Spinal subdural hematoma following tissue plasminogen activator treatment for acute ischemic stroke.

A 49-year-old woman with an acute ischemic stroke was treated by the intravenous administration of tissue plasminogen activator within 2 h of symptom onset. She complained of severe upper thoracic back pain the following day. Progressive paraparesis was detected on the third admission day. Spinal MRI demonstrated an acute anterior subdural hematoma from the C7 to T2 level. An urgent laminectomy was performed. Neurologists must be aware of the possibility that neck or back pain after thrombolysis for ischemic stroke may be the first presenting symptom of spinal hematoma.

Radiological considerations of posterior cervical lateral mass fixation using plate and screw.

The aim of this study is to determine whether the posterior cervical fusion methods with the plate-screw system applied to the lateral mass of cervical spine are radiologically safe to patients. The lateral cervical X-rays and CT scans were done on 40 normal adults without cervical problem. Based on Roy-Camille and Magerl's method, the theological trajectory of screw was shown on films and the parameters were measured. The study based on Roy-Camille's method showed less than one percent chance of injury on the facet joint and the mean depth of the screw to be 10.5 +/- 1.4 mm. On the other hand, Magerl's method showed the mean depth of screw to be 11.9 +/- 1.5 mm which is slightly larger than that of Roy-Camille's method and no chance of facet injury occurred. A reduced lateral angle of screw (19.6 +/- 3.5 degrees C) performed with the concept based on Magerl's method resulted a longer depth of screw (13.5 +/- 2.1 mm). Both Roy-Camille and Magerl's methods seemed to be radiologically safe to normal persons. However, the authors recommend the reduced lateral angle (19.6 +/- 3.5 degrees C) of screw based on the Magerl's method more than an original Magerl's methods.