ABSTRACT
BACKGROUND: In this study, we aim to evaluate the potential effects of methylprednisolone on the neurological outcome of spinal cord injury (SCI) patients with thoracolumbar junction (T10-L1) spine fractures. METHODS: The data from 182 SCI patients who sustained a thoracolumbar junction spine fracture were operated by us between September 2008 to January 2015 were analysed retrospectively. The patients were divided into two groups: Group 1 underwent methylprednisolone treatment in conjunction with early surgical intervention, while group 2 underwent only early surgical intervention without methylprednisolone treatment. American Spinal Injury Association (ASIA) motor index scores of the patients were evaluated and compared with statistical methods at admission and at the first-year follow-up. RESULTS: The main follow-up period was 14.4±1.4 months in group 1 and 13.6±1.7 months in group 2. Initial and last follow-up ASIA scores of the patients were similar between groups (p>0.05), but the complication rate was significantly high in group 1 (p<0.05). CONCLUSION: The findings showed that steroids have no significant beneficial effects on the neurological outcome but have significant side effects and leads to increased complication rate in SCI patients.
Subject(s)
Lumbar Vertebrae/injuries , Methylprednisolone/therapeutic use , Nervous System Diseases , Spinal Fractures , Thoracic Vertebrae/injuries , Anti-Inflammatory Agents/therapeutic use , Humans , Nervous System Diseases/drug therapy , Nervous System Diseases/etiology , Retrospective Studies , Severity of Illness Index , Spinal Fractures/complications , Spinal Fractures/drug therapy , Spinal Fractures/surgeryABSTRACT
Spinal epidural lipomatosis is a rare condition which is described as the accumulation of fat in the extradural territory and often causes dural impingement. Spinal epidural lipomatosis has been implicated in causing a variety of neurologic impairments ranging from back pain, radiculopathy, claudication, myelopathy or even cauda equina syndrome. We report a 46-year-old female with obesity and a history of chronic back pain and radiculopathy who developed idiopathic Spinal epidural lipomatosis diagnosed by magnetic resonance imaging. The purpose of this report is to present a case of spinal epidural lipomatosis presenting with symptomatic cord compression and also remind this rare condition as a the differential diagnosis of epidural lesions in patients with risk factors.
Subject(s)
Lipomatosis/diagnostic imaging , Obesity/complications , Spinal Cord Compression/pathology , Epidural Space , Female , Humans , Magnetic Resonance Imaging , Middle Aged , Polyradiculopathy/etiologyABSTRACT
Alice in Wonderland syndrome (AIWS), named for Lewis Carroll's titular character, is a disorder characterized by transient episodes of visual hallucinations and perceptual distortions, during which objects or body parts are perceived as altered in various ways (metamorphopsia), including enlargement (macropsia) or reduction (micropsia) in the perceived size of a form. Migraine aura is a transient neurological symptom that most commonly involves the visual fields and occurs before the headache phase. Aura symptoms include the perception of flashing lights that begin in the center of vision and expand in jagged patterns out into the periphery. Symptoms may be somatosensory, such as numbness and tingling in the lips or fingers. They may also involve a profound alteration of the perception of space and time (the "Alice in Wonderland" syndrome). In this article, we present a child had Alice in Wonderland syndrome as aura of migraine.
Subject(s)
Alice in Wonderland Syndrome/psychology , Migraine with Aura/psychology , Adolescent , Alice in Wonderland Syndrome/drug therapy , Anticonvulsants/therapeutic use , Hallucinations , Humans , Male , Migraine with Aura/drug therapy , Valproic Acid/therapeutic useABSTRACT
Posttraumatic spondyloptosis develops as a result of complete subluxation of the vertebral bodies and causes complete transection of the spinal cord. Severe trauma-related spondyloptosis of the upper-mid thoracic region is a rare form of spinal trauma. Traumatic midthoracic spondyloptosis is quite rare, and radiology plays an important role in the diagnosis and treatment of this condition. Surgical reconstruction and stabilization are required for early mobilization and rehabilitation of patients with this injury. Here, we report the clinical features, radiographic findings, and management of an unusual case of traumatic midthoracic spondyloptosis that showed complete spinal cord transection and was operated.
