• Title/Summary/Keyword: Extradural

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Diagnostic Imaging of Intervertebral Disk Disease in 3 Dogs (추간판 질환 3례에서의 진단영상)

  • 엄기동;장동우;서민호;정주현;최호정;이기창;이희천;이영원;최민철
    • Journal of Veterinary Clinics
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    • v.18 no.3
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    • pp.284-287
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    • 2001
  • Three dogs referred to Veterinary Medical Teaching Hospital, Seoul National University were diagnosed as intervertebral disc disease. Physical examination, neurologic examination, survey radiograph, and myelography were performed in patients. Case 1 showed narrowing intervertebral space and calcified intervertebral disc material in survey radiograph. Case 2 showed increased opacity in the intervertebral opacity in survey radiograph. All of 3 cases showed extradural pattern during myelography. In survey radiography, radiographic signs consistent with intervertebral disc herniations include narrowing of the disc space and the dorsal intervertebral articular process joint space, small intervertebral foramen, increase opacity in the intervertebral foramen and extruded, mineralized disc material within the vertebral canal. Myelography is useful for evaluating the spinal cord and the cauda equina. Indication for myelography includes confirming a spinal lesion seen or suspected on survey radiograph, defining the extent of a survey lesion, finding a lesion not observed on survey radiograph, and distinguishing between surgical and nonsurgical lesion. In presentcases, two of three cases show radiographic signs of IVDD with survey radiograph and all of three case show extradural pattern during myelography. It is observed that intervertebral disc disease is one of the most important indication for radiographic examination and myelography of the vertebral column of small animals.

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Diffuse Large B-cell Lymphoma of the Sacral Nerve Root; Presenting as a Polyradiculoneuropathy

  • Oh, Sung-Han;Noh, Jae-Sub;Chung, Bong-Sub;Paik, So-Ya
    • Journal of Korean Neurosurgical Society
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    • v.37 no.1
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    • pp.70-72
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    • 2005
  • Primary spinal cord lymphomas are rare, and are either extra-/intradural masses with leptomeningeal infiltration or intramedullary in nature. The authors present a patient with a diffuse large B-cell lymphoma involving the sacral nerve root, extension to extradural space, and the cranial nerve.

Spinous Process-Splitting Hemilaminoplasty for Intradural and Extradural Lesions

  • Lee, Young-Seok;Kim, Young-Baeg;Park, Seung-Won
    • Journal of Korean Neurosurgical Society
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    • v.58 no.5
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    • pp.494-498
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    • 2015
  • Objective : To describe a novel spinous process-splitting hemilaminoplasty technique for the surgical treatment of intradural and posterior epidural lesions that promotes physiological restoration. Methods : The spinous process was split, the area of the facet lamina junction was drilled, and en bloc hemilaminectomy was then performed. After removing intradural and posterior epidural lesions, we fitted the previously en bloc-removed bone to the pre-surgery same shape, and held it in place with non-absorbable sutures. Surgery was performed on 16 laminas from a total of nine patients between 2011 and 2014. Bony union of the reconstructed lamina was assessed using computed tomography (CT) at 6 months after surgery. Results : Spinous process-slitting hemilaminoplasty was performed for intradural extramedullary tumors in eight patients and for ossification of the ligament flavum in one patient. Because we were able to visualize the margin of the ipsilateral and contralateral dura, we were able to secure space for removal of the lesion and closure of the dura. None of the cases showed spinal deformity or other complications. Bone fusion and maintenance of the spinal canal were found to be perfect on CT scans. Conclusion : The spinous process-splitting hemilaminoplasty technique presented here was successful in creating sufficient space to remove intradural and posterior epidural lesions and to close the dura. Furthermore, we were able to maintain the physiological barrier and integrity after surgery because the posterior musculature and bone structures were restored.

