Cases reported "Polyradiculopathy"

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1/12. cauda equina syndrome due to lumbosacral arachnoid cysts in children.

    We describe the clinical, neuroradiological and surgical aspects of two children in whom symptoms attributable to cauda equina compression were caused by spinal arachnoid cysts. The first patient presented with recurrent urinary tract infections due to neurogenic bladder dysfunction, absent deep tendon reflexes and sensory deficit in the lower limbs. The second child presented with unstable gait as a result of weakness and diminished sensation in the lower extremities. Spinal magnetic resonance imaging revealed a lumbosacral arachnoid cyst in both patients. During surgery the cysts were identified and excised. Two years after surgery, the sensory deficits of the first patient have disappeared and patellar and ankle reflexes can be elicited, but there is no improvement in bladder function. Neurological examination of the second patient was normal. We conclude that the diagnosis of cauda equina syndrome should prompt a vigorous search for its aetiology. Lumbosacral arachnoid cysts are a rare cause of cauda equina syndrome in children.
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keywords = urinary
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2/12. cauda equina syndrome secondary to idiopathic spinal epidural lipomatosis.

    STUDY DESIGN: Three cases of idiopathic epidural lipomatosis are reported. OBJECTIVES: Description of the relationship between spinal pathologic overgrowth of fat tissue and neurologic symptoms. SUMMARY OF BACKGROUND DATA: Idiopathic epidural lipomatosis is a very rare condition; it is usually secondary to chronic steroid therapy or endocrinopathic diseases. methods: Three men with a mean age of 58.5 years, who experienced intermittent claudication, bilateral radicular pain in both legs, and urinary dysfunction with hypoesthesia in the perineal region, were evaluated by plain radiography and magnetic resonance imaging, the results of which demonstrated a pathologic overgrowth of fat tissue in the spinal canal with a marked impingement of the dural sac. obesity, endocrinopathic diseases, and chronic steroid therapy were excluded for all patients. Surgical treatment was performed by wide multilevel laminectomies, fat debulking, and instrumented posterolateral fusion. RESULTS: After surgery there was a gradual improvement in symptoms and signs so that 2 years later the patients returned to daily activities and were neurologically normal. CONCLUSIONS: Spinal epidural lipomatosis can be a cause of back pain but rarely radicular impingement. magnetic resonance imaging is the procedure of choice. The treatment must be performed early by wide surgical decompression.
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keywords = urinary
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3/12. Symptomatic spinal intradural arachnoid cysts in the pediatric age group: description of three new cases and review of the literature.

    Spinal arachnoid cysts are a relatively uncommon lesion that may be either intra- or extradural, and intradural spinal arachnoid cysts are even less common. These cysts are usually asymptomatic but may produce symptoms by compressing the spinal cord or nerve roots suddenly or progressively. We present three cases in the pediatric age group with spinal intradural arachnoid cysts without a preceding history of trauma. Three patients with symptomatic intradural arachnoid cysts were investigated with conventional T1- and T2-weighted magnetic resonance imaging (MRI). The MRI scans demonstrated the intradural arachnoid cysts with slightly lower CSF signal intensity on the gradient echo images and slightly higher signal intensity on T1-weighted images. The first cyst was located at the level T12-L1 and compressed the conus medullaris, with neurogenic bladder and cauda equina syndrome for 2 months. The second was located at the level C5-T1 ventrally, with spastic gait and neurogenic bladder for 4 years. The other was located at T2-3 ventrally, with sudden onset of quadriplegia after jumping rope. The combined treatment of total resection and wide fenestration in our three patients produced an excellent return of neurologic function in each one, except for residual urinary disturbance in case 2. Intradural spinal arachnoid cysts appear to result from an alteration of the arachnoid trabeculae; some such cysts are ascribed anecdotally to previous trauma or arachnoiditis, whereas the majority are idiopathic and congenital. The majority of intradural spinal arachnoid cysts occur in the thoracic region and most are dorsal to the neural elements. Only 10 cases have been reported in which the intradural arachnoid cysts were located anterior to the cervical spinal cord, of which 8 were in the pediatric age group, like our case 2. myelography, postcontrast CT myelography and MRI have been demonstrated as useful for the diagnosis of intradural arachnoid cysts. MRI is the imaging modality of choice, and the extent, size and nature of the lesion in our cases were well demonstrated by MRI. Surgical treatment is necessary if progressive neurological dysfunction appears in the course of spinal cord compression. Complete surgical excision of the cysts is the best choice of treatment, and wide fenestration and shunting of the cyst to the peritoneum, pleural cavity or right atrium were the modalities of choice. MRI offers a noninvasive and effective means to make the diagnosis of arachnoid cysts easier. Intradural arachnoid cysts may cause progressive myelopathy; however, the postoperative prognosis is good if the operation is performed prior to neurologic deficits.
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keywords = urinary
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4/12. Rapid, symptomatic enlargement of a lumbar juxtafacet cyst: case report.

