Prevalence and Screening of Deep Vein Thrombosis in Patients with Osteoporotic Vertebral Fracture.

AIM: To determine the prevalence of a deep vein thrombosis (DVT) in osteoporotic vertebral fractures. MATERIAL AND METHODS: Data were retrospectively collected from the medical records of 50 patients who were admitted to the Kameda Medical Center for osteoporotic vertebral fracture from 2019 to 2020. Inpatients were screened for DVT using D-dimer, and those who were screened positive underwent lower extremity venous ultrasonography to confirm DVT. Associations between various clinical factors and DVT were analyzed. RESULTS: Six (12.0%) inpatients with osteoporotic vertebral fractures were found to have DVT. Two (33.3%) of the six had proximal DVT, although no pulmonary embolism was detected by chest computed tomography angiography. Univariate analysis showed that D-dimer values and duration from onset to hospitalization were predictive of DVT (p < 0.05). CONCLUSION: The prevalence of DVT among inpatients with osteoporotic vertebral fractures was 12.0%. This finding emphasizes the importance of DVT screening using D-dimer in those with osteoporotic vertebral fractures.

Two cases of normal pressure hydrocephalus caused by ependymoma of the cauda equina.

BACKGROUND: Normal pressure hydrocephalus (NPH) associated with tumors of the cauda equina is rare. Here, we report two cases of NPH attributed to cauda equina ependymomas. CASE DESCRIPTION: A 63-year-old male presented with progressive gait disturbance, dementia, and urinary incontinence. When the lumbar MR documented an intradural tumor involving the cauda equina at the L2-L3 level; the tumor was excised; pathologically, it proved to be a myxopapillary ependymoma. Postoperatively, however, the patient's continued gait disturbance led to a brain CT that documented ventricular dilation consistent with NPH; following ventriculoperitoneal (VP) shunt placement his symptoms improved. A 65-year-old female also presented with gait disturbance, dementia, and urinary retention. Here, procedures were performed in reverse. When a brain CT showed hydrocephalus, a VP shunt was placed. When symptoms persisted, a lumbar MR demonstrated a T12-L2 intradural tumor; following a lumbar laminectomy for tumor excision, symptoms stabilized. The pathological diagnosis was also consistent with a conus/cauda equina ependymoma. Over the next 10 years, the patient had residual bladder dysfunction (e.g., requiring straight catheterization), but had no shunt dysfunction. CONCLUSION: We observed two cases of ependymomas of the cauda equina and brain CTs documenting NPH that was successfully surgically managed with stabilization of neurological deficit. In the first case, L2-L3 laminectomy for tumor removal was succeeded by shunting for NPH, while in the second case, initial VP shunting for NPH was followed by a T12-L2 laminectomy for tumor excision.