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Kayastha SR, Pandey A, Pandey A, Keshari S, Pandey A. Hirayama disease successfully treated by posterior fixation: a case report. Ann Med Surg (Lond) 2024; 86:3708-3712. [PMID: 38846881 PMCID: PMC11152793 DOI: 10.1097/ms9.0000000000002076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/09/2024] [Indexed: 06/09/2024] Open
Abstract
Introduction and importance Hirayama disease is a rare form of motor neuron amyotrophy that usually presents with weakness and atrophy of the distal upper extremities in young males. It is believed that it is caused by spinal cord compression during neck flexion because of the widening of the posterior extradural space. This case has been brought to attention due to its extraordinary rarity, serving as an educational tool for medical professionals and to advocate for surgical intervention when deemed necessary. Case presentation The authors present a case of a young male in his 20s who was diagnosed with Hirayama disease, had weakness and atrophy in both of his upper limbs, and has been successfully treated by posterior fixation at C4, C5, and C6 with lateral mass screws. Clinical discussion The majority of cases stabilize after 2-3 years of progression; therefore, cervical collars are generally sufficient for therapy. However, in certain serious cases with progression even after that time, surgical intervention is an option. Because this is such an uncommon incidence, surgical therapy has not been explored and is controversial. Conclusion The use of posterior fixation at C4, C5, and C6 with lateral mass screws as a therapy for Hirayama disease may be regarded as a successful approach.
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Affiliation(s)
| | - Archana Pandey
- Kathmandu University School of Medical Sciences, Dhulikhel Hospital
| | | | - Suraj Keshari
- Kathmandu University School of Medical Sciences, Dhulikhel Hospital
| | - Ajit Pandey
- Kathmandu University School of Medical Sciences, Dhulikhel Hospital
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2
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Yun JH, Jung C, Kim EJ, Park J, Yeom J, Jung JS, Kim KE. Characteristics of Hirayama Disease in Young South Korean Soldiers. J Clin Neurol 2024; 20:293-299. [PMID: 38330418 PMCID: PMC11076185 DOI: 10.3988/jcn.2023.0244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/26/2023] [Accepted: 10/03/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND AND PURPOSE The purpose of this study was to describe the clinical presentation and features in electrodiagnostic and imaging investigations of young South Korean males diagnosed with Hirayama disease (HD). METHODS We reviewed the electronic medical records of South Korean enlisted soldiers who were diagnosed with HD and discharged from military service during 2011-2021. We investigated the clinical characteristics and results of electrodiagnostic and magnetic resonance imaging (MRI) investigations. We analyzed laterality and identified the involved muscles using needle electromyography (EMG). Loss of lordosis, localized cervical cord atrophy, loss of attachment between the posterior dura and subjacent lamina, asymmetric flattening of the cord, crescent-shaped mass in the posterior epidural space, and noncompressive intramedullary T2-weighted high signal intensity were investigated using neutral- or flexion-position MRI. RESULTS Forty-two male patients aged 20.2±0.8 years (mean±standard deviation) were identified. All patients complained of hand weakness, and 10 complained of hand tremor (23.8%). Four patients (9.5%) had symptoms in both upper limbs, and five (11.9%) had sensory disturbances. Needle EMG revealed that muscles in the C7-T1 myotome were commonly involved, and C5-C6 involvement of the deltoid (10.5%) and biceps brachii (12.5%) was also observed. In cervical MRI, localized cord atrophy (90.0%) was the most characteristic finding, and cord atrophy was most severe at the C5-C6 level (58.3%). CONCLUSIONS This is the first description of a large number of patients with HD in South Korea. The clinical presentation and features found in electrodiagnostic and imaging investigations will improve the understanding of HD in the young South Korean male population.
