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PubMed1985

Paraganglioma of the cauda equina: a histological, ultrastructural and immunocytochemical study of two cases with a review of the literature.

The clinical and pathological features of two paragangliomas arising in the cauda equina are described and compared with 14 previous reports. The light microscopic features were similar to those of paragangliomas from other sites, with a 'Zellballen' pattern of cells containing argyrophil granules. Electron microscopy showed densely staining membrane-bound granules, cilia and fibrous bodies in the cytoplasm. The last two features only occur in paragangliomas from this site. gamma-Enolase was demonstrated by the peroxidase-antiperoxidase technique for the first time in these neoplasms. This technique was also used to demonstrate cytokeratins, which appear to be associated with the presence of fibrous bodies. The pathological findings suggest that paragangliomas in this site arise from pre-existing paraganglia, possibly of the visceral autonomic group. The prognosis in cases treated by complete excision appears to be good.

Adult↗
PubMed1976

Histiocytosis X of the cauda equina.

Laminectomy, performed on a 46-year-old woman because of weakness and paresthesias of the lower limbs, showed multiple discrete yellow nodules on the nerve roots of the cauda equina. One of these lesions was excised and proved to be a granuloma consistent with the diagnosis of histiocytosis X.

Cauda Equina↗
PubMedDate not supplied

[Selective epidural phlebography in the diagnosis of tumors of the cervical spinal cord and of the cauda equina roots].

The method of selective epidural phlebography (SEP) was applied in the diagnosis of tumors of the cervical segment of the spinal cord and the roots of cauda equina in 45 patients. The diagnosis was confirmed in 32 of the 37 patients who were operated on. The SEP method does not produce serious complications and allows circulatory disorders in the vertebral venous plexuses to be revealed. The diagnostic value of the method is higher in tumors of superocervical localization and hourglass tumors.

Adolescent↗
PubMed1998

Nephrogenic diabetes insipidus and tethered cord syndrome with a lipoma of the cauda equina.

The tethered cord syndrome is characterized by sensory and motor disturbances of the lower extremities and incontinence. We report a 12-year-old girl with a cauda equina lipoma and a tethered spinal cord, whose chief complaints were polyuria and polydipsia. She was diagnosed as having nephrogenic diabetes insipidus. This unusual complication of the tethered cord syndrome was most likely due to a hydronephrosis secondary to a neurogenic bladder. Thus, spinal lesions have to be considered in patients with polyuria and polydipsia.

Cauda Equina↗
PubMed2005

Paraganglioma of the cauda equina: a case report and literature review.

A 26-year-old man presented with left leg pain and progressive paraparesis. Imaging revealed a large intradural tumour compressing the cauda equina. The lesion was radically resected and histological analysis revealed it to be a paraganglioma. The clinical features of this rare tumour are described with a review of the literature.

Adult↗
PubMed1982

Clinical recording of pressure on the spinal cord and cauda equina. Part 1: the spinal block infusion test: method and clinical studies.

When an intraspinal expanding lesion causes a spinal block, a segment of the spinal cord or cauda equina will be subjected to general pressure from the surrounding tissue. This spinal block pressure, the spinal equivalent to intracranial pressure, was measured by lumbar infusion of fluid and simultaneous recording of the volume-pressure curve caudal to the block. The point of deviation from or breakthrough of the exponential volume-pressure curve indicated the spinal block pressure. Spinal block pressure of about 500 mm H2O and more could be determined by this method, and, when it was combined with Queckenstedt's test, lower pressures could be assessed as well. In the static (thoracic) part of the spine, spinal block pressure up to the level of arterial blood pressure was recorded. In the dynamic part of the spine, however, spinal block pressure could exceed arterial blood pressure due to external compressive forces during extension of the spine. There was a general tendency for more severe neurological deficits in patients with high spinal block pressure; but the duration of the pressure, additional focal pressure, and spinal cord compared with nerve root compression seemed equally important factors. The recording has implications for diagnosis, positioning of patients for myelography and surgery, selection of high-risk patients for the most appropriate surgical procedure, and detection of postoperative hematoma. There were no complications associated with the recordings.

Adolescent↗
PubMed1998

Continuous microspinal anaesthesia: another perspective on mechanisms inducing cauda equina syndrome.

Continuous spinal anaesthesia through a microspinal catheter technique has been criticised on several grounds and is now rarely used. This paper reviews the possible causes of the cauda equina syndrome which have been described and, on the basis of research in cadaver preparations, a glass 'spine' model and clinical experience in over 200 cases, suggests how these problems might be avoided. The use of careful insertion techniques, limiting the length of catheter inserted into the subarachnoid space and the use of no stronger than 0.5% bupivacaine solution are recommended.

Aged↗
PubMed1979

Bulbocavernosus reflex in patients with conus medullaris and cauda equina lesions.

