Cause Of Spinal Cord Compression Research Articles

Neurologic and magnetic resonance imaging features of German Shepherd Dogs with cervical spondylomyelopathy: 10 cases (2006-2018).

To describe the neurologic signs and MRI findings for German Shepherd Dogs (GSDs) with cervical spondylomyelopathy (CSM). 10 GSDs with confirmed CSM. Medical records from January 2006 through July 2018 were reviewed to identify dogs with CSM. For each CSM-affected dog, information regarding age, duration of clinical signs, presence of neurologic signs, and treatments administered were obtained; the main site and cause of spinal cord compression and other vertebral and spinal cord changes were identified on MRI images. Data for 9 male and 1 female (mean age, 6.2 years) GSDs with CSM were assessed. Dogs were classified as having chronic (n = 9) or acute (1) CSM. Nine dogs had ataxia; 1 dog had only signs of cervical hyperesthesia. Neurologic examination findings localized the lesion to the cervical portion of the vertebral column in each dog. The main spinal cord compression site was at the C6-7 (n = 5), C5-6 (4), or C4-5 (1) intervertebral spaces; osseous proliferation of the articular processes was the sole or a contributory cause of these compressions for 6 of the 10 dogs. Eight dogs also had dorsal compression of the spinal cord as the result of ligamenta flava hypertrophy. The 10 GSDs of the present retrospective case series had CSM that was often characterized by osseous changes and a ligamentous component and were older than dogs of other breeds (eg, Great Dane and Mastiff) with osseous-associated CSM described in previous reports. Cervical spondylomyelopathy should be a differential diagnosis for GSDs with ataxia, paresis, or signs of cervical hyperesthesia.

Anesthetic Management in a Patient With Surgical Excision of Spinal Cords Hydatid Cyst: A Case Report

Echinococcosis granulosus is the leading cause of spinal hydatid disease. Hydatidosis of the bone happens in 0.5%-3% of all the cases: the involvement in the vertebral column is 50%. In the endemic areas, one of the common causes of spinal cord compression is hydatid disease, and the diagnosis may remain obscure until specifying symptoms ensuing from complications due to root and cord compression. We present a case of recurrent spinal cords hydatid cyst in a 44 years old patient because it occurs rarely, and anesthetic management in such cases has never evaluated before.

Spinal Cord Compression Secondary to Extramedullary Hematopoiese in a Patient with a Beta-Thalassemia

Extramedullary hematopoiesis (EMH) is a rare cause of spinal cord compression (SCC). EMH represents the growth of blood cells outside of the bone marrow and occurs in a variety of hematologic illnesses, including various types of anemia and myeloproliferative disorders. Although EMH usually occurs in the liver, spleen, and lymph nodes, it may also occur within the spinal canal. When this occurs, the mass effect can compress the spinal cord, potentially leading to the development of neurological deficits. We present a case of SCC secondary to EMH. Our patient is a 26-year-old male with beta-thalassemia who presented with both upper thoracic and lower extremity symptoms of spinal cord compression. This report illustrates the importance of considering EMH in the differential diagnosis of SCC, even in the absence of signs of its most common etiologies.

Acute idiopathic spinal subdural hematoma: What to do in an emergency?

Acute spinal cord compression usually results from trauma, infection, or cancer. Spinal subdural hematoma is an uncommon cause of spinal cord compression that occurs after spine trauma or spinal invasive procedure, especially in context of coagulopathy. In the following reported case, an 82-year-old woman with a history of rapidly progressive paraparesis after a sudden middle back pain, with no previous trauma or coagulopathy, due to an acute spontaneous spinal subdural hematoma. In fact, the main difficulty was to determine, in an emergency situation, the right strategy to identify both the lesion and its cause to adapt therapeutics. This case not only provides an illustrative unusual condition in an emergency department but also a challenging discussion to choose the right treatment for a sudden neurological impairment. According to a literature review of the idiopathic cases of spinal subdural hematomas without coagulopathy, the clinical outcome depends on severity of neurological impairment. MRI is the main examination to perform in an emergency. Thus surgical evacuation should be performed in emergency in patients presenting with severe neurological impairment.