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Affiliation(s)
- Jae-Hyun Yun
- Department of Rehabilitation Medicine, Armed Forces Capital Hospital, Seongnam, Korea
| | - Chul Jung
- Department of Rehabilitation Medicine, Armed Forces Capital Hospital, Seongnam, Korea
| | - Eun Jin Kim
- Department of Rehabilitation Medicine, Armed Forces Capital Hospital, Seongnam, Korea
| | - Jaechan Park
- Department of Rehabilitation Medicine, Armed Forces Capital Hospital, Seongnam, Korea
| | - Jiwoon Yeom
- Department of Rehabilitation Medicine, Armed Forces Capital Hospital, Seongnam, Korea
| | - Ji Su Jung
- Department of Rehabilitation Medicine, Armed Forces Capital Hospital, Seongnam, Korea
| | - Kyoung-Eun Kim
- Department of Rehabilitation Medicine, Armed Forces Capital Hospital, Seongnam, Korea
- Clinical Medical Research Center, Armed Forces Capital Hospital, Seongnam, Korea.
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Sol N, Hartman J, Ten Kate M, van Kempen Z, van der Kooi A, Vandertop P, Tuinman PR, van Oosten B. Successful treatment of respiratory failure in Hirayama disease. Am J Emerg Med 2024; 76:272.e3-272.e5. [PMID: 38072732 DOI: 10.1016/j.ajem.2023.11.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 11/25/2023] [Indexed: 01/22/2024] Open
Abstract
Hirayama disease is a self-limiting cervical motor neuron disease, usually affecting the spinal cord at level C7-T1. We share an unusual case of Hirayama disease in a young man affecting roots C4-C6. He presented in coma due to diaphragm weakness and hypercapnic respiratory failure. Diagnosis was achieved via clinical presentation, neurophysiological examination, ultrasonography of the diaphragm and dynamic MR-imaging. Conservative treatment with a cervical collar resulted in remarkable improvement in respiratory and motor function.
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Affiliation(s)
- Nik Sol
- Department of Neurology, Amsterdam University Medical Center, the Netherlands.
| | - Joost Hartman
- Department of Intensive Care, Amsterdam University Medical Center, the Netherlands
| | - Mara Ten Kate
- Department of Radiology, Amsterdam University Medical Center, the Netherlands
| | - Zoé van Kempen
- Department of Neurology, Amsterdam University Medical Center, the Netherlands
| | - Anneke van der Kooi
- Department of Neurology, Amsterdam University Medical Center, the Netherlands
| | - Peter Vandertop
- Department of Neurosurgery, Amsterdam University Medical Center, the Netherlands
| | - Pieter-Roel Tuinman
- Department of Intensive Care, Amsterdam University Medical Center, the Netherlands
| | - Bob van Oosten
- Department of Neurology, Amsterdam University Medical Center, the Netherlands
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Abreu Tanure A, Rosifini Alves Rezende LG, Pazim AC, Leal Ribeiro M. Supercharged End-to-Side Anterior Interosseous to Ulnar Motor Nerve Transfer for Hirayama Disease: A Case Report. Hand (N Y) 2022; 17:NP12-NP16. [PMID: 34963323 PMCID: PMC9274879 DOI: 10.1177/15589447211063556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Hirayama disease is a rare condition of cervical myelopathy. Its early identification and correction can optimize functional outcomes. However, late presentation and some more severe cases may be associated with loss of hand function. Among the cases described, there are no reports of nerve transfers for this condition. We presented the first case report of a Hirayama disease of isolated ulnar nerve impairment managed with nerve transfer. Electroneuromyography showed isolated preganglionic involvement of C7, C8, and T1, with no sensory changes. The patient underwent nerve transfer with anterior interosseous nerve to ulnar nerve supercharge end-to-side, recovering hand function in 7 months.
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Affiliation(s)
| | - Luis Guilherme Rosifini Alves Rezende
- University of São Paulo, Brazil,Luis Guilherme Rosifini Alves Rezende, Hand Division of the Department of Orthopaedics, Traumatology and Anestesiology, Hospital of Clinics, Ribeirao Preto Medical School, University of Sao Paulo, 3900 Bandeirantes Avenue, Ribeirao Preto, Sao Paulo 14048900, Brazil.
