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Arthrosc Tech 2021 Apr 22;10(4):e1179-e1186. Epub 2021 Apr 22.

Department of Orthopedic Surgery, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A.

Heterotopic ossification (HO) can occur as a complication of various pathologies affecting the hip including trauma, tendon avulsions, chronic injury, spinal cord injury, and soft-tissue disruption caused by surgery. When HO is present alongside intra-articular hip pathology such as femoroacetabular impingement syndrome (FAIS) or labral pathology, consideration should be made to combine the surgical excision of the HO with the FAIS decompression or labral repair if the location and size of the HO is appropriate for arthroscopic excision. Often times, the HO is located in such a position that any central compartment work can be completed before turning to the HO excision. Read More

BMJ Case Rep 2021 May 5;14(5). Epub 2021 May 5.

Neurosurgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.

A 64-year-old man was referred to A&E by his general practitioner with worsening back and acute bilateral leg pain and weakness with urinary retention. His MRI scan demonstrated spinal canal stenosis at the level of L1-L2 and a diagnosis of cauda equina syndrome (CES) was made. CES is a rare neurological condition caused by compression of the central spinal nerves at the termination of the cord. Read More

Thorac Cancer 2021 May 5. Epub 2021 May 5.

Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Fukuoka, Japan.

Neuromyelitis optica spectrum disorders (NMOSDs) are autoimmune demyelinating diseases involving the central nervous system, affecting the spinal cord and optic nerves. There are few reports of paraneoplastic NMOSD associated with malignant melanoma. Here, we report a rare case of anti-aquaporin 4 (AQP4) antibody-positive NMOSD associated with malignant melanoma. Read More

BMJ Case Rep 2021 May 4;14(5). Epub 2021 May 4.

Neurology Department, Morriston Hospital, Swansea, UK.

Neuromyelitis optica spectrum disorder (NMOSD) is an uncommon antibody-mediated disease of the central nervous system, often associated with aquaporin-4 antibodies (AQP4-Ab). NMOSD may present as a subacute myelopathy, progressing over days with MRI revealing a contiguous inflammatory lesion of the spinal cord, ≥3 vertebral segments, a longitudinally extensive transverse myelitis. We describe an unusual paraneoplastic form of AQP4-Ab NMOSD that developed in a patient with an advanced diffuse large B-cell lymphoma. Read More

J Int Med Res 2021 May;49(5):3000605211012367

Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, Republic of Korea.

Trigger point injection (TPI) is commonly administered for myofascial pain syndrome management, but occasionally leads to complications, including bleeding, muscle hematoma, vasovagal syncope, skin infections, and pneumothorax. This report presents a case of TPI-induced iatrogenic spinal cord injury (SCI). A 59-year-old woman received TPI for myofascial pain on both thoracolumbar paraspinal muscles. Read More

J Surg Case Rep 2021 Apr 19;2021(4):rjab090. Epub 2021 Apr 19.

Department of Neurosurgery, Tufts University School of Medicine, Boston, MA, USA.

A 42-year-old woman from a medically underserved community in rural New England was referred by her primary care provider (PCP) for televisit during the coronavirus disease 2019 (COVID-19) pandemic following 2 years of chronic neck pain and numbness in her left hand that was initially concerning for demyelinating disease. Upon further evaluation, it was revealed that she had experienced a traumatic fall with a concussion and symptoms consistent with central cord syndrome but had refused magnetic resonance imaging (MRI) at her initial medical evaluation. On MRI conducted 1 month prior to neurosurgical evaluation she was found to have a disc bulge and 4-mm T2-hyperintense lesion at the C4-C5 level that was consistent with a chronic spinal cord injury secondary to spinal trauma with associated vertebrogenic injury. Read More

Praxis (Bern 1994) 2021 Apr;110(6):324-335

Klinik für Neurochirurgie, Kantonsspital St. Gallen, St. Gallen.

Acute Traumatic Central Cord Syndrome: Etiology, Pathophysiology, Clinical Manifestation, and Treatment The acute traumatic central cord syndrome (ATCCS) represents an injury to the spinal cord with disproportionately greater motor impairment of the upper than the lower extremities, with bladder dysfunction and with varying degrees of sensory loss below the level of the respective lesion. The mechanism of ATCCS is most commonly a traumatic hyperextension injury of the cervical spine at the base of an underlying spondylosis and spinal stenosis. The mean age is 53 years, and segments C4 to Th1 are most frequently affected. Read More

Childs Nerv Syst 2021 Apr 24. Epub 2021 Apr 24.

