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Hematomyelia

Spinal Cord Hemorrhage


Presentation

  • At 25 months after the surgery, she presented no neurological deficit without recurrence and cervical deformity.[ncbi.nlm.nih.gov]
  • Two patients with a non-traumatic hematomyelia at T9 and C3-C7 respectively, are presented. Both patients presented with pain and a Brown-Sequard syndrome.[ncbi.nlm.nih.gov]
  • However, children may present with hematomyelia or spinal cord injury without radiographic abnormality even after a minor trauma. A 15-month-old girl presented with a 24-hour history of progressive neurologic deficits.[ncbi.nlm.nih.gov]
  • We present a case of a 51-year-old man who presented acute onset epigastric pain, paraplegia, and sensory loss below his nipples.[ncbi.nlm.nih.gov]
  • A 34-year-old woman with Factor XI deficiency presented with rapidly progressive quadriplegia following a 1-week prodrome of cervical pain. At operation, a spontaneous hematomyelia was evacuated from the C4-6 vertebral level.[ncbi.nlm.nih.gov]
Pharyngitis
  • Branches from the left occipital and ascending pharyngeal arteries and those from the left C2 radicular, left posterior spinal and anterior spinal arteries formed these multiple shunts, linking with a common venous drain flowing into the right petrosal[ncbi.nlm.nih.gov]
Sneezing
  • 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]
Fever
  • 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]
  • .• Fever and local pain and tenderness in the back, not necessarily confined to the lumbar spine, are followed within a few days by radicular pain and a rapidly progressive paraparesis and sensory loss in the lower parts of the body, with sphincteric[slideshare.net]
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]
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]
  • 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]
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]
Epigastric Pain
  • We present a case of a 51-year-old man who presented acute onset epigastric pain, paraplegia, and sensory loss below his nipples.[ncbi.nlm.nih.gov]
Back Pain
  • A 71-year-old woman on warfarin (2.5 mg daily) developed severe low back pain with reduced touch sensation and weakness of the lower limbs that progressed to complete paralysis within 28 to 30 hours.[ncbi.nlm.nih.gov]
  • Intern Med. 2014;53(6):623-6 Authors: Famularo G, Sajeva MR, Gasbarrone L Abstract A 71-year-old woman on warfarin (2.5 mg daily) developed severe low back pain with reduced touch sensation and weakness of the lower limbs that progressed to complete paralysis[londonspine.com]
  • The first symptom of epidural (extradural) spinal cord compression is usually the patient's complaint to the local back pain. Back pain can be enhanced in the supine position and forcing the patient to wake up at night.[minclinic.ru]
  • His back pain returned in June 2012; when MRI revealed a C1-T7 syrinx with features concerning for an underlying lesion. He did not pursue further workup at the time as he was asymptomatic except for intermittent back pain .[omicsonline.org]
  • Back pain and percussion tenderness are the usual features of compression by metastatic tumor.• The treatment of most spinal tumors, even the intramedullary ones, is surgical excision with radiation therapy. 24. Intramedullary astrocytoma 25.[slideshare.net]
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]
  • 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]
  • 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]
  • Clinically, IC are often disclosed after a progressive history of paraparesis and paresthesiae. Acute discovery with hematomyelia has been also documented [ 7 ].[em-consulte.com]
Dysesthesia
  • 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]
  • Case material A 10-year-old girl complaining about lower thoracic pain for several days suddenly developed lower body dysesthesias and paraparesis.[springermedizin.de]
  • Gait problem (12%) and dysesthesias (16%) were encountered less often.[syringomyeli.com]
  • The leg dysesthesia persisted, as did bladder disturbances, treated by intermittent self-catheterization. Fig. 1 Spinal MRI images of the first inflammatory event ( a ) and the hematomyelia ( b and c ). a .[bmcneurol.biomedcentral.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]
  • 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]
Flaccid Paralysis
  • 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]
  • 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]
Urinary Retention
  • 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]
  • Bladder distension may indicate urinary retention. A spinal bruit (overlying a spinal AVM) may be specific. Occasionally, nevus (moles) or angiolipomas are found.[now.aapmr.org]

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]
Xanthochromia
  • 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

  • However, subtotally resected lesions and/or syndromal cases may recur, requiring further treatment. Definitive answers await more cases with longer follow-up.[ncbi.nlm.nih.gov]
  • The prompt surgical treatment of this entity and the usefulness of magnetic resonance imaging in the preoperative diagnosis and on the planning of the surgical strategy is particularly emphasized.[ncbi.nlm.nih.gov]
  • Treatment is based on prompt replacement therapy as the occurrence and development of neurologic dysfunction are related to the length of time between the onset of symptoms and the factor replacement.[ncbi.nlm.nih.gov]
  • After medical and surgical treatment, the transverse symptoms largely subsided with rehabilitation of the patient.[ncbi.nlm.nih.gov]
  • Please always consult your primary doctor for final diagnosis and treatment.[xmri.com]

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]
  • 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.[ncbi.nlm.nih.gov]
  • 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]
  • Prognosis .—This depends upon the extent and location of the clot.[henriettes-herb.com]
  • Conclusion 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.[springermedizin.de]

Etiology

  • The causes of spontaneous, nontraumatic spinal cord hematoma include vascular malformations of the spinal cord (the most common), clotting disorders, inflammatory myelitis, spinal cord tumors, abscess, syringomyelia, and unknown etiologies.[sumerdoc.blogspot.com]
  • The common etiologies of hematomyelia are trauma, vascular malformations, coagulopathies, the use of anticoagulants, intramedullary tumors, and syringomyelia [1] . Idiopathic hematomyelia causing epiconus syndrome is even more rare [2] .[deepdyve.com]
  • Recognition of the clinical pattern of spinal cord injury should lead clinicians to perform imaging studies to evaluate for compressive etiologies. Downloads month by month Downloads Download data is not yet available.[pagepress.org]
  • Etiology .—Spinal apoplexy may be due to traumatism, to changes in the coats of the blood-vessels, or to excessive blood-pressure. Pathology .[henriettes-herb.com]

Epidemiology

  • 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]
Sex distribution
Age distribution

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]
  • Lloyd postulated as early as 1894 a pathophysiological relationship between posttraumatic arachnoid scarring and cyst formation.[syringomyeli.com]
  • National Guideline/Academic Resource Pathophysiology There are several differences between the pediatric spine and the adult spine. The age of 8 years traditionally is considered a transition point in anatomic development.[ahcmedia.com]

Prevention

  • Early diagnosis by magnetic resonance imaging (MRI) prevents major morbidity and mortality from intraspinal hemorrhage.[ncbi.nlm.nih.gov]
  • 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]
  • Early diagnosis, appropriate management and immediate intervention are needed to prevent irreversible neurological sequelae. The elusive clinical features at presentation may cause an important diagnostic delay.[ncbi.nlm.nih.gov]
  • Immuno-modulating agents must be envisaged in severe neurosarcoidosis, to prevent complications.[bmcneurol.biomedcentral.com]

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