Lesions of the Spinal Epidural Space Producing Cord Compression

Shenkin, Henry A.; Horn, Robert C.; Grant, Francis C.

doi:10.1001/archsurg.1945.01230040132001

Cited by 81 publications

(16 citation statements)

References 39 publications

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“…However, other authors have disputed the value of laminectomy and have stated that surgery should be directed at pain relief (Arseni et al, 1959;Rasmussen, Kernohan and Adson, 1940;Shenkin, Horn and Grant, 1945). In this series, half of the patients were subjected to laminectomy and only one of the seven benefitted from the operative procedure.…”

Section: Discussionmentioning

confidence: 83%

Vertebral metastases and spinal cord compression

et al. 1983

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Summary. Clinical interest in spinal compression and resultant paraplegia due to metastases has mounted in recent years. This has stimulated attention to the neuropathology of the condition. Fourteen cases of spinal cord compression due to vertebral metastases are compared with over 100 traumatic cases. In the traumatic lesions there is central haemorrhagic necrosis leading to cavitation and gliosis with nerve root regeneration in the late stages. In the metastatic cases, lesions are often peripheral, pie-shaped and are related to vascular factors. The neuro pathology of cord necrosis due to metastatic spinal disease is therefore different to trauma. These observations have clinical importance in planning treatment.

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Section: Discussionmentioning

confidence: 83%

Vertebral metastases and spinal cord compression

et al. 1983

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“…In our review of English literature, only eight cases below the age of 2 years had been reported with no age below the first year of life (Table 1). [4][5][6][7][8][9] The term 'crib death' has been used to describe sudden unexplained death of neonates. 10 In postmortem examination of infants with 'crib death', spinal epidural hematomas were the causal factor in 10% of cases.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7][8][9] This region is more commonly affected as a result of significant disproportion of the weight ratio of the head to the body in pediatric population, in which the head proportion is larger and heavier than in adults. In addition, gaining the head control is an important neuromuscular development milestone during the first 4-6 months of life.…”

Section: Discussionmentioning

confidence: 99%

“…A summary of presenting symptoms and signs from the reported cases includes irritability, abdominal fullness and pain, neck pain, torticollis, rigid neck position, staggering gait, and fever. [4][5][6][7][8][9] The innumerable clinical presentations often result in delaying diagnosis. In our case, the infant initially presented with irritable crying, neck stiffness, and limited range of motion of the neck, followed by neurological deficit as showed by decrease in ability to roll over and decrease limb movements.…”

Section: Discussionmentioning

confidence: 99%

“…In our review of reported cases in toddlers, most of the cases had complete functional recovery including our patient, suggesting the surgical decompression results in good outcome even with delayed diagnosis. [4][5][6][7][8][9] Laminectomy of the involved segment is the main surgical modality in most cases. However, some authors are concerned that laminectomy will limit normal development in young children, resulting in kyphosis, lordosis, scoliosis or tethered cord.…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous spinal epidural hematoma in a 4-month-old infant

Lee

Huang

et al. 2006

Spinal Cord

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Study design: A case report and a review of literature. Objectives: To present the first youngest infant of a 4-month-old boy with spontaneous spinal epidural hematoma in cervicothoracic spine. Setting: National Cheng Kung University Hospital, Tainan, Taiwan. Methods: A 4-month-old boy who initially presented with irritable crying, neck stiffness, and fever followed by progressive quadriparesis. Magnetic resonance imaging (MRI) of the spine disclosed a space-occupying lesion on the right posterior-lateral aspect of the cervicothoracic spinal canal. Laminectomy with reconstruction in situ from C4 to T4 was performed 5 days after the onset of symptoms. Results: The boy had gradual improvement of his neurological status. Follow-up visit 1 year later, the infant's growth and development was within normal limit without any neurological deficits; his repeat MRI showed complete fusion of each implanted lamina and well expansion of the spinal cord. Conclusions: Prompt surgical decompression is valuable, irrespective of the time interval between symptom onset and operation in infant.

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Neurologic Complications of Myelomatosis

Silverstein¹,

Doniger²

1963

Archives of Neurology

130

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have been described previously,1-9 there still remains some controversy concerning the incidence, pathogenesis, and treatment of the several types of neurologic complications of the disease. Many of the previous publications of the neurologic aspects of myelomatosis were based on observations of small series of patients who were sometimes specially selected (eg, those admitted to a neurosurgical service). The emphasis of many of the previous reports has been either on the direct compression of the nervous system by myeloma tumor or on distant "toxic" effects. In the older literature, the criteria for the diagnosis of multiple myeloma have, at times, also been uncertain.The purpose of this communication is to report and discuss the neurologic complications observed in 277 patients admitted to a general hospital, where a diagnosis of multiple myeloma was eventually proved. Materials and MethodsThe 277 patients were all studied at The Mount Sinai Hospital, New York. The clinical and labora¬ tory features of some 90 of these patients were collected in a monograph ten years ago.8 A few others have also been previously reported.8"11 For inclusion in this series all patients satisfied at least two of the following criteria for the diagnosis of myelomatosis: (1) histologie (biopsy or autopsy) proof of the disease; (2) bone marrow obtained by aspiration, showing more than 15% plasma cells ;(3) a homogeneous protein spike in serum or urine electrophoresis ; (4) Bence Jones proteinuria ; and (5) characteristic abnormalities on roentgenograms of the skull and other bones. The last three criteria were accepted only if another disease (eg, macroglobulinemia, leukemia, metastatic carcinoma) was excluded. Seven patients with a solitary plasmacytoma have been included, although not all could be followed until their disease became generalized.The neurologic data were obtained by reviewing clinical records, autopsy protocols, operative notes, myelograms, and other available studies. For con-

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Lesions of the Spinal Epidural Space Producing Cord Compression

Cited by 81 publications

References 39 publications

Vertebral metastases and spinal cord compression

Vertebral metastases and spinal cord compression

Spontaneous spinal epidural hematoma in a 4-month-old infant

Neurologic Complications of Myelomatosis

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