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Cerebral Palsy, Cerebellar Ataxia, AIDS, Phacomatosis, Neuromuscular Disorders, and Epilepsy
Published in Jacques Corcos, Gilles Karsenty, Thomas Kessler, David Ginsberg, Essentials of the Adult Neurogenic Bladder, 2020
NF2 is characterized by the presence of schwannomas.37 Spinal schwannomas may lead to upper motor neuron syndromes due to spinal cord compression.38–39 Other tumors can involve the spinal cord, including ependymomas, meningiomas, or hamartomas.39–45 Those may involve the conus or cauda equina and may present with mixed upper and/or lower motor neuron bladder symptoms.45–47
Spinal CordAnatomical and Physiological Features
Published in Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal, Principles of Physiology for the Anaesthetist, 2020
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal
It is located within the vertebral canal which provides structural protection and encloses the central canal of the spinal cord which contains cerebrospinal fluid. It is held in place by spinal roots, the denticulate ligaments and strands of pia mater. The spinal cord extends from the foramen magnum to the level of the L2 vertebra. Caudally, the spinal cord tapers to form the conus medullaris. Beyond the L2 vertebra, the spinal canal is filled with spinal roots descending caudally to exit from their intervertebral foramina. In the caudal canal at the sacral region, the spinal roots fan out to form the cauda equina.
Examine the gait
Published in Hani TS Benamer, Neurology for MRCP PACES, 2019
The most common cause of absent ankle jerks and extensor plantars in clinical practice is an elderly patient with diabetes and cervical myelopathy. Other causes include subacute combined degeneration of the cord, taboparesis, Friedreich’s ataxia, motor neurone disease and conus medullaris lesion.
Effect of untethering on occult tethered cord syndrome: a systematic review
Published in British Journal of Neurosurgery, 2022
Hamid Rezaee, Ehsan Keykhosravi
The occult tethered cord syndrome (OTCS) is characterized by the same clinical findings as TCS, including urological dysfunctions (e.g. urinary incontinence), orthopedic dysfunctions (e.g. back pain), and neurological abnormalities in the lower limbs. In some cases, surgery has been offered for patients with normal conus terminalis (or conus medullaris) based on their MRIs. Usage of surgical untethering for the management of OTCS is a controversial issue since it has been rejected by many pediatric neurosurgeons. Moreover, the benefits of SFT in the management of OTFTS have been both confirmed and rejected by the results of the previous research.5–8 In this regard, the association of the presenting signs and symptoms with postoperative outcomes should be assessed to determine the effectiveness of SFT in the management of OTCS. The symptoms of OTCS can be categorized into four main groups, namely neuro-cutaneous signs, such as localized hypertrichosis on the back and discoloration of the skin; neurological symptoms, including pain, weakness of the lower limbs, or reflex changes; orthopedic symptoms, such as club foot and other deformities of the feet; and urological symptoms, like urinary incontinence.
The cystic dilation of ventriculus terminalis with neurological symptoms: Three case reports and a literature review
Published in The Journal of Spinal Cord Medicine, 2018
The presence of a fifth ventricle has been described in literature as a normal developmental phenomenon, especially in newborns and infants.8 The longitudinal diameter of the terminal ventricle is 8–10 mm, and its transverse diameter is 2–4 mm.10 The VT reaches its final size during the second year of life.11 A pathological study by Choi et al.12 demonstrated that the VT has always been detectable through the histologic examination of the adult or pediatric conus medullaris, while neuroimaging techniques can barely detect it. In one magnetic resonance series, it was identified in 2.6% of children under five years of age;5 but it rarely persists through adulthood.13 The persistence of a fifth ventricle in adulthood, especially when unaccompanied by other malformative pathologies of the central nervous system, is extremely rare.7 Despite this, the symptomatic dilation of the VT can be seen in young adults.13,14 By 2013, 33 cases had been reported,13 and after that year, 10 cases had been reported.15–18 MRI is the best modality for studying the cord and its syrinx, but in infants whose posterior elements of the spine have not become bony, an ultrasound can also be used to check the status of the terminal ventricle.19
Schistosoma haematobium, a rare aetiology of spinal cord compression
Published in British Journal of Neurosurgery, 2018
Jawad Laaguili, Laminou Habibou Mahamane, Laurent Lemeri Mchome, Diawara Seylan, Mahjouba Boutarbouch, Abdessamad El Ouahabi
Authors present the case of a 8-year-old boy with no suggestive past-medical story of Schistosomiasis infection, admitted due to symptoms of spinal cord compression. The magnetic resonance imaging (MRI) shows an expansive lesion at the Conus, extending from D10–L1, heterogeneous signal on T1 and T2 with the presence of T2 hypointense areas surrounded by intense ring enhancement (Figure 1). A provisional diagnosis of a spinal tumor was then concluded. The patient was operated on, through a posterior approach. After laminotomy of D10 to L1, the dural opening under microscope showed enlarged edematous Conus medullaris. According to the nature of Conus involvement, it was not possible to excise the lesions. The lesion was farm and adherent to the cone with no cleavage plan. That limited us to do biopsies only. Schistosomal granulomas were found after Histological examination (Figure 2). Treatment was completed by administration of Praziquantel, with adjuvant corticosteroid therapy for 10 days. Removal of suprapubic catheter was possible after a week with complete regression of urinary disorders and partial improvement of anal incontinence.