The improbability of by-passing of sensory tracts interrupted by injury to the spinal cord and cauda equina.
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The importance of the myelography in comparison to CT (CT-myelography) is demonstrated in a patient with an intradural neurinoma.
An unusual case of a capillary hemangioma of the filum terminale is presented. The successful removal returned the patient to an asymptomatic state.
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A case of ankylosing spondylitis associated with massive dural ectasia is presented. Computed tomography and magnetic resonance imaging characteristics are shown, and possible causes are discussed.
UNLABELLED: This study assesses the frequency of lower limb and back pain in children with Guillain-Barré syndrome and reviews the magnetic resonance imaging results of those undergoing spinal imaging. Over an 8-y period, nine children presented with various combinations of severe back pain, leg pains, impairment of gait and bladder dysfunction. Guillain-Barré syndrome was confirmed on clinical examination and peripheral electrophysiology (n = 8). Magnetic resonance imaging in four patients, following contrast injection, showed enhancement of the cauda equine and, additionally, of the cervical nerve roots in one of the patients. A further patient, who was not scanned with contrast, had abnormal thickening of the lumbar roots. Carbamazepine and steroids were effectively used for analgesia in three cases. All the patients recovered. CONCLUSION: Guillain-Barré syndrome should be considered in the differential diagnosis of children presenting with back and/or leg pain. Early diagnosis ensures prompt monitoring for autonomic dysfunction and respiratory compromise.
Although the specific etiology of NCE remains unknown, many advances have been made in recent years. It is hoped that we can expect continued success in this area. Etiologic and pathophysiologic determination of NCE is the key to developing an appropriate therapeutic regimen.
Lumbosacral conditions are now recognized as compromising a significant percentage of problems for dogs and cats with rear limb abnormalities. Diagnosis is based on logically ruling out the more common maladies and then performing specific diagnostic procedures that definitively show the lesion(s).
Magnetic resonance imaging continues to dominate the literature on spinal imaging and further advances have occurred during the last year. It is now the investigation of choice for most problems. Intraoperative sonography also may have a place, but other modalities are being superseded. Plain films retain a value in trauma.
Tick-borne encephalitis virus is an important human pathogen in Europe. The infection usually presents as meningitis, meningoencephalitis, or meningoencephalomyelitis and only rarely as symptoms of isolated myeloradiculitis. We describe the lumbar MR imaging finding in a 48-year-old man with serologically confirmed tick-borne encephalitis in which there was enhancement of the ventral surface of the conus and the anterior nerve roots from the T12 level extending along the length of the ventral cauda.
Ventral nerve roots of the lumbar area in seven pigs were transected intradurally and resutured microsurgically immediately after transection. Four to seven months after repair electromyography was done via intradural electric stimulation of the resutured roots. Reinnervation was found. Patterns were compared with data from intact animals.
A 56 year old woman developed symptoms of lumbar nerve root compression caused by a granuloma arising in the ligamentum flavum. The histological features of the lesion are discussed and the clinical and radiological findings of the patient are described.
The clinical and neuroradiological findings in a rare case of plexiform neurofibroma with bone scintigraphy, myelography and selective spinal angiography are described. The difficulties with the preoperative differential diagnosis from other intraspinal space occupying lesions are discussed and the importance of intraoperative biopsy and electrical stimulation is stressed.
A 44-year-old male patient suffering from sexual and voiding dysfunction did not exhibit any sensorimotor deficit except for a lax anal sphincter with loss of the bulbocavernosus reflex (BCR). The absence of both the electrically induced BCR and cortical evoked responses to stimulation of the dorsal penile nerve as well as partial denervation of the pelvic floor musculature suggested damage to the lower sacral roots. The site of the lesion as indicated by electrophysiological findings was confirmed by computerized tomography and magnetic resonance imaging. The operation revealed a lipoma involving a few cauda fibers which produced a distension in the region of the conus medullaris.
A 78-year-old woman developed an osteoporotic fracture of L2 followed two months later by spinal cord compression. Imaging study findings suggested a malignancy but a biopsy showed osteonecrosis, of which there was no evidence on the imaging studies. Osteonecrosis may be the cause of neurologic compromise associated with osteoporotic vertebral fractures.