Presentation and Medical Management of Fibrocartilaginous Embolism in the Emergency Department

Jones, Derick D.; Watson, Robert E.; Heaton, Heather A.

doi:10.1016/j.jemermed.2016.05.049

Cited by 8 publications

(18 citation statements)

References 14 publications

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“…After 3 weeks from onset, difficulty in ambulating on tiptoe has not improved. Although the degree of recovery of spinal cord ischemia is generally poor, our patient showed relatively good neurologic improvement, which may because the involved spinal cord area was the lumbosacral part and the extent of spinal cord ischemia was small compared with previous reports 2,5,23 . Our review showed half of the cases were treated by steroids and/or anticoagulant.…”

Section: Treatment and Prognosis Of Fce Of The Spinal Cordcontrasting

confidence: 51%

“…years of age, including our case, were reviewed [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] .…”

Section: Case Descriptionmentioning

confidence: 99%

“…FCE is often misdiagnosed with transverse myelitis, like in our patient 3 . Although a definitive diagnosis of FCE can only be made after an autopsy, diagnosis by clinical and radiological features is considered possible [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] . The number of clinically diagnosed cases has been exceeding the number of autopsy-proven cases, and we found only 3 pediatric cases of FCE of the spinal cord that were pathologically defined 17,19,20 .…”

Section: Diagnosis Of Fce Of the Spinal Cordmentioning

confidence: 99%

“…FCE is well described in veterinary literature; recently, it has also been increasingly recognized in humans [3][4][5][6][7] . However, it is currently not well recognized among pediatricians due to its rarity.…”

Section: Introductionmentioning

confidence: 99%

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Fibrocartilaginous Embolism of the Spinal Cord in Children: A Case Report and Review of Literature

Yamaguchi

Nagase

Nishiyama

et al. 2019

Pediatric Neurology

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Fibrocartilaginous embolism (FCE) is assumed to be caused by the migration of fibrocartilaginous nucleus pulposus components through retrograde embolization to the spinal cord artery. FCE is currently not well recognized among pediatricians due to its rarity. We present the case of a previously healthy 15-year-old soccer player who, after kicking a ball, developed progressive weakness in both legs and ischuria the next day. Magnetic resonance imaging revealed T2 hyperintensity in the anterior horn of the spinal cord at the Th12/L1 level with Schmorl's node at the level of L1/2. We also reviewed previous literature of FCE of the spinal cord in children (<18 years of age), and a total of 25 pediatric patients, including our case, were reviewed. The median age was 14 years and 64% of the reviewed patients were female. The most common trigger event was intense exercise or sports (52%). The neurological symptoms started within 1 day in most cases and time to symptom peak varied from a few hours to 2 weeks. The most common initial neurologic symptoms were weakness or plegia (100%), followed by paresthesia or numbness (44%). Affected areas of the spinal cord were distributed evenly from the cervical to thoracolumbar regions. Although steroids and anticoagulants were most commonly used, the prognosis was quite poor (mostly mild to severe sequelae and 3 patients died). Although FCE is a very rare condition, pediatricians should be aware of the characteristics and include FCE of the spinal cord in their differential diagnosis, especially for physically active patients.

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Section: Treatment and Prognosis Of Fce Of The Spinal Cordcontrasting

confidence: 51%

“…years of age, including our case, were reviewed [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] .…”

Section: Case Descriptionmentioning

confidence: 99%

Section: Diagnosis Of Fce Of the Spinal Cordmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Fibrocartilaginous Embolism of the Spinal Cord in Children: A Case Report and Review of Literature

Yamaguchi

Nagase

Nishiyama

et al. 2019

Pediatric Neurology

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“…Den vanligste årsaken til spinalt infarkt er aortapatologi eller at det oppstår iatrogent etter aortakirurgi, men fibrocartilaginøse embolier er i litteraturen beskrevet å vaere en sannsynlig underdiagnostisert årsak til medullaere infarkter (2,3). Teorier går ut på at fibrocartilaginøst materiale fra nucleus pulposus i degenererte skiver kan migrere via naerliggende karstrukturer, retrograd videre til den arterielle blodforsyningen (2,4). Vanligst er embolier til medulla, men det er også beskrevet fibrocartilaginøse embolier til lunge, hjerne, virvelcorpora og costae (2).…”

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