No abstract available.
Ageusia* ; Humans ; Myasthenia Gravis* ; Thymoma

Dot-like hippocampal hyperintensities on diffusion-weighted magnetic resonance imaging (MRI) have been reported as an interesting imaging finding of transient global amnesia (TGA). We report three patients with such dot-like hippocampal hyperintensities who did not present with anterograde amnesia. Episodes associated with the Valsalva maneuver such as nausea or vomiting might have produced the dot-like hippocampal hyperintensities in these patients. However, depending on the individual susceptibility to hippocampal lesions, clinical symptoms of TGA might not be present even when hippocampal lesions are present.
Amnesia, Anterograde ; Amnesia, Transient Global* ; Hippocampus ; Humans ; Magnetic Resonance Imaging* ; Nausea ; Valsalva Maneuver ; Vomiting

OBJECTIVE: We introduce innovative method of cervical column reconstruction and performed the reconstruction with a flanged titanium mesh cage (TMC) instead of a plate after anterior corpectomy for cervical spondylotic myelopathy (CSM) and an ossified posterior longitudinal ligament (OPLL).METHODS: Fifty patients with CSM or OPLL who underwent anterior cervical reconstruction with a flanged TMC were investigated retrospectively. Odom’s criteria were used to assess the clinical outcomes. The radiographic evaluation included TMC subsidence, fusion status, and interbody height. Thirty-eight patients underwent single-level and 12 patients underwent two-level corpectomy with a mean follow-up period of 16.8 months.RESULTS: In all, 19 patients (38%) had excellent outcomes and 25 patients (50%) had good outcomes. Two patients (4%) in whom C5 palsy occurred were categorized as poor. The fusion rate at the last follow-up was 98%, and the severe subsidence rate was 34%. No differences in subsidence were observed among Odom’s criteria or between the single-level and two-level corpectomy groups.CONCLUSION: The satisfactory outcomes in this study indicate that the flanged TMC is an effective graft for cervical reconstruction.
Cervical Vertebrae ; Female ; Follow-Up Studies ; Humans ; Longitudinal Ligaments ; Methods ; Ossification of Posterior Longitudinal Ligament ; Paralysis ; Retrospective Studies ; Spinal Cord Diseases ; Spondylosis ; Titanium ; Transplants

Objective: : Spinal cord stimulation (SCS) is an effective treatment for chronic neuropathic pain. However, its clinical efficacy in regard to specific types of pain has not been well studied. The primary objective of this study was to retrospectively analyze the clinical outcomes of paddle-type SCS according to the type of neuropathic pain. Methods: : Seventeen patients who underwent paddle-lead SCS at our hospital were examined. Clinical outcomes were evaluated pre- and postoperatively (3 months, 1 year, and last follow-up) using the Neuropathic Pain Symptom Inventory (NPSI). The NPSI categorizes pain as superficial, deep, paroxysmal, evoked, or dysesthesia and assess the duration of the pain (pain time score). Changes in NPSI scores were compared with change in Visual analogue scale (VAS) scores. Results: : After SCS, the pain time score improved by 45% (independent t-test, p=0.0002) and the deep pain score improved by 58% (independent t-test, p=0.001). Improvements in the pain time score significantly correlated with improvements in the VAS score (r=0.667, p=0.003, Spearman correlation). Additionally, the morphine milligram equivalent value was markedly lower after vs. before surgery (~49 mg, pared t-test, p=0.002). No preoperative value was associated with clinical outcome. Conclusion : The NPSI is a useful tool for evaluating the therapeutic effects of SCS. Chronic use of a paddle-type spinal cord stimulation improved the deep pain and the pain time scores.