Objective: Myelopathy is used to describe any neurologic deficit related to the spinal cord. Determining the etiology is important for detecting emergency situations and treating the cause.
Materials and Methods:We evaluated 28 patients who were diagnosed as having and treated for myelopathy between January 2014 and January 2015 in our hospital. The clinical and laboratory findings of the patients and their response to treatment were assessed.
Results:Of the 28 patients, 16 were male and 12 were female, the mean age was 48 years (range, 22-77 years). The most common initial symptoms were sensorial deficits and motor weakness. Demyelinating diseases were the most common diseases and multiple sclerosis was the most frequent etiology among demiyelinating diseases. Cervical spinal cord was the most frequent region involved in myelopathy episodes which was detected by magnetic resonance imaging on T2W images. We observed clinical improvement in 15 of the 20 patients who were treated with corticosteroids. In addition, vitamin B12 treatment led to clinical improvement in two patients who were diagnosed as having subacute combined degeneration.
Conclusion:The diagnosis and etiology of myelopathy and identification of rare conditions that require emergency surgery or interventional treatments are of utmost importance.
Keywords: Myelopathy, paraparesis, spinal cord damageAmaç: Miyelopati spinal kord ile ilgili herhangi bir nörolojik defisiti tanımlamak için kullanılır. Etiyolojinin belirlenmesi, acil durumların saptanması ve nedene yönelik tedavilerin başlanması açısından önemlidir.
Gereç ve Yöntem:Bu çalışmaya Ocak 2014-Ocak 2015 yılları arasında hastanemizde miyelopati tanısı ile tetkik ve tedavi edilen 28 hasta dahil edildi. Hastaların klinik, demografik özellikleri, görüntüleme, laboratuvar bulguları ve tedaviye yanıtları değerlendirildi.
Bulgular:Hastaların 16'sı erkek, 12'si kadındı. Yaş ortalamaları 48 (aralık, 22-77) idi. Hastaların başlangıç şikayetleri çoğunlukla motor ve duyusal semptomlardan oluşmaktaydı. Etiyolojide en sık demiyelinizan hastalıklar, bunlar içerisinden de multipl skleroz saptandı. Manyetik rezonans görüntüleme sonuçlarına göre en sık servikal bölgede miyelopati ile uyumlu T2A görüntülerde sinyal artışı izlendi. Yirmi hastaya steroid tedavisi verilirken bu hastalardan 15'inde tedaviye yanıt alındı. Subakut kombine dejenerasyon tanısı alan iki hasta B12 tedavisinden yarar gördü.Sonuç: Çalışmamızda miyelopati tanısı alan hastaların tanı, tedavi ve prognozları değerlendirildi. Acil durumların önemi, ayırıcı tanıda göz önünde bulundurulması gereken durumlar vurgulanmaya çalışıldı.
Puerperal hematoma is one of the life threatening obstetrical emergencies. Surgical ligation of bleeding vessel may not always be possible for the patients who were hemodynamically unstable, hence pelvic arterial angiography may be preferred as the first line treatment modality for these cases. Pelvic arterial angiography and embolization is a safe, tolerable, and minimally invasive treatment modality in the diagnosis and treatment of pelvic hemorrhage. We present a case of puerperal hematoma after a normal spontaneous delivery treated with bilateral iliac arterial embolization.
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