ABSTRACT
Papilledema, is a known complication of various spinal pathologies. It has, however, been only infrequently reported following spinal injury, and may be overlooked in these cases. Presented herein is a 27 year old male who suffered thoracic and lumbar spinal injuries. Papilledema following mild increase in intracranial pressure (IICP) developed 3 weeks following trauma, and subsided within 8 weeks. The importance of routine repeat ophthalmoscopic examinations following spinal injury to detect changes characteristic of IICP is emphasized.
Subject(s)
Papilledema/etiology , Spinal Cord Injuries/complications , Acetazolamide/therapeutic use , Adult , Brain/diagnostic imaging , Dexamethasone/therapeutic use , Humans , Intracranial Pressure , Male , Ophthalmoscopy , Papilledema/diagnosis , Papilledema/drug therapy , Spinal Cord Injuries/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
Widespread periarticular new-bone formation (myositis ossificans) was studied in 45 patients with brain damage who were in long-term coma. Thirty-six of these patients displayed myositis ossificans around at least one major joint. The development of myositis ossificans was shown to be independent of the sex and age of the patient and also of the aetiology, duration and outcome of the coma. Radiographic evidence first appeared between one and two months after the onset of coma. The maximal spread of myositis ossificans was reached in the first five months after the onset of coma. Progression of the disease was not observed after 14 months. Myositis ossificans was defined as a progressive self-limiting disease found in comatose patients.
Subject(s)
Coma/complications , Myositis Ossificans/etiology , Adolescent , Adult , Child , Child, Preschool , Elbow Joint/diagnostic imaging , Female , Hip Joint/diagnostic imaging , Humans , Infant , Knee Joint/diagnostic imaging , Male , Middle Aged , Myositis Ossificans/diagnostic imaging , Radiography , Shoulder Joint/diagnostic imaging , Time FactorsABSTRACT
The cases of two adults who developed viral encephalomyelitis are presented. The diagnosis of herpes virus hominis infection was made as a result of the rising titers of herpes virus on indirect fluorescence tests in the serum and the cerebrospinal fluid. Both patients developed retinal vasculitis with retinal edema and hemorrhages. The importance of follow-up examinations of the fundus is stressed to avoid rhegmatogenous retinal detachment caused by retinal tears.
Subject(s)
Encephalitis/etiology , Herpes Simplex/diagnosis , Retinitis/etiology , Aged , Antibodies, Viral/cerebrospinal fluid , Arteritis/etiology , Edema/etiology , Fundus Oculi , Humans , Male , Retinal Hemorrhage/etiology , Retinal Vessels , Simplexvirus/immunologyABSTRACT
Twenty patients with heterotopic ossification were HLA typed. The group consisted of 12 patients with severe cranio-cerebral injury and 8 with spinal cord injury. No significant differences in the frequency of any HLA antigens were found in these patients when compared to 631 healthy matched controls. None of the patients was B27 positive.
Subject(s)
Brain Injuries/immunology , Histocompatibility Antigens/analysis , Ossification, Heterotopic/immunology , Spinal Cord Injuries/immunology , Adolescent , Adult , Female , Hip Joint/immunology , Humans , Male , Middle Aged , Ossification, Heterotopic/etiology , Pelvic Bones/immunology , Spondylitis, Ankylosing/etiology , Spondylitis, Ankylosing/immunologyABSTRACT
A total of 35 cases of periarticular new bone formation (PNBF) was observed among 160 patients with coma following severe craniocerebral trauma. All cases were associated with blunt trauma and none with penetrating wounds. Only 6 of 500 cases of acute non-traumatic hemiplegia developed PNBR, and all 6 of them followed craniotomy, brain surgery and coma. New bone formation first appeared mainly between 50 and 120 days after craniocerebral injury with prolonged coma. Three-quarters of the patients with PNBF showed involvement of the shoulder joint, but this was not associated with previous subluxation. Metabolic studies were done in some patients; no disturbances were found in the metabolism of calcium, phosphorus or alkaline phosphatase. The pathologic process of PNBF seemed to stabilize some 6 to 8 months following trauma, and surgery after this period produced functional improvement in the 3 patients in whom it was tried. No satisfactory pathophysiological explanation has been found for the phenomenon of PNBR. Prolonged coma is common to all patients who suffered from PNBF and is probably an etiologic factor. The absence of PNBF in cases of cerebrovascular accident with subluxations of the gleno-humeral joint and intensive physiotherapy seems to contradict the suggestion of microtrauma as an etiological factor.
