Adhesive arachnoiditis after percutaneous fibrin glue treatment of a sacral meningeal cyst

2014 ◽  
Vol 20 (6) ◽  
pp. 763-766 ◽  
Author(s):  
Kazunori Hayashi ◽  
Junji Nagano ◽  
Satoshi Hattori
Keyword(s):  
Fibrin Glue ◽  
Subarachnoid Space ◽  
Ganglion Cells ◽  
Histopathological Examination ◽  
Cauda Equina ◽  
Mri Scan ◽  
Cyst Excision ◽  
Meningeal Cyst ◽  
Mri Study ◽  
Cyst Cavity

The authors present the case of a 64-year-old woman who was referred for severe sacral pain. She reported that her pain had been longstanding, and had greatly increased after percutaneous fibrin glue placement therapy for a sacral meningeal cyst 2 months earlier at a different hospital. An MRI scan obtained immediately after fibrin glue placement at that hospital suggested that fibrin glue had migrated superiorly into the subarachnoid space from the sacral cyst to the level of L-4. On admission to the authors' institution, physical examination demonstrated no abnormal findings except for perianal hypesthesia. An MRI study obtained at admission demonstrated a cystic lesion in the peridural space from the level of S-2 to S-4. Inhomogeneous intensity was identified in this region on T2-weighted images. Because the cauda equina and nerve roots appeared to be compressed by the lesion, total cyst excision was performed. The cyst cavity was filled with fluid that resembled CSF, plus gelatinous material. Histopathological examination revealed that the cyst wall was composed of hyaline connective tissue with some calcification. No nervous tissue or ganglion cells were found in the tissue. The gelatinous material was acellular, and appeared to be degenerated fibrin glue. Sacral pain persisted to some extent after surgery. The authors presumed that migrated fibrin glue caused the development of adhesive arachnoiditis. The risk of adhesive arachnoiditis should be considered when this therapy is planned. Communication between a cyst and the subarachnoid space should be confirmed to be sufficiently narrow to prevent the migration of injected fibrin glue.

Spinal extradural meningeal cyst: correct radiological and histopathological diagnosis

2002 ◽  
Vol 13 (4) ◽  
pp. 1-4 ◽  
Author(s):  
Kimiaki Sato ◽  
Kensei Nagata ◽  
Yasuo Sugita
Keyword(s):  
Cell Layer ◽  
Histopathological Examination ◽  
Histopathological Diagnosis ◽  
Ct Myelography ◽  
Meningeal Cyst ◽  
Spinal Subarachnoid Space ◽  
Male Patients ◽  
Meningeal Cysts ◽  
Dural Defects ◽  
Cyst Cavity

Object Spinal extradural meningeal cysts are uncommon and rarely cause neural compression. The clinical, radiological, and histopathological characteristics of the lesions are discussed and previous reports reviewed. Methods The authors describe five cases of a spinal extradural meningeal cyst (three female and two male patients, with a mean age of 47 years (range 14–75 years). Four of the cysts were located at the thoracolumbar level, the fifth at the sacral level. Radiological and neuroimaging-based diagnosis was made using a combination of magnetic resonance imaging, myelography, and/or computerized tomography (CT) myelography. A connection between the spinal subarachnoid space and the cyst cavity was demonstrated on myelography and/or CT myelography in all cases, and dural defects were confirmed visually intraoperatively. In all cases histopathological examination confirmed that the cyst wall was formed by nonspecific fibrous connective tissue without a single-cell layer of inner arachnoid lining. Conclusions A diagnosis of spinal extradural meningeal cyst is difficult to make based solely on histopathological examination. It is essential that the final characterization and diagnosis be based on intraoperative inspection combined with radiological and histopathological findings.

