Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of cervical intramedullary neurenteric cyst was reported. A 12-year-old girl was admitted with severe pain over the nape and shoulders, and weakness of all extremities. At the age of 4 years, she had suffered from the nape pain and paraparesis which, however, cleared later spontaneously. Neurological examination revealed evidences of presumptive cervical intramedullary lesion, and myelography showed a complete block at the third cervical level accordingly. Surgical exploration through C3-C5 laminectomy disclosed an intramedullary cyst situated within the right half of the cord. The cyst was removed except for its upper and lower apices. Excellent clinical results followed the operation. The cyst was composed of collagen fibers with an inner epithelial lining, which consisted of single or pseudostratified layer of columnar, cuboidal or squamous cells. Cells were ciliated at some parts. The base of the epithelial cells rested upon the basement membrane. Nuclei were positioned near the base of the cells, to present a row. The cytoplasm in the majority of cells contained abundant mucin positive to PAS staining. Pathological diagnosis of neurenteric cyst was made on the basis of these histological findings. Usually intraspinal neurenteric cyst is located in the subarachnoid space and ventrally to the spinal cord. Neurenteric cyst appears histologically similar to ependymal cyst, though, in the latter the epithelial cells seldom contain mucin, and only in scanty amount, if any present. Embryogenesis during the third week of embryonic life was discussed in relation to the development of neurenteric cyst.
 ...
PMID:[A case of cervical intramedullary neurenteric cyst]. 673 1

We have reported a case of cervical spontaneous hematomyelia caused by cavernous hemangioma. A 47-year-old woman experienced a sudden onset of pain in the neck on 5 December 1979. One week after the onset she began to have tetraparesis. There was a rapidly increasing weakness of the extremities and she was referred to our department on 25 December 1979. At the time, the positive neurological findings were flaccid tetraplegia, bilateral loss of all sensory perception below the C4 level and urinary retention. Chest x-ray films demonstrated an elevation of right diaphragma. Roentgenograms of the cervical spine were normal. Emergency myelography via cisternal puncture revealed a central filling defect at the level of C3-C5. But there was no displacement of dentate ligament on lateral view, suggesting an intramedullary mass lesion. Laminectomy from C2 to Th1 and evacuation of the intramedullary blood clot at C3-C5 level were performed successfully. Microscopic examination of clots revealed cavernous hemangioma. The postoperative course was uneventful and the patient gradually improved in her motility. In the review of the literature including our case, vascular malformations are the commonest cause of spontaneous hematomyelia. They are found 12 out of 18 cases (Table 1). The symptoms of spontaneous hematomyelia are characterized by sudden onset of pain and rapid development of long tract sign in a previously asymptomatic individual. Operated cases are summarized in table 2. Good operative results are obtained 6 out 9 cases. We will emphasize that in a case of spontaneous hematomyelia with acute progression of transverse myelopathy, early diagnosis and operation are extremely important, and for this purpose, myelography is considered to be one of the most useful examinations.
 ...
PMID:[An operated case of cervical spontaneous hematomyelia]. 712 34

This report will relate our experience with the y-plate, which we used in the treatment of 39 patients (32 women and 7 men) with a mean age of 62.6 years (range 47 to 79 years) between 1987 and 1994. All patients had rheumatoid arthritis. Occipitocervical fusion was indicated by instabilities within the occipitocervical region and in cases with additional basilar invagination and/or after transoral dens resection for decompression of the spinal cord. The length of the fusion depended on the pathological changes of the subaxial cervical spine. Before surgery, 35 patients suffered from strong and 4 patients from moderate pain in the neck and/or the back of the head. On a linear scale from 0 to 10, the pain was rated as 8:1 on average (range 4 to 10). 31 patients had an instability of the atlantoaxial region and 19 patients a basilar invagination of the odontoid. A cervical myelopathy was found in 20 cases. One surgeon fused the occiput to C2 in 22 cases, to C3-C5 in 8 cases and to C7-T2 in 9 cases. An important factor in this operation is the integration of atlantoaxial screws in order to resist the translational dislocation of C1/C2. In 13 patients a resection of the odontoid had to be performed to adequately decompress the spinal cord. A reduction of C2 without dens resection was performed in cases with reducible instability C1/2. 32 of the patients could be controlled with a minimum follow-up of 12 months (average 32.2 months, range 12 to 66 months). Out of the other 7, 6 patients had died. At the time of follow-up, the pain was rated as 2.3 on average (range 0 to 10). A myelopathy was present in 2 cases. Six patients required further operations on the cervical spine; 4 patients developed an instability at the level(s) below the fusion and an enlargement of the fusion to these levels has been performed. The fusion rate was 96.9%, despite breakage of the implant in 3 and a screw loosening in 2 patients. According to the criteria of Conaty, the result was satisfying in 25 (75%) and not satisfying in 8 patients (25%). These results show the effectiveness of the occipitocervical fusion with the y-plate in rheumatoid arthritis. A transoral dens resection is only indicated in cases with basilar invagination causing a compression of the spinal cord or in such cases where a compression caused by the dens or the retrodental pannus formation cannot be treated by a reduction of the second cervical vertebra alone.
 ...
PMID:[Occipitocervical fusion in chronic polyarthritis]. 970 35

