scholarly journals A Case of Idiopathic Thoracic Spinal Subdural Hematoma With Bilateral Lower Limb Paralysis

Cureus ◽  
2021 ◽  
Author(s):  
Takashi Dezawa ◽  
Keiji Hasegawa ◽  
Shintarou Tsuge ◽  
Akito Wada ◽  
Hiroshi Takahashi
Keyword(s):  
Subdural Hematoma ◽  
Lower Limb ◽  
Thoracic Spinal ◽  
Lower Limb Paralysis ◽  
Spinal Subdural Hematoma ◽  
Bilateral Lower Limb

scholarly journals Bilateral lower limb paralysis as initial symptom of neurofibromatosis type 2: A case report

2017 ◽  
Vol 4 (1) ◽  
pp. 24
Author(s):  
Mitsuru Yamagishi ◽  
Masaya Takahashi ◽  
Masahiro Nonaka ◽  
Yumiko Someno ◽  
Yoko Nakai ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Lower Limb ◽  
Neurofibromatosis Type ◽  
Spinal Tumor ◽  
Spinal Tumors ◽  
Thoracic Region ◽  
Lower Limb Paralysis ◽  
Bilateral Lower Limb ◽  
Tendon Reflexes

Neurofibromatosis type 2 (NF2) is an autosomal dominant disorder characterized by multiple tumors including schwannomas, meningiomas and ependymomas of the central nervous system. Although paresthesias, muscle weakness, muscle atrophy, and gait unsteadiness have been reported as clinical symptoms of spinal tumors, there are no reports of patients with NF2 who developed paralysis. A 7-year-old female consulted with our hospital because of sudden bilateral lower limb paralysis. She had not recognized the abnormalities, including paralysis, paraplegia and muscle weakness of bilateral lower limb before administration. Because of the aggravated bilateral patellar tendon reflexes, Achilles tendon reflexes, and the positive bilateral Babinski reflexes, a magnetic resonance imaging (MRI) of the spinal cord was performed. MRI revealed multiple spinal tumors in the cervical, thoracic, lumbar, and sacral regions. In particular, a 12 mm ×  33 mm spinal tumor was present in the thoracic region and was pressing against the spinal cord. Surgery was urgently performed to remove the spinal tumor in the thoracic region. Histopathological examination revealed that the tumor was a schwannoma. Gadolinium-enhanced MRI of the head was performed to explore the intra-cranial lesions: bilateral vestibular schwannomas and tumors in the left oculomotor nerve and right glossopharyngeal nerve were also discovered. Auditory brainstem response was performed to evaluate the bilateral VSs, and the results were normal. Nine months after the surgery, MRI of the head and spinal cord showed that her tumors had not increased in size. This represents the first reported case of NF2 complicated bilateral lower limb paralysis as initial neurological symptom.

Spontaneous thoracic spinal subdural hematoma associated with fibromuscular dysplasia

2008 ◽  
Vol 8 (5) ◽  
pp. 478-481 ◽  
Author(s):  
Sang-Dae Kim ◽  
Je-On Park ◽  
Se-Hoon Kim ◽  
Young-Hen Lee ◽  
Dong-Jun Lim ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Anticoagulant Therapy ◽  
Spinal Cord Compression ◽  
Subdural Hematoma ◽  
Poor Prognosis ◽  
Fibromuscular Dysplasia ◽  
Cord Compression ◽  
Middle Aged ◽  
Thoracic Spinal ◽  
Spinal Subdural Hematoma

✓Spontaneous spinal subdural hematoma (SDH) is an uncommon cause of acute spinal cord compression. When it does occur, however, it may have disastrous results and a poor prognosis. The nontraumatic acute spinal SDH usually results from a defect in a hemostatic mechanism (such as coagulopathy or the use of anticoagulant therapy) or from iatrogenic causes (such as spinal puncture). Fibromuscular dysplasia (FMD) is a nonatherosclerotic systemic arteriopathy of unknown cause that typically affects the small and medium arteries in young to middle-aged women. The authors report on their experience with a patient with an acute spontaneous spinal SDH that occurred in conjunction with FMD.

scholarly journals Sudden bilateral lower limb paralysis with dural ectasia in Neurofibromatosis type 1

2021 ◽  
Vol 2 (9) ◽  
pp. e0165
Author(s):  
Victor Mutua ◽  
Newnex Mong’are ◽  
Brian Bundi ◽  
Chris von Csefalvay ◽  
David Oriko ◽  
...  
Keyword(s):  
Neurofibromatosis Type 1 ◽  
Lower Limb ◽  
Neurofibromatosis Type ◽  
Dural Ectasia ◽  
Lower Limb Paralysis ◽  
Bilateral Lower Limb

scholarly journals Thoracic spinal subdural hematoma complicating anterior cervical discectomy and fusion: case report

2016 ◽  
Vol 24 (2) ◽  
pp. 295-299 ◽  
Author(s):  
Nicole M. Protzman ◽  
Jennifer Kapun ◽  
Christopher Wagener
Keyword(s):  
Operating Room ◽  
Subdural Hematoma ◽  
Functional Mobility ◽  
Anterior Cervical Discectomy ◽  
Diagnosis And Treatment ◽  
Motor Deficits ◽  
Cervical Discectomy ◽  
Thoracic Level ◽  
Thoracic Spinal ◽  
Spinal Subdural Hematoma

