Presentation
presenting mainly with pain and paresis). [springermedizin.de]
Whereas these are predominantly boys, we report two girls who presented with hematomyelia (one cervical, one thoracic) and an acute, severe neurological deficit. [agris.fao.org]
Hematomyelia usually presents with an acute onset and rapid deterioration in neurologic status [6]. [hindawi.com]
At 25 months after the surgery, she presented no neurological deficit without recurrence and cervical deformity. [ncbi.nlm.nih.gov]
Spinal Cord Hemangioblastoma Presenting with Subarachnoid Hemorrhage. Neurol Med Chir (Tokyo). 1998 Jun;38(6):355-8. 2. [nnp.ima-press.net]
Entire Body System
- Fever
A report of quadriparesis in dengue fever due to hematomyelia. [neurologyindia.com]
At hospital admission we observed a fever of 38ºC and atrial fibrillation with a rapid ventricular response. [ncbi.nlm.nih.gov]
[…] vascular, and neoplastic IMAGING General Features Imaging Recommendations DIFFERENTIAL DIAGNOSIS CLINICAL ISSUES Presentation Natural History & Prognosis DIAGNOSTIC CHECKLIST Consider Selected References Kumar MS et al: A report of quadriparesis in dengue fever [app.statdx.com]
A slight fever may follow after twenty-four or forty-eight hours. The type of paralysis may be monoplegia, hemiplegia, or paraplegia. Disturbance of the sensory functions may give rise to hyperesthesia, anesthesia, paresthesia, etc. Diagnosis . [henriettes-herb.com]
- Lower Extremity Pain
Back or lower extremity pain occur in at least 20%. By the time of diagnosis, symptoms likely include asymmetric leg weakness, gait disturbance, sensory complaints, sphincter impairment, pain, and hyperreflexia. [now.aapmr.org]
Gastrointestinal
- Nausea
Head and arm pains were joined by SAH -typical headache, nausea, and vomiting in only a few minutes, which was associated with retrograde blood flow into the basal cisterns of the brain and the fourth ventricle. [ingentaconnect.com]
Continued Other signs of an ulcer include: Bloating Burping Not feeling hungry Nausea Vomiting Weight loss for no clear reason Ulcers can bleed into your stomach or intestines, which can be dangerous to your health. [webmd.com]
When signs or symptoms do occur with H. pylori infection, they may include: An ache or burning pain in your abdomen Abdominal pain that's worse when your stomach is empty Nausea Loss of appetite Frequent burping Bloating Unintentional weight loss When [mayoclinic.org]
Case Report History The patient was a 37 year-old Chinese male who presented on July 28; 2013 with progressively worsening left arm and left leg numbness; nausea; non-positional headaches and hiccups. [omicsonline.org]
Approximately one-third of patients with SSAH present with cerebral symptoms, including headache, nuchal rigidity, nausea/vomiting, sensorimotor deficits, seizure, and mental status alteration. [pubs.rsna.org]
- Vomiting
Head and arm pains were joined by SAH -typical headache, nausea, and vomiting in only a few minutes, which was associated with retrograde blood flow into the basal cisterns of the brain and the fourth ventricle. [ingentaconnect.com]
Seek immediate medical help if you experience: Severe or persistent abdominal pain Difficulty swallowing Bloody or black tarry stools Bloody or black vomit or vomit that looks like coffee grounds Causes The exact way H. pylori infects someone is still [mayoclinic.org]
Continued Other signs of an ulcer include: Bloating Burping Not feeling hungry Nausea Vomiting Weight loss for no clear reason Ulcers can bleed into your stomach or intestines, which can be dangerous to your health. [webmd.com]
Approximately one-third of patients with SSAH present with cerebral symptoms, including headache, nuchal rigidity, nausea/vomiting, sensorimotor deficits, seizure, and mental status alteration. [pubs.rsna.org]
Musculoskeletal
- Neck Pain
Prompt diagnosis of hematomyelia first requires recognition of a myelopathy syndrome (transverse, central, anterior, posterior, or hemi-cord) often accompanied by sudden, severe back or neck pain and sometimes radicular pain. [mayoclinic.pure.elsevier.com]
