1/170. Lumbar intraspinal synovial cysts of different etiologies: diagnosis by CT and MR imaging.Intraspinal synovial cysts arises from a facet joint and may cause radicular symptoms due to nerve root compression. In the present study, three surgically and histologically proved cases of synovial cyst of the lumbar spine with different etiology are described. The purpose of this report is to illustrate the imaging features of various etiologies of intraspinal synovial cysts allowing a correct preoperative diagnosis. review of the literature enables us to say that to our knowledge, there is no reported article collecting the imaging findings of intraspinal synovial cysts with different etiologies. Only single cases with rheumatoid arthritic or traumatic origin have been reported to date. We believe that computed tomography and particularly magnetic resonance imaging are the methods of choice which provide the most valuable diagnostic information.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
2/170. Spinal aspergillus abscess in a patient with bronchocentric granulomatosis.aspergillus fumigatus hyphae is often found in the lung tissue of patients with bronchocentric granulomatosis (BCG). This organism is believed to be one agent responsible for inciting the hypersensitivity response and subsequent development of the characteristic pathology that defines BCG. The definitive etiology of this disease, however, remains conjectural. Corticosteroids represent the mainstay of therapy. The fungi recovered from patients with BCG are considered noninvasive; thus, the risk of fungal invasion secondary to steroid-induced immunosuppression is believed to be negligible. However, we report a case of spinal aspergillus abscess that developed in a patient with BCG subsequent to steroid therapy. This case also highlights the necessity for aggressive medical and neurosurgical intervention to avert the development of neurological sequelae.- - - - - - - - - - ranking = 0.0099552072231495keywords = organ (Clic here for more details about this article) |
3/170. Pyogenic osteomyelitis of the spine in the elderly: three cases of a synchronous non-axial infection by a different pathogen.STUDY DESIGN: A retrospective chart review of patients over 65 years of age treated at the spine Care Unit for pyogenic vertebral osteomyelitis. OBJECTIVES: To assess the reliability of peripheral blood, urine and sputum cultures in the treatment of pyogenic vertebral osteomyelitis in the elderly. SETTING: Study performed at the spine Care Unit, Meir Hospital, Kfar-Saba, israel. methods: The Meir hospital records were searched for patients over 65 years of age, treated at the spine Care Unit for pyogenic vertebral osteomyelitis. charts, culture results and imaging studies were reviewed. A medline literature search was performed to survey the literature regarding pyogenic vertebral osteomyelitis in the elderly with emphasis on diagnostic imaging modalities and surgical treatment. RESULTS: Three patients were identified with concurrent peripheral infection by a different organism than the organism causing the vertebral osteomyelitis. Delay in correct diagnosis led to neurologic impairment in all patients and surgical treatment was performed in all three to drain the epidural abscess, decompress the spinal cord and obtain direct tissue culture. Following decompression and epidural abscess evacuation, one patient has functionally recovered and was ambulating with a cane, two patients did not recover and remained paraparetic and ambulate in a wheelchair. CONCLUSIONS: Pyogenic vertebral osteomyelitis in the elderly can be caused by a different pathogen than that isolated from blood, sputum or urine cultures. In the elderly, a biopsy of the vertebral lesion should be obtained for susceptibility studies prior to conservative treatment with bracing and intravenous antibiotics.- - - - - - - - - - ranking = 0.019910414446299keywords = organ (Clic here for more details about this article) |
4/170. Fungal spinal osteomyelitis in the immunocompromised patient: MR findings in three cases.The MR imaging findings of fungal spinal osteomyelitis in three recipients of organ transplants showed hypointensity of the vertebral bodies on T1-weighted sequences in all cases. Signal changes and enhancement extended into the posterior elements in two cases. Multiple-level disease was present in two cases (with a total of five intervertebral disks involved in three cases). All cases lacked hyperintensity within the disks on T2-weighted images. In addition, the intranuclear cleft was preserved in four of five affected disks at initial MR imaging. MR features in candida and Aspergillus spondylitis that are distinct from pyogenic osteomyelitis include absence of disk hyperintensity and preservation of the intranuclear cleft on T2-weighted images. Prompt recognition of these findings may avoid delay in establishing a diagnosis and instituting treatment of opportunistic osteomyelitis in the immunocompromised patient.- - - - - - - - - - ranking = 0.0099552072231495keywords = organ (Clic here for more details about this article) |
