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1.
Article in Spanish | LILACS, BINACIS | ID: biblio-1353936

ABSTRACT

Introducción: Los hemangiomas agresivos constituyen el 1% del total de los hemangiomas vertebrales. Pueden producir dolor, fracturas, deformidad y compromiso neurológico, generalmente de larga evolución. Se han descrito diferentes opciones terapéuticas, pero el manejo óptimo sigue sin estar claro. Comunicamos dos casos de paraparesia aguda secundaria a un hemangioma torácico agresivo, describimos su tratamiento y evolución. Realizamos una revisión narrativa de la bibliografía. Conclusión: Mediante la descompresión y la artrodesis tempranas seguidas de radioterapia, se logró la recuperación neurológica completa y el control de la enfermedad en un seguimiento a mediano plazo. Nivel de Evidencia: IV


Introduction: Aggressive hemangiomas make up 1% of all vertebral hemangiomas. They can produce pain, fractures, deformity and slowly progressive neurological compromise. Different treatment approaches have been described, but optimal management remains unclear. We report two cases of acute paraparesis secondary to aggressive thoracic hemangioma, we describe their treatment and evolution. We carry out a narrative review of the literature on vertebral hemangiomas. Conclusion: Through early decompression and arthrodesis followed by local adjuvant radiotherapy, we obtained complete neurological recovery and disease control in a medium-term follow-up. Level of Evidence: IV


Subject(s)
Adult , Radiotherapy , Spinal Neoplasms , Acute Disease , Paraparesis , Hemangioma
2.
Rev. bras. ortop ; 55(6): 796-799, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1156192

ABSTRACT

Abstract Gout is a crystalline arthropathy frequent in the population, but gouty spondyloarthropathy, also called axial gout, is uncommon. The current case report presents a rare case of cervical myelopathy secondary to axial gout. A 50-year-old female patient, without previous pathologies, presented with loss of strength, altered sensitivity, and pyramidal release for 2 years. The computed tomography showed a lytic image in the spinous process of C7, and signs of myelopathy with myelomalacia on magnetic resonance imaging of the cervical spine. After the surgical procedure and biopsy of the material, the diagnosis was gout, and treatment for the pathology was started, with complete improvement of the condition. The diagnosis of axial gout should be included in the spectrum of the differential diagnosis of diseases that affect the spine. Although gouty spondyloarthritis (or spondylitis) is uncommon, there is an underestimated occurrence due to the lack of investigation of the cases. The early diagnosis and treatment of the pathology can prevent patients from presenting complications of the disease, as reported in the present study.


Resumo A gota é uma artropatia cristalina frequente na população; entretanto, a espondiloartropatia gotosa, também chamada de gota axial, é incomum. O presente relato de caso apresenta um caso raro de mielopatia cervical secundária a gota axial. Uma paciente de 50 anos de idade, sem patologias prévias, apresentou quadro de perda de força, alteração de sensibilidade e liberação piramidal há 2 anos. A tomografia computadorizada evidenciou imagem lítica no processo espinhoso de C7, e sinais de mielopatia com mielomalácia foram observados na ressonância magnética da coluna cervical. Após o procedimento cirúrgico e biópsia do material, o diagnóstico foi de gota, e o tratamento para a patologia foi iniciado, com melhora completa do quadro. O diagnóstico de gota axial deve ser incluído no espectro do diagnóstico diferencial das doenças que acometem a coluna vertebral. Apesar de a espondiloartrite gotosa ser incomum, há uma ocorrência subestimada devido a não investigação dos casos. O diagnóstico precoce e tratamento da patologia pode evitar que pacientes apresentem complicações da doença, como a relatada no presente estudo.


