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Syringomyelia with Central Canal Enlargement Caused by Postoperative Inflammation after Surgery for Intradural Lumbar Disc Herniation.
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 PDFPersistent Post-dural Puncture Headaches One Year After Lumbar Puncture: A Case Report.
Cureus
November 2024
Department of Internal Medicine, Aga Khan University Hospital, Nairobi, KEN.
Post-dural puncture headaches usually occur when the cerebrospinal fluid (CSF) leaks due to trauma to the dura mater. This often results in spontaneous intracranial hypotension characterized by orthostatic headaches, neck stiffness, and nausea. In this case report, we discuss a 20-year-old male patient who developed symptoms of intracranial hypotension one year following a lumbar puncture.
View Article and Find Full Text PDFImpact of contrast administration and CT reconstruction plane on Hounsfield units for assessing underlying bone quality in the lumbar spine.
J Neurosurg Spine
December 2024
Departments of1Neurosurgery.
Objective: Hounsfield units (HUs) may better predict biomechanical complications of instrumented fusion than conventional bone quality measures. Typically, noncontrast axial slices are used. This study aims to address the influence of reconstruction plane and contrast administration on measured HUs in patients undergoing lumbar spine imaging.
View Article and Find Full Text PDFFluoroscopic, Computed Tomographic, and Magnetic Resonance Myelography.
Neuroimaging Clin N Am
February 2025
Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University Medical Center, Center for Academic Medicine, Stanford University Center for Academic Medicine; Radiology + MC: 5659, 453 Quarry Road, Palo Alto, CA 94304, USA. Electronic address: https://twitter.com/BryanLanzman.
Despite all the advantages of magnetic resonance (MR) imaging, there still exist contraindications or limitations to its use. Thus, MR imaging has not entirely replaced fluoroscopic or computed tomographic (CT) myelography to depict the outline of the spinal cord and its nerve roots after intrathecal injection of contrast medium. The growing recent interest of neuroradiologists to accurately diagnose and treat cerebrospinal fluid leaks has also driven a resurgent need for familiarity with this image-guided procedure.
View Article and Find Full Text PDFAlternative Percutaneous Dural Puncture Routes: Cervical, Thoracic, Lumbar, and Sacral.
Neuroimaging Clin N Am
February 2025
Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University Medical Center, Center for Academic Medicine, Radiology + MC: 5659, 453 Quarry Road, Palo Alto, CA 94304, USA. Electronic address: https://twitter.com/BryanLanzman.
Patients requiring lumbar punctures (LPs) are frequently challenging or may be impossible to do through a standard lower lumbar route. Therefore, if clinically indicated, consideration of alternative anatomic access routes to the spinal subarachnoid space may be necessary. However, some of these approaches are unpopular or seldom used, may be challenging to perform, or are associated with potential significant complications especially when combined with limited operator experience.
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