• 제목/요약/키워드: Acute Myelopathy

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Acute Myelopathy Caused by a Cervical Synovial Cyst

  • Kim, Dong Shin;Yang, Jin Seo;Cho, Yong Jun;Kang, Suk Hyung
    • Journal of Korean Neurosurgical Society
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    • 제56권1호
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    • pp.55-57
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    • 2014
  • Synovial cysts of the cervical spine, although they occur infrequently, may cause acute radiculopathy or myelopathy. Here, we report a case of a cervical synovial cyst presenting as acute myelopathy after manual stretching. A 68-year-old man presented with gait disturbance, decreased touch senses, and increased sensitivity to pain below T12 level. These symptoms developed after manual stretching 3 days prior. Computed tomography scanning and magnetic resonance imaging revealed a 1-cm, small multilocular cystic lesion in the spinal canal with cord compression at the C7-T1 level. We performed a left partial laminectomy of C7 and T1 using a posterior approach and completely removed the cystic mass. Histological examination of the resected mass revealed fibrous tissue fragments with amorphous materials and granulation tissue compatible with a synovial cyst. The patient's symptoms resolved after surgery. We describe a case of acute myelopathy caused by a cervical synovial cyst that was treated by surgical excision. Although cervical synovial cysts are often associated with degenerative facet joints, clinicians should be aware of the possibility that these cysts can cause acute neurologic symptoms.

Guillain-Barr$\'{e}$ Syndrome Combined with Acute Cervical Myelopathy

  • Abai, Siez;Kim, Sung-Bum;Kim, Joo-Pyung;Lim, Young-Jin
    • Journal of Korean Neurosurgical Society
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    • 제48권3호
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    • pp.298-300
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    • 2010
  • Authors describe a patient who developed a myelopathy associated with Guillain-Barr$\'{e}$ syndrome and cervical myelopathy. We provide radiological evidence of non-compressive herniated cervical intervertebral disc with cord signal changes and show the clinical and electrophysiological result of coexisting Guillain-Barr$\'{e}$ syndrome and cervical myelopathy. We tried to introduce and review the case of Guillain-Barr$\'{e}$ syndrome which was combined with cervical myelopathy to let us recollect the presumptive cause.

수술후 자연발생 경추간판탈출에 의한 척수병증: 증례보고 및 문헌고찰 (Acute postoperative myelopathy caused by spontaneous developed cervical disc herniation: Case report & literature review)

  • 이정우;이근형;이주환
    • 한국산학기술학회논문지
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    • 제20권10호
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    • pp.303-308
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    • 2019
  • 65세 남자환자에서 전신마취하 관절경 어깨 수술후 갑자기 발생한 사지 마비 증례를 보고하고자 한다. 환자는 술 후 급격한 사지 마비 증상을 보였으며 마취 관리상 특별한 문제는 없었다. 환자의 수술시 자세와 관련하여 마취 유도시에 기관삽관을 위한 과도한 경추 신전은 시행되지 않았으며 수술중 자세에서도 경추부의 과도한 회전이나 신전 또한 진행되지 않았다. 그러나 수술이 종료된 후 근이완의 완전한 회복과 의식 및 자발호흡은 확인되었으나 사지 마비 증상 및 배뇨장애 증상을 보였다. 신속히 시행한 경추부 자기공명 영상에서 경추간판에 의한 척수 신경 압박 소견 보이는 척추성 경추증 증상을 보였다. 환자는 21일간의 고농도 스테로이드 정주 요법을 포함한 보존적 치료 후에 감각 및 운동신경의 완전한 회복을 보이고 다른 신경학적 이상 소견은 보이지 않은 채로 퇴원하였다. 외상과 관련 없이 사지 마비로 나타나는 수술후 척추성 경추증의 발생은 흔하지 않다. 본 증례를 통해 수술후 발생한 비외상성 척추성 경추증 발생에 대해 타 증례 보고와 비교 분석하여 고찰해 보고자 한다. 임상 의사는 60세 이상의 노년층에서의 수술후 사지 마비에 대해 척추성 경추증의 원인 기여에 대해서도 고려하기를 권고한다.

