首页 > 最新文献

Spinal Cord Series and Cases最新文献

英文 中文
Holocord pilocytic astrocytoma in a young woman with intracranial extension: case report and review of the MRI characteristics. 一名年轻女性罹患伴颅内扩展的 Holocord 型朝粒细胞星形细胞瘤:病例报告和磁共振成像特征回顾。
IF 0.7 Q4 CLINICAL NEUROLOGY Pub Date : 2024-06-22 DOI: 10.1038/s41394-024-00656-z
Sima Kiani Salmi, Amirreza Dehghanian, Ali Taherifard, Alireza Dehghan

Introduction: Pilocytic astrocytoma is a low-grade glioma more frequently seen in patients <20. It is pretty uncommon in the spinal cord. Rarely, astrocytoma may involve the most or total length of the spinal cord; in that case, they are called "holo-cord astrocytoma." In this case report, we are reporting the third holo-cord pilocytic astrocytoma in an adult patient and the first with an extension to the Magendie foramen.

Case presentation: We presented a 24-year-old woman with complaints of progressively worsening neck and back pain since one year ago. The patient's MRI showed a very large intradural and intramedullary cystic lesion with a solid component within the spinal cord extending from the medulla to the conus medullaris. Partial resection of the solid part of the cervical portion of the tumor was performed. Histopathological evaluation of the resected tumor segments was compatible with grade I pilocytic astrocytoma. After one year of follow-up, neck and back pain has reduced, and neurological functions have improved.

Conclusion: Spinal cord pilocytic astrocytoma may present as a holo-cord tumor and can rarely extend to the intracranial fossa. Although this tumor does not arise from the central canal, in this case, it was extended through the Magendie foramen. Symptoms could be subtle despite extensive cord involvement. On MRI, this tumor presents as an intramedullary holo-cord cystic lesion intermixed with a solid component with a variable enhancement of the solid component.

导言:嗜酸性星形细胞瘤是一种低级别胶质瘤,多见于病例中的患者:我们接诊了一名 24 岁的女性患者,她主诉自一年前以来颈部和背部疼痛逐渐加重。患者的磁共振成像显示,脊髓内有一个非常大的硬膜内和髓内囊性病变,其中有一个实性部分从髓质延伸至髓圆。医生对肿瘤颈椎部分的实性部分进行了部分切除。对切除的肿瘤部分进行的组织病理学评估显示,该肿瘤属于I级柔毛细胞性星形细胞瘤。经过一年的随访,颈背部疼痛减轻,神经功能也有所改善:结论:脊髓柔毛细胞性星形细胞瘤可能表现为全脊髓肿瘤,很少会扩展到颅内窝。虽然这种肿瘤并非来自中央管,但在本病例中,它通过马氏孔扩展。尽管广泛累及脊髓,但症状可能并不明显。在核磁共振成像中,这种肿瘤表现为髓内全脊髓囊性病变与实性成分混杂,实性成分呈不同程度的强化。
{"title":"Holocord pilocytic astrocytoma in a young woman with intracranial extension: case report and review of the MRI characteristics.","authors":"Sima Kiani Salmi, Amirreza Dehghanian, Ali Taherifard, Alireza Dehghan","doi":"10.1038/s41394-024-00656-z","DOIUrl":"10.1038/s41394-024-00656-z","url":null,"abstract":"<p><strong>Introduction: </strong>Pilocytic astrocytoma is a low-grade glioma more frequently seen in patients <20. It is pretty uncommon in the spinal cord. Rarely, astrocytoma may involve the most or total length of the spinal cord; in that case, they are called \"holo-cord astrocytoma.\" In this case report, we are reporting the third holo-cord pilocytic astrocytoma in an adult patient and the first with an extension to the Magendie foramen.</p><p><strong>Case presentation: </strong>We presented a 24-year-old woman with complaints of progressively worsening neck and back pain since one year ago. The patient's MRI showed a very large intradural and intramedullary cystic lesion with a solid component within the spinal cord extending from the medulla to the conus medullaris. Partial resection of the solid part of the cervical portion of the tumor was performed. Histopathological evaluation of the resected tumor segments was compatible with grade I pilocytic astrocytoma. After one year of follow-up, neck and back pain has reduced, and neurological functions have improved.</p><p><strong>Conclusion: </strong>Spinal cord pilocytic astrocytoma may present as a holo-cord tumor and can rarely extend to the intracranial fossa. Although this tumor does not arise from the central canal, in this case, it was extended through the Magendie foramen. Symptoms could be subtle despite extensive cord involvement. On MRI, this tumor presents as an intramedullary holo-cord cystic lesion intermixed with a solid component with a variable enhancement of the solid component.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11193805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141440903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Safety of ultrasound-guided percutaneous suprapubic catheter insertion in spinal cord injury patients. 脊髓损伤患者在超声引导下经皮插入耻骨上导管的安全性。
IF 1.2 Q4 CLINICAL NEUROLOGY Pub Date : 2024-06-12 DOI: 10.1038/s41394-024-00653-2
Christian Tiburtius, Kai Fiebag, Birgitt Kowald, Oliver Balzer, Sven Hirschfeld-Araujo, Roland Thietje, Ralf Böthig

