqxmd.com/read/29849324/an-unusual-case-of-posterior-reversible-encephalopathy-syndrome
#12
Robert P Zemple, Tomer Pelleg, Moises R Cossio
A 21-year-old pregnant female with no significant past medical history presented with acute onset headache and nausea as well as tonic-clonic seizures, then rapidly decompensated into a coma with complete absence of brainstem reflexes. The patient was ultimately diagnosed with hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome) and subsequent posterior reversible encephalopathy syndrome (PRES) with brainstem involvement. Emergent delivery and blood pressure control resulted in rapid and complete neurologic recovery...
August 2017: Clinical practice and cases in emergency medicine
https://www.readbyqxmd.com/read/29849301/posterior-reversible-encephalopathy-syndrome-presenting-as-stroke-mimic
#13
Daniel Frick, Martin Huecker, Hugh Shoff
We present the case of a 33-year-old male with end stage renal disease presenting to the emergency department (ED) with headache, dizziness, and unilateral weakness. Initial concern was for ischemic or hemorrhagic stroke. Magnetic resonance imaging confirmed posterior reversible encephalopathy syndrome (PRES). The patient was treated appropriately and made a full neurologic recovery. PRES is an under-recognized diagnosis in the ED. As a stroke mimic, PRES can lead the clinician on an incorrect diagnostic pathway with potential for iatrogenic harm...
August 2017: Clinical practice and cases in emergency medicine
https://www.readbyqxmd.com/read/29843882/neural-stem-cells-alleviate-inflammation-via-neutralization-of-ifn-%C3%AE-negative-effect-in-ischemic-stroke-model
#14
Guilong Zhang, Lukui Chen, Wanghao Chen, Bingqian Li, Yongbo Yu, Fan Lin, Xiaoyuan Guo, Hong Wang, Guojian Wu, Bin Gu, Wei Miao, Jun Kong, Xingxing Jin, Guoqing Yi, Yang You, Xinhui Su, Ning Gu
Inflammatory response generated by ischemic stroke commonly affects functional or structural recovery. The aim of this study was to examine the IFN-γ caused inflammatory effects on NSCs in vitro and in vivo. We found that IFN-γ did not affect NSCs proliferation but increased the SOD2 level of inflammatory oxidative stress in NSCs culturing. High dose IFN-γ (500 ng) injection aggravated the level of inflammation in the cerebral ischemic model but did not alter the repairing functions of the NSCs in vivo. NSCs based treatment, including the NSCs-IFN-γ combined treatment, significantly improved the ischemic microenvironment by decreasing CD4+, CD8+ T cells and microglia infiltration...
June 1, 2018: Journal of Biomedical Nanotechnology
https://www.readbyqxmd.com/read/29804413/-effects-of-scoliosis-research-society-schwab-grade-%C3%A2-osteotomy-for-post-traumatic-thoracolumbar-kyphosis
#15
Q H Zhao, Z Z Zhu, X Sun, B L Shi, B Wang, B P Qian, Z Liu, C Z Du, L Xu, Y Qiu
Objective: To evaluate the effectiveness of Scoliosis Research Society (SRS)-Schwab grade Ⅳ osteotomy in the treatment of post-traumatic thoracolumbar kyphosis (PTK). Methods: From October 2012 to January 2015, a total of 31 patients [12 males, 19 females, mean age (43±10) years] with symptomatic PTK undergoing SRS-Schwab grade Ⅳ osteotomy in Nanjing Drum Tower Hospital were retrospectively reviewed.Radiographic changes were evaluated with preoperative, postoperative and follow-up X-ray.The measurements included thoracic kyphosis (TK), lumbar lordosis (LL), thoracolumbar kyphosis (TLK), focal kyphosis (FK), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS) and sagittal vertical axis (SVA)...
