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At least 163 records · Page 9Linked to original sources
PubMed1985

Progressive cauda equina syndrome and extensive calification/ossification of the lumbosacral meninges.

A patient with longstanding ankylosing spondylitis (AS) developed a cauda equina syndrome. The myelogram showed a block at the L2 level. Vertebral computerised tomography showed calcification in the centre of the spinal canal. The patient also had features suggestive of a diffuse idiopathic skeletal hyperostosis (DISH). Meningeal calcification has never been reported in AS, so we suggest that this is related to an associated DISH. Cauda equina syndrome has not been described in DISH, and calcification of meninges has not been reported in AS, so we suggest that the meningeal calcifications and associated cauda equina syndrome are related to DISH.

Calcinosis↗
PubMed2001

Blood flow measurement in experimental chronic cauda equina compression in dogs: changes in blood flow at various conditions.

The purpose of this study was to present a simple method of measurement of blood flow in the nerve root, assess the reliability of this method, and examine the changes of blood flow in chronic cauda equina compression in an experimental setting. A total of 15 dogs were used to determine the blood flow of cauda equina in normal (n = 5), sham (n = 5), and 10 mm Hg compressed cauda equina for 1 week (n = 5). The speed of blood flow was calculated using a specially designed microscope supplied with a video camera. Blood flow in chronic 10 mm Hg compression decreased compared with the sham and normal groups. The kappa value was between 0.75 and 0.96. We conclude that this method might be useful for measurement of blood flow in the nerve root and for confirming the reduction in blood flow of compressed cauda equina.

Animals↗
PubMed1987

Elusive tumor of the cauda equina. Case report.

A patient with a mobile schwannoma of the cauda equina is described. There was considerable discrepancy between the localization of the tumor at myelography and the findings at both initial surgery and repeat myelography, confirmed by definitive surgery. Such mobility is rare, but should be kept in mind when surgery is performed for a tumor of the cauda equina.

Cauda Equina↗
PubMed1994

Primary lymphoma of the cauda equina: myelographic, CT myelographic, and MR appearance.

This case demonstrates the myelographic, CT myelographic, and MR appearance of primary lymphoma of the cauda equina. It also illustrates the utility of high-resolution CT myelography in certain lesions of the cauda equina. The authors feel that CT myelography, with its inherent ability to depict individual nerve roots and therefore any pathologic involvement as well, should be considered an adjunct to MR in imaging the cauda equina.

Aged↗
PubMed2006

Multiple extradural arachnoid cysts at the spinal cord and cauda equina levels in the young.

STUDY DESIGN: A case report of multiple extradural arachnoid cysts at the spinal cord and cauda equina levels in the young. OBJECTIVE: To report an exceedingly rare case of multiple extradural arachnoid cysts at the spinal cord and cauda equina levels in the young. SETTING: Department of Orthopaedic Surgery, Tokai, Japan. CASE REPORT: An 11-year-old boy was diagnosed with multiple extradural arachnoid cysts at the spinal cord and cauda equina levels extending from the T5 to L5 vertebrae and surgery was performed. At 2 years after surgery, no recurrence was observed and muscle weakness of the lower extremities and sensory disturbance improved. CONCLUSION: Excision of only the arachnoid cysts at the spinal cord level led to a favorable outcome.

Arachnoid Cysts↗
PubMed1995

Intra-extradural hemangioblastoma of the cauda equina.

This is a case report of a hemangioblastoma of the cauda equina with intra-extradural extension in the form of a dumbbell tumor. For the first time diagnosis of an intra-extradural spinal hemangioblastoma was made by computerized tomography (CT) and magnetic resonance imaging (MRI). A total excision was performed with microneurosurgical techniques and application of Nd:YAG laser. Clinical appearance, neuroradiological diagnostic procedures and neurosurgical therapy of intra-extradural hemangioblastomas of the cauda equina and of spinal hemangioblastomas of other localization were compared.

Adult↗
PubMed1991

[Mobile neurinoma of the cauda equina; a case report].

A case of mobile tumor of the cauda equina was presented with a brief review of factors relating to the mobility. A 66-year-old man was admitted to our hospital complaining of left lumbago aggravated by coughing or assuming the supine position. However, neurological examination failed to reveal any abnormalities. The initial myelography showed complete obstruction above the superior border of the L1 vertebra, while the second myelography showed the same obstruction, but it had moved upwards to the superior border of T12. Surgery revealed an elastic, soft tumor and cystic dilatation of the subarachnoid space above and below the tumor. The tumor was mobile but originated from a single elongated and tortuous nerve of the cauda equina. Pathologic examination revealed neurinoma.

