1/15. Spontaneous spinal subdural hematoma in a young adult with hemophilia.Spontaneous spinal subdural hemorrhage is a rare clinical problem that usually manifests with a sudden onset of pain and paralysis. This article reports on an 18-year-old male with hemophilia a and cerebral palsy, who experienced a several month history of transient back, hip, and leg pain accompanied by gait difficulties that ultimately culminated in a more striking episode of lower extremity weakness, irritability, and diffuse pain involving the neck, back, and legs. In the absence of any clinical or radiographic evidence of hemarthrosis, osteomyelitis, or intracranial hemorrhage, imaging of the spine disclosed a large, apparently multicompartmentalized intraspinal lesion, consistent with old hemorrhage. This extended from the thoracic to the sacral region, with the largest extent at the lumbosacral junction. Following correction of factor viii levels, surgical exploration was undertaken and demonstrated liquefied blood within the subdural space without violation of the underlying arachnoid. Because the chronic subdural blood flowed quite easily through the dural opening by simply angling the operating table, a limited exposure was required to achieve a substantial evacuation of the clot. This case calls attention to the often protean manifestations of this process, the potential for a chronic course to the clinical symptoms, and the possibility of achieving substantial clot evacuation and clinical recovery with a limited operative approach.- - - - - - - - - - ranking = 1keywords = paralysis (Clic here for more details about this article) |
2/15. Chronic subdural haematomas and Parkinsonian syndromes.We describe three men with parkinsonian syndromes caused or aggravated by chronic subdural haematomas. A 63-year-old man developed tremor at rest, rigidity and bradykinesia one week after he fell and hit his head. A 70-year-old patient suffering from tardive dyskinesia and drug-induced parkinsonism experienced deterioration of his bradykinetic symptoms over two weeks. There was no history of trauma. The third patient, a 82-year-old man with idiopathic Parkinson's disease had a marked increase of his left-sided parkinsonian symptoms. Again, there was no history of trauma. In all three patients chronic subdural haematomas were demonstrated by computed tomography. Evacuation of the chronic subdural haematoma resulted in disappearance respectively improvement of the movement disorder. Diagnostic evaluations appear to be delayed and initial misinterpretations are frequent. The findings of our report and review of the literature point out that a favourable outcome after appropriate surgical treatment is achieved in most instances.- - - - - - - - - - ranking = 1828.1872382342keywords = parkinsonism, parkinsonian (Clic here for more details about this article) |
3/15. Complete paraplegia as a result of regional anesthesia.Complications after spinal or epidural anesthesia are rare. We report 2 cases of postoperative, complete paraplegia after regional anesthesia in orthopaedic patients not on anticoagulants. The paralysis was likely the result of spinal cord compression secondary to an epidural hematoma in 1 case and subdural hematoma in 1 case. A review of the literature regarding complications of regional anesthesia is presented. Regional anesthesia should be administered with caution and in selected patients.- - - - - - - - - - ranking = 1keywords = paralysis (Clic here for more details about this article) |
4/15. A complicated case of intracranial hypotension: diagnostic and management strategies.We report a case of a patient aged 66 years, with spontaneous intracranial hypotension presenting initially with postural headache, complicated by subdural haematomas and followed by progressive decline of his clinical condition evolving in obtundation state, cranial nerve involvement and gaze paralysis. The patient underwent a long course of different therapeutical approaches: medical and surgical treatment, intrathecal saline infusion and epidural blood patching (EBP). Rapid and dramatic relief of the patient's symptoms was obtained after a third lumbar EBP and he was discharged asymptomatic two weeks later.- - - - - - - - - - ranking = 1keywords = paralysis (Clic here for more details about this article) |
5/15. Spinal subdural hematoma.The authors report a case of spinal subdural hematoma in a 51-year-old man who experienced a sudden onset of back pain accompanied by vomiting and headache without paralysis or paraparesis. CT Scan, myelography and MRI revealed a subdural hematoma at the levels of 6th, 7th and 8th thoracic vertebrales. laminectomy allowed the removal of an encapsulated cyst formation filled with xanthochromic fluid and some blood clots. The follow-up was uneventful.- - - - - - - - - - ranking = 1keywords = paralysis (Clic here for more details about this article) |
6/15. levodopa-responsive parkinsonism following central herniation due to bilateral subdural hematomas.A 66-year-old man suffered bilateral subdural hematomas progressing to central herniation, despite repeated surgical evacuations. This eventually resolved, leaving him with a severe parkinsonian syndrome that was responsive to levodopa. MRI and CT showed midbrain compression from central herniation, and a follow-up MRI revealed thinning of the pars compacta. The clinical and radiologic evidence suggested that midbrain compression from central herniation was the probable cause of parkinsonism in this patient.- - - - - - - - - - ranking = 4691.1401497293keywords = parkinsonism, parkinsonian (Clic here for more details about this article) |
7/15. The abnormal pupil in cheyne-stokes respiration. Case report.cheyne-stokes respiration commonly induces a rhythmic pupillary dilatation during hyperpnea and constriction during apnea. Failure of a pupil to dilate during hyperventilation indicates underlying sympathetic nerve paralysis. This report deals with an instance in which one pupil failed to constrict during apnea due to oculomotor nerve compression. The periodic respirations and anisocoria disappeared following surgical evacuation of a large ipsilateral subdural hematoma.- - - - - - - - - - ranking = 1keywords = paralysis (Clic here for more details about this article) |
8/15. Bilateral subdural hematoma presenting as subacute parkinsonism.We describe the case history of an 83-year-old man with subacute parkinsonism. CT scanning of the head showed a bilateral frontal subdural hematoma. The hypokinetic syndrome almost completely disappeared after surgical removal of the hematoma. The pathogenesis is discussed, and the importance of CT scanning in subacute parkinsonism of unknown origin is stressed.- - - - - - - - - - ranking = 5036.0620408163keywords = parkinsonism (Clic here for more details about this article) |
9/15. Parkinsonism caused by chronic subdural hematoma. A case report.A 48 year-old man with chronic subdural hematoma presented with a parkinsonian syndrome. Removal of the hematoma was followed by gradual disappearance of the extrapyramidal symptoms, as in other, rare, published cases.- - - - - - - - - - ranking = 494.4217823824keywords = parkinsonian (Clic here for more details about this article) |
10/15. Complete third nerve paralysis and decreasing vision secondary to subdural hematoma.We treated a patient with a subacute subdural hematoma who manifested only a complete third cranial nerve paralysis and decreased visual acuity. The gravity of delayed diagnosis in such a situation should prompt the ophthalmologist to consider subdural hematoma as the underlying cause in cases of third nerve paralysis.- - - - - - - - - - ranking = 6keywords = paralysis (Clic here for more details about this article) |
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