Abstract
The objective of this study is to discuss the possible role of cervical posterior epidural plexus engorgement during cervical flexion in the pathogenesis of Hirayama myelopathy. In Hirayama disease, MRI during neck flexion often shows that the posterior dura detaches from the posterior arches compressing the spinal cord. Autopsies demonstrated asymmetric changes in the anterior horns consistent with chronic ischemic damage, attributed to arterial insufficiency during flexion or to microcirculatory changes due to compression by the tight dura. In a 15-year-old patient with 5-year history of distal upper limbs weakness, MRI demonstrated marked venous engorgement of the posterior epidural plexus in cervical flexion, confirmed by angiography. Laminectomy from C3 to C6 with duraplasty was performed. At one-year follow-up, the clinical condition of the patient remained stable. In Hirayama myelopathy, compression of the spinal cord by the tight dura is probably the most important pathogenetic factor. However, venous congestion in flexion might play an additional role in determining spinal cord ischemic changes.
| Original language | English |
|---|---|
| Pages (from-to) | 845-848 |
| Number of pages | 4 |
| Journal | Neurological Sciences |
| Volume | 31 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Dec 2010 |
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Keywords
- Cervical flexion myelopathy
- Epidural venous engorgement
- Hirayama disease
- Juvenile muscular atrophy of distal upper extremity
ASJC Scopus subject areas
- Clinical Neurology
- Psychiatry and Mental health
- Dermatology
Cite this
Angiographically proven cervical venous engorgement : A possible concurrent cause in the pathophysiology of Hirayama's myelopathy. / Ciceri, Elisa F.; Chiapparini, Luisa; Erbetta, Alessandra; Longhi, Laura; Cicardi, Benedetta; Milani, Nicoletta; Solero, Carlo Lazzaro; Savoiardo, Mario.
In: Neurological Sciences, Vol. 31, No. 6, 12.2010, p. 845-848.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Angiographically proven cervical venous engorgement
T2 - A possible concurrent cause in the pathophysiology of Hirayama's myelopathy
AU - Ciceri, Elisa F.
AU - Chiapparini, Luisa
AU - Erbetta, Alessandra
AU - Longhi, Laura
AU - Cicardi, Benedetta
AU - Milani, Nicoletta
AU - Solero, Carlo Lazzaro
AU - Savoiardo, Mario
PY - 2010/12
Y1 - 2010/12
N2 - The objective of this study is to discuss the possible role of cervical posterior epidural plexus engorgement during cervical flexion in the pathogenesis of Hirayama myelopathy. In Hirayama disease, MRI during neck flexion often shows that the posterior dura detaches from the posterior arches compressing the spinal cord. Autopsies demonstrated asymmetric changes in the anterior horns consistent with chronic ischemic damage, attributed to arterial insufficiency during flexion or to microcirculatory changes due to compression by the tight dura. In a 15-year-old patient with 5-year history of distal upper limbs weakness, MRI demonstrated marked venous engorgement of the posterior epidural plexus in cervical flexion, confirmed by angiography. Laminectomy from C3 to C6 with duraplasty was performed. At one-year follow-up, the clinical condition of the patient remained stable. In Hirayama myelopathy, compression of the spinal cord by the tight dura is probably the most important pathogenetic factor. However, venous congestion in flexion might play an additional role in determining spinal cord ischemic changes.
AB - The objective of this study is to discuss the possible role of cervical posterior epidural plexus engorgement during cervical flexion in the pathogenesis of Hirayama myelopathy. In Hirayama disease, MRI during neck flexion often shows that the posterior dura detaches from the posterior arches compressing the spinal cord. Autopsies demonstrated asymmetric changes in the anterior horns consistent with chronic ischemic damage, attributed to arterial insufficiency during flexion or to microcirculatory changes due to compression by the tight dura. In a 15-year-old patient with 5-year history of distal upper limbs weakness, MRI demonstrated marked venous engorgement of the posterior epidural plexus in cervical flexion, confirmed by angiography. Laminectomy from C3 to C6 with duraplasty was performed. At one-year follow-up, the clinical condition of the patient remained stable. In Hirayama myelopathy, compression of the spinal cord by the tight dura is probably the most important pathogenetic factor. However, venous congestion in flexion might play an additional role in determining spinal cord ischemic changes.
KW - Cervical flexion myelopathy
KW - Epidural venous engorgement
KW - Hirayama disease
KW - Juvenile muscular atrophy of distal upper extremity
UR - http://www.scopus.com/inward/record.url?scp=78650510272&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=78650510272&partnerID=8YFLogxK
U2 - 10.1007/s10072-010-0405-3
DO - 10.1007/s10072-010-0405-3
M3 - Article
C2 - 20857161
AN - SCOPUS:78650510272
VL - 31
SP - 845
EP - 848
JO - Neurological Sciences
JF - Neurological Sciences
SN - 1590-1874
IS - 6
ER -