Subject(s)
Humans , Female , Middle Aged , Spinal Cord Compression , Spinal Cord Diseases , Biopsy , Magnetic Resonance Imaging , Magnetic Resonance Spectroscopy , Paraparesis , Spondylarthropathies , Diagnosis, Differential , Triquetrum Bone , Gout , Joint Diseases
3.
Rev. Hosp. Ital. B. Aires (2004) ; 39(3): 94-97, sept. 2019. ilus.
Article in Spanish | LILACS | ID: biblio-1048277

ABSTRACT

Las fístulas arteriovenosas durales medulares son malformaciones vasculares adquiridas que constituyen una causa muy infrecuente de mielopatía progresiva (5-10 casos por millón de habitantes por año). La resonancia magnética es el estudio por imágenes de elección para su diagnóstico. A continuación presentamos el caso de una paciente femenina de 89 años, que consultó a la guardia de nuestra institución por un cuadro de paraparesia moderada asociada a parestesias e incontinencia urinaria posterior a esfuerzo físico. Se le diagnosticó una fístula arteriovenosa dural medular como causante de su cuadro. (AU)


Spinal dural arteriovenous fistulas (SDAVF) are acquired spinal vascular malformations and a rare cause of progressive myelopathy (5-10 new cases per year and per 1 million inhabitants). Magnetic resonance imaging is the diagnosis modality of choice. We present a case of a 89-year-old female patient who consulted the emergency department of our institution because of paraparesis and lower extremities paresthesias associated with urinary incontinence post physical effort. With the final diagnosis of spinal dural arteriovenous fistula, as a cause of the clinical symptoms. (AU)


Subject(s)
Humans , Male , Female , Middle Aged , Aged, 80 and over , Arteriovenous Fistula/diagnostic imaging , Dura Mater/abnormalities , Paresthesia , Atrial Fibrillation/complications , Spinal Cord Diseases/diagnostic imaging , Tobacco Use Disorder/complications , Urinary Incontinence , Arteriovenous Fistula/etiology , Arteriovenous Fistula/epidemiology , Low Back Pain/complications , Aortic Aneurysm, Abdominal/complications , Paraparesis , Fecal Incontinence , Hypertension/complications , Hypesthesia , Erectile Dysfunction , Anticoagulants/therapeutic use
4.
Pesqui. vet. bras ; 39(1): 32-39, Jan. 2019. ilus
Article in English | LILACS, VETINDEX | ID: biblio-990241

ABSTRACT

Clinical and pathological features of bovine lymphoma involving the spinal cord were evaluated through a retrospective study of the necropsy database from 2005 to 2017. Thirty-four cases of bovine lymphoma were found, 24 of which had central nervous system involvement restricted to the spinal cord. All cattle were Holstein cows 2.5-12 years-old (median age, six years-old). The clinical course was 7-21 days, and the main neurological sign was pelvic limb paresis (81.8%). The lymphoma often affected the spinal cord in a multifocal manner. Lumbar segments were the mostly affected sites (23/24), followed by the sacral segments and cauda equina (20/24), cervical (5/24) and thoracic (5/24) segments. Tumors were in the epidural space, peripheral to the pachymeninges (extradural) and between layers of adipose tissue. In addition, two cases had progressive hemorrhagic myelomalacia. Further organs affected included the lymph nodes (100%), abomasum (79.2%), heart (75%) and kidneys (45.8%). Microscopically, all lymphomas had a diffuse pattern, with no meningeal or medullar infiltration. According to the REAL/WHO classification, all these neoplasms were mature B-cell lymphomas. Diffuse large B-cell lymphoma (DLBCL) was observed in 95.8% (23/24) of the cases. The following subtypes were observed in the DLBCL group in descending order: immunoblastic (60.9%, 14/23), centroblastic (26.1%, 6/23), anaplastic (8.7%, 2/23) and T-cell rich (4.3%, 1/23).(AU)


