scholarly journals Idiopathic Hypertrophic Spinal Pachymeningitis: A Diagnostic Challenge: A Case Report and Review of the Literature

2019 ◽  
Vol 11 (01) ◽  
pp. 175-177
Author(s):  
Abdulla Alsulaiman
Keyword(s):  
Surgical Intervention ◽  
Cord Compression ◽  
Sensory Level ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Neurological Damage ◽  
Hypertrophic Pachymeningitis ◽  
Diagnostic Challenge ◽  
Spinal Compression ◽  
Early Surgical Intervention

AbstractIdiopathic hypertrophic pachymeningitis (IHP) can resemble other disorders associated with spinal compression. It is a rare inflammatory fibrosing disease of the dura of unidentified etiology and is considered a diagnosis of exclusion. We present a case of idiopathic hypertrophic spinal pachymeningitis occupying a long segment of cervical dura. This is a case of 38-year-old female patient, who suffered progressive neck pain for 2-year duration. Examination revealed spasticity in all four limbs, plus three symmetric reflexes all over, and the sensory level at T4. Magnetic resonance imaging showed spinal cord compression by a thickened anterior and posterior dura adjacent to the cord from C2 to C7. The diagnosis of spinal IHP was confirmed through biopsy. The patient improved after treatment with corticosteroids. Early surgical intervention with postoperative corticosteroid therapy is a known treatment for this disease, as a way to prevent irreversible neurological damage.

Idiopathic hypertrophic spinal pachymeningitis

2011 ◽  
Vol 15 (2) ◽  
pp. 195-201 ◽  
Author(s):  
Moksha G. Ranasinghe ◽  
Omar Zalatimo ◽  
Elias Rizk ◽  
Charles S. Specht ◽  
G. Timothy Reiter ◽  
...  
Keyword(s):  
Conservative Therapy ◽  
Surgical Intervention ◽  
Clinical Course ◽  
Unknown Etiology ◽  
Inflammatory Disorder ◽  
Review Of The Literature ◽  
Neurological Damage ◽  
Hypertrophic Pachymeningitis ◽  
Pathological Confirmation ◽  
Prompt Diagnosis

Spinal idiopathic hypertrophic pachymeningitis (IHP) is a rare, chronic, nonspecific, granulomatous inflammatory disorder of the dura with unknown etiology. It can cause a localized or diffuse thickening of the dura mater with compression of the spinal canal and possible myelopathic symptoms. The authors report 3 consecutive cases of spinal IHP with a review of the literature. The diagnosis of spinal IHP was based on biopsy and pathological confirmation. Typical MR imaging findings suggestive of spinal IHP were noted in all cases. The clinical course may be marked by deterioration despite conservative therapy and may require surgical intervention to prevent irreversible neurological damage. Therefore, prompt diagnosis and institution of proper treatment is critical.

scholarly journals IgG4-related intracranial disease

2018 ◽  
Vol 32 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Shahine Goulam-Houssein ◽  
Jeffrey L Grenville ◽  
Katerina Mastrocostas ◽  
David G Munoz ◽  
Amy Lin ◽  
...  
Keyword(s):  
Plasma Cells ◽  
Surgical Intervention ◽  
Case Series ◽  
Hypertrophic Pachymeningitis ◽  
Diagnostic Challenge ◽  
Perineural Spread ◽  
Related Disease ◽  
The Third ◽  
Igg4 Related Disease ◽  
Intracranial Involvement

IgG4-related disease (IgG4-RD) is a multi-organ chronic inflammatory process caused by infiltration of IgG4-positive plasma cells in one or more organs. Intracranial involvement has only recently become better recognized. Our case series adds to the growing literature on the varying presentations of intracranial IgG4 by describing the clinical and imaging findings of three patients who presented to our institution with intracranial involvement. Our first patient presented with a mass-forming IgG4 pachymeningitis mimicking a sphenoid wing meningioma, which is to our knowledge the largest mass-forming pachymeningitis published in the literature. Our second case depicts another presentation of extensive IgG4 pachymeningitis involving both cavernous sinuses and surrounding Meckel’s caves. The third case describes a patient with presumed lymphocytic hypophysitis, which was later determined to be IgG4-related hypophysitis with concomitant pachymeningitis and perineural spread along the optic nerves. The delayed diagnoses in our cases illustrates the diagnostic challenge that clinicians face in differentiating intracranial IgG4-RD from other infiltrative diseases such as sarcoidosis, granulomatous disease, tuberculosis and lymphoma. Earlier consideration of IgG4-related hypophysitis and hypertrophic pachymeningitis in the differential diagnosis can prevent significant morbidity including unnecessary surgical intervention and organ failure secondary to extensive fibrosis.

