1/14. Hyperacute spinal subdural haematoma as a complication of lumbar spinal anaesthesia: MRI.We report two cases of hyperacute spinal subdural haematoma secondary to lumbar spinal anaesthesia, identified with MRI. Prompt diagnosis of this infrequent, potentially serious complication of spinal anaesthesia is essential, as early surgical evacuation may be needed. Suggestive MRI findings in this early phase include diffuse occupation filling of the spinal canal with poor delineation of the spinal cord on T1-weighted images, and a poorly-defined high-signal lesion with a low-signal rim on T2-weighted images.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
2/14. Cranial nerve palsy and intracranial subdural hematoma following implantation of intrathecal drug delivery device.BACKGROUND AND OBJECTIVES: Complications related to cerebrospinal fluid (CSF) leak and low CSF pressure can occur following placement of an intrathecal drug delivery device. methods: A 58-year-old man with chronic, intractable lower back pain underwent implantation of an intrathecal drug delivery device. On the fourth postoperative day, he developed a postural headache and diplopia with findings compatible with left sixth cranial nerve palsy. The headache subsequently became constant and nonpostural. Cranial magnetic resonance imaging was obtained that showed the presence of a posterior subdural intracranial hematoma. Conservative treatment for postdural puncture headache did not improve the symptomatology. Therefore, an epidural blood patch was performed that produced rapid improvement and eventual resolution of symptoms. CONCLUSIONS: Intrathecal catheter implantation can result in CSF loss that might not resolve promptly with conservative therapy. In this case, epidural blood patch proved to be a safe and effective form of treatment.- - - - - - - - - - ranking = 0.076923076923077keywords = spinal (Clic here for more details about this article) |
3/14. paraparesis after lumbar puncture in a male with leukemia.A diagnostic lumbar puncture was performed in a 12-year-old male with acute lymphoblastic leukemia. Because of thrombocytopenia (platelet count 42,000/mm(3)), a platelet transfusion was given immediately before the lumbar puncture. However, the platelet count was not re-examined. The patient developed progressive paraparesis shortly after the lumbar puncture. magnetic resonance imaging revealed an extensive spinal subdural hematoma from the T2 to S2 level. This case report illustrates the sometimes dramatic consequences of lumbar puncture in patients with childhood leukemia. Guidelines for the examination of the platelet count and correction of thrombocytopenia before lumbar puncture are discussed.- - - - - - - - - - ranking = 0.076923076923077keywords = spinal (Clic here for more details about this article) |
4/14. Acute spontaneous spinal subdural haematoma: MRI features.We present MRI findings in three patients with acute spontaneous subdural haematomas of the spine. Acute haematomas (1-3 days) were isointense or gave slightly high signal on T1-and heterogeneous signal on T2-weighted images. MRI precisely defined the level and extent of the haematoma preoperatively. The MRI was prospectively correctly interpreted as acute subdural haematomas in all patients. As a specific, noninvasive modality, MRI is the preferred imaging technique in this rare clinical entity.- - - - - - - - - - ranking = 0.30769230769231keywords = spinal (Clic here for more details about this article) |
5/14. Fatal subdural haemorrhage following lumbar spinal drainage during repair of thoraco-abdominal aneurysm.A 63-year-old male patient collapsed and died from a major subdural haemorrhage 5 days after elective repair of a Type III thoraco-abdominal aortic aneurysm. The anaesthetic technique had included the use of a lumbar cerebrospinal fluid drain. The management of the patient is described, and the association between subdural haemorrhage and cerebrospinal fluid drainage is discussed.- - - - - - - - - - ranking = 0.46153846153846keywords = spinal (Clic here for more details about this article) |
6/14. Schwannoma of the cervical spine presenting with acute haemorrhage.Acute haemorrhagic presentation of spinal schwannoma is a rare event. A case of cervical spinal schwannoma presenting with spontaneous spinal subdural and intramedullary haemorrhage is described.- - - - - - - - - - ranking = 0.23076923076923keywords = spinal (Clic here for more details about this article) |
