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1.
J Neurol Surg A Cent Eur Neurosurg ; 84(2): 212-215, 2023 Mar.
Article in English | MEDLINE | ID: mdl-34126639

ABSTRACT

Vitamin K antagonists have been frequently prescribed as anticoagulants with the potential side effect of spontaneous hematomyelia with a poor prognosis. However, to our knowledge, there has been no report of spontaneous hematomyelia combined with the use of a non-vitamin K antagonist. A 63-year-old man presented with left leg weakness, impaired sensation, and urinary retention while taking rivaroxaban (non-vitamin K antagonist) for 4 months for atrial fibrillation. Anticoagulant agents were discontinued. Methylprednisolone pulse therapy was administered without surgical hematoma evacuation. Three months after the initial development of the hematomyelia, the symptoms improved to grade 5 for both lower extremities, and there was complete recovery in sensory and urinary functions. This might be the first description of a complete recovery of neurologic deficits without hematoma evacuation in spontaneous hematomyelia patients caused by non-vitamin K antagonist therapy.


Subject(s)
Atrial Fibrillation , Spinal Cord Vascular Diseases , Stroke , Male , Humans , Middle Aged , Anticoagulants/adverse effects , Rivaroxaban/adverse effects , Atrial Fibrillation/chemically induced , Atrial Fibrillation/complications , Atrial Fibrillation/drug therapy , Spinal Cord Vascular Diseases/chemically induced , Spinal Cord Vascular Diseases/complications , Spinal Cord Vascular Diseases/drug therapy , Hematoma/complications , Stroke/etiology
2.
Int J Neurosci ; 132(1): 77-88, 2022 Jan.
Article in English | MEDLINE | ID: mdl-33045891

ABSTRACT

OBJECTIVE: Microglial activation is an essential pathological mechanism of spinal cord ischemia-reperfusion injury (SCIRI). Previous studies showed dexmedetomidine (DEX) could alleviate SCIRI while the mechanism was not clear. This study aims to investigate the role of DEX in microglial activation and clarify the underlying mechanism. METHODS: The motion function of mice was quantified using the Basso Mouse Scale for Locomotion. The expression of long non-coding RNA (lncRNA) small nucleolar RNA host gene 14 (SNHG14) was determined by qRT-PCR. The expression of high-mobility group box 1 (HMGB1) was measured by western blot. The activation of microglia was evaluated by the expression of ED-1 and the levels of TNF-α and IL-6. The interplay between SNHG14 and HMGB1 was confirmed with RNA pull-down and RIP assay. The stability of HMGB1 was measured by ubiquitination assay and cycloheximide-chase assay. RESULTS: DEX inhibited microglial activation and down-regulated SNHG14 expression in SCIRI mice and oxygen and glucose deprivation/reoxygenation (OGD/R)-treated primary microglia. Functionally, SNHG14 overexpression reversed the inhibitory effect of DEX on OGD/R-induced microglial activation. Further investigation confirmed that SNHG14 bound to HMGB1, positively regulated HMGB1 expression by enhancing its stability. In addition, the silence of HMGB1 eliminated the pro-activation impact of SNHG14 overexpression on DEX-treated microglia under the OGD/R condition. Finally, in vivo experiments showed SNHG14 overexpression abrogated the therapeutic effect of DEX on SCIRI mice by up-regulating HMGB1. CONCLUSION: DEX accelerated HMGB1 degradation via down-regulating SNHG14, thus inhibiting microglial activation in SCIRI mice.


Subject(s)
Dexmedetomidine/pharmacology , HMGB1 Protein/drug effects , Microglia/drug effects , RNA, Long Noncoding/drug effects , Reperfusion Injury/drug therapy , Spinal Cord Vascular Diseases/drug therapy , Animals , Behavior, Animal , Disease Models, Animal , Locomotion/drug effects , Mice , Signal Transduction/drug effects
3.
J Stroke Cerebrovasc Dis ; 25(6): 1552-6, 2016 Jun.
Article in English | MEDLINE | ID: mdl-27012218

ABSTRACT

We report a case of left upper cervical posterior spinal artery (PSA) syndrome caused by atherosclerosis of the left vertebral artery. A 70-year-old female experienced sudden dizziness and paralysis of the left upper and lower limbs. Diffusion-weighted magnetic resonance imaging (DWI) of the brain showed high signal intensity at the vermis and lower left hemisphere of the cerebellum, and magnetic resonance angiography showed that the entire left vertebral artery was thin. The patient was treated with an intravenous infusion of tissue plasminogen activator 2 hours after symptom onset and made a full recovery. Repeat DWI, fluid-attenuated inversion recovery images, and T2-weighted images showed high signal intensity in the left upper cervical PSA area from the lower medulla oblongata to the C2 level in addition to the cerebellum. Previously reported cases of cervical posterior artery syndrome are reviewed.