Onyx embolization of a thoracolumbar perimedullary spinal arteriovenous fistula in an infant presenting with subarachnoid and intraventricular hemorrhage

2009 ◽  
Vol 3 (3) ◽  
pp. 211-214 ◽  
Author(s):  
Tyler J. Kenning ◽  
Eric M. Deshaies ◽  
Matthew A. Adamo ◽  
John B. Waldman ◽  
Alan S. Boulos
Keyword(s):  
Intraventricular Hemorrhage ◽  
Pediatric Patients ◽  
Surgical Intervention ◽  
Resonance Imaging ◽  
Diagnostic Challenge ◽  
Negative Results ◽  
Spinal Arteriovenous Fistula ◽  
Diagnostic Angiography ◽  
Spontaneous Subarachnoid Hemorrhage ◽  
The Brain

Identifying a source of spontaneous subarachnoid hemorrhage (SAH) or intraventricular hemorrhage (IVH) in patients with negative results on cranial angiographic imaging can be a diagnostic challenge. The authors present the case of a 14-month-old girl who presented with lethargy and spontaneous SAH and IVH, and later became acutely paraplegic. Except for the SAH and IVH, findings on neuroimages of the brain were normal. Magnetic resonance imaging revealed an intramedullary thoracolumbar spinal cord hemorrhage that was found to be associated with arterialized veins intraoperatively. Catheter-based diagnostic angiography identified a spinal perimedullary macroarteriovenous fistula (macro-AVF) that was completely embolized with Onyx, negating the need for further surgical intervention. The authors believe this to be the first reported case of a thoracolumbar perimedullary macro-AVF presenting with SAH and IVH. In addition, descriptions of Onyx embolization of a spinal AVF in the literature are rare, especially in pediatric patients.

scholarly journals Pregnancy-Associated Pyogenic Sacroiliitis: Case Report and Review

2003 ◽  
Vol 11 (1) ◽  
pp. 53-57 ◽  
Author(s):  
Mohammad O. Almoujahed ◽  
Riad Khatib ◽  
Joseph Baran
Keyword(s):  
Magnetic Resonance Imaging ◽  
Surgical Intervention ◽  
Joint Involvement ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Pyogenic Sacroiliitis ◽  
Joint Tenderness ◽  
Septic Sacroiliitis ◽  
Peripartum Period ◽  
Post Abortion

Background: Pyogenic sacroiliitis occurs infrequently during the peripartum period.Case:A case at our institution and a review of the literature were analyzed. A total of 15 cases were discovered. The onset of illness was during pregnancy (40% of cases), within 3 weeks postpartum (40%) or post-abortion (20%), and the presentation was usually acute (< 7 days in 67% of cases). Frequent manifestations included localized pain in the hips or buttock, sacroiliac joint tenderness and fever. Computed tomography or magnetic resonance imaging revealed joint involvement in all cases tested. Microbiology was confirmed by blood (40%) or joint aspirate (75%), and most patients were treated with antibiotics. Surgical intervention took place in five cases. Pretermlabor was reported in only one case. All patients respondedwell to therapy without locomotive disability, and persistent pain was uncommon.Conclusion:Septic sacroiliitis should be considered in peripartum patients who present with fever and severe localized pain. Medical management is usually curative, and without an adverse effect on pregnancy.

scholarly journals Is abdominal tuberculosis a surgical problem?