Study design: Retrospective chart audit.

Objectives: To evaluate the safety of ultrasound-guided percutaneous suprapubic catheter (SPC) insertion in patients with spinal cord injury/disease (SCI/D) and to attempt to identify risk factors for complications.

Setting: Specialized German centre for spinal cord injuries.

Methods: This retrospective chart analysis evaluated demographic, neurologic, and neuro-urologic data and the incidence and type of complications within the first 30 days after suprapubic bladder catheter insertion in SCI/D patients in the period between January 1st, 2013, and December 31st, 2022.

Results: The data of 721 SCI/D patients (244 women and 477 men, 386 tetraplegics and 355 paraplegics) were analysed. There were 44 complications (6.5%), of which 11 (1.5%) were major complications according to Clavien-Dindo ≥ 3. Among these were one small bowel injury and one peritoneal injury each, but no fatal complications. Regarding major complications (according to Clavien-Dindo ≥3), only patient age was identified as a risk factor (p = 0.0145). Gender, SCI/D level, neurological completeness, and severity of SCI/D or type of neurogenic lower urinary tract dysfunction (Odds ratio [95% CI] 1.6423 [0.4961;5.4361], 1.0421 [0.3152;3.4459], 0.3453 [0.0741;1.6101], 2.8379 [0.8567;9.4004] and 2.8095 [0.8097;9.7481] respectively) did not show any association with the frequency of major complications.

Conclusions: Mild complications, especially temporary hematuria or infectious complications, are not uncommon after SPC insertion in SCI/D patients. Major complications occur only rarely, and no risk factor other than age could be detected. On this basis, pre-intervention education on informed consent for SCI/D patients can be provided on an evidence-based approach.