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5
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Kusel K, Warne R, Lakshmanan R, Mason M, Bynevelt M, Shah S. Hirayama disease: the importance of flexion imaging. BJR Case Rep 2022; 8:20210105. [PMID: 35136641 PMCID: PMC8803229 DOI: 10.1259/bjrcr.20210105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 08/11/2021] [Accepted: 08/26/2021] [Indexed: 11/16/2022] Open
Abstract
Hirayama disease is a rare cervical myelopathy characterised by asymmetrical upper limb weakness and muscle atrophy in the forearm and hand. MRI of the cervical spine plays an essential role in diagnosis, however, the characteristic findings are often only seen when the patient is imaged with the neck in flexion. We present a case of a 15-year-old male who presented with left forearm and hand weakness with muscle wasting. An MRI of the cervical spine with the neck in a neutral position demonstrated atrophy of the spinal cord with intrinsic signal abnormality between C5 and C7. Further imaging with the patient’s neck in flexion demonstrated the hallmark features of Hirayama disease. There was anterior displacement of the thecal sac and spinal cord, and an enlarged, crescent-shaped dorsal epidural space which enhanced following i.v. gadolinium administration. The atrophic segment of cord contacted the posterior vertebral bodies when the neck was in full flexion. This case highlights the importance of imaging patients suspected of having this entity with the neck in full flexion in order to make a diagnosis.
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Affiliation(s)
- Kieran Kusel
- Department of Radiology, Perth Children’s Hospital, Nedlands, WA, Australia
| | - Richard Warne
- Department of Radiology, Perth Children’s Hospital, Nedlands, WA, Australia
| | - Rahul Lakshmanan
- Department of Radiology, Perth Children’s Hospital, Nedlands, WA, Australia
| | - Michael Mason
- Department of Radiology, Perth Children’s Hospital, Nedlands, WA, Australia
| | - Michael Bynevelt
- Neurological Intervention and Imaging Service of Western Australia, Perth Children’s Hospital, Nedlands, WA, Australia
| | - Snehal Shah
- Department of Neurology, Perth Children’s Hospital, Nedlands, WA, Australia
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6
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Choi HW. Fasciculations in Children. Pediatr Neurol 2021; 125:40-47. [PMID: 34628142 DOI: 10.1016/j.pediatrneurol.2021.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 08/19/2021] [Accepted: 08/28/2021] [Indexed: 11/26/2022]
Abstract
Fasciculations are the most common form of spontaneous muscle contraction. They frequently occur in healthy individuals. However, there are a minority of situations that fasciculations are observed in association with specific neurologic disorders. Publications concerning the evaluation of pediatric patients experiencing fasciculations are limited. These children may undergo invasive or expensive diagnostic investigations that are unnecessary. Moreover, without careful consideration of differential diagnoses, rare neuromuscular disorders that present with fasciculations in the pediatric age group can be under-recognized by pediatric neurologists. This review examines the most important pediatric disorders presenting with fasciculations and other spontaneous muscle contractions to guide pediatric neurologists in evaluating these children.
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Affiliation(s)
- Hyoung Won Choi
- Division of Pediatric Neurology, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Lemoyne, Pennsylvania.
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7
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Wang L, Wen H, Chen S, Wang H, Zheng Y, Chen R, Li J, Jiang K, Xiang H, Zhu M, Zhou M, Yao S, Hong D. Benign monomelic amyotrophy of lower limb in a cohort of chinese patients. Brain Behav 2021; 11:e02073. [PMID: 33650811 PMCID: PMC8035448 DOI: 10.1002/brb3.2073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/23/2020] [Accepted: 01/31/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Benign monomelic amyotrophy of lower limb (BMALL) is a neurogenic syndrome representing an unclear field. Further studies might be helpful to elucidate uncertainties regarding causation, outcome, and the risk of progression to amyotrophic lateral sclerosis (ALS). METHODS According to the inclusion and exclusion criteria, 37 patients with BMALL were retrospectively collected in three neuromuscular centers from January 2012 to October 2018. The detailed medical data were summarized. Multiple laboratory tests were examined. Routine electrophysiological examinations, muscle MRI of lower limbs, and muscle biopsy were conducted. RESULTS The cohort included 24 male and 13 female cases with median age of onset 47 years. Muscle MRI revealed that the distribution of involved muscles matched with the extent of fat infiltration, so the pattern muscle atrophy can be divided into the following four types: six patients with thigh atrophy (type I), 14 patients with leg atrophy (type II); 10 patients with disproportionate atrophy in both thigh and leg (type III); and seven patients with well-proportionate atrophy in both thigh and leg (type IV). Electrophysiological findings showed neurogenic pattern, spontaneous activity, and abnormal H reflex, which suggested a disorder of spinal anterior horn cell in the patients with types I-III. However, no electrophysiological abnormalities were found in the patients with type IV. Muscle pathology varied from almost normal pattern to advanced neurogenic pattern in nine biopsied patients. Follow-up showed that two patients with type II developed to ALS four years later, and all patients with type IV were in stable condition without any complaints. CONCLUSION Muscle MRI was useful to exactly localize the distribution of involved muscles in BMALL patients. The distribution of atrophic muscles can be roughly divided into four types based on the MRI features. The classification of distributing types might be as an indicator for the prognosis of BMALL.
