The Experts below are selected from a list of 33 Experts worldwide ranked by ideXlab platform
Wenyuan Ding - One of the best experts on this subject based on the ideXlab platform.
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magnetic resonance t2 image Signal intensity ratio and clinical manifestation predict prognosis after surgical intervention for cervical spondylotic myelopathy
Spine, 2010Co-Authors: Yingze Zhang, Yong Shen, Linfeng Wang, Wenyuan DingAbstract:STUDY DESign A retrospective imaging study of 73 patients who underwent surgery for cervical spondylotic myelopathy (CSM) between April 2005 and July 2007. OBJECTIVE To investigate whether magnetic resonance (MR) T2 image Signal intensity (SI) ratio and clinical manifestation can assess the prognosis in patients with CSM. SUMMARY OF BACKGROUND DATA The association between intramedullary high SI on T2-weighted MR images and surgical outcome in CSM remains controversial. The means of quantizing SI ratio for the disease has not been discussed. METHODS A total of 73 patients with cervical compressive myelopathy were retrospectively enrolled and were treated with anterior, posterior, and posterior-anterior united decompression. A total of 1.5-T magnetic resonance imaging was performed in all patients before surgery. T2-weighted images of sagittal increased SI on the cervical spinal cord were obtained, and the regions of interest (ROIs) are taken by 0.05 cm. T2-weighted MR images of sagittal normal cord SI on the cervical between C7-T1 disc levels were obtained, and the ROIs are taken by 0.3 cm. SI value is measured by computer, and the SI ratio between the regions 0.05 cm and 0.3 cm has been calculated. If no intramedullary high SI was noted on T2-weighted MR images, the ROIs were taken by 0.05 cm of the severe compression cord. All patients had been divided into 3 groups by hierarchical clustering analysis with SI ratio (Group 1: low SI ratio, Group 2: middle SI ratio, and Group 3: high SI ratio). Statistical analyses were performed with SPSS 11.0. RESULTS There are Significant differences between 3 groups by comparing the recovery rate (P < 0.001), age (P = 0.003), duration of disease (P = 0.001), Babinski Sign (P < 0.001), preoperative JOA score (P = 0.006), and postoperative JOA score (P < 0.001). There are no Significant differences on sex among 3 groups (P = 0.387). By using the multiple comparison analysis, the above results are further shown. CONCLUSION Patients with low SI ratio who were not too old and had a shorter duration of disease experienced a good surgical outcome. However, with the increase of SI ratio and the occurrence of Pyramidal Sign, a poor prognosis after surgery will show. SI ratio and clinical manifestation can be a predictor of surgical outcome.
Hossam Elnoamany - One of the best experts on this subject based on the ideXlab platform.
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Sensitivity of Pyramidal Signs in Patients with Cervical Spondylotic Myelopathy
Korean Spine Society, 2016Co-Authors: Hossam ElnoamanyAbstract:Study DeSignThis was a retrospective study.PurposeThe purpose of this study was to study the relationship between prevalence of Pyramidal Signs and the severity of cervical myelopathy. The study is focused on patients having increased Signal intensity in T2-weighted magnetic resonance imaging.Overview of LiteratureCervical spondylotic myelopathy is the most common cause of spinal cord dysfunction in elderly population. It is the consequence of spondylotic changes leading to cervical cord injury with resulting clinical deficits. Diagnosis in such patients is made based on clinical and radiographic features. A patient must have both symptoms and Signs consistent with cervical cord injury as well as radiographic evidence of damage to spondylotic cord.MethodsForty-six patients with complaint of cervical spondylotic myelopathy with increased Signal intensity in T2-weighted magnetic resonance imaging were included in the study. The neurological finding of the patients was reviewed for the presence of Pyramidal Signs. The prevalence of each Pyramidal Sign was calculated and correlated to severity of cervical myelopathy. The motor function scores of the upper and lower extremities for cervical myelopathy set by the Japanese Orthopedic Association (motor Japanese Orthopaedic Association score, m-JOA) scores were used to assess severity of myelopathy.ResultsThe most prevalent Signs were hyperreflexia (89.1%), Hoffmann reflex (80.4%), Babiniski Sign (56.5%), and ankle clonus (39.1%). Babiniski Sign, ankle clonus, and Hoffmann reflex showed Significant association with the lower m-JOA score.ConclusionsIn patients with cervical myelopathy, hyperreflexia exhibited highest sensitivity whereas ankle clonus demonstrated lowest sensitivity. The prevalence of the Pyramidal Signs is correlated with increasing severity of myelopathy
Yingze Zhang - One of the best experts on this subject based on the ideXlab platform.