The clinical value and practical application of the electrically induced BC reflex was investigated in 40 patients with traumatic or compressive lesions of the conus medullaris or cauda equina. It was shown that the BC reflex was either absent or delayed depending upon the invovlement of the sacral 2--4 spinal and radicular segments. The latency of the BC reflex was normal in patients with mainly epiconus and lumbar cord involvement. The loss of the BC reflex in the acute period of traumatic lesions was an adverse prognostic sign while the presence of the reflex whether or not delayed, indicated a more benign final outcome of sphincter and sexual reflex disturbances. In chronic progressive compression, the latency of BC reflex was often delayed.

Cauda Equina↗
PubMed1980

Electrophysiological evaluation of the afferent spinal roots and nerves in patients with conus medullaris and cauda equina lesions.

The clinical value and practical application of the lumbosacral evoked electrospinogram (Espg) and somatosensory cerebral evoked potentials (SEP) were investigated in 52 patients with conus medullaris or cauda equina lesions. It was shown that the destruction or compression of the conus/cauda equina region by traumatic fracture and dislocation of upper lumbar vertebrae, by midline herniation of the nucleus pulposus and by tumoral mass, produced significant reduction in amplitude and delay in latency of Espg recorded just above the lesion site, and the SEP behaved in a similar way. The degree of abnormality was found to be in accord with the severity of clinical sensorimotor deficits in the legs. Tumoural compression caused more significant delay in evoked responses than traumatic injury. From the diagnostic point of view, Espg and SEP were useful in showing latent and manifest involvement of the lumbosacral sensory roots and these are discussed in relation to other electrodiagnostic tests.

Adolescent↗
PubMed1991

Percutaneous stimulation of the cauda equina. A new diagnostic method in spinal stenosis.

A study to determine the feasibility of measurement of conduction velocities through the lumbosacral nerve roots by direct percutaneous stimulation of the cauda equina is reported. The technique was applied to a series of normal volunteers and its reliability and reproducibility confirmed. An electrophysiologic defect was demonstrated in most patients with surgically proven lateral recess stenosis. Electrophysiologic recovery was shown in patients examined after surgery. Although the technique can be refined, these early results are encouraging.

Cauda Equina↗
PubMed1984

Suprapubic endoscopic vesical neck suspension (Stamey procedure) for control of urinary incontinence in a woman following cauda equina injury.

Suprapubic endoscopic suspension of the vesical neck is a popular and effective procedure for the treatment of stress urinary incontinence in women. A woman who suffered a traumatic cauda equina injury had areflexic detrusor dysfunction with normal intravesical filling pressure. The patient had moderate proximal urethral dysfunction resulting in incontinence despite an adequate intermittent self-catheterization regimen and treatment with an alpha-sympathomimetic drug. Following suprapubic endoscopic vesical neck suspension she has remained totally continent on intermittent self-catheterization.

Adolescent↗
PubMed1995

[The partial cauda equina syndrome].

In order to reduce the number of patients with a complete cauda equina-syndrome we reviewed the records of 63 surgically treated patients with lumbar root compression and bladder symptoms. Patients with a complete cauda equina-syndrome were excluded. Twenty-seven (43%) patients were admitted to the neurosurgical department more than 24 hours after the onset of bladder symptoms, an unacceptable delay mainly due to the reluctance of the patients to seek medical attention. The bladder symptoms remitted completely in 61 patients (97%). In spite of this the partial cauda equina-syndrome can still progress to a complete syndrome, so we recommend that all patients receiving conservative treatment for a lumbar disc prolapse should be advised to seek medical attention should voiding problems arise.

Adult↗
PubMed1985

Priapism as a feature of claudication of the cauda equina.

A case is reported of a man 60 years of age with degenerative stenosis of the lumbar canal at the L3-4 level and lumbar arachnoiditis, whose symptoms of claudication of the cauda equina were accompanied by uncomfortable involuntary erections. All symptoms were relieved by surgical decompression.

Arachnoiditis↗
PubMed1994

Magnetic resonance imaging of the cauda equina in Guillain-Barré syndrome.

We report three patients (two children and one adult) with Guillain-Barré syndrome and magnetic resonance imaging evidence of gadolinium enhancement of the cauda equina and lumbar nerve roots. All three patients exhibited symmetric ascending paralysis and areflexia, and two (one child, one adult) suffered urinary incontinence and retention. Similar enhancement has been observed in patients with chronic inflammatory demyelinating polyneuropathy and suggests proximal nerve inflammation. Magnetic resonance imaging in Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy may have diagnostic utility.

Cauda Equina↗
PubMed1983

Significance of detrusor compliance in patients with localized partial lesions of the spinal cord and cauda equina.

Detrusor compliance was measured by cystometry irrespective of any symptoms of lower urinary trace dysfunction in 70 patients with localized, partial, surgically treatable lesions of the spinal cord and cauda equina. Compliance was found to be normal in all patients with upper motor neuron lesions; reduced compliance was encountered only in those with lower motor neuron lesions. Reduced compliance was closely associated with lesions of the conus medullaris and with detrusor hyperreflexia, and it is therefore likely that the mechanism of compliance involves a significant neural component. Incontinence, particularly nocturnal incontinence, was encountered more frequently among those with reduced compliance than in those with normal compliance, whereas retention of urine was comparatively rare with reduced compliance.

Adult↗