Presentation
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]
Contrast enhancement is generally present and is usually heterogeneous. [appliedradiology.com]
Case presentation A 50-year-old African-American woman presented with a 4-month history of numbness, paresthesias, and mild left-hand weakness. [jmedicalcasereports.biomedcentral.com]
Rarely, symptoms of subarachnoid hemorrhage may be present. Intratumoral hemorrhage can cause an abrupt deterioration, a presentation most often associated with ependymomas. [emedicine.medscape.com]
They present as enhancing masses and will not cause a differential problem. All other cord tumors are uncommon. The images are of a patient with neurofibromatosis who has multiple ependymomas. They present as multiple enhancing masses. [radiologyassistant.nl]
Entire Body System
- Arm Pain
This condition can cause neck pain/stiffness, arm pain, weakness in the hands, muscle spasms, loss of coordination and sometimes loss of bowel or bladder control. [centerforneuroandspine.com]
Gastrointestinal
- Constipation
[…] the spinal cord typically cause symptoms in the arms and/or legs including gradually worsening muscle weakness which may lead to paralysis, sensory loss or abnormal sensations, bowel or bladder problems including urinary retention, incontinence and constipation [pacificneuroscienceinstitute.org]
Bladder and bowel dysfunction with urinary retention, incontinence, constipation can occur at any level of cord involvement. [clinicaladvisor.com]
The tumor may involve the nerve roots.Symptoms may include gradual onset of pain with pain increasing as the tumor grows, numbness, weakness, constipation, and incontinence (loss of bladder control).Surgical removal of the tumor is the treatment of choice [atlantabrainandspine.com]
Cardiovascular
- Hypotension
In the setting of severe hypotension, dissecting aortic aneurysm, rapidly progressive quadriplegia, or paraplegia with sharp midline back pain suggests anterior spinal artery syndrome. Acute spinal MS is a relatively painless febrile illness. [clinicaladvisor.com]
Musculoskeletal
- Neck Pain
At our office visit she complained of an insidious onset of neck pain, which had recently become quite severe. There was no obvious injury to cause progressive neck pain. Any posture other than lying flat in bed caused her significant discomfort. [spinemd.com]
What Cervical Spine Pain Could Mean Neck pain can be debilitating and there is a wide range of possible causes. [centerforneuroandspine.com]
Some common signs of spinal tumors may include: Pain (back and/or neck pain, arm and/or leg pain) Muscle weakness or numbness in the arms or legs Difficulty walking General loss of sensation Difficulty with urination (incontinence) Change in bowel habits [cancercenter.com]
Discitis and osteomyelitis of the cervical spine in a 52-year-old man with fever and neck pain. [aafp.org]
Neck pain; pain that extends toward the shoulder, between the shoulder blades, and even pain in the back of the head. There may also be radicular symptoms with pain, numbness, or weakness extending into the arms or legs. [acsneuro.com]
- Leg Weakness
Later, spastic leg weakness develops. Deficits may be asymmetric. [merckmanuals.com]
Spinal Tumor Symptoms Symptoms often include neck and back pain, arm or leg weakness or numbness, and change in bowel or bladder habits. [cpmc.org]
The patient should be asked about paresthesias, numbness or weakness. Muscle weakness, if progressive, must be evaluated urgently. [aafp.org]
Two other rare patterns include the Brown-Sequard hemicord syndrome (same side motor sensory findings and opposite side loss of pain and temperature) and central cord syndrome which in the cervical cord will produce more arm over leg weakness, with dissociated [clinicaladvisor.com]
- Spine Pain
The cervical spine has openings that allow arteries to pass blood to the brain. What Cervical Spine Pain Could Mean Neck pain can be debilitating and there is a wide range of possible causes. [centerforneuroandspine.com]
Neurologic
- Paresthesia
Initial symptoms included occipital pain, glove-type numbness, and paresthesia of the upper extremities. In all three cases, myelopathic signs preceded radicular signs. [journals.lww.com]
Clinically, they sought medical care because of progressive paresthesias or urinary incontinence caused by a nodular, fairly circumscribed intraspinal tumor of the cervical and thoracic spinal cord, respectively. [sogacot.org]
