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Caudal Spinal Cord Tumor


Presentation

  • Presenting an inter-disciplinary perspective, the book includes up-to-date information on therapy [including neurosurgical], new information on developmental disorders of the spine, and a definitive chapter on trauma, including information on biomechanics[books.google.com]
  • […] in the present case.[chiromt.biomedcentral.com]
  • Both intratumoral cysts and polar cysts can be present.[appliedradiology.com]
  • An uncommon presentation is acute headache due to subarachnoid hemorrhage 8 . In children, progressive scoliosis may be seen. Motor regression and frequent falls may be the presenting features in young children 7 .[radiopaedia.org]
Physician
  • A unique third section, Administrative Issues, has been added to this edition to address technical aspects of NIOM machines, remote monitoring, billing, ethical and legal issues, and training requirements for physicians and technologists.[books.google.com]
  • ., Pembina County Memorial Hospital and Wedgewood Manor, Cavalier, North Dakota Am Fam Physician. 2001 Aug 15;64(4):631-639. Physicians who work in primary care settings and emergency departments frequently evaluate patients with neck and back pain.[aafp.org]
  • Some physicians use the terms syringomyelia or hydromyelia interchangeably.[rarediseases.org]
  • Research – Our physicians work with academic medicine researchers to develop new techniques, enhancing orthopedic care. Collaboration – Our team of experts works together to develop an individualized treatment plan for you.[houstonmethodist.org]
  • When performed by an experienced physician using fluoroscopic guidance, the risk of experiencing a serious complication is minimized. Overall, ESIs are usually very well tolerated and most patients do well.[spine.org]
Movement Disorder
  • New applications and clinical innovations are interwoven throughout, and there is a completely new chapter on the use of NIOM in movement disorders surgery.[books.google.com]
  • ., touch) that would not be expected to cause pain dysgeusia distorted taste perception dysgraphia a writing disability that results in incorrectly spelled or written words dyskinesia blanket term for movement disorders characterized by increased motor[strokecenter.org]
Dentist
  • Dentist visits 3. Behavioral Optometrist Visit 4. Visit to Dr. Nazarov 5. Visits and Genomics Testing 6. Follow-up Home Virtual Reality 7. Evolution Talk 8. Virtual reality platform to do home exercises 9.[metodoessentis.com]
Epilepsy
  • […] spike-and-wave complex generalized synchronous pattern seen on electroencephalogram, consisting of a sharply contoured fast wave followed by a slow wave; seen in generalized epilepsy spina bifida failure of bone fusion in the posterior midline of the[strokecenter.org]
Fecal Incontinence
  • incontinence, erectile dysfunction, loss of rectal tone, abnormal bulbocavernosus and anal wink reflexes).[msdmanuals.com]
  • Both conus medullaris and cauda equina lesions are associated with urinary retention and incontinence and fecal incontinence or constipation.[emedicine.medscape.com]
  • […] rarely abnormal. 78 , 82 Urinary tract infection is the predominant sign in an affected infant, but urinary retention is occasionally seen. 77 Once a child is toilet trained, the onset of secondary urinary incontinence, especially in conjunction with fecal[pediatrics.aappublications.org]
Papule
  • These include non-midline cutaneous lesions, benign coccygeal dimples (discussed previously); diffuse and evenly distributed lumbosacral hair, isolated café au laít and Mongolian spots, hypo- and hypermelanotic macules or papules, and isolated gluteal[pediatrics.aappublications.org]
Back Pain
  • When to see a doctor There are many causes of back pain, and most back pain isn't caused by a tumor.[mayoclinic.org]
  • View/Print Figure Low Back Pain FIGURE 1. Suggested approach to the initial assessment of the patient with acute low back pain. (CT computed tomographic; MRI magnetic resonance imaging) Adapted from Bigos SJ, et al.[aafp.org]
  • The first symptom of epidural (extradural) spinal cord compression is usually the patient's complaint to the local back pain. Back pain can be enhanced in the supine position and forcing the patient to wake up at night.[minclinic.ru]
  • Low back pain is very common. It affects millions of people. In most cases, you don't need surgery for low back pain.[webmd.com]
  • Not all people with back pain and/or leg pain and changes in bowel or bladder function have cauda equina syndrome.[emedicinehealth.com]
Low Back Pain
  • Low back pain is very common. It affects millions of people. In most cases, you don't need surgery for low back pain.[webmd.com]
  • View/Print Figure Low Back Pain FIGURE 1. Suggested approach to the initial assessment of the patient with acute low back pain. (CT computed tomographic; MRI magnetic resonance imaging) Adapted from Bigos SJ, et al.[aafp.org]
  • The Epidemiology of low back pain. Best Pract Res Clin Rheumatol. 2010;24:769–81. View Article PubMed Google Scholar Manchikanti L, Singh V, Falco FJ, Benyamin RM, Hirsch JA. Epidemiology of low back pain in adults.[chiromt.biomedcentral.com]
  • Symptoms of cauda equina syndrome include low back pain, numbness and/or tingling in the buttocks and lower extremities ( sciatica ), weakness in the legs, and incontinence of bladder and/or bowels.[medicinenet.com]
  • Some of the early symptoms related to cauda equina syndrome, including low back pain and muscle weakness, are more often caused by simple disk herniation, which does not require urgent attention.[emedicinehealth.com]
Muscular Atrophy
  • Other spinal cord problems include Tumors Infections such as meningitis and polio Inflammatory diseases Autoimmune diseases Degenerative diseases such as amyotrophic lateral sclerosis and spinal muscular atrophy Symptoms vary but might include pain, numbness[medlineplus.gov]
  • This may or may not correlate with the diagnosis of spinal stenosis which is based on clinical findings of radiculopathy, neurogenic claudication, weakness, bowel and bladder dysfunction, spasticity, motor weakness, hyperreflexia and muscular atrophy.[en.wikibooks.org]
Myopathy
  • […] the end of the procedure creatine kinase enzyme that catalyzes the conversion of creatine to phosphocreatine and is released into the blood by tissues—particularly muscle—that consume adenosine triphosphate (ATP) rapidly; elevated levels are seen in myopathy[strokecenter.org]
