scholarly journals The clinical and subclinical features of spinal cord injury on magnetic resonance imaging of patients with N2O intoxication

2020 ◽  
Vol 12 (2) ◽  
Author(s):  
Tran Anh Tuan ◽  
Nguyen Minh Duc ◽  
Than Van Sy ◽  
Trinh Minh Hung ◽  
Tran Cuong ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Vitamin B12 ◽  
Roc Curve ◽  
Total Duration ◽  
Serum Levels ◽  
Resonance Imaging ◽  
Spinal Cord Lesions ◽  
Cord Injury

Nitrous oxide (N2O) is a weak anesthetic gas that was first used in 1844 in the field of dental anesthesia. However, currently, N2O is being abused for entertainment purposes in the form of N2O-filled balloons, called funky balls, which can cause many adverse effects, especially nervous system injury. This study aimed to investigate the detailed clinical and subclinical features associated with N2O intoxication. We retrospectively reviewed 47 patients diagnosed with N2O intoxication, from May 2018 to July 2019, and collected demographic data, clinical and laboratory tests, and spinal cord magnetic resonance imaging (MRI) findings. The mean time of funky ball use was 8.8 months, with a mean use of 36.3 balls per day. All patients presented with superficial sensory disorders. Reductions in muscle strength, decreased vibration sensation, and decreased or lost tendon reflexes were the most common clinical signs of N2O intoxication. Romberg sign and Lhermitte sign were observed in 39 patients (83%) and 21 patients (44.7%), respectively. Spinal cord lesions on MRI were observed in 32 patients (68.1%), which mostly presented with an inverted V sign. The total duration of N2O use, the number of days of using N2O per week, and the presence of Lhermitte sign (P<0.05) were significantly different between patients with and without spinal cord lesions on MRI. Serum levels of homocysteine and vitamin B12 were significantly different between the time of admission and discharge (P<0.05). Our study indicated that the days of using N2O per week was significantly associated with Spinal Cord Injuries (SCI) on MRI. According to the Receiver Operating Characteristic (ROC) curve analysis, a cutoff days of using per week value of 2.5 days could predict SCI with a sensitivity of 81.3%, a specificity of 73.3%, and an area under the ROC curve (AUC) of 0.813. Changes in the serum levels of homocysteine and vitamin B12 were effective markers for the evaluation of treatment response.

Spinal Cord Biopsy: A Review of 38 Cases

Neurosurgery ◽  
2003 ◽  
Vol 52 (4) ◽  
pp. 806-816 ◽  
Author(s):  
Aaron A. Cohen-Gadol ◽  
Ofer M. Zikel ◽  
Gary M. Miller ◽  
Allen J. Aksamit ◽  
Bernd W. Scheithauer ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Preoperative Magnetic Resonance Imaging ◽  
Resonance Imaging ◽  
Imaging Studies ◽  
Benign Lesions ◽  
Spinal Cord Lesions ◽  
Clinicopathological Findings ◽  
Preoperative Magnetic Resonance

Abstract OBJECTIVE Neurosurgeons are frequently asked to evaluate patients for spinal cord biopsies when preoperative magnetic resonance imaging studies demonstrate nonspecific features. These lesions often appear unresectable, but surgeons must decide whether a biopsy is warranted. To determine the best approach to these cases, we evaluated the clinicopathological findings for patients with unknown spinal cord lesions who underwent spinal cord biopsies. METHODS Thirty-eight consecutive patients who underwent spinal cord biopsies at the Mayo Clinic (Rochester, MN) between August 1988 and July 1998 were studied. A detailed review of the case histories, radiological results, surgical notes, histological findings, and outcomes was performed. RESULTS Spinal cord biopsies were performed for 21 male and 17 female patients (mean age, 42.1 yr) with progressive neurological deficits related to spinal cord lesions. All patients underwent preoperative magnetic resonance imaging evaluations. High T2-weighted signal intensity and spinal cord expansion were identified in 92 and 87% of cases, respectively. After gadolinium infusion, the majority (94%) of the inflammatory lesions demonstrated patchy and often peripherally situated enhancement. This neuroradiological pattern was less common for neoplasms (50%) and benign lesions (40%). The most common pathological findings were inflammatory changes of demyelination or sarcoidosis, which together accounted for 13 cases (34%). Nonspecific changes or benign lesions were observed in 10 cases (26%). Neoplasms were identified in eight cases (21%). One case of tuberculosis and one of schistosomiasis were found. Overall, 47% of the preoperative diagnoses made by the attending surgeon were correct. For 26% of the patients, specific treatment was based on the biopsy results. The average follow-up period was 12 months (standard deviation, 14 mo; range, 0–50 mo). CONCLUSION Preoperative laboratory and imaging studies are often diagnostically inconclusive in cases of spinal cord lesions with nonspecific features. Biopsies should be considered for patients with progressive symptomatic lesions.

Magnetic Resonance Imaging Examinations of Gluteal Decubitus Ulcers in Spinal Cord Injury Patients

1996 ◽  
Vol 19 (1) ◽  
pp. 5-8 ◽  
Author(s):  
Jennifer Y. Hencey ◽  
Michael Vermess ◽  
Herman H. Van Geertruyden ◽  
Joseph E. Binard ◽  
Setty Manchepalli
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Decubitus Ulcers ◽  
Cord Injury

Delayed Magnetic Resonance Imaging in Patients With Cervical Spinal Cord Injury Without Radiographic Abnormality

Spine ◽  
2016 ◽  
Vol 41 (16) ◽  
pp. E981-E986 ◽  
Author(s):  
Jun Ouchida ◽  
Yasutsugu Yukawa ◽  
Keigo Ito ◽  
Yoshito Katayama ◽  
Tomohiro Matsumoto ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Magnetic Resonance ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Resonance Imaging ◽  
Radiographic Abnormality ◽  
Cord Injury

scholarly journals Monitoring of Short-Term Erythropoietin Therapy in Rats with Acute Spinal Cord Injury Using Manganese-Enhanced Magnetic Resonance Imaging

2014 ◽  
Vol 25 (4) ◽  
pp. 582-589 ◽  
Author(s):  
Martin Thomas Freitag ◽  
Gábor Márton ◽  
Krisztián Pajer ◽  
Jens Hartmann ◽  
Nadja Walder ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Magnetic Resonance ◽  
Acute Spinal Cord Injury ◽  
Resonance Imaging ◽  
Short Term ◽  
Cord Injury
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