We present the case of a previously well 44-year-old woman who developed severe acute neck pain and right-sided motor deficit after a session of traditional Chinese massage that entailed minimal neck manipulation. [ncbi.nlm.nih.gov]
Paraplegia, sensory disturbance, bladder and rectal disturbance developed gradually over two weeks, accompanied by severe back and neck pain. MRI showed hematomyelia extending from the C1 to T11 segments of the spinal cord. [unboundmedicine.com]
- Back Pain
After 3 months of rehabilitation, numeric pain rating scale of back pain decreased, and Berg Balance Scale score, Korean version of modified Barthel index score improved. [ncbi.nlm.nih.gov]
— A 6-year-old boy had progressive thoracic back pain of one month's duration, with an acute spastic paraparesis. Mental status, cranial nerve function, coordination of his arms and anal tone were normal. [jamanetwork.com]
Back pain often associated with radiating radicular pain, which intensified by coughing, sneezing or straining. Often back pain and local pain on palpation precede in weeks other symptoms of spinal cord epidural (extradural) compression. [minclinic.ru]
Acute hematomyelia is often accompanied by sudden severe back or neck pain and then presents with myelopathy syndromes due to the mass effect’s acute obstruction of CSF and blood in the spine. [hindawi.com]
Urogenital
- Urinary Retention
It must be suspected in any patient taking anticoagulant agents who complains of local or referred spinal pain associated with limb weakness, sensory deficits, or urinary retention. [ncbi.nlm.nih.gov]
A 63-year-old man presented with left leg weakness, impaired sensation, and urinary retention while taking rivaroxaban (non–vitamin K antagonist) for 4 months for atrial fibrillation. Anticoagulant agents were discontinued. [thieme-connect.com]
Two days prior to admission he developed urinary retention and fever. Also he complained of loss of warm and cold sensations on the left side of one-day duration. [jneuro.com]
Presentation [ edit ] CCS is characterized by disproportionately greater motor impairment in upper compared to lower extremities, and variable degree of sensory loss below the level of injury in combination with bladder dysfunction and urinary retention [en.wikipedia.org]
Neurologic
- Meningism
= jaundice combined with the blood changes of anemia mening/o/arteri/(i)tis = inflammation of the meningeal arteries mening/o/en/cephal/itis = inflammation of the meningeal area in the brain mening/o/malac/ia = abnormal softening of the meninges my/o/ [quizlet.com]
—The same line of treatment as used in spinal-meningeal hemorrhage, can be carried out in this lesion. The Eclectic Practice of Medicine, 1907, was written by Rolla L. Thomas, M. S., M. D. [henriettes-herb.com]
Other spinal cord problems include Tumors Infections such as meningitis and polio Inflammatory diseases Autoimmune diseases Degenerative diseases such as amyotrophic lateral sclerosis and spinal muscular atrophy Symptoms vary but might include pain, numbness [icdlist.com]
Disease, diseased - see also Syndrome Minor's 336.1 Edema, edematous 782.3 spinal cord 336.1 Embolism 444.9 spinal cord (nonpyogenic) 336.1 Foix-Alajouanine syndrome 336.1 Hematoma (skin surface intact) (traumatic) - see also Contusion spinal (cord) (meninges [icd9data.com]
영문 meninges 한글 수막, 뇌척수막 설명 뇌막은 크게 3종류의 막으로 구성되어 있으며, 제일 바깥막은 뼈을 싸고 있는 막과도 연결되는 경질막(dura mater)이고, 그 다음 거미막(arachnoid membrane), 그리고 유막(pia mater)으로 구성되어 있다. 이중 거미막과 유막을 합쳐서 연수막(leptomeninges)이라고 부르고, 맨위 경질막을 경질막(pachymeninx)이라 부른다. [kmle.co.kr]
- Dysesthesia
Case material A 10-year-old girl complaining about lower thoracic pain for several days suddenly developed lower body dysesthesias and paraparesis. [agris.fao.org]
The following 1.5 years, she complained of intermittent cervicalgia and left brachial dysesthesias, with MR suggesting active residual cavernoma. Interestingly, her complaints gradually disappeared, and she is currently asymptomatic. [ncbi.nlm.nih.gov]
We report the case of 48-year-old man receiving warfarin and aspirin therapy, who showed upper limb pain and dysesthesia from left axilla to left femur. [unboundmedicine.com]
- Paresthesia
Disturbance of the sensory functions may give rise to hyperesthesia, anesthesia, paresthesia, etc. Diagnosis . [henriettes-herb.com]