7/14. Nonsurgical treatment of an upper thoracic spinal subdural hemorrhage.STUDY DESIGN: A case report of an upper thoracic spinal subdural hemorrhage which was managed successfully by conservative treatment. OBJECTIVES: Spinal subdural hemorrhage is rare and can cause serious neurologic symptoms. Surgery is the most common treatment and is believed to prevent further neurologic injury. A case of an upper thoracic spinal subdural hemorrhage which was managed successfully by conservative therapy is reported. SETTING: Department of Orthopaedic Surgery, Tokai University School of medicine, Isehara, japan. methods: A 29-year-old woman presented with acute severe back pain. She experienced acutely developed weakness of both lower extremities, hypesthesia below T6 and urinary retention. magnetic resonance imaging performed on the day of hospital admission revealed the existence of a subdural hematoma in the upper thoracic spine. muscle strength of the lower extremities was grade 0 on admission, but improved slightly on day 1. The decision was made to manage the patient nonoperatively by corticosteroid and diuretic administration. RESULTS: Improvement was gradual but progressive. muscle strength was grade 4 out of 5 on the 28th day. magnetic resonance imaging at 3 months except for mild urinary retention. CONCLUSIONS: Spinal subdural hemorrhage can be treated nonoperatively by correlating magnetic resonance image findings with the clinical condition.- - - - - - - - - - ranking = 0.46153846153846keywords = spinal (Clic here for more details about this article) |
8/14. Intracranial subdural hematoma after unintended durotomy during spine surgery.PURPOSE: To report a case of intracranial subdural hematoma occurring after a spinal dural tear that was made unintentionally during the course of a posterior laminectomy and spinal fusion at the L(5)-S(1) level. The possible physiopathological mechanisms are discussed. Clinical features: On the fourth postoperative day, a 59-yr-old woman displayed persistent headache following unintended durotomy during spine implant revision. Perioperative blood loss was 2840 mL and intravascular replacement was about 3000 mL. She was hydrated with iv fluids and treated with non-steroidal anti-inflammatory drugs. The symptoms improved but persisted. With the aggravation of the headache complicated with unconsciousness and the appearance of focal neurological signs on the eighth day, a computed tomography was obtained and revealed a right subdural hematoma. Following surgical drainage, the patient made an uneventful recovery. CONCLUSION: This case reminds us that subdural hematoma formation can complicate durotomy during spine surgery. Neurological deterioration in the postoperative period should prompt clinicians to rule out the diagnosis and intervene rapidly as appropriate.- - - - - - - - - - ranking = 0.15384615384615keywords = spinal (Clic here for more details about this article) |
9/14. exercise-induced acute spinal subdural hematoma: a case report.A 63-year-old woman developed acute back pain and sciatica after playing hula-hoop. urinary incontinence was also noted. magnetic resonance imaging revealed acute thoracolumbar spinal subdural hematoma. After emergency surgical decompression and evacuation of the spinal subdural hematoma, the patient had good recovery without any postoperative neurologic deficit. In this article, we describe and review the clinical presentations, characteristic findings from imaging studies, and treatment of spinal subdural hematoma.- - - - - - - - - - ranking = 0.53846153846154keywords = spinal (Clic here for more details about this article) |
10/14. Delayed traumatic spinal epidural hematoma with spontaneous resolution of symptoms.Post-traumatic spinal epidural hematomas are uncommon, usually requiring emergent neurosurgical evacuation. We present a symptomatic delayed post-traumatic epidural hematoma of the T-spine that resolved within hours of administration of high dose steroids. A 22-year-old man presented 10 days after sustaining blunt trauma during a motor vehicle crash. He developed signs of acute cord compression with loss of sensation and motor function in bilateral lower extremities with priapism. magnetic resonance imaging demonstrated a spinal epidural hematoma with 50% canal stenosis at the T4 level. His symptoms improved 1 h after the administration of high dose steroids. All symptoms resolved completely while the patient was in the Emergency Department and he was treated conservatively by neurosurgery with no further sequelae. Thoracic spinal epidural hematoma is an uncommon condition that may present in delayed fashion after trauma with significant neurologic compromise. If neurologic symptoms improve with initial steroid therapy, patients with this condition may be treated conservatively with steroids and observation.- - - - - - - - - - ranking = 0.53846153846154keywords = spinal (Clic here for more details about this article) |
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