Pneumocephalus secondary to cerebrospinal fluid leak associated with a lumbar pressure ulcer in a man with paraplegia.

Background: Pneumocephalus is a well-known condition following head trauma, but is uncommon in injuries or surgeries of the spine. Even more unusual is its occurrence in association with an eroding pressure ulcer and the subsequent penetration of the intrathecal space. This article reports such a case in a man with spinal cord injury.

Giant urinoma in spinal cord injury: report of two cases.

Background: A urinoma is a cyst formed by the extravasation of urine from any constituent of the urinary tract; that is, via the kidney, ureter, urinary bladder, or the urethra. It may vary in its site and size according to its etiology, the point of the extravasation, and its duration and time of diagnosis. It commonly is associated with obstruction of the lower urinary tract by an impacted urinary calculus.

Marjolin's ulcer in patients with spinal cord injury.

Background: The term "Marjolin's ulcer" is now synonymous with malignant transformation, usually ectodermal and rarely mesenchymal, of chronic ulcers, sinus tracts, and burn scars.

Design: Literature search and personal experience with 5 patients during a 30-year period in a spinal cord injury center.

Findings: Five cases of Marjolin's ulcer diagnosed among approximately 10,000 patients indicate the rarity of the metaplasia.

Surgical aspects of autonomic dysreflexia.

Autonomic dysreflexia (AD) is a characteristic syndrome that occurs in spinal cord injury (SCI) patients with lesions above the sympathetic outflow at T6 and rarely in those with lesions below T10. Symptoms are initiated by noxious stimuli below the level of injury which result in massive sympathetic discharges from the isolated cord. These produce what may be called a sympathetic storm manifest by severe life threatening hypertension.

Muscle release in the management of spasticity in spinal cord injury.

Muscle spasticity and contractures in the spinal cord injured are a big problem interfering with rehabilitation, leading to inconveniences and complications in these patients. Management is based on pharmacotherapy, physiotherapy and surgeries. The authors are against central neurosurgery except on rare occasions.