178 Suspected Cauda Equina Syndrome in a District General Hospital

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
L Ellerton ◽  
H Benjamin-Laing ◽  
W J Harrison
Keyword(s):  
General Hospital ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
District General Hospital ◽  
Bladder Function ◽  
Mri Scan ◽  
Eligibility Criteria ◽  
Joint Project ◽  
Tertiary Centre ◽  
Patient Morbidity

Abstract Introduction Cauda Equina Syndrome (CES) is rare but when the diagnosis is delayed patient morbidity is significant. Recently, NICE Clinical Knowledge Summaries have updated their red flags on CES to be more explicit enabling earlier referral and diagnosis. A joint project between Orthopaedics and Radiology departments aimed to assess the current pathway of Cauda Equina Investigation at a District General Hospital. Method Data was collected from the local Radiology database for requests between July 2017 and August 2018. This included both direct requests to assess for CES and implied. Raw data revealed a potential of 600 patients, of which we have analysed 332 patients met the eligibility criteria. Results Only 58 patients had a documented complete bladder function assessment, of those 33% had incomplete or partial bladder emptying. Time to MRI scan ranged from 50mins – 23 hours & 52 mins. 47% had negative scans with CES or Cord compromise on MRI scan was demonstrated on 9%. 23 patients were transferred urgently to the receiving tertiary centre. Conclusions We found that nearly 90% of patients were being incompletely assessed and time to scan ranged significantly. We are producing a trust wide suspected CES pathway to improve patient assessment.

Lateral Sacral Artery Aneurysm: Case Report and Review of the Literature

Neurosurgery ◽  
2005 ◽  
Vol 57 (1) ◽  
pp. E197-E197 ◽  
Author(s):  
Michaël Bruneau ◽  
Pierre Goffette ◽  
Guy Cosnard ◽  
Denis Rommel ◽  
Christian Raftopoulos
Keyword(s):  
Renal Transplantation ◽  
Medical History ◽  
Iliac Artery ◽  
Cauda Equina ◽  
Artery Aneurysm ◽  
Treatment Modalities ◽  
Spinal Epidural Hematoma ◽  
Mri Scan ◽  
History Of ◽  
The Right

Abstract OBJECTIVE AND IMPORTANCE: We report the third case of an aneurysm of the lateral sacral artery (AnLSA). In all cases, because of an incorrect preoperative diagnosis, the surgeons were confronted with severe and unexpected hemorrhaging, and surgery was aborted without effective treatment. Our purpose is to present the preoperative features of AnLSA and its treatment modalities. CLINICAL PRESENTATION: A 54-year-old man had a medical history of renal transplantation on his left external iliac artery. He complained of acute lumbar pain associated with cauda equina syndrome, which resolved within a few hours. At that time, a magnetic resonance imaging (MRI) scan revealed an intracanal hematoma extending from S1 to T12. Six weeks later, a second MRI scan demonstrated an oval-shaped intracanal mass behind the vertebral body of S1 with intense gadolinium enhancement. INTERVENTION: An anterior epidural mass was found. An incision into this mass resulted in significant arterial hemorrhaging. Transparietal embolization with a cotton compress and closure of the aneurysm wall were performed. The postoperative clinical status was stable, and a delayed angiographic study suggested a diagnosis of aneurysm of the right LSA, a branch of the internal iliac artery. Its pathophysiology was explained by the development of a high-flow transpelvic shunt from the right iliac artery territory to the left, to maintain the renal graft blood flow that had initially been reduced by stenosis of the left common iliac artery. Six weeks later, a new MRI scan demonstrated that the AnLSA had increased in size. The lesion was then excluded endovascularly by injection of glue. CONCLUSION: A medical history of renal transplantation with MRI scans showing an anterior epidural mass behind S1 or a spontaneous spinal epidural hematoma are features that must evoke a diagnosis of AnLSA. Treatment is mandatory and is best achieved by embolization. Surgery based on angiographic findings is indicated if the lesion is responsible for a compressive hematoma.

