No abstract available.
Central Cord Syndrome ; Spinal Cord Diseases* ; Spinal Cord Ischemia

The pathological lesion in spinal injury is usually more severe in the central gray matter and spreads centrifugally to surrounding white matter. Opiate antagonists, naloxone, by blocking the pathophysiologic effect of endorphins, should increase both mean arterial pressure and spinal cord blood flow and limit neurologic injury. Naloxone produce increase of lateral column blood flow and ameliorate the central gray matter ischemia. We have investigated the effects of naloxone on histopathological change in cats subjected to thoracic cord contusion. The histopathological evaluation of the injured spinal cords in naloxone-treated cats had less tissue damage than would be observed in time-matched standards. The acute histopathology in saline-treated cats had lesions typical of what we would expect in untreated cats, but the chronic histopathology had slightly better than typical that.
Animals ; Arterial Pressure ; Cats ; Contusions ; Endorphins ; Ischemia ; Naloxone* ; Spinal Cord Injuries* ; Spinal Cord* ; Spinal Injuries

STUDY DESIGN: A case report. OBJECTIVES: To report a rare cause of non-traumatic spinal cord injury (SCI) during surfing SUMMARY OF LITERATURE REVIEW: Surfer's myelopathy is a non-traumatic SCI associated with the hyperextension posture during paddling in surfing. Although the definite pathomechanism has not been identified, cord ischemia followed by arterial infarction may be related to this injury. MATERIALS AND METHODS: A young healthy male patient presented with a SCI that occurred during his first time surfing. Magnetic resonance imaging revealed a T2-hyperintense lesion in the spinal cord from D10 to the conus medullaris. RESULTS: The patient completely recovered without any neurologic deficits after steroid therapy and other forms of supportive management. CONCLUSIONS: Since surfing is becoming more common in Korea, awareness of surfer's myelopathy is important for early diagnosis and proper management.
Early Diagnosis ; Humans ; Infarction ; Ischemia ; Korea ; Magnetic Resonance Imaging ; Male ; Neurologic Manifestations ; Posture ; Spinal Cord ; Spinal Cord Diseases* ; Spinal Cord Injuries ; Spinal Cord Ischemia

Ischemic myelopathy is a rare and uncommon disease than the cerebral ischemia. Ischemia of spinal cord usually occur in the midthoracic regions (T4-T8). The major arteries supplying spinal cord are anterior and posterior spinal arteries. Anterior spinal artery is more responsible for the ischemic change of the spinal cord. We report a 45 years old man with ischemia of the spinal cord and acute renal failure due to rhabdomyolysis following the heavy alcohol ingestion.
Acute Kidney Injury ; Arteries ; Brain Ischemia ; Eating* ; Humans ; Ischemia* ; Middle Aged ; Rhabdomyolysis* ; Spinal Cord Ischemia ; Spinal Cord*

BACKGROUND: Paraplegia remains unresolved as the most dreaded operative complication with surgical treatment of descending thoracic and thoracoabdominal aortic diseases. In this study, the neuroprotective effect of trimetazidine that has been used clinically for ischemic heart disease was investigated in a rabbit spinal cord ischemia model. MATERIAL AND METHOD: Thirty-three New Zealand white rabbits were randomized as follows: control group undergoing abdominal aortic occlusion but receiving no pharmacologic intervention(Group 1, n=17); TMZ group(Group 2, n=16) receiving 3 mg/kg trimetazidine intravenously before the occlusion of the aorta. Ischemia was induced by clamping the abdominal aorta just distal to the left renal artery for 30 minutes. Neurologic status was assessed at 2, 24, and 48 hours after the operation according to the modified Tarlov scale, then the lumbosacral spinal cord was processed for histopathologic examinations 48 hours after the final assessment. RESULT: The average motor function score was significantly higher in the TMZ group(3.20 +/- 0.77 vs 1.13 +/- 1.25 at 2 hours, 3.50 +/- 0.76 vs 1.45 +/- 1.57 at 24 hours, and 3.91 +/- 0.30 vs 1.86 +/- 1.86 at 48 hours after operation; p value spinal cord injury during aortic clamping and that it may have clinical utility for the thoracoabdominal aortic surgery.
Aorta ; Aorta, Abdominal ; Aortic Diseases ; Constriction ; Ischemia ; Myocardial Ischemia ; Neuroprotective Agents ; Paraplegia ; Rabbits ; Renal Artery ; Spinal Cord Injuries ; Spinal Cord Ischemia* ; Spinal Cord* ; Trimetazidine*

