Akutes Querschnittssyndrom durch Embolien von Nucleus-pulposus-Gewebe

Peiffer, J.; Wenig, Ch.; Mäusle, E

doi:10.1055/s-0028-1104118

Cited by 15 publications

(6 citation statements)

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“…One patient was receiving oral contraceptives [ 151, and another was pregnant [2]. In 3 patients a fall preceded the onset of symptoms [18,21,221. Symptoms were apparent on awakening from sleep in 3 patients [13,15,161.…”

Section: Discussionmentioning

confidence: 99%

“…Pain was the initial symptom in all but 1 patient [2] and was followed by the development of a rapidly progressive spinal-cord syndrome. In most patients the cervical cord was affected, but there were 3 in whom involvement was initially in the lumbosacral area [ 14,21,221. Death, usually secondary to an infective complication, occurred between 3 hours and 11 months after the onset of symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…In 9 patients plain radiographs of the cervical spine were obtained and were reported as either negative or showing minor degenerative changes [ 14, 2 11. On 6 occasions myelography was undertaken with negative results [6,13,16,21,221. Cerebrospinal fluid was normal in 8 patients [2,6,10,12,13,18,211; in 1 the protein level was elevated to 69 mg/dl[6] and in another the white cell count was 70/mm3 [15].…”

Section: Discussionmentioning

confidence: 99%

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Spinal cord infarction secondary to intervertebral disc embolism

Srigley

Lambert

Bilbao

et al. 1981

Annals of Neurology

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Spinal cord infarction secondary to intervertebral disc embolism

Srigley

Lambert

Bilbao

et al. 1981

Annals of Neurology

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“…The clinical history preceding the onset of symptoms was variable in the reported cases, including falls, symptoms on awakening from sleep, and in some cases the onset is sudden with no identifiable antecedant. 2,[6][7][8][9][10][11][12] How the disc material enters into the vascular system is not clear, and many theories have been proposed. The blood supply to the spinal cord is characterized by an extensive network of epidural arteriovenous anastomoses, as demonstrated by postmortem intravascular injection of gelatinated ink.…”

Section: Discussionmentioning

confidence: 99%

Spinal cord infarction secondary to nucleus pulposus embolization in pregnancy

Uppal¹,

Dash²,

Sharer³

et al. 2003

Mod Pathol

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Nucleus pulposus (NP) embolism is an extremely rare cause of spinal cord infarction. To our knowledge, it has not been reported in pregnancy in the English literature. A 41-year-old pregnant woman presented with clinical symptoms initially attributed to a transverse myelitis. After a complicated clinical course, she expired, and was found at autopsy to have NP embolism to the spinal cord. In conclusion NP embolism is a rare cause of spinal cord infarction, and should be considered in the differential of a patient presenting with symptoms compatible with spinal cord infarction in the pregnant as well as nonpregnant state. Embolization of fibrocartilaginous material to the spinal cord vessels is a rare cause of spinal cord infarction. The etiology is unknown, although some cases have been reported to occur following trauma, which may be minor. To our knowledge, nucleus pulposus (NP) embolism to the spinal cord vessels has not been reported during pregnancy in the English language literature. We herein report such a case and review the salient literature on this topic. CaseA 41-year-old G5P3105 woman presented to the labor and delivery service at 25 þ weeks gestational age with a chief complaint of sudden onset of lower extremity tingling, weakness, and inability to walk. The weakness developed in less than 30 min. She denied trauma, viral infection, contact with ill individuals, unusual food ingestion, or the use of alternate medicines. The patient had five other children, and her prior pregnancies were uneventful.On examination, she had decreased muscle tone, complete loss of strength, and absent deep tendon reflexes in the lower extremities. Plantar responses were absent. Sensory examination revealed the absence of perception to fine touch, pinprick, vibration, temperature, and joint position in the lower extremities below the T10 level. Rectal sphincter tone was absent. The remainder of the neurological examination was normal.Laboratory examination revealed normal serum chemistry and hematology. The patient's antithrombin-III level was mildly low at 74 (normal 85-120). Protein C, protein S, dilute Russell viper venom times (for lupus anticoagulant), and anticardiolipin antibody were normal. An Magnetic Resonance Imaging (MRI) of cervical, thoracic, and lumbar spine with and without contrast did not reveal any abnormalities, but showed mild disc protrusions at the C3-4 and C4-5 levels producing mild cervical stenosis and mild flattening of the thecal sac and cord. Lumbar puncture showed normal cerebrospinal fluid with one cell, protein 36 mg/dl, and glucose 62 mg/dl. The patient continued to be symptomatic, and an MRI of the spine was repeated a day later. Increased signal was noted within the cord from the conus to T6-7, compatible with either cord infarction or myelitis. An MRI of the brain with and without contrast was normal. Somatosensory evoked potentials to the right and left median nerve stimulations were normal. Cortical potentials were absent with right and left peroneal nerve stimulation. These findin...

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“…A-V (ASA) 7 A-V (ASA) 11 Hubert et alP7 1974 17/F 48 hours 11 days C4-T6 A (ASA) 12 Roitzsch'°1975 69/F ? 11 months T12-L4…”

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confidence: 99%