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Yaginuma K, Watanabe M, Saito Y, Takahashi N, Ohara Y, Kobayashi S, Mochizuki K, Suyama K, Sato M, Sano H, Hashimoto K, Kikuta A, Hosoya M. Pneumorrhachis in children: A report of two cases and review of the literature. Radiol Case Rep 2019; 14:1325-1329. [PMID: 31516647 PMCID: PMC6732755 DOI: 10.1016/j.radcr.2019.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/05/2019] [Accepted: 08/09/2019] [Indexed: 10/26/2022] Open
Abstract
Pneumorrhachis refers to the clinical presentation of air within the spinal canal, and it is rarely associated with pneumomediastinum, particularly in young children. Pneumorrhachis associated with pneumomediastinum is generally asymptomatic. Here we report 2 unusual cases involving very young children with pneumorrhachis secondary to pneumomediastinum and present a review of the relevant literature. Case 1 involved a 4-year-old girl who presented with wheezing, violent coughing, and dyspnea associated with bronchiolitis. Case 2 involved a 3-year-old boy who presented with wheezing, violent coughing, and dyspnea associated with interstitial pneumonia possibly caused by graft-versus-host disease with human herpesvirus 6 infection after allogeneic hematopoietic stem cell transplantation. In both cases, pneumorrhachis improved with oxygen inhalation therapy and treatment of the underlying disease. Pneumorrhachis is rarely associated with neurological problems; however, decompressive laminectomy may be indicated to relieve the air block. Because pneumorrhachis is rare in children and neurological sequelae may be difficult to identify, close clinical, and radiographic observations are necessary. Plain radiography is not sufficient, and computed tomography should be performed to rule out intraspinal air.
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Affiliation(s)
- Kazufumi Yaginuma
- Department of Pediatrics, Fukushima Medical University, 1 Hikarigaoka, Fukushima-shi, Fukushima 960-1295, Japan
| | - Masahiro Watanabe
- Department of Pediatrics, Fukushima Medical University, 1 Hikarigaoka, Fukushima-shi, Fukushima 960-1295, Japan
| | - Yasushi Saito
- Department of Pediatrics, Fukushima Medical University, 1 Hikarigaoka, Fukushima-shi, Fukushima 960-1295, Japan
| | - Nobuhisa Takahashi
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
| | - Yoshihiro Ohara
- Department of Pediatrics, Fukushima Medical University, 1 Hikarigaoka, Fukushima-shi, Fukushima 960-1295, Japan
| | - Shogo Kobayashi
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
| | - Kazuhiro Mochizuki
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
| | - Kazuhide Suyama
- Department of Pediatrics, Fukushima Medical University, 1 Hikarigaoka, Fukushima-shi, Fukushima 960-1295, Japan
| | - Masatoki Sato
- Department of Pediatrics, Fukushima Medical University, 1 Hikarigaoka, Fukushima-shi, Fukushima 960-1295, Japan
| | - Hideki Sano
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
| | - Koichi Hashimoto
- Department of Pediatrics, Fukushima Medical University, 1 Hikarigaoka, Fukushima-shi, Fukushima 960-1295, Japan
| | - Atsushi Kikuta
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
| | - Mitsuaki Hosoya
- Department of Pediatrics, Fukushima Medical University, 1 Hikarigaoka, Fukushima-shi, Fukushima 960-1295, Japan
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Hartley R, Baldi S, Brightling C, Gupta S. Novel imaging approaches in adult asthma and their clinical potential. Expert Rev Clin Immunol 2015; 11:1147-62. [PMID: 26289375 DOI: 10.1586/1744666x.2015.1072049] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Currently, imaging in asthma is confined to chest radiography and CT. The emergence of new imaging techniques and tremendous improvement of existing imaging methods, primarily due to technological advancement, has completely changed its research and clinical prospects. In research, imaging in asthma is now being employed to provide quantitative assessment of morphology, function and pathogenic processes at the molecular level. The unique ability of imaging for non-invasive, repeated, quantitative, and in vivo assessment of structure and function in asthma could lead to identification of 'imaging biomarkers' with potential as outcome measures in future clinical trials. Emerging imaging techniques and their utility in the research and clinical setting is discussed in this review.
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Affiliation(s)
- Ruth Hartley
- a 1 Department of Infection, Inflammation and Immunity, Institute for Lung Health, University of Leicester, Leicester, LE3 9QP, UK
| | - Simonetta Baldi
- a 1 Department of Infection, Inflammation and Immunity, Institute for Lung Health, University of Leicester, Leicester, LE3 9QP, UK
| | - Chris Brightling
- a 1 Department of Infection, Inflammation and Immunity, Institute for Lung Health, University of Leicester, Leicester, LE3 9QP, UK
| | - Sumit Gupta
- a 1 Department of Infection, Inflammation and Immunity, Institute for Lung Health, University of Leicester, Leicester, LE3 9QP, UK.,b 2 Radiology Department, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, LE3 9QP, UK
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Gokhale S, Gokhale S. A case of spontaneous extracranial epidural emphysema. Med Princ Pract 2013; 23:177-9. [PMID: 23949596 PMCID: PMC5586849 DOI: 10.1159/000353465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 05/29/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To report a rare case of spontaneous extracranial epidural emphysema. CLINICAL PRESENTATION AND INTERVENTION An 18-year-old woman with a recent diagnosis of squamous cell carcinoma of the esophagus presented with acute onset of cough, dyspnea and subcutaneous emphysema. An esophageal endoscopy revealed an ulcerative lesion in the upper third of the esophagus that was diagnosed as squamous cell carcinoma. A computed tomographic scan of the chest showed spinal epidural emphysema in addition to pneumomediastinum and pneumoperitoneum. A few days later, the patient died of aspiration pneumonia and persistent epidural emphysema. CONCLUSION The spontaneous extracranial epidural emphysema in our case resulted from a bout of cough with tracking of air from the pneumomediastinum through the emaciated tissue planes into the epidural space.
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Affiliation(s)
- Sankalp Gokhale
- Department of Neurology, Duke University School of Medicine, Durham, N.C., USA
| | - Sanjay Gokhale
- Department of Pediatrics, Rajhans Hospital, Saphale, India
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