Subject(s)
Decompression, Surgical/methods , Spinal Cord Injuries/surgery , Spinal Fractures/complications , Spinal Fusion/methods , Thoracic Vertebrae/injuries , Accidents, Traffic , Bone Screws , Chest Tubes , Dura Mater/injuries , Dura Mater/surgery , Hemothorax/etiology , Hemothorax/surgery , Humans , Internal Fixators , Joint Dislocations/complications , Male , Motorcycles , Osteotomy , Paraplegia/etiology , Ribs/surgery , Spinal Cord Injuries/etiology , Spinal Cord Injuries/rehabilitation , Spinal Fractures/surgery , Spinal Fusion/instrumentation , Sternum , Young AdultSubject(s)
Cavernous Sinus/pathology , Intracranial Aneurysm/complications , SUNCT Syndrome/complications , Angiography, Digital Subtraction , Brain/pathology , Empty Sella Syndrome/pathology , Endovascular Procedures , Eye Diseases/etiology , Female , Humans , Intracranial Aneurysm/pathology , Intracranial Aneurysm/surgery , Magnetic Resonance Imaging , Middle Aged , Pain/etiology , SUNCT Syndrome/pathology , SUNCT Syndrome/surgery , StentsABSTRACT
Vasospasm is an important cause of morbidity and mortality with subarachnoid hemorrhage (SAH). The effect of intraperitoneal administration of selenium, which is an antioxidant on cerebral vasospasm was investigated in an experimental model. By means of intracisternal blood injection model, SAH was induced in 24 rabbits, which were randomly divided into 3 groups (group 1= control group, group 2=SAH alone group, and group 3=SAH plus selenium group). Basilar artery angiography was performed on day 0 and day 3 as described. Intraperitoneal selenium (0.05 mg/kg) treatment was started after the induction of SAH and administered once a day. Three days later, the animals were killed and the basilar artery was examined histologically for the luminal diameter and thickness of the arterial muscular wall. The mean values for the measurements of angiographic luminal diameter, pathologic luminal area, muscular wall thickness derived from the blind observer were analyzed statistically. There was no statistically significant difference in basal angiographic luminal diameter evaluation between groups 1-2-3 (P>0.005). But in third day angiography; comparison of group 2 and group 1-3 showed statistically significant differences (P<0.001). In pathologic investigation; there was statistically significant difference in luminal area and muscular wall thickness of the basilar artery between groups 1, 2, and 3 (P<0.005). Intraperitoneal selenium treatment was found effective by increasing the angiographic diameter; pathologic luminal area and reducing muscular wall thickness measurements. This is the first study to show that intraperitoneal administration of selenium is effective in preventing vasospasm after SAH in rabbits.
Subject(s)
Selenium/administration & dosage , Subarachnoid Hemorrhage/complications , Trace Elements/administration & dosage , Vasospasm, Intracranial/prevention & control , Animals , Basilar Artery/diagnostic imaging , Basilar Artery/drug effects , Basilar Artery/ultrastructure , Disease Models, Animal , Injections, Intraperitoneal , Male , Rabbits , Radiography , Vasospasm, Intracranial/etiologyABSTRACT
OBJECTIVE: Optimal timing of stabilization for spinal injuries is discussed controversially. The goal of this study is to investigate the neurological recovery and its influencing factors in thoracolumbar spine fractures after surgical decompression and stabilization within 8 h of spinal cord injury versus surgery which is performed between 3 and 15 days. METHODS: Twenty-seven patients undergoing thoracolumbar stabilization with neurological deficit for an acute thoracolumbar spinal injury at the level of Th8-L2 vertebra at Selcuk University between March 2004 and December 2006 were recorded. Patients with neurological deficit and medically stable for surgery underwent immediate stabilization within 8 h defined as group I (n = 12) and patients underwent operation in 3-15 days after thoracolumbar injury were defined as group II (n = 15). Patients were assessed for neurologic deficit and improvement as defined by the scoring system of American spinal injury association (ASIA). RESULTS: In spite of comparable demographic data, patients in group I had a significantly shorter overall hospital and intensive care unit stay and had lesser systemic complications such as pneumonia and also exhibited better neurological improvement than group II (p < 0.05). CONCLUSION: Early surgery may improve neurological recovery and decrease hospitalization time and also additional systemic complications in patients with thoracolumbar spinal cord injuries. Thus early stabilization of thoracolumbar spine fractures within 8 h after trauma appears to be favorable.