Paresthesia
  • Neurologic deficits may not improve, and a risk of worsening exists, including pain, paralysis, paresthesia, bowel or bladder problems, and sexual dysfunction.[emedicine.medscape.com]
  • Grieve points out that some clinicians are far too anxious to blame upper limb paresthesiae on the presence of a cervical rib just because it is there.[chiro.org]
  • […] following: Low back pain Pain in one leg (unilateral) or both legs (bilateral) that starts in the buttocks and travels down the back of the thighs and legs ( sciatica ) Numbness in the groin or area of contact if sitting on a saddle (perineal or saddle paresthesia[emedicinehealth.com]
  • Then develop a syndrome of transverse myelopathy with paresthesias, alternating with loss of sensitivity. Motor paresis starts in the toes and feet and rises to the spinal cord compression level.[minclinic.ru]
Ataxia
  • I would describe Hurcules as having “ambulatory tetraparesis with an upper-motor neuron, general proprioceptive ataxia. The thoracic limbs are worse than the pelvic limbs and the left side is more affected than the right.”[sevneurology.com]
  • Affected individuals may also develop pain and stiffness (spasticity) in the legs and uncoordinated movements (ataxia), eventually affecting the ability to walk. In severe cases, paralysis of the arms or legs can occur.[rarediseases.org]
  • […] links [ edit ] 06-093c. at Merck Manual of Diagnosis and Therapy Home Edition Cauda_equina_syndrome at the Duke University Health System 's Orthopedics program v t e Lesions of spinal cord and brain Spinal cord / vascular myelopathy sensory: Sensory ataxia[en.wikipedia.org]
  • […] injury characterized by an increase in the number and size of astrocytes (primary reaction) and cytoplasmic changes including increased glial filaments and glassy eosinophilic cytoplasm followed by formation of a dense gliotic scar (secondary reaction) ataxia[strokecenter.org]
  • Tumors projecting into the posterior fossa produce symptoms of intracranial pressure such as nystagmus, papilledema, vertigo, ataxia, past pointing, and asteriognosis.[chiro.org]
Sciatica
  • Symptoms of cauda equina syndrome include low back pain, numbness and/or tingling in the buttocks and lower extremities ( sciatica ), weakness in the legs, and incontinence of bladder and/or bowels.[medicinenet.com]
  • People with pain in both legs (bilateral sciatica ) have less chance or full recovery than persons with single leg pain (unilateral sciatica).[emedicinehealth.com]
  • Ankylosing spondylitis (Bechterew's disease) Back pain in pregnancy Coccydynia (sore tailbone) Compression fracture of the spine Degenerative and hereditary myelopathy Epiduritis and spinal abscess Low back pain, pain in leg, Sherman Mau diseases Lumbago, sciatica[minclinic.ru]
  • Sciatica -type pain on one side or both sides, although pain may be wholly absent Weakness of the muscles of the lower legs (often paraplegia ) Achilles (ankle) reflex absent on both sides. [6] : 216 Sexual dysfunction Absent anal reflex and bulbocavernosus[en.wikipedia.org]
  • Quite often, it manifests as sciatica or radiculopathy.[emedicine.medscape.com]
Hyporeflexia
  • Acute, severe lesions (eg, infarction, traumatic lesions) cause spinal shock with flaccid paresis (decreased muscle tone, hyporeflexia, and no extensor plantar responses).[msdmanuals.com]
  • The neurologic examination usually reveals symmetric weakness with either flaccidity and hyporeflexia (if the diagnosis is made early) or spasticity and hyperreflexia (if the diagnosis is made later). 13 The sudden onset of myelopathy secondary to spinal[aafp.org]
  • […] acute inflammatory demyelinating polyneuropathy) acute, ascending, and progressive neuropathy believed to result from an autoimmune response triggered by an antecedent illness or various medical conditions and characterized by weakness, paresthesias, hyporeflexia[strokecenter.org]
  • These reflexes should be compared bilaterally to judge whether the hyporeflexia is unilateral. Unilateral hyperreflexia is pathognomonic of an upper motor neuron lesion.[chiro.org]
Sensation Disorder
  • In the beginning of the spinal cord lesions by intradural extramedullary tumors in patients have radicular sensation disorders syndrome and asymmetrical neurological disorders.[minclinic.ru]
Urinary Retention
  • However, it mimics conus medullaris syndrome, causing distal leg paresis and sensory loss in and around the perineum and anus (saddle anesthesia), as well as bladder, bowel, and pudendal dysfunction (eg, urinary retention, urinary frequency, urinary or[msdmanuals.com]
  • retention, incontinence and constipation, as well as back pain.[pacificneuroscienceinstitute.org]
  • Detrusor weaknesses causing urinary retention and post-void residual incontinence as assessed by bladder scanning the patient after the patient has urinated.[en.wikipedia.org]
  • Post-operative course The patient experienced transient urinary retention after surgery. The patient was kept in the hospital for 3 weeks of intravenous (IV) antibiotics. His urinary retention and constipation had resolved at the time of discharge.[pediatricneurosciences.com]
  • Both conus medullaris and cauda equina lesions are associated with urinary retention and incontinence and fecal incontinence or constipation.[emedicine.medscape.com]
Urinary Incontinence
  • Urinary incontinence is often associated with a syrinx when the lesion causes disruption of the sacral pathways. Sexual dysfunction may also occur in association with loss of sphincter control.[neurospinewi.com]
  • incontinence, especially in conjunction with fecal incontinence and/or constipation, is the most common presentation of a tethering lesion, although urinary tract infection is still common in this age group as well. 77 , 81 , 83 As the child matures,[pediatrics.aappublications.org]
  • incontinence, followed by rhythmic muscle contractions ( clonic phase) tonic neck reflexes movements and postures of the arm and leg when the neck is bent forwards, backwards, or to the side that are present in normal infants and are incorporated in[strokecenter.org]
Overflow Incontinence
  • When the tumor causes pressure on the second or third sacral nerve roots, micturition is affected and there is paralysis of bladder contractions, bladder distention, and retention of urine with overflow incontinence.[neurospinewi.com]