Neuro-oncology Clinic, Center for Rare Cancers, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, Kyounggi-do, 10408, Republic of Korea.

Introduction: The term caudal duplication syndrome (CDS) was first introduced for complex anomalies of the distal caudal end of the trunk. The pathoembryogenesis of CDS is yet unknown, although a few theories have been proposed. We reviewed the previously proposed pathoembryogenetic theories and suggested a new perspective through the common clinical characteristics shown in CDS cases reported in the literature. Read More

Global Spine J 2021 Apr;11(1_suppl):66S-72S

Department of Neurosurgery, UVA School of Medicine, Charlottesville, VA, USA.

Study Design: Systematic Review.

Objectives: To review the literature surrounding the cost-effectiveness of implanting spinal cord stimulators for failed back surgery syndrome.

Methods: A systematic review was conducted inclusive of all publications in the Medline database and Cochrane CENTRAL trials register within the last 10 years (English language only) assessing the cost-effectiveness of Spinal Cord Stimulator device implantation (SCSdi) in patients with previous lumbar fusion surgery. Read More

J Pain 2021 Apr 19. Epub 2021 Apr 19.

Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore MD 21201, USA; UM Center to Advance Chronic Pain Research, University of Maryland, Baltimore, Baltimore MD 21201. Electronic address:

Chronic Overlapping Pain Conditions, including irritable bowel syndrome (IBS) and temporomandibular disorder (TMD), represent a group of idiopathic pain conditions that likely have peripheral and central mechanisms contributing to their pathology, but are poorly understood. These conditions are exacerbated by stress and have a female predominance. The presence of one condition predicts the presence or development of additional conditions, making this a significant pain management problem. Read More

PLoS One 2021 22;16(4):e0250196. Epub 2021 Apr 22.

Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States of America.

Introduction: The evidence for vertical transmission of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is not well established. Therefore, the objective of this review is to summarize emerging evidence on the vertical transmission of Severe Acute Respiratory Syndrome Coronavirus 2.

Methods: We conducted a systematic search in PubMed, CINAHL, Web of Science, SCOPUS, and CENTRAL. Read More

Spinal Cord Ser Cases 2021 Apr 13;7(1):30. Epub 2021 Apr 13.

Central Institute of Orthopaedics, Vardhman Mahavir Medical College and Associated Safdarjung Hospital, New Delhi, India.

Introduction: Posterior fracture-dislocation of fifth lumbar vertebra (L5) is a rare injury pattern. Existing Aihara classification system lacks its mention.

Case Presentation: We report two cases of posterior fracture-dislocation of L5 with comminuted fracture of body that presented with cauda equina syndrome. Read More

Zh Nevrol Psikhiatr Im S S Korsakova 2021 ;121(3):64-69

Clinic of the Medical University, Kazan, Russia.

Objective: To study a role of central sensitization (CS) in patients with Failed Back Surgery Syndrome (FBSS) after decompression of the lumbar and/or sacral roots.

Material And Methods: The study included three groups of patients: 1) early FBSS (e-FBSS, =23), pain after surgery decreased, but continued to significantly bother the patient, or recurred in the first 6 months after surgery; 2) middle FBSS (m-FBSS, =42), pain after surgery completely stopped, but recurred within 6-12 months; 3) late FBSS (l-FBSS, =31), if pain relapse occurred more than 12 months later. Neurological status assessment, study of muscle trigger zones (MTZ), postoperative scar trigger zones (TZS), pain assessment according to the Visual Analogue Scale (VAS), CS assessment according to the Russian version of the Central Sensitization Inventory (CSI) were performed. Read More

J Neurol Sci 2021 05 27;424:117422. Epub 2021 Mar 27.

Department of Neurology, Alfried Krupp Hospital, Alfried-Krupp-Strasse 21, 45130 Essen, Germany; German Society of Neurology, Reinhardtstrasse 27 C, 10117 Berlin, Germany.

Importance: Primary angiitis of the central nervous system (PACNS) is a rare condition which is often misdiagnosed. In order to avoid mistakes in the management, a step by step approach is necessary.

Observations: The most common presenting symptoms of PACNS are encephalopathy-related cognitive and affective abnormalities, headaches and multifocal symptoms associated with recurrent episodes of ischemia or hemorrhage. Read More

Top Spinal Cord Inj Rehabil 2021 ;27(1):84-91

Department of Physical Medicine and Rehabilitation, Penn State University Milton Hershey Medical Center, Hershey, Pennsylvania.