BACKGROUND: Paraplegia remains unresolved as the most dreaded operative complication with surgical treatment of descending thoracic and thoracoabdominal aortic diseases. In this study, the neuroprotective effect of trimetazidine that has been used clinically for ischemic heart disease was investigated in a rabbit spinal cord ischemia model. MATERIAL AND METHOD: Thirty-three New Zealand white rabbits were randomized as follows: control group undergoing abdominal aortic occlusion but receiving no pharmacologic intervention(Group 1, n=17); TMZ group(Group 2, n=16) receiving 3 mg/kg trimetazidine intravenously before the occlusion of the aorta. Ischemia was induced by clamping the abdominal aorta just distal to the left renal artery for 30 minutes. Neurologic status was assessed at 2, 24, and 48 hours after the operation according to the modified Tarlov scale, then the lumbosacral spinal cord was processed for histopathologic examinations 48 hours after the final assessment. RESULT: The average motor function score was significantly higher in the TMZ group(3.20 +/- 0.77 vs 1.13 +/- 1.25 at 2 hours, 3.50 +/- 0.76 vs 1.45 +/- 1.57 at 24 hours, and 3.91 +/- 0.30 vs 1.86 +/- 1.86 at 48 hours after operation; p value spinal cord injury during aortic clamping and that it may have clinical utility for the thoracoabdominal aortic surgery.
Aorta ; Aorta, Abdominal ; Aortic Diseases ; Constriction ; Ischemia ; Myocardial Ischemia ; Neuroprotective Agents ; Paraplegia ; Rabbits ; Renal Artery ; Spinal Cord Injuries ; Spinal Cord Ischemia* ; Spinal Cord* ; Trimetazidine*

Man-in-the-barrel syndrome (MIBS) is a clinical syndrome of bilateral upper limb weakness with normal lower extremity function. It can be caused by various neurological conditions such as bilateral cerebral hypoperfusion, syringomyelia, motor neuron disease, or cervical myelopathies. We report a patient with MIBS after cervical spinal cord ischemia. It is postulated to be caused by ischemic insults of anterior spinal artery from repeated and prolonged neck extension.
Arteries ; Humans ; Lower Extremity ; Motor Neuron Disease ; Neck ; Spinal Cord Diseases ; Spinal Cord Ischemia* ; Spinal Cord* ; Syringomyelia ; Upper Extremity

The spinal dural arteriovenous fistula (SDAVF) is rare, presenting with progressive, insidious symptoms, and inducing spinal cord ischemia and myelopathy, resulting in severe neurological deficits. If physicians have accurate and enough information about vascular anatomy and hemodynamics, they achieve the good results though the surgery or endovascular embolization. However, when selective spinal angiography is unsuccessful due to neurological deficits, surgery and endovascular embolization might be failed because of inadequate information. We describe a patient with a history of vasospasm during spinal angiography, who was successfully treated by spinal stereotactic radiosurgery using Novalis system.
Angiography ; Central Nervous System Vascular Malformations* ; Hemodynamics ; Humans ; Radiosurgery* ; Spinal Cord Diseases ; Spinal Cord Ischemia

Paraplegia secondary to spinal cord infarction is a recognized complication of open thoracic and thoracoabdominal aortic aneurysm (TAA) repair. TAA is serious and unpredictable condition. Therefore, aortic repair requires thorough information on managing the potential complications will facilitate improve control the problem. We report the symptoms and management of paraplegia in a patient who underwent stent insertion as TAA.
Aortic Aneurysm, Abdominal ; Aortic Aneurysm, Thoracic ; Humans ; Infarction ; Paraplegia ; Spinal Cord ; Spinal Cord Ischemia ; Stents

Peripheral arterial disease is one part of systematic atherosclerosis, becoming a heavy burden of human health. Patients in end stage of peripheral arterial disease manifest critical limb ischemia with severe rest pain and refractory ulcer. Surgical revascularization is the optimal option for patients with critical limb ischemia to avoid major amputation and improve quality of life. However, some of them contraindicate surgical revascularizations owing to coexisting morbidities. Spinal cord stimulation is reported to be effective and minimally invasive in pain relief and limb salvage for patients with limb ischemia. Here, we reported one case with chronic critical limb ischemia and gangrene of foot who underwent spinal cord stimulation, which was, as we knew, the first case in China. He was diagnosed with Burger disease and accompanied with history of stroke, chronic obstructive pulmonary disease and Castleman's disease. It showed totally occlusive lesions of external iliac and femoropopliteal artery and no outflows below the knee in the computed tomography angiography. Given the complexity of lesions and weakness of the patient, spinal cord stimulation was indicated for control of rest pain and limb salvage. As specified, we implanted the temporary neurostimulator as the first step. After 2 weeks from temporary neurostimulator implantation, the patient achieved significant relief in intensity of pain, and acquired 20% improvement of transcutaneous oxygen pressure. The satisfactory results indicated probable effectiveness of spinal cord stimulation, thus we performed the permanent neurostimulator implantation 1 month later. During 2 months of follow-up, the patients stabilized at Fountain III with pain relief with one kind of nonsteroidal anti-inflammatory drug. In our case, we confirmed the significant validity of spinal cord stimulation for pain control and consequent improvement of quality of life in non-reconstructable chronic critical limb ischemia. Furthermore, we reviewed that a number of published studies suggested that spinal cord stimulation be a reasonable option for patients with critical rest pain, especially who contraindicated surgical revascularization. The application of spinal cord stimulation in pain relief for non-reconstructable chronic critical limb ischemia was approved by related guidelines released by European Society of Cardiology and Trans-Atlantic Inter-Society Consensus. Further investigations are required for assessing the long-term outcome in limb salvage.
China ; Humans ; Ischemia ; Leg ; Limb Salvage ; Male ; Quality of Life ; Spinal Cord ; Spinal Cord Stimulation ; Treatment Outcome