scholarly journals A rare case of multiple spinal epidural abscesses and cauda equina syndrome presenting to the emergency department following acupuncture

2016 ◽  
Vol 9 (1) ◽  
Author(s):  
Jing Jing Chan ◽  
Jen Jen Oh
Keyword(s):  
Emergency Department ◽  
Cauda Equina Syndrome ◽  
Rare Case ◽  
Cauda Equina ◽  
Spinal Epidural

Cauda Equina Syndrome After Spinal Epidural Steroid Injection Into an Unrecognized Paraganglioma

2013 ◽  
Vol 29 (12) ◽  
pp. e39-e41 ◽  
Author(s):  
Stylianos Pikis ◽  
José E. Cohen ◽  
John M. Gomori ◽  
Yakov Fellig ◽  
Chrysostomos Chrysostomou ◽  
...  
Keyword(s):  
Cauda Equina Syndrome ◽  
Steroid Injection ◽  
Cauda Equina ◽  
Epidural Steroid Injection ◽  
Epidural Steroid ◽  
Spinal Epidural

Just the facts: Risk stratifying nontraumatic back pain for Cauda Equina Syndrome in the emergency department

CJEM ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. 652-654
Author(s):  
Zoe Polsky ◽  
Margriet Greidanus ◽  
Anjali Pandya ◽  
W. Bradley Jacobs
Keyword(s):  
Emergency Department ◽  
Back Pain ◽  
Cauda Equina Syndrome ◽  
Bowel Movement ◽  
Chronic Back Pain ◽  
Cauda Equina ◽  
Digital Rectal Examination ◽  
Acute Onset ◽  
Clinical Exam ◽  
History Of

A 43-year-old male, with a history of chronic back pain, presents to the emergency department (ED) with acute onset chronic pain. He states he “tweaked something” and has been debilitated by back pain, radiating down both his legs, for 24 hours. He has not had a bowel movement but denies noticing any “saddle anesthesia.” His clinical exam is limited by pain, and it is difficult to determine if he has objective weakness. His perineal sensation is intact, as is his sensation upon digital rectal examination. The patient has a post-void residual of 250 mL, but you are unsure how to interpret this value. As an emergency physician, when should you suspect, and how should you evaluate cauda equina syndrome?

scholarly journals Cauda equina syndrome due to Factor Xa inhibitor (Rivaroxaban): Case report and review of literature

2020 ◽  
Vol 7 (1) ◽  
pp. 7
Author(s):  
SR Gowda ◽  
PJ O’Hagan ◽  
JT Griffiths
Keyword(s):  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Factor Xa ◽  
Epidural Haematoma ◽  
Sudden Onset ◽  
Lower Limbs ◽  
Spontaneous Bleeding ◽  
Gradual Improvement ◽  
Spinal Epidural Haematoma ◽  
Spinal Epidural

Background: Factor Xa inhibitors are widely used by the physicians to reduce the incidence of thrombosis in order to protect the cardiovascular function. Although complications of bleeding and spontaneous gastrointestinal sources have been reported before, there are very sporadic cases of spinal epidural haematoma causing neurological compromise. Case presentation: We report a case of spontaneous spinal epidural haematoma (SSEH) in an 85-year-old female patient treated with Rivaroxaban, a new agent to prevent the incidence of thrombo-embolic events. Anticoagulant therapy is a recognised risk factor in the development of spontaneous bleeding and haematomas. The patient presented to the emergency department with sudden onset of severe back pain in the lumbar spine associated with paraplegia in the lower limbs. Magnetic resonance imaging (MRI) of the spine demonstrated a SSEH from T12 to L5 affecting the cauda equina. Rivaroxaban was discontinued and the patient was monitored as an inpatient. There was gradual improvement in the symptoms of the lower limbs. Conclusion: This rare condition of incomplete cauda equina syndrome due to Rivaroxaban therapy has not been reported previously. Clinicians must have a high index of suspicion in patients on regular anti-coagulation regimen.

scholarly journals Expediting the management of cauda equina syndrome in the emergency department through clinical pathway design

