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At least 307 records · Page 17Linked to original sources
PubMed1993

Sclerosing fibrous tumor of the cauda equina: a fibroblastic variant of peripheral nerve tumors?

The case of a 43-year-old man with an unusual mesenchymal tumor of the cauda equina is presented. A well-circumscribed firm tumor was found in the lower spinal canal at L1 level. Although a nerve root was involved, the adjacent dura mater or filum terminale was unrelated to the tumor. Microscopically, the tumor was rich in collagen and made up of irregularly intertwining fascicles of fibroblastic spindle cells lacking in nuclear atypia or mitotic activity. Partial broad hyalinization of collagen was another histological feature of the tumor. Histological and immunohistochemical studies failed to reveal any findings that suggested known fibrous neoplasms, such as schwannoma, neurofibroma and meningioma, originating in the nervous system. Ultrastructural features of the tumor cells were consistent with those of fibroblasts. Hence, the present tumor is regarded as a unique pure fibroblastic tumor (fibroma) derived from the interstitium of a nerve root in the cauda equina.

Adult↗
PubMed2000

Ganglioneuroblastoma of the cauda equina.

A 39-year-old lady presented with low back pain and neurogenic claudication. Magnetic resonance imagining revealed an intradural neoplasm in the cauda equina region. The patient underwent lumbar laminectomy and total excision of the neoplasm. Biopsy showed it to be a ganglioneuroblastoma, which is rare in the spinal canal and so far does not appear to have been reported in the region of the cauda equina. Its management is discussed.

Adult↗
PubMedDate not supplied

Chemodectoma of the cauda equina: case report.

Well-differentiated paragangliomas have been found in unusual sites where conspicuous paraganglions are not normally found. A patient with a chemodectoma of the cauda equina is described. The importance of differentiating such tumors from those far more commonly seen in the region of the cauda equina, namely, ependymomas, hemangioblastomas, and metastatic carcinomas is emphasised.

Cauda Equina↗
PubMed2006

Cauda equina syndrome and profound hearing loss after spinal anesthesia with isobaric bupivacaine.

A 33-yr-old man undergoing anorectal surgery developed cauda equina syndrome and bilateral profound hearing loss after single-injection spinal anesthesia with isobaric bupivacaine. There was no pain on needle placement. Neurologic assessment found impaired sensation to pinprick in the perineal region, lower extremity paralysis, and bowel and bladder incontinence. In addition, he developed a bilateral profound hearing loss involving the low frequencies, with the left side more affected than the right side. Although hearing impairment can occur with cerebrospinal fluid leakage, the etiology of cauda equina syndrome is uncertain. The simultaneous occurrence of these events has not been previously reported.

Adult↗
PubMed1990

Nerve-roots of the cauda equina. The effect of hypotension and acute graded compression on function.

The influence of hypotension on the function of nerve-roots of the cauda equina under acute graded compression was studied with use of an established porcine model. In twenty adult miniature pigs, the nerve-roots of the cauda equina were compressed at pressures of zero (sham), fifty, 100, or 200 millimeters of mercury, and hypotension was induced with sodium nitroprusside. Compression was maintained for two hours, and a ninety-minute period of recovery followed. The nerve-roots were monitored electrophysiologically throughout the experiment. To assess the effect of compression and hypotension on the function of the nerve-roots, values of afferent and efferent amplitude and nerve-conduction velocity were compared with values in twenty adult miniature pigs that had similar graded compression without hypotension. Hypotension significantly affected efferent and afferent amplitudes at the end of the compression period; the effect remained significant at the end of the recovery period. The most profound effect of hypotension occurred during compression at fifty millimeters of mercury--a pressure that had no effect on the function of the nerves in normotensive animals.

Animals↗
PubMed1985

Bladder and urethral function and supersensitivity to subcutaneously administered bethanechol in cats with chronic cauda equina lesions.

The failure of bethanechol chloride to induce voiding in patients with neurogenic bladder, despite a positive bethanechol test, is being reported more frequently. An experimental model was designed in the cat to study the response of the bladder and urethra to subcutaneous and intraarterial bethanechol after complete and partial sacral decentralization. Complete sacral rhizotomy abolished the micturition reflex. Basal urethral perfusion pressure was not affected by complete sacral rhizotomy and a significant part of this basal urethral pressure remained sympathetically mediated. However, the urethral constriction response to bladder filling was lost in half the cats with complete lesions. Bladder and urethral supersensitivity to bethanechol chloride in cats with complete lesions was characterized by a shift to the left of the i.a. dose-response curve, and by the presence of responses to doses of s.c. bethanechol chloride which are subthreshold in normal cats. The urethra also showed exaggerated constriction responses to i.a. and s.c. bethanechol. After complete lesions a part of the bladder and urethral responses to s.c. bethanechol was adrenergically mediated and exerted through the vesicourethral short neuron system. The rest of the response was due to stimulation of urethral muscarinic receptors. Partial sacral lesions were compatible with a micturition reflex and the urethra retained its reflex response to bladder distension. After partial decentralization the bladder and urethra also showed responses to subthreshold doses of s.c. bethanechol. While the bladder response to s.c. bethanechol did not show a significant adrenergic component in cats with partial lesions, most of the urethral response was sympathetically mediated. In conclusion, complete cauda equina lesions result in an areflexic detrusor with frequent loss of the urethral responsiveness to bladder filling. Urethral supersensitivity to s.c. bethanechol might be responsible for a non-voiding outcome after bethanechol injection in patients with complete cauda equina lesions, despite a positive bethanechol test. Because the detrusor reflex is preserved and the urethra is less supersensitive to bethanechol after partial cauda equina lesions, these may represent a better indication for bethanechol therapy than do complete ones.