Comparison of Clinical and Anatomical Differences of Vertebral Artery Dissection between Minor Trauma and Non-trauma Causes (경증 외상관련 척추동맥박리의 임상양상 및 해부학적 위치 비교)

  • Chong, Yeon Hee;Ahn, Ji Yun;Oh, Bum Jin;Kim, Won;Lim, Kyoung Soo
    • Journal of Trauma and Injury
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    • v.20 no.2
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    • pp.101-105
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    • 2007
  • Purpose: This study aimed to find any difference in the clinical or the anatomical findings of vertebral artery dissection (VAD) between the trauma and the non-trauma groups. Methods: We retrospectively reviewed the clinical data and radiologic images of VAD patients. We compared data on symptoms, neurologic deficit, National institutes of health stroke scale (NIHSS) at admission, Rankin score (RS) at admission and discharge, and radiological findings including anatomical features, between the trauma and the non-trauma groups. Results: From January 1997 to May 2006, 42 patients were enrolled and 13 patients (31%) had a history of earlier trauma. Focal neurologic deficit (trauma group 11/13 vs. non-trauma group 11/29), cerebral stroke (10/13 vs. 9/29), and extradural lesions of dissection (6/13 vs. 3/28) were more common in the trauma group than non-trauma group (p=0.007, p=0.017, p=0.018, respectively) and NIHSS at admission and discharge were significantly higher (p=0.012, p=0.001, respectively). Dissecting aneurysms were less frequent in the trauma group (2/13 vs. 19/29, p=0.006). Subarachnoid hemorrhage and unfavorable prognostic value (Rankin score at discharge ${\geq}$ 2) showed no differences between the groups (p=0.540, p=0.267, respectively). Conclusion: In VAD patients after trauma, focal neurologic deficit due to ischemic stroke and a steno-occlusive pattern are more frequent than they are in non-trauma patients. The location of dissection was most frequent at the extradural vertebral artery in the trauma group. NIHSS was higher in the trauma groups but the incidence of an unfavorable prognostic value (RS ${\geq}$ 2) was not significantly different between the groups.

Measurement of Critical Structures around Paraclinoidal Area : A Cadaveric Morphometric Study

  • Lee, Hyun-Woo;Park, Hyun-Seok;Yoo, Ki-Soo;Kim, Ki-Uk;Song, Young-Jin
    • Journal of Korean Neurosurgical Society
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    • v.54 no.1
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    • pp.14-18
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    • 2013
  • Objective : Although removal of the anterior clinoid process (ACP) is essential surgical technique, studies about quantitative measurements of the space broadening by the anterior clinoidectomy are rare. The purposes of this study are to investigate the dimension of the ACP, to quantify the improved exposure of the parasellar space after extradural anterior clinoidectomy and to measure the correlation of each structure around the paraclinoidal area. Methods : Eleven formalin-fixed Korean adult cadaveric heads were used and frontotemporal craniotomies were done bilaterally. The length of C6 segment of the internal carotid artery on its lateral and medial side and optic nerve length were checked before and after anterior clinoidectomy. The basal width and height of the ACP were measured. The relationships among the paraclinoidal structures were assessed. The origin and projection of the ophthalmic artery (OA) were investigated. Results : The mean values of intradural basal width and height of the ACP were 10.82 mm and 7.61 mm respectively. The mean length of the C6 lateral and medial side increased 49%. The mean length of optic nerve increased 97%. At the parasellar area, the lengths from the optic strut to the falciform liament, distal dural ring, origin of OA were 6.69 mm, 9.36 mm and 5.99 mm, respectively. The distance between CN III and IV was 11.06 mm. Conclusion : With the removal of ACP, exposure of the C6 segments and optic nerve can expand 49% and 97%, respectively. This technique should be among a surgeon's essential skills for treating lesions around the parasellar area.

Discal Cyst in a Malamute Dog (말라뮤트 개에서 발생한 디스크 낭종 증례)

  • Kim, Jae-Hwan;Park, Noh-Won;Kwon, Young-Hang;Lim, Jong-Hwan;Bae, Jang-Hoon;Eom, Ki-Dong
    • Journal of Veterinary Clinics
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    • v.31 no.5
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    • pp.445-448
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    • 2014
  • A 7-year-old, male Alaskan malamute was referred for a routine dental management. On the physical examination, the right hindlimb ataxia with a mild delay in proprioception was noted. On magnetic resonance images, an extradural ventral cystic structure compressing the spinal cord was found at the level between the first and second lumbar vertebra. The cyst showed hypointense on a T1-weighted image with rim enhancement and hyperintense on a T2-weighted image. The cystic lesion was removed through right-side hemilaminectomy. In the histopathological examination, evenly distributed fibroblasts and collagenous stroma with several cartilaginous materials were seen. The neurological signs of the right hindlimb were successfully recovered within a week in follow-up neurological examination and showed normal gait at 6 months after surgery.

