Spinal-cord compression caused by vertebral haemangioma relieved by percutaneous catheter embolisation.
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Osteoblastoma is an infrequent but important cause of pain in the back and neurological findings in children and young adults. Its diagnosis may be difficult and often delayed (in one series, 23% of patients had not been diagnosed after 2 years of symptoms). MRI may be useful to noninvasively image the lesion, its soft tissue and bony extent and its relationship, if any, to the spinal cord.
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Gastrointestinal neuroendocrine tumors are derived from the diffuse neuroendocrine system of the gastrointestinal tract which is composed of amine and acid producing cells with different hormonal profiles, depending on the site of origin. The tumors they produce can be divided into carcinoid tumors and pancreatic endocrine tumors. We believe this to be only the fourth case in the literature of a patient presenting with cord compression as a result of a metastatic neuroendocrine tumor (MEDLINE 1966-2000).
Damage to the central nervous system is followed by local release of excitatory amino acids, e.g. glutamate. These have been claimed to increase the metabolic need of already hypoxic neurons, and thereby to promote cell death. To investigate whether N-methyl-D-aspartate (NMDA) receptor-mediated mechanisms are involved in the damage consequent to spinal cord injury, 20 rats were exposed to 5-min compression of the thoracic spinal cord produced with a load of 35 g on a 2.2 x 5 mm sized plate. One group of animals was given a noncompetitive NMDA channel blocker, MK-801, in a dose of 10 mg/kg b.w and one group saline alone. The neurologic function was evaluated on the inclined plane for 4 days when spinal cord blood flow (SCBF) was measured with the 14C-iodoantipyrine autoradiographic technique. One day after trauma the animals in both groups were paraparetic and exhibited a significantly decreased capacity angle at the inclined plane test (about 35 degrees compared with about 63 degrees before compression). Thereafter, the motor function improved slightly, but to a similar extent in the two groups. On Day 4, gray and white matter SCBF was similar in the two groups. The results indicate that MK 801 in the dose used does not prevent the development of neurologic dysfunction or the reduction in SCBF after spinal cord compression.
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A case of spinal epidural extramedullary haematopoiesis in thalassemia is reported. Role of computed tomography in this rare manifestation is emphasized with brief review of literature.
Calcification and/or ossification of the ligamenta flava is a well reported clinicopathologic entity causing narrowing of the spinal canal cord compression. It has been described almost exclusively in Japanese people. The authors present the case of a non Japanese patient with thoracic myelopathy caused by ossification of the ligamentum flavum.
A case of osteomyelitis of the spine is described. A member of the Alkalescens-Dispar group was isolated from the lesion.
A haemangioma extending from the first thoracal vertebra into the extradural spinal canal presented clinically as slowly progressive incomplete cord compression. Radiographic, myelographic, and CT findings are demonstrated and an additional lumbar vertebral haemangioma was found. The study of magnetic resonance imaging (MRI) done by spin-echo technique indicated that signal intensities within the vascular malformation measured in various recovery (TR) and echo times (TE) are largely the result of different blood flow velocities.
We retrospectively evaluated the medical records of 17 hospice patients who developed spinal cord or cauda equina compression due to metastatic epidural tumor to ascertain the nature and outcome of the disorder in this setting. Epidural compression occurred following admission to the hospice in five cases and prior to admission in 12 cases. Six patients were ambulatory following treatment, and this favorable outcome occurred only in those who were ambulatory at diagnosis. In the group of patients who were paraplegic after treatment, problems related to pain, decubitus ulcers, and constipation were most challenging. This experience highlights the need for a more vigilant approach to back pain in patients at risk of epidural compression in the hospice setting. Further studies are necessary to establish the appropriate management of these patients.
Plasmocytoma is a plasma cell tumor, which occurs in various structures of the body. When the spinal column is involved, it may cause cord compression. In this study, 14 cases of spinal plasmocytomas are presented. Seven of them were male and seven female. The major complaints were pain in twelve cases, motor weakness in eight cases, and bladder disturbance in six cases. On neurological examination, twelve of the patients had impairment of extremity movements (85.7%), and eight had sensory losses (57.1%). Compression was more frequent in the thoracic region. There was a total block in nine and partial block in five cases. All patients underwent surgery. In thirteen cases laminectomy was performed, in one thoracotomy. In this report, complaints, clinical and laboratory findings, neurological examination, and histopathology of our cases are reviewed and the results discussed.
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