Animals↗
PubMed2006

Cystic dilation of the conus ventriculus terminalis presenting as an acute cauda equina syndrome relieved by decompression and cyst drainage: case report.

OBJECTIVE AND IMPORTANCE: The ventriculus terminalis of the conus, or "fifth ventricle" refers to the ependymal-lined space in the middle of the conus that is present in childhood and whose persistence into adulthood is rare. A number of cases of cystic dilatation of the ventriculus terminalis have been described in adulthood. Patients tend to present with either pain alone or gradually progressive conus or cauda equina syndromes with varying degrees of recovery after cyst drainage. Presentation with an acute cauda equina syndrome and its successful surgical management has not been previously reported. CLINICAL PRESENTATION: A 57-year-old woman experienced back pain and bilateral sciatica ascribed to diabetic neuropathy for 2 years. Over a 24-hour period she developed bilateral lower extremity weakness, saddle anesthesia, and bowel and bladder incontinence. Lumbosacral magnetic resonance imaging demonstrated a large cystic dilatation of the ventriculus terminalis. INTERVENTION: She was taken for emergency surgical decompression and cyst drainage. Immediately after surgery, she experienced significant increase in lower extremity strength and has since regained continence. CONCLUSION: Cystic dilation of the ventriculus terminalis should be part of the differential diagnosis for a cauda equina syndrome; surgical decompression with simple cyst drainage can result in excellent clinical results.

Decompression, Surgical↗
PubMed1993

Magnetic resonance imaging of the cauda equina in chronic inflammatory demyelinating polyneuropathy.

We report a patient with biopsy proven chronic inflammatory demyelinating polyneuropathy whose magnetic resonance imaging demonstrated abnormal enhancement of the cauda equina after administration of gadolinium. Enhancement may reflect alteration of the blood-nerve barrier secondary to inflammation. Magnetic resonance imaging of the cauda equina could be a useful adjunct in the early diagnosis of chronic inflammatory demyelinating polyneuropathy.

Adult↗
PubMed2001

Lumbar cauda equina syndrome associated with the use of gelfoam: case report.

STUDY DESIGN: A case of cauda equina syndrome is reported. OBJECTIVE: To recognize a serious complication related to the use of Gelfoam in the lumbar spine. SUMMARY AND BACKGROUND DATA: Absorbable hemostatic gelatin sponges have long been used to control bleeding around the spinal cord. Despite widespread use and a safe history with few reported adverse reactions, Gelfoam sponges have potential for complications that may be overlooked. METHOD: A case of cauda equina syndrome is reported and discussed. RESULTS: A retained Gelfoam sponge was found in the epidural space after lumbar decompression and fusion for spinal stenosis. The retained gelatin sponge had expanded and solidified, causing a mass affect. The resultant nerve compression led to progressive myelopathy. On removal of the Gelfoam, symptoms rapidly resolved. CONCLUSIONS: Although the use of Gelfoam in spine surgery generally is considered safe, care must be taken to avoid placing a large mass of sponge in a potentially closed space. If Gelfoam is not handled properly, it can engorge and fail to be resorbed appropriately, thus causing a mass effect. If neurologic compromise develops, Gelfoam should be considered a potential cause and subsequently removed.

Bone Screws↗
PubMed1999

Renal cell carcinoma: a rare source of cauda equina metastasis. Case report.

The authors present the case of a patient in whom intradural metastasis from renal cell carcinoma spread to the cauda equina. To the authors' knowledge, this is only the second report of its kind. This male patient had undergone nephrectomy for the treatment of renal cell carcinoma for 5 years and was diagnosed as having metastatic lung disease 1 year prior to admission. The patient presented with lower back pain that radiated to both legs, but he exhibited no sensorimotor deficits. The majority of cauda equina tumors are primary tumors, and metastases are very rare. The literature is reviewed with reference to current molecular genetic paradigms of metastatic renal cell carcinoma.

Aged↗
PubMed2006

Inferior vena cava thrombosis causing acute cauda equina syndrome. Case report.

