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PubMed2004

[Paragangliomas of the cauda equina: report of two cases].

Extraadrenal paragangliomas involving the spinal cord are not common and usually take the compression of the cauda equine. Two cases of paraganglioma of the cauda equina with a different presentation are reported, and the clinical and histopathology findings of this tumor, as well as diagnosis, treatment and prognosis are review. We stress the importance of the high tumor vascularization form of intradural that can make impossible achieve a complete resection. Laminotomy and intraoperatory echography are very useful in the approach to intradural tumors, such as paraganglioma.

Adult↗
PubMed1998

Sarcoidosis of the cauda equina mimicking leptomeningeal malignancy.

Isolated neurosarcoidosis can present with a wide range of central nervous system manifestations. We present two cases of cauda equina sarcoidosis misdiagnosed initially as leptomeningeal malignancy, and review the literature. This unusual manifestation of neurosarcoidosis is typified by an indolent, chronic process with limited response to corticosteroid therapy.

Cauda Equina↗
PubMed2004

Primary malignant peripheral nerve sheath tumor of the cauda equina in a child case report.

STUDY DESIGN: A case report of primary malignant peripheral nerve sheath tumor (MPNST) of the cauda equina in a child is presented, and the literature is reviewed. OBJECTIVE: To discuss the problems involved in the treatment of primary intradural MPNSTs. SETTING: A department of orthopaedic surgery in Japan. METHODS: A 4-year-old boy complained of low-back pain radiating to the left calf. MRI revealed an intradural tumor at L3-L5 level. Following laminectomy of L3, L4 and L5, the tumor was removed en bloc. Based on pathological and immunohistological findings, the tumor was diagnosed as an MPNST. RESULTS: Although adjuvant chemotherapy was administered local recurrence and cerebral and spinal metastases of the tumor were found 6 months after the operation. Following additional incomplete removal of the recurrent tumor, radiation therapy was administered. Although recurrent and metastatic tumors disappeared or diminished in size by radiation, tumors increased in size thereafter, despite additional adjuvant chemotherapy. At 21 months after the first operation, he died of pneumonia. CONCLUSIONS: Reported clinical outcomes for patients with primary intradural MPNST are very poor. Although no gold standard for the treatment of tumors has been established yet, surgical removal of tumors combined with postoperative high-dose radiation may be recommended.

Brain Neoplasms↗
PubMedDate not supplied

CT of long-standing ankylosing spondylitis with cauda equina syndrome.

The authors present distinctive computed tomographic (CT) findings in two cases of long-standing ankylosing spondylitis accompanied by the cauda equina syndrome. Multiple, asymmetric erosions of the posterior elements of the lumbar spine on CT were correlated with thecal diverticula demonstrated by myelography. The pathogenesis of these erosions may be related to arachnoiditis in the early phase of the spondylitis.

Cauda Equina↗
PubMed1994

Paraganglioma of the cauda equina with associated syringomyelia: case report.

We present an association not previously described in which the rare entity of paraganglioma of the cauda equina was found in association with syringomyelia of the cervico-thoracic cord. The patient, a 50-year-old woman presented with a long history of lower back pain with recent onset of sciatic pain and altered sensation in the right leg. Surgical resection of the tumor with intraoperative syringostomy of the syrinx has led to eradication of all symptoms and at 5 months shows no evidence of residual pathology.

Cauda Equina↗
PubMed1998

Clear-cell meningioma of the cauda equina.

Meningiomas are rare tumours in children and lumbar lesions are exceptional. We report a clear-cell meningioma (CCM) of the cauda equina in a 10-year-old girl. The tumour was diagnosed by MRI, showing an enhancing intradural mass extending from L1 to L4. Pathology and immunohistochemical study demonstrated a CCM. The patient had a recurrence 6 months after the operation requiring further surgery. CCM are rare lesions, characterised by abundant cytoplasmic glycogen particles. Complete surgical removal is necessary because, despite their benign histological appearance, CCM are potentially aggressive and may recur, spread locally and even metastasize.

Back Pain↗
PubMed1992

Acute cauda equina syndrome from a ruptured aneurysm in the sacral canal. Case report.

The case is presented of a young woman with acute cauda equina syndrome from a ruptured aneurysm in the sacral canal. The lesion was associated with pathological enlargement of the lateral sacral arteries bilaterally, which presumably occurred to provide cross-pelvic collateral flow in response to the diversion of the right internal iliac artery for renal transplantation. The patient presented with signs and symptoms of spontaneous spinal epidural hemorrhage. The radiographic features of this lesion are described. In addition to angiography and partial embolization of the vascular supply, contrast-enhanced high-resolution computerized tomography was essential in the diagnosis and treatment of this unique aneurysm.

Acute Disease↗
PubMed1993

[Intraneural distribution of the arteries in the cauda equina of newborn infants].

Mesoscopic study of the irrigation of the lumbosacral segment of the spinal cord and the roots of the cauda equina was carried out in corpses of 18 Brazilian newborns of either sex. Through the abdominal portion of the aorta nine newborns were injected with neoprene latex and the others were injected with a 5% solution of gelatin coloured with black Indian ink. The latter were cleared by the Spalteholz technique. Two types of arterial distribution were determined: (a) proximal and distal radicular arteries supplying the corresponding roots, which presented in their middle third an arterial low density, that is, hypo-irrigation; (b) segmental spinal arteries, varying in number, more frequent on the left side and having a larger caliber than that of the radicular arteries, accompanying the roots without providing collateral branches to the neural roots and anastomosed with the spinal arteries.