研究设计回顾性病历审计:评估脊髓损伤/疾病(SCI/D)患者在超声引导下经皮耻骨上导管(SPC)插入的安全性,并尝试确定并发症的风险因素:地点:德国脊髓损伤专科中心:这项回顾性图表分析评估了2013年1月1日至2022年12月31日期间SCI/D患者的人口统计学、神经学和神经-神经学数据,以及耻骨上膀胱导管插入后头30天内并发症的发生率和类型:分析了 721 名 SCI/D 患者(244 名女性和 477 名男性,386 名四肢瘫痪患者和 355 名截瘫患者)的数据。共有 44 例并发症(6.5%),根据 Clavien-Dindo ≥ 3 标准,其中 11 例(1.5%)为主要并发症。其中小肠损伤和腹膜损伤各1例,但无致命并发症。关于主要并发症(根据 Clavien-Dindo ≥3),只有患者年龄被确定为风险因素(p = 0.0145)。性别、SCI/D 水平、神经功能完整性、SCI/D 严重程度或神经源性下尿路功能障碍类型(Odds ratio [95% CI] 1.6423 [0.4961;5.4361], 1.0421 [0.3152;3.4459]、0.3453[0.0741;1.6101]、2.8379[0.8567;9.4004]和2.8095[0.8097;9.7481])与主要并发症的发生频率没有任何关联:结论:SCI/D 患者插入 SPC 后,轻微并发症,尤其是暂时性血尿或感染性并发症并不少见。结论:轻微并发症,尤其是暂时性血尿或感染性并发症在 SCI/D 患者插入 SPC 后并不少见,而严重并发症则很少发生,除年龄外,未发现其他风险因素。在此基础上,可以循证方法为 SCI/D 患者提供干预前的知情同意教育。
{"title":"Safety of ultrasound-guided percutaneous suprapubic catheter insertion in spinal cord injury patients.","authors":"Christian Tiburtius, Kai Fiebag, Birgitt Kowald, Oliver Balzer, Sven Hirschfeld-Araujo, Roland Thietje, Ralf Böthig","doi":"10.1038/s41394-024-00653-2","DOIUrl":"10.1038/s41394-024-00653-2","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective chart audit.</p><p><strong>Objectives: </strong>To evaluate the safety of ultrasound-guided percutaneous suprapubic catheter (SPC) insertion in patients with spinal cord injury/disease (SCI/D) and to attempt to identify risk factors for complications.</p><p><strong>Setting: </strong>Specialized German centre for spinal cord injuries.</p><p><strong>Methods: </strong>This retrospective chart analysis evaluated demographic, neurologic, and neuro-urologic data and the incidence and type of complications within the first 30 days after suprapubic bladder catheter insertion in SCI/D patients in the period between January 1st, 2013, and December 31st, 2022.</p><p><strong>Results: </strong>The data of 721 SCI/D patients (244 women and 477 men, 386 tetraplegics and 355 paraplegics) were analysed. There were 44 complications (6.5%), of which 11 (1.5%) were major complications according to Clavien-Dindo ≥ 3. Among these were one small bowel injury and one peritoneal injury each, but no fatal complications. Regarding major complications (according to Clavien-Dindo ≥3), only patient age was identified as a risk factor (p = 0.0145). Gender, SCI/D level, neurological completeness, and severity of SCI/D or type of neurogenic lower urinary tract dysfunction (Odds ratio [95% CI] 1.6423 [0.4961;5.4361], 1.0421 [0.3152;3.4459], 0.3453 [0.0741;1.6101], 2.8379 [0.8567;9.4004] and 2.8095 [0.8097;9.7481] respectively) did not show any association with the frequency of major complications.</p><p><strong>Conclusions: </strong>Mild complications, especially temporary hematuria or infectious complications, are not uncommon after SPC insertion in SCI/D patients. Major complications occur only rarely, and no risk factor other than age could be detected. On this basis, pre-intervention education on informed consent for SCI/D patients can be provided on an evidence-based approach.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11169511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Delayed spinal arachnoiditis with syringomyelia following aneurysmal subarachnoid haemorrhage: a case report with patient experience. 动脉瘤性蛛网膜下腔出血后迟发性脊髓蛛网膜炎伴鞘膜积液:病例报告与患者经验。
IF 0.7 Q4 CLINICAL NEUROLOGY Pub Date : 2024-06-10 DOI: 10.1038/s41394-024-00654-1
Nityanand Jain, Liga Jaunozolina, Inga Putraima, Kaspars Auslands, Andrejs Millers

Background and importance: Syringomyelia, or the formation of fluid-filled cysts within the spinal cord, associated with delayed spinal arachnoiditis is an uncommon complication of aneurysmal subarachnoid haemorrhage. To date, about 18 cases have been reported in medical literature, with just two reported in patients under the age of 35 years.

Clinical presentation: A 27-year-old female patient complained of sudden, severe headaches in the occipital region, nuchal rigidity, and drowsiness when she presented at our institution. A head computed tomography scan revealed intraventricular bleeding in the lateral and fourth ventricles with more extensive haemorrhaging in the frontal horns. A left posterior inferior cerebellar artery (PICA) aneurysm was confirmed via digital subtraction angiogram, and endovascular embolization was done. Two years later, the patient reported intense pain in the lower back along with symptoms suggestive of spinal cord compression. Spinal magnetic resonance imaging (MRI) showed spinal adhesions from C1 to L4, syringomyelia with some vasogenic oedema extending from T3 to T9 level, and a cyst in the lumbar region. Consequently, a right hemilaminectomy was performed along with microsurgical release of arachnoid adhesions and placement of a subdural drain. Radiological and symptomatic improvements were observed. Since then, the patient's clinical condition has remained stable during the past three years of follow-up visits.

Conclusions: Literature on optimal treatment modalities and patient prognosis is scarce and debated. The time for symptom improvement depends on the level and extent of spinal cord involvement. Rehabilitation may be required for most patients, as complete symptomatic recovery may not be attainable.