Lumbar Intraspinal Extradural Ganglion Cysts

  • Cho, Sung-Min;Rhee, Woo-Tack;Choi, Soo-Jung;Eom, Dae-Woon
    • Journal of Korean Neurosurgical Society
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    • v.46 no.1
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    • pp.56-59
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    • 2009
  • The lumbar intraspinal epidural ganglion cyst has been a rare cause of the low back pain or leg pain. Ganglion cysts and synovial cysts compose the juxtafacet cysts. Extensive studies have been performed about the synovial cysts, however, very little has been known about the ganglion cyst. Current report is about two ganglion cysts associated with implicative findings in young male patients. We discuss about the underlying pathology of the ganglion cyst based on intraoperative evidences, associated disc herniation at the same location or severe degeneration of the ligament flavum that the cyst originated from in young patients.

Lower Extremity Paralysis Developed during Pain Control in Lung Cancer Patient -A case report- (폐암 환자에서 통증치료중 발생한 하지 마비 -증례 보고-)

  • Kim, Hong-Beum;Song, Pil-Oh
    • The Korean Journal of Pain
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    • v.9 no.2
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    • pp.439-442
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    • 1996
  • Continuous epidural analgesia has been used widely for chronic pain control, especially in cancer patients. As one of the complications, paraplegia developed during continuous epidural analgesia may be caused by epidural abscess, epidural hematoma, neural damage, chronic adhesive arachnoiditis, anterior spinal artery syndrome, delayed migration of extradural catheter into subdural space or subarachnoid space and preexisting disease. A 55-years-old male with lung cancer was implanted with continuous thoracic epidural catheter for pain control. Twenty days after catheterization, moderate back pain, weakness of lower extremity and urinary difficulty were developed. We suspected epidural abscess at first and made differential diagnosis with MRI which showed metastatic cancer at T2-4 spine, And compressed spinal cord was the main cause of the lower extremity paralysis.

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Clinical Experience of Leukemia with Extradural Chloroma during Treatment of Lower Back Pain -A case report- (요통 치료 도중 발견된 경막외강 녹색종을 동반한 백혈병 환자 경험 -증례 보고-)

  • Lim, Kyung-Joon;Oh, Kyoung-Hee;Moon, Hyun-Seok
    • The Korean Journal of Pain
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    • v.13 no.1
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    • pp.119-122
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    • 2000
  • Granulocytic sarcoma (chloroma) is a rare, solid tumor of myelogenous stem cells, shows usually in patients with acute myelogenous leukemia and less commonly in patients with chronic myelogenous leukemia or myeloproliferative disorders. We report here a patient presenting acute paraparesis due to spinal epidural granulocytic sarcoma causing spinal cord compression in acute myelogenous leukemia with a brief review of literature.

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Discal Cyst of the Lumbar Spine

  • Hwang, Jae-Ha;Park, In-Sung;Kang, Dong-Ho;Jung, Jin-Myung
    • Journal of Korean Neurosurgical Society
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    • v.44 no.4
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    • pp.262-264
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    • 2008
  • Discal cysts are rare lesions that can cause radiating leg pain. Because they are very rare, their natural history and the details of the therapeutic guidelines for the treatment of these cysts are still unknown. A 30-year-old male patient presented to our institute with radiating pain in his left leg and mild back pain. Magnetic resonance imaging (MRI) revealed an intraspinal extradural cystic mass with low signal intensity on T1-weighted images and high signal intensity on T2-weighted images at the L5-S1 level. The partial hemilaminectomy and cyst resection were performed. We report a patient with low back pain and radiating leg pain caused by a lumbar discal cyst and discuss the treatment of this cyst.