Os aspectos clínicos e patológicos do linfoma bovino afetando a medula espinhal foram avaliados através de um estudo retrospectivo dos protocolos de necropsia durante o período de 2005-2017. De um total de 34 bovinos com linfoma, 24 apresentaram afecção do sistema nervoso central (SNC) restrito a medula espinhal. Todos os bovinos afetados eram fêmeas, da raça Holandesa, com 2,5 a 12 anos de idade (idade mediana de seis anos). Clinicamente, os casos tiveram uma evolução de sete a 21 dias, com a principal alteração neurológica caracterizada por paresia de membros pélvicos, a qual foi observada em 81,8% dos casos. O linfoma afetou frequentemente a medula espinhal de maneira multifocal. Os segmentos lombares foram os mais envolvidos (23/24), seguidos pelos sacrais e cauda equina (20/24), cervicais (5/24) e torácicos (5/24). Os tumores estavam localizados no espaço epidural, periférica à paquimeninge (extradural) e associada ao tecido adiposo. Em dois casos foi também observada mielomalacia hemorrágica progressiva. Os órgãos acometidos com maior frequência, concomitantemente ao espaço epidural, foram os linfonodos (100%), abomaso (79,2%), coração (75%) e rins (45,8%). Microscopicamente, todos os linfomas exibiam um padrão difuso, sem infiltração em meninges e medula espinhal (extradural). De acordo com a classificação da REAL/WHO, todos esses neoplasmas foram incluídos como linfomas de células B maduras. O linfoma difuso de grandes células B (LDGCB) foi observado em 95,8% (23/24) dos casos. Os subtipos classificados dentro do grupo dos LDGCB's foram em ordem decrescente: imunoblástico (60,9%; 14/23), centroblástico (26,1%; 6/23), anaplásico (8,7%; 2/23), e rico em células T (4,3%; 1/23).(AU)


Subject(s)
Animals , Female , Cattle , Spinal Cord Compression/veterinary , Cattle , Enzootic Bovine Leukosis/diagnosis , Enzootic Bovine Leukosis/pathology , Paraparesis/veterinary
5.
Article in English | WPRIM | ID: wpr-759985

ABSTRACT

We encountered a very rare case of spontaneous spinal cerebrospinal fluid (CSF) leakage and a spinal intradural arachnoid cyst (AC) that were diagnosed at different sites in the same patient. These two lesions were thought to have interfered with the disease onset and deterioration. A 30-year-old man presented with sudden neck pain and orthostatic headache. Diplopia, ophthalmic pain, and headache deteriorated. CSF leakage was confirmed in C2 by radioisotope cisternography, and an epidural blood patch was performed. While his symptoms improved gradually, paraparesis suddenly progressed. Thoracolumbar magnetic resonance imaging (MRI) revealed an upper thoracic spinal intradural AC, which was compressing the spinal cord. We removed the outer membrane of the AC and performed fenestration of the inner membrane after T3-4 laminectomy. Postoperative MRI showed complete removal of the AC and normalized lumbar subarachnoid space. All neurological deficits including motor weakness, sensory impairment, and voiding function improved to normal. We present a case of spontaneous spinal CSF leakage and consecutive intracranial hypotension in a patient with a spinal AC. Our report suggests that if spinal CSF leakage and a spinal AC are diagnosed in one patient, even if they are located at different sites, they may affect disease progression and aggravation.


Subject(s)
Adult , Arachnoid , Blood Patch, Epidural , Cerebrospinal Fluid Leak , Cerebrospinal Fluid , Diplopia , Disease Progression , Headache , Humans , Intracranial Hypotension , Laminectomy , Magnetic Resonance Imaging , Membranes , Neck Pain , Paraparesis , Spinal Cord , Subarachnoid Space
7.
Rev. Pesqui. Fisioter ; 8(4): 558-563, nov., 2018. ilus
Article in English, Portuguese | LILACS | ID: biblio-968834

ABSTRACT

Introdução: A função sensorial é reconhecida como precursora da recuperação do movimento, sendo assim, os sintomas apresentados por pessoas com HTLV-1 podem trazer prejuízo na realização de atividades funcionais Objetivo: Sistematizar o conhecimento sobre alterações sensoriais em pacientes com HTLV-1. Metodologia: Trata-se de uma revisão sistemática, com a busca primária dos artigos realizada nas bases de dados Medline, via biblioteca virtual Pubmed, sendo incluídos estudos observacionais que abordaram a alteração sensorial em indivíduos com HTLV-1. A estratégia de busca foi conduzida de forma independente por dois pesquisadores e as divergências resolvidas por consenso. Resultados: Foram encontrados 44 estudos na busca primária, e destes foram incluídos quatro estudos que abordaram a alteração sensorial em indivíduos com HTLV-1, com um total de 240 participantes. Todos os artigos foram classificados como baixo risco de viés no que diz respeito à descrição da questão do estudo, resultados e discussão. Conclusão: identificou-se uma alta prevalência de dor e alteração na sensibilidade vibratória em relação às outras disfunções sensoriais, no entanto, a escassez de trabalhos publicados acerca deste tema sugere que novas abordagens sejam feitas mostrando uma grande lacuna de conhecimento a ser explorada. [AU]


