Spinal hamartoma in a neonate: Unusual presentation and MR imaging findings

We report an extremely rare case of a congenital spinal cord hamartoma in a male neonate who presented with upper extremity weakness and a port wine stain on the right upper extremity and chest. MR imaging findings are described, and the importance of localizing the lesion in the spinal canal with respect to the dura and its impact on neurosurgical management is stressed.     

Lingual hamartoma in an infant: CT and MR imaging

Lingual hamartoma is a rare tongue mass, primarily diagnosed in childhood. In most cases in the literature, the masses were surgically removed without preoperative imaging. There are only 3 cases reported in the clinical literature that describe preoperative imaging findings. We report the clinical and imaging findings in an infant with lingual hamartoma and review the literature.     

An elderly man with bilateral lung disease

A 60-year-old man with a past history of sprue was admitted with cough and dyspnea and was found to have diffuse, bilateral interstitial lung disease with Kerley-B lines and pleural effusions. An open lung biopsy revealed a diffuse lymphatic infiltration of the interstitium with lymphocytes which were judged to be neoplastic rather than inflammatory. Thus non-Hodgkin's lymphoma was diagnosed. A good response to therapy was obtained.     

Spinal reflex plasticity in response to alpine skiing in the elderly

The present study was designed to assess the influence of 12 weeks (28.5 ± 2.6 skiing days) of alpine skiing on spinal reflex plasticity, strength and postural control in senior citizens. Therefore, soleus H-reflexes and postural stability were measured during bipedal quiet and unstable stance in 22 (12 male and 10 female) elderly subjects aged 66.6 ± 1 years. Furthermore, the maximal isometric force was determined in a leg press. The results showed an increased H-reflex excitability after the training (+39%; P<0.05) while no changes occurred in the background EMG. The postural sway decreased after training (-6.6 cm; P ≤ 0.05) and the maximal force increased (+16.1%; P<0.05). No adaptations in any parameter could be observed in the control group. The present study demonstrated that skiing training was effective to alter the spinal reflex activity in elderly individuals. The increased H-reflexes correspond to adaptations known from strength training in young subjects. It may be assumed that alpine skiing induced a functional adaptation in that subjects have learned to integrate Ia afferent feedback more efficiently to ensure adequate motoneuron output.     

Sudden collapse after minor head injury in an elderly man; association with cardiocerebral decompensation and fat embolism syndrome

An 86-year-old man suffering from right hemiparesis and dementia fell from a stretcher and sustained laceration and bruising to his right eyebrow. He was brought to an emergency room, and his wounds were treated. Shortly after discharge, his respiratory and mental status dramatically declined. Despite supportive care, he died about three hours after re-admission. Autopsy revealed a minor laceration to the eyebrow with minor intracranial injuries, mild cardiomegaly (370 g) with right atrial dilatation, pericardial effusion (170 ml) and marked pulmonary edema. Microscopically, fatty droplets were observed in the lung capillaries, the glomeruli and the intracerebral vessels. Although the extent of the original injuries seemed insufficient to cause systemic fat embolism syndrome (FES), the patient's decreased cardiac reserves and stress associated with this event likely contributed to his death consistent with the physiochemical model of FES pathogenesis.     

Spinal cord vascularity. I. Extraspinal sources of spinal cord arteries in man.

The arrangement of extraspinal sources of the spinal cord arterial supply in man is more complicated than previously described, especially with regard to the origin and branching of the aortic segmental arteries. The fact that other arteries in the neck than the vertebral artery, such as the costo-cervical trunk and the ascending cervical artery may contribute to the supply of the cervical cord is confirmed, and also the occurrence of two or more spinal branches from different sources entering the same intervertebral foramen. Frequent occurrence of two or more segmental arteries arising from a common stem and variations in the branching of the subcostal arteries were found; their functional significance on the spinal cord circulation is not known. The fact that no significant anterior root artery was ever seen at the level of the vascular anomaly suggests that the anomaly is of no clinical importance. Nevertheless, obstruction of a common stem entail the risk of spinal cord infarction due to involvement of an important posterior root artery. On the other hand, the spinal cord seems to be fairly well protected against ischaemic injury following limited interference with the extraspinal arteries due to a profuse supply of intra- and extraspinal collaterals.     

Presurgical embolization of neurogenic hamartoma in an infant. A case report.

The vessels supplying a rare congenital tumor (neurogenic hamartoma) were deliberately occluded by emboli. This extensive tumor presented both in the oropharynx and in the left middle cranial fossa. Using a 3.7 French catheter, Gelfoam emboli suspended in contrast medium were injected into the vessels of the tumor under fluoroscopic visualization. The once vacular tumor was then removed in two stages with little blood loss.