The Cervical Herniated Intervertebral Disc Presenting with False Localizing Thoracic Sensory Levels

Symptoms of compressive cervical myelopathy classically include spasticity and weakness, predominantly involving the lower extremities. Sensory abnormalities are reportedly common in the upper extremities, but are often vague or misleading. The sensory findings are usually localized 2-3 spinal segments below the actual spinal cord compression. In our current series, 3 patients presented with progressive symptoms of weakness and hyperreflexia involving the lower extremities without upper extremity symptoms and with a distant thoracic sensory level ranging from T10 to T12. All 3 patients were eventually found to have a cervical herniated intervertebral disc. The direct physical effects of compression and vascular compromise in the central cervical cord compression may be responsible for the reported abnormality at a distinct thoracic sensory level. Failure to diagnose cervical myelopathy because of the presence of a thoracic sensory level can delay appropriate treatment or lead to incorrect therapy.

Seasonal Variation of Fibrinolytic Activity

BACKGROUND AND PURPOSE: Among the many factors having influence on seasonal incidence of thrombotic disease, we studied the seasonal variation of fibrinolytic activity, which might be thought to have influence on seasonal incidence of thrombotic disease. SUBJECT AND METHOD: Seasonal plasma tissue type plasminogen activator (t-PA) and euglobulin fibrinolytic activity (EFA) were measured in 18 male and 22 female normal volunteers during a year. RESULT: The level of t-PA was higher in winter than in spring (p<0.05), but was not significantly different in the other couples of four seasons. The level of EFA was higher in winter than in summer and in autumn (p<0.01), and was slightly higher in winter than in spring without significance. The level of EFA was higher in spring than in summer (p<0.05). There was no correlation between the level of t-PA and that of EFA in any of the seasons. CONCLUSION: The fibrinolytic activity is higher at lower temperature than at higher temperature. Thus, it seems that a rise in fibrinolytic activity in cold weather counters certain changes which make a thrombotic event.