Arteries↗
PubMed1983

Suspected epidural compression of the spinal cord and cauda equina by metastatic carcinoma. Clinical diagnosis and survival.

Data from 133 patients with cancer and suspected compression of the spinal cord or cauda equina was reviewed. Although there were differences in presenting symptoms and signs between the group of 62 patients with compression and the 71 without, no single symptom or sign discriminated adequately between the two groups. Multiple logistic regression was used to try to develop an index of signs and symptoms which could identify those without compression, thereby sparing them a myelogram. Eight characteristics, in combination, proved most effective as an index, but they were not perfect predictors of patients with block. Final diagnoses in the group without compression were: vertebral metastases 35%, carcinomatous meningitis 24%, plexopathy and/or neuropathy 21%, other 30% (10% had two diagnoses). Sixty-six percent of those with compression and 50% of those without compression died within six months, although patients rarely survived for much longer.

Adolescent↗
PubMed1989

Outcome of laminectomy for civilian gunshot injuries of the terminal spinal cord and cauda equina: review of 88 cases.

Case records of 88 patients with low-velocity gunshot injuries of the terminal spinal cord and cauda equina treated by laminectomy at Cook County Hospital between 1969 and 1987 were reviewed. Sixty-one patients were operated upon within 72 hours of injury, 29 of whom (47.5%) experienced neurological improvement or pain relief. Twenty-seven patients were operated upon at a later time for associated injuries, 13 of whom (48.1%) experienced neurological improvement or pain relief. When laminectomy was delayed for more than 2 weeks, either arachnoid adhesions (15%) or occult abscesses (17%) were observed. From this review as well as from the literature, it appears that the timing of laminectomy for gunshot injuries of the thoracolumbar and lumbosacral spine is not essential to neurological recovery. It appears, however, that adequate debridement of these injuries, performed as soon as the patient is stable from any associated injuries, may help to mitigate the late sequelae of arachnoiditis, infection, and pain syndromes in the lower extremities.

Adolescent↗
PubMed1979

Cauda equina syndrome and arteriovenous fistula.

Traumatic arteriovenous fistulae, resulting in delayed damage to the cervical spinal cord and roots, are well documented. This report concerns an iliac arteriovenous fistula with damage to the cauda equina.

Adult↗
PubMed2004

Cauda equina compression syndrome in a child due to lumbar disc herniation.

INTRODUCTION: Cauda equina syndrome with sphincter dysfunction is an uncommon and feared complication of lumbar disc herniation. CASE REPORT: Lumbar disc disease in the pediatric age has been reported infrequently, but to the best of our knowledge, this is the first pediatric case of acute lumber disc herniation presenting with caudal compression.

Adolescent↗
PubMed2004

Spinal epidural hematoma causing acute cauda equina syndrome.

Spinal epidural hematoma (SEH) is an uncommon cause of acute cauda equina syndrome. Most of these hematomas are caused by trauma, anticoagulation therapy, and vascular anomalies or occur following spinal epidural procedures and, rarely, spinal surgery. Spontaneous SEH is an extremely rare occurrence. The incidence of symptomatic postoperative SEH is 0.1 to 3%. Clinical evaluation is the most important tool in the early diagnosis of SEH. Once the disease is suspected clinically and confirmed on diagnostic imaging, emergency evacuation of the lesion should be performed. Prognosis depends on the rate of development of symptoms, interval to surgery, level of spinal involvement, and degree of neurological deficit.

Acute Disease↗
PubMed2004

Cauda equina melanoma presenting with subarachnoid hemorrhage. A case report.

The case of a 57-year-old woman with a primary melanoma of the cauda equina is reported. The peculiarity of the case is the very rare clinical presentation mimicking a subarachnoid hemorrhage. The patient underwent surgical excision of the mass. The clinicopathological and neuroradiological features are summarized.

Cauda Equina↗
PubMed1980

Rheumatoid arthritis of the lumbar spine leading to anterior vertebral subluxation and compression of the cauda equina.

A 71-year-old woman with rheumatoid arthritis suffered a spontaneous anterior subluxation of the fourth lumbar vertebra with compression of the cauda equina. The patient was operated upon with a decompressive lumbar laminectomy and a stabilizing posterior interbody fusion of L4 and L5. Histological examination of the unstable L4-L5 motor segment showed that the apophyseal and discovertebral joints had been destroyed by rheumatoid granulation tissue.

Aged↗
PubMed1992

[Priapism caused by cauda equina compression. Report of a case and review of the literature].

As a result from the mechanical irritation provoked on the sacral roots, the cauda equina compression syndrome can involve, as part of its symptomatic state, involuntary erections and mictional disorders which arise when standing and stretching the spine. In the eight cases of priapism from this cause reported in the international literature, surgical decompression has solved the clinical picture. We now present a new case with the peculiarity that, following unsuccessful surgical therapy, the infiltration of the compromised spinal roots has rendered excellent results.

Aged↗
PubMedDate not supplied

Primitive neuroectodermal tumors of the cauda equina in adults with no detectable primary intracranial neoplasm--three case studies.

We studied three cases of primitive neuroectodermal tumors surgically removed from the cauda equina region of adults. There was no clinical or radiological evidence of cerebellar medulloblastoma, other intracranial tumor or paraspinal sympathetic neuroblastoma. Two patients died: autopsies revealed no primary intracranial neoplasm. One patient is alive 3 years after surgery with no detectable intracranial tumor. The tumors had the light and electron microscopic features of primitive neuroectodermal tumors as described earlier in the literature. In addition, in all three cases many tumor cells could be stained for cytoplasmic neurofilament antigen.

Adult↗