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Affiliation(s)
- Lulu Wang
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Han Wen
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Shuyun Chen
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Huan Wang
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yilei Zheng
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ran Chen
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jingjing Li
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Kaiyan Jiang
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Haijie Xiang
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Min Zhu
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Meihong Zhou
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Sheng Yao
- Department of Neurology, The Sixth Medical Center of General PLA Hospital, Beijing, China
| | - Daojun Hong
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China.,Department of Neurology, Peking University People Hospital, Beijing, China
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8
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Sekioka A, Fukumoto K, Kawasaki T, Koyama M, Fujimoto Y, Miyake H, Nomura A, Yamada S, Kanai R, Makino A, Urushihara N. A 5-year-old boy with acute neurological disorder from anteflexion-induced cervical cord compression after tracheal surgery: Radiological findings similar to Hirayama disease. Int J Pediatr Otorhinolaryngol 2021; 140:110491. [PMID: 33213963 DOI: 10.1016/j.ijporl.2020.110491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/06/2020] [Accepted: 11/07/2020] [Indexed: 11/26/2022]
Abstract
Constant neck flexion has been considered crucial to reducing anastomotic tension after tracheal resection. However, in rare cases, anteflexion can cause cervical cord damage, leading to acute neurological disorders such as tetraplegia. Here, we report a case of 5-year-old boy presenting with acute neurological disorder triggered by a chin-to-chest position over 4 days of deep sedation after cricotracheal resection. The radiological findings would suggest a mechanism similar to Hirayama disease, in which a shift of the dura leads to chronic muscular weakness and atrophy in young populations.
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Affiliation(s)
- Akinori Sekioka
- Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan.
| | - Koji Fukumoto
- Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Tatsuya Kawasaki
- Department of Pediatric Critical Care, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Masashi Koyama
- Department of Radiology, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Yoh Fujimoto
- Department of Orthopedics, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Hiromu Miyake
- Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Akiyoshi Nomura
- Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Susumu Yamada
- Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Risa Kanai
- Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Akihiro Makino
- Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Naoto Urushihara
- Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan
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9
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Idiculla PS, Govindarajan R. A Case of Cervical Spondylotic Amyotrophy Mimicking Amyotrophic Lateral Sclerosis. Case Rep Neurol 2020; 12:314-320. [PMID: 33082770 PMCID: PMC7548943 DOI: 10.1159/000509684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 06/21/2020] [Indexed: 11/21/2022] Open
Abstract
Cervical spondylotic amyotrophy (CSA) is a rare clinical condition characterized by weakness and atrophy of the upper limb with minimal to no associated sensory deficits. The detection of the disease is based on clinical features at presentation, neurological examination, electrophysiological studies, and imaging. The proposed pathophysiological mechanisms include selective damage to the ventral root or anterior horn cells of the spinal cord. Depending on the muscle groups that are involved, CSA is broadly classified into a proximal type and a distal type. The clinical profiles of patients with CSA and ALS have a very close resemblance to each other, especially at the early stages of the disease. Cervical spine magnetic resonance imaging (MRI) may show T2 hyperintensity in both proximal and distal types. Electromyogram demonstrates denervation potentials and reduced motor unit potentials in the affected muscles. The conservative management is often the first-line modality, and those who fail to respond to conservative treatment have severe muscular atrophy and weakness, and distal-type CSA are considered potential candidates for surgery. We present the case of a 57-year-old female who presented with a 1-year history of left-hand weakness and wasting with no sensory deficits. She denied any involvement of her other hand or bilateral lower limbs, and she was referred to our clinic with the potential diagnosis of amyotrophic lateral sclerosis (ALS). An elaborate history, physical examination, electrophysiological studies, and imaging assisted us in reaching the diagnosis of CSA, 1 year after the onset of symptoms.
