Yıl: 2012 Cilt: 22 Sayı: 5 Sayfa Aralığı: 667 - 670 Metin Dili: Türkçe

Cervical intradural glass fragment: A rare cause of neuropathic pain

Öz:
Delici-kesici yaralanmalar sonrası intradural yabancı cisimler oldukça nadirdir. Omurilik kanalı içerisinde yabancı cisim olarak cam parçası görülmesi ve bunun yer değiştirerek geç dönemde semptomlara yol açması daha da nadirdir. Bu çalışmada, omurilik kanalı içerisinde yer değiştiren cam parçasına bağlı geç dönemde şikayetleri ortaya çıkan 33 yaşında bir erkek hasta sunulmuş; nadir görülmesi ve genel tecrübeye katkıda bulunmak amacıyla tartışılması amaçlanmıştır. Hastanın 21 yıl önce cam kapıya çarpma sonrası ağız mukozasına cam parçaları saplandığı öğrenilmiş ve bu parçaların servikal spinal intradural mesafeye ulaşarak hastada radiküler bulgularla birlikte nöropatik ağrıya sebep olduğu görülmüştür. Omuriliğin delici-kesici yaralanmalarında nadir de olsa yabancı cisimlerin omurilik kanalında kalabileceği ve bunların hem medüller hem de radiküler bulgulara yol açabileceği unutulmamalıdır. Orofarinks mukozasının delici-kesici yaralanmalarında da yabancı cisimlerin omurilik kanalına ulaşarak, erken dönemde veya yer değiştirme sonrası geç dönemde klinik bulgular ortaya çıkartabileceği gözden kaçırılmamalıdır.
Anahtar Kelime:

Nöropatik ağrının nadir bir nedeni olarak intradural cam parçası

Öz:
Intradural foreign bodies after penetrating injuries are seen very rarely. Limited number of cases of glass fragments in the spinal canal were reported previously. Migration of foreign bodies and delayed onset of neurological symptoms due to foreign bodies were also reported. In this report a 33-year-old male patient was presented, who had penetration of glass fragments through oropharyngeal mucosa in to the spinal canal after crashing into a glass door. Glass fragment, which migrated through an unusual route, and reached cervical spinal intradural space, caused neuropathic pain with radicular symptoms, 21 years after the initial injury. This case report emphasize that after penetrating injuries of spine, foreign bodies may remain silent until the patient became symptomatic years after the initial injury and these foreign bodies may migrate to extreme distant and unexpected locations in the central nervous system.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Olgu Sunumu Erişim Türü: Erişime Açık
  • 1. Adornato DC Jr, Collis JS Jr: Stab wounds of the spinal cord. Int Surg 57:147-150, 1972
  • 2. Arasil E, Tascioglu AO: Spontaneous migration of an intracranial bullet to the cervical spinal canal causing Lhermitte’s sign. Case report. J Neurosurg 56:158-159, 1982
  • 3. Avci SB, Acikgoz B, Gundogdu S: Delayed neurological symptoms from the spontaneous migration of a bullet in the lumbosacral spinal canal; case report. Paraplegia 33:541-542, 1995
  • 4. Baghai P, Sheptak PE: Penetrating spinal injury by a glass fragment: Case report and review. Neurosurgery 11:419–422, 1982
  • 5. Duz B, Cansever T, Secer HI, Kahraman S, Daneyemez MK, Gonul E: Evaluation of spinal missile injuries with respect to bullet trajectory, surgical indications and timing of surgical intervention: A new guideline. Spine 33(20): E746-753, 2008
  • 6. Farooq M, Dhar S, Butt MF: Late onset neurogenic claudication in a case of metallic intradural ballistic fragment. Joint Bone Spine 74:187-189, 2007
  • 7. Ilkko E, Reponen J, Ukkola V, Koivukangas J: Spontaneous migration of foreign bodies in the central nervous system. Clin Radiology 53:221-225, 1998
  • 8. Jeffery JA, Borgstein R: Case report of a retained bullet in the lumbar spinal canal with preservation of cauda equina function. Injury 29:724-726, 1989
  • 9. Jones DF, Woosley RE: Delayed myelopathy secondary to retained intraspinal metallic fragment. J Neurosurg 55: 979-982, 1981
  • 10. Karim NO, Nabors MW, Golocovsky M, Cooney FD: Spontaneous migration of a bullet in the spinal subarachnoid space causing delayed radicular symptoms. Neurosurg 18: 97-100, 1986
  • 11. Kuijen JM, Herpers MJ, Beuls EA: Neurogenic claudication, a delayed complication of a retained bullet. Spine 22:910-914, 1997
  • 12. Lipschitz R: Associated injuries and complications of stab wounds of the spinal cord. Paraplegia 5:75-82, 1967
  • 13. Miyazaki Y, Inaba K: Transfixion of cervical cord by a glass fragment-report of a case. No Shinkei Geka 4:799-803, 1976 (Japanese)
  • 14. Oertel MF, Kreitschmann-Andermahr I, Ryang YM, Gilsbach, Korinth MC: The awakened intraspinal glass shard. Acta Neurochir 151: 99-101, 2009
  • 15. Opel DJ, Lundin DA, Stevenson KL, Klein EJ: Glass foreign body in the spinal canal of a child: Case reportand review of the literature. Pediatr Emerg Care 20:468–472, 2004
  • 16. Pal D, Timothy J, Marks P: Penetrating spinal injuries with wooden fragments causing cauda equina syndrome: Case report and literature review. Eur J Spine Suppl 5:574-577, 2006
  • 17. Rubin G, Tallman D, Sagan L, Melgar: An unusual stab wound of the cervical spinal cord: A case report. Spine 26:444–447, 2001
  • 18. Simpson RK Jr, Venger BH, Narayan RK: Treatment of acute penetrating injuries of the spine: A retrospective analysis. J Trauma 29:42–46, 1989
  • 19. Sorensen N, Krauss J: Movement of hemostatic clips from the ventricles through the aqueduct to the lumbar spinal canal. Case report. J Neurosurg 74:143-146, 1991
  • 20. Taniura S, Tatebayashi K, Akatsuka K, Takenobu A, Kamitani H, Yokota M, Watanabe T: Transoral penetration of a half-split chopstick between the basion and the dens. Am J Neuroradiol 25: 871-872, 2004
  • 21. Thakur RC, Khosla VK, Kak VK: Non-missile penetrating inju- ries of the spine. Acta Neurochir (Wien) 113:144–148, 1991
  • 22. Topliff EE, Daly JS: Accidental puncture of the cerebrospinal canal. Can Med Assoc J 24:836-838, 1931
  • 23. Waters RL, Sie IH: Spinal cord injuries from gunshot wounds to the spine. Clin Ortop Relat Res 408:120-125, 2003
  • 24. Williams DT, Chang DL, DeClerk MP: Penetrating spinal cord injuries with retained canal fragments. CJEM 11:172-173, 2009
  • 25. Wolf SM: Delayed traumatic myelopathy following transfixion of the spinal cord by a knife blade. Case report. J Neurosurg 38:221-225, 1973
  • 26. Wu WQ: Delayed effects from retained foreign bodies in the spine and spinal cord. Surg Neurolog 25:214-218, 1986
APA AKCAKAYA M, ARAS Y, YORUKOGLU A, OVALIOGLU C, SENCER A (2012). Cervical intradural glass fragment: A rare cause of neuropathic pain. Turkish Neurosurgery, 22(5), 667 - 670.
Chicago AKCAKAYA Mehmet Osman,ARAS Yavuz,YORUKOGLU Ali Guven,OVALIOGLU Cem,SENCER Altay Cervical intradural glass fragment: A rare cause of neuropathic pain. Turkish Neurosurgery 22, no.5 (2012): 667 - 670.
MLA AKCAKAYA Mehmet Osman,ARAS Yavuz,YORUKOGLU Ali Guven,OVALIOGLU Cem,SENCER Altay Cervical intradural glass fragment: A rare cause of neuropathic pain. Turkish Neurosurgery, vol.22, no.5, 2012, ss.667 - 670.
AMA AKCAKAYA M,ARAS Y,YORUKOGLU A,OVALIOGLU C,SENCER A Cervical intradural glass fragment: A rare cause of neuropathic pain. Turkish Neurosurgery. 2012; 22(5): 667 - 670.
Vancouver AKCAKAYA M,ARAS Y,YORUKOGLU A,OVALIOGLU C,SENCER A Cervical intradural glass fragment: A rare cause of neuropathic pain. Turkish Neurosurgery. 2012; 22(5): 667 - 670.
IEEE AKCAKAYA M,ARAS Y,YORUKOGLU A,OVALIOGLU C,SENCER A "Cervical intradural glass fragment: A rare cause of neuropathic pain." Turkish Neurosurgery, 22, ss.667 - 670, 2012.