Idiopathic Hypertrophic Dorsal Pachymeningitis - Imaging Features

Idiopathic Hypertrophic Spinal Pachymeningitis (IHSP) is a rare disease causing chronic inflammatory hypertrophy of the dura mater. It may be idiopathic or secondary to other diseases. It is an extremely rare cause of spinal cord compression. This process can be present throughout the entire spine but is commonly reported in the cervical and dorsal spine. IHSP is a diagnosis of exclusion since it is associated with trauma, infection, and autoimmune diseases. We describe a rare case of Idiopathic Hypertrophic Dorsal Pachymeningitis (IHDP) in a 42 -year -old woman presenting with progressive weakness of both lower limbs for the past 2 years and outline the important clinical and radiographic features of the disease.

Recurrent spontaneous spinal epidural hematoma in children: case report

Spontaneous spinal epidural hematomas are a rare cause of spinal cord compression in children. These are typically isolated events and could be associated to hemophilia. Symptoms typically include a sudden onset of back pain followed by neurologic deterioration including weakness, numbness, and incontinence. Recurrent spontaneous spinal epidural hematomas have been reported only in two instances in adults. There has been one report of recurrent spontaneous spinal epidural hematomas involving a child. This case report details the case of a 9-year-old female with a recurrent spontaneous spinal epidural hematomas who presented with one episode of lower extremity paresis and 2 years after first episode developed a recurrence hematoma causing cervical pain without motor deficit. The patient was operated and had a good outcome. The authors described this rare case.

Spinal Extradural Arachnoid Cyst: A Case Report

Spinal extradural arachnoid cyst is a rare cause of spinal cord compression resulting in spinal myelopathy. We report a case of 12-year-old boy diagnosed with extradural thoracolumbar spinal arachnoid cyst presenting with back and leg pain, progressive left leg weakness, mild muscular atrophy and difficulty in walking. The boy presented with progressive weakness of distal left lower limb and intermittent claudication. MRI-scan revealed an extramedullary non-enhancing fluid signal intensity lesion with cord compression. The patient underwent zip laminectomy from T9 - L2 level using electric drill and total excision of the extradural cyst, microsurgical repair of the dural defect, followed by laminoplasty, using ethibond sutures was done. Intraoperative finding revealed an elongated 10 cm long cystic lesion with finger-like projections extending in the extradural space from T9 - L2 level, causing significant compression and displacement of the cord. The cyst was in communication with intradural subarachnoid space with a small ovoid-shaped arachnoid opening at T12 level on the left side adjacent to T11 nerve root. The postoperative course was uneventful and patient was discharged on postoperative day seven. Neurologically, the patient showed some improvement. On one-month follow-up, there was remarkable improvement in movement of the lower limbs. He was able to walk independently without limping gait; however, he still had mild weakness in his left leg (4+/5).Nepal Journal of Neuroscience, Volume 15, Number 2, 2018, Page: 49-54

An unusual cause of spinal cord compression

An unusual cause of spinal cord compression

A rare cause of thoracic spinal cord compression by multiple large Tarlov cysts

Introduction The spinal extradural arachnoid cyst (SEAC) is a rare cause of spinal cord compression. Tarlov cyst (TC) is predominantly found at the lumbosacral level of the spine. Bifocal location of SEACs, thoracic and sacral, is rarely reported in the literature. We report a case of thoracic spinal cord compression by SEAC associated with asymptomatic multiple sacral cysts. The surgical management and postoperative outcome are discussed. Material and methods Case presentation: a 34-year-old woman was referred to the hospital for acute thoracic pain superimposed on a background of chronic long-standing back pain. She was complaining of walking difficulties. Neurological examination demonstrated a spastic paraparesis. MRI was performed, and revealed a large cystic formation from T7-11 and at the level of the sacrum. Based on the imaging findings, a diagnosis of SEAC was suspected. For spinal cord decompression, we did laminectomies at the level of interest from T7-11 exposing the SEACs. The cysts were dissected carefully from the underlying dura after removal of the CSF. We found nerve tissue in the cysts. We excised the cyst and preserved the nerve roots. Then, a duraplasty was performed with autologous grafts from the lumbar fascia. The patient dramatically improved after surgery and was still doing well at follow-up. Conclusion It is important to keep in mind that before any clinical presentation of spinal cord compression a radiological exploration is necessary. Although the surgical treatment of CT is controversial especially at the sacral lumbar level, decompression at the dorsal level in this case is indisputable.