Subject(s)
Atherosclerosis/complications , Cervical Vertebrae/blood supply , Spinal Cord Vascular Diseases/etiology , Vertebral Artery/diagnostic imaging , Adult , Aged , Aged, 80 and over , Atherosclerosis/diagnosis , Atherosclerosis/drug therapy , Atherosclerosis/physiopathology , Diffusion Magnetic Resonance Imaging , Female , Humans , Infusions, Intravenous , Magnetic Resonance Angiography , Male , Middle Aged , Platelet Aggregation Inhibitors/therapeutic use , Spinal Cord Vascular Diseases/diagnostic imaging , Spinal Cord Vascular Diseases/drug therapy , Spinal Cord Vascular Diseases/physiopathology , Thrombolytic Therapy , Tissue Plasminogen Activator/administration & dosage , Treatment Outcome , Vertebral Artery/physiopathology , Young Adult
4.
J Spinal Cord Med ; 33(1): 85-9, 2010.
Article in English | MEDLINE | ID: mdl-20397450

ABSTRACT

BACKGROUND/OBJECTIVE: Many atherothrombotic complications are associated with coronary angiography. Spinal cord embolism with high morbidity and mortality is one of these complications. METHODS: Case report. RESULTS: A 65-year-old woman was admitted to the hospital with acute myocardial infarction. Immediately after coronary angiography, she complained of paresthesia and paraparesis of her legs. Magnetic resonance imaging (MRI) detected hyperintensity at the level of the conus medullaris. Antiaggregant therapy and a physiotherapy program continued. After 2 months, clinical and MRI findings had improved. CONCLUSIONS: Invasive procedures such as coronary angiography can lead to serious atherothrombotic complications.


Subject(s)
Coronary Angiography/adverse effects , Embolism/etiology , Spinal Cord Vascular Diseases/etiology , Aged , Coronary Angiography/methods , Embolism/complications , Embolism/drug therapy , Embolism/rehabilitation , Female , Functional Laterality/physiology , Humans , Magnetic Resonance Imaging , Myocardial Infarction/diagnosis , Platelet Aggregation Inhibitors/therapeutic use , Spinal Cord Vascular Diseases/complications , Spinal Cord Vascular Diseases/drug therapy , Spinal Cord Vascular Diseases/rehabilitation
5.
Spinal Cord ; 39(12): 657-61, 2001 Dec.
Article in English | MEDLINE | ID: mdl-11781864

ABSTRACT

STUDY DESIGN: A case report of an upper thoracic spinal subdural hemorrhage which was managed successfully by conservative treatment. OBJECTIVES: Spinal subdural hemorrhage is rare and can cause serious neurologic symptoms. Surgery is the most common treatment and is believed to prevent further neurologic injury. A case of an upper thoracic spinal subdural hemorrhage which was managed successfully by conservative therapy is reported. SETTING: Department of Orthopaedic Surgery, Tokai University School of Medicine, Isehara, Japan. METHODS: A 29-year-old woman presented with acute severe back pain. She experienced acutely developed weakness of both lower extremities, hypesthesia below T6 and urinary retention. Magnetic resonance imaging performed on the day of hospital admission revealed the existence of a subdural hematoma in the upper thoracic spine. Muscle strength of the lower extremities was grade 0 on admission, but improved slightly on day 1. The decision was made to manage the patient nonoperatively by corticosteroid and diuretic administration. RESULTS: Improvement was gradual but progressive. Muscle strength was grade 4 out of 5 on the 28th day. Magnetic resonance imaging at 3 months except for mild urinary retention. CONCLUSIONS: Spinal subdural hemorrhage can be treated nonoperatively by correlating magnetic resonance image findings with the clinical condition.


Subject(s)
Hematoma, Subdural, Acute/drug therapy , Hemostatics/administration & dosage , Methylprednisolone/administration & dosage , Spinal Cord Vascular Diseases/drug therapy , Thoracic Vertebrae/pathology , Adult , Drug Therapy, Combination , Female , Follow-Up Studies , Hematoma, Subdural, Acute/diagnosis , Humans , Magnetic Resonance Imaging/methods , Spinal Cord Vascular Diseases/diagnosis , Treatment Outcome
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