Představujeme kazuistiku 34leté pacientky, heterozygotky Leidenské mutace, postižené autozomálně dominantní polycystickou chorobou ledvin (AD PCKD), přijaté pro náhle vzniklé symptomy netraumatické inkompletní transverzální míšní léze v úrovni Th4-5. Vstupní zobrazení mozku a celé míchy magnetickou rezonancí (MR) neprokázalo žádné ložiskové změny. Pomocí CT angiografie jsme vyloučili disekci aorty. V likvoru byl normální nález. Třetího dne se na kontrolní MR hrudní míchy vykreslilo ložisko myelopatie přibližně v úrovni Th5. Pátého dne bylo toto ložisko již bez podstatného vývoje. Dle klinického průběhu a výsledků komplementárních vyšetření jsme stav hodnotili jako míšní ischemii. Doplněná transezofageální echokardiografie a bubble test prokázaly high­‐grade permanentní pravo-levý zkrat při otevřeném foramen ovale (FOP). Další laboratorní a zobrazovací vyšetření k objasnění etiologie byla negativní. Byla indikována okluze FOP. Pacientka rehabilitovala a její zdravotní stav se postupně zlepšoval.

We present a case report of a 34-year-old female patient, heterozygote f.V Leiden, affected by autosomal dominant polycystic kidney disease (AD PCKD), admitted for sudden onset of symptoms of a non-traumatic incomplete transverse spinal cord lesion at the Th4-5 level. Initial magnetic resonance (MR) imaging of the brain and whole spinal cord showed no focal changes. CT angiography was used to exclude aortic dissection. The CSF showed normal findings. On the third day, a follow-up MRI of the thoracic spinal cord showed a focus of myelopathy at approximately Th5 level. On the fifth day, this lesion was no longer significantly developed. We assessed the condition as spinal cord ischemia based on the clinical course and the results of complementary examinations. The supplementary transesophageal echocardiography and bubble test revealed a high-grade, permanent right-to-left shunt with a patent foramen ovale (FOP). Further laboratory and imaging investigations to clarify the aetiology of spinal cord infractions were negative. FOP occlusion was indicated. The patient was rehabilitated and her condition gradually improved.

• MeSH
• Diagnosis, Differential MeSH
• Adult MeSH
• Foramen Ovale, Patent diagnosis   complications   MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   MeSH
• Spinal Cord Ischemia * diagnosis   etiology   classification   rehabilitation   MeSH
• Polycystic Kidney, Autosomal Dominant diagnosis   MeSH
• Prednisone pharmacology   therapeutic use   MeSH
• Pregabalin pharmacology   therapeutic use   MeSH
• Thrombophilia diagnosis   genetics   complications   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

• MeSH
• Infarction diagnostic imaging   etiology   pathology   MeSH
• Skin Manifestations MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Spinal Cord Ischemia * diagnostic imaging   pathology   MeSH
• Aged, 80 and over MeSH
• Vertebral Body * diagnostic imaging   pathology   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Publication type
• Letter MeSH
• Case Reports MeSH

Článek popisuje případ kocoura s diagnózou fibrokartilaginózní embolie, který začal doporučovanou intenzivní rehabilitační terapii. Po zhoršení stavu byla diagnóza upravena na aortální tromboembolii. Hirudoterapií došlo k úpravě neuromuskulárních deficitů. Popsán je postup práce rehabilitačního pracoviště, které u většiny pacientů pracuje na základě lékařských zpráv z referujících pracovišť.

The article describes the case of a cat diagnosed with fibrocartilaginous embolism who started the recommended intensive rehabilitation therapy. After deterioration of the condition, the diagnosis was modified to aortic thromboembolism. Neuromuscular deficits were corrected by hirudotherapy. The work procedure of the rehabilitation unit, which works with most patients on the basis of medical reports from referring units, is described.

• MeSH
• Aorta * anatomy & histology   MeSH
• Embolism and Thrombosis * mortality   veterinary   MeSH
• Cats MeSH
• Spinal Cord Ischemia * etiology   rehabilitation   veterinary   MeSH
• Leeching MeSH
• Animals MeSH
• Check Tag
• Cats MeSH
• Male MeSH
• Animals MeSH
• Publication type
• Case Reports MeSH

• MeSH
• Diagnosis, Differential MeSH
• Humans MeSH
• Magnetic Resonance Imaging * MeSH
• Spinal Cord diagnostic imaging   pathology   MeSH
• Spinal Cord Ischemia diagnostic imaging   pathology   MeSH
• Brain diagnostic imaging   pathology   MeSH
• Myelitis diagnostic imaging   pathology   MeSH
• Neuromyelitis Optica * diagnostic imaging   pathology   MeSH
• Optic Neuritis diagnostic imaging   pathology   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH

• MeSH
• Brown-Sequard Syndrome diagnosis   etiology   physiopathology   MeSH
• Central Cord Syndrome classification   physiopathology   MeSH
• Defecation physiology   MeSH
• Lateral Medullary Syndrome classification   physiopathology   MeSH
• Humans MeSH
• Spinal Cord * anatomy & histology   physiopathology   MeSH
• Spinal Cord Ischemia * etiology   physiopathology   MeSH
• Urination physiology   MeSH
• Sexual Dysfunction, Physiological etiology   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

• MeSH
• Acute Coronary Syndrome etiology   drug therapy   classification   pathology   therapy   MeSH
• Implantable Neurostimulators MeSH
• Myocardial Ischemia * diagnosis   pathology   therapy   MeSH
• Cardiovascular Agents pharmacology   classification   therapeutic use   MeSH
• Humans MeSH
• Spinal Cord Stimulation history   methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

• MeSH
• Intracranial Hemorrhages diagnosis   etiology   therapy   MeSH
• Brain Ischemia diagnosis   physiopathology   therapy   MeSH
• Humans MeSH
• Hypoxia-Ischemia, Brain diagnosis   etiology   therapy   MeSH
• Nervous System Diseases diagnosis   etiology   therapy   MeSH
• Infant, Newborn, Diseases * diagnosis   etiology   therapy   MeSH
• Infant, Newborn MeSH
• Neonatal Abstinence Syndrome diagnosis   etiology   therapy   MeSH
• Spinal Cord Injuries diagnosis   complications   therapy   MeSH
• Peripheral Nerve Injuries diagnosis   etiology   therapy   MeSH
• Muscle Hypertonia etiology   therapy   MeSH
• Muscle Hypotonia diagnosis   etiology   therapy   MeSH
• Check Tag
• Humans MeSH
• Infant, Newborn MeSH
• Publication type
• Review MeSH

• MeSH
• Emergencies MeSH
• Critical Care MeSH
• Wounds and Injuries MeSH
• Emergency Treatment MeSH
• Publication type
• Atlas MeSH

• Conspectus
• Patologie. Klinická medicína
• NML Fields
• urgentní lékařství
• NML Publication type
• kolektivní monografie

Background. The relative rarity of ischemic compared with traumatic spinal cord injury (SCI) has limited a comparison of the outcomes of these conditions. Objective. To investigate the neurological and functional recovery of ischemic compared with traumatic acute SCI. Methods. Data were derived from the European Multicenter Study Spinal Cord Injury database. Patients with ischemic (iSCI) or traumatic SCI (tSCI), aged 18 years or older were evaluated at different time points from incidence: at about 1 month, 3 months, and 6 months. The neurological status was assessed at each time point by the International Standards for Neurological Classification of Spinal Cord Injury and the functional status by the Spinal Cord Independence Measure. Walking ability was evaluated by Walking Index for Spinal Cord Injury, 10-Meter Walk Test, and 6-Minute Walk Test. Because of the imbalances of the 2 groups in respect to size and lesion severity, a matching procedure according to age, neurological level, and severity of injury was performed. Outcomes evaluation was performed by means of a 2-way repeated-measures ANOVA. Results. The matching procedure resulted in 191 pairs. Both groups significantly improved from about 15 days after the lesion to 6 months. No differences were found in the course of neurological and functional recovery of iSCI compared with tSCI. Conclusions. This analysis from a representative cohort of participants revealed that from 15 days following the cord damage onward, the outcomes after iSCI and tSCI are comparable. This finding supports the potential enrolment of patients with acute iSCI into clinical trials from that point in time after the event and an evaluation up to 6 months afterward.

• MeSH
• Acute Disease MeSH
• Databases, Factual MeSH
• Adult MeSH
• Functional Status * MeSH
• Outcome Assessment, Health Care * MeSH
• Middle Aged MeSH
• Humans MeSH
• Spinal Cord Ischemia physiopathology   MeSH
• Follow-Up Studies MeSH
• Recovery of Function physiology   MeSH
• Spinal Cord Injuries physiopathology   MeSH
• Aged MeSH
• Severity of Illness Index MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Research Support, Non-U.S. Gov't MeSH
• Comparative Study MeSH

Publikace pojednává ve 26 kapitolách o míšním poranění - od jeho vzniku až po návrat jedince do běžného života.; Publikace pojednává o míšním poranění, od jeho vzniku až po návrat jedince do běžného života.V obecné části jsou shrnuty anatomické a patofyziologické poznámky, vyšetřovací postupy, klinický obraz, prognóza a epidemiologická data. Hlavní oddíly knihy zpracovávají základní fáze po poranění míchy.

• MeSH
• Spinal Cord Injuries etiology   rehabilitation   therapy   MeSH

• Conspectus
• Patologie. Klinická medicína
• NML Fields
• ortopedie
• NML Publication type
• kolektivní monografie