11/164. Tuberculous radiculomyelitis complicating tuberculous meningitis: case report and review.Tuberculous radiculomyelitis (TBRM) is a complication of tuberculous meningitis (TBM), which has been reported rarely in the modern medical literature. We describe a case of TBRM that developed in an human immunodeficiency virus (hiv)-infected patient, despite prompt antituberculous treatment. To our knowledge, this is the second case of TBRM reported in an hiv-infected patient. We also review 74 previously reported cases of TBRM. TBRM develops at various periods after TBM, even in adequately treated patients after sterilization of the cerebrospinal fluid (CSF). The most common symptoms are subacute paraparesis, radicular pain, bladder disturbance, and subsequent paralysis. CSF evaluation usually shows an active inflammatory response with a very high protein level. MRI and CT scan are critical for diagnosis, revealing loculation and obliteration of the subarachnoid space along with linear intradural enhancement. As in other forms of paradoxical reactions to antituberculous treatment, there is evidence that steroid treatment might have a beneficial effect.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
12/164. Spinal manifestations of vertebral artery dissection.Among 111 patients with vertebral artery dissection (VAD), two presented with spinal manifestations: one with a C5-C6 radiculopathy and the other with a cervical myelopathy. Of 13 previously reported cases of spinal manifestations of VAD (mean age 37 years), ischemic cervical myelopathy was noted in seven; cervical radiculopathy, often at C5-C6 and primarily motor, in five; and hemorrhagic complications in one, with chest pain being part of the presentation.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
13/164. Neck-tongue syndrome.Two patients with neck-tongue syndrome, a rare disorder of the upper cervical nerves that results in paroxysmal neck pain and paresthesia of the tongue, are described. Signs are the result of compression of the C2 root by disorders affecting the first two cervical vertebrae. Conservative management is effective in most cases if no masses are in the involved area. The disorder has been observed rarely in children. Clinical onset occurred at 6 and 11 years of age, respectively, in the reported patients.- - - - - - - - - - ranking = 1.0094453121175keywords = pain, upper (Clic here for more details about this article) |
14/164. neck pain secondary to radiculopathy of the fourth cervical root: an analysis of 12 surgically treated patients.neck pain can originate from any number of factors. Perhaps the most difficult symptom complex to resolve is axial neck pain arising from upper cervical nerve root compression. The purpose of this study is to report the results of surgical intervention in a series of patients with neck pain from C4 radiculopathy. Twelve consecutive patients who were diagnosed with C4 radiculopathy were retrospectively reviewed (follow-up, 22 /-16.3 months). patients underwent either anterior cervical discectomy and fusion or posterior laminoforaminotomy at the C3-C4 segment. The results show that a good to excellent clinical result can be achieved in most patients (92% in our series). The importance of identifying patients with C4 radiculopathy lies in the fact that surgery can alter the natural history of neck pain secondary to upper cervical root radiculopathy, unlike axial neck pain from degenerative disk disease.- - - - - - - - - - ranking = 9.0188906242349keywords = pain, upper (Clic here for more details about this article) |
15/164. Nonsurgical treatment for radicular of pain of zygoapophyseal joint cyst origin: therapeutic selective nerve root block.We report the first case of zygoapophyseal joint cyst-induced radicular pain successfully treated with therapeutic selective nerve root block. A 56-year-old dentist presented with pain involving the lateral thigh, lateral calf, and foot dorsum that worsened with standing and walking. magnetic resonance imaging of the lumbar spine showed a cyst emanating from the right L4-L5 zygoapophyseal joint, resulting in central canal and lateral recess stenosis. The patient was treated with two fluorscopically guided therapeutic L5 selective nerve root blocks. The patient remained pain free at 18-month follow-up.- - - - - - - - - - ranking = 7keywords = pain (Clic here for more details about this article) |
16/164. Static magnetic field therapy for pain in the abdomen and genitals.Two adolescents with debilitating, medication-resistant, chronic pain of the low back and abdomen with intermittent pain of the genitalia were diagnosed with intervertebral disk disease at spinal cord levels that correlated with their signs. Both patients had undergone multiple evaluations by physicians of different specialties and both underwent appendectomy without relief of their pain. The history of the onset of pain was important in determining the affected levels. The pain of both individuals was mimicked and localized by percussion of the vertebral spines at the level of disk protrusion. This maneuver and careful review of the history were important in making the correct diagnosis in each case. In both patients, treatment with novel magnetic devices provided rapid relief that was sustained for more than 2 years. These cases highlight the need for careful evaluation and correct diagnosis of abdominal and genital pain in young patients to avoid costly and unnecessary medical intervention and the stigma of painful debility.- - - - - - - - - - ranking = 11.163467980048keywords = pain, back (Clic here for more details about this article) |
17/164. spinal canal stenosis at the level of axis.We describe a rare case of marked segmental stenosis of the axis secondary to developmental hypertrophy of the posterior neural arch causing severe neck pain and headache in the occipital region. The patient made a remarkable recovery following decompressive laminectomy and foraminal decompression.- - - - - - - - - - ranking = 1.0214034808559keywords = pain, headache (Clic here for more details about this article) |
18/164. L5 radicular pain related to a cystic lesion of the posterior longitudinal ligament.A 35-year-old man with a long history of left L5 radicular pain was found to have an intraspinal cystic lesion causing radicular compression. magnetic resonance imaging demonstrated a round lesion situated in the anterior epidural space, with uniform high signal intensity on T2-weighted sequences characteristic of a cystic lesion. During surgery a liquid-containing cyst originating from the posterior longitudinal ligament was punctured and resected. The histologic aspect was that of a ganglion cyst without synovial layers. The radiologic differential diagnoses are discussed.- - - - - - - - - - ranking = 5keywords = pain (Clic here for more details about this article) |
19/164. Paravertebral venous plexus distention (Batson's): an inciting etiologic agent in lumbar radiculopathy as observed by venous angiography.Can the paravertebral plexus of veins adjacent to the spinal nerve root within the narrow confines of the lateral neural canal be a collateral generator of radicular pain when no other evidence of spinal pathology is evident? A patient with complaints of intractable lumbar radiculopathy and an otherwise unremarkable clinical neuromusculoskeletal examination, as well as normal imaging and electrodiagnostic studies, is reviewed with special reference to symptomatic and paravertebral venous responses to both a valsalva maneuver and dipyridamole infusion as imaged by magnetic venous angiography.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
20/164. Sterile, benign radiculitis associated with lumbosacral lateral recess spinal canal stenosis: evaluation with enhanced magnetic resonance imaging.Two cases of symptomatic lumbar lateral recess stenosis are described in which the compressed nerve root became focally enhanced on magnetic resonance imaging (MRI) studies performed with gadolinium dtpa. Two men with low back pain and lumbar radiculopathy were examined with contrast-enhanced MRI studies, which showed intradural enhancement of the symptomatic nerve roots. In selected cases of lateral recess stenosis, focal radicular injury may be visualized on enhanced MRI as a result of a breakdown of the blood-brain barrier.- - - - - - - - - - ranking = 4.4584002695649keywords = back pain, pain, back (Clic here for more details about this article) |
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