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10
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Shah AS, Yahanda AT, Athiraman U, Tempelhoff R, Chicoine MR. Spinal cord infarction with resultant paraplegia after Chiari I decompression: case report. J Neurosurg Spine 2020; 32:615-621. [PMID: 31860815 DOI: 10.3171/2019.10.spine19921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 10/22/2019] [Indexed: 11/06/2022]
Abstract
Paraplegia after posterior fossa surgery is a rare and devastating complication. The authors reviewed a case of paraplegia following Chiari decompression and surveyed the literature to identify strategies to reduce the occurrence of such events.An obese 44-year-old woman had progressive left arm pain, weakness, and numbness and tussive headaches. MRI studies revealed a Chiari I malformation and a cervicothoracic syrinx. Immediately postoperatively after Chiari decompression the patient was paraplegic, with a T6 sensory level bilaterally. MRI studies revealed equivocal findings of epidural hematoma at the site of the Chiari decompression and in the upper thoracic region. Surgical exploration of the Chiari decompression site and upper thoracic laminectomies identified possible venous engorgement, but no hematoma. Subsequent imaging suggested a thoracic spinal cord infarction. Possible explanations for the spinal cord deficit included spinal cord ischemia related to venous engorgement from prolonged prone positioning in an obese patient in the chin-tucked position. At 6.5 years after surgery the patient had unchanged fixed motor and sensory deficits.Spinal cord infarction is rare after Chiari decompression, but the risk for this complication may be increased for obese patients positioned prone for extended periods of time. Standard precautions may be insufficient and intraoperative electrophysiological monitoring may need to be considered in these patients.
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Affiliation(s)
| | | | | | - Rene Tempelhoff
- 2Anesthesia, Washington University School of Medicine, St. Louis, Missouri
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11
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Song J, Cui ZY, Chen ZH, Jiang JY. Analysis of the Effect of Surgical Treatment for the Patients with Hirayama Disease from the Perspective of Cervical Spine Sagittal Alignment. World Neurosurg 2019; 133:e342-e347. [PMID: 31562968 DOI: 10.1016/j.wneu.2019.09.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 09/03/2019] [Accepted: 09/05/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study was carried out to analyze the surgical effect of cervical spine sagittal alignment for patients with Hirayama disease (HD). METHODS Forty-four subjects were retrospectively analyzed for the parameters of cervical spine sagittal alignment. The case group consisted of 23 patients with HD, whereas the control group consisted of 21 healthy adolescent subjects. Pre- and postoperative cervical spine sagittal parameters of the patients with HD were collected; the cervical sagittal parameters of the healthy adolescent subjects were also collected. Sagittal alignment parameters were compared between the patients with HD and the healthy adolescent subjects, and between the pre- and postoperative parameters for the patients with HD. RESULTS Forty-four subjects completed the follow-up, with the average follow-up period being 18.0 months. No significant differences were detected between the HD and control groups for clinical parameters (P > 0.05). The preoperative HD group had smaller values compared with the control group in the sagittal parameters of C2-7 cervical lordosis (CL) angle, T1 slope, thoracic inlet angle (TIA), and cervical tilt angle (P < 0.05). For the patients with HD, the preoperative values were smaller compared with the postoperative HD values for the parameters of C2-7 CL angle, T1 slope, and cervical tilt angle (P < 0.05). We found no significant differences between the postoperative patients with HD and the healthy subjects, including C2-7 CL angle, C2-7 sagittal vertical axis, T1 slope, TIA, neck tilt angle, cervical tilt angle, and cranial tilt angle (P > 0.05). CONCLUSIONS Patients with HD have sagittal imbalance of the cervical spine compared with age-matched healthy adolescent subjects, and surgical treatment could correct the sagittal imbalance.