背景和重要性:鞘膜积液或在脊髓内形成充满液体的囊肿,并伴有迟发性脊髓蛛网膜炎,是动脉瘤性蛛网膜下腔出血的一种不常见并发症。迄今为止,医学文献共报道了约 18 个病例,其中仅有两个病例的患者年龄在 35 岁以下:临床表现:一名 27 岁的女性患者到我院就诊时,主诉突然出现枕部剧烈头痛、颈部僵硬和嗜睡。头部计算机断层扫描显示,侧脑室和第四脑室有脑室内出血,额角出血范围更大。通过数字减影血管造影检查,确诊为左侧小脑后下动脉(PICA)动脉瘤,并进行了血管内栓塞治疗。两年后,患者报告下背部剧烈疼痛,并伴有脊髓压迫症状。脊柱磁共振成像(MRI)显示,从C1到L4有脊柱粘连,T3到T9水平有鞘膜积液和一些血管源性水肿,腰部还有一个囊肿。因此,患者接受了右侧半椎板切除术,同时通过显微手术松解了蛛网膜粘连,并放置了硬膜下引流管。术后患者的影像学和症状均有所改善。此后,在过去三年的随访中,患者的临床状况一直保持稳定:有关最佳治疗方式和患者预后的文献很少,而且存在争议。症状改善的时间取决于脊髓受累的程度和范围。大多数患者可能需要进行康复治疗,因为症状可能无法完全恢复。
{"title":"Delayed spinal arachnoiditis with syringomyelia following aneurysmal subarachnoid haemorrhage: a case report with patient experience.","authors":"Nityanand Jain, Liga Jaunozolina, Inga Putraima, Kaspars Auslands, Andrejs Millers","doi":"10.1038/s41394-024-00654-1","DOIUrl":"10.1038/s41394-024-00654-1","url":null,"abstract":"<p><strong>Background and importance: </strong>Syringomyelia, or the formation of fluid-filled cysts within the spinal cord, associated with delayed spinal arachnoiditis is an uncommon complication of aneurysmal subarachnoid haemorrhage. To date, about 18 cases have been reported in medical literature, with just two reported in patients under the age of 35 years.</p><p><strong>Clinical presentation: </strong>A 27-year-old female patient complained of sudden, severe headaches in the occipital region, nuchal rigidity, and drowsiness when she presented at our institution. A head computed tomography scan revealed intraventricular bleeding in the lateral and fourth ventricles with more extensive haemorrhaging in the frontal horns. A left posterior inferior cerebellar artery (PICA) aneurysm was confirmed via digital subtraction angiogram, and endovascular embolization was done. Two years later, the patient reported intense pain in the lower back along with symptoms suggestive of spinal cord compression. Spinal magnetic resonance imaging (MRI) showed spinal adhesions from C1 to L4, syringomyelia with some vasogenic oedema extending from T3 to T9 level, and a cyst in the lumbar region. Consequently, a right hemilaminectomy was performed along with microsurgical release of arachnoid adhesions and placement of a subdural drain. Radiological and symptomatic improvements were observed. Since then, the patient's clinical condition has remained stable during the past three years of follow-up visits.</p><p><strong>Conclusions: </strong>Literature on optimal treatment modalities and patient prognosis is scarce and debated. The time for symptom improvement depends on the level and extent of spinal cord involvement. Rehabilitation may be required for most patients, as complete symptomatic recovery may not be attainable.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11165000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141301606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A physiatrist's role in managing unique challenges in pregnancy and delivery in a patient with incomplete lumbar SCI: a case report. 理疗师在处理不完全腰椎 SCI 患者怀孕和分娩过程中的独特挑战中的作用:病例报告。
IF 1.2 Q4 Medicine Pub Date : 2024-06-04 DOI: 10.1038/s41394-024-00652-3
Lauren Hall, Connie Hsu, Chloe Slocum, John Lowry

Introduction: Women of childbearing age make up around 5-10% of individuals with spinal cord injury (SCI) and may face unique medical and functional complications during pregnancy, including prolonged hospitalization and increased risk of early rehospitalization due to falls.

Case presentation: Here, we discuss a case of a young ambulatory woman with a lumbar motor incomplete spinal cord injury who underwent successful delivery via cesarean section and the role of the physiatrist in the management of the patient's antepartum, intrapartum, and postpartum complications. The patient faced significant antepartum challenges secondary to her neurogenic bladder and pelvic floor weakness, resulting in increased use of her manual wheelchair. The physiatry team assisted with the co-development of a multidisciplinary bladder plan for increased urinary frequency and urinary tract infection prevention with the patient's obstetrics physician (OB). In addition, the physiatry team assisted with the procurement of a new wheelchair suited for the patient's pregnancy and childcare needs in anticipation of decreased mobility during this time. Regarding intrapartum challenges, the physiatry team worked with the patient and her OB to develop a safe birth plan considering the method of delivery, epidural usage, and the need for pelvic floor therapy before and after childbirth.

Discussion: The patient had a successful cesarean section delivery, with return to independent mobility soon after childbirth. In summary, this case demonstrates that there is a need for a multidisciplinary approach to patients with SCI during pregnancy and that the role of physiatry is critical to optimizing medical and functional outcomes.

