Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042024 (incontinence)
 13,409 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 72-year-old man presented with several months of increasing lumbar pain, sciatica, lower extremity weakness, numbness in his buttocks and posterior thighs, burning sensations in his scrotum, and urinary incontinence. Myelogram-computed tomography scan demonstrated a high grade incomplete block at the T12-L1 level due to bilateral synovial cysts and simultaneously a high grade partial block at L4-L5 due to spinal stenosis. Laminectomy of the T-12 vertebra and partial laminectomy of the L-1 vertebra with excision of both synovial cysts and laminectomies of the L-4 and L-5 vertebrae with foraminotomies resulted in a reversal of the patient's symptomatology.
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PMID:Bilateral symptomatic intraspinal T12-L1 synovial cysts. 362 50

A five-year-old domestic longhair was presented with hind-limb ataxia and some degree of incontinence of two weeks' duration. An enlarged spinal canal from the twelfth thoracic (T12) vertebra to the third lumbar (L3) vertebra was identified on survey radiographs. An intradural-extramedullary cavity at the twelfth (T12) and thirteenth (T13) thoracic vertebrae, filled with contrast material, was demonstrated on myelography. A left-sided hemilaminectomy was performed over this region, and a subarachnoid cavitation or cyst was found to be the cause of the severe spinal-cord compression. The cyst was drained. The cat showed improvement in the neurological signs during the first three weeks postoperatively. Six months later, no neurological deficits were identified on follow-up examination.
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PMID:Subarachnoid cyst in a cat. 911 21

Multiple spinal meningiomas are relatively rare and account for only 2 to 3.5% of all spinal meningiomas. A case of multiple meningiomas of the thoracic (T) spine was reported. This 77-year-old woman was admitted with progressive motor weakness and sensation disturbance in both legs for 4 months. Neurological findings on admission revealed paraparesis, hyperesthesia, and hypalgesia below the dermatome of T10 level and hyporeflexia of both ankles. Urinary and stool incontinence were also noted. Magnetic resonance imaging (MRI) documented two intradural extramedullary lesions with different intensity at the T9 and T12 levels. Both tumors were totally resected. Histopathologic examination showed all psammomatous meningiomas with more or less psammoma bodies. There were no any manifestations of von Recklinghausen's disease in this patient. MRI is a choice of diagnostic tool to detect spinal tumors, especially multiple spinal meningiomas. Different intensities in MRI may infer different components of meningiomas. Follow-up study after operation three months later disclosed she could walk very well.
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PMID:Multiple spinal meningiomas--a case report. 1022 43

Achondroplasia is the most common genetic disorder associated with bone dysplasia. The mode of inheritance is autosomal dominance, while most cases appear to represent a new mutation. Achondroplastic patients suffer from dwarfism, and from typical features of the head and limbs (rhizomelia, macrocephaly, frontal bossing and kyphosis). Half of the patients show various neurological complications. The most serious complication of achondroplasia is respiratory impairment, apnea and sudden infant death, resulting from compression of the medulla oblongata. This study describes the neurosurgical sequels in 10 achondroplastic patients, who underwent 12 surgical procedures. The average age was 14 years (ages ranged from 3 months to 40 years). The patients suffered from back pain, muscle weakness, incontinence, hypotonia, psychomotor delay, apnea and respiratory arrest. Four patients were diagnosed as suffering from obstructive sleep apnea. Craniocervical MRI showed: narrowing of the foramen magnum, fusion of C1, spinal stenosis, and severe cervicomedullary or spinal cord compression. In 5 patients the MRI also showed ventriculomegaly of the lateral and third ventricles. Seven patients underwent foramen magnum decompression and C1 laminectomy. Three patients with severe spinal cord compression underwent laminectomy of the involved spines (T12-L5). Two of the patients required more then one operation due to the recurrence of their neurological symptoms. There was no need for duraplasty or shunt procedures. The average hospital stay was 6 days. Eight patients showed improvement or resolution of symptoms, with an average follow-up period of 13.5 months after the last operation (ranged 6-24 months). We conclude that early neurological and MRI evaluations are required in achondroplasia patients, in order to prevent the high morbidity and mortality during infancy and childhood. In adults, MRI evaluation is needed if the patient has neurological symptoms. Early identification and immediate cervicomedulary decompression procedure can prevent the serious complications occurring in achondroplasia, including respiratory failure, apnea and sudden death.
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PMID:[Neurosurgical aspects in achondroplasia: evaluation and treatment]. 1175 76

Although radical resection is the best treatment for local aggressive benign tumors or malignant tumors of the spine, total spondylectomy for lower thoracic vertebrae may cause anterior spinal artery syndrome. There are few reports in the literature in which this syndrome has been documented in association with thoracic spondylectomy, although this syndrome is the most common neurologic complication after abdominal aortic surgery. A 50-year-old woman with a giant cell tumor of the thoracic vertebrae was treated by posterior and anterior surgery. Thoracic segmental arteries from T10 to T12 had to be resected bilaterally to dissect the aorta free from the tumor. After resection of all feeding arteries to the tumor, the tumor and entire parts of T10, T11, and T12 were removed. Postoperative neurologic examination disclosed flaccid paralysis of the lower extremities and sphincter incontinence. Although pain and temperature sensation were absent, vibration and position sense were intact, showing anterior spinal artery syndrome. Intraoperative somatosensory-evoked potential monitoring only showed that transient deterioration failed to adequately reflect this neurologic injury. Major reconstructive surgery involving lower thoracic regions may cause anterior spinal artery syndrome. Somatosensory-evoked potential monitoring might not reliably predict overall neurologic outcome involving the blood supply of the lower thoracic regions.
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PMID:Anterior spinal artery syndrome after total spondylectomy of T10, T11, and T12. 1246 71

