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J Orthop Case Rep 2021 Apr;11(4):75-79

Department of Orthopaedics and Spine Surgery, Ganga Medical Centre and Hospitals Private Limited, Coimbatore, Tamil Nadu, India.

Introduction: Idiopathic spontaneous spinal subdural hematoma (ISSSDH) is uncommon in occurrence, and its association with concomitant intracranial subdural hematoma (ISDH) is very exceptional. Lack of recognition of ISDH in a patient with SSDH can lead to unanticipated events. We report a rare case of ISSSDH and unrecognized ISDH and treated surgically with a good outcome. Read More

J Pediatr Neurosci 2021 Jan-Mar;16(1):61-64. Epub 2021 Jun 25.

Department of Neurosurgery, RNT Medical College, Udaipur, India.

Introduction: Spontaneous spinal intramedullary hematoma is a rare cause of acute paraplegia in adults and is extremely uncommon in children. Very few cases with no apparent etiology (such as trauma, vascular lesions) have been reported in adults. We did not find any apparent cause for the hematoma in our patient and to the best of our knowledge, this is first case reported in infants. Read More

Bull Emerg Trauma 2021 Jul;9(3):151-154

Consultant and Honorary Senior Lecturer in Intensive Care Medicine and Anaesthesia, St Mary's Hospital, Imperial College NHS Trust, London, United Kingdom.

Blunt chest trauma is a rare cause of acute coronary syndrome and can be masked by other injuries in polytrauma patients. It can have devastating consequences due to damage to the myocardial tissue if left un-recognized. Myocardial injury can result in life-threatening arrhythmias and complications such as systolic and diastolic dysfunction. Read More

Clin Case Rep 2021 Jul 21;9(7):e04522. Epub 2021 Jul 21.

Vascular Surgeon European Vascular Center Aachen-Maastricht University Hospital of the RWTH Aachen Aachen Germany.

Spinal epidural hematoma is a rare but devastating complication of iliac vein stenting. Radicular back pain during and after procedure is an alarming sign for this complication. Read More

Eur Spine J 2021 Jul 20. Epub 2021 Jul 20.

Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Konoe-Cho, Yoshida, Sakyo-Ku, Kyoto, 606-8501, Japan.

Purposes: This study aimed to investigate the histopathological changes that occur within 2 weeks following spinal cord injury (SCI) in dogs.

Methods: Eight adult female Beagle dogs were included in this study, and SCI was induced using an epidural balloon catheter. Two dogs were killed at each of the following four time points: immediately after the procedure and 1 day, 1 week, and 2 weeks after the procedure. Read More

Bratisl Lek Listy 2021 ;122(8):594-597

Introduction: The occurrence of symptomatic spinal epidural hematoma after spine surgery is a rare, but serious major complication whose incidence usually requires urgent surgical intervention. Obesity is currently considered to be one of the most common metabolic diseases.

Methods: Prospective analysis of patients who underwent surgical treatment of degenerative lumbar spine disease from January 2016 to February 2018 with one-year follow-up. Read More

JAMA Neurol 2021 Jul 19. Epub 2021 Jul 19.

University of Washington, Seattle.

Importance: A head computed tomography (CT) with positive results for acute intracranial hemorrhage is the gold-standard diagnostic biomarker for acute traumatic brain injury (TBI). In moderate to severe TBI (Glasgow Coma Scale [GCS] scores 3-12), some CT features have been shown to be associated with outcomes. In mild TBI (mTBI; GCS scores 13-15), distribution and co-occurrence of pathological CT features and their prognostic importance are not well understood. Read More

Ann Transl Med 2021 Jun;9(12):977

Guangzhou University of Chinese Medicine, Guangzhou, China.

Background: The aim of the present study was to evaluate the curative effect and safety of thoracic full-endoscopic unilateral laminotomy with bilateral decompression (TE-ULBD) for treating ossification of the ligamentum flavum (OLF) with myelopathy.

Methods: Between January 2015 and December 2018, 23 consecutive patients with symptomatic thoracic OLF were treated with TE-ULBD. Of these, 21 (13 women and 8 men, aged 49-75 years) were included in the study and followed up for a minimum of 1 year. Read More

Neurologia (Engl Ed) 2021 Jul 12. Epub 2021 Jul 12.

Hospital Universitario Miguel Servet, Zaragoza, Spain.

J Neurol Surg A Cent Eur Neurosurg 2021 Jul 14. Epub 2021 Jul 14.

Department of Neurosurgery, Him Plus Hospital, Suncheon, Republic of Korea.

Background:  We present the case of an intracranial subdural hygroma resulting from intraoperatively undetected dural tear after unilateral biportal endoscopic (UBE) spine surgery for lumbar spinal stenosis.

Case Description:  An 80-year-old woman presented with insidious onset, gradually progressing low back pain, and right leg pain of 1-year duration. The pain radiated to the right L4-L5 dermatomes. Read More

Respir Med Res 2020 Aug 26;80:100786. Epub 2020 Aug 26.

