1/9. Intraneural monophasic synovial sarcoma: a case report.STUDY DESIGN: A case report. OBJECTIVES: To illustrate a rare case of synovial sarcoma arising within a peripheral nerve. SUMMARY OF BACKGROUND DATA: A synovial sarcoma arising within a peripheral nerve is very unusual. Only five cases of primary synovial sarcoma within a peripheral nerve have been reported. This is the first case with involvement of the nerve root. The authors diagnosed the tumor arising within the S1 nerve root as synovial sarcoma using cytogenetic analysis that detected the chimeric SYT/SSX gene. methods: In addition to the immunohistochemical study, a reverse transcription-polymerase chain reaction (RT-PCR) assay was conducted for the SYT-SS10 fusion gene using archival formalin-fixed paraffin-embedded tumor specimens. RESULTS: Computed tomography scan, magnetic resonance imaging performed before surgery, and the intraoperative findings showed that the tumor was embedded within the S1 nerve root. Although the histologic findings were suggestive of a malignant peripheral nerve sheath tumor, the results of the cytologic study confirmed its diagnosis of synovial sarcoma. CONCLUSION: Primary intraneural synovial sarcoma, although rare, must be distinguished from malignant peripheral nerve sheath tumor. The molecular assay of the detection of the SYT/SSX fusion gene is useful to make a definite diagnosis of monophasic synovial sarcoma.- - - - - - - - - - ranking = 1keywords = lyme (Clic here for more details about this article) |
2/9. Treatment of lower lumbar radiculopathy caused by osteoporotic compression fracture: the role of vertebroplasty.The authors used vertebroplasty for the treatment of severe lower lumbar radicular pain caused by osteoporotic compression fracture. patients presented with severe radiating leg pain rather than lower back pain from recent osteoporotic compression fracture of lower lumbar vertebra. Radiologic findings showed osteoporotic compression fracture combined with preexisting stenosis of the intervertebral foramen resulting in root compression. After injection of polymethylmethacrylate into the compressed vertebral body through the pedicle of the symptomatic side, all seven patients experienced dramatic pain relief that lasted throughout the mean follow-up duration of 9.1 months. They conclude that vertebroplasty may be an effective way of relieving radicular pain caused by osteoporotic compression fracture combined with foraminal stenosis.- - - - - - - - - - ranking = 1keywords = lyme (Clic here for more details about this article) |
3/9. Radicular pain after vertebroplasty: compression or irritation of the nerve root? Initial experience with the "cooling system".STUDY DESIGN: During vertebroplasty (VP), polymethylmethacrylate (PMMA) may leak into the posterior epidural venus plexus, provoking symptoms ranging from radicular pain to medullar compression. OBJECTIVES: To propose and test the feasibility of a procedure (cooling system) to prevent radicular irritation caused by foraminal PMMA leakage. SUMMARY OF BACKGROUND DATA: Foraminal leak of PMMA, as observed during VP, may lead to radiculalgia. Several mechanisms of nerve root irritation have been proposed. Considering heat or local chemical irritation has led us to treat immediately by local periradicular irrigation with a cooling liquid. methods: Four consecutive patients with observed foraminal leakage were treated by local fluid injection. Immediately after observation of a foraminal leak, a 20-gauge Chiba needle was positioned to reach the foramen. Ten cubic centimeters of lidocaine (0.2%) was followed by 100-200 cc of pressurized saline perfusion within 10-20 minutes (cooling system). RESULTS: In all patients with foraminal leakage, no radicular pain existed after application of the cooling system. No complications were observed with its use. CONCLUSION: In presence of a foraminal leakage, the immediate application of a cooling irrigation may protect the root from injury, which is explained by the hypothesis that the main mechanism of injury may be more related to heat or chemical irritation of the nerve than compression.- - - - - - - - - - ranking = 1keywords = lyme (Clic here for more details about this article) |