Autonomic dysfunction, pain, paresthesia, and depression were common and impeded recovery in some patients. [neurology.org]
Subacute Combined Degeneration (SCD) of the Cord• This is the name applied to the spinal cord disease resulting from a deficiency of cobalamin (vitamin B12)• It begins with symptoms and signs of posterior column disorder (paresthesias of hands and feet [slideshare.net]
Then develop a syndrome of transverse myelopathy with paresthesias, alternating with loss of sensitivity. Motor paresis starts in the toes and feet and rises to the spinal cord compression level. [minclinic.ru]
A 60-year-old female presented with gradual onset of worsening back pain, lower extremity weakness, and paresthesia (over 6-8 days). She was found to have a spinal arteriovenous malformation in the thoracic region. [emedicine.medscape.com]
- Flaccid Paralysis
On evaluation (at another hospital), she was found to have flaccid paralysis of all 4 limbs with complete loss of sensation below C4. She had shallow respiration and was intubated and electively ventilated. [neurologyindia.com]
The patient was vitally stable but in flaccid paralysis till the discharge date and he was under antibiotic coverage along with steroids. Physiotherapy follow-up in an outpatient basis was arranged. [sjmms.net]
The subsequent congestive ischemia usually involves the posterior sensory elements of the spinal cord, but can progress to paralysis. [emedicine.medscape.com]
Ischemic myelopathy often presents with flaccid paralysis below the level of injury along with hyporeflexia and reduced rectal tone. Bladder distension may indicate urinary retention. A spinal bruit (overlying a spinal AVM) may be specific. [now.aapmr.org]
paralysis, absent deep tendon reflexes Sympathetic interruption Diagnosis/Evaluation Children with spinal cord trauma must be evaluated and recognized promptly. [ahcmedia.com]
- Hyperreflexia
By the time of diagnosis, symptoms likely include asymmetric leg weakness, gait disturbance, sensory complaints, sphincter impairment, pain, and hyperreflexia. If not treated, 50% of patients will be unable to walk within 3 years of onset. [now.aapmr.org]
Demyelinative Myelopathy• Among young adults in northern climates, multiple sclerosis is the most frequent cause of symmetric or asymmetric paraparesis with hyperreflexia and sensory ataxia. [slideshare.net]
An L1 sensory-motor level, lower limb hyperreflexia including Babinski’s signs, and decreased rectal sphincter tone were noted. Emergency MR demonstrated hematomyelia (T8–T11), intramedullary edema (T6–L1), and an ImC at T9–T10 (Fig. 1a). [springermedizin.de]
S3-S4 Squeezing glans penis or tapping on the mons pubis during rectal examination usually stimulates the trigone of the bladder causing a reflex contraction of the anal sphincter Decreased bladder function Fecal retention Unexplained ileus Autonomic hyperreflexia [ahcmedia.com]
Workup
He did not pursue further workup at the time as he was asymptomatic except for intermittent back pain. [omicsonline.org]
CT myelography is indicated in the workup of spinal cord tumors only if MRI is contraindicated. The spinal cord is typically enlarged at the level of tumor. [sjmms.net]
Cerebrospinal Fluid
- Xanthochromia
Detection of xanthochromia in cerebrospinal fluid by spectrophotometric scan. Am J Clin Pathol 2014;142(Suppl 1):A02. Leep Hunderfund AN, Wijdicks EF. Intramedullary spinal cord hemorrhage (hematomyelia). Rev Neurol Dis 2009;6E54–61. Choi BS, Lee S. [ejcrim.com]
In our case, examination of the CSF revealed xanthochromia. After contact with CSF, haemoglobin breaks down to oxyhaemoglobin, which colours the CSF pink[3]. [ncbi.nlm.nih.gov]
C2-C3 laminectomy revealed xanthochromia of right dorsal roots with cord bulge. Midline myelotomy revealed organized blood clot with pseudo-capsule adherent to cord tissue. [jneuro.com]
A cerebrospinal fluid analysis revealed xanthochromia, increased protein level, and red blood cell count. The patient underwent dorsal laminoplasty and resection of the intramedullary tumor. [sjmms.net]
Treatment