导言:育龄妇女约占脊髓损伤(SCI)患者的 5-10%,在怀孕期间可能面临独特的医疗和功能并发症,包括住院时间延长和因跌倒而增加早期再住院的风险:在此,我们将讨论一名腰部运动性不完全性脊髓损伤并通过剖腹产顺利分娩的年轻产妇的病例,以及理疗师在处理患者产前、产中和产后并发症方面所扮演的角色。由于神经源性膀胱和骨盆底肌无力,患者在产前面临着巨大的挑战,导致她需要更多地使用手动轮椅。理疗团队协助患者的产科医生(OB)共同制定了一个多学科膀胱计划,以增加排尿次数并预防尿路感染。此外,考虑到患者在此期间行动不便,理疗团队还协助采购了适合其怀孕和育儿需要的新轮椅。关于产前挑战,考虑到分娩方式、硬膜外麻醉的使用以及产前和产后盆底治疗的需要,物理治疗小组与患者及其产科医生合作制定了安全分娩计划:讨论:该患者成功进行了剖腹产,产后很快就恢复了独立活动能力。总之,该病例表明,需要对妊娠期 SCI 患者采取多学科治疗方法,而理疗师的作用对于优化医疗和功能结果至关重要。
{"title":"A physiatrist's role in managing unique challenges in pregnancy and delivery in a patient with incomplete lumbar SCI: a case report.","authors":"Lauren Hall, Connie Hsu, Chloe Slocum, John Lowry","doi":"10.1038/s41394-024-00652-3","DOIUrl":"10.1038/s41394-024-00652-3","url":null,"abstract":"<p><strong>Introduction: </strong>Women of childbearing age make up around 5-10% of individuals with spinal cord injury (SCI) and may face unique medical and functional complications during pregnancy, including prolonged hospitalization and increased risk of early rehospitalization due to falls.</p><p><strong>Case presentation: </strong>Here, we discuss a case of a young ambulatory woman with a lumbar motor incomplete spinal cord injury who underwent successful delivery via cesarean section and the role of the physiatrist in the management of the patient's antepartum, intrapartum, and postpartum complications. The patient faced significant antepartum challenges secondary to her neurogenic bladder and pelvic floor weakness, resulting in increased use of her manual wheelchair. The physiatry team assisted with the co-development of a multidisciplinary bladder plan for increased urinary frequency and urinary tract infection prevention with the patient's obstetrics physician (OB). In addition, the physiatry team assisted with the procurement of a new wheelchair suited for the patient's pregnancy and childcare needs in anticipation of decreased mobility during this time. Regarding intrapartum challenges, the physiatry team worked with the patient and her OB to develop a safe birth plan considering the method of delivery, epidural usage, and the need for pelvic floor therapy before and after childbirth.</p><p><strong>Discussion: </strong>The patient had a successful cesarean section delivery, with return to independent mobility soon after childbirth. In summary, this case demonstrates that there is a need for a multidisciplinary approach to patients with SCI during pregnancy and that the role of physiatry is critical to optimizing medical and functional outcomes.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11150403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intermittent catheterisation: individuals' rights, accessibility, and environmental concerns. 间歇性导尿:个人权利、可及性和环境问题。
IF 1.2 Q4 Medicine Pub Date : 2024-05-31 DOI: 10.1038/s41394-024-00651-4
Andrei Krassioukov, Michel Wyndaele, Matthias Walter, Veronique Keppenne, Blayne Welk, Desiree Vrijens, Francois Theron
{"title":"Intermittent catheterisation: individuals' rights, accessibility, and environmental concerns.","authors":"Andrei Krassioukov, Michel Wyndaele, Matthias Walter, Veronique Keppenne, Blayne Welk, Desiree Vrijens, Francois Theron","doi":"10.1038/s41394-024-00651-4","DOIUrl":"10.1038/s41394-024-00651-4","url":null,"abstract":"","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11143204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141184636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Use of transcranial motor evoked potentials (TcMEPs) in spine deformity surgery in a case of Charcot-Marie-tooth disease—what we should know? A case report 经颅运动诱发电位(TcMEPs)在一例 Charcot-Marie-tooth 病脊柱畸形手术中的应用--我们应该知道些什么?病例报告
IF 1.2 Q4 Medicine Pub Date : 2024-05-25 DOI: 10.1038/s41394-024-00648-z
Abhishek Srivastava, Vikas Hanasoge, Anuj Gupta, A. Jayaswal
{"title":"Use of transcranial motor evoked potentials (TcMEPs) in spine deformity surgery in a case of Charcot-Marie-tooth disease—what we should know? A case report","authors":"Abhishek Srivastava, Vikas Hanasoge, Anuj Gupta, A. Jayaswal","doi":"10.1038/s41394-024-00648-z","DOIUrl":"https://doi.org/10.1038/s41394-024-00648-z","url":null,"abstract":"","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141098329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Successful recovery from cardiac arrest due to atlantoaxial subluxation in Down syndrome: a case report 唐氏综合征患者因寰枢椎脱位导致心脏骤停后成功康复:病例报告
IF 1.2 Q4 Medicine Pub Date : 2024-05-25 DOI: 10.1038/s41394-024-00649-y
Hiroshi Imamura, Y. Hamano, H. Kamijo, Michitaro Ichikawa, Y. Kashima, Hiroki Oba
{"title":"Successful recovery from cardiac arrest due to atlantoaxial subluxation in Down syndrome: a case report","authors":"Hiroshi Imamura, Y. Hamano, H. Kamijo, Michitaro Ichikawa, Y. Kashima, Hiroki Oba","doi":"10.1038/s41394-024-00649-y","DOIUrl":"https://doi.org/10.1038/s41394-024-00649-y","url":null,"abstract":"","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141098225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Surgical treatment for recurrent thoracic ventral intradural arachnoid cyst secondary to tuberculous meningitis: a case report. 继发于结核性脑膜炎的复发性胸腹腔硬膜内蛛网膜囊肿的手术治疗:病例报告。
IF 0.7 Q4 CLINICAL NEUROLOGY Pub Date : 2024-05-23 DOI: 10.1038/s41394-024-00650-5
Yushi Sakamoto, Takayoshi Shimizu, Bungo Otsuki, Shuichi Matsuda