Aged↗
PubMed1983

Paraganglioma of the cauda equina.

The authors present two cases of paraganglioma located in the cauda equina. Diagnosis was suspected by light microscopy and confirmed with the identification of characteristic neurosecretory vesicles. The presence of cytoplasmic filaments in both of our cases and of cilia in one case are very unusual findings in paraganglioma and seem to be characteristic of this location. The cauda equina is a extremely rare location for this type of tumor and, as far is known, only ten other cases have been reported. Paraganglioma should be considered as a diagnostic possibility in order not only to make a correct diagnosis, but also to prepare tissues for special stains and biological and electronmicroscopic studies.

Adult↗
PubMed1984

Pressure changes within the cauda equina following constriction of the dural sac. An in vitro experimental study.

In order to register pressure changes within the cauda equina, a highly sensitive pressure measuring catheter was inserted through a hole in the dural sac. Its tip was placed among the nerve roots of the cauda equina at levels L2, L3, and L4 in seven freshly removed human specimens. The cross-sectional area of the dural sac then was decreased gradually by constriction of a circular clamp. The inside diameter of the clamp and the corresponding area was determined when further reduction of the circumference of the clamp caused the first signs of a pressure increase, the critical size, among the nerve roots. The average critical size was 76.9 mm2 at the L2 level, corresponding to a diameter of 11.4 mm At the L3 level, the corresponding figures were 71.5 mm2 and 11.1 mm, and at the L4 level 64.8 mm2 and 10.6 mm, respectively. It seemed reasonable to assume that the critical sizes determined in this way could be threshold values below which a further constriction of the size of the dural sac would cause an impairment of the circulatory and/or the nerve function of the cauda equina.

Aged↗
PubMed1999

Paraganglioma of the cauda equina. Case report with 33-month recurrence free follow-up and review of the literature.

Paraganglioma of the cauda equina is an unusual tumor and do not have the secretory properties of the same tumors arising outside the nervous system. In none of the few cases reported in literature a preoperative diagnosis was possible, and the surgical findings raised questions in the differential diagnosis with ependymomas. A rare case of paraganglioma of the cauda equina studied both pre- and postoperatively by MRI, and treated with subtotal excision combined with radiotherapy is described. Results and recurrence rates of the cases reported in literature are reviewed. Though MRI imaging has proven to be more sensitive than other radiological procedures, we stress the difficulties of preoperative diagnosis of paragangliomas in this site. The correct diagnosis of the paraganglioma of the cauda equina still relies on immunochemistry and electron microscopy. Total excision is often very difficult owing the tendency of these neoplasms to infiltrate cauda's roots. A 33-month recurrence free follow-up of our patient confirms that successful treatment is achieved by subtotal resection combined with radiotherapy.

Adult↗
PubMed1979

Electrodiagnosis of compression of individual nerve roots of the cauda equina.

Segmental electrodiagnosis of compression of individual nerve roots of the cauda equina has been attempted in 45 patients, including cases of disc hernia, spondylsis and spondylolisthesis. The needle electrode was inserted into the nerve root either just lateral to the intervetebral foramen or through the posterior sacral foramen. The recordings made on stimulating a single nerve root were somatosensory evoked potential, the cauda equina action potential and the M and H waves. Mixed spinal nerve root action potentials were also recorded by stimulating the sciatic, peroneal and tibial nerves. It was shown that a diagnosis could be made from the somatosensory evoked potential, the H wave and root pain reproduction, and also the diagnosis of a subclinical compression involvement. In other words, the neurophysiological state of dysfunction of individual roots in each aspect of compression can be expressed.

Action Potentials↗
PubMed1998

The advantage of magnetic resonance imaging in diagnosis of cauda equina syndrome in dogs.

Three dogs were evaluated in our study using magnetic resonance imaging (MRI) to reveal the anatomical deformity and the degree of the lesion of cauda equina. In all dogs, MRI revealed soft tissue, such as cauda equina, epidural fat, and intervertebral disc, at the lumbosacral region clearly without contrast medium. Our results suggest that MRI has some advantages in evaluating cauda equina syndrome in dogs.

Animals↗
PubMedDate not supplied

Cauda equina syndrome secondary to disseminated zygomycosis.