May 22, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29792388/cerebral-ischaemia-reperfusion-injury-could-be-managed-by-using-tramadol
#16
Ibrahim Akkurt, Cansel Cetin, Ahmet Melih Erdogan, Gungor Cagdas Dincel, Aslı Fahriye Ceylan, Ucler Kisa, Jonathan Oppong, Adem Akkurt, Mustafa Ogden, Bulent Bakar
OBJECTIVES: No valid treatment modality that will repair stroke damage and provide neurological recovery has yet been identified in literature. Studies demonstrated that adequate quality of life could be provided if post-stroke pain could be treated sufficiently and timely. Besides its pain relief effects, tramadol has oedema-reducing and anti-inflammatory properties. With these in mind, this study investigated the influence of tramadol in acute and/or chronic ischaemia/reperfusion (I/R) injury...
May 24, 2018: Neurological Research
https://www.readbyqxmd.com/read/29787539/a-concomitant-bone-fracture-delays-cognitive-recovery-from-traumatic-brain-injury
#17
Yujin Suto, Katsuhiro Nagata, Syed M Ahmed, Christina Jacovides, Kevin D Browne, John Cognetti, Maura T Weber, Victoria E Johnson, Ryan Leone, Lewis J Kaplan, Douglas H Smith, Jose L Pascual
BACKGROUND: Brain injury progression after severe TBI is associated with worsening cerebral inflammation but it is unknown how a concomitant bone fracture (BF) affects this progression. Enoxaparin (ENX) decreases penumbral leukocyte (LEU) mobilization after TBI and improves neurological recovery. We hypothesized that a concomitant BF worsens learning/memory recovery weeks after TBI and that ENX improves this recovery. METHODS: CD1 male mice underwent controlled cortical impact (CCI) or sham craniotomy with or without tibial fracture, receiving either daily ENX (0...
April 30, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29782242/case-254-posttraumatic-migrating-fat-embolus-causing-fat-emboli-syndrome
#18
Sébastien Molière, Stéphane Kremer, Guillaume Bierry
History An otherwise healthy 18-year-old man was admitted to the emergency department with a closed displaced fracture of the left femoral shaft ( Fig 1 ) after a high-velocity motorbike accident. At admission, other physical examination findings were unremarkable. Initial unenhanced and contrast material-enhanced (120 mL of Iomeron 400; Bracco Imaging, Milan, Italy) computed tomography (CT) was performed in the arterial and venous phases from the head to the knees. No abnormalities were noted in the brain or chest at initial CT...
June 2018: Radiology
https://www.readbyqxmd.com/read/29774769/serum-mediated-activation-of-bone-marrow-derived-mesenchymal-stem-cells-in-ischemic-stroke-patients-a-novel-preconditioning-method
#19
Gyeong Joon Moon, Yeon Hee Cho, Dong Hee Kim, Ji Hee Sung, Jeong Pyo Son, Sooyoon Kim, Jae Min Cha, Oh Young Bang
Stroke induces complex and dynamic, local and systemic changes including inflammatory reactions, immune responses, and repair and recovery processes. Mesenchymal stem cells (MSCs) have been shown to enhance neurological recovery after stroke. We hypothesized that serum factors play a critical role in the activation of bone marrow (BM) MSCs after stroke such as by increasing proliferation, paracrine effects, and rejuvenation. Human MSCs (hMSCs) were grown in fetal bovine serum (FBS), normal healthy control serum (NS), or stroke patient serum (SS)...
January 1, 2018: Cell Transplantation
https://www.readbyqxmd.com/read/29764824/achieving-full-neurological-recovery-in-snakebite-using-best-supportive-care
#20
Sally Wright, Genevieve Haddock
A 29-year-old woman presented to a community hospital in Sierra Leone 2 hours after being bitten by an unknown snake. On arrival, she was agitated though alert, however deteriorated into respiratory arrest. There was no local availability of antivenom. The patient remained in respiratory arrest undergoing best supportive care in a low-resource setting for 2 hours 55 minutes before returning to spontaneous ventilation. She went on to make a full neurological recovery. Though spontaneous recovery following snakebite envenoming is rare, this case showcases that good communication and basic manoeuvres can have a hugely positive impact on patient outcome...
May 14, 2018: BMJ Case Reports
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