Service de pneumologie et de soins intensifs, hôpital Européen Georges-Pompidou, AP-HP, Paris, France; Université de Paris, Paris, France; Inserm UMRS 11400, Paris, France. Electronic address:

Subarachnoid-pleural fistula (SPF) is a rare complication of spine surgery with a transthoracic approach. The outcome of such an injury is affected by not only the pulmonary status due to the pleural effusion but also the neurological one, secondary to the intracranial hypotension. After reviewing the few published cases of SPF, the journey to diagnosis seams heterogenous and the management plan non-uniform. Read More

Int Heart J 2021 Jul 6. Epub 2021 Jul 6.

Department of Pediatrics, Miyazaki Prefectural Miyazaki Hospital.

Spontaneous spinal epidural hematoma (SSEH) is considered to be a relatively rare disease that can result in serious neurological sequelae. The pathogenesis and risk factors of SSEH are still unknown, and its differential diagnosis varies widely. Misdiagnosis with more common conditions such as stroke or aortic syndromes can occur. Read More

Childs Nerv Syst 2021 Jul 6. Epub 2021 Jul 6.

Department of Neurological Surgery, University of Illinois at Chicago, 912 South Wood Street, 451N - MC 799, Chicago, IL, 60612, USA.

Background: Spontaneous spinal epidural hematoma (SSEH) is a rare neurologic entity, especially in infants, that develops in the absence of underlying coagulopathy, bleeding diathesis, infection, vascular malformation, trauma, iatrogenic, or other identifiable cause. In contrast to adults, diagnosis is frequently delayed or missed in infants due to non-specific symptoms and limited clinical examination.

Case Illustration: An 11-month-old female demonstrated symptoms of irritability, intermittent diarrhea, lethargy, decreased oral intake, and difficulties crawling before presenting to the emergency room. Read More

Hemodial Int 2021 Jul 5. Epub 2021 Jul 5.

Department of Emergency Medicine, National Taiwan University, National Taiwan University Hospital, Taipei, Taiwan.

Spontaneous spinal epidural hematoma (SEH) is extremely rare in patients with end-stage renal disease (ESRD). We report a case of a 71-year-old man with ESRD presented with progressive left limb weakness. Magnetic resonance imaging (MRI) revealed spinal cervical SEH involving C3-5 level. Read More

Surg Neurol Int 2021 7;12:256. Epub 2021 Jun 7.

Department of Neurosurgery and Endovascular Neurosurgery, University of Patras, University Hospital of Patras, Patras, Achaia, Greece.

Background: Spontaneous spinal epidural hematomas (SSEHs) are often attributed to anticoagulation. Although they are rare, they may contribute to significant morbidity and mortality.

Case Description: An 83-year-old female with a history of atrial fibrillation on apixaban, presented with 4 days of back pain, progressive lower extremity weakness and urinary retention. Read More

Ulus Travma Acil Cerrahi Derg 2021 Jul;27(4):478-482

Department of Surgery, Trauma Center, Dankook University Hospital, Cheonan-Republic of Korea.

Traumatic chylothorax is a rare condition following blunt trauma. Although a chyle leak resulting from direct damage to the duct may occur at any level because of an anatomical variation, an airway obstruction due to thoracic duct injury after blunt trauma has never been described. Here, we report a very unusual case with airway obstruction due to thoracic duct injury after whiplash injury. Read More

Asian J Neurosurg 2021 Jan-Mar;16(1):159-163. Epub 2021 Mar 20.

Department of Neurosurgery, Sahyadri Speciality Hospital, Pune, Maharashtra, India.

Melanocytomas of the central nervous system are rare benign or intermediate grade localized melanocytic tumors. Despite its benign nature, it can follow a locally aggressive course with propensity to recur. We present the case of a 29 years old female who presented with a recurrent lesion in cervical spine and rapidly progressing quadriparesis. Read More

J Pain Res 2021 24;14:1909-1913. Epub 2021 Jun 24.

Neurosurgical Associates of Lancaster, Lancaster, PA, USA.

Introduction: Low-back pain with accompanying neurogenic claudication is a common diagnosis in pain and spine centers around the world, with an evolving algorithm of treatment. One option for the treatment of neurogenic claudication by decompressive strategies centers on percutaneous direct decompressive techniques. Although commonly employed in clinical practice, there have been no formal investigations looking at safety of percutaneous direct decompression without the use of an epidurogram and relying on osteal landmarks. Read More

J Intensive Care Med 2021 Jun 29:8850666211024886. Epub 2021 Jun 29.

Department of Neurosurgery, The Permanente Medical Group, 23545Kaiser Permanente Medical Center, Redwood City, CA, USA.

Spontaneous intracranial hypotension typically manifests with orthostatic headaches and is caused by spinal dural tears, ruptured meningeal diverticula, or CSF-venous fistulas. While most patients are diagnosed and treated in the outpatient setting, some patients will occasionally present in the emergent ICU setting due to subdural hematomas, coma, or downward brain herniation. In this review paper, we will discuss the diagnostic and treatment steps that intensivists can undertake to coordinate a team approach to successfully manage these patients. Read More

Radiol Case Rep 2021 Aug 12;16(8):2207-2210. Epub 2021 Jun 12.