Background: Sensory function is recognized as a precursor of the movement recovery. Therefore, the symptoms presented by people with HTLV-1 can result in impairment in the performance of functional activities. Aim: To systematize knowledge about sensory alterations in patients with HTLV-1. Methods: This is a systematic review, with the primary search of the articles carried out in the Medline databases, via the Pubmed virtual library, including observational studies that addressed the sensory alteration in individuals with HTLV-1. The search strategy was conducted independently by two researchers and the divergences resolved by consensus. Results: A total of 44 studies were found in the primary search, including four studies addressing sensory impairment in individuals with HTLV-1, with a total of 240 participants. All articles were classified as low risk of bias regarding the description of the study question, results and discussion. Conclusion: We identified a high prevalence of pain and altered vibratory sensitivity in relation to other sensory disorders, however, shortage of published works on this topic suggests new approaches are made showing a large knowledge gap to be explored. [AU]


Subject(s)
Viruses , Paraparesis , Sensation
8.
Rev. méd. hondur ; 86(1/2): 37-39, ene-. jul. 2018.
Article in Spanish | LILACS | ID: biblio-1007350

ABSTRACT

Introducción: Las metástasis de la columna vertebral son la manifestación de una neoplasia sistémica. Se evidencia que la prevalencia de los tumores metastásicos de la columna es alta, siendo estos 40 veces más frecuentes que todos los tumores primarios óseos combinados. La historia natural de la columna vertebral metastásica es la compresión parcial o total de la médula espinal o de las raíces nerviosas conociéndose esto como síndrome de compresión medular. Un tercio de los casos que presentan este síndrome son la primera manifestación del tumor, especialmente en el cáncer de pulmón, con tendencia a metastatizar en un 13%. Caso Clínico: Se presenta el caso de un paciente masculino de 40 años de edad, sin antecedentes de interés, quien es ingre-sado por paraparesia asociada a incontinencia urinaria y fecal; dos días después del ingreso se le realizó una resonancia magnética con gadolinio la cual reportó lesión a nivel de T3 que comprimía y ensanchaba la vértebra por lo que se le diagnóstico síndrome de compresión medular. Se le realizó una laminectomia descompresiva y biopsia dando ésta el diagnóstico de carcinoma metastásico en columna vertebral, de probable origen pulmonar según estudio inmunohistoquímico. Conclusiones: El diagnóstico y tratamiento oportuno es fundamental para revertir la evolución natural de esta enfermedad, instaurándose el tratamiento dentro de las primeras 12 a 24 h evitando así una discapacidad neurológica signiicativa...(AU)


Subject(s)
Humans , Male , Adult , Spinal Cord Compression , Paraparesis , Lung Neoplasms , Spinal Neoplasms
9.
Article in Korean | WPRIM | ID: wpr-716510

ABSTRACT

Neurocysticercosis (NCC) by Taenia solium is the most common parasitic infection of the central nervous system involving the cerebrum. However, spinal involvement of NCC is rare. Spinal NCC can cause radiculopathy, myelopathy, cauda equina syndrome, and even paraparesis, depending on its location and size. Spinal NCC may require surgical treatment as a first-line treatment because medical therapy can further aggravate the inflammation due to dead cysts, resulting in clinical deterioration. The current standard therapy for spinal NCC is surgical decompression followed by medical therapy. We experienced a case of widespread thoracolumbar intradural extramedullary cysticercosis involving the spinal canal with cerebral cysticercosis. We report this rare case with literature review.


