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PubMed2001

Spontaneous intracranial hypotension with diffuse dural enhancement of the spinal canal and transient enlargement of the pituitary gland.

Spontaneous intracranial hypotension is a rare phenomenon characterized by postural headache, neck rigidity, nausea and vomiting. Imaging findings on magnetic resonance imaging (MRI) is characteristic with diffuse intracranial pachymeningeal thickening and enhancement following intravenous gadolinium. We present a case of spontaneous intracranial hypotension with two unusual imaging findings; pachymeningeal enhancement of the spinal canal and enlargement of the pituitary gland in addition to the diffuse intracranial pachymeningeal enhancement. In this case report, we will discuss the clinical features, MRI findings and underlying pathophysiology of this rare condition.

Adult↗
PubMed1989

[Angioma and angioblastoma of the spinal canal. Clinical and long-term results].

32 patients were operated on because of vascular processes in the spinal canal. 12 woman and 20 men had fallen ill, the average age at the time of operation being 38 years. Preoperatively 18 patients already showed an incomplete or complete transverse lesion with a mean duration of the disease being 37 months. After the operation 62.5 per cent of the patients showed an improvement. 46.8 per cent were able to walk on their own, 15.6 per cent needed support. 10 patients (31%) became again fit to work. Six patients (18.8%) are in need of care. The total lethality, related to three years post operation, was 18.8 per cent.

Adult↗
PubMed2004

Operative treatment for degenerative lumbar spinal canal stenosis.

The authors have made a retrospective study of a cohort of patients who underwent surgery for spinal stenosis. A total of 85 patients were surgically treated for spinal stenosis between 1993 and 1997, and 79 patients were available for re-evaluation. The average time of follow-up was 79 months. Twenty patients with monosegmental stenosis underwent fenestration and undercutting, 16 patients had a hemilaminectomy or laminectomy and 43 patients had an instrumented fusion after decompression. The severity of the clinical complaints, the degree of stenosis and the extent of the instability determined the method of operation used. Results were more variable when extensive decompression (hemilaminectomy or more) was needed and segmental stability was reduced by resection of large portions of the facet joints. Instability clearly worsened the results. The overall results clearly show that limited decompression is an ideal operative method, provided the indication is correct. Fusion cannot be avoided if segmental instability is present. This retrospective study shows that satisfactory long-term results can be achieved in lumbar spinal stenosis with surgery adapted to the degree of instability and the degree of stenosis.

Adult↗
PubMed1993

[Clinical and pathological study of myelopathy accompanied with cervical spinal canal stenosis--with special reference to complication of mental retardation or cerebral palsy].

We studied 3 cases with myelopathy caused by cervical spinal canal stenosis (developmental), who had been suffering from walking difficulty followed by tetraplegia, clinically and pathologically. In all 3 cases, mental retardation and/or cerebral palsy was diagnosed. We hypothesized that the brain damage in the developmental stage might also cause developmental disturbance in the cervical spine. In all cases, pathological investigation showed decreased antero-posterior diameter and degeneration in the gray matter and in the lateral and posterior column in the involved cervical spinal cord. The findings, such as relative preservation of the anterior column and cyst formation in the gray matter, were thought to be in common with cervical spondylotic myelopathy or ossification of the occipital longitudinal ligament (OPLL) which had been reported before. In one case we found aberrant peripheral nerve bundles and peripheral type remyelination in the transverse spinal cord lesion. Compared to the pathological change in the OPLL, our cases showed more severe degenerative change in the spinal segments with a relatively preserved antero-posterior diameter of the spinal cord, which supports the theory that the dynamic factor plays a more important role than the static compression factor. We concluded that the aging process and/or dystonic neck movement added spondylotic change to the narrow canal, and excess movement of the neck and/or falls caused dynamic injury to the spinal cord and secondary circulatory disturbance further worsened spinal lesions. When elderly patients with cerebral palsy develop motor symptoms, we should consider cervical spinal stenosis as a possible cause.

Aged↗
PubMed1985

Cheirolumbar dysostosis and constitutional narrowness of the cervical spinal canal.

In this paper we describe the second case of cheirolumbar dysostosis associated with constitutional narrowness of the cervical spinal canal. This case is the 32nd case of cheirolumbar dysostosis described in the literature. Cheirolumbar dysostosis is not a rare dysostosis and may occur in association with various anomalies.

Cervical Vertebrae↗
PubMed2004

Anesthetic management of a patient in prone position with a drill bit penetrating the spinal canal at C1-C2, using a laryngeal mask.

UNLABELLED: Airway management in patients with penetrating neck trauma must guarantee cervical spine stability. Moreover, the prone position increases the risk of difficult ventilation and cervical spine injury. A 19-yr-old patient was brought to the emergency room in prone position with a drill bit protruding from the posterolateral aspect of his neck. The bit had entered the spinal canal below the first cervical vertebra, and placed near the odontoid peg. He was referred for surgical removal of the drill. The use of an inhaled induction of anesthesia, avoiding muscle relaxants, and ventilation through a laryngeal mask airway inserted in the prone position seemed to offer a satisfactory approach. IMPLICATIONS: Management of patients with penetrating neck trauma must guarantee cervical spine stability. Moreover, the prone position increases the risk of difficult ventilation and cervical spine injury. Anesthesia may be induced and the airway can be managed with the patient already in the prone position for surgery.

Accidents↗