2019 ◽  
Vol 8 (4) ◽  
pp. e000597 ◽  
Author(s):  
Kevin G Buell ◽  
Sujan Sivasubramaniyam ◽  
Mark Sykes ◽  
Kamran Zafar ◽  
Lucy Bingham ◽  
...  
Keyword(s):  
Emergency Department ◽  
Clinical Pathway ◽  
Cauda Equina Syndrome ◽  
Primary Outcome ◽  
Cauda Equina ◽  
Neurological Dysfunction ◽  
Time Interval ◽  
Decompression Surgery ◽  
Retrospective Case ◽  
Pdsa Cycle

IntroductionCauda equina syndrome (CES) is a neurosurgical emergency. Early diagnosis with MRI and subsequent surgical decompression surgery can prevent permanent neurological dysfunction. Charing Cross Hospital (CXH) is a tertiary neurosurgical referral centre where in the emergency department (ED), current practice mandated a neurosurgery review prior to requesting MRI.HypothesisIt was hypothesised that a new clinical pathway, with better coordination from the ED, radiology and neurosurgical teams could reduce the time of presentation to diagnosis or exclusion of CES.MethodRetrospective case-note analysis of patients presenting with back pain to CXH ED over a 3-month period was performed. The primary outcome was the time interval between the patient’s arrival to the ED and the MRI preliminary report.ResultsThe baseline primary outcome was recorded at 8 hours and 16 min (n=30). A new clinical pathway was designed empowering ED senior decision makers to order MRIs prior to neurosurgical review. Two Plan-Do-Study-Act (PDSA) cycles were performed, each measured over a 2-month period. The first PDSA cycle was performed after the pathway was initially launched (n=17), while the second PDSA cycle measured the effect of staff education and active promotion of the pathway (n=17). MRI was requested earlier, waiting and reporting time for MRI were reduced. The exclusion or diagnosis of CES was reduced to 5 hours and 54 min in PDSA 1 and 5 hours 17 min in PDSA 2, a 29% and 36% reduction (p=0.048 and p=0.012, respectively).ConclusionThe clinical protocol was a cost-neutral and sustainable intervention that effectively reduced the time taken to diagnose or exclude CES and ED waiting times.

scholarly journals Traumatic extradural lumbar haematoma due to a pathological metastatic vertebral body fracture L3. Case report and review of the literature

2016 ◽  
Vol 30 (2) ◽  
pp. 237-240
Author(s):  
Daniel Balasa ◽  
Gabriela Butoi ◽  
Radu Baz ◽  
Anca Hancu
Keyword(s):  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Epidural Haematoma ◽  
Metastatic Tumor ◽  
Neurological Status ◽  
Extradural Haematoma ◽  
Spinal Epidural Haematoma ◽  
Body Fracture ◽  
Traumatic Fracture ◽  
Spinal Epidural

Abstract Spinal epidural haematoma (SEH) is a rare entity. We present the case of a 45 years old patient with lumbar epidural hematoma produced by a L3 vertebral tumoral (metastatic) fracture. Neurological status: cauda equina syndrome with sphincterian deficits, incomplete paraplegia (Frankel C), with neurological level L1. Emergency surgery was performed (L3-L2-bilateral laminectomy, L1 left laminectomy, posterior stabilization L2-L4 by titan screws) offering the possibility to progressive motor, sensitive and sphincterian deficites recovery. Abbreviations: Computer Tomography-CT, Magnetic resonance Imaging-MRI, Spinal epidural haematoma-SEH, Visual analogue scale of pain-VAS. Conclusion: We present a patient with a compressive subacute extradural haematoma, due to a traumatic fracture on a vertebral metastatic tumor who produced cauda equina syndrome. Surgical emergency intervention was mandatory for a good neurological outcome.

Cauda equina syndrome in a patient diagnosed with type 1 Gaucher disease: a rare case

2018 ◽  
Vol 35 (1) ◽  
pp. 191-194
Author(s):  
M. Sahinoglu ◽  
A. Mutlukan ◽  
E. Koktekir ◽  
H. Karabagli
Keyword(s):  
Cauda Equina Syndrome ◽  
Gaucher Disease ◽  
Rare Case ◽  
Cauda Equina ◽  
Type 1 Gaucher Disease
Sign in / Sign up

Export Citation Format

Share Document