5/170. actinomycosis--an unusual case of an uncommon disease.actinomycosis is an uncommon disease caused by organisms of the actinomyces genus. These organisms are commonly found in the mucous membranes but do not cause infection unless there is disruption of the membranes, as occurs, for example, during dental trauma or abdominal surgery. Use of an IUD is also a risk factor for pelvic actinomycosis. The disease is usually insidious and is often mistaken for other conditions. Treatment of the infection, once diagnosed, is a regimen of long-term antibiotics such as penicillin, clindamycin, and others. Our patient had pelvic and sacral actinomycosis without any of the traditional risk factors for infection.- - - - - - - - - - ranking = 0.019910414446299keywords = organ (Clic here for more details about this article) |
6/170. Iatrogenic Mycobacterium infection after an epidural injection.STUDY DESIGN: Case report. OBJECTIVES: Successful excision of the mass and identification of the causative agent by histologic and microbiologic studies. SUMMARY OF BACKGROUND DATA: Spinal pain, caused by an infective mass, developed in a 39-year-old man 3 months after an epidural injection for low back pain. methods: Exploratory surgery was performed to remove the mass, and histologic and microbiologic studies were conducted. RESULTS: The inflammatory mass was excised successfully, and several specimens were examined for bacteriologic presence. Histologic examination of the excised specimen showed chronic granulomatous inflammation, and subsequent microbiologic studies cultured an acid- and alcohol-fast bacillus that was later identified as mycobacterium fortuitum. CONCLUSION: A review of the literature shows that this is a particularly uncommon micro-organism.- - - - - - - - - - ranking = 0.0099552072231495keywords = organ (Clic here for more details about this article) |
7/170. Cervical spine abnormalities in down syndrome.down syndrome (DS) is the most common of the chromosomal disorders and manifests abnormalities in several organ systems. While mental retardation, skull and brain anomalies, and the development of Alzheimer-type neuropathological changes in patients greater than age 40 years are well recognized by neurologists and neuropathologists, less appreciated are the various cervical spine abnormalities that can occur. Widening of the anterior atlanto-odontoid distance (AAOD) and atlantooccipital instability occur in up to 21% and 63% of DS patients, respectively, but neurologic complaints are uncommon and rarely are severe enough to contribute to the patient's demise. We present a case of 49-year-old DS patient whose triplegia, subacute progressive respiratory failure, and death could be attributed to severe degenerative joint disease of the cervical spine with osteophyte formation and severe spinal canal stenosis. We provide the first detailed correlation study between pre-mortem magnetic resonance imaging (MRI) and extensive autoptic dissection in an adult DS patient with cervical spine abnormalities, as well as a review of the literature.- - - - - - - - - - ranking = 0.0099552072231495keywords = organ (Clic here for more details about this article) |
8/170. Neuroimages of disseminated neurotuberculosis: report of one case.We report a 38-year-old male patient with rare concurrent intracranial and intramedullary tuberculoma demonstrated by serial magnetic resonance image (MRI) and confirmed by a pathological study. The involvement of the middle cerebral artery is also shown by magnetic resonance angiography. These findings have a good correlation with the clinical features including cranial nerve involvement, stroke-like symptoms, and paraplegia.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
9/170. brucella disc infection mimicking lumbar disc herniation: a case report.brucellosis is a zoonotic disease and still a major health problem in many geographical areas. In this paper a forty year-old woman with spinal brucellosis associated with epidural abscess formation and mimicking lumbar disc herniation is presented. Compression of spinal nerve root(s) by epidural masses due to brucella disc infection is a rare condition and should be kept in mind in differential diagnosis of lumbar disc herniation. The crucial role of magnetic resonance imaging in differential diagnosis is also emphasised.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
10/170. Pyogenic osteomyelitis of the spine.The records of 30 patients who had suffered from vertebral osteomyelitis were reviewed. They conformed to a constant pattern, though varying in tems of: (i) the severity of the disease due to host-organism interrelationship; and (ii) age distribution. Causative organisms could not always be identifed, though all lesions settled with conservative measures of rest and antibiotics. A high proportion of the patients who were followed up for more than one year were back at work. The anatomical distribution of the lesions can be explained by our knowledge of the vascular supply to the vertebral bodies.- - - - - - - - - - ranking = 0.019910414446299keywords = organ (Clic here for more details about this article) |
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