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At least 1,639 records · Page 91Linked to original sources
PubMed1987

Somatosensory evoked potentials following pudendal nerve stimulation as indicators of low sacral root involvement in a postlaminectomy patient.

Somatosensory cortical evoked potential studies (SEPs) following stimulation of the pudendal nerves proved useful in objectively documenting preoperative low sacral root involvement in a 33-year-old postlaminectomy patient, presenting with impending cauda equina syndrome and treated by piriformis muscle release with good clinical results. Preoperative P40(P1) latencies of SEPs were abnormally prolonged (47 msec) and returned to normal values (38 msec) postoperatively. This new noninvasive electrodiagnostic method has been described previously for normal subjects only. Further experience with this method is still needed, especially to elucidate the diagnostic reliability of various SEP parameters.

Adult↗
PubMedDate not supplied

Asymmetrical, transitional, lumbosacral vertebral segments in six dogs: a characteristic spinal syndrome.

Clinical findings in six dogs with asymmetrical, transitional, lumbosacral vertebral segments are reported. All dogs exhibited low back pain and varying degrees of asymmetrical cauda equina dysfunction. Results of myelography, epidurography, and magnetic resonance imaging (MRI) indicated a unilateral disk protrusion in all dogs. In the dogs with MRIs, focal degenerative alterations in the vertebral end plates and adjacent body of the vertebra were detected. All dogs were treated with a dorsal laminectomy or hemilaminectomy. Results following surgery were good or excellent in all six dogs.

Animals↗
PubMedDate not supplied

Case report: MR findings of Guillain-Barré syndrome.

Guillain-Barré syndrome (GBS) is characterized as an acute, symmetrically progressive, inflammatory demyelinating polyneuropathy. We report a case of GBS in which gadolinium-enhanced magnetic resonance (MR) imaging showed marked enhancement of nerve roots of the conus medullaris and cauda equina. On enhanced MR imaging, the spinal cord and nerve roots in the thecal sac generally do not take up much gadolinium because of the blood-nerve barrier or blood-brain barrier. Therefore, in our case, marked enhancement of nerve roots indicates a breakdown of the blood-nerve barrier. It is thought to correlate with the inflammatory infiltration of GBS.

Cauda Equina↗
PubMed1981

Acute and chronic effects of intrathecal morphine in monkeys.

In a double-blind study, seven Macaca fascicularis monkeys receiving intrathecal (i.t.) morphine in saline, 0.07 mg kg-1, were compared with a control group of four monkeys receiving either lumbar puncture alone (n = 1) or i.t. saline (n = 3). Neither morphine nor saline solutions contained preservatives. Arterial blood gas tensions, respiration, arterial pressure, e.c.g., state of consciousness and motor function were recorded for 24 h. The control group was sacrificed 42 days later and the study group was sacrificed at 6 (n = 2) or 42 days (n = 5) after injection. The central nervous system, meninges, nerve roots and dorsal root ganglia were examined macroscopically and microscopically. Respiratory depression did not occur in either the control or the study groups. There were moderate but statistically significant decreases in systolic and diastolic arterial pressures following i.t. morphine. In both groups, the pathological findings were localized to the cauda equina region and characterized by mononuclear cell infiltration. In neither group was there evidence of demyelination, arachnoiditis or necrosis. Focal endoneurial fibrosis was found in only one animal in the control group following multiple lumbar punctures associated with paraesthesia. The features appeared to correlate with the physical trauma associated with lumbar puncture rather than with the injectate.

Animals↗
PubMed1985

Pharmacokinetics and excretion of iohexol after lumbar myelography in man.

Pharmacokinetics and excretion of iohexol, a new nonionic water-soluble contrast medium, were determined after lumbar myelography. Peak plasma concentrations were obtained 2 to 6 hours after injection and ranged from 29 to 177 microgram/ml. Terminal elimination half-life was 4.0 hours, and over 90% of the dose was recovered in the urine within 24 hours. In one patient with a large lumbar cauda equina tumor, absorption and excretion were delayed; but eventually 99% was recovered indicating a large capacity for reabsorption via the lumbar subarachnoid space. One mild headache of 5 minutes' duration was reported in a 73-year-old woman. No significant changes in vital signs, neurologic examinations, or serum chemistries were observed.

Adult↗
PubMed1991

The role of radiation therapy in the management of hematopoietic neurologic complications in thalassemia.

Extramedullary hematopoiesis is encountered in some severe anemic conditions. Very rarely it may cause neurologic symptoms, leading to spinal cord or cauda equina compression. Two patients with thalassemia who developed neurologic complications are described. Diagnosis was based on clinical findings, CT scan and magnetic-resonance imaging (MRI). The two patients responded successfully to irradiation and blood transfusion. The prognosis is excellent, if recognized at an early stage. Our experience supports the role of radiation therapy as standard treatment for this complication.

