Emergency radiology
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Emergency radiology · Apr 2011
Case ReportsImaging findings in spinal subarachnoid hemorrhage in patient with hemophilia A: an unusual cause for back pain.
Back pain and presentation with spinal canal hemorrhage in hemophilia is not common; however, these are significant clinical issues and may lead to significant neurological issues and morbidity. We present an interesting case of severe back pain in a young patient with moderate hemophilia A. Imaging confirmed subarachnoid hemorrhage in the spinal canal without intracranial hemorrhage. ⋯ We also describe the anatomy and imaging features of hemorrhage in the different spinal canal compartments, including the subarachnoid space. Spinal canal hemorrhage in hemophilia is an emergency and serious condition and must be diagnosed and treated promptly. It is important to be aware of the diagnostic features of the spinal canal hemorrhage and carefully assess the spinal canal in hemophiliacs on cross-sectional studies.
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Emergency radiology · Jan 2011
ReviewApplication of imaging guidelines in patients with suspected cervical spine trauma: retrospective analysis and literature review.
Safe and efficient clearance of cervical spine injury in blunt trauma patients has been a controversial topic among health professionals. The increased availability of CT scanners in major trauma centers seems to be a factor that has led to increased number of unnecessary cervical spine imaging using this imaging modality. The objective of this study was to investigate the applicability and efficacy of a pre-test clinical criterion in order to stratify post-blunt trauma victims based on their risk of sustaining cervical spine injury and in turn recommend an appropriate imaging modality accordingly. ⋯ No patients with low-risk injuries were demonstrated to have a significant cervical spine injury. There was a statistically significant greater proportion of acute cervical spine injuries detected in the high-risk group (p value = 0.0024). Hence, using Goergen's diagnostic algorithm could reduce the number of unnecessary cervical spine CT scans ordered, while not compromising the quality of care in post-blunt trauma victims.
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Emergency radiology · Jan 2011
Review Case ReportsSurfer's myelopathy--an unusual cause of acute spinal cord ischemia: a case report and review of the literature.
Surfer's myelopathy is an emergent medical condition, representing a rare type of nontraumatic injury of the spinal cord, triggered by continued hyperextension of the back in inexperienced surfers. Subsequent acute spinal cord ischemia is the main pathological "substrate" for extensive cord myelopathy, determining potential neurological damage and thus predicting a patient's outcome. ⋯ We report a case of 23-year-old male in whom the diagnosis of surfer's myelopathy was made based on an appropriate clinical history and imaging findings compatible with acute spinal cord ischemia. We also discuss miscellaneous pathological conditions, causing acute myelopathy, which can mimic clinical signs or/and imaging appearance of this rare, but potentially disabling disorder.