Zachary's Pain is Changing

Dr. Jordan
Zachary had one of his really bad episodes where the Benadryl did not work at all on Saturday. Monday and Tuesday he complained of back pain so I gave him a Benadryl and sent him on to school. Today he complained of his legs and back pain I gave him a Benadryl and sent him to school with his TENS on.

For more in depth/detailed information go to http://hug-z.blogspot.com

Dear Mrs. Huguley, I have spent hours looking at Zachary's spine MRI looking for other explanations for his spine stiffness. His vertebra (bones) look fine to me and to radiology. This is one reason that I am asking several specialists to review Zachary's case with me. I would like someone with spine and/or spinal rehabilation expertise to see him. I spoke to both Dr. Levy in Neurology and Dr. Sudhir Kathuria in neuroradiology/interventional radiology at Johns Hopkins. They feel that rather than an arachnoid cyst along his thoracic spine that he most likely has an old subdural fluid collection, perhaps this occured at the time of the MVA years ago. The subdural fluid can be seen on MRI and appears to be clear fluid, not blood but the way that fluid gets into the subdural space is usually tearing of very small veins in the subdural space at the time of trauma. Over time, the blood is removed by the body and clear fluid is left. This fluid collection stretches from about T2-T10. Arachnoid cysts and subdural fluid collections are very similar in appearance, but you are usually born with an arachnoid cyst and a subdural fluid collection may appear after trauma. There is not a way to "repair" or remove this fluid from along the spine according to several neurosurgeons and neuroradiologists and his spinal cord looks "healthy." Superficial siderosis is still the diagnosis. I can email you some slides that show the adhesion/fluid collection in the thoracic spinal cord (I will remove Zachary's name and medical record number as they will be sent via regular email). If they do not make sense, I can review them with you at our next appointment.