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magnetic resonance t2 image Signal intensity ratio and clinical manifestation predict prognosis after surgical intervention for cervical spondylotic myelopathy
Spine, 2010Co-Authors: Yingze Zhang, Yong Shen, Linfeng Wang, Wenyuan DingAbstract:STUDY DESign A retrospective imaging study of 73 patients who underwent surgery for cervical spondylotic myelopathy (CSM) between April 2005 and July 2007. OBJECTIVE To investigate whether magnetic resonance (MR) T2 image Signal intensity (SI) ratio and clinical manifestation can assess the prognosis in patients with CSM. SUMMARY OF BACKGROUND DATA The association between intramedullary high SI on T2-weighted MR images and surgical outcome in CSM remains controversial. The means of quantizing SI ratio for the disease has not been discussed. METHODS A total of 73 patients with cervical compressive myelopathy were retrospectively enrolled and were treated with anterior, posterior, and posterior-anterior united decompression. A total of 1.5-T magnetic resonance imaging was performed in all patients before surgery. T2-weighted images of sagittal increased SI on the cervical spinal cord were obtained, and the regions of interest (ROIs) are taken by 0.05 cm. T2-weighted MR images of sagittal normal cord SI on the cervical between C7-T1 disc levels were obtained, and the ROIs are taken by 0.3 cm. SI value is measured by computer, and the SI ratio between the regions 0.05 cm and 0.3 cm has been calculated. If no intramedullary high SI was noted on T2-weighted MR images, the ROIs were taken by 0.05 cm of the severe compression cord. All patients had been divided into 3 groups by hierarchical clustering analysis with SI ratio (Group 1: low SI ratio, Group 2: middle SI ratio, and Group 3: high SI ratio). Statistical analyses were performed with SPSS 11.0. RESULTS There are Significant differences between 3 groups by comparing the recovery rate (P < 0.001), age (P = 0.003), duration of disease (P = 0.001), Babinski Sign (P < 0.001), preoperative JOA score (P = 0.006), and postoperative JOA score (P < 0.001). There are no Significant differences on sex among 3 groups (P = 0.387). By using the multiple comparison analysis, the above results are further shown. CONCLUSION Patients with low SI ratio who were not too old and had a shorter duration of disease experienced a good surgical outcome. However, with the increase of SI ratio and the occurrence of Pyramidal Sign, a poor prognosis after surgery will show. SI ratio and clinical manifestation can be a predictor of surgical outcome.
Hiroshi Tsukagoshi - One of the best experts on this subject based on the ideXlab platform.
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Alcoholic cerebellar degeneration with Pyramidal Sign--in relation to alcoholic myelopathy
No to shinkei = Brain and nerve, 1993Co-Authors: Kuniaki Tsuchiya, S Watabiki, T Shiojiri, A Matsumoto, Hiroshi TsukagoshiAbstract:Two cases of alcoholic cerebellar degeneration with Pyramidal Sign were reported. Patient 1 with alcohol dependence syndrome was a 46-year-old woman. After the alcohol abuse of about eight years, she complained of gait disturbance. The gait disturbance progressively worsened in about two months and she could not ambulate freely by herself. Neurological examination revealed nystagmus, ataxic and spastic gait, slight weakness and spasticity of the lower extremities, hyperreflexia of the extremities, bilateral Babinski's Signs, and incoordination of the lower extremities. Examination of liver function and serum B12 was normal. Cranial CT scan and MRI revealed atrophy of the cerebellar vermis and dorsal part of the cerebellum. Though neurological Signs slightly improved after the admission to our hospital and the abstinence from alcohol abuse, ataxic gait and hyperreflexia of the extremities have continued. Patient 2 was a 58-year-old man. He was a heavy drinker, but was not a patient with alcohol dependence syndrome. After the heavy drinking of about 40 years, he complained of gait disturbance. The gait disturbance had progressively worsened in about four months. Neurological examination revealed ataxic gait, hyperreflexia of the lower extremities, and bilateral Babinski's Signs. Laboratory examination revealed slight liver dysfunction with minimal GPT and moderate gamma-GTP elevation. Examination of serum B12 was normal. Cranial CT scan and MRI revealed atrophy of the cerebellar vermis. Though bilateral Babinski's Signs disappeared after the abstinence from heavy drinking, ataxic gait and hyperreflexia of the lower extremities have continued. Alcoholic myelopathy without hepatic cirrhosis was rarely reported. In the relation of alcoholic cerebellar degeneration to alcoholic myelopathy, our cases are interesting and important.