Non-communicating extradural arachnoid cyst: a rare case report with review of literature

Abstract Extradural arachnoid cysts in the spine are uncommon causes of spinal cord compression in the paediatric population that are thought to arise from congenital defects in the duramater. In most literatures it is describe that such cysts communicating with the intrathecal subarachnoid space through a small defect in the dura. In this case report we describe a case of a child who presented with spinal cord compression caused by a large spinal extradural arachnoid cyst that did not communicate with the intradural subarachnoid space. An 9 year-old girl presented with progressive lower-extremity weakness, myelopathy, and severe gait ataxia. Magnetic resonance imaging of the spine demonstrated a large extradural arachnoid cyst extending from T4 to T9. The patient underwent a thoracic laminectomy for en bloc resection of the spinal extradural arachnoid cyst. Intra-operatively, the dura was intact and there was no evidence of communication into the intradural subarachnoid space. Postoperatively, the patient’s motor strength and ambulation improved immediately, and no subsequent cerebrospinal fluid leak occurred.

Diagnóstico por tomografia computadorizada da extrusão de disco intervertebral em paciente geriatra: Relato de Caso

Intervertebral disc disease (IVDD) is the most common cause of spinal cord compression in dogs, resulting in neurological problems, which can be classified into two types: Hansen type I (disc extrusion) and Hansen type II (disc protrusion), pressing the nerves of the marrow causing pain, ataxia, paralysis and paraplegia. The indicated treatment should be based on the degree of injury, and may be the clinical treatment associated with physical therapy, for less severe cases, based on the successes in the recovery of the condition, reported in the literature. The objective of this study was to report the efficiency of computed tomography as a complementary tool for conclusive diagnosis of DDIV and the success of clinical and physiotherapeutic treatment for this disease. The animal in question was an 11-year-old poodle that presented ataxia and motor incoordination and was diagnosed with an intervertebral disc extrusion between the T12 and T13 vertebrae by means of computed tomography. The treatment chosen was based on anti-inflammatories and physiotherapy focusing on the strengthening of the epaxial and hipaxial musculature. After 45 days of initiation of treatment, a significant improvement of the animal was observed, however, a future surgical intervention was not ruled out.

Metastatic Spinal Cord Compression and Steroid Treatment: A Systematic Review.

Systematic review. We conducted a systematic review of the literature to answer the following questions regarding the use of steroid therapy in metastatic spinal cord compression (MSCC): 1. In cases of MSCC, what is the effect of steroid administration before definitive radiotherapy or surgery on ambulatory status, bowel and bladder function and survival? 2. What steroid dosing regimens are associated with the best outcomes concerning neurological symptoms and complication prevention in cases of MSCC? Currently, there is significant variation in the initial bolus dose, daily maintenance dose and duration of treatment when steroids are used as a bridge to definitive therapy for MSCC. A literature search following PRISMA guidelines was conducted in June 2016, using Medline via Ovid SP, Medline via PubMed, Embase, Biosis Previews and the Cochrane Library. Search terms used in each database varied slightly to optimize results. All generic steroid formulations were included along with spinal cord compression or myelopathy combined with metastatic or malignant tumors. Papers discussing acute traumatic causes of spinal cord compression were excluded, as were papers discussing cord compression from nonmetastatic tumors or epidural lipomatosis. Subjects were limited to adult humans undergoing definitive treatment with radiotherapy or surgery. Of the 309 papers retrieved, 66 full text studies were reviewed and 6 papers were found to address the stated questions. There is a paucity of high quality literature evaluating the use of steroids in MSCC. On the basis of the evidence available an initial 10 mg intravenous bolus of dexamethasone followed by 16 mg PO QD has been associated with fewer complications compared with 100 mg bolus and 96 mg QD. Weaning of steroids should occur rapidly after definitive treatment. Risk of gastric bleeding or perforation can be managed with the routine use of proton-pump inhibitors. Level IIIa.