Adult↗
PubMedDate not supplied

[Clinical characteristics of chronic post-traumatic spinal neurogenic pain syndrome].

In order to define clinical features of chronic posttraumatic spinal neurogenic pain syndrome we have analyzed a group of 23 patients with posttraumatic neurogenic pain. Patients (21 males and 2 females) were aged from 22 to 59 years, averagely 35.8 years. Painful sensations had the character of mechanical-incisive pain in 7 (30%) patients, and thermal pain equivalents in 3 (13%) patients. In 13 (57%) patients, sensor structure of this painful state had the character of associated thermal and mechanical painful sensations. Typical posttraumatic chronic spinal syndrome in our group of patients had persistent thermal qualities, of fluctuating intensity, with periodical, intensive pain onsets of mechanical character. Level of conus and cauda equina is predilectional level of the lesion for the development of intensive pain syndrome. Posttraumatic pain syndrome can be classified as intermittent and steady pain in relation to the rhythm of its manifestation, and as diffuse and dermatomal pain in relation to extension, in which painful state of occasional rhythm and dermatomal topography is the optimal indication for operative neurosurgical treatment.

Adult↗
PubMed1994

[Spinal stenosis and instability of the lumbar spine. Current aspects of pathophysiology and pain mechanisms].

The pathophysiology of spinal stenosis and segmental instability is discussed. The critical magnitude of the cross-sectional area of the cauda equina in the lower part of the vertebral canal is related to the dynamic loading of the spine, nerve impulse conduction and nerve root nutrition. Present knowledge of segmental instability is discussed, and an account is given of findings obtained during dynamic measurements with an intervertebral motion device (IMD), which indicate pathological motion patterns to differ from one pair of vertebrae to another.

Adult↗
PubMed1975

The spinal evoked response in infants and children.

Summated responses to peroneal nerve stimulation were recorded from surface electrodes placed over the spine of 60 infants and children. These potentials generally were greater in amplitude in infants than in older children. Over the cauda equina and rostral cord, initially positive triphasic potentials were recorded. Over the caudal cord, complex potentials were recorded in children less than three years of age. The conduction velocity of the response from midlumbar to lower cervical recording sites was less in infants than in older children and progressively increased with age, reaching adult values after the fourth year.

Adolescent↗
PubMed1997

Rheumatologic emergencies.

True rheumatologic emergencies are rare but they do occur. In many cases, the initial assessment, diagnosis, and treatment will rest in the hands of the primary care physician. Most common is acute onset of inflammatory arthritis. Properly diagnosed, adequate to dramatic improvements are usual with appropriate treatment. No less pressing are the neurologic emergencies such as spinal stenosis, cauda equina syndrome, and GCA. Among these, the potential for neurologic complications is high, so prompt diagnosis and treatment are essential. Cervical spine involvement in RA is common; again, neurologic complications are possible. The role of mechanical stabilization via surgery is not as well delineated but should be considered in patients with intractable pain due to C1-C2 facet joint disease and those with progressive neurologic deficiencies.

Arthritis, Infectious↗
PubMed2003

Inflammatory myofibroblastic tumour of the spinal cord: case report and review of the literature.

Inflammatory myofibroblastic tumours (IMT), also called inflammatory pseudotumours, nodular lymphoid hyperplasia, plasma-cell granuloma and fibrous xanthoma, are rare soft-tissue lesions characterised by inflammatory cells and a fibrous stroma. Clinically and radiologically, they may look like malignant tumours. They rarely affect the central nervous system and are very rare in the spinal cord. We report an IMT of the spinal cord in a 22-year-old woman presenting with spinal cord compression and a cauda equina syndrome. MRI showed a lesion at T9 with extramedullary and intramedullary components giving low signal on T2-weighted images and enhancing homogeneously. Pial lesions on the lumbar enlargement and thoracic spinal were present 11 months after surgery, when the lesion recurred. We present the radiological, operative and pathological findings and review the literature.

Adult↗
PubMed1996

Extramedullary haematopoiesis in thalassaemia: results of radiotherapy: a report of three patients.

Extramedullary haematopoiesis is sometimes encountered in severe anaemia. Rarely, it may cause neurological symptoms, leading to spinal cord or cauda equina compression. Three patients with thalassaemia intermedia, who developed neurological complications, are described. The diagnoses were based on the clinical findings, computed tomography and magnetic resonance imaging. Small doses of radiotherapy (10-20 Gy in 5-10 fractions) relieved symptoms in all of these patients. Our experience supports the role of radiation therapy as a treatment for this complication.