Department of Neurosurgery, Sterling Hospitals, Memnagar, Ahmedabad, Gujarat 380052, India.

Spontaneous spinal epidural hematoma is a rare predominantly idiopathic entity which can prompt acute neurologic symptoms and if not managed in time can lead to devastating outcomes. High index of suspicion is required for early diagnosis on MRI for a prompt management of patients showing sudden neurologic deficits. Our patient was 42-year-old female who presented with sudden onset of numbness followed by weakness in both lower limbs and urinary retention without any comorbidity or any medication. Read More

Turk Neurosurg 2021 Jan 26. Epub 2021 Jan 26.

National Neuroscience Institute King Fahad Medical City, Department of Neurosurgery, Riyadh, Kingdom of Saudi Arabia.

Aim: Epidural hematoma (EDH) is a commonly encountered neurosurgical condition. Numerous articles have been published on EDH. Bibliometric analysis studies the chronological trends and ranks the most impactful articles in a given field. Read More

Ann Transl Med 2021 May;9(10):881

Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China.

Background: Spinal cord injury (SCI) is a traumatic disease that is associated with high morbidity, disability, and mortality worldwide. The animal spinal cord contusion model is similar to clinical SCI; therefore, this model is often used to study the pathophysiological changes and treatment strategies for humans after SCI. The present study aimed to introduce a novel, minimally invasive technique to establish an SCI model, and to evaluate its advantages compared with conventional methods. Read More

Med Devices (Auckl) 2021 15;14:173-183. Epub 2021 Jun 15.

DePuy Synthes, Raynham, MA, USA.

Purpose: Minimally invasive surgery (MIS) of the spine has been associated with favorable outcomes compared to open surgery. This study evaluated matched cohorts treated with MIS versus open posterior lumbar fusion for costs, payments, healthcare utilization and outcomes.

Patients And Methods: This study used the Premier Healthcare and IBM MarketScan Commercial and Medicare Databases. Read More

Semin Cardiothorac Vasc Anesth 2021 Jun 23:10892532211023337. Epub 2021 Jun 23.

University of Pittsburgh, Pittsburgh, PA, USA.

Cardiac surgeries are known to produce moderate to severe pain. Pain management has traditionally been based on intravenous opioids. Poorly controlled pain can result in increased incidence of respiratory complications such as atelectasis and pneumonia leading to prolonged intubation and intensive care unit length of stay and subsequent prolonged hospital stay. Read More

Headache 2021 Jun 21;61(6):969-971. Epub 2021 Jun 21.

University of South Carolina School of Medicine, Greenville, SC, USA.

Objectives/background: Expand the differential diagnosis of sentinel headache to include spontaneous spinal epidural hematoma (SSEH) and reinforce the need for lumbar puncture in the evaluation of thunderclap headache. SSEH is a rare clinical presentation especially in the absence of bleeding tendencies. Clinicians recognize SSEH with typical presenting signs and symptoms including regional paraspinal muscular contraction and pain along with myelopathy. Read More

Rev Esp Anestesiol Reanim 2021 Jun 17. Epub 2021 Jun 17.

Servicio de Anestesiología y Reanimación, Hospital General Universitario Gregorio Marañón, Madrid, España.

J Orthop Surg Res 2021 Jun 18;16(1):393. Epub 2021 Jun 18.

Center for Musculoskeletal Surgery, Charité - University Medicine Berlin, Charitéplatz 1, 10117, Berlin, Germany.

Background: With a reported rate of 0.7-20%, postoperative spinal implant infection (PSII) is one of the most common complications after spine surgery. While in arthroplasty both haematoma formation and perioperative blood loss have been identified as risk factors for developing periprosthetic joint infections and preoperative anaemia has been associated with increased complication rates, literature on the aetiology of PSII remains limited. Read More

J Pak Med Assoc 2021 Apr;71(4):1290-1291

Department of Radiology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.

Spinal subdural haematoma (SSDH) is very rare but potentially life debilitating spinal vascular condition, often developing acutely. Usually managed conservatively but may require immediate evacuation to prevent potential harm to the spinal cord. Predisposing factors can be spontaneous or iatrogenic. Read More

Eur J Case Rep Intern Med 2021 10;8(5):002593. Epub 2021 May 10.

Service de Médecine Interne, Diabète et Maladies Métaboliques, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.

A 74-year-old patient anticoagulated with rivaroxaban for chronic atrial fibrillation presented to the emergency department with acute lumbar pain with progressive weakness of the lower limbs and inability to stand up. No previous trauma was reported. Neurological examination was consistent with a complete spinal cord syndrome at the level of T6. Read More

J Wound Care 2021 Jun;30(6):476-481

Conflict Medicine Program, Global Health Institute, American University of Beirut, Lebanon.

Objective: A surgical approach to the treatment of spinal defects and disorders has become more common because of the medical and technological advancements achieved in the last decade. This rising trend in spinal surgeries is associated with adverse events, most notably wound complications. From its introduction, negative pressure wound therapy (NPWT) has proved to be essential in the management of complex wounds and in speeding up wound recovery. Read More