Introduction: Spinal intradural arachnoid cysts (SIACs) are rare spinal entities that are categorized as primary or secondary pathologies. Secondary cysts can arise from various traumatic or inflammatory causes including subarachnoid hemorrhage, intrathecal injection or surgery, and infectious meningitis/arachnoiditis. Only a few cases of SIAC secondary to tuberculous meningitis have been previously reported, without details of the surgical treatment.

Case presentation: A 27-year-old woman diagnosed with tuberculous meningitis developed myelopathy caused by thoracic ventral SIAC and intradural abscess. The patient underwent abscess evacuation and cyst fenestration; however, cyst recurrence occurred. The 2nd surgery consisted of cyst resection via a posterolateral approach with expansive duraplasty and spinal arthrodesis. Re-recurrence occurred, and at the 3rd surgery, cyst-subarachnoid bypass was performed. One year after the 3rd surgery, the myelopathic symptoms recovered, and MR images demonstrated a decreased cyst size.

Discussion: Here, we report a rare case of recurrent thoracic SIAC secondary to tuberculous meningitis and arachnoiditis. Simple fenestration is associated with a high risk of recurrence in this pathology. Ventrally located thoracic cysts can be approached with posterolateral approach with pedicles resected followed by instrumented arthrodesis. Even in cases involving gross total resection of the cyst wall, there is a risk of recurrence. In such cases, cyst-subarachnoid bypass with a large-diameter tube can be effective.