Workup

  • Autoimmune and degenerative disorders These disorders include the following: Transverse myelitis Multiple sclerosis Viral infection or its sequela Amyotrophic lateral sclerosis Workup Overview The diagnostic workup overlaps, in part, with the workup presented[emedicine.medscape.com]
  • Treatment After diagnostic workup, spinal cord edema (swelling) should be managed preoperatively with oral or IV steroids. Edema is most commonly managed with a corticosteroid such as Decadron (dexamethasone).[neurospinewi.com]
  • Clinical Testing and Workup A specialized imaging technique called magnetic resonance imaging (MRI) is used to diagnose syringomyelia.[rarediseases.org]
  • Isolated coccygeal dimples do not require further workup or treatment. FIGURE 9 Benign coccygeal dimple within the gluteal cleft and overlying the tip of the coccyx.[pediatrics.aappublications.org]

Treatment

  • Standard Therapies Treatment The treatment of syringomyelia is directed toward the specific symptoms that are apparent in each individual. Treatment may require the coordinated efforts of a team of specialists.[rarediseases.org]
  • What Is the Treatment for Cauda Equina Syndrome? Medical treatment options are useful in certain persons, depending on the underlying cause of the cauda equina syndrome.[emedicinehealth.com]
  • ABSTRACT To provide a guideline of accurate diagnosis and proper methods of treatment of spinal cord tumor the author analyzed 83 cases of spinal cord tumor who had been operated at the Department of Neurosurgery of Yonsei University College of Medicine[jkns.or.kr]
  • Microsurgical treatment for spinal tumors. Singapore Med J. 2005;46:74-77. Prevedello DM, Koerbel A, Tatsui CE, et al. Prognostic factors in the treatment of the intradural extramedullary tumors: Astudy of 44 cases.[appliedradiology.com]