소형견에서 섬유연골 색전성 척수증 2례 (Fibrocartilaginous Embolic Myelopathy in Two Small Breed Dogs)

  • 임지혜;정창수;변예은;김완희;이영원;권오경
    • 한국임상수의학회지
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    • 제23권2호
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    • pp.218-221
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    • 2006
  • This report described clinical findings and Magnetic resonance image (MRI) results in two small breed dogs with fibrocartilaginous embolism (FCE). They were admitted with asymmetric acute-onset tetra/paraparesis with superficial pain sensation. In addition, there were no back pain and no progression of clinical signs. Cerebrospinal fluid and laboratory findings were evaluated. MRI revealed a similar focal intramedullary lesion of hyperintensive signals on T2-weighted images. Based on these findings, it was diagnosed as fibrocartilaginous embolic myelopathy in those two dogs.

Paraplegia due to Acute Aortic Coarctation and Occlusion

  • Park, Chang-Bum;Jo, Dae-Jean;Kim, Min-Ki;Kim, Sang-Hyun
    • Journal of Korean Neurosurgical Society
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    • 제55권3호
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    • pp.156-159
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    • 2014
  • Coarctation and occlusion of the aorta is a rare condition that typically presents with hypertension or cardiac failure. However, neuropathy or myelopathy may be the presenting features of the condition when an intraspinal subarachnoid hemorrhage has compressed the spinal cord causing ischemia. We report two cases of middle-aged males who developed acute non-traumatic paraplegia. Undiagnosed congenital abnormalities, such as aortic coarctation and occlusion, should be considered for patients presenting with nontraumatic paraplegia in the absence of other identifiable causes. Our cases suggest that spinal cord ischemia resulting from acute spinal subarachnoid hemorrhage and can cause paraplegia, and that clinicians must carefully examine patients presenting with nontraumatic paraplegia because misdiagnosis can delay initiation of the appropriate treatment.

Clinical Experience and Management of Cervico-Thoracic Epidural Hematoma

  • Ahn, Sang-Soak;Song, Young-Jin
    • Journal of Korean Neurosurgical Society
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    • 제47권5호
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    • pp.381-384
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    • 2010
  • Spinal epidural hematoma (SEH) causing acute myelopathy is rare. The usual clinical presentation of a SEH is sudden severe neck or back pain that progresses toward paraparesis or quadriparesis, depending on the level of the lesion. Recent studies have shown that early decompressive surgery is very important for patient's recovery. We experienced five patients of cervico-thoracic epidural hematomas associated with neurologic deficits that were treated successfully with surgical intervention.

두 마리 고양이에서 발생한 급성 척수 경색의 자기 공명 영상학적 진단 증례 (Magnetic Resonance Imaging Features of Suspected Acute Spinal Cord Infarction in Two Cats)

  • 정선영;김보은;지서연;윤정희;최민철
    • 한국임상수의학회지
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    • 제30권4호
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    • pp.320-323
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    • 2013
  • 척수 경색은 고양이에서 급성 척수 병증의 주요한 원인으로써 인식되고 있다. 사후 조직 병리학적 검사를 통해 확진 할 수 있지만 MR 영상학적 특징은 척수 경색의 진단에 가치있는 정보를 제공한다. 본 증례의 목적은 두 마리의 고양이에서 발생한 급성 척수 경색의 영상학적 특징을 설명하고 그 진단에 있어서 low field MRI (0.3 Tesla)의 유용성을 평가하는 것이다. 미확인 연령의 중성화 수컷, mixed breed 고양이가 급성의 사지 부전 마비를 주증으로 내원하였고 9살령의 중성화 암컷 domestic short hair 고양이는 후지 부전 마비로 내원하였으며 하루 후 후지 완전 마비가 나타났다. 이후 실시된 MR 영상에서 첫번째 고양이의 경우 두번째 경추부터 여섯번 째 경추 수준의 척수에서 병변이 분포하였으며 두번째 고양이의 경우 두번째 요추부터 다섯번째 요추 수준에서 병변이 나타났다. 두 고양이에서 공통적으로 주로 회백질에 분포한 척수 실질 내에 국소적인 병변이 확인되었으며 T2 강조 영상 및 FLAIR 영상에서 고신호를 나타내었고 DWI 영상에서 고신호, ADC map 에서는 저신호를 나타내었다. 히스토리, 임상증상 및 다른 실험실적 검사와 함께 MR 영상학적 특징을 통해 두 고양이에서 급성 척수 경색이 진단되었다.