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Affiliation(s)
- Jian Song
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhong-Yi Cui
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhen-Hao Chen
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Jian-Yuan Jiang
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China.
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Freeman CW, Lazor JW, Loevner LA, Nabavizadeh SA. Variations of the CNS Venous System Mimicking Pathology: Spectrum of Imaging Findings. J Neuroimaging 2019; 29:673-688. [DOI: 10.1111/jon.12664] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/05/2019] [Accepted: 09/06/2019] [Indexed: 12/18/2022] Open
Affiliation(s)
- Colbey W. Freeman
- Department of RadiologyHospital of the University of Pennsylvania Philadelphia PA
| | - Jillian W. Lazor
- Division of Neuroradiology, Department of RadiologyHospital of the University of Pennsylvania Philadelphia PA
| | - Laurie A. Loevner
- Division of Neuroradiology, Department of RadiologyHospital of the University of Pennsylvania Philadelphia PA
| | - Seyed Ali Nabavizadeh
- Division of Neuroradiology, Department of RadiologyHospital of the University of Pennsylvania Philadelphia PA
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14
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Small JE, Ho DT, Martin D. Hirayama Disease. Neuroradiology 2019. [DOI: 10.1016/b978-0-323-44549-8.00035-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Rosliakova A, Zakroyshchikova I, Bakulin I, Konovalov R, Kremneva E, Krotenkova M, Suponeva N, Zakharova M. Hirayama disease: analysis of cases in Russia. Neurol Sci 2018; 40:105-112. [PMID: 30284056 DOI: 10.1007/s10072-018-3588-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 09/25/2018] [Indexed: 10/28/2022]
Abstract
The fourteen cases of Hirayama disease (HD) are presented in this article. HD is seldom disease characterized by juvenile muscular atrophy of upper extremities and benign course. All cases were diagnosed in the Research Center of Neurology (Moscow, Russia) during the year 2015-2017. Such methods as MRI (magnetic resonance imaging), EMG (electromyography), and NCS (nerve conduction studies) have been used to confirm diagnosis of HD. Transcranial magnetic stimulation was used to exclude upper motor neuron involvement in two cases. The original scale of neurological disturbances in HD has been proposed by authors to reveal correlations of HD severity with age of patients and duration of disease.Most of patients with HD are young males with common clinical signs. Detected MRI and EMG data were also comparable with previous publications. Independence of HD severity from age and duration of the disease may be the result of individual physical characteristics of dura mater and other structures of the cervical vertebra. In some our cases, amyotrophic lateral sclerosis and other neurological disorders were misdiagnosed before. In view of different prognosis in these pathologies and possible correction of HD, early diagnosis is very important.
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16
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Salome M, Barkhof F, Visser L. Hirayama disease; an atypical clinical manifestation of a cervical myelopathy with typical MRI features. BMJ Case Rep 2017; 2017:bcr-2016-217780. [PMID: 28052949 DOI: 10.1136/bcr-2016-217780] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Mariet Salome
- Department of Neurology, Elisabeth TweeSteden Hospital, Tilburg, The Netherlands
| | - Frederik Barkhof
- Department of Radiology, VU Medical Centre, Amsterdam, The Netherlands
| | - Leo Visser
- Department of Neurology, Elisabeth TweeSteden Hospital, Tilburg, The Netherlands
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17
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Koutsis G, Velonakis G, Breza M, Karavasilis E, Zambelis T, Panas M. Neck flexion-induced finger tremor: A novel observation in Hirayama disease. J Neurol Sci 2016; 364:42-4. [DOI: 10.1016/j.jns.2016.03.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 02/07/2016] [Accepted: 03/04/2016] [Indexed: 11/29/2022]
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