An Unusual Spinal Meningioma in a Child: Case Report

Neurosurgery ◽  
1985 ◽  
Vol 17 (2) ◽  
pp. 313-316 ◽  
Author(s):  
Hsiu Chih Liu ◽  
Stephen J. De Armond ◽  
Michael S. B. Edwards
Keyword(s):  
Case Report ◽  
Subarachnoid Space ◽  
Similar Case ◽  
Cauda Equina ◽  
Atypical Meningioma ◽  
Spinal Meningioma

Abstract Meningiomas seldom occur in children, and spinal meningioma in a child is rare. We report the case of a boy, 3 years and 5 months of age, who had an unusual atypical meningioma involving the subarachnoid space from T-2 to the cauda equina. To our knowledge, no similar case has been reported previously.

Survival of adult rat retinal ganglion cells with regrown axons in peripheral nerve grafts: a comparison of graft attachment with suture or fibrin glue

2000 ◽  
Vol 93 (2) ◽  
pp. 275-278 ◽  
Author(s):  
Grant A. Robinson ◽  
Roger D. Madison
Keyword(s):  
Nervous System ◽  
Peripheral Nerve ◽  
Fibrin Glue ◽  
Ganglion Cells ◽  
Nerve Graft ◽  
Retinal Ganglion ◽  
Content Type ◽  
Adult Rat ◽  
Peripheral Nerve Graft ◽  
Fine Print

Object. The goal of this study was to examine whether the method of attachment of a peripheral nerve graft would have an effect on retinal ganglion cell (RGC) regeneration.Methods. The number of adult rat RGCs with regrown axons in a peripheral nerve graft was compared under two grafting conditions: 1) attachment of the graft to the optic nerve stump made using a suture; and 2) attachment made using fibrin glue. Counts of RGCs retrogradely labeled with FluoroGold from the grafts 1 month after attachment revealed approximately seven times the number of RGCs in the fibrin-glue group compared with the suture group.Conclusions. The use of fibrin glue may be a useful tool for enhancing the regrowth of central nervous system neuron axons into peripheral nervous system grafts.

Interdural Cyst of the Lumbosacral Region

Neurosurgery ◽  
1984 ◽  
Vol 14 (3) ◽  
pp. 287-294 ◽  
Author(s):  
L. Done Stephen ◽  
L. Hayman Anne ◽  
F. J. New Paul ◽  
R. Davis Kenneth ◽  
H. Chapman Paul
Keyword(s):  
Cerebrospinal Fluid ◽  
Cyst Wall ◽  
Subarachnoid Space ◽  
Cauda Equina ◽  
Pain Syndrome ◽  
Lumbosacral Region ◽  
Rare Type ◽  
Computed Tomographic ◽  
Point Of Entry ◽  
Cauda Equina Compression

Abstract The purpose of this report is to call attention to the clinical, myelographic, and computed tomographic appearance of a very rare type of dural cyst within the lumbosacral spinal canal. We report this condition in three unrelated boys who presented with symptoms of cauda equina compression. Our experience suggests that these cysts are congenital in origin. Anatomically, the cyst wall consisted of a dura-like layer without arachnoid. There was a small ventral defect allowing incomplete communication with the compressed subarachnoid space. Cerebrospinal fluid-like fluid accumulated within the interdural cyst as a result of this communication. Treatment consisted of obliteration of the point of entry between cyst and subarachnoid space in all cases and partial cyst wall excision in one case. After operation, the two patients who had presented with long-standing sphincter disturbance had partial improvement in function and the child with a pain syndrome was completely relieved of symptoms.

scholarly journals Spinal extradural arachnoid cyst: Rare cases from Indian Institutes

2020 ◽  
Vol 11 ◽  
pp. 306
Author(s):  
Jitender Chaturvedi ◽  
Punit Singh ◽  
Sunil Malagi ◽  
Nishant Goyal ◽  
Anil Kumar Sharma
Keyword(s):  
Arachnoid Cyst ◽  
Surgical Procedures ◽  
Type I ◽  
Case Description ◽  
Dural Repair ◽  
Cyst Excision ◽  
Meningeal Cyst ◽  
Spinal Lesions ◽  
Compressive Myelopathy ◽  
Extradural Arachnoid Cyst