Adult↗
PubMed1981

Intradural spinal metastases.

A medullary cone metastasis from an adenocarcinoma of esophagus, and a solitary lumbar spinal nerve root metastasis from a breast carcinoma, gave rise to two cases of cauda equina syndrome. Muscle strength in the lower limbs improved postoperatively, while the disturbances of bladder, bowel, and pelvic floor function remained unchanged in the 1st case. The second patient benefited from operation, and regained useful life despite vertebral osseous involvement. It is suggested that tumour cells reached the spinal cord and the subarachnoid space by haematogeneous spread and by way of perineural lymphatics respectively.

Adenocarcinoma↗
PubMed1976

Subarachnoid block and enlargement of the spinal canal in hypertrophic neuritis.

A case of Dejerine-Sottas hypertrophic neuritis is reported. The patient, a 45-year-old male, suffered from chronic hypertrophic polyneuropathy, abnormal pupils, fasciculations, tremor, back pain, impotence, sphincter disorders, cramps, and lightning pains in the lower extremities. Besides extensive subarachnoid block, there was X-ray evidence of enlargement of the bony spinal canal with scalloping of the lumbar vertebrae. Surgical exploration showed these abnormalities to be due to extreme hypertrophy of the cauda equina. Histologic findings in peripheral nerve and lumbar root biopsies were typical of hypertrophic neuropathy of the onion bulb type. Vertebral changes secondary to hypertrophied nerve roots appear not to have been described before in hypertrophic neuritis; however, knowledge of their possible occurrence may be of practical importance in the management of similar future cases. A simple way of visualizing enlarged peripheral nerves is briefly described.

Cauda Equina↗
PubMed1984

Spinal cord compression secondary to Gaucher's disease.

A case of compression of the spinal cord and cauda equina secondary to collapse of the T-12 and L-3 vertebral bodies in a patient with type 1 Gaucher's disease is presented. Decompressive laminectomies were done at both the T-12 and L-3 levels with moderate improvement of the patient's neurologic findings. Histologic examinations confirmed the presence of Gaucher's cells in the bone. Review of the literature revealed only one previous report.

Cauda Equina↗
PubMed1992

Case report: arachnoiditis following intracranial 'Thorotrast'.

A patient is reported with a painless, progressive cauda equina lesion due to arachnoiditis, the result of the contrast medium 'Thorotrast' (thorium dioxide) introduced into the brain over 30 years previously. Contrast medium introduced into the lumbar spine can give rise to aseptic adhesive inflammation (arachnoiditis). It rarely gives rise to clinical problems but, when it does so, is usually associated with back pain and only very rarely with progressive neurological deficit.

Abscess↗
PubMed1992

Application of superfine fiberscope for endovasculoscopy, ventriculoscopy, and myeloscopy.

In the past three years, we have used a superfine fiberscope for endovasculoscopy, ventriculoscopy, and myeloscopy. Flexible superfine fiberscope, 0.75 mm in outer diameter, could visualize various intravascular findings. In in-vivo canine experiment, sequential changes of thrombus produced by endothelial abrasion by needle or balloon in the canine carotid artery can be clearly seen. And thrombolysis by focal arterial injection of tissue plasminogen activator was sequentially observed. In the clinical study, we could evaluate the stenotic lesions of the subclavian and vertebral arteries before and after balloon angioplasty. During ventriculoscopy, a 2 mm of mini-caliber fiberscope was introduced under ultrasound monitoring, and provided clear visualization of intraventricular tumours. In myeloscopy, draining veins of arteriovenous malformations and nerve roots of the cauda equina could be clearly seen by flexible fiberscope. From these results, it can be said that the superfine fiberscope provides clear and useful visualizations of the interior of vessels, ventricles, and the intrathecal area of the spinal canal. The new applications of this superfine fiberscope for minimally invasive neurosurgery may bring about a marked improvement of therapeutic results.

Animals↗
PubMed1979

Gunshot wounds to the spinal cord.

A series of 59 patients with gunshot wounds to the spinal cord is presented. Seventeen injuries were cervical, 30 were thoracic, 11 were lumbar, and one was sacral. Twenty-nine patients had immediate complete sensorimotor loss of function, 18 had sensory or motor sparing below the cord lesions, and 12 had injury of the cauda equina. Thirty-nine patients were treated with decompressive laminectomy, four with local wound debridement only, three with cervical traction and subsequent anterior cervical fusion; 13 had only conservative therapy. Eleven patients had return to normal function and 20 patients had some degree of improvement. There was no significant difference in the outcome between patients operated on and those treated conservatively.

Adolescent↗