In the recovery room immediately after surgery, paresthesias and hyperesthesia may be troublesome. E. [clinicaladvisor.com]
Case presentation A 50-year-old African-American woman presented with a 4-month history of numbness, paresthesias, and mild left-hand weakness. [jmedicalcasereports.biomedcentral.com]
Ectopic sensory discharges and paresthesiae in patients with disorders of peripheral nerves, dorsal roots and dorsal columns. Pain 20: 231–245, 1984 Google Scholar 22. Brieg A: Adverse Mechanical Tension in the Central Nervous System. [link.springer.com]
- Tingling
Depending on the location and size of a spinal cord tumor, symptoms may also include numbness and tingling in the arms and legs, muscle weakness, balance and coordination problems, and a loss of bladder or bowel control. [nyulangone.org]
When the tumor presses on the spinal cord, symptoms may begin with numbness or tingling in the arms or legs. Next, patients may experience clumsiness, not knowing where their feet are, and difficulty with buttons or keys. [cancercenter.com]
These can take the form of numbness, tingling, decreased sensitivity to temperature or cold sensations. Motor problems. [drugs.com]
Sensory symptoms of tingling and numbness in the local dermatome are common and ascending numbness with paresthesias is frequent. [clinicaladvisor.com]
The presentation is similar to that for lumbar disc herniation (i.e., pain, tingling and weakness in the distribution of one nerve root to the upper extremity). MRI is the modality of choice for identifying cervical disc herniation ( Figure 5 ). [aafp.org]
- Hyperreflexia
One emergency department study found that nine patients who presented with severe myelopathy had a low incidence of extensor plantar responses and hyperreflexia. 1 View/Print Table TABLE 3 Levels of Spinal Nerve Root Supply and Measures for Evaluating [aafp.org]
A neurological examination revealed hypesthesia and mild weakness in her left C8 spinal nerve distribution, as well as mild hyperreflexia and a Babinski’s sign in the left lower extremity. [jmedicalcasereports.biomedcentral.com]
Other signs evident upon physical examination may include spine tenderness, stiffening of gait, trophic changes of extremity, sensory loss, hyperreflexia, clonus, and scoliosis or torticollis (generally in children). [emedicine.medscape.com]
Below that level, Upper Motor Neuron (UMN) findings are those of spasticity, hyperreflexia with upgoing Plantar reflex also called Babinski’s sign With Extradural lesion (i.e. spinal metastasis), early symptoms are motor and sensory in an asymmetric onset [clinicaladvisor.com]
- Radiculopathy
More often, spinal carcinoid tumors manifest by mass effect: myelopathy and/or radiculopathy[ 6 – 8, 13 – 15 ]. [jmedicalcasereports.biomedcentral.com]
[…] disc absorbs shock, provides resistance to compression and allows flexibility of the vertebral column. 7 A compromised (degenerated or anatomically abnormal) disc lends itself to abnormal motion and herniation of the nucleus pulposus, with potential radiculopathy [aafp.org]
The symptoms are chronic and consist mainly of pain, myelopathy and radiculopathies. Occasionally, these ependymomas may bleed and produce subarachnoid hemorrhage or hematomyelia and hence acute symptoms. 12. Ependymomas are characterized by slow [slideshare.net]
- Clonus
Coming down the stairs or stepping off a curb will reveal ankle clonus felt as “vibrations” by patient. [clinicaladvisor.com]
Other signs evident upon physical examination may include spine tenderness, stiffening of gait, trophic changes of extremity, sensory loss, hyperreflexia, clonus, and scoliosis or torticollis (generally in children). [emedicine.medscape.com]
Urogenital
- Urinary Retention
retention, incontinence and constipation, as well as back pain. [pacificneuroscienceinstitute.org]
Bladder and bowel dysfunction with urinary retention, incontinence, constipation can occur at any level of cord involvement. [clinicaladvisor.com]
These images are of a 31 year old male with headache, voiding disturbances, urinary retention, sensory level C3. The CSF analysis revealed 400/3 cells (meaning no infection) and a slightly higher protein level. [radiologyassistant.nl]
- Urinary Incontinence
Clinically, they sought medical care because of progressive paresthesias or urinary incontinence caused by a nodular, fairly circumscribed intraspinal tumor of the cervical and thoracic spinal cord, respectively. [sogacot.org]
