Disc fragment migration occurs in 35%-72% of lumbar disc herniations. Most of the herniated disc fragments migrate in the rostal, caudal and lateral directions. Posterior epidural disc fragment migration is a rare finding and posterior migration causing Cauda Equina syndrome is exceptionally rare. We report here on two cases of L4-5 disc fragment posterior epidural migration that caused Cauda Equina syndrome, and this was diagnosed by performing radiological examination, and we also include a review of the related literature.
Intervertebral Disc Displacement ; Polyradiculopathy

Spontaneous epidural hematomas (SEHs) of the lumbar spine are rare. The pathogenesis is not entirely clear, but several reports have suggested that bleeding originating in the venous epidural plexus is the cause. This is the second report of a SEH thought to be the result of facet joint hemorrhage with no previous synovial cyst formation. A magnetic resonance image revealed a mass beginning in the left epidural space and continuing through to the left L5-S1 facet joint. Surgically, the epidural hematoma, which was covered by a very thin translucent membrane, was visualized directly. A histopathological examination revealed the wall of the epidural hematoma to be composed of very thin fibrous connective tissue with no synovium lining. The purpose of this study was to report a case of an epidural hematoma originated from lumbar facet joint, diagnosed by radiological examination, and to present a review of the subject literature.
Connective Tissue ; Epidural Space ; Hematoma* ; Hemorrhage ; Membranes ; Spine ; Synovial Cyst ; Synovial Membrane ; Zygapophyseal Joint*

Intradural cervical disc herniation is an extremely rare condition and its pathogenesis is not certain. We experienced a case of intradural cervical disc herniation at the C4-5 level in a 56-year-old man. The preoperative sagittal T1- and T2- weighted images revealed an intradural iso-intensity lesion, with the spinal cord behind the posterior longitudinal ligament at the C4-5 disc level. The post-contrast T1-weighted image revealed a peripheral enhanced intradural lesion. We report here on a case of an intradural cervical disc herniation that was diagnosed by radiological examination, and we include a review of the related literature.
Humans ; Longitudinal Ligaments ; Middle Aged ; Spinal Cord

Symptomatic spinal epidural gas-containing cystic lesion is a rare clinical disease entity. We recently experienced two cases of symptomatic epidural gas-containing cysts that were the main cause of the patients?radiculopathy and the cysts were removed surgically. These lesions were actually gas containing ruptured disc herniations from the vacuum discs at the same level. We report herein on the radiological findings along with conducting a review of the related literature.
Spine ; Vacuum

Pulmonary involvement of salmonella infection is very rare and only one case of salmonella empyema had been reported in Korea. A 53-year-old woman presented to Kyung Hee Medical Center with 2-months history of left chest pain and mild fever. 3 months prior to admission, the patient was taken to laparoscopic laser cholecystectomy due to gall stone in other hospital. Chest X-ray taken on admission day showed pneumonic infiltration at left lower lung field with pleural effusion. Salmonella Group B was identified from the cultures of stool, blood, and pleural fluid. After consecutive therapy with two weeks of ceftriaxone and three weeks of ciprofloxacin combined with repeated pleural aspirations, the patient was recovered and discharged. But she was readmitted two months later due to fever and generalized malaise. The result of blood culture showed growth of Salminella Group B. The excisional biopsy of right supraclavicular lymph node disclosed necrotizing lymphadenitis. She was recovered clinically and no more bacteremia occurred after two weeks of ciprofloxacin therapy. We present very rare case of empyema due to salmonella infection and review the pertinent literature.
Aspirations (Psychology) ; Bacteremia ; Biopsy ; Ceftriaxone ; Chest Pain ; Cholecystectomy ; Ciprofloxacin ; Empyema* ; Female ; Fever ; Gallstones ; Humans ; Korea ; Lung ; Lymph Nodes ; Lymphadenitis ; Middle Aged ; Pleural Effusion ; Salmonella Infections ; Salmonella* ; Thorax

Spinal en plaque meningioma is rarely found in the spinal canal, although lateral sphenoid wing meningioma displays a propensity for growth en plaque. We encountered a case of completely circumferential spinal en plaque meningioma, which is an even rarer condition. Herein, we report the CT & MRI findings along with a review of the related literature.
Magnetic Resonance Imaging ; Meningioma* ; Spinal Canal ; Spine*

Intraspinal synovial cysts are commonly found in the lumbar spine and occur less commonly in the cervical spine. Occurrence of a cyst in the thoracic spine causing myelopathy is extremely rare. We report here the radiological findings of a case of a thoracic intraspinal synovial cyst that caused myelopathy at the T2-3 level with an accompanying review of the clinical literature.
Spinal Cord Diseases ; Spine ; Synovial Cyst

PURPOSE: To determine the incidence of pseudolesions seen in the posterior aspect of segment IV of the liveron CT arterial portography(CTAP), and to evaluate the findings of CT hepatic arteriorgraphy(CTHA) and celiacangiography. MATERIALS AND METHODS: We retrospectively analysed 450 cases of patients who had undergone CTHA,CTAP and celiac arteriorgraphy for the diagnosis and treatment of hepatic lesion, and evaluated the incidence andimaging findings of pseudolesions in segment IV of the liver, as seen on CTAP, CTHA and celiac arteriography. RESULT: In 28 of 450 patients(6.2%), pseudolesions of focal perfusion defect were seen in segment IV on CTarterial portography. Pseudolesions were seen on CTAP on 39 different section slices ; these were wedge-shaped in41% of cases(16/39), rectangular in 30.8%(12/39), ovoid-shaped in 23.1%(9/39), and half moon-shaped in 5.1%(2/39); they were from 1 to 3cm(average, 1.5cm) in anteroposterior diameter, from 1 to 3cm(average, 1.9cm) in width, andfrom 1 to 4cm(average, 1.9cm) in craniocaudal diameter. Twenty-seven patients underwent CTHAs ; hyperattenuationwas seen in 13(48.2%), isoattenuation in 12(44.4%), and hypoattenuation in two(7.4%). In 19 of 28 celiacangiograms(67.9%), the right gastric artery was seen to arise from the hepatic artery, and aberrant right gastricveins directly draining into the left lobe of the liver were seen in three(10.7%). CONCLUSION: The incidence ofpseudolesion seen in segment IV of the liver on CTAP was 6.2% (28/450), and in 3 of 28 cases(10.7%), celiacangiography showed aberrant right gastric venous drainage. For pseudolesions, CTHA showed variable attenuation,and this modality is less sensitive than CTAP for the detection of pseudolesion.
Angiography ; Arteries ; Diagnosis ; Drainage ; Hepatic Artery ; Humans ; Incidence ; Liver* ; Perfusion ; Portography* ; Retrospective Studies