Prognosis

  • Prognosis of Meningioma of the Spinal Cord Benign meningiomas are associated with a very good survival prognosis with approximately 100% 5 year survival.[myvmc.com]
  • Overall, prognosis is dictated by the pathology and location of the individual tumor. Keywords: ependymoma ; schwannoma ; spinal cord tumor Copyright 2017 Wolters Kluwer Health, Inc. All rights reserved[journals.lww.com]
  • Prognosis [ edit ] The prognosis for complete recovery is dependent upon many factors. The most important of these is the severity and duration of compression upon the damaged nerve(s).[en.wikipedia.org]
  • Prognosis In general, the earlier the detection of the tumor and the more minor the neurological deficit, the better the prognosis for treatment and recovery. Advanced age and severe neurologic deficit are associated with a poor prognosis.[emedicine.medscape.com]
  • Key Points – Intradural tumor resection has the potential for significant neurologic morbidity. 1 – Prognosis and outcome are highly variable and dependent on pathology. 1 , 2 II.[neupsykey.com]

Etiology

  • , and it is important to distinguish between etiologies due to the range of treatments and prognoses between the separate entities.[appliedradiology.com]
  • ETIOLOGIC PICTURE See Table 5.11. Table 5.11.[chiro.org]
  • With regard to studies of the urinary tract, back pain with positive urinalysis results may suggest a genitourinary (GU) etiology. Renal ultrasonography or a GU CT scan can be diagnostic.[emedicine.medscape.com]
  • Intramedullary abscess of the spinal cord in the antibiotic era: Clinical features, microbial etiologies, trends in pathogenesis, and outcomes. Clin Infect Dis 1998;27:619-26. 5. Simon JK, Lazareff JA, Diament MJ, Kennedy WA.[pediatricneurosciences.com]
  • Etiology and Pathophysiology: Spinal cord tumors can be primary or metastatic.[neurospinewi.com]

Epidemiology

  • This single hospital-based epidemiological study, in the absence of any such or community-based epidemiological study in the region, will hopefully serve the purpose of spinal tumor predictability in a given population and the approaches of management[ruralneuropractice.com]
  • Primary spinal cord glioma: a Surveillance, Epidemiology, and end results database study. J Neurooncol2010;98(1):83–92 Dodul Mondal 18.[slideshare.net]
  • CES-I with its more favourable prognosis may become CES-R at a later stage. [22] Epidemiology [ edit ] The nerve roots extending from the lumbar spine are susceptible to compression, leading to CES.[en.wikipedia.org]
  • The Epidemiology of low back pain. Best Pract Res Clin Rheumatol. 2010;24:769–81. View Article PubMed Google Scholar Manchikanti L, Singh V, Falco FJ, Benyamin RM, Hirsch JA. Epidemiology of low back pain in adults.[chiromt.biomedcentral.com]
  • Epidemiology Tumors of the spinal cord are rare and reported to represent approximately 10-15% of all central nervous system tumors. Overall, they represent an estimated incidence of 0.5-2.5 cases per 100,000 population.[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • Etiology and Pathophysiology: Spinal cord tumors can be primary or metastatic.[neurospinewi.com]
  • Pathophysiology of tethered cord syndrome and similar complex disorders. Neurosurgical Focus. 2007;23(2):1-10. DOI: 10.3171/FOC-07/08/E6 Filippidis A, Kalani M, Theodore N, Rekate H.[physio-pedia.com]
  • Normal Embryology and the Pathophysiology of Spinal Cord Tethering Dysraphic CNS malformations arise during the second, third, and fourth weeks of human embryogenesis, generally referred to as the period of neurulation.[pediatrics.aappublications.org]
  • Pathophysiology The distal or terminal region of the spinal cord, the conus medullaris and cauda equina, is a complex region of spinal anatomy and transition from the central to peripheral nervous system.[emedicine.medscape.com]
  • […] waves and some physiological functions normal pressure hydrocephalus (NPH) clinical symptom complex characterized by abnormal gait, urinary incontinence, and dementia in the setting of hydrocephalus with normal cerebrospinal fluid pressure; proposed pathophysiology[strokecenter.org]

Prevention

  • Drink plenty of fluids and use good personal hygiene to prevent urinary tract infections. Check for waste and clear the bowels with gloved hands. If needed, use glycerin suppositories or enemas. Wear protective pads and pants to prevent leaks.[webmd.com]
  • . • Immaculate hemostasis and placement of moist Cottonoids (Saramall, Tandil, Argentina) in the epidural space will prevent the accumulation of blood in the operative cavity. – Midline durotomy is performed just rostral to the tumor and extended caudal[neupsykey.com]
  • SLIDESHOW Sciatica Symptoms, Causes, Treatments See Slideshow Can cauda equina syndrome be prevented? Cauda equina syndrome occurs as a result of conditions which are not predictable and is therefore not a preventable syndrome.[medicinenet.com]
  • Página 310 - A randomized trial comparing ticlopidine hydrochloride with aspirin for the prevention of stroke in high-risk patients. ‎[books.google.es]
  • This thickening prevents the ascension of the conus medullaris, resulting in an abnormally elongated spinal cord.[physio-pedia.com]

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