Brown Tumor of the Thoracic Spine : First Manifestation of Primary Hyperparathyroidism

  • Sonmez, Erkin;Tezcaner, Tugan;Coven, Ilker;Terzi, Aysen
    • Journal of Korean Neurosurgical Society
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    • 제58권4호
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    • pp.389-392
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    • 2015
  • Brown tumors also called as osteoclastomas, are rare nonneoplastic lesions that arise in the setting of primary or secondary hyperparathyroidism. Parathyroid adenomas or hyperplasia constitute the major Brown tumor source in primary hyperparathyroidism while chronic renal failure is the leading cause in secondary hyperparathyroidism. Most of the patients with the diagnosis of primary hyperparathyroidism present with kidney stones or isolated hypercalcemia. However, nearly one third of patients are asymptomatic and hypercalcemia is found incidentally. Skeletal involvement such as generalized osteopenia, bone resorption, bone cysts and Brown tumors are seen on the late phase of hyperparathyroidism. The symptoms include axial pain, radiculopathy, myelopathy and myeloradiculopathy according to their locations. Plasmocytoma, lymphoma, giant cell tumors and metastates should be ruled out in the differential diagnosis of Brown tumors. Treatment of Brown tumors involve both the management of hyperparathyroidism and neural decompression. The authors report a very rare spinal Brown tumor case, arisen as the initial manifestation of primary hyperparathyroidism that leads to acute paraparesis.

Spinal Epidural Hematoma after Pain Control Procedure

  • Nam, Kyoung-Hyup;Choi, Chang-Hwa;Yang, Moon-Seok;Kang, Dong-Wan
    • Journal of Korean Neurosurgical Society
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    • 제48권3호
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    • pp.281-284
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    • 2010
  • Spinal epidural hematoma is a rare complication associated with pain control procedures such as facet block, acupuncture, epidural injection, etc. Although it is an uncommon cause of acute myelopathy, and it may require surgical evacuation. We report four patients with epidural hematoma developed after pain control procedures. Two procedures were facet joint blocks and the others were epidural blocks. Pain was the predominant initial symptom in these patients while two patients presented with post-procedural neurological deficits. Surgical evacuation of the hematoma was performed in two patients while in remaining two patients, surgery was initially recommended but not performed since symptoms were progressively improved. Three patients showed near complete recovery except for one patient who recovered with residual deficits. Although, spinal epidural hematoma is a rare condition, it can lead to serious complications like spinal cord compression. Therefore, it is important to be cautious while performing spinal pain control procedure to avoid such complications. Surgical treatment is an effective option to resolve the spinal epidural hematoma.

손발저림의 원인(原因)에 대(對)한 동서의학적(東西醫學的) 고찰(考察) (Consideration of the Son-Bal Jeorim in oriental and western medicine)

  • 박치영;임낙철;김영일;홍권의
    • 혜화의학회지
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    • 제13권1호
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    • pp.47-59
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    • 2004
  • Objectives & Methods: We investigated 28 books to study etiology and pathology of Son-Bal Jeorim. Result and Conclusion 1. The eiology of Son-Bal Jeorim is same as it of Bee Jeung(痺症). 2. Generally speaking, the cause of Bee Jeung was distributed Wind(風), Coldness(寒), Wetness (濕) of meridian. Bee Jeung can be devided into SilBi(實痺) and HeoBi(虛痺). In SilBi(實痺) there are PungHanSeupBi(風寒濕痺) and YeolBi(熱痺). In HeoBi(虛痺), there are GiHyeolHeoBi(氣血虛痺), EumheoBi(陰虛痺) and YangHeoBi(陽虛痺). 3. Son-Bal Jeorim belong to peripheral neuropathy in western medicine. 4. Syndrome of acute motor paralysis with variable disturbance of sensory and autonomic function, subacute sensorymotor paralysis, syndrome of chronic sensorimotor polyneuropathy, neuropathy with mitochondrial disease, syndrome of mononeuropathy or nerve plexusopathy. 5. Peripheral neuropathy is caused by carpal tunnel syndrome, diabetic neuropathy, uremic neuropathy, hepatic neuropathy, hypothyroid neuropathy, hyperthyroid neuropathy, neuropathy due to malnutrition, neuropathy due to toxic material, neuropathy due to drug, paraneoplastic neuropathy, hereditary neuropathy, etc. 6. Cerebral apoplexy, myelopathy, peripheral circulatory disturbance, anxiety syndrome cause symptoms of peripheral neuropathy

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