Pure intramedullary spinal-cord metastases (ISCM) are a rare manifestation of cancer. We report a case of ISCM from gastric cancer. A 68-year-old man, treated with total gastrectomy for a gastric cancer, presented 9 months later with paresis of the left arm, pain and dissociated sensory loss. Magnetic resonance imaging revealed a pure intramedullary lesion at the C3-C5 level. After surgical resection, pathological findings revealed an undifferentiated adenocarcinoma of gastric origin. To our knowledge, this is only the second report of ISCM from gastric cancer in the literature.
 ...
PMID:Pure intramedullary spinal cord metastasis secondary to gastric cancer. 1646 55

We report on a case of cervical cutaneomeningospinal angiomatosis (Cobb's syndrome), a rare somatic disorder, characterized by vascular abnormalities of the spinal cord, with a triad of associated vascular skin, muscle, bone, and dura involvement at the same somite. This case follows an 18-year-old male patient presenting with left extremity weakness and back cervical pain. Magnetic resonance imaging (MRI) revealed a spinal cord arteriovenous malformation (AVM) at the C3-C5 level. Cobb's syndrome was diagnosed by coexistence of cutaneous naevi in a dermatomal pattern and neurological signs of a spinal cord lesion together with cervical MRI and angiography. The patient underwent a combination of staged endovascular embolization and microsurgical resection. Multiple biopsies of the mass including the skin, muscle, dura, and spinal cord at the same somite revealed that the lesions had a similar pathology. Post-operative immunohistochemical characterizations on specimen included CD31, smooth muscle actin (SMA), vascular endothelial growth factor (VEGF), and matrix metalloproteinase (MMP-9). The unique associations of somatic and spinal cord lesion as well as angiogenic and inflammatory factor expressions in all specimens are reported.
 ...
PMID:Angiogenic and inflammatory factor expressions in cutaneomeningospinal angiomatosis (Cobb's syndrome): case report. 2151 66

Melanotic schwannoma (MS) is an unusual variant of nerve sheath neoplasm. Only 10% of these tumors will undergo malignant degeneration, with exceedingly rare reported metastasis. We present a 32-year-old woman with a 6-month history of cervical pain and left arm progressive weakness. Neurological examination showed a left upper limb radicular pain, with pyramidal syndrome at C5 level. The magnetic resonance imaging (MRI) study highlighted an intradural extramedullary heterogeneous mass along the spinal cord at the C4-C5 level, slightly hyperintense with T1 and hypointense with T2-weighted sequences, invading the left neural foramen. The patient underwent C3-C5 laminectomy with total resection of a black tumor. In the postoperative period, a patent deficit of shoulder abduction ensued related to the nervous section. Microscopically, compactly fascicles of spindle-shaped cells with pleomorphic and hypercromatic nuclei, dark brown intracellular pigments, as well as some mitotic figures were seen. Immunohistochemical stains for S-100, Human Melanoma Black-45 (HMB-45), and vimentin were positive, with Ki-67 Labelling Index (LI) of 15% compatible with MS. Six months after radiotherapy she presents local recurrence and lung metastatic dissemination of the MS. She underwent left pulmonary segmentectomy, followed by chemotherapy and radiosurgery. The patient developed a febrile neutropenia and worsening of general status, and died after 3 months due to respiratory complications. MS are rare tumors with potential for local recurrence and distal metastasis. Complete surgical resection remains as the treatment of choice, once the uncommon cases with malignant progression shows low response to chemo and radiotherapy.
...
PMID:Melanotic schwannoma of the cervical spine progressing with pulmonary metastasis: case report. 2407 73