Spinal cord injury (SCI) substantially increases the risk of neurogenic obesity, diabetes, and metabolic syndrome. Much like in the general population, a discussion of these syndromes in SCI would be incomplete without acknowledging the association of SCI with sleep-disordered breathing (SDB). This article will outline the interplay between obesity and obstructive sleep apnea (OSA), discussing the pathophysiology of obesity in OSA both for the general population and SCI population. Read More

Top Spinal Cord Inj Rehabil 2021 ;27(1):23-35

Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida.

Over two-thirds of persons with spinal cord injury (SCI) experience neurogenic obesity-induced cardiometabolic syndrome (CMS) and other chronic comorbidities. Obesity is likely to impede social and recreational activities, impact quality of life, and impose additional socioeconomic burdens on persons with SCI. Advances in imaging technology facilitate the mapping of adiposity and its association with the cardiometabolic profile after SCI. Read More

Orphanet J Rare Dis 2021 Mar 31;16(1):152. Epub 2021 Mar 31.

Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, the Ministry of Education Key Laboratory, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, 100730, China.

Background: Central nervous system (CNS) involvement is extremely rare in eosinophilic granulomatosis with polyangiitis (EGPA), but is associated with a poor prognosis in the five-factor score. This study aims to elucidate the clinical features and independently associated factors of EGPA with CNS involvement.

Results: CNS involvement was observed in 17. Read More

Mult Scler 2021 Mar 23:13524585211002097. Epub 2021 Mar 23.

Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada/Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.

Objective: The central vein sign (CVS) and "paramagnetic rim lesions" (PRL) are emerging imaging biomarkers in multiple sclerosis (MS) reflecting perivenular demyelination and chronic, smoldering inflammation. The objective of this study was to assess relationships between cognitive impairment (CI) and the CVS and PRL in radiologically isolated syndrome (RIS).

Methods: Twenty-seven adults with RIS underwent 3. Read More

J Neurosci 2021 Apr 16;41(17):3900-3916. Epub 2021 Mar 16.

Visceral Pain Research Group, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, 5042 South Australia, Australia

Understanding the sensory mechanisms innervating the bladder is paramount to developing efficacious treatments for chronic bladder hypersensitivity conditions. The contribution of Mas-gene-related G protein-coupled receptors (Mrgpr) to bladder signaling is currently unknown. Using male and female mice, we show with single-cell RT-PCR that subpopulations of DRG neurons innervating the mouse bladder express (14%) and (38%), either individually or in combination, with high levels of coexpression with (81%-89%). Read More

J Neurotrauma 2021 Apr 6. Epub 2021 Apr 6.

Department of Neurosurgery and University of Maryland School of Medicine, Baltimore, Maryland, USA.

The therapeutic significance of timing of decompression in acute traumatic central cord syndrome (ATCCS) caused by spinal stenosis remains unsettled. We retrospectively examined a homogenous cohort of patients with ATCCS and magnetic resonance imaging (MRI) evidence of post-treatment spinal cord decompression to determine whether timing of decompression played a significant role in American Spinal Injury Association (ASIA) motor score (AMS) 6 months following trauma. We used the test, analysis of variance, Pearson correlation coefficient, and multiple regression for statistical analysis. Read More

Mult Scler Relat Disord 2021 Feb 28;51:102871. Epub 2021 Feb 28.

Department of Neurology, Medical University of Lodz, Poland.

Hypereosinophilic syndrome (HES) is a rare disorder characterized by a persistent eosinophilia with a multi-organ involvement including neurological manifestation. A 59-year-old man was referred from a neurosurgery unit with a spastic triparesis with predominant left side involvement, dissociated sensory loss to Th7, and metastasis-like lesions in a brain CT. MRI examination of the thoracic spine revealed an intraspinal T2-hyperintensive lesion with a subtle central gadolinium enhancement at Th4-Th8 level. Read More

J Spinal Cord Med 2021 Mar 11:1-15. Epub 2021 Mar 11.

Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Context: Recent literature points towards myelitis, like encephalitis, as a common central nervous system complication of COVID-19. This review elaborates on disorders of the spinal cord caused by the SARS-CoV-2 virus.

Objectives: To review the published data about SARS-CoV-2-associated spinal cord disorders and assess their clinical, neuroimaging, treatment, and prognostic aspects. Read More

Diagnostics (Basel) 2021 Feb 23;11(2). Epub 2021 Feb 23.

Vascular Diseases Center, University Hospital of Ferrara, 44121 Ferrara, Italy.

