Postoperative acute disseminated encephalomyelitis after exposure to microfibrillar collagen hemostat

Sani, Sepehr; Boco, Tibor; Lewis, Steven L.; Cochran, Elizabeth J.; Patel, Ajay; Byrne, Richard W.

doi:10.3171/jns/2008/109/7/0149

Cited by 13 publications

(8 citation statements)

References 12 publications

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“…Recurrent ADEM may reflect either a susceptibility of the physical barriers or antigenic modifications in certain brain regions as a result of an initial local infection and insult. This view is consistent with localized ADEM occurring in the region of an excised brain tumor (Sani et al 2008) and with recurrent transverse myelitis occurring at the same segmental level (Pandit and Rao 1996).…”

Section: Relapsing Variants Of Adem: Multiphasic or Recurrentsupporting

confidence: 77%

Acute disseminated encephalomyelitis: current knowledge and open questions

Steiner

Kennedy

2015

J. Neurovirol.

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Acute disseminated encephalomyelitis (ADEM) is usually an acute, multi-focal, and monophasic immune-mediated disease of the central nervous system. The disorder is mainly a condition of the pediatric age group, but neurologists are also involved in the management of adult patients. The lack of defined diagnostic criteria for ADEM underlies the limited understanding of its epidemiology, etiology, pathogenesis, course, prognosis, therapy, as well as the association with, and distinction from, multiple sclerosis. The present review summarizes current knowledge and outlines unanswered questions the answers to which should be eventually provided through a synergistic combination of clinical and basic research.

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Section: Relapsing Variants Of Adem: Multiphasic or Recurrentsupporting

confidence: 77%

Acute disseminated encephalomyelitis: current knowledge and open questions

Steiner

Kennedy

2015

J. Neurovirol.

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“…The recurrence may reflect either a susceptibility of the physical barriers or antigenic modifications in certain brain regions as a result of an initial insult. This view is consistent with localized ADEM occurring in the region of an excised brain tumor [30] and with recurrent transverse myelitis taking place at the same segmental level [31].…”

Section: Ademsupporting

confidence: 52%

Post infectious CNS disorders: towards a unified approach

2010

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The spectrum of post infectious (PI) central nervous system (CNS) conditions includes a range of grey and white-matter disorders which can occur after viral or bacterial infections or in response to vaccinations. The clinical, radiological and immunological phenomenology raises a number of issues regarding the nature of immune-mediated CNS abnormalities, their etiology, pathogenesis and therapy. Here we focus on crucial issues pertaining to pathogenesis and aim to identify where current knowledge is insufficient in order to suggest future avenues of clinical and experimental research that may help to devise optimal therapy for these conditions.

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“…In one case report, in addition to the development of a foreign body granulomatous mass lesion, the patient developed disseminated encephalomyelitis hypothesized to be secondary to the microfibrillar hemostatic agent. 8…”

Section: Discussionmentioning

confidence: 99%

Two Cases of Cerebral Infarcts Caused by Topical Hemostatic Agent Embolism

Coss

Tlomak

Cochran

2020

Am J Forensic Med Pathol

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Resorbable topical hemostatic agents are widely used in surgical procedures to control intraoperative bleeding. There have been multiple reports of complications from use of these agents, including pulmonary vasculature thromboembolism, cerebral venous sinus occlusion, and postoperative inflammatory mass lesions each containing the hemostatic agent. We report 2 cases of inadvertent intra-arterial embolization of hemostatic agent. Both cases followed elective surgical cervical spinal procedures, during which gelatin-based local hemostatic agents were used to control unanticipated bleeding. Postoperatively, both patients exhibited neurologic defects and were found to have infarcts of the brain. At autopsy, vertebrobasilar thromboemboli containing foreign material grossly and microscopically consistent with hemostatic matrix material were found in both cases. These are the first reports of hemostatic agent embolization resulting in cerebral infarcts and leading to death.

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Postoperative acute disseminated encephalomyelitis after exposure to microfibrillar collagen hemostat

Cited by 13 publications

References 12 publications

Acute disseminated encephalomyelitis: current knowledge and open questions

Acute disseminated encephalomyelitis: current knowledge and open questions

Post infectious CNS disorders: towards a unified approach

Two Cases of Cerebral Infarcts Caused by Topical Hemostatic Agent Embolism

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