Osteoporotic vertebral fractures (OVF) commonly occur at the thoracolumbar junction, and delayed neurological deficits are rare. Here, a 76-year-old female presented with low back pain and the late onset of symptoms characterized by lumbar radiculopathy. She had been suffering from lower back pain for four weeks and developed lumbar radiculopathy in the left L3 area.
View Article and Find Full Text PDFA simple bone cyst (SBC) in the posterior lumbar bone structure is very rare. Here, we report a case of SBC at the L5 lumbar lamina with venous obstruction associated with ligamentum flavum thickening. A 59-year-old woman presented with intermittent claudication due to low back pain and bilateral sciatica.
View Article and Find Full Text PDFBackground: Intractable hiccups (IH) due to syringomyelia or syringomyelia/syringobulbia associated with Chiari type I malformations (CMI) are extremely rare. Here, we present two patients who presented with IH; one had a CMI with syringomyelia/syringobulbia, and the other, with CMI and syringomyelia.
Case Description: The first patient was an 18-year-old female who presented with IH attributed to a holocord syrinx and syringobulbia involving the right dorsolateral medulla.
Objective: This study was aimed to report the clinical characteristics of intramedullary schwannomas and discuss imaging findings and treatment strategies.
Methods: The inclusion criterion was consecutive patients with intramedullary schwannomas who were surgically treated at 8 centers between 2009 and 2020. Clinical characteristics included age, sex, clinical presentation, disease duration, and follow-up period.
Background: Lumbar ligamentum flavum hematomas (LFHs) are rare. However, when they occur and contribute to epidural cauda equina compression, timely surgical intervention is frequently warranted.
Case Description: A 69-year-old female presented with the left lower extremity sciatica and gait disturbance of 2 weeks' duration that ultimately evolved into a paraparesis/cauda equina syndrome.
Background: Patients with both nonrheumatoid retro-odontoid pseudotumors (ROPTs) and congenital craniocervical junction (CCJ) abnormalities are rare. Here, a 73-year-old female presented with neck pain and myelopathy due to MR-documented ROPT with intramedullary hyperintensity at the CCJ warranting an occipital-cervical fusion.
Case Description: A 73-year-old female originally developed occipitalgia and became quadriparetic within the subsequent 7 months.
Background: Osteoporotic vertebral fractures (OVF) commonly occur at the thoracolumbar junction, but are less frequently encountered in the mid-thoracic region. Here, a 69-year-old female presented with back pain and the new onset of symptoms characterized by the inability to belch.
Case Description: A 69-year-old female presented with back pain.
Background: Normal-pressure hydrocephalus (NPH) and spinal intradural extramedullary benign tumors rarely exist together. Here, a 72-year-old female who presented with NPH symptoms (i.e.
View Article and Find Full Text PDFKnee arthrofibrosis is a common complication of knee surgery, caused by excessive scar tissue, which results in functional disability. However, no curative treatment has been established. E8002 is an anti-adhesion material that contains L-ascorbic acid, an antioxidant.
View Article and Find Full Text PDFSpinal arteriovenous (AV) shunts are rare conditions that sometimes present with myelopathy symptoms. The progression of the symptoms is usually gradual; however, some cases show rapid deterioration. We retrospectively investigated the factors that induced the rapid deterioration of myelopathy symptoms in patients with spinal AV shunts.
View Article and Find Full Text PDFAs headache is known as one of the most common symptoms in the patients with Chiari malformation type 1 (CM1), it is difficult to find out CM1-related headache among the symptoms because headache itself is commonly seen. Herein, we retrospectively review the cases of six CM1 patients complaining only of headache by which they complained of deterioration in daily life activities. The symptom of headache worsened during anteflexion (n = 2; 33%), retroflexion (n = 1; 17%), jumping (n = 3; 50%), going up the stairs (n = 1; 17%), and running (n = 1; 17%).
View Article and Find Full Text PDFObjective: Endoscopic third ventriculostomy (ETV) has now become an accepted mode of hydrocephalus treatment. However, the long-term effects of ETV for myelomeningocele-related hydrocephalus (MMC-rH) after shunt malfunction remains unclear. We aimed to assess the long-term outcome and the factors associated with the success of ETV for MMC-rH after shunt malfunction.
View Article and Find Full Text PDFObjective: The purpose of the present study was to compare the treatment success rates of primary neurosurgical and endovascular treatments in patients with spinal dural arteriovenous fistulas (dAVFs).
Methods: Data from 199 consecutive patients with thoracic and lumbosacral spinal dAVFs were collected from 18 centers. Angiographic and clinical findings, the rate of initial treatment failure or recurrence by procedures, risk factors for treatment failure, complications, and neurological outcomes were statistically analyzed.
Objective: The optimal treatment method for persistent Blake's pouch cyst (BPC) remains unclear owing to its low prevalence. We aimed to characterize a patient population with adult BPC and to identify the risk factors associated with endoscopic third ventriculostomy (ETV) for BPC. This study reports the largest number of BPC cases in adults and is the first report to reveal the long-term outcomes of ETV in such patients.
View Article and Find Full Text PDFPercutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive spinal surgical technique. PELD can be performed via 2 routes, transforaminal (TF) or interlaminar. The TF approach is a well-established modality in the treatment of patients with herniated lumbar discs.
View Article and Find Full Text PDFPerineural adhesions leading to neuropathy are one of the most undesirable consequences of peripheral nerve surgery. However, there are currently no widely used compounds with anti-adhesive effects in the field of peripheral nerve surgery. E8002 is a novel, anti-adhesive, multi-layer membrane that contains L-ascorbic acid (AA).
View Article and Find Full Text PDFObjective: Spinal arteriovenous shunts are rare vascular lesions and are classified into 4 types (types I-IV). Due to rapid advances in neuroimaging, spinal epidural AVFs (edAVFs), which are similar to type I spinal dural AVFs (dAVFs), have recently been increasingly reported. These 2 entities have several important differences that influence the treatment strategy selected.
View Article and Find Full Text PDFThe source of bleeding in postoperative spinal epidural hematoma (pSEH) is often unclear. We describe a surgical case of pSEH in which the source of bleeding was thought to be the deep cervical artery (DCA). A 67-year-old man underwent C laminectomy, C unilateral open door laminoplasty, and C partial laminotomy for cervical spondylotic myelopathy.
View Article and Find Full Text PDFNeuropathic pain after spinal surgery, so-called failed back surgery syndrome, is a frequently observed common complication. One cause of the pain is scar tissue formation, observed as post-surgical epidural adhesions. These adhesions may compress surrounding spinal nerves, resulting in pain, even after successful spinal surgery.
View Article and Find Full Text PDFDement Geriatr Cogn Dis Extra
March 2018
Background: Intracranial arachnoid cysts are space-occupying lesions that typically remain stable or decrease in size over time. Cysts in infants younger than 1 year of age are remarkably different from those in older children and adults in terms of cyst localization and enlargement. Arachnoid cysts of the posterior fossa (PFACs) are very rare in infants and do not typically grow or present with clinical symptoms, such that surgical treatment is generally considered to be unnecessary.
View Article and Find Full Text PDFBackground: Cervical laminoplasty, utilizing different spacers to ''keep the door open,'' is the gold standard in Japan for treating ossification of the posterior longitudinal ligament (OPLL) and cervical spondylotic myelopathy (CSM). Here, we utilized a novel titanium ''basket'' spacer (Laminoplasty Basket: L-Basket; Ammtec, Tokyo) to perform open door cervical laminoplasty to keep the "door open" while also allowing for bony fusion across the open door.
Methods: Twenty-seven patients with/without OPLL were treated with open door laminoplasty utilizing the basket spacer.
Background: Fourth ventricle mass lesion in neurosarcoidosis is very rare and difficult to be diagnosed pathologically. We report a rare case of progressive hydrocephalus associated with neurosarcoidosis mass lesion located at the fourth ventricle outlet and suprasellar region.
Case Description: A 23-year-old man had a disturbance of consciousness and neck stiffness with fever.
Background: Although endoscopic third ventriculostomy is a safe procedure, the authors report a case of aneurysmal subarachnoid hemorrhage as an unusual and serious complication of an endoscopic third ventriculostomy and ventricular drainage.
Case Description: A 60-year-old male presented with obstructive hydrocephalus caused by midbrain tumors was admitted to our hospital. Endoscopic third ventriculostomy and external ventricular drainage were successfully performed.
The clinical features of the genetically determined forms of familial Parkinson's disease (PD) have been described in multiple reports, but there have been few comparative neuropathologic studies. Five familial PD cases, with mutations in SNCA, were matched for age, sex, and Alzheimer type pathology with sporadic PD cases. Immunohistochemistry for phospho-tau and α-synuclein was performed in 8 brain regions.
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