We describe a case of cauda equina syndrome secondary to disseminated zygomycosis. A 52-year-old man had myelodysplastic syndrome, progressive weakness of the lower extremities, and incontinence. Neuroradiological findings were consistent with lumbar stenosis and probable disk herniation. A lung lesion was also discovered on the chest roentgenogram. The patient's condition rapidly deteriorated after surgical decompression. Attempts at determining other etiologies were unsuccessful. At autopsy, disseminated zygomycosis was found affecting the lung and the vasculature of the cauda equina and lumbosacral nerve roots, with resultant focal demyelination of these structures. Ribbon-like hyphal elements were also present in the caudal roots. This opportunistic pathogen is discussed along with the diagnostic challenge presented by its unusual clinical presentation.

Autopsy↗
PubMed1998

Posterior epidural migration of an extruded lumbar disc fragment causing cauda equina syndrome. Clinical and magnetic resonance imaging evaluation.

STUDY DESIGN: Retrospective case report. OBJECTIVES: To illustrate the rare occurrence of cauda equina syndrome resulting from posterior epidural disc fragment migration documented by magnetic resonance imaging. SUMMARY OF BACKGROUND DATA: Disc fragment migration patterns are generally limited by the attachments of the posterior longitudinal ligament and its associated "midline septum" and "peridural" or "lateral membrane." The majority of symptomatic lumbar disc herniations are noted to be in a lateral position with resultant nerve root irritation. Although caudal, rostral, and lateral migration of disc fragments are common, posterior epidural migration of an extruded disc fragment has been reported only rarely, and only once in association with cauda equina syndrome. METHODS: The patient described in this report presented with an acute cauda equina syndrome. Investigation with magnetic resonance imaging revealed a posterior epidural mass, which was hypointense on T1-weighted and T2-weighted images. Postgadolinium imaging showed rim enhancement of the lesion. The preoperative differential diagnosis included epidural abscess, hematoma, or neoplasm. An urgent decompressive lumbar laminectomy was performed. At surgery, the lesion proved to be a massive extruded disc fragment. RESULTS: At the 1-year follow-up examination, the patient had recovered full motor, sensory, urologic, and sexual function. CONCLUSIONS: Extruded disc fragments may migrate posterior to the thecal sac. Magnetic resonance images of a posterior disc fragment may mimic those of other more common posterior epidural lesions.

Cauda Equina↗
PubMed2000

Intraneural growth of a capillary haemangioma of the cauda equina.

Solitary intraneural haemangiomas are very rare. A case of intraneural capillary haemangioma involving two nerve roots of the cauda equina is reported. The patient was a 63-year-old woman with a three years history of intermittent lumbalgia and numbness of the ventral surface of the left thigh. Magnetic resonance imaging detected an intradural extramedullary nodular space occupying mass at the level of the conus medullaris. Laminectomy of T12 and complete removal of the tumour were performed. Histopathological analysis demonstrated a capillary haemangioma. The tumour was located within the sheaths of a spinal nerve root. The lesion consisted of a myriad of small and very small vessels, reticularly arranged with normal nerve fascicles dispersed within the nodules of clustered capillaries. The present case of an intraneural capillary haemangioma of the cauda equina appears to be one of the first reported examples of this entity in the world's literature. The clinical presentation, diagnostic procedures and therapeutic options of intraneural haemangiomas of the conus medullaris and cauda equina are discussed. The current literature is reviewed.

Cauda Equina↗
PubMed1997

Clinical analysis of two-level compression of the cauda equina and the nerve roots in lumbar spinal canal stenosis.