Early recognition, diagnosis, medical treatment, and urgent surgery can decrease morbidity. Using high-dose steroid treatment and microscopic hematoma evacuation may decrease morbidity. [hindawi.com]
Non-traumatic spontaneous spinal subdural hematoma in a patient with non-valvular atrial fibrillation during treatment with rivaroxaban. Am J Case Rep 2015; 16: 377-381 [thieme-connect.com]
Treatment was embolization with immediate isolation of the AVM. VIEW THE ENTIRE ARTICLE HTML PDF References Shaban A, Moritani T, Al Kasab S, Sheharyar A, Limaye KS, Adams HP Jr. Spinal cord hemorrhage. J Stroke Cardiovasc Dis 2018;27:1435–1446. [ejcrim.com]
However, subtotally resected lesions and/or syndromal cases may recur, requiring further treatment. Definitive answers await more cases with longer follow-up. [agris.fao.org]
Some recommend surgical treatment as soon as possible if there is neurological deterioration. [ncbi.nlm.nih.gov]
Prognosis
Hematomyelia usually has an acute onset and rapid progression, which results in a poor prognosis. However, there have been a few cases in which the clinical symptoms have progressed chronically, with a good prognosis. [ncbi.nlm.nih.gov]
Conclu sion With adequate surgical treatment either in the acute phase in case of dramatic deterioration or after clinical recuperation, prognosis of symptomatic ImC may be surprisingly good. [agris.fao.org]
Functional prognosis was better in patients with a single episode of hematomyelia. Abbreviations ASIA American Spinal Injury Association © 2014 American Society of Neuroradiology [ajnr.org]
Spinal SDH predominates in the sixth decade. [20, 21, 22] Prognosis Prognosis varies but generally is correlated with severity of deficit, particularly the “completeness” of the spinal cord injury. [emedicine.medscape.com]
Etiology
The etiology of idiopathic spontaneous hematomyelia (ISH) is unknown, and there are few published case reports. [hindawi.com]
Etiology idiopathic vascular malformations 2-3 arteriovenous malformations cavernous hemangiomas angiomas intramedullary tumors spinal cord metastases anti-coagulation therapy 4 coagulopathies radiation therapy 5 spinal instrumentation surgery lumbar [radiopaedia.org]
Spinal cord hemorrhage can be divided based on etiology, into two types: (1) traumatic and (2) non-traumatic. [emedicine.medscape.com]
Epidemiology
Epidemiology, demographics, and pathophysiology of acute spinal cord injury. Spine (Phila Pa 1976). 2001 Dec 15. 26 (24 Suppl):S2-12. [QxMD MEDLINE Link]. Burns AS, Marino RJ, Flanders AE, Flett H. [emedicine.medscape.com]
Bacteriology and epidemiology of Helicobacter pylori infection. http://www.uptodate.com/home. Accessed Jan. 9, 2017. Crowe SE. Indications and diagnostic tests for Helicobacter pylori infection. http://www.uptodate.com/home. Accessed Jan. 9, 2017. [mayoclinic.org]
Epidemiology of sarcoidosis in Japan. Eur Respir J. 2008;31:372–9. View Article PubMed Google Scholar Duhon BS, Shah L, Schmidt MH. Isolated intramedullary neurosarcoidosis of the thoracic spine: case report and review of the literature. [bmcneurol.biomedcentral.com]
Epidemiology including risk factors and primary prevention VM accounts for about 3% to 5% of all SCIs. [now.aapmr.org]
Pathophysiology
The pathophysiology of spontaneous hematomyelia is discussed. [ncbi.nlm.nih.gov]
Surgical Neuroangiography: Clinical and Interventional Aspects in Adults covers a variety of protocols and strategies combining functional vascular anatomy with a complete appreciation of the various disease processes, their pathophysiology, clinical [books.google.com]
Epidemiology, demographics, and pathophysiology of acute spinal cord injury. Spine (Phila Pa 1976). 2001 Dec 15. 26 (24 Suppl):S2-12. [QxMD MEDLINE Link]. Burns AS, Marino RJ, Flanders AE, Flett H. [emedicine.medscape.com]
Prevention
This case of infantile intramedullary spinal cord cavernous angioma presenting with cervical hematomyelia shows osteoplastic laminotomy of the cervical spine might be helpful to prevent consequent cervical deformity in pediatric cases. [ncbi.nlm.nih.gov]
A high index of suspicion, prompt recognition, and immediate intervention are essential to prevent major morbidity and mortality from intraspinal hemorrhage. [jamanetwork.com]