Spinal dementia: Don't miss it, it's treatable.

IF 2.4 3区医学 Q2 CLINICAL NEUROLOGY

Neuroradiology Pub Date : 2024-10-01 Epub Date: 2024-07-10 DOI:10.1007/s00234-024-03425-9

Horst Urbach, A El Rahal, K Wolf, C Zander, T Demerath, F Volz, J Beck, N Lützen

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Abstract

Background & purpose: Around 5% of dementia patients have a treatable cause. To estimate the prevalence of two rare diseases, in which the treatable cause is at the spinal level.

Methods: A radiology information system was searched using the terms CT myelography and the operation and classification system (OPS) code 3-241. The clinical charts of these patients were reviewed to identify patients with a significant cognitive decline.

Results: Among 205 patients with spontaneous intracranial hypotension (SIH) and proven CSF leaks we identified five patients with a so-called frontotemporal brain sagging syndrome: Four of those had CSF venous fistulas and significantly improved by occluding them either by surgery or transvenous embolization. Another 11 patients had infratentorial hemosiderosis and hearing problems and ataxia as guiding symptoms. Some cognitive decline was present in at least two of them. Ten patients had ventral dural tears in the thoracic spine and one patient a lateral dural tear at C2/3 respectively. Eight patients showed some improvement after surgery.

Discussion: It is mandatory to study the (thoracic) spine in cognitively impaired patients with brain sagging and/ or infratentorial hemosiderosis on MRI. We propose the term spinal dementia to draw attention to this region, which in turn is evaluated with dynamic digital subtraction and CT myelography.

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脊髓痴呆症：不要错过，它是可以治疗的。

背景与目的：约5%的痴呆症患者有可治疗的病因。目的：估算两种罕见疾病的患病率，这两种疾病的可治疗病因都在脊柱层面：方法：使用CT脊髓造影术和手术与分类系统（OPS）代码3-241搜索放射学信息系统。对这些患者的临床病历进行审查，以确定认知能力明显下降的患者：在205名自发性颅内低血压（SIH）和已证实有脑脊液渗漏的患者中，我们发现了五名所谓的额颞叶脑下垂综合征患者：其中四名患者患有脑脊液静脉瘘，通过手术或经静脉栓塞治疗后，病情明显好转。另外 11 名患者有脑室下血肿，主要症状为听力问题和共济失调。其中至少有两人出现认知能力下降。10 名患者的胸椎腹侧硬膜撕裂，1 名患者的 C2/3 硬膜外侧撕裂。八名患者术后病情有所好转：讨论：对于磁共振成像显示脑下垂和/或脑室下血肿的认知障碍患者，必须对（胸椎）脊柱进行研究。我们提出脊髓痴呆一词，以引起人们对这一区域的注意，进而通过动态数字减影和 CT 髓造影对这一区域进行评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neuroradiology 医学-核医学

CiteScore

5.30

自引率

3.60%

发文量

214

审稿时长

4-8 weeks

期刊介绍： Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.