Kuniaki Tsuchiya - One of the best experts on this subject based on the ideXlab platform.
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Dentatorubropallidoluysian atrophy: Clinicopathological study of eight autopsy cases with special reference to the clinicopathological correlation between Pyramidal Sign and involvement of the Pyramidal tract
Neuropathology, 1995Co-Authors: Kuniaki Tsuchiya, Shinsaku Oyanagi, Kunimasa Arima, Kenji Ikeda, T. Akashi, Susumu Ando, T. Kurosawa, Nobuhiko Sunohara, Kimitaka Anami, Hiroyuki ShimadaAbstract:This paper reports a clinicopathological study of eight Japanese patients with dentatorubropallidoluysian atrophy (DRPLA) with special reference to the clinicopathological correlation between the Pyramidal Sign and involvement of the Pyramidal tract. None of the patients were related. There were five males and three females with age at disease onset ranging from 8 to 43 years, and the length of clinical course from 12 to 28 years. In each case the pattern of inheritance of the disease was consistent with that of an autosomal dominant trait. The neurological examination revealed that all eight individuals had dementia and showed cerebellar Signs. Seven patients had epilepsy and choreoathetoid involuntary movement; myoclonus was evident in six cases. Degeneration of the globus pallidus (the lateral segment in particular) and of the dentate nucleus were the principal pathological features of the DRPLA patients. Pyramidal Signs were noted in four patients. Evidence of Pyramidal tract involvement was found in three cases. However, the clinicopathological correlation between Pyramidal Sign and Pyramidal tract involvement was weak as there was concurrence of both in only one case. We suggest that Pyramidal Signs are being overlooked in DRPLA.
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Alcoholic cerebellar degeneration with Pyramidal Sign--in relation to alcoholic myelopathy
No to shinkei = Brain and nerve, 1993Co-Authors: Kuniaki Tsuchiya, S Watabiki, T Shiojiri, A Matsumoto, Hiroshi TsukagoshiAbstract:Two cases of alcoholic cerebellar degeneration with Pyramidal Sign were reported. Patient 1 with alcohol dependence syndrome was a 46-year-old woman. After the alcohol abuse of about eight years, she complained of gait disturbance. The gait disturbance progressively worsened in about two months and she could not ambulate freely by herself. Neurological examination revealed nystagmus, ataxic and spastic gait, slight weakness and spasticity of the lower extremities, hyperreflexia of the extremities, bilateral Babinski's Signs, and incoordination of the lower extremities. Examination of liver function and serum B12 was normal. Cranial CT scan and MRI revealed atrophy of the cerebellar vermis and dorsal part of the cerebellum. Though neurological Signs slightly improved after the admission to our hospital and the abstinence from alcohol abuse, ataxic gait and hyperreflexia of the extremities have continued. Patient 2 was a 58-year-old man. He was a heavy drinker, but was not a patient with alcohol dependence syndrome. After the heavy drinking of about 40 years, he complained of gait disturbance. The gait disturbance had progressively worsened in about four months. Neurological examination revealed ataxic gait, hyperreflexia of the lower extremities, and bilateral Babinski's Signs. Laboratory examination revealed slight liver dysfunction with minimal GPT and moderate gamma-GTP elevation. Examination of serum B12 was normal. Cranial CT scan and MRI revealed atrophy of the cerebellar vermis. Though bilateral Babinski's Signs disappeared after the abstinence from heavy drinking, ataxic gait and hyperreflexia of the lower extremities have continued. Alcoholic myelopathy without hepatic cirrhosis was rarely reported. In the relation of alcoholic cerebellar degeneration to alcoholic myelopathy, our cases are interesting and important.