    STUDY DESIGN: A case is reported in which a 45-year-old man developed cauda equina syndrome caused by enlargement of an L4-L5 juxtafacet cyst diagnosed 4 months earlier. OBJECTIVES: To highlight the short interval that can elapse between the discovery of a juxtafacet cyst and its remarkable progression. SUMMARY OF BACKGROUND DATA: Although juxtafacet cysts are acquired lesions, how long they take to develop remains unclear. hemorrhage is a well-known cause of rapid or even dramatic cyst enlargement. This is the first report providing magnetic resonance imaging evidence of rapid, remarkable enlargement of a nonhemorrhagic juxtafacet cyst. methods: The patient underwent conservative treatment for an L4-L5 right juxtafacet cyst diagnosed by magnetic resonance imaging during evaluation of posttraumatic lower back pain. Four months later, the patient presented with severe pain radiating down the right lateral leg, urinary retention, and impaired dorsal flexion of the right foot. Repeat magnetic resonance imaging showed the cyst now markedly enlarged and occupying almost the entire width of the canal. RESULTS: The cyst was removed, and the patient's symptoms abated. At 15 months after surgery, he is symptom-free. CONCLUSIONS: Juxtafacet cyst may occasionally enlarge and cause severe symptoms within months.
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ranking = 144.05572013075
keywords = urinary retention, retention, urinary
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5/12. Sudden bilateral foot drop: an unusual presentation of lumbar disc prolapse.

    Bilateral acute foot drop is reported in a 30-year-old healthy male. He presented with a 7-day history of sudden severe backache, radiating to both the lower limbs and 1-day history of sudden bilateral ankle weakness that progressed to bilateral foot drop within 6 hours. He also developed retention of urine. Investigations revealed a large central disc prolapse at L3-4 with significant canal stenosis at that level. Following surgery the patient had progressive improvement.
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ranking = 4.44391109501
keywords = retention
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6/12. cauda equina syndrome in lumbar spinal stenosis: case report and incidence in Jutland, denmark.

    BACKGROUND: cauda equina syndrome in spinal stenosis is a rare complication. During a 5-year period (1996-2000), 340 cases of spinal stenosis were diagnosed in the County of South Jutland, denmark. The annual incidence of spinal stenosis was 272 per million inhabitants. During that period, only one patient with acute cauda equina syndrome in spinal stenosis was diagnosed: that is, the patient described herein. methods AND RESULTS: A 74-year-old woman appeared with urinary retention and fecal incontinence for the previous 24 hours. Computed tomography scan showed spinal stenosis from L2 to L4. She underwent an urgent operation and recovered within 5 days from her anal sphincter paresis and within 5 weeks from her bladder paresis.
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ranking = 5.44391109501
keywords = retention, urinary
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7/12. cauda equina syndrome secondary to constipation: an uncommon occurrence.

    Suspected spinal cord or cauda equina pathology is an emergency that must be dealt with swiftly, with appropriate referral and investigations. constipation is a clinical diagnosis of exclusion, but should not be forgotten as a cause of major morbidity when severe in nature. It can mimic an acute abdomen, sepsis and even spinal cord pathology. We describe a case of cauda equina syndrome in a young man. The pathology responsible was found to be constipation with faecal impaction, once nerve and bony pathology were excluded. When treated, there was almost immediate resolution of the neurologic signs and urinary retention.
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ranking = 144.05572013075
keywords = urinary retention, retention, urinary
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8/12. Unusual manifestations of herpes zoster. A clinical and electrophysiological study.

    The literature on complicated herpes zoster is summarized in this paper. The case histories of 18 patients with herpes zoster are presented. Two patients had encephalitis, 2 had myelitis and the other 14 patients had various types of lower motor neurone disturbance. Both patients with encephalitis--one of who developed choreo-athetosis during the illness--recovered fully. Only 1 of the 2 patients with myelitis recovered fully; the other remains severely paraparetic and the reason for her incomplete recovery may be related to the presence of generalized arteriolar disease associated with seronegative rheumatoid disease. One patient developed a guillain-barre syndrome 3 weeks after the onset of herpes zoster. Recovery in the 15 patients with lower motor neurone involvement has been slow butcomplete--or almost complete--in all but 1, a patient with persistent facial weakness as part of the Ramsay Hunt syndrome and who also had weakness of one upper limb. Seven other patients had lower limb weakness. In 2 patients the weakness was confined to abdominal myotomes and 2 other patients had urinary retention. Electromyographic abnormalities were found in the muscles which were weak and frequently also in muscles which appeared strong. It is emphasized that neurological disturbances other than sensory abnormalities may be found in patients with herpes zoster. Motor complications of various types are not uncommon.
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ranking = 144.05572013075
keywords = urinary retention, retention, urinary
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9/12. urinary retention due to sacral myeloradiculitis: a clinical and neurophysiological study.

    We report 5 cases of sacral myeloradiculitis presenting with transient urinary retention. Neurophysiological testing, including bulbocavernosus reflex, pudendal evoked response and external anal sphincter electromyography, was performed. Parasympathetic pelvic nerves, pudendal nerves as well as the spinal cord seem to be involved to various degrees in this infrequent disorder.
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ranking = 161.83136451079
keywords = urinary retention, retention, urinary
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10/12. Benign transient urinary retention.

    Three cases of acute urinary retention due to sacral myeloradiculitis are described. The authors stress the importance of diagnosing this rare and benign condition, which, in the past, has too often been mislabelled as either psychogenic or the first manifestation of a demyelinating disease.
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ranking = 720.27860065377
keywords = urinary retention, retention, urinary
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