Acute epidural hematoma complicating Paget's disease of the skull

Itoyama, Yoichi; Fukumura, A; Ito, Y.; Matsukado, Yasuhiko

doi:10.1016/0090-3019(86)90281-8

Cited by 12 publications

(9 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is recommended that asymptomatic disease affecting the skull or spine must be treated with bisphosphonates. One of the newer bisphosphonates such as pamidronate, alendronate, risedronate, or tiludronate is recommended as they do not cause the mineralization defects seen with etidronate 12,15 . Chronic, slowly progressive neurologic deficits should initially be treated with bisphosphonates 12 .…”

Section: Discussionmentioning

confidence: 99%

Vertigo as the first manifestation of paget’s disease: a case report

Boukas

Bazoukis

2017

JFSF

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Vertigo as the first manifestation of paget’s disease: a case report

Boukas

Bazoukis

2017

JFSF

View full text Add to dashboard Cite

“…b Microscopic section of the removed bone showing irregular bone trabeculae, with marked osteoblastic margin, frequent osteoclasts, and focal mosaic pattern. H&E, original magnification 100 [3,5,6]. In the remaining patient the hemorrhage originated in an osteogenic sarcoma [4].…”

mentioning

confidence: 99%

“…There are four reports of acute epidural hematomas in patients with Paget's disease [3,4,5,6], three of which were in elderly individuals following a minor head injury Fig. 1 a Computed tomography showing the epidural hematoma, a midline shift, and an abnormally thickened skull.…”

mentioning

confidence: 99%

“…In these cases the first manifestation of the disease was an acute episode of neurological deterioration that initially suggested stroke. A minor blow to the head in patients with Paget's disease can cause a skull fracture that in turn gives rise to a copious hemorrhage from the abnormally vascular bone [3,4,5,6]. A contributing factor is the brain retraction which is found in the elderly.…”

mentioning

confidence: 99%

“…A contributing factor is the brain retraction which is found in the elderly. Skull radiography may fail to reveal the fracture [3,4,5]. The diagnostic method of choice is CT, which depicts both the bone characteristics and the epidural hematoma [3,6].…”

mentioning

confidence: 99%

See 2 more Smart Citations

Cranial epidural hematoma in Paget’s disease of the bone

et al. 2000

View full text Add to dashboard Cite

The neurologic complications of paget's disease

Poncelet

1999

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

Paget's disease of bone is assoCiated with involvement of the central and peripheral nervous system. The brain, spinal cord, cauda equina, spinal roots, and cranial nerves can be a f f e c t e d in Paget's disease due to their anatomic relationship to bone. Neurologic syndromes are uncommon but include headache, dementia, brain stem and cerebellar dysfunction, cranial neuropathies, myelopathy, cauda equina syndrome, and radiculopathies. The central complications result from pagetic involvement of the skull. Expansion of diseased bone can result in compression of cranial nerves as they exit their bony foramina. Softening of the skull leads to basilar invagination with compression of the brain stem, cerebellum, and lower cranial nerves. Brain stem Compression can cause hydrocephalus. Rarely, there is direct compression of the brain from acute epidural hematoma or hypertrophy of the calvarium. Myelopathy, cauda equina syndrome, and radiculopathies most commonly result from hypertrophy of the spine with direct compression. Spinal sten& can also result from ossification of extradural structures or pathologic fractures. Ischemia from vascular compression or a steal syndrome has also been described. Neurologic complications rarely occur due to sarcomatous transformation of pagetic bone. Magnetic resonance imaging (MRI), computerized tomography (CT)-myelography, and bone X-rays are helpful to localize the lesion and direct therapy. Treatment options include surgical decompression, ventricular shunt placement, and medical management with calcitonin andor the bisphosphonates. The selection of treatment will vary depending upon the rate of progression and the severity of the neurologic deficit. (J Bone Miner Res 1999,14, suppl. 2:88-91)

show abstract

Acute epidural hematoma complicating Paget's disease of the skull

Cited by 12 publications

References 24 publications

Vertigo as the first manifestation of paget’s disease: a case report

Vertigo as the first manifestation of paget’s disease: a case report

Cranial epidural hematoma in Paget’s disease of the bone

The neurologic complications of paget's disease

Contact Info

Product

Resources

About