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Spinal Cord Lesion


Presentation

  • We present a case of sarcoid isolated to the intramedullary spinal cord, which was a diagnostic and therapeutic challenge. We review the case and then present a review of the literature with an emphasis on presentation, diagnosis and treatment.[ncbi.nlm.nih.gov]
  • Hemangiopericytoma is an aggressive vascular tumour that rarely affects the central nervous system and is even more rarely spinal in presentation.[ncbi.nlm.nih.gov]
  • We report a patient who presented with atypical clinical manifestations including worsening abdominal pain from an intramedullary spinal cord lesion.[ncbi.nlm.nih.gov]
  • Although this was a presumed diagnosis based on other lesions, our case is the first in which both intramedullary and epidural masses are present.[ncbi.nlm.nih.gov]
  • The results of the present study support our hypothesis that the etiology of the palsy is a transient disturbance of the spinal cord following a decompression procedure.[ncbi.nlm.nih.gov]
Hyperthermia
  • Repeated hyperthermia combined with limited evaporative heat loss was sufficient to increase plasma volume, probably by alterations in fluid regulatory hormones.[ncbi.nlm.nih.gov]
Fecal Incontinence
  • The most important factors are the spasm, decubitus nature, insufficient motivation, deformity, urinary and fecal incontinence.[boneandspine.com]
  • This is called fecal incontinence .[northshore.org]
Back Pain
  • Progressive lower back pain, paraplegia, and urinary incontinence subsequently developed. Magnetic resonance imaging (MRI) revealed a lesion of the thoracic spinal cord and thecal sac; a biopsy specimen was obtained ( Figure 1 ).[nejm.org]
  • Back pain is a serious presentation in children and should be appropriately worked up.[appliedradiology.com]
  • Case presentation A 51-year-old Iranian woman presented with 2-month history of progressive unremitting back pain, exacerbated at night, superimposed on a creeping paraparesis.[casesjournal.biomedcentral.com]
  • APEX SPINE CENTER - your specialist for back pain, neck pain, disc herniation, spinal stenosis, spinal surgery, disc surgery, spinal canal narrowing, spinal stenosis, endoscopic disc surgery in Germany, Switzerland, Alsace (Alsace), Rheinland-Pfalz, Baden[apex-spine.de]
  • There are three common types of spinal tumors that can cause back pain: vertebral column tumors, intradural-extramedullary tumors, and intramedullary tumors. 1.[spine-health.com]
Muscle Spasticity
  • Symptoms may include: Muscle weakness or paralysis in the trunk, arms or legs Loss of feeling in the trunk, arms, or legs Muscle spasticity Breathing problems Problems with heart rate and blood pressure Digestive problems Loss of bowel and bladder function[hopkinsmedicine.org]
  • Some people with spinal cord injuries experience one of two types of muscle tone problems: uncontrolled tightening or motion in the muscles (spasticity) or soft and limp muscles lacking muscle tone (flaccidity). Fitness and wellness.[mayoclinic.org]
  • You may also learn how to handle problems such as pressure injuries , urinary tract infections , and muscle spasticity . Do daily tasks, such as cook, brush your teeth, and move from a wheelchair to a bed or chair.[northshore.org]
  • Motor function: A body function controlled by muscles. Spasticity: The permanent tightening of a joint into an abnormal position. Spinal cord: A long rope-like piece of nervous tissue that runs from the brain down the back.[encyclopedia.com]
Low Back Pain
  • Red flags See also separate Neck Pain (Cervicalgia) and Torticollis and Low Back Pain and Sciatica articles. Red flags that suggest spinal compression include: Insidious progression.[patient.info]
