Unlabelled: A 57-year-old woman, with a history of deep venous thrombosis and medicated with warfarin, presented at the hospital with acute back pain with paraplegia, headache, high blood pressure and vomiting. Imaging of the spine showed an acute intradural extramedullary haemorrhage with blood clot formation. The patient underwent surgery and received intensive post-surgical physiotherapy but remains paraplegic. Non-traumatic spinal intradural extramedullary haematoma (SIEH) is a rare neurological emergency that can result in spinal cord compression. Physicians should always consider this clinical entity as a differential diagnosis, especially in a patient presenting with acute back pain on anticoagulant therapy.
Learning Points: Non-traumatic spinal intradural extramedullary haematoma is extremely rare.Acute cases can lead to spinal cord compression.Physicians should consider this clinical entity in anticoagulated patients presenting with acute onset of back or radicular pain followed by paraplegia, intestinal and bladder dysfunction.
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http://dx.doi.org/10.12890/2018_000951 | DOI Listing |
Cureus
December 2024
Department of Neurosurgery, Medical Research Institute Kitano Hospital, PIIF Tazuke-Kofukai, Osaka, JPN.
Intramedullary spinal cord metastasis (ISCM) is a rare manifestation of renal cell carcinoma (RCC). A 73-year-old man presented with left shoulder pain and left upper extremity weakness for two months. Magnetic resonance imaging (MRI) revealed intramedullary and intradural extramedullary lesions at the C5 level, compressing the spinal cord from the center of the cord and the left ventral side.
View Article and Find Full Text PDFWorld Neurosurg
January 2025
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University; Spine Center, China International Neuroscience Institute (CHINA-INI); Research Center of Spine and Spinal Cord, Beijing Institute of Brain Disorders, Capital Medical University; Lab of Spinal Cord Injury and Functional Reconstruction, China International Neuroscience Institute (CHINA-INI); National Center for Neurological Disorders, Beijing, CHINA. Electronic address:
Background: Revision surgery for patients with persistent, recurrent, or progressive syringomyelia following foramen magnum decompression (FMD) for Chiari malformation I-syringomyelia (CM-SM) is not uncommon and presents both strategic and technical challenges.
Methods: We conducted a retrospective study including all patients who underwent revision Cerebellar Tonsillectomy (CTL) for CM-SM between 2003 and 2023. Additionally, we performed uni- and multivariate analyses to identify possible factors contributing to failed CTL outcomes.
Brain Sci
January 2025
Centre of Medical Sciences, Jan and Jędrzej Śniadeccy University of Science and Technology, 85-796 Bydgoszcz, Poland.
Background/objectives: While most studies on the postoperative condition of patients with spinal cord tumors describe long-term outcomes, data are needed on immediate surgical outcomes demanding rehabilitation to make informed assessments for postoperative planning. The aim of this study was to identify factors predicting function and rehabilitative needs after intradural spinal tumor surgery.
Methods: Eighty-five prospectively recruited patients underwent surgery for intradural intramedullary (ID-IM; = 23) and extramedullary (ID-EM; = 62) tumors.
NMC Case Rep J
December 2024
Department of Orthopedic Surgery, NHO Osaka Minami Medical Center, Kawachinagano, Osaka, Japan.
Intradural lumbar disc herniation (ILDH) is a very rare condition, with cerebrospinal fluid (CSF) leakage as a postoperative complication. The central canal of the conus medullaris was reported to communicate with the subarachnoid space through a caudal aperture; however, this aperture has never been observed in vivo. Herein, we report a case of L1/2 ILDH with postoperative spinal adhesive arachnoiditis and syringomyelia in which the communication considered to be a caudal aperture was detected.
View Article and Find Full Text PDFCureus
December 2024
Neurosurgery, Al-Azhar University, Giza, EGY.
Intradural disc herniation (IDDH) is a rare condition, accounting for less than 0.5% of herniated disc cases, primarily affecting the lumbar region and often presenting with severe nerve compression or cauda equina syndrome. This paper presents the case of a 60-year-old female with a history of hypertension, dyslipidemia, stroke, and hypothyroidism, who arrived with severe lower back pain, lower limb weakness, and urinary retention.
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