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Patrick P. Han, Nicholas Theodore, Randall W. Porter, Paul W. Detwiler, MichaeL T. Lawton, and Robert F. Spetzler

that enters the dura at a dural root sleeve. An intradural extramedullary vein drains the lesion and facilitates retrograde flow into the coronal venous plexus on the dorsal surface of the spinal cord. The retrograde flow causes intramedullary venous hypertension and results in chronic intramedullary ischemic changes. Middle-aged patients often become symptomatic with progressive myelopathy or the cauda equina syndrome. Our case represents the rare presentation of a subdural hematoma from a Type I spinal AVM. Although there was evidence of a subdural hematoma on MR

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. If the hematoma persists and becomes chronic, there can be moderate but invalidating symptoms, which subsequently require surgical treatment. In the case describe by Tasdemiroglu, it would be interesting to know whether longterm follow-up MR imaging was performed and, if so, whether the ASSH had been completely reabsorbed. References 1. Han PP , Theodore N , Prter RW , ert al : Subdural hematoma froma Type I spinal arteriovenous malformation. Case report. J Neurosurg (Spine 2) 90 : 255 – 257 , 1999 Han PP

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Mehmet Senoglu, Sam Safavi-Abbasi, Nicholas Theodore, Nicholas C. Bambakidis, Neil R. Crawford, and Volker K. H. Sonntag

. 4 , 8 , 14 , 15 , 19 , 20 However, the medical records of our CT-documented cases indicated that none of these patients had chronic symptoms or neurological deficits related to their anomaly. All patients were neurologically intact, and none required surgical intervention. Only seven patients had transient neck pain after head and neck trauma probably unrelated to the C-1 anomaly. This finding is consistent with the literature. Most reported cases have either been asymptomatic or have experienced only transient neurological symptoms (see Table 2 ). TABLE 2

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Nicholas C. Bambakidis, John Butler, Eric M. Horn, Xukui Wang, Mark C. Preul, Nicholas Theodore, Robert F. Spetzler, and Volker K. H. Sonntag

I n the U nited S tates , the effects of SCI on society and healthcare are staggering. As many as 300,000 persons live with chronic disabilities related to SCI, and each year new SCIs affect 10,000–14,000 people (mean age at injury, 30 years).14 The annual cost to society is estimated to reach $8 billion, and the individual costs to patients can reach $1.35 million over their lifetime. As our ability to prolong the lives of these patients progresses, these costs would be expected to increase proportionally. Impressive strides have been made in the ability

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Nicholas C. Bambakidis, Eric M. Horn, Peter Nakaji, Nicholas Theodore, Elizabeth Bless, Tammy Dellovade, Chiyuan Ma, Xukui Wang, Mark C. Preul, Stephen W. Coons, Robert F. Spetzler, and Volker K. H. Sonntag

effects of chronic growth factor activity to be studied in a minimally invasive manner. Disclaimer The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper. This article contains some figures that are displayed in color online but in black and white in the print edition. References 1 Agrawal S , Schaffer DV : In situ stem cell therapy: novel targets, familiar challenges . Trends Biotechnol 23 : 78 – 83 , 2005 2 Alvarez-Buylla A , Garcia-Verdugo JM

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Giriraj K. Sharma, Jennifer M. Eschbacher, Timothy D. Uschold, and Nicholas Theodore

eosinophilic neuropil. Ewing sarcoma/PNET is a family of small round cell tumors that often demonstrate Homer-Wright rosettes. These tumors commonly occur in the soft tissue or bone of patients younger than 30 years old. 13 To date, only 10 reported cases of schwannoma have pathological features consistent with neuroblastoma. 3–6 , 8 , 14 We report the first case of a spinal neuroblastoma-like schwannoma, located at the right L-1 spinal nerve root. Case Report History and Examination This 61-year-old woman presented with the chief complaint of chronic lower

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Francisco A. Ponce, Brendan D. Killory, Scott D. Wait, Nicholas Theodore, and Curtis A. Dickman

-up imaging (mean 54 months). The patient with mild persistent Horner syndrome reported that it had no effect on her activities. No other long-term neurological complications were reported. Discussion The benefits of thoracoscopy over open thoracotomy include lower rates of pulmonary complications, postoperative pain, intercostal neuralgias, shoulder girdle dysfunctions, and chronic pain syndromes. 5 , 10 In addition to fewer morbidities, thoracoscopy preserves surgical efficacy for benign paraspinal neurogenic tumors. Although these tumors are rare, they account for

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David A. Wilson, David J. Fusco, and Nicholas Theodore

history of occipital neuralgia, a common symptom of high cervical instability. The latter 2 mechanisms are not mutually exclusive as the mechanical forces of the fall, in the setting of preexisting instability and a screw extending beyond the odontoid tip, may have caused the vascular injury. In this case, given the clear failure of anterior odontoid fusion and symptoms of instability, we believe that hypermobility of the dens, either at the time of the fall or chronically, is the most likely underlying cause of pseudoaneurysm formation and hemorrhage. Because the

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Nikolay L. Martirosyan, Jeanne S. Feuerstein, Nicholas Theodore, Daniel D. Cavalcanti, Robert F. Spetzler, and Mark C. Preul

gray matter. 48 The pia mater is a strong membrane. Therefore, the large vessels on the surface of the spinal cord and in the anterior median sulcus are relatively spared from major damage due to mechanical stress. The ASA and PSA possess heavier mesenchymal-supporting investment, and electron microscopic studies suggest that white matter vasculature possesses denser glial packing than vessels of gray matter. 4 Autoregulation With Injury Spinal cord injury is associated with marked vasculature changes. To further understand chronic changes as a result of

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Udaya K. Kakarla, M. Yashar S. Kalani, Giriraj K. Sharma, Volker K. H. Sonntag, and Nicholas Theodore

fewer than 5% of immunocompetent patients, coccidioidal infection evolves into disseminated extrapulmonary disease, commonly manifesting as meningitis, cutaneous and soft-tissue nodules, and fungal osteomyelitis. 12 , 17 Treatment of the coccidioidomycosis of the spine is by no means routine. Although radiographically similar to bacterial osteomyelitis, coccidioidal osteomyelitis is an unrelenting disease, frequently resistant to medical management. Given the chronic nature of this disease, the standard rules for the treatment of infections afflicting the spinal