A spinal subdural hematoma is a rare clinical entity with considerable consequences without prompt diagnosis and treatment. Throughout the literature, there are limited accounts of spinal subdural hematoma formation following spinal surgery. This report is the first to describe the formation of a spinal subdural hematoma in the thoracic spine following surgery at the cervical level. A 53-year-old woman developed significant paraparesis several hours after anterior cervical discectomy and fusion of C5–6. Expeditious return to operating room for anterior cervical revision decompression was performed, and the epidural hematoma was evacuated without difficulty. Postoperative imaging demonstrated a subdural hematoma confined to the thoracic level, and the patient was returned to the operating room for a third surgical procedure. Decompression of T1–3, with evacuation of the subdural hematoma was performed. Postprocedure, the patient’s sensory and motor deficits were restored, and, with rehabilitation, the patient gained functional mobility. Spinal subdural hematomas should be considered as a rare but potential complication of cervical discectomy and fusion. With early diagnosis and treatment, favorable outcomes may be achieved.

scholarly journals Spontaneous thoracic spinal subdural hematoma associated with apixaban therapy

2019 ◽  
Vol 2019 (4) ◽  
Author(s):  
Javier Ardebol ◽  
Mario Cahueque ◽  
Wiliam Lopez ◽  
Enrique Azmitia
Keyword(s):  
Subdural Hematoma ◽  
Thoracic Spinal ◽  
Spinal Subdural Hematoma

Giant cell arteriitis in critical bilateral lower limb ischemia

VASA ◽  
2013 ◽  
Vol 42 (5) ◽  
pp. 375-378 ◽  
Author(s):  
Magdalena Chudala ◽  
Katarzyna Drozdz ◽  
Pawel Gac ◽  
Tomasz Kuniej ◽  
Bozena Sapian-Raczkowska ◽  
...  
Keyword(s):  
Giant Cell ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Lower Limb Ischemia ◽  
Bilateral Lower Limb

scholarly journals Hypokalaemic periodic paralysis secondary to subclinical hyperthyroidism: an uncommon cause of acute muscle paralysis

2021 ◽  
Vol 14 (6) ◽  
pp. e240666
Author(s):  
Alvin Oliver Payus ◽  
Sat Lin Liew ◽  
Nee Tiong ◽  
Norlaila Mustafa
Keyword(s):  
Lower Limb ◽  
Beta Blockers ◽  
Thyroid Function Test ◽  
Periodic Paralysis ◽  
Subclinical Hyperthyroidism ◽  
Thyroid Medication ◽  
Lower Limb Paralysis ◽  
Clinical Phenomenon ◽  
Potassium Replacement ◽  
Hypokalaemic Periodic Paralysis

Hypokalaemic periodic paralysis secondary to subclinical hyperthyroidism is an uncommon clinical phenomenon characterised by lower limb paralysis secondary to hypokalaemia in the background of subclinical hyperthyroidism. In this article, we report a patient who presented with progressive lower limb muscle weakness secondary to hypokalaemia that was refractory to potassium replacement therapy. He has no diarrhoea, no reduced appetite and was not taking any medication that can cause potassium wasting. Although he was clinically euthyroid, his thyroid function test revealed subclinical hyperthyroidism. His 24-hour urine potassium level was normal, which makes a rapid transcellular shift of potassium secondary to subclinical hyperthyroidism as the possible cause. He was successfully treated with potassium supplements, non-selective beta-blockers and anti-thyroid medication. This case report aimed to share an uncommon case of hypokalaemic periodic paralysis secondary to subclinical hyperthyroidism, which to our knowledge, only a few has been reported in the literature.

scholarly journals Ipsilateral Motor Pathways and Transcallosal Inhibition During Lower Limb Movement After Stroke

2021 ◽  
pp. 154596832199904
Author(s):  
Brice T. Cleland ◽  
Sangeetha Madhavan
Keyword(s):  
Lower Limb ◽  
Functional Outcomes ◽  
Motor Pathways ◽  
Movement Accuracy ◽  
Transcallosal Inhibition ◽  
Paretic Limb ◽  
Bilateral Lower Limb ◽  
Ankle Movement ◽  
Lower Limb Movement ◽  
Clinical Measures

Background Stroke rehabilitation may be improved with a better understanding of the contribution of ipsilateral motor pathways to the paretic limb and alterations in transcallosal inhibition. Few studies have evaluated these factors during dynamic, bilateral lower limb movements, and it is unclear whether they relate to functional outcomes. Objective Determine if lower limb ipsilateral excitability and transcallosal inhibition after stroke depend on target limb, task, or number of limbs involved, and whether these factors are related to clinical measures. Methods In 29 individuals with stroke, ipsilateral and contralateral responses to transcranial magnetic stimulation were measured in the paretic and nonparetic tibialis anterior during dynamic (unilateral or bilateral ankle dorsiflexion/plantarflexion) and isometric (unilateral dorsiflexion) conditions. Relative ipsilateral excitability and transcallosal inhibition were assessed. Fugl-Meyer, ankle movement accuracy, and walking characteristics were assessed. Results Relative ipsilateral excitability was greater during dynamic than isometric conditions in the paretic limb ( P ≤ .02) and greater in the paretic than the nonparetic limb during dynamic conditions ( P ≤ .004). Transcallosal inhibition was greater in the ipsilesional than contralesional hemisphere ( P = .002) and during dynamic than isometric conditions ( P = .03). Greater ipsilesional transcallosal inhibition was correlated with better ankle movement accuracy ( R2 = 0.18, P = .04). Greater contralateral excitability to the nonparetic limb was correlated with improved walking symmetry ( R2 = 0.19, P = .03). Conclusions Ipsilateral pathways have increased excitability to the paretic limb, particularly during dynamic tasks. Transcallosal inhibition is greater in the ipsilesional than contralesional hemisphere and during dynamic than isometric tasks. Ipsilateral pathways and transcallosal inhibition may influence walking asymmetry and ankle movement accuracy.

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