  • It can cause low back pain, weakness or paralysis in the lower limbs, loss of sensation, bowel and bladder dysfunction, and loss of reflexes. Unlike in conus medullaris syndrome, symptoms often occur on only one side of the body.[en.wikipedia.org]
Muscle Twitch
  • This means that when the muscle receptors are briefly stretched by the tap, the nerve impulses in the afferent pathway travel directly to the motor neurons and excite them reflexly to cause the normally visible muscle twitch.[encyclopedia.com]
Hyperreflexia
  • Autonomic hyperreflexia is a serious peripartum complication associated with spinal cord lesions. Although the majority of reported cases have occurred with lesions at T-5 or higher, we report a case occurring in a patient with a lesion at T-10.[ncbi.nlm.nih.gov]
  • […] extermities is due to nerve root return and must not be mistaken for evidence of return of spinal function; - spinal shock (spinal cord concussion): - usually invovles 24-72 hour period of paralysis, hypotonia, & areflexia, and at its conclusion there may be hyperreflexia[wheelessonline.com]
  • Hyperreflexia From my perspective, I have no bladder or bowl problems but I do have leg and arm pain (was told I have fibromyalgia 2 years ago) and have Hashimoto's (thyroid) which is an autoimmune.[thisisms.com]
Clonus
  • […] must not be mistaken for evidence of return of spinal function; - spinal shock (spinal cord concussion): - usually invovles 24-72 hour period of paralysis, hypotonia, & areflexia, and at its conclusion there may be hyperreflexia, hypertonicity, and clonus[wheelessonline.com]
  • Upper motor neurone signs in the lower limbs (Babinski's sign: up-going plantar reflex, hyperreflexia, clonus, spasticity). Lower motor neurone signs in the upper limbs (atrophy, hyporeflexia).[patient.info]
Unable to Walk
  • More than being unable to walk Worldwide, millions of people are dependent on a wheelchair after having sustained a spinal cord injury, most often as the result of a traffic accident or a fall.[wingsforlifeworldrun.com]
  • Spinal pain is often present for three months and neurological symptoms for two months before paraplegia, but almost 50% of patients are unable to walk by the time of diagnosis. Of these, almost 70% remain immobile.[patient.info]
  • The levels go from 0 (client unable to walk) to 20 (client walking without braces and/or devices and without physical assistance for at least 10 m).[nature.com]
Radiculomyelopathy
Urinary Incontinence
  • Two females in each group underwent tension-free vaginal tape for stress urinary incontinence (SUI), reducing episodes per week of SUI by 90% after 5 years.[ncbi.nlm.nih.gov]
  • Progressive lower back pain, paraplegia, and urinary incontinence subsequently developed. Magnetic resonance imaging (MRI) revealed a lesion of the thoracic spinal cord and thecal sac; a biopsy specimen was obtained ( Figure 1 ).[nejm.org]
  • Male Stress Urinary Incontinence surgery Female Stress Urinary Incontinence PHARMACEUTICAL TREATMENT Your doctor may prescribe medications to improve bladder function, such as reduce bladder contractions, lower urinary frequency, improve loss of bladder[nafc.org]
  • The presenting symptoms of ISCM vary from pain, sensory loss, weakness, urinary incontinence to pseudo Brown-Sequard and/or Brown-Sequard syndrome [ 5 ]. The duration of symptoms before diagnosis of ISCM ranges from days to a few months [ 5 , 6 ].[casesjournal.biomedcentral.com]
  • ., urinary urgency or hesitancy, partial retention of urine, mild urinary incontinence), bowel dysfunction (e.g., constipation or urgency), and sexual dysfunction (e.g., erectile dysfunction or impotence in men, genital anesthesia or numbness in women[healthcentral.com]
Overflow Incontinence
  • There may be overflow incontinence when the bladder cannot physically hold any more urine.[neuroanatomy.wisc.edu]