2015 ◽  
Vol 97 (6) ◽  
pp. 414-419 ◽  
Author(s):  
S Pattanayak ◽  
S Behuria
Keyword(s):  
Developing Countries ◽  
Acute Abdomen ◽  
Surgical Intervention ◽  
Abdominal Tuberculosis ◽  
Review Of The Literature ◽  
Diagnostic Challenge ◽  
Comprehensive Review ◽  
Surgical Emergencies ◽  
Different Types ◽  
Global Health Problem

Introduction Abdominal tuberculosis (TB) has always been a diagnostic challenge, even for the astute surgeon. In developing countries, extrapulmonary TB often presents as an acute abdomen in surgical emergencies such as perforations and obstructions of the gut. Abdominal TB in different forms has been found more often as an aetiology for the chronic abdomen. This paper aims to evaluate TB as a surgical problem. Methods A comprehensive review of the literature on abdominal TB was undertaken. PubMed searches for articles listing abdominal TB/different types/diagnosis/treatment (1980–2012) were performed. Results TB is still a global health problem and the abdomen is one of the most common sites of extrapulmonary TB. Presentation may vary from an acute abdomen to a number of different chronic presentations, which can mimic other abdominal diseases. While some may benefit from antitubercular therapy, others may develop surgical problems such as strictures or obstruction, which may necessitate surgical intervention. Conclusions Abdominal TB should always be considered one of the differential diagnoses of acute or chronic abdomen in endemic areas.

scholarly journals Pediatric Ovarian Torsion: A Diagnostic Challenge in COVID-19 Times

2020 ◽  
Vol 18 (2) ◽  
pp. 120-123
Author(s):  
R. Chanchlani ◽  
M. Jangid ◽  
R. Ahmad ◽  
P. Sharma
Keyword(s):  
Abdominal Pain ◽  
Surgical Intervention ◽  
Lower Abdominal Pain ◽  
Exploratory Laparotomy ◽  
Ovarian Torsion ◽  
Diagnosis And Treatment ◽  
Diagnostic Challenge ◽  
Delay In Diagnosis ◽  
Functional Loss ◽  
Early Surgical Intervention

Ovarian torsion is a rare gynecological emergency in children and an early surgical intervention is needed to salvage the ovary. Herein, we present a case of eight year old girl who presented with complaints of lower abdominal pain during ongoing COVID-19 pandemic. She was diagnosed as a case of ovarian torsion on right side. She underwent exploratory laparotomy and ovarian cystectomy was performed. Delay in diagnosis and treatment of ovarian torsion may have grave consequences, resulting in functional loss of the ovary.

Feline intervertebral disc disease: a review of the literature

2002 ◽  
Vol 15 (03) ◽  
pp. 137-144 ◽  
Author(s):  
R. M. Rayward
Keyword(s):  
Intervertebral Disc ◽  
Surgical Intervention ◽  
Surgical Techniques ◽  
Neurological Dysfunction ◽  
Type I ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Clinically Significant

SummaryIntervertebral disc disease should be considered in the differential diagnosis of feline myelopathy. Animals of any age, breed or gender may be affected and onset of neurological dysfunction may be variable. The thoracolumbar junction and to a lesser extent the mid lumbar spine are the most commonly affected sites and Hansen type I disc extrusions predominate. Standard investigations (radiography, myelography, computed tomography, magnetic resonance imaging) and surgical techniques (laminectomy, hemilaminectomy, fenestration, durotomy) may be employed. Although response to conservative treatment is variable, surgically treated cases generally respond favourably but neurological recovery may be incomplete. Following surgical intervention, a recurrence of clinically significant IVDD has not been reported.

Cervical epidural actinomycosis

2001 ◽  
Vol 95 (1) ◽  
pp. 132-134
Author(s):  
Behzad Eftekhar ◽  
Ebrahim Ketabchi ◽  
Mohammad Ghodsi ◽  
Ali Ahmadi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cord Compression ◽  
Clinical Entity ◽  
Rare Clinical Entity ◽  
Upper Limbs ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Radiological Findings ◽  
Content Type ◽  
Fine Print

✓ Cervical actinomycosis causing spinal cord compression is a rare clinical entity. In a review of the literature, the authors found only 13 cases with actinomycosis-related spinal neurological deficit. The authors describe the case of a 26-year-old man who presented with neck pain and partial paresis of the upper limbs. Magnetic resonance imaging revealed a long cervical epidural enhancing lesion that extended from C-1 to T-2. The radiological findings resembled metastasis and other epidural infections. The patient was treated medically with penicillin and amoxicillin for 7 months and recovered neurologically. The authors conclude that although cervical epidural actinomycosis is a rare clinical entity resembling metastasis and other infections in this region, it should be considered so that this unique infection can be diagnosed in the least invasive fashion and, whenever possible, unnecessary surgery can be avoided.

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