4/9. MR imaging in neuroborreliosis of the cervical spinal cord.The central nervous system is involved in 10-20% of cases in lyme disease. The neurological symptoms, time course of the disease and imaging findings are multifaceted. We report two patients with cervical radiculitis. magnetic resonance imaging revealed strong enhancement of the cervical nerve roots on contrast-enhanced T1-weighted images. These imaging patterns of borrelia-associated radiculitis have not been reported before. knowledge of these imaging features may help to diagnose neuroborreliosis, which presents with non-specific symptoms.- - - - - - - - - - ranking = 71.756113635649keywords = borrelia (Clic here for more details about this article) |
5/9. sciatica, disk herniation, and neuroborreliosis. A report of four cases.We report four cases of sciatica in patients with same-level disk herniation confirmed by computed tomography and a final diagnosis of acute radiculitis caused by borrelia burgdorferi, with a favorable response to ceftriaxone therapy. The neurological manifestations of lyme disease are protean, and a potential contribution of concomitant disk disease to sciatica can lead to diagnostic wanderings. Disk lesions and infectious conditions that can cause sciatica are discussed. Whether a favorable response to antibiotic therapy should be taken as proof of B. burgdorferi radiculitis deserves discussion. In practice, in a patient with clinical manifestations suggesting disk-related nerve root pain and residing or having traveled to an endemic area, B. burgdorferi infection should be looked for, as both etiologies can coexist.- - - - - - - - - - ranking = 513.0006354084keywords = burgdorferi (Clic here for more details about this article) |
6/9. Chronic borrelia encephalomyeloradiculitis with severe mental disturbance: immunosuppressive versus antibiotic therapy.A 57-year-old male was repeatedly admitted to hospital because of complex neurological symptoms, including radicular pain, disturbance of micturition, seizures, and severely impaired mental state. The diagnosis was encephalomyeloradiculitis possibly of viral origin, and treatment with immunosuppressants was initiated. An alternating course with a tendency towards improvement ensued. Two and a half years after the occurrence of the initial symptoms, identification of specific antibodies in the blood and CSF led to the diagnosis of borreliosis with CNS involvement. High-dose therapy with penicillin rapidly reduced the symptoms, beginning with those of radicular pain and followed by an improvement of the mental state. attention is directed to the wide spectrum of clinical symptoms of chronic borreliosis with CNS involvement. Previous reports that immunosuppression may result in some improvement but with a tendency towards relapse are confirmed. Our encouraging treatment results support those of other reports that penicillin therapy may lead to improvement even at late chronic stages in patients with severe CNS deficits.- - - - - - - - - - ranking = 287.02445454259keywords = borrelia (Clic here for more details about this article) |
7/9. Lymphocytic meningoradiculitis and encephalomyelitis due to borrelia burgdorferi: a clinical and serological study of 18 cases.Clinical features of 18 patients with either lymphocytic meningoradiculitis (n = 17) or chronic encephalomyelitis (n = 1) due to borrelia burgdorferi are reported. Arthropod bites were recorded in only seven patients. High titres of anti B burgdorferi antibodies were detected in sera from all patients and in CSF from 12 out of 17 patients tested. All patients had CSF abnormalities especially pleocytosis and oligoclonal bands. A falsely positive syphilitic serology was observed in the CSF from the patient with encephalomyelitis.- - - - - - - - - - ranking = 1026.0012708168keywords = burgdorferi (Clic here for more details about this article) |
8/9. Borrelia meningoradiculitis with severe pains.A 54-year-old woman with severe pains in the region of the right arcus costalis is presented. This case was a great therapeutic and diagnostic problem during 4 weeks. A borrelia meningoradiculitis was finally diagnosed by detection of specific antibodies in the cerebrospinal fluid. Intravenous benzylpenicillin in combination with epidural morphine hydrochloride resulted in a dramatic relief of the severe pains.- - - - - - - - - - ranking = 71.756113635649keywords = borrelia (Clic here for more details about this article) |
9/9. Chronic muscle weakness caused by borrelia burgdorferi meningoradiculitis.A 19-year-old man developed chronic weakness of the lower limbs as the predominant manifestation of borrelia burgdorferi infection of the nervous system. Spirochetes were demonstrated in the cerebrospinal fluid. The condition resolved following intravenous penicillin treatment.- - - - - - - - - - ranking = 855.001059014keywords = burgdorferi (Clic here for more details about this article) |