Workup

  • […] fracture; can be used when plain radiography is inadequate or fails to visualize segments of the axial skeleton Magnetic resonance imaging (MRI) - Used for suspected spinal cord lesions, ligamentous injuries, and other soft-tissue injuries or pathology See Workup[emedicine.medscape.com]
Plasma Volume Increased
  • Plasma volume increased from day 1 by 1.5 0.6 % on day 7 (P 0.05). No sweat secretion was detected or changes in body mass observed from any participant.[ncbi.nlm.nih.gov]

Treatment

  • To assess the current place of this procedure in the treatment of the neuropathic bladder of spinal origin, we studied the outcomes of sphincterotomy in 32 patients.[ncbi.nlm.nih.gov]
  • Current practice supports the role of surgery for biopsy; mainstay of treatment is corticosteroids.[ncbi.nlm.nih.gov]
  • The number of spasms per hour was calculated before and after PVS and no treatment. Spasticity was evaluated by the Modified Ashworth Scale (MAS). Reduction in spasticity and spasms.[ncbi.nlm.nih.gov]
  • Hemangiopericytomas show a slow clinical evolution with a strong propensity to relapse long after previous treatment and thus, once identified, prolonged follow-up for recurrence is indicated.[ncbi.nlm.nih.gov]
  • Treatment is key for spinal tumours, as any damage it causes can be made more severe or indeed, permanent, if treatment is not sought soon enough.[spinalcord.com]

Prognosis

  • Diagnosis and prognosis of acute cervical spine cord injury . Original Text by Clifford R. Wheeless, III, MD.[wheelessonline.com]
  • Treatment and prognosis As a ‘spinal lesion’ can cover so many kinds of diagnosis, there are varying forms of treatment and different prognoses an individual can have. A lesion is categorized dependent upon its size and location.[spinalcord.com]
  • The prognosis of a patient who has an intramedullary cord lesion is grave, the treatment is mostly undertaken to relieve pain and to preserve or stabilize neurologic function.[casesjournal.biomedcentral.com]
  • Functional prognosis in the elderly spinal cord injured . Arch Phys Med Rehabil 1982; 63 : 513–514. 7. Cifu DX , Huang ME , Kolakowsky-Hayner SA , Seel RT .[nature.com]

Etiology

  • The results of the present study support our hypothesis that the etiology of the palsy is a transient disturbance of the spinal cord following a decompression procedure.[ncbi.nlm.nih.gov]
  • Spinal cord infarction: etiology and outcome. Neurology. 1996;47 (2): 321-30. Pubmed citation 4. Beck K. Das Syndrom des Verschlusses der vorderen Spinalarterie. Deutsche Zeitschrift f. Nervenheilkunde. 1952;167 (3): 164-186. doi:10.1007/BF00242756[radiopaedia.org]
  • If there is no focal cord expansion or considerable mass effect, non-neoplastic etiologies should be considered first. Cysts can be tumoral or nontumoral.[appliedradiology.com]
  • Etiology: Since 2005, motor vehicle crashes account for 42.1% of reported SCI cases. The next most common cause of SCI is falls, followed by acts of violence (primarily gunshot wounds), and recreational sporting activities.[fscip.org]
  • Motor and sensory loss may be permanent or temporary, depending on the etiology; function may be lost briefly due to concussion or more lastingly due to a contusion or laceration.[merckmanuals.com]

Epidemiology

  • Gender does not seems to influence spinal cord rehabilitation outcomes despite the fact that men and women showed significant epidemiological differences.[ncbi.nlm.nih.gov]
  • Epidemiology The characteristics of the two groups are shown in Tables 1 and 2 .[nature.com]
  • He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education.[lifeinthefastlane.com]
  • Epidemiology of traumatic spinal cord injury. Kirshblum S, Campagnolo DI, DeLisa JA, eds. Spinal Cord Medicine . Baltimore, Md: Lippincott Williams & Wilkins; 2002. 69-81. Go BK, DeVivo MJ, Richards JS. The epidemiology of spinal cord injury.[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology 1. The spinal cord and nerve roots may be injured by: a. Compression from bone, ligaments, extruded disc material and tumors. b. Disruption or overstretching of neural tissues c. Edema following compression or concussion d.[kobiljak.msu.edu]
  • A review of the pathophysiology of cervical spondylotic myelopathy with insights for potential novel mechanisms drawn from traumatic spinal cord injury. Spine . 1998;23:2730–7. 3. Wilkinson M.[aafp.org]
  • Epidemiology, demographics and pathophysiology of acute spinal cord injury . Spine 2001; 24S : S2–S12. 20. McKinley WO , Seel RT , Hardman JT . Nontraumatic spinal cord injury: incidence, epidemiology and functional outcome .[nature.com]

Prevention

  • There is some evidence that cranberry products may prevent urinary tract infection. In the future, bacterial interference and vaccination may be a possibility for prevention of urