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Spinal Cord Disease
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Intradural intramedullary (uncommon): Glial cell tumors (80% of intramedullary tumors): Ependymoma (many arise from filum terminale, approximately 50% of intramedullary primary tumors).Astrocytoma (mostly cervical).Oligodendroglioma (rare).
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
NLUTD in Duchenne muscular dystrophy (DMD) is unusual.73–78 Several reports73–75 showed various presentations, including UI or retention. The mechanism of NLUTD is unclear. Myopathic changes within the detrusor muscle would be expected to cause a flaccid bladder, while pathology in skeletal pelvic floor muscles could account for SUI.75 The upper motor neuron lesions are likely due to scoliosis, or complications of its surgical treatment, or due to altered expression of dystrophin on the CNS.74–75 NLUTD might be associated with fatty infiltration of the filum terminale. Sectioning of the filum terminale has resulted in recovery of urinary continence in a reported case.78
The nervous system and the eye
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
James A.R. Nicoll, William Stewart, Fiona Roberts
Ependymomas (WHO grade II) are predominantly intracranial tumours, arising in relation to the ventricles, with occasional examples arising in the spinal cord. A common site is in the fourth ventricle in children. Tumour cells are characteristically orientated around small blood vessels to form perivascular pseudorosettes. A high-grade variant (anaplastic ependymoma, WHO grade III) has a marked tendency to seed through the CSF pathways. Myxopapillary ependymoma (WHO grade I) arises at the lower end of the spinal cord from the filum terminale. It is a very slowly growing gelatinous tumour that ensheathes the nerve roots of the cauda equina. The tumour consists of papillary structures comprising a central vascular core surrounded by mucoid connective tissue and covered by ependymal cells.
Effect of untethering on occult tethered cord syndrome: a systematic review
Published in British Journal of Neurosurgery, 2022
Hamid Rezaee, Ehsan Keykhosravi
Nazar et al. reported that nearly half of their subjects experienced severe pain that markedly curtailed their physical and social activities. The pain onset was gradual in the majority of patients (83%), while in 25% of them, the pain progressed following an accident. Moreover, the pain was concentrated in the mid to upper lumbar region in the majority of patients (72%) and increased by lumbar flexion and prolonged sitting and standing. According to the main criterion of filum terminale was an increasing pain associated with lumbar flexion which is commonly accompanied by paravertebral muscle spasm. They reported that some patients routinely complained of superimposed sharp lightning pain along the spine with minimal lumbar flexion.16
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
Syringomyelia should be clearly differentiated from a dilated ventriculus terminalis. The later occurs immediately cephalad to a normally located conus medullaris, is not associated with other dysraphic anomalies and is not related to history of trauma and surgical intervention and is non-progressive on follow-up MRI.4 According to Coleman et al.5 Stilling described a VT in 1859, and in 1875 Krause identified it as a true ventricle lined by ciliated ependymal cells. Krause named it the “fifth ventricle.” The development of the VT, or the fifth ventricle, can be considered a normal process of embryonal development.7 The origin of the VT can be traced to the embryonic development of the spinal cord, which can be subdivided into two stages: neurulation and canalization or retrogressive differentiation.8 Neurulation starts when the embryo is three-weeks old, and it is responsible for the formation of the neural tube through the progressive closure of the neural plate and its separation from the overlying ectoderm. The distal cord develops from a caudal cell mass that forms from the neuralepithelium and a notochord caudal to the primary neural tube. The caudal cell mass develops microcysts that coalesce to form an ependyma-lined tube that fuses with the central canal of the neural tube. With differentiation, the caudal end of the cell mass involutes, leaving a focal prominence in the ependyma-lined canal in the conus medullaris with a fibrous tail, which is the filum terminale.7 The VT appears after approximately 45 days (between the 43rd and the 48th day) after conception.8
Congenital Spinal Lipomatous Malformations. Part 1. Spinal Lipomas, Lipomyeloceles, and Lipomyelomeningoceles
Published in Fetal and Pediatric Pathology, 2020
Regression in late embryonic life reduces almost the entire coccygeal spinal cord to the filum terminale. The filum is a thin continuation of nonfunctional spinal cord caudal to the conus medullaris in which residual neural cells, including neurons and glial cells, tend to be scattered or nested in fibrous tissue. Ependyma-like cells may be present and an ependymal canal with a serpiginous lining may be found in the rostral filum. Blood vessels and some adipocytes are also present, while a variable amount of fatty tissue may encase the filum. The mature filum extends through the caudal dural sac at the level of S2 where it usually ends in sacrococcygeal bone [17, 163].