Subject(s)
Central Nervous System , Cerebrum , Cysticercosis , Decompression, Surgical , Humans , Inflammation , Neurocysticercosis , Paraparesis , Polyradiculopathy , Radiculopathy , Spinal Canal , Spinal Cord Diseases , Spine , Taenia solium
10.
Psychiatry Investigation ; : 428-431, 2018.
Article in English | WPRIM | ID: wpr-714287

ABSTRACT

Neurologic symptoms that develop unconsciously and are incompatible with known pathophysiologic mechanisms or anatomic pathways belong to Conversion Disorder (CD). CD diagnosis is based on the clinical history and the exclusion of physical disorders causing significant distress or social and occupational impairment. In a subgroup of CD, called functional weakness (FW), symptoms affecting limbs may be persistent, thus causing a permanent or transient loss of limb function. Physiotherapy, pharmacotherapy, hypnotherapy and repetitive transcranial magnetic stimulation (rTMS) have been proposed as treatment strategies for FW-CD. Herein, we report a 30 year-old male, presenting with lower limb functional paraparesis, having obtained positive, objectively, and stable effects from a prolonged r-TMS protocol associated to a multidisciplinary approach, including psychological and sexuological counseling, and monitored by gait analysis. We postulate that our rTMS protocol, combined with a multidisciplinary approach may be the proper treatment strategy to improve FW-CD.


Subject(s)
Brain , Conversion Disorder , Counseling , Diagnosis , Drug Therapy , Extremities , Gait , Humans , Hypnosis , Lower Extremity , Male , Neurologic Manifestations , Paraparesis , Transcranial Magnetic Stimulation
11.
Asian Spine Journal ; : 734-742, 2018.
Article in English | WPRIM | ID: wpr-739270

ABSTRACT

STUDY DESIGN: Retrospective study. PURPOSE: To determine prognostic factors of neurological complications (NCs) of posterior thoracolumbar surgeries. OVERVIEW OF LITERATURE: There have been few reports on the prognosis of NCs according to the causes and treatment methods. METHODS: The subjects were 65 patients who had NCs for 19 years (1995–2013) after posterior thoracolumbar surgeries in Seoul Sacred Heart General Hospital. The degree of neurological injury was assessed using numeric scales as follows: G1, increased leg pain or sensory loss; G2, hemiparesis; G3, paraparesis; G4, cauda equine syndrome; and G5, complete paraplegia. The relative degree of neurological recovery was evaluated using four numeric scales as follows: Gr1, complete recovery; Gr2, almost complete recovery with residual sensory loss or numbness; Gr3, partial recovery with apparent neurological deficit; and Gr4, no recovery. The prognostic factors were investigated in terms of demographic and surgical variables that were available in a retrospective review. RESULTS: The causes were as follows: epidural hematoma (EH), 25 patients (38.5%); insufficient decompression and fusion, 14 patients (21.5%); mechanical injury, 11 patients (16.9%); insufficient discectomy, four patients (6.2%); and unknown, 11 patients (23.1%). The grade of neurological injury was as follows: G1, 11 patients (16.9%); G2, 34 patients (52.3%); G3, 15 patients (23.1%); G4, three patients (4.6%); and G5, two patients (3.1%). Thirteen patients received conservative treatment, and 52 underwent revision surgeries. Neurological recovery was as follows: Gr1, 21 patients (32.3%); Gr2, 17 patients (26.2%); Gr3, 20 patients (30.8%); and Gr4, seven patients (10.8%). The prognosis depended on the causes (p =0.041). The subgroup analysis of the revision group revealed a significant correlation between the degree of neurological recovery and the timing of revision, irrespective of causes (r =0.413, p =0.002). CONCLUSIONS: The prognosis of NC depended on the causes. EH was the best and unknown was the worst prognostic factor. Revision should be performed as soon as possible for a better prognosis.


Subject(s)
Decompression , Diskectomy , Heart , Hematoma , Hospitals, General , Humans , Hypesthesia , Leg , Paraparesis , Paraplegia , Paresis , Prognosis , Retrospective Studies , Seoul , Weights and Measures
12.
Acta neurol. colomb ; 33(2): 115-118, abr.-jun. 2017.
Article in Spanish | LILACS | ID: biblio-886432

ABSTRACT

RESUMEN Se reporta un caso de mielopatía por HTLV-1 en paciente afrodescendiente en su sexta década de vida, procedente de Popayán, Cauca. Presentó sintomatología no típica desde años atrás, pero en los últimos meses aparecieron síntomas característicos y por ello se realizó diagnóstico de HTVL-1 por Elisa. La enfermedad progresó sin posibilidad de detención y solo se le pudo ofrecer manejo analgésico, terapia física y medidas de confort. Se discute la importancia de hacer un diagnóstico temprano para HTLV-1 y la necesidad de intervención antes de que la enfermedad sea incapacitante. Encontramos dos estudios, uno en Perú y otro en Brasil donde se descubren dos formas de identificar objetivamente cambios tempranos en pacientes seropositivos para este virus.