STUDY DESIGN: This study is a prospective, clinical study assessing the efficacy of selective decompression of the responsible level in two-level stenosis in accordance with neurologic findings defined by the gait load test, and functional diagnosis based on selective nerve root block. OBJECTIVE: To clarify the clinical features of two-level stenosis regarding the neurologic level responsible for the symptoms, neurogenic intermittent claudication, and the outcome of selective decompression. SUMMARY OF BACKGROUND DATA: Experimental studies have indicated that double-level compression of the cauda equina induces a more severe impairment of nerve function than does single-level compression. However, few studies have focused on the clinical importance of two-level stenosis. The clinical effects of two-level stenosis on the cauda equina and nerve roots are unknown. METHODS: A total of 81 patients with lumbar spinal canal stenosis due to spondylosis and degenerative spondylolisthesis were divided into two groups, two-level stenosis at L3-L4 and L4-L5, and one-level stenosis at L4-L5, based on myelography. The types of neurogenic intermittent claudication, the level responsible for neurologic findings, and the postsurgical outcome were compared between both groups. The level responsible for the symptoms in two-level stenosis was determined in accordance with neurologic findings on the gait load test and functional diagnosis based on a selective nerve root block. All patients underwent a prospective, selective decompression at the neurologically responsible level only. The average follow-up period was 4.6 years (range, 1-8 years). RESULTS: The patients with two-level stenosis more frequently had cauda equina symptoms than those with one-level stenosis, except patients with degenerative spondylolisthesis. It was therefore assumed that two-level stenosis was associated with cauda equina impairment, Changes in neurologic condition before and after the gait test were observed in four patients with two-level stenosis. Finally, for 28 patients with two-level stenosis, the levels responsible for the neurologic symptoms were the caudal level (L4-L5) in 22 patients, the cranial level (L3-L4) in 1 patient, and both cranial and caudal levels (L3-L4 and L4-L5) in 5 patients. All stenotic levels on the myelogram were not always symptomatic in two-level stenosis. However, in one-level stenosis, all of the responsible levels completely corresponded to the myelogram. Selective decompression only at the neurologically responsible level improved neurogenic intermittent claudication in all patients. The asymptomatic levels at which the stenotic condition was left unchanged at surgery did not become symptomatic at follow-up; in addition, there was no significant difference in the postoperative outcome between two-level stenosis and one-level stenosis. CONCLUSIONS: Two-level stenosis in patients with lumbar spondylosis is associated with production of cauda equina lesions. The gait load test provides information regarding changes in symptoms and neurologic condition during exercise. The responsible levels should be determined based on neurologic findings after the gait load test and a selective nerve root block. It is uncommon for both stenotic levels to be symptomatic in patients with two-level stenosis. Less invasive surgery such as selective decompression for the responsible level in patients with two-level stenosis is a useful technique with a good potential for long-term success.

Aged↗
PubMed1979

Lipoma of the cauda equina: case report and review of the literature.

Lipoma of the cauda equina is an uncommon condition, accounting for some 1% of spinal tumours. The literature is reviewed and the case is reported of a 41-year-old diabetic woman, who was seen in 1968 with a 37-year history of left foot deformity followed by left leg weakness and sensory loss resulting in a left below-knee amputation, with subsequent development of osteomyelitis and a chronic sinus, and of urinary incontinence and sensory loss in the right foot. A complete spinal block was evident below L3. Biopsy and limited removal of a portion of a lipoma of the cauda equina associated with considerable arachnoiditis was performed in 1967 and resulted in the disappearance of chronic back pain and cessation of faecal incontinence. There was partial restoration of bladder function and of perianal and left thigh sensation. This led to the patient being able to resume her household duties, and to visit friends and social functions after having been deprived of these pleasures for many years. Her condition has been well maintained since.

Cauda Equina↗
PubMed1996

Epidural hematoma of a cauda equina in a child with hemophilia A.

PURPOSE: The presenting signs, treatment, and outcome of an epidural hematoma of the cauda equina in a child with severe hemophilia are reported for the first time. PATIENTS AND METHODS: A 20-month-old boy with severe hemophilia A (factor VIII <0.01 U/ml) presented with a 12-day history of refusal to stand and constipation of 5-7 days duration. He had normal deep tendon reflexes with normal sensation and withdrawal to pinprick of his lower extremities bilaterally. He stood on his right leg, but had inversion of his left foot and refused to bear weight on his left leg. MRI revealed an epidural hematoma of the cauda equina and a distended bladder. Factor VIII replacement therapy and lumbosacral laminectomy with evacuation of the hematoma resulted in recovery of a normal gait, but bladder dysfunction persisted for 11 months. Clean intermittent catheterization (CIC) was required until bladder function returned. RESULTS: Complete neurologic recovery occurred 11 months after presentation CONCLUSION: This case demonstrates the following points: (a) an epidural hematoma of the cauda equina in a child with severe hemophilia can present with neurologic findings that are as subtle as those seen in normal children; (b) CIC can be performed safely over an extended period without factor VIII replacement; and (c) complete recovery is possible, despite prolonged bladder dysfunction and a 12-day interval between the onset of symptoms and treatment.

Cauda Equina↗