简介脊髓硬膜内蛛网膜囊肿(SIAC)是一种罕见的脊髓疾病,可分为原发性和继发性两种。继发性囊肿可由各种创伤或炎症原因引起,包括蛛网膜下腔出血、鞘内注射或手术以及感染性脑膜炎/蛛网膜炎。以前仅有几例继发于结核性脑膜炎的蛛网膜下腔囊肿病例报道,但没有手术治疗的详细情况:一名被诊断为结核性脑膜炎的 27 岁女性因胸腹 SIAC 和硬膜内脓肿而出现脊髓病变。患者接受了脓肿清除术和囊肿切开术,但囊肿复发。第二次手术是通过后外侧入路切除囊肿,并进行扩张性硬脊膜成形术和脊柱关节置换术。囊肿再次复发,第三次手术时,进行了囊肿-蛛网膜下腔分流术。第3次手术后一年,脊髓病症状恢复,磁共振图像显示囊肿缩小:讨论:我们在此报告了一例继发于结核性脑膜炎和蛛网膜炎的罕见的复发性胸廓 SIAC 病例。在这种病理情况下,单纯的栅栏开裂与复发的高风险有关。位于中央的胸椎囊肿可采用后外侧入路,切除椎弓根,然后用器械进行关节固定。即使是完全切除囊壁的病例,也有复发的风险。在这种情况下,使用大直径导管进行囊肿-蛛网膜下腔分流术可能有效。
{"title":"Surgical treatment for recurrent thoracic ventral intradural arachnoid cyst secondary to tuberculous meningitis: a case report.","authors":"Yushi Sakamoto, Takayoshi Shimizu, Bungo Otsuki, Shuichi Matsuda","doi":"10.1038/s41394-024-00650-5","DOIUrl":"10.1038/s41394-024-00650-5","url":null,"abstract":"<p><strong>Introduction: </strong>Spinal intradural arachnoid cysts (SIACs) are rare spinal entities that are categorized as primary or secondary pathologies. Secondary cysts can arise from various traumatic or inflammatory causes including subarachnoid hemorrhage, intrathecal injection or surgery, and infectious meningitis/arachnoiditis. Only a few cases of SIAC secondary to tuberculous meningitis have been previously reported, without details of the surgical treatment.</p><p><strong>Case presentation: </strong>A 27-year-old woman diagnosed with tuberculous meningitis developed myelopathy caused by thoracic ventral SIAC and intradural abscess. The patient underwent abscess evacuation and cyst fenestration; however, cyst recurrence occurred. The 2nd surgery consisted of cyst resection via a posterolateral approach with expansive duraplasty and spinal arthrodesis. Re-recurrence occurred, and at the 3rd surgery, cyst-subarachnoid bypass was performed. One year after the 3rd surgery, the myelopathic symptoms recovered, and MR images demonstrated a decreased cyst size.</p><p><strong>Discussion: </strong>Here, we report a rare case of recurrent thoracic SIAC secondary to tuberculous meningitis and arachnoiditis. Simple fenestration is associated with a high risk of recurrence in this pathology. Ventrally located thoracic cysts can be approached with posterolateral approach with pedicles resected followed by instrumented arthrodesis. Even in cases involving gross total resection of the cyst wall, there is a risk of recurrence. In such cases, cyst-subarachnoid bypass with a large-diameter tube can be effective.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11116473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141088974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cauda equina syndrome with surgical intervention in pregnancy during the periviable period. 围产期妊娠手术治疗马尾综合征。
IF 1.2 Q4 Medicine Pub Date : 2024-05-11 DOI: 10.1038/s41394-024-00646-1
Mary Taylor Winsten, Jessica Fine, Fatimah Fahimuddin, Diana Baxter, Tamika Auguste

Introduction: Cauda equina syndrome (CES) following lumbar disc herniation is exceedingly rare in pregnancy and there is limited literature outlining management of CES in pregnancy. There is further limited data addressing the management of periviable pregnancies complicated by CES.

Case presentation: A 38-year-old female at 22 weeks gestation presented with worsening lower back pain radiating to the right posterior lower extremity. She was initially managed with conservative therapy, but re-presented with worsening neurologic symptoms, including fasciculations and perineal numbness. Magnetic resonance imaging showed a large herniated disc at L4-5, and given concern for CES, she underwent emergent decompression surgery, which was complicated by a superficial wound dehiscence. She ultimately carried her pregnancy to term and had a cesarean delivery. The patient's residual neurologic symptoms continued to improve with physical therapy throughout the postpartum period.

Discussion: Cauda equina syndrome is a rare spinal condition with potentially devastating outcomes if not managed promptly. Diagnosis and management of CES in pregnancy is the same as in non-pregnant patients, however, standardization of patient positioning for surgery, surgical approach, anesthetic use, and fetal considerations is lacking. A multidisciplinary approach is critical, especially at periviable gestational ages of pregnancy. Our case and review of the literature demonstrates that patients in the second trimester can be managed surgically with prone positioning, intermittent fetal monitoring, and continued management of the pregnancy remains unchanged. Given the rarity of these cases, there is a need for a consensus on management and continued care in pregnant patients with CES.