Posttraumatic Acute Spinal Subdural Hematoma of the Spine

AbstractAcute spinal subdural hematoma (ASSH) is a rare cause of spinal cord compression and neurologic deficits. The authors report a case of 23-year-old male patient who developed ASSH following spinal injury and discuss the characteristic imaging findings of ASSH. Magnetic resonance imaging (MRI) of the spine showed hypointense collection on T2W images seen posteriorly extending from inferior endplate of C5 to superior endplate of D3 with preservation of the epidural fat signal. The patient underwent surgical evacuation of the hematoma and made a good recovery in his neurological functions.

Spinal thoracic extradural angiolipoma manifesting as acute onset of paraparesis: Case report and review of literature

Background:Angiolipomas are benign tumors most commonly found in the thoracic spine. They are composed of mature adipocytes and abnormal vascular elements that usually present with a slowly progressive course of neurological deterioration.Case Description:A 35-year-old female, with a prior history of back pain, acutely developed paraparesis. When the thoracic magnetic resonance imaging (MRI) revealed a dorsal epidural mass at the T3-T5 level, she underwent a laminectomy for gross total excision of the lesion that proved to be an angiolipoma. On the second postoperative day, the patient was again able to ambulate.Conclusion:The angiolipomas of spine are rare causes of spinal cord compression, and those presenting with acute neurological deficits should be immediately treated.

Spinal intradural arachnoid cyst in an adult with spinal dysraphism

Spinal arachnoid cyst is an uncommon cause of spinal cord compression and rarelycan complicate congenital cord malformations. We report a 48 year gentleman presented withprogressive spastic paraparesis of 6 months duration associated with difficulty in walking;now he was able to walk with support. MRI dorsal spine showed hypo-intense lesion on T1Wimages, becoming hyper-intense on T2W images extending from D 5-8 level. The patientunderwent D-5 to D-8 laminectomy, during surgery after opening the dura there was CSFfilled cyst. Histopathological examination confirmed the diagnosis of an arachnoid cyst. Aswas seen in present case, excision of thearachnoid cyst is associated with immediateimprovement of motor functions, particularly if the operation is performed prior to development of neurological deficits.

Anterior thoracic intradural spinal arachnoid cyst- A rare cause of spinal cord compression in a Two-Year old child

Anterior thoracic intradural spinal arachnoid cyst- A rare cause of spinal cord compression in a Two-Year old child

Spinal epidural angiolipomas: Clinical characteristics, management and outcomes.

Purpose:The spinal epidural angiolipomas are rare expansive processes made of mature lipomatous and angiomatous elements. They often have a benign character. Their etiology, pathogenesis remains uncertain, and it is a cause of spinal cord compression. The magnetic resonance imaging is the most important neuroradiological examination. Histological examination is the only examination to confirm the diagnosis. Surgery is the treatment of choice.Methods:A retrospective study of all patients operated on for a spinal epidural angiolipoma at the Department of Neurosurgery at the National Institute of Neurology of Tunis between January 2000 and December 2014 (15 years) was performed. The aim of this study is to describe the clinical, radiological, histological characteristics and the treatment of this tumor.Results:A total of nine patients were operated from January 01, 2000 to November 30, 2014. The average age of our patients was 51 years with ages that ranged from 29 to 65 with a male predominance. The period between onset of symptoms and diagnosis ranged from 24 months with an average 12 months. Posterior localization of the tumor was seen in all patients. Surgical resection was performed for all cases. The postoperative course has been satisfactory, with a complete recovery of neurological functions in all patients.Conclusions:The spinal epidural angiolipomas is rare expansive process causing spinal cord compression. Treatment is exclusively surgical resection. The functional outcome of spinal epidural angiolipomas is particularly favorable with a complete neurological recovery is if the patient was quickly operated.