SUMMARY A case of HTLV-I myelopathy is reported in an Afro-descendant patient in his sixth decade of life, from Popa-yán Cauca Colombia. It has not been typical symptomatology since years, but in the last months characteristic symptoms appear and it is when diagnosis of HTVL-1 is made by Elisa (9.51 positive). The disease progresses without the possibility of arrest and can only be offered analgesic management, physical therapy and comfort measures. The importance of making an early diagnosis for HTLV-1 and the need for intervention before the disease is disabling is discussed. We found two studies, one in Peru and one in Brazil, where two ways of objectively identifying early changes in seropositive patients.


Subject(s)
Retroviridae , Spinal Cord Diseases , Paraparesis , Muscle Spasticity
13.
Article in English | WPRIM | ID: wpr-91200

ABSTRACT

OBJECTIVE: To examine the effect of meningomyelocele sac size on prognosis by retrospective review of 64 cases operated for meningomyelocele between January 2009 and December 2012. METHODS: We evaluated newborn babies operated for meningomyelocele by retrospectively reviewing their files for head circumference, location and with of the defect, accompanying anomalies, treatments administered, drugs that mother used during pregnancy. Based on the defect size, 3 patient groups were created as 0–24 cm² (group I), 25–39 cm² (group II), and 40 cm² and above (group III). RESULTS: Throughout the study, 64 babies were evaluated. Mean head circumference was 37.4 cm (range, 30.7–50 cm). Based on their location, 49 of the defects (76.5%) were lumbar, 7 (10.9%) were thoracolumbar, 4 (6.2%) were thoracic, 3 (3.1%) were sacral, 1 (1.5%) was cervical. Mean size of the meningomyelocele sac was 4.7 cm×5.8 cm (range, 1 cm×1 cm—10 cm×8 cm), 13 of the babies (20.3%) had skin defect requiring flap. According to accompanying anomalies, 47 of the babies (73.4%) had hydrocephalus, 7 (10.9%) had club foot, 1 (1.5%) had diastematomyelia, 1 (1.5%) had tethered cord. Thirty-nine of the babies (60.9%) had paraplegia, 10 (15.6%) had paraparesis, 8 (12.5%) had monoplegia; neurological examination in the remaining 7 babies was normal. CONCLUSION: In our study, increased diameter of meningomyelocele sac was associated with greater amount of neural tissue within the sac, which worsens the prognosis. Sac localization was not changing prognosis but infection rates, hospitalization duration were increased in babies with bigger diameter of sacs.


Subject(s)
Foot , Head , Hemiplegia , Hospitalization , Humans , Hydrocephalus , Infant, Newborn , Meningomyelocele , Mothers , Neural Tube Defects , Neurologic Examination , Paraparesis , Paraplegia , Pregnancy , Prognosis , Retrospective Studies , Skin
14.
Article in English | WPRIM | ID: wpr-64990

ABSTRACT

BACKGROUND: We aimed to evaluate the incidence, predictive factors, and impact of acute kidney injury (AKI) after thoracic endovascular aortic repair (TEVAR). METHODS: A total of 53 patients who underwent 57 TEVAR operations between 2008 and 2015 were reviewed for the incidence of AKI as defined by the RIFLE (risk, injury, failure, loss, and end-stage kidney disease risk) consensus criteria. The estimated glomerular filtration rate was determined in the perioperative period. Comorbidities and postoperative outcomes were retrospectively reviewed. RESULTS: Underlying aortic pathologies included 21 degenerative aortic aneurysms, 20 blunt traumatic aortic injuries, six type B aortic dissections, five type B intramural hematomas, three endoleaks and two miscellaneous diseases. The mean age of the patients was 61.2+/-17.5 years (range, 15 to 85 years). AKI was identified in 13 (22.8%) of 57 patients. There was an association of preoperative stroke and postoperative paraparesis and paraplegia with AKI. The average intensive care unit (ICU) stay in patients with AKI was significantly longer than in patients without AKI (5.3 vs. 12.7 days, p=0.017). The 30-day mortality rate in patients with AKI was significantly higher than patients without AKI (23.1% vs. 4.5%, p=0.038); however, AKI did not impact long-term survival. CONCLUSION: Preoperative stroke and postoperative paraparesis and paraplegia were identified as predictors for AKI. Patients with AKI experienced longer average ICU stays and greater 30-day mortality than those without AKI. Perioperative identification of high-risk patients, as well as nephroprotective strategies to reduce the incidence of AKI, should be considered as important aspects of a successful TEVAR procedure.


