Endoscopic Endonasal Odontoidectomy

We present a case of a 66-year-old man with no pertinent past medical history, who presented with progressive quadriparesis and gait ataxia over last 6 months (Nurick's grade 2). Neurological exam revealed pattern suggestive of high-cervical myelopathy with no evidence of cranial nerve paresis. Magnetic resonance imaging (MRI) of his CVJ revealed a large pannus behind the dens with severe spinal cord compression, mild contrast enhancement was noted posterior to the pannus, likely from the ligamentous structures; pannus was hypointense on both T1- and T2-weighted images. Further, a computerized tomography (CT) scan did not reveal any obvious malalignment. He underwent an EE odontoidectomy, followed by posterior cervical fusion. He had an unremarkable postoperative period and recovered fully from his myelopathy over the next 6 months. The histopathological examination of the pannus revealed a degenerated disk. In this video, we have a step by step description of the EE approach to the odontoid and discuss the surgical nuances.The link to the video can be found at: https://youtu.be/pjg68_vK0C4. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  open access Full text
Source: Journal of Neurological Surgery Part B: Skull Base - Category: Neurosurgery Authors: Tags: Skull Base: Operative Videos Source Type: research

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We cover a lot of news and announcements about digital health technologies to provide context for you. Even within The Medical Futurist team, there are favorite technologies and trends. And we thought it would be time to share the technologies we’re excited about! With advancements in exoskeleton technology, A.I.’s ever-increasing importance in healthcare and technologies like 5G and quantum computing soon going mainstream, there’s much to be excited about! Without further ado, let’s jump in! 1. Quantum Computing: faster, cheaper and safer Late last month, Google claimed “quantum suprema...
Source: The Medical Futurist - Category: Information Technology Authors: Tags: Future of Medicine digital health Healthcare technology digital technology Source Type: blogs
Conclusions There is weak evidence for a positive effect of short-term whole-body vibration training on spasticity of lower limbs, mobility, balance, and postural control. Besides, positive effect of the long-term effect of whole-body vibration training on mobility in patients with neurological disorders. The optimal whole-body vibration training parameters in treating patients with neurological disorders remain unclear.
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Original Research Articles Source Type: research
We present the case of a spinal cord-injured patient with neurological sequelae and delayed posterior circu-la-tion stroke caused by bilateral vertebral artery dissection. The signs of cerebellar and occipital lobe ischemia were masked by manifestations of spinal cord injury. The patient was unconscious and in a serious condition, but, despite no proper stroke treatment, only residual dysarthria and upper limb ataxia were seen after reha-bilitation. Any clinical suspicion based on the combination of head or neck trauma with atypical or evolving neuro-logical symptoms should be verified for the possibility of a vertebral ar...
Source: Ortopedia, Traumatologia, Rehabilitacja - Category: Orthopaedics Authors: Tags: Ortop Traumatol Rehabil Source Type: research
Publication date: May 2019Source: Journal of the American College of Radiology, Volume 16, Issue 5, SupplementAuthor(s): Expert Panel on Neurologic Imaging:, Amy F. Juliano, Bruno Policeni, Vikas Agarwal, Judah Burns, Julie Bykowski, H. Benjamin Harvey, Jenny K. Hoang, Christopher H. Hunt, Tabassum A. Kennedy, Gul Moonis, Jeffrey S. Pannell, Matthew S. Parsons, William J. Powers, Joshua M. Rosenow, Jason W. Schroeder, Konstantin Slavin, Matthew T. Whitehead, Amanda S. CoreyAbstractAtaxia can result from an abnormality in the cerebellum, spinal cord, peripheral nerves, and/or vestibular system. Pathology involving the brain...
Source: Journal of the American College of Radiology - Category: Radiology Source Type: research
Shanshan Zhang1, Dongli Yuan2 and Ge Tan1* 1Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China 2The Institute of Medical Information, Chongqing Medical University, Chongqing, China Primary systemic vasculitis can affect every structure in both the central and peripheral nervous system, causing varied neurological manifestations of neurological dysfunction. Early recognition of the underlying causes of the neurological symptoms can facilitate timely treatment and improve the prognosis. This review highlights the clinical manifestations of primary systemic vasc...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Conclusion The key problem with the ND field is the lack of understanding in the events preceding the development of protein-based markers – such as Tau – currently used to diagnose NDs. By this stage, the diseases become more difficult to treat. SncRNAs play an important regulatory role in the maintenance of the homeostatic brain. Therefore, changes in their concentration levels can be indicative of mechanistic changes that could precede protein-based markers. One single sncRNA biomarker is unlikely to differentiate between diseases. However, a combination of sncRNA biomarkers could be illustrative of the me...
Source: Frontiers in Genetics - Category: Genetics & Stem Cells Source Type: research
Conclusions: We report the potential beneficial effects of ITB treatment in patients with inherited ataxia who also suffer from spasticity/spasms. ITB treatment indication in neurological disorders allows for extension to the treatment of spasticity/ spasms in patients with hereditary ataxia.Stereotact Funct Neurosurg
Source: Stereotactic and Functional Neurosurgery - Category: Neurosurgery Source Type: research
CONCLUSION/CLINICAL RELEVANCE: Seromas are a complication following cervical instrumentation that can cause compression of the adjacent spinal cord resulting in functional decline. The seroma, in this case, led to the loss of vibration and proprioception with resultant ataxia, signs that are not routinely identified on ISNCSCI exam; therefore, this highlights the need to broaden the neurological examination when evaluating a patient with spinal cord injury who has experienced a neurological setback. PMID: 30547736 [PubMed - as supplied by publisher]
Source: Journal of Spinal Cord Medicine - Category: Orthopaedics Tags: J Spinal Cord Med Source Type: research
MAGNETIC resonance imaging of the cervical spine was performed in a patient with spinocerebellar ataxia type 2, who required surgery after a fall. It demonstrates a fracture at the base of the odontoid process of the C2 vertebra (type 2, labeledFx) that was considered unstable. Also noted is a hypointense area posterior to the fracture that represents spinal cord edema. Patients with unstable cervical spine fractures who require intubation present a challenge, as mobilization of the spine during instrumentation of the airway has the potential of causing or worsening spinal cord injury. All airway maneuvers can produce some...
Source: Anesthesiology - Category: Anesthesiology Source Type: research
Electrical injury causes direct damage to nerves. It may manifest as peripheral nerve injury, spinal cord damage, cerebellar ataxia, hypoxic encephalopathy, or intracerebral hemorrhage. Various factors determine the severity of electric injury, including type of current, amperage, voltage, tissue resistance, pathway of the current, and duration of contact with the body. However, the severity of the electrical injury is not proportional to the source voltage, visible burns, loss of consciousness, or neuroimaging findings.
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research
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