Edit concept Question Editor Create issue ticket

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]
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]
Pathologist
  • At routine autopsy no cause of death was found by the pathologist. Postmortem neurosurgical consultation disclosed hematomyelia and associated damage of the cervical spinal cord.[ncbi.nlm.nih.gov]
Aspiration
  • The soft gelatinous tumor was subtotally resected and the adjacent chronic liquid hematoma was aspirated. The immunohistochemical and ultrastructural findings indicated a diagnosis of tanycytic ependymoma.[ncbi.nlm.nih.gov]
  • After thoracic vertebra 5 and 6 laminectomy, microscopic dural opening was revealed, a small paramedian myelotomy was performed at the level, and blunt dissection and aspiration of the hematoma were done.[hindawi.com]
  • The tumor was carefully excised using Rhoton micro-instruments; Cavitron Ultrasonic Surgical Aspirator ( CUSA ) and bipolar. We first internally debulked the tumor with the CUSA.[omicsonline.org]
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]
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]
  • 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]
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]
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
  • 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]
  • 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]
  • 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]
  • Case Report An 80-year-old man developed sudden severe back pain with no history of trauma, and then he tried to walk. However, due to weakness and numbness in his legs, he could not walk and collapsed to the ground.[hindawi.com]
Neck Pain
  • Though exceedingly rare, hematomyelia should be considered in the list of differential diagnoses in any case of neck pain and motor deficit after seemingly trivial injury.[ncbi.nlm.nih.gov]
  • 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]
  • 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]
Shoulder Pain
  • Abstract A 23-year-old Japanese woman experienced sudden severe shoulder pain, and subsequently died of cardiorespiratory arrest after an 8-day course of illness.[ncbi.nlm.nih.gov]
  • pain Non-compressive oncological myelopathy Osteochondrosis and its symptoms Osteochondrosis of the thoracic spine, intercostal neuralgia Osteoporosis (vertebral body) Rules of disability patients care with arms and legs muscles paralysis (paraplegia[minclinic.ru]
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]
  • 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]
Meningism
  • —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]
  • The glucose content in the patient's cerebrospinal fluid may also be in the normal range, if the tumor is not accompanied by widespread spinal membranes carcinomatous meningitis.[minclinic.ru]
  • Conditions known to predispose to syrinx formation include Arnold-Chiari malformation, meningitis, trauma, scoliosis and trauma. In rare cases, such a hemorrhage may occur spontaneously. [2][emedicine.medscape.com]
  • […] 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/lip/oma[quizlet.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]
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]
  • 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]
  • 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]
  • Gait problem (12%) and dysesthesias (16%) were encountered less often.[syringomyeli.com]
Flaccid Paralysis
  • paralysis, loss of sphincter tone, and ascending sensory loss. [9] Spinal subarachnoid hemorrhage (SAH) may cause symptoms due to blood in the subarachnoid space, or blood dissecting into the spinal cord or along nerve root sheaths.[emedicine.medscape.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]
  • 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]
  • 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]
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

  • Most reported cases are about surgical treatment of intramedullary spinal cord hemorrhage, but there are no reports of rehabilitation effectiveness reported.[ncbi.nlm.nih.gov]
  • No anticoagulation was used during endovascular treatment.[ajnr.org]

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]
  • 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]
  • 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]
  • Prognosis .—This depends upon the extent and location of the clot.[henriettes-herb.com]

Etiology

  • Spontaneous intramedullary spinal cord hemorrhage (hematomyelia) is a rare disease and most cases have specific etiologies such as cavernous malformations and tumor.[ncbi.nlm.nih.gov]
  • Summary of intramedullary spinal cord hemorrhage etiologies, with history and associated clues, common imaging findings, and representative management. Adapted from Leep, Hunderfund, & Wijdicks (2009).[emedicine.medscape.com]
  • 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]

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]
  • Bacteriology and epidemiology of Helicobacter pylori infection. . Accessed Jan. 9, 2017. Crowe SE. Indications and diagnostic tests for Helicobacter pylori infection. . Accessed Jan. 9, 2017.[mayoclinic.org]
  • 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.ro]
  • Lloyd postulated as early as 1894 a pathophysiological relationship between posttraumatic arachnoid scarring and cyst formation.[syringomyeli.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]
  • 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.[londonspine.com]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!