JaLCDOI 10.18926/AMO/55441
フルテキストURL 71_5_427.pdf
著者 Nagata, Kosei| Chikuda, Hirotaka| Inokuchi, Koichi| Ishii, Keisuke| Kobayashi, Atsuki| Kanai, Hiroyuki| Miyoshi, Kota|
抄録 Cervical spine dislocation and fracture of a transverse process are isolated risk factors for vertebral artery injuries (VAIs), which can cause a life-threatening ischemic stroke. Since in vivo experiments are not possible, it has not been unclear whether damage to or extension of vertebral arteries is more predictive of a VAI. To identify the imaging characteristics associated with VAI, we analyzed 36 vertebral arteries from 22 cervical spine dislocation patients who underwent computed tomography angiography (Aug. 2008-Dec. 2014). We evaluated (1) the posttraumatic elongation of the vertebral artery and (2) the presence of fracture involving the transverse foramen. VAI was found in 20 (56%) of the 36 vertebral arteries. The rate of residual shift (vertebral artery elongation) was not markedly different between the VAI and no-VAI groups. However, the rate of >1 mm displacement into the foramen and that of fracture with gross displacement (≥2 mm) differed significantly between the groups. We found that greater displacement of fractured transverse processes with cervical spine dislocation was a risk factor for VAI. These results suggest that direct damage to the vertebral arteries by transverse process fragments is more likely to predict a VAI compared to elongation, even in cervical spine dislocation.
キーワード vertebral artery injury cervical spine dislocation CT angiography transverse process vertebral artery elongation
Amo Type Original Article
発行日 2017-10
出版物タイトル Acta Medica Okayama
71巻
5号
出版者 Okayama University Medical School
開始ページ 427
終了ページ 432
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 29042701
JaLCDOI 10.18926/AMO/54501
フルテキストURL 70_4_261.pdf
著者 Nagata, Kosei| Yamamoto, Shinichi| Miyoshi, Kota| Sato, Masaki| Arino, Yusuke| Mikami, Yoji|
抄録 Eosinophilic granulomatosis with polyangiitis (EGPA, Churg-Strauss syndrome) is a rare systemic vasculitis and is difficult to diagnose. EGPA has a number of symptoms including peripheral dysesthesia caused by mononeuropathy multiplex, which is similar to radiculopathy due to lumbar disc hernia or lumbar spinal stenosis. Therefore, EGPA patients with mononeuropathy multiplex often visit orthopedic clinics, but orthopedic doctors and spine neurosurgeons have limited experience in diagnosing EGPA because of its rarity. We report a consecutive series of patients who were initially diagnosed as having lumbar disc hernia or lumbar spinal stenosis by at least 2 medical institutions from March 2006 to April 2013 but whose final diagnosis was EGPA. All patients had past histories of asthma or eosinophilic pneumonia, and four out of five had peripheral edema. Laboratory data showed abnormally increased eosinophil counts, and nerve conduction studies of all patients revealed axonal damage patterns. All patients recovered from paralysis to a functional level after high-dose steroid treatment. We shortened the duration of diagnosis from 49 days to one day by adopting a diagnostic algorithm after experiencing the first case.
キーワード eosinophilic granulomatosis with polyangiitis mononeuropathy multiplex lumbar disc hernia lumbar spinal stenosis nerve conduction study
Amo Type Case Report
発行日 2016-08
出版物タイトル Acta Medica Okayama
70巻
4号
出版者 Okayama University Medical School
開始ページ 261
終了ページ 268
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2016 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 27549670
Web of Sience KeyUT 000384748600005