Workup
He did not pursue further workup at the time as he was asymptomatic except for intermittent back pain. [omicsonline.org]
The second panel shows a small enhancing ependymoma of the thoracic spine that was found during the workup for the cervical syrinx. [emedicine.medscape.com]
Treatment
Treatment is microsurgical excision, followed by radiation depending on nature of the tumor. [medtube.net]
Your radiotherapy team use this scan to plan your treatment. At the beginning of each treatment session, you lie in the same position but under the radiotherapy machine. The treatment itself only takes a few minutes. [macmillan.org.uk]
Non-Surgical Treatment The type of non-surgical treatment determined appropriate is dependent on many factors including the type of tumor (benign or malignant), its stage, treatment objective (e.g. pain reduction, cure), and patient’s life expectancy [atlantabrainandspine.com]
Radiation Therapy Your doctor may recommend radiation therapy as a standalone treatment or as additional treatment to destroy any tumor cells that may remain after surgery. [stanfordhealthcare.org]
Treatment at a major brain and spine center will give patients the widest range of expert treatment options, along with access to clinical trials for spine tumors. [weillcornellbrainandspine.org]
Prognosis
What is the prognosis for a patient after a chordoma diagnosis? It is important to remember that the prognosis for each person is unique, and depends on many different factors. [chordomafoundation.org]
Unfortunately, even if the most aggressive treatment is attempted, the prognosis is usually unfavorable. There are few promising therapies being developed for GBM treatment. [bnasurg.com]
Prognosis and Patient Counseling. With epidural spinal metastases prognosis is generally poor. For example, median survival after radiotherapy for lung primary is 1.5 months while with breast cancer it is 9 months. [clinicaladvisor.com]
Prognosis The prognosis will depend upon the location of the tumor on the spinal cord, the type of tumor and the size of the tumor at the time of diagnosis. [drugs.com]
The treatment and prognosis for a spine tumor vary based on whether it is primary or metastatic, benign or malignant, and other factors. [weillcornellbrainandspine.org]
Etiology
Review of etiology, diagnosis, and multi-disciplinary approach to treatment. Cancer Practice 3: 207–218, 1995. Google Scholar 18. Epstein FJ, Farmer JP, Freed D: Adult intramedullary spinal cord ependymomas: The result of surgery in 38 patients. [link.springer.com]
The etiology of intramedullary spinal tumors remains obscure but undoubtedly varies according to histology. [emedicine.medscape.com]
Epidemiology
They provide comprehensive information about the diagnosis, treatment, epidemiology, and prognostic factors of chordoma: Building a global consensus approach to chordoma: a position paper from the medical and patient community Chordoma: current concepts [chordomafoundation.org]
Epidemiology Frequency Spinal tumors occur with an incidence of 1.1 case per 100,000 persons. Intramedullary spinal tumors comprise approximately 2-4% of all CNS neoplasms. [emedicine.medscape.com]
Pathophysiology
Pathophysiology The pathophysiology of intramedullary spinal cord tumors varies according to tumor type. Ependymomas are usually indolent, encapsulated tumors that are histologically benign. [emedicine.medscape.com]
Prevention
Prevention Although spinal cord tumors cannot be prevented, some forms of cancer that spread to the spinal cord can be prevented or cured before they can spread to the spine. [drugs.com]
Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/TraumaticBrainInjury/index.html. Updated November 4, 2010. Accessed November 20, 2014. Visocchi M, Di Rocco F, Meglio M. [cancercarewny.com]
You can prevent some tumors by maintaining a healthy lifestyle. We do not know a lot about preventing spine tumors. Early detection of a spine tumor is the best known step to successful treatment. [mountsinai.org]
Tests may include: MRI scan of the spinal canal and spinal cord with and without contrast material Angiography —uses contrast material to see blood vessels Plain x-rays and CT scan of the spinal canal Prevention There are no current guidelines to prevent [seattleneurosciences.com]
It may not be possible to prevent spinal cord compression in all cases because there are so many possible causes. [healthline.com]