The Experts below are selected from a list of 252 Experts worldwide ranked by ideXlab platform
K. Yodo - One of the best experts on this subject based on the ideXlab platform.
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Diffusion-weighted MRI of the cervical spinal cord using a single-shot fast spin-echo technique: findings in normal subjects and in Myelomalacia
Neuroradiology, 2003Co-Authors: Kazuhiro Tsuchiya, Shichiro Katase, Akira Fujikawa, Junichi Hachiya, Hitoshi Kanazawa, K. YodoAbstract:We have implemented a new diffusion-weighted MRI (DWI) sequence based on the single-shot fast spin-echo technique. We hypothesised that this would add information to conventional MRI for diagnosis of lesions of the cervical spinal cord. DWI was performed using a technique in which echo collection after the application of motion-probing gradients was done in the same manner as in the single-shot fast spin-echo technique. We first imaged six healthy volunteers to demonstrate the cervical spinal cord using the sequence. Then we applied the sequence to 12 patients with cervical Myelomalacia due to chronic cord compression. The spinal cord was well seen in all subjects without the distortion associated with echo-planar DWI. In the patients, lesions appeared as areas of low- or isointense signal on DWI. Calculated apparent diffusion coefficients of the lesions (3.30±0.38×10-3 mm2/s) were significantly higher than those of normal volunteers (2.26±0.08×10-3 mm2/s). Increased diffusion in areas of cervical Myelomalacia, suggesting irreversible damage, can be detected using this technique.
Vijay Nath Mishra - One of the best experts on this subject based on the ideXlab platform.
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Focal Myelomalacia and syrinx formation after accidental intramedullary lidocaine injection during lumbar anesthesia: a report of 3 cases.
Journal of the neurological sciences, 2006Co-Authors: Sunil Pradhan, Ramakant Yadav, Pradeep Kumar Maurya, Vijay Nath MishraAbstract:Three cases of focal Myelomalacia and syrinx formation occurring as complications of lumbar spinal anesthesia are reported. In all three instances complication occurred due to accidental injection of lidocaine into the substance of the spinal cord. The primary complaint in all the three cases was severe sharp and shooting pain in both lower limbs, being more severe in certain dermatomes. Neurological deficits were noticed after the effect of the anesthetic agent had worn off. Sensory and motor deficits were asymmetrical and focal; these improved in 6-12 months time. Pain persisted for 1-3 years and then subsided gradually. Carbamazepine and gabapentin were effective in symptomatic relief of this pain. MRI of the dorsolumbar spine done 4-6 months after the spinal anesthetic procedure showed myelomalacic changes with focal syrinx formation in the conus and epiconus region of the spinal cord. The syrinx extended 1-2 vertebral segments in the vertical plane but was confined to a small area in the axial plane. Attempting to use higher lumbar intervertebral spaces for access to the subarachnoid space or epidural space may lead to inadvertent puncture of the lower dorsal spaces; this makes the procedure of spinal anesthesia at this level prone for spinal cord injury, with subsequent risk of development of myelomalacic syrinx in the conus and epiconus region of the spinal cord.
Jürgen W. Spranger - One of the best experts on this subject based on the ideXlab platform.
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Abnormal subcortical somatosensory evoked potentials indicate high cervical myelopathy in achondroplasia.
European journal of pediatrics, 1999Co-Authors: R. Boor, G. Fricke, K. Brühl, Jürgen W. SprangerAbstract:Children with achondroplasia may have high cervical myelopathy due to stenosis of the cranio-cervical junction resulting in neurological disability and an increased rate of sudden death. To detect myelopathy we recorded somatosensory evoked potentials (SEPs) after median nerve stimulation in 30 patients with achondroplasia aged 13 months to 18 years (mean 6 years). In addition to the conventional technique of recording the cortical N20 and the central conduction time (CCT), we employed a noncephalic reference electrode recording the subcortical waveforms N13b and P13, generated near the cranio-cervical junction. The findings were related to the clinical status and MRI results. Eighteen patients had MRI evidence of spinal cord compression with indentation or narrowing of the upper cervical cord, and 13 showed signs of Myelomalacia. Seven patients had neurological abnormalities. The sensitivities of the SEPs were 0.89 for cervical cord compression, 0.92 for Myelomalacia and 1.0 for the clinically symptomatic patients. There were no false-positive results. The subcortical SEPs were more sensitive than the conventional recordings. However, the conventional SEPs were highly specific in the most severely affected patients; here the specificity was 1.0 for patients with Myelomalacia and 0.96 for symptomatic patients. Postoperative SEPs improved after occipital decompression in two children.
Nestor Galvez-jimenez - One of the best experts on this subject based on the ideXlab platform.
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Sirsasana (headstand) pose causing compressive myelopathy with Myelomalacia.
JAMA neurology, 2013Co-Authors: Michelle Ferreira, Nestor Galvez-jimenezAbstract:A 52-YEAR-OLD WOMAN presented to our institution with bilateral hand numbness. She compulsively practiced yoga for more than 30 years and performed daily headstand poses. Examination showed weak grip, right Hoffmann sign, inability to tandem, and impaired vibration and proprioception. Imaging showed severe multilevel degenerative disease, spinal stenosis, and secondary compressive myelopathy with Myelomalacia worse at C5 (Figure).
Scott Falci - One of the best experts on this subject based on the ideXlab platform.
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Posttraumatic spinal cord tethering and syringomyelia: surgical treatment and long-term outcome.
Journal of neurosurgery. Spine, 2009Co-Authors: Scott Falci, Charlotte Indeck, Daniel P. LammertseAbstract:Object Permanent neurological loss after spinal cord injury (SCI) is a well-known phenomenon. There has also been a growing recognition and improved understanding of the pathophysiological mechanisms of late progressive neurological loss, which may occur after SCI as a result of posttraumatic spinal cord tethering (SCT), Myelomalacia, and syringomyelia. A clinical study of 404 patients sustaining traumatic SCIs and undergoing surgery to arrest a progressive myelopathy caused by SCT, with or without progressive Myelomalacia and cystic cavitation (syringomyelia) was undertaken. Both objective and subjective long-term outcomes were evaluated. To the authors' knowledge, this is the first series of this size correlating long-term patient perception of outcome with long-term objective outcome analyses. Methods During the period from January 1993 to November 2003, 404 patients who had previously sustained traumatic SCIs underwent 468 surgeries for progressive myelopathies attributed to tethering of the spinal co...
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Surgical treatment of posttraumatic tethered, myelomalacic and cystic spinal cords
Seminars in Spine Surgery, 2005Co-Authors: Scott FalciAbstract:Progressive neurologic loss from posttraumatic spinal cord tethering can occur within months, to more than thirty years subsequent to a spinal cord injury. This article discusses our understanding of the pathophysiology leading to progressive cord injury, as well as surgical treatment strategies. The relationship of progressive Myelomalacia and cystic necrosis of the spinal cord is discussed as well.
