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April 1981 54 4 473 479 10.3171/jns.1981.54.4.0473 Lumbar disc protrusion in children Robert G. Fisher Richard L. Saunders April 1981 54 4 480 483 10.3171/jns.1981.54.4.0480 Bacteriology of intracranial abscess in children Itzhak Brook April 1981 54 4 484 488 10.3171/jns.1981.54.4.0484 Intracranial pressure in nontraumatic ischemic and hypoxic cerebral insults Howard J. Senter Aizik Wolf Franklin C. Wagner Jr. April 1981 54 4 489 493 10.3171/jns.1981.54.4.0489 Pathophysiology of “tethered cord syndrome” Shokei Yamada David E. Zinke Delmar Sanders

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Shokei Yamada, David E. Zinke and Delmar Sanders

report, we include these cases in the category of “tethered cord syndrome.” The question remains as to the cause of tethering-induced dysfunction of the spinal cord. Impairment of blood flow, 12, 27, 39 function, 12, 26, 27, 31, 43 and metabolism 20, 50 has been observed in the traumatized or compressed cord. Many studies have demonstrated that impaired circulation in the brain leads to progressive functional and morphological deterioration and finally to cell death. 6, 9, 11, 13, 16, 18, 28, 30, 36–38, 51 In spite of this background work, it has not been

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Bahram Chehrazi, Jacqualyn Parkinson and Richard Bucholz

proprioception in rt LE; pin sensation & motor function absent below C-7 prolonged & small P 1 from rt; depressed waveform 4 wks post-trauma paraparetic with improved sensory function decrease in P 1 latency; bilateral recovery of waveform excellent recovery; persistent weakness of intrinic muscles 2 tethered cord syndrome preoperative lt LE paresis & sensory loss prolonged P 1 & decreased amplitude intraoperative increased P 1 latency from lt

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14 17 10.3171/jns.1982.57.1.0014 Late sequelae of spinal cord trauma Dennis R. S. Osborne George Vavoulis Blaine S. Nashold Jr. Philip J. Dubois Burton P. Drayer E. Ralph Heinz July 1982 57 1 18 23 10.3171/jns.1982.57.1.0018 Considerations in the diagnosis and treatment of syringomyelia and the Chiari malformation Leslie D. Cahan John R. Bentson July 1982 57 1 24 31 10.3171/jns.1982.57.1.0024 Tethered cord syndrome in adults Dachling Pang James E. Wilberger Jr. July 1982 57 1 32 47 10.3171/jns.1982.57.1.0032 Clinical recording of pressure on the

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Dachling Pang and James E. Wilberger Jr.

N eurological deterioration due to longitudinal traction of the conus, the so-called “tethered cord syndrome” (TCS), has been recognized for a long time. The actual tethering has been attributed to a variety of pathological entities, including a thickened, tight filum terminale, 2, 14, 27, 29–31 intradural lipomas with or without a connecting extradural component, 2, 9, 12, 34, 45, 50 intradural fibrous adhesions, 2, 50 diastematomyelia, 10, 20, 22, 28, 36 dermal sinus tracts, 2 and adherence of the neural placode following previous closure of a

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T. S. Park, Wayne S. Cail, Johnny B. Delashaw and John Kattwinkel

terminated at L2–3, making the tethered cord syndrome unlikely. Embolic spinal cord infarction was also unlikely, since there was no history of a previous invasive procedure, such as umbilical catheterization, before the infant's development of acute paraparesis. A spinal cord AVM or an intramedullary conus medullaris lesion was therefore suspected prior to surgery. Spinal angiography was not performed because of the risk of increased morbidity in a newborn infant. Operation At 9 days of age, the patient underwent a laminectomy from L-3 to T-5. Upon exposure of the

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Thorir S. Ragnarsson, Quentin J. Durward and Richard E. Nordgren

contributed to the clinical improvement in these two cases. Perhaps the success of the cordectomy operation for posttraumatic syringomyelia is due to its dual function of syrinx drainage and release of a tether. The tethered cord syndrome of dysraphism with associated filum terminale thickening and low-lying conus presenting with a lower cord and conus syndrome is well recognized in children and adults. 2, 9, 10, 17 The most frequently suggested mechanism for the myelopathy in that setting is traction leading to mechanical distortion and ischemia of the cord. 1, 4, 17

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Ian R. Whittle, Ian H. Johnston and Michael Besser

11 1 lipomeningocele lumbosacral lipomeningocele with low conus medullaris neurologically normal; posterior midline lumbosacral lipoma 12 1½ caudal agenesis syndrome, sacral meningocele sacral meningocele; hemisacral agenesis; gross rectal dilatation chronic constipation; urinary sphincter dysfunction (?) 13 1 tethered cord syndrome (meningocele closed at 1 wk) dorsal lumbar meningocele with low conus medullaris neurologically normal 14 2 double diastematomyelia, thick filum, & tethered cord syndrome thoracic and

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R. Michael Scott, Samuel M. Wolpert, Louis E. Bartoshesky, Seymour Zimbler and George T. Klauber

✓ Four children with previously repaired myelomeningoceles presented toward the end of the first decade or early in the second decade of life with deteriorating lower-extremity and bladder function. Myelography and computerized tomography scanning demonstrated irregular filling defects at the area of the myelomeningocele repair, and surgical exploration disclosed dermoid tumors that were adherent to the placode and adjacent roots. Dermoid tumors should be considered in the differential diagnosis of neurological deterioration in children with a repaired myelomeningocele.

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Intraspinal lipomas with spina bifida

Prognosis and treatment in 73 cases

Alain Pierre-Kahn, Jacques Lacombe, J. Pichon, Yves Giudicelli, Dominique Renier, Christian Sainte-Rose, M. Perrigot and Jean-François Hirsch

syndrome in adults. J Neurosurg 57 : 32 – 47 , 1982 Pang D, Wilberger JE Jr: Tethered cord syndrome in adults. J Neurosurg 57: 32–47, 1982 15. Pecquery R , Malagrida L , Guidicelli Y : Adipocyte adenylate cyclase and alpha- and beta-adrenergic receptors in one case of multiple symmetric lipomatosis. Biomedicine 33 : 64 – 66 , 1980 Pecquery R, Malagrida L, Guidicelli Y: Adipocyte adenylate cyclase and alpha- and beta-adrenergic receptors in one case of multiple symmetric lipomatosis. Biomedicine 33: 64