Schistosomiasis of the Spina Cord,Conus and Cauda
スポンサーリンク
概要
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Schistosomiasis of the spinal cord and especially of the conus and cauda is to the mind of the author not rare. The author′s collection of five cases in nearly two years is presented. All cases came to surgery and were verified histologically. Two were diagnosed preoperatively.The literature on the subject is studied and presented. The mode of infestation of the spinal canal, the pathology, clinical picture and particularly the myelographic appearance are detailed. The value of serological tests is under study.The author believes that the clinical and radiological features are so suggestive as to allow a more or less correct preoperative diagnosis. The patient is usually a boy between 10-20 years of age who comes suffering from low back and bilateral sciatic pains followed by the rapid onset of combined conus and cauda lesion with early onset and prominence of urinary incontinence. Evidence of bilharzial infestation in the urinary or intestinal tracts may be distincly lacking. Myelography reveals a localized block of the size of one vertebral body at the level of D12 or L1 having irregular often trifid edges and demonstrating abrupt intramedullary swelling.A combination of pre-operative antibilharzial treatment and surgical decompression-with possible postoperative antibilharzial therapy especially if the condition is only recognised at operation-generally offers the best chances for cure. The prognosis in conus and cauda lesions is good.
- 日本脳神経外科学会の論文