PubMed · 419485
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K Solheim. 1979-01-20. [Neurogenic intermittent claudication].. https://pubmed.ncbi.nlm.nih.gov/419485/
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Twenty-seven cases of complete subarachnoid block discovered through myelography are analysed with regard to the causes of obstruction, the neurologic symptoms, and the cerebrospinal fluid. The neurologic signs in cases of cauda equina compression, most often caused by massive disc protrusions (20 patients), vary considerably and rarely correspond to the gross myelographic findings. Bilateral neurologic symptoms of any degree with or without sphincter disturbance were observed in 21 among 27 cases and are signs of cauda compression. In contrast to cases of sciatica with unilateral root compression and radicular symptoms neurological symptoms are not reliable in revealing the site of the lesion in cases of massive central disc protrusions. Therefore radiculography (myelography of the cauda equina) is necessary for diagnosis. In addition to the well-known elevation of the spinal fluid protein and pleocytosis, the presence of neutrophile granulocytes is frequently found (11 of 20 cases) in cytological analysis.
A case of a lumbosacral disc herniation of traumatic origin with compression of the cauda equina in a child is reported. The problems of early diagnosis, timely operative procedure, and prognosis of neurological deficit of operated disc herniation in childhood are discussed.
The clinical value and practical application of the electrically induced BC reflex was investigated in 40 patients with traumatic or compressive lesions of the conus medullaris or cauda equina. It was shown that the BC reflex was either absent or delayed depending upon the invovlement of the sacral 2--4 spinal and radicular segments. The latency of the BC reflex was normal in patients with mainly epiconus and lumbar cord involvement. The loss of the BC reflex in the acute period of traumatic lesions was an adverse prognostic sign while the presence of the reflex whether or not delayed, indicated a more benign final outcome of sphincter and sexual reflex disturbances. In chronic progressive compression, the latency of BC reflex was often delayed.