Subject(s)
Acute Kidney Injury , Aortic Aneurysm , Comorbidity , Consensus , Endoleak , Glomerular Filtration Rate , Hematoma , Humans , Incidence , Intensive Care Units , Kidney Failure, Chronic , Mortality , Paraparesis , Paraplegia , Pathology , Perioperative Period , Retrospective Studies , Risk Factors , Stroke
15.
Korean Journal of Spine ; : 71-73, 2016.
Article in English | WPRIM | ID: wpr-168437

ABSTRACT

A rare case of solitary diffuse large B-cell lymphoma arising from the lumbar spinal nerve root is reported. A 37-year-old man presented with a 3-month history of progressive numbness and paraparesis in both legs. The initial diagnosis was benign primary intradural extramedullary tumor including schwannoma and meningioma. Histopathological examination revealed diffuse large B-cell lymphoma. While a well-defined T1 isointense mass is common in primary spinal schwannoma, the present case was atypical and had a yellowish neural component. The pathogenesis and radiological findings of spinal diffuse large B-cell lymphoma are discussed and related literature is reviewed.


Subject(s)
Adult , B-Lymphocytes , Diagnosis , Humans , Hypesthesia , Leg , Lymphoma, B-Cell , Meningioma , Neurilemmoma , Paraparesis , Spinal Cord Compression , Spinal Nerve Roots , Spine
16.
Korean Journal of Spine ; : 77-79, 2016.
Article in English | WPRIM | ID: wpr-168435

ABSTRACT

Thoracic spinal cord herniation is a rare disease cause of progressive myelopathy. Magnetic resonance image is a useful tool to diagnose preoperatively. Operation is a treatment of option. Sixty-six-year-old female visited Dong-A University Medical Center for progressive gait disturbance with falling tendency to right side. She had radiating pain and tingling sense on both leg. Sense of touch and temperature was decreased below T6 level. Both hip and knee motor power were grade IV. Magnetic resonance imaging scan showed anterior displacement of the spinal cord at T4-T5 vertebral level. Under the diagnosis of thoracic spinal cord herniation with dura defect, operation was performed for the patient with intraoperative neuromonitoring. Laminectomy at T4 and T5 level was done, and intradural exploration of the spinal cord revealed dura defect about 25mm×8mm in size. Spinal cord was released under microscope and dura defect was repaired with Lyoplant. The patient's symptom improved after the surgical procedure, but touch and temperature sense under T6 level had unchanged.


Subject(s)
Academic Medical Centers , Accidental Falls , Diagnosis , Female , Gait , Hernia , Hip , Humans , Knee , Laminectomy , Leg , Magnetic Resonance Imaging , Paraparesis , Rare Diseases , Spinal Cord Diseases , Spinal Cord , Thermosensing , Thorax
17.
Korean Journal of Spine ; : 80-82, 2016.
Article in English | WPRIM | ID: wpr-168434

ABSTRACT

Fractures in ankylosing spondylitis (AS) are often difficult to identify and treat. If combined with osteoporosis, the spine becomes weaker and vulnerable to minor trauma. An 83-year-old woman with a history of chronic AS and severe osteoporosis developed paraparesis and voiding difficulty for 4 days prior. She had been placed in the lateral decubitus position in a bedridden state in a convalescent hospital due to the progressive paraparesis. The laboratory findings showed CO₂ retention in the arterial blood gas analysis. After the patient was transferred to the computed tomography (CT) room, a CT was taken in the supine position. Approximately half an hour later, the resident in our neurosurgical department checked on her, and the neurological examination showed a complete paraplegic state. She was treated conservatively and finally expired 20 days later.


