Franz E. Glasauer

Familial syringomyelia: Case report and review of the literature

BACKGROUND Syringomyelia is an uncommon disease of the spinal cord, occurring sporadically. However, rare familial cases with autosomal dominant or recessive inheritance patterns are reported and their incidence quoted as approximately 2%. Only one previous report originated from the United States. METHODS We present a brother and sister with syringomyelia and associated Chiari type I malformation; both patients responded to surgical treatment. We review the world literature and briefly discuss pathogenetic theories of syringomyelia as well as the relevance of the histocompatibility leukocyte antigen profile. RESULTS Both genetic and environmental factors appear to be involved in familial syringomyelia. CONCLUSION We recommend that close relatives of patients affected with familial syringomyelia undergo routine neurologic and radiologic surveys.

Myelographic demonstration of lumbosacral nerve root avulsion.

Avulsion of cervical nerve roots by A traction injury to the shoulder girdle is well known (1, 7, 12), but, on the other hand, traumatic avulsion of lumbosacral nerve roots is exceedingly rare. A search of the literature revealed only 3 reported cases to date of this condition with myelographic demonstration. The first was described by Finney and Wulfman in 1960 (3), and 2 more were reported recently by Goodell (4). The 2 case reports which form the basis of this communication describe the characteristic radiographic and clinical features of lumbar or sacral nerve root avulsion. Case I: F. H., a 22-year-old man, was admitted to a local hospital on Oct. 9, 1962, following an auto accident in which he sustained cerebral concussion and fractures of the right upper and lower extremities. The pelvic fractures included separation of the right sacroiliac joint and of the pubic symphysis with marked deformity (Fig. 1). Due to the numerous fractures, a complete neurological examination could not be carried out. It...

Sarcoidosis of the cervical spinal canal: case report.

A patient with sarcoidosis presenting as an intradural extramedullary space-occupying lesion in the cervical spinal canal is described.

Subdural empyema in Africans in Rhodesia.

Subdural empyema was encountered in 44 African patients in Rhodesia during the period from 1970 to 1974. Subdural empyema seems to be a relatively frequent occurrence in Africans. Sixty-eight per cent of the patients were below the age of 20 years, and males predominated. More than half of the patients had either a history or evidence of an infectious process outside the central nervous system, and about 60% demonstrated focal neurological signs. The diagnosis was confirmed by either surgery or postmortem examination. Cultures of available specimens were positive in 50%. The predominant organisms identified were Streptococcus, followed by Staphylococcus. Surgical treatment consisted mainly of multiple burr holes, drainage of the empyema, and irrigation. The mortality rate in this study was 59%, and some recognizable contributing factors are elaborated. In the discussion the authors compare these observations with pertinent reviews from the literature. Some of these findings correlate well with other reports, whereas other observations are attributed to factors partly inherent in the socio-economic structure of the African population in Rhodesia.

The use of intraoperative echoencephalography

SUMMARYThirty selective patients were examined by transdural (26) and cortical (4) echoencephalography during craniotomies or trephinations. The results of this examination proved to be helpful in outlining the extent and depth of the lesion and in the selection of the site for the cortical incision. The accuracy of the method was found to be sufficient and may improve with further experience and refinement of the technique.

Hyperhidrosis as the presenting symptom in post-traumatic syringomyelia

Post-traumatic syringomyelia is now a well known entity and occurs months or years after a spinal cord injury. The presenting symptoms are usually pain, progressive motor weakness, sensory changes, and increased spasticity. Profuse sweating or hyperhidrosis can be a symptom of the post-traumatic syrinx or can occur in autonomic dysreflexia provoked by peripheral stimuli. We present two patients with cervical spine fractures whose presenting symptom of posttraumatic syringomyelia was hyperhidrosis affected by posture. The pathophysiology involved and the management of these patients is discussed.

The radiology of cerebrospinal fluid shunts and their complications

Abstract The three commonly used types of cerebrospinal fluid shunts are ventriculo-cisternal, ventriculo-atrial, and ventriculo-peritoneal shunts. These consist of catheters, valves, flushing devices and reservoirs. The radiographic features of several shunt systems are described. The radiographically recognizable complications of cerebrospinal fluid shunts are cranial, cardiovascular, and abdominal. The cranial complications include displacement and disconnection of the ventricular catheter. Cardiovascular changes include retraction of catheters, embolism and thrombosis of vessels and, rarely, damage to the cardiac wall. Migration of catheters out of or into the abdominal cavity and occasional volvulus or bowel perforation represent the possible abdominal complications. All of these complications ultimately lead to cessation of function of the shunt.

Ring formation on computerized tomography in the postoperative patient

Ring formation with contrast infusion in computerized tomography has been described with various entities. The current report demonstrates its appearance in three postoperative patients from whom cerebral tumors had been removed. These examples of postoperative ring formation are compared with the ring formation in the scan of an unoperated patient with an intracerebral hematoma.

Neurosurgery in a different society: the People??s Republic of China

An interdisciplinary clinical neurosciences delegation representing the International Committee of the Congress of Neurological Surgeons visited the neurosurgical departments of major teaching hospitals in five cities of the Peoples Republic of China. This report describes the clinical and research activities observed, with reference to the unique social, political, economic, and cultural environment in China. Although facilities and equipment are limited, diagnostic accuracy and surgical technique are excellent. Results for certain disorders seemed comparable to those obtained in western neurosurgical centers. Given the clinical expertise of our Chinese colleagues and the large numbers of cases treated in Chinese medical centers, a significant contribution to neurosurgical knowledge can be expected from the exchange of information and future collaboration that have now become possible.

An unusual location for heterotopic ossification: lumbar anterior longitudinal ligament.

Heterotopic ossification (HO) is a well known complication of spinal cord injury. It usually affects the hips and knees, with less common involvement of the shoulders and elbows. We present a patient with incomplete tetraplegia who developed HO in the left hip and in the plane of the lumbar anterior longitudinal ligament from L3 to L5. During evaluation for the patients complaints of low back pain, a fracture was noted in the HO which was confirmed by three-dimensional CT scan. We postulate that this fracture contributed to his symptoms. Review of the literature on HO in spinal cord injured patients indicates this to be an unusual location for HO. Although HO of the lumbar anterior longitudinal ligament is a rare occurrence, this possibility should be considered in the evaluation of back pain in spinal cord injured patients.