A six year old girl was admitted to the Kenyatta National Hospital paediatric unit with history of headaches, fever, neck stiffness and paraesthesias of the lower limbs. She was empirically commenced on antimeningitic treatment. Her neurological state deteriorated over a period of two months to paraparesis and paraplegia of the lower limbs with urinary and stool incontinence. A neurology review revealed a sensory level at T10 with power grade 2 in the lower limbs. A myelogram revealed a block of contrast at T12. An impression of cord compression by an intraspinal tumour was made. Laminectomy and posterior midline myelotomy was performed. At operation a greyish-white intramedullary mass lesion was found. Histology revealed a schistosoma mansoni ovum surrounded by granulomatous tissue with giant cells and polymorphoneuclear leucocytes. The child was commenced on paziquantel 1000 mg and dexamethasone 24 mg per day in divided doses. There was marked neurological improvement and the patient went home one month later. She was able to walk without support and was continent of urine and stool at the time of discharge.
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PMID:Schistosoma mansoni of the conus medularis: case report. 1550 44

We report the case of a 28-year-old young man who presented with progressive paraparesis and urinary incontinence. Initial spinal MR scans showed a sausage-like lesion that extended between L1 and S2. At surgery, an encapsulated intradural extramedullary tumor was removed en bloc. The initial histopathological diagnosis was ependymoma. The tumor recurred locally to double its original size only 4 months later. After second surgery, 5,100 cGy of local spinal radiation was given since the pathologist believed that the new tumor exhibited anaplastic features. Subsequently tumor recurred at T6-10 levels and later in the right parasellar region. Surgery was undertaken for both recurrences and radiation to whole spine and to whole brain respectively followed surgery. At 11 months after the initial presentation, a new tumor was diagnosed at T11-T12 levels. After fifth surgery, chemotherapy with cisplatin, doxorubicin and vincristine was started. At this stage, review of all five surgical specimens by an outside neuropathologist was considered crucial. The new and correct histological diagnosis was germinoma. A new chemotherapy regimen targeted for germinoma was then started. The patient remains alive with no evidence of disease at 22 months after initial presentation. Primary spinal germinomas are exceedingly rare. A review of the literature revealed only 14 biopsy-proven spinal germinoma cases. Our case is clearly unique in aggressivity of the tumor, a feature often unexpected for germinomas. This case proves that the dissemination risk may be very serious for germinomas and that the craniospinal radiation may be a more secure treatment mode.
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PMID:Aggressive spinal germinoma with ascending metastases. 1613 16

One third of patients with achondroplasia develop spinal stenosis requiring surgical intervention. However, this condition rarely develops before the age of 15 years. The goal of the current study was to identify anatomical factors and clinical symptoms associated with early presentation of lumbar stenosis in such patients. The charts of 22 pediatric patients with achondroplasia who developed lumbar spinal stenosis requiring surgery (subjects) were reviewed retrospectively, focusing on clinical presentation, physical examination findings, and radiographic data. These findings were compared with those of a group of patients who had not developed stenotic symptoms (controls). Analysis was performed using chi2 test. Significance was set at P < 0.05. All 22 subjects presented with neurogenic claudication (weakness, pain, and/or numbness), and 77% had bladder incontinence. Compared radiographically with controls, the subjects had a significantly larger average percentage decrease in the transverse interpedicular distance from T12 to L5 (-8% vs -19%, respectively) and a significantly greater thoracolumbar kyphosis angle (24.2-degree angle vs 14.1-degree angle, respectively). These features were associated with an increased likelihood of developing symptomatic stenosis. The study indicated that 6 patients (32%) of the control group had caudal widening of the lumbar spine from T12 to L5.
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PMID:Early presentation of spinal stenosis in achondroplasia. 1731 32

Spinal intradural extramedullary teratoma is a rare condition that develops more commonly in children than in adults and may be associated with spinal dysraphism. We report a rare case of adult-onset intradural extramedullary teratoma in the thoracolumbar spinal cord with no evidence of spinal dysraphism and without the history of prior spinal surgery. The patient was a 38-year-old male whose chief complaint was urinary incontinence. X-ray images of the thoracolumbar spine showed the widening of the interpedicular distance and posterior marginal erosion of the vertebral bodies and pedicles at the T11, T12, and L1 level. Magnetic resonance imagings of the lumbar spine showed a lobulated inhomogeneous high signal intradural mass (87x29x20 mm) between T11 and L1 and a high signal fluid collection at the T11 level. Laminectomy of the T11-L1 region was performed, and the mass was subtotally excised. The resected tumor was histopathologically diagnosed as a mature cystic teratoma. The patient's symptom of urinary incontinence was improved following the surgery.
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PMID:Spinal intradural extramedullary mature cystic teratoma in an adult. 1911 71

We report a case of a skeletally immature achondroplastic adolescent with significant thoracolumbar lordosis who presented with neurogenic claudication and urinary incontinence progressing over a 1-year period. She underwent decompressive lumbar laminectomy from T12 to L5 with preservation of the facet joints. Over the ensuing 4 years of follow-up, she developed a progressive thoracolumbar kyphosis that progressed to 105 degrees. She remained neurologically intact and was fully ambulatory, but had severe back pain in the area of the deformity. Because of the severity and progression of her deformity, a combined anterior and posterior fusion and stabilization was required. We present this case and a review of the literature on spinal stenosis in achondroplasia and the complication of post-laminectomy kyphosis.
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PMID:Postlaminectomy kyphosis in an achondroplastic adolescent treated for spinal stenosis. 1929


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