(1) Background: internal jugular vein thrombosis (IJVthr) is a potentially life-threating disease but no comprehensive reviews on etiology, symptomatology, diagnosis and current treatment guidelines are yet available; (2) Methods: we prospectively developed a protocol that defined objectives, search strategy for study identification, criteria for study selection, data extraction, study outcomes, and statistical methodology, according to the PRISMA standard. We performed a computerized search of English-language publications listed in the various electronic databases. We also retrieved relevant reports from other sources, especially by the means of hand search in the Glauco Bassi Library of the University of Ferrara; (3) Results: using the predefined search strategy, we retrieved and screened 1490 titles. Read More

Breastfeed Med 2021 Mar 5. Epub 2021 Mar 5.

Japan Drug Information Institute in Pregnancy, National Center for Child Health and Development, Tokyo, Japan.

Brotizolam is a sedative-hypnotic thienotriazolodiazepine that is a benzodiazepine analog used for debilitating insomnia. Anxiety, depression, and sleep disorders occur in about 15% of pregnant and lactating women; however, no studies have examined brotizolam transfer across the placenta or its excretion into breast milk. In this case report, we assessed brotizolam concentrations in maternal and neonatal blood, cord blood, and breast milk. Read More

Surg Neurol Int 2021 10;12:50. Epub 2021 Feb 10.

Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma, United States.

Background: Thalamic pain syndrome is classically described as chronic pain after an infarct of the thalamus. It leads to a decrease in the quality of life, especially for patients with inadequate treatment. Supportive imaging, such as a thalamic lesion or infarct, is widely accepted as necessary to diagnose this condition. Read More

Nervenarzt 2021 Mar 2. Epub 2021 Mar 2.

Klinik für Neurologie und Experimentelle Neurologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.

Many neuroimmunological diseases, such as encephalopathy, encephalitis, myelitis and acute disseminated encephalomyelitis (ADEM) have occurred more frequently after infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which indicates a parainfectious or postinfectious association. The most likely underlying mechanisms include virus-triggered overactivation of the immune system with hyperinflammation and cytokine storm but potentially also the development of specific autoantibodies against central nervous system (CNS) tissue. These were predominantly detected in the cerebrospinal fluid of severely ill coronavirus disease 2019 (COVID-19) patients. Read More

J Neurovirol 2021 04 1;27(2):354-358. Epub 2021 Mar 1.

Dept of Anesthesiology and Intensive Care, Medical Faculty, Aja University of Medical Sciences, Tehran, Iran.

A 63-year-old Caucasian male, known case of controlled type 2 diabetes, chronic renal failure, and ischemic heart disease, was presented with weakness and loss of movement in lower limbs, an absent sensation from the chest below, constipation, and urinary retention. About 4 days before these symptoms, he experienced a flu-like syndrome. Suspicious for COVID-19, his nasopharyngeal specimen's reverse transcription-polymerase chain reaction (RT-PCR) resulted positive. Read More

Oper Neurosurg (Hagerstown) 2021 Feb 27. Epub 2021 Feb 27.

Department of Spine surgery, Hôpital Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.

Thoracic disc herniation is a rare and severe condition, whose treatment may have complications including dural tears. Although benign in most cases, dural tears may induce iatrogenic transdural herniation of the spinal cord. The video demonstrates the diagnosis and surgical treatment of iatrogenic transdural herniation of the spinal cord. Read More

J Neurochem 2021 Feb 26. Epub 2021 Feb 26.

Neugeneron, Dallas, TX, 75243, USA.

MECP2 duplication syndrome (MDS), a rare X-linked genomic disorder affecting predominantly males, is caused by duplication of the chromosomal region containing the methyl CpG binding protein-2 (MECP2) gene, which encodes methyl-CpG-binding protein 2 (MECP2), a multi-functional protein required for proper brain development and maintenance of brain function during adulthood. Disease symptoms include severe motor and cognitive impairment, delayed or absent speech development, autistic features, seizures, ataxia, recurrent respiratory infections and shortened lifespan. The cellular and molecular mechanisms by which a relatively modest increase in MECP2 protein causes such severe disease symptoms are poorly understood and consequently there are no treatments available for this fatal disorder. Read More

J Pain 2021 Feb 23. Epub 2021 Feb 23.

Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida.

Fibromyalgia is a chronic widespread pain syndrome associated with hypersensitivity to nociceptive stimuli. This increased sensitivity of FM patients has been associated with central sensitization of dorsal horn neurons. Increasing evidence, however, suggests that the mechanisms of FM hypersensitivity not only affect pain but include light, smell, and sound. Read More