Background: Spinal extradural arachnoid cyst (SEDAC), accounting for approximately 1% of all spinal lesions, rarely causes compressive myelopathy. It is usually found at lower thoracic or upper lumbar levels in males in their forties to sixties. The standard surgical procedures include direct dural repair. Case Description: A 37-year-old male presented with myelopathy attributed to a type I meningeal cyst (SEDAC) that was successfully managed with a laminectomy, cyst excision, and direct dural sleeve repair. Similar cases reported in the literature were also reviewed. Conclusion: SEDACs, although rare, must be considered among the differential diagnoses for compressive myelopathy/neurogenic bladder.

scholarly journals Pleural-Based Intrathoracic Cystic Lymphangioma in an Infant Mimicking a Pneumonia

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Zev Frimer ◽  
Daniel Fink ◽  
Ruth Cytter-Kuint ◽  
Victoria Doviner ◽  
Elie Picard
Keyword(s):  
Benign Tumor ◽  
Histopathological Examination ◽  
Cystic Lymphangioma ◽  
Cervical Region ◽  
Resonance Imaging ◽  
Mri Scan ◽  
Radiographic Findings ◽  
First Case ◽  
Magnetic Resonance Imaging Mri ◽  
One Year

Cystic lymphangioma is an uncommon benign tumor that occurs primarily in children in the cervical region. We report the first case of a pleural-based cystic lymphangioma in an infant. The patient was admitted for RUL pneumonia. Because of the persistence of the radiographic findings despite clinical improvement, a computed tomography (CT) and a magnetic resonance imaging (MRI) scan were performed. They showed a multiloculated cystic lesion in the superior posterior right hemithorax. A surgical procedure was performed with complete resection of the tumor. Histopathological examination showed a pleural-based intrathoracic multicystic lymphangioma. One year after the surgery, the patient feels well without any sign of recurrence.

Abstract 12412: Imaging the PM/AICD Patient; Does the Diagnostic Value Justify the Risk?

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Huma Y Samar ◽  
June Yamrozik ◽  
Ronald Williams ◽  
Mark Doyle ◽  
Robert Biederman
Keyword(s):  
Mr Imaging ◽  
Final Diagnosis ◽  
Diagnostic Value ◽  
List Type ◽  
Mri Imaging ◽  
Mri Scan ◽  
Additional Information ◽  
Patient Diagnosis ◽  
Life Saving ◽  
Mri Study

Background: MR imaging is infrequently performed on patients with implanted pacemakers/AICDs. When the risk justifies the end, however, consideration to perform 'high-risk’ scanning can be made on a case-by-case basis but typically with trepidation. This raises a critically important question: "Is the MRI scan adding valuable and irrefutable information to warrant such risk? Methods: 84 patients with implanted devices (13AICD,10 AICD/PM,5 retained leads, 6 REVO and 50 dual chamber PM.) were imaged via MRI/CMR (1.5T GE, Milwaukee, WI) over 3 years in a single institution. Specific criteria were followed for all patients to objectively define whether final diagnosis by MRI imaging enhanced patient care. A checklist of 3 questions was answered following scan interpretation by both the technologist and performing MRI physician(s): 1) Did the diagnosis change? 2) Did the MRI provide additional information to the existing diagnosis? 3) Did patient management change? If ‘Yes’ was answered to any of the above questions, it was considered that the MRI scan was of value to patient diagnosis and/or therapy. Results: All patients completed the procedure with no death, VT/VF, power-on-reset or adverse events. Average MRI study time: 20±55min. The device was interrogated pre and post MRI by EP/cardiologist to determine changes in impedance, amplitude or threshold. No clinically meaningful changes occurred, no post-procedure revisions to generator/lead or parameters were required. Conclusion: The use of PM/AICD imaging in MRI remains controversial. Our study shows that MR imaging in carefully selected patients under the supervision of experienced physicians is not only safe but extremely beneficial, substantially adding value and often irrefutable information to patient diagnosis and management. PM/AICDs when imaged properly are safe and no longer 'forbidden’ in the MRI environment. Moreover there is frequently marked life-altering and life-saving information obtained.

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