Subject(s)
Aged, 80 and over , Blood Gas Analysis , Female , Hospitals, Convalescent , Humans , Neurologic Examination , Osteoporosis , Paraparesis , Spinal Fractures , Spine , Spondylitis, Ankylosing , Supine Position
18.
Arq. bras. neurocir ; 34(3): 220-224, ago. 2015. ilus
Article in Portuguese | LILACS | ID: biblio-2363

ABSTRACT

Lipomatose epidural é a doença causada pelo aumento da quantidade de gordura no espaço epidural da coluna vertebral, levando à compressão medular ou radicular. A medula toracolombar é a mais comumente envolvida. É geralmente encontrada em homens. As principais causas são a obesidade, altos níveis de corticoides exógenos ou endógenos e hipotireoidismo. A forma idiopática é rara, correspondendo a 17% dos casos. Manifesta-se como mielopatia compressiva ou das raízes da cauda equina. A ressonância magnética é o exame de escolha; sugere-se o diagnóstico quando a espessura da camada de gordura epidural ultrapassa 6 mm. Nós adotamos neste caso a laminectomia com ressecção da gordura epidural, citada como uma das possíveis formas de tratamento. A maioria dos trabalhos demonstramelhora gradual, acentuada ou completa, do déficit neurológico nos primeiros 2 anos após a cirurgia.


Epidural lipomatosis is a disease caused by increased fat content in the epidural space of the spine, leading to root or spinal cord compression. The thoracolumbar spinal cord is themost commonly involved. It is usually found in men. Themain causes are obesity, high levels of exogenous or endogenous steroids and hypothyroidism. The idiopathic form is rare, accounting for 17% of cases. It manifests as compressive myelopathy or radiculopathy. MRI is the test of choice, suggests the diagnosis when the thickness of the epidural fat exceeds 6mm. We adopt in this case laminectomy with fat resection, cited as one of the possible forms of treatment. Most studies show a gradual improvement, marked or complete neurological recovery in the first two years after surgery.


Subject(s)
Humans , Male , Adolescent , Adult , Middle Aged , Lipomatosis/diagnosis , Lipomatosis/pathology , Spinal Cord Compression , Epidural Space/pathology , Paraparesis
19.
Rev. méd. hered ; 26(2): 98-102, abr.-jun. 2015. ilus
Article in Spanish | LIPECS, LILACS, LIPECS | ID: lil-752367

ABSTRACT

Se presenta el caso de una mujer de 51 años que desarrolló paraparesia y una masa abdominal palpable más pérdida de peso en el lapso de cuatro meses. La masa destruía la 5ª vértebra lumbar y se extendía a los tejidos blandos adyacentes. En suero se halló un patrón de gamapatía monoclonal por cadenas ligeras de tipo lambda. La punción aspiración de la masa reveló un plasmocitoma. El paciente recibió radiación y quimioterapia. Fue dada de alta con disminución de la paraparesia. (AU)


A 51 year-old woman developed paraparesis, a palpable abdominal mass and weight loss during the last four months. A mass that was destroying the 5th lumbar vertebra and invading the adjacent soft tissues was found. A monoclonal gamopathy pattern in serum due to light chain type lambda was shown. The patient received radiation plus chemotherapy. She was discharged with amelioration of paraparesis. (AU)


Subject(s)
Humans , Female , Middle Aged , Plasmacytoma , Paraparesis , Multiple Myeloma
20.
Korean Journal of Spine ; : 193-195, 2015.
Article in English | WPRIM | ID: wpr-56401

ABSTRACT

Spinal cord compressing syndrome due to synovial cyst (SC) of the thoracolumbar spine is a rare clinical condition. In this report we aim to heighten awareness of the thoracolumbar facet synovial cyst as a possible cause of thoracic myelopathy. The SC was removed thoroughly by laminectomy. The patient had an excellent recovery. The etiological and therapeutic aspects are discussed.


Subject(s)
Humans , Laminectomy , Paraparesis , Spinal Cord , Spinal Cord Diseases , Spine , Synovial Cyst
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