导言:腰椎间盘突出症引起的马尾综合征(CES)在妊娠期极为罕见,有关妊娠期马尾综合征治疗的文献资料也非常有限。此外,有关围产期妊娠并发 CES 的治疗数据也非常有限:一名妊娠 22 周的 38 岁女性因下腰痛加剧并向右后下肢放射而就诊。她最初接受了保守治疗,但再次出现神经症状恶化,包括筋膜痉挛和会阴部麻木。磁共振成像显示她的L4-5椎间盘突出,考虑到CES,她接受了紧急减压手术,但手术因表皮伤口裂开而变得复杂。最终,她怀胎十月,进行了剖腹产。在整个产后期间,通过物理治疗,患者残留的神经症状继续得到改善:讨论:马尾综合征是一种罕见的脊柱疾病,如果不及时治疗,可能会造成严重后果。妊娠期马尾综合征的诊断和处理与非妊娠期患者相同,但患者的手术体位、手术方法、麻醉剂的使用以及胎儿的考虑因素等都缺乏标准化。多学科方法至关重要,尤其是在妊娠围孕期。我们的病例和文献综述表明,妊娠后三个月的患者可以通过俯卧位、间歇性胎儿监护和持续的妊娠管理进行手术治疗。鉴于此类病例的罕见性,有必要就 CES 孕妇的管理和持续护理达成共识。
{"title":"Cauda equina syndrome with surgical intervention in pregnancy during the periviable period.","authors":"Mary Taylor Winsten, Jessica Fine, Fatimah Fahimuddin, Diana Baxter, Tamika Auguste","doi":"10.1038/s41394-024-00646-1","DOIUrl":"10.1038/s41394-024-00646-1","url":null,"abstract":"<p><strong>Introduction: </strong>Cauda equina syndrome (CES) following lumbar disc herniation is exceedingly rare in pregnancy and there is limited literature outlining management of CES in pregnancy. There is further limited data addressing the management of periviable pregnancies complicated by CES.</p><p><strong>Case presentation: </strong>A 38-year-old female at 22 weeks gestation presented with worsening lower back pain radiating to the right posterior lower extremity. She was initially managed with conservative therapy, but re-presented with worsening neurologic symptoms, including fasciculations and perineal numbness. Magnetic resonance imaging showed a large herniated disc at L4-5, and given concern for CES, she underwent emergent decompression surgery, which was complicated by a superficial wound dehiscence. She ultimately carried her pregnancy to term and had a cesarean delivery. The patient's residual neurologic symptoms continued to improve with physical therapy throughout the postpartum period.</p><p><strong>Discussion: </strong>Cauda equina syndrome is a rare spinal condition with potentially devastating outcomes if not managed promptly. Diagnosis and management of CES in pregnancy is the same as in non-pregnant patients, however, standardization of patient positioning for surgery, surgical approach, anesthetic use, and fetal considerations is lacking. A multidisciplinary approach is critical, especially at periviable gestational ages of pregnancy. Our case and review of the literature demonstrates that patients in the second trimester can be managed surgically with prone positioning, intermittent fetal monitoring, and continued management of the pregnancy remains unchanged. Given the rarity of these cases, there is a need for a consensus on management and continued care in pregnant patients with CES.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11088644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140908784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
On Professor Robert Lipschitz, MB, ChB, PhD(Med), FRCS(Edin) and the Spinal Cord Injury Service, Chris Hani Baragwanath Hospital, Soweto, Johannesburg, South Africa. 关于南非约翰内斯堡索韦托克里斯-哈尼-巴拉夸那思医院的罗伯特-利普施茨教授(医学博士、医学博士、医学博士、爱丁堡皇家脊髓损伤研究中心)和脊髓损伤服务。
IF 1.2 Q4 Medicine Pub Date : 2024-05-07 DOI: 10.1038/s41394-024-00645-2
Avi Ohry

Professor Robert Lipschitz, MB, ChB, PhD(Med), FRCS(Edin) was a pioneer who established the Spinal Cord Injury Unit, at Chris Hani Baragwanath Hospital, Soweto, Johannesburg, South Africa. A brief description of his academic and clinical accomplishments is given.

罗伯特-利普施茨教授是南非约翰内斯堡索韦托克里斯-哈尼-巴拉夸那思医院脊髓损伤科的创始人之一。本文简要介绍了他的学术和临床成就。
{"title":"On Professor Robert Lipschitz, MB, ChB, PhD(Med), FRCS(Edin) and the Spinal Cord Injury Service, Chris Hani Baragwanath Hospital, Soweto, Johannesburg, South Africa.","authors":"Avi Ohry","doi":"10.1038/s41394-024-00645-2","DOIUrl":"10.1038/s41394-024-00645-2","url":null,"abstract":"<p><p>Professor Robert Lipschitz, MB, ChB, PhD(Med), FRCS(Edin) was a pioneer who established the Spinal Cord Injury Unit, at Chris Hani Baragwanath Hospital, Soweto, Johannesburg, South Africa. A brief description of his academic and clinical accomplishments is given.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11076579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Spinal Cord Series and Cases
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1