The authors report a case of a 16-year-old girl who presented with a 1-week history of progressive low-back pain, buttock paresthesias, and bilateral lower extremity pain and weakness. Magnetic resonance (MR) imaging and MR venography studies of her lumbar spine revealed engorgement of the epidural venous plexus and mild compression of the cauda equina. A lower extremity and pelvic venogram revealed occlusive thrombosis of the femoral and iliac veins as well as of the inferior vena cava (IVC). The patient required an IVC thrombectomy due to progressive symptoms, after which she improved and returned to baseline status in 1 week. Imaging studies afterwards showed resolution of the venous engorgement and decompression of the cauda equina. This is the second published report of an association between IVC thrombosis and cauda equina syndrome.

Acute Disease↗
PubMed2002

[Primitive neuroectodermal tumor of the cauda equina. Report of a case].

Primitive neuroectodermal tumors are malignant neoplasms whose classification has been controversial. Spinal primitive neuroectodermal tumors are rare and at the cauda equina are even less common. We report the case of a 40 year-old man with a history of progressive back pain and gait difficulty. After the diagnosis of a primitive neuroectodermal tumor of the cauda equina, the patient presented seeding to the intracranial subarachnoid space followed by a poor outcome. We review the literature of primary spinal primitive neuroectodermal tumors.

Adult↗
PubMed2003

Cauda equina syndrome: outcome and implications for management.

A retrospective review of all patients who had surgery for cauda equina syndrome (CES) due to a herniated lumbar disc between January 1996 and November 1999 was undertaken. All underwent laminectomy and discectomy, and had been admitted as emergencies with cauda equina syndrome. Ten women and 10 men with a mean age of 45 years (range 33-67) had their diagnosis verified with MRI in 19 cases and CT in one case. Only half the patients had been catheterized at the time of admission to the neurosurgical unit. Nine patients had emergency decompressive surgery within 5 h of presentation to our unit. The others had surgery on the next available list, but within 24 h of admission. No difference was found between urgently operated patients and those operated on the next available list when urological outcome and quality of life assessments were made using a validated questionnaire at a mean time of 16 months after surgery (range10-48). Twenty per cent of a control group who had undergone laminectomy and discectomy for large disc herniations, but without CES had new urological symptoms when questioned postoperatively, but similar quality of life status. Emergency decompressive surgery did no significantly improve outcome in CBS compared with a delayed approach.

Adult↗
PubMed1976

Electrophysiological technique for evaluating lesions of the conus medullaris and cauda equina.

The authors describe the use of evoked electromyographic responses recorded in the anal sphincter induced by stimulation of the bladder wall and urethra in evaluating lesions of the conus medullaris and cauda equina in 110 patients. This reflex response took effect by way of the pelvic nerves and cauda equina to the sacral cord where the pudendal nerve nucleus was activated, resulting in a contraction of the external anal sphincter. Various lesions along this pathway have been shown to produce either increased latencies and depressed responses or complete loss of response depending on the extent of the lesion. The correlation of results of this technique with clinical, myelographic, and operative findings indicate it to be a useful clinical tool.

Anal Canal↗
PubMedDate not supplied

Cauda equina syndrome complicating ankylosing spondylitis: MR features.

A case of cauda equina syndrome complicating long standing ankylosing spondylitis is presented. Bony erosions were demonstrated on CT. Magnetic resonance showed arachnoid diverticula filling the erosions. Magnetic resonance obviated the need for intrathecal contrast medium injection.

Cauda Equina↗
PubMed1990

Surgically confirmed cauda equina and nerve root injury following percutaneous discectomy at an outside institution: a case report.

A 39-year-old woman sustained a permanent nerve root and cauda equina injury following a left-sided L5-S1 automated percutaneous discectomy (PERC) performed with the Nucleotome at an outside institution. Despite delayed surgery, which included excision of a sequestrated L5-S1 disc on the right and intradural exploration and resultant confirmation of a disrupted cauda equina, S1 radiculopathy, sacral numbness, and overflow incontinence persisted. Although PERC using the Nucleotome has been accepted by some as a safe alternative to the surgical management of disc disease, the paucity of similar complications reported in the literature may more closely reflect the medicolegal climate rather than the inherent safety of this technique.

Adult↗
PubMed1977

Sarcoid of the cauda equina. Case report.

An unusual case of sarcoid involving the cauda equina, resulting in progressive paraparesis, is presented. There was no evidence of sarcoid involvement outside the nervous system, and the diagnosis was established through thoracolumbar exploration. The patient was treated with steroids postoperatively, and had a moderate recovery of neurological function.

Adult↗
PubMed1985

Sacral sparing with cauda equina compression from central lumbar intervertebral disc prolapse.

Sparing of sensation in sacral dermatomes and of sphincter control was found in eight out of fourteen cases of severe cauda equina compression from massive central lumbar disc prolapse. Although the triangular shape of the lumbar spinal canal may be one factor for this it was found from a necropsy model that the increase in linear strain on the stretched roots of the cauda equina is least in the more centrally placed lower sacral roots. It is argued that the lower tension in these roots is determined by Young's Modulus.

Adult↗