Clinical presentation of a dorsal epidural arachnoid cyst after an epidural anaesthesia

Abstract Background Arachnoid cysts are dural diverticula with liquid content similar to cerebrospinal fluid, with 1% occurring in the spinal cord. They locate mainly in the dorsal region of the thoracic spine, and are unusual causes of spinal cord compression. Clinical case The case is presented of a previously healthy 15-year-old boy, with a 20-month history of spastic paraparesis that started apparently after epidural block for ankle osteosynthesis. There was decreased sensitivity and strength of the pelvic limbs and gradually presented with anaesthesia from T12 to L4 dermatomes, L5 and S1 bilateral hypoaesthesia and 4+/5 bilateral strength, in the L2 root and 2+/5 in L3, L4, L5, S1, hyperreflexia, Babinski and clonus, but with no alteration in the sacral reflexes. In the magnetic resonance it was diagnosed as an extradural arachnoid cyst from T6 to T9. The patient underwent a T6 to T10 laminotomy, cyst resection, dural defect suture, and laminoplasty. One year after surgery, the patient had recovered sensitivity, improvement of muscle strength up to 4+/5 in L2 to S1, and normal reflexes. Conclusions After the anaesthetic procedure, increased pressure and volume changes within the cyst could cause compression of the spinal cord, leading to symptoms. Despite being a long-term compression, the patient showed noticeable improvement.

Treatment of thoracic disc herniation. Case report

Abstract Background Herniated thoracic intervertebral disc is a rare cause of spinal cord compression. Its frequency varies from 0.15% to 1.7% of all disc herniations, and produces symptoms in 0.5–0.8%. Clinical cases Case 1. A 50-year-old woman, with pain and burning sensation in left hemithorax of four months of onset. It was treated as a herpetic syndrome, with no improvement. She was seen after thirteen days of exacerbation of clinical symptoms. The physical examination showed asymmetric paraparesis, lower left pelvic limb 1/5, and right pelvic limb 3/5, sensory level T8, with left Babinski positive. A thoracic disc herniation in space T8–T9 was diagnosed. Case 2. A 55-year-old patient with a history of presenting pain in lumbar area of 5 years onset. She also had radicular pain that radiated to the right pelvic limb, with intensity 10/10 on a Visual Analogue Scale. Her physical examination showed muscle strength 5/5, with normal sensitivity in all dermatomes and tendon reflexes, and a positive right Babinski. Thoracic disc herniation T7–T8 level was diagnosed. Discussion Due to anatomical conditions that define this type of hernia, the extracavitary posterolateral approach should be the recommended surgical procedure when the simultaneously performed anterior decompression and fixation with posterior instrumentation are the treatments proposed. Conclusion Despite the different anatomical structures of this special area, it was possible to obtain satisfactory results for both clinical cases.

Inpatient rehabilitation following operative spontaneous spinal epidural hematoma mimicking stroke: a case report.

Spontaneous spinal epidural hematoma (SSEH) is a rare cause of spinal cord compression. Symptoms may include sudden-onset axial pain followed by neurologic involvement including weakness, numbness and incontinence. Here we report the case of a patient followed prospectively after surgical intervention following SSEH and recovery following inpatient rehabilitation. This patient presented with right hemiplegia, neurogenic bladder and bowel with autonomic dysfunction. the patient with significant gains in Functional Independence Measure scale that improved from 15 on admission to 35 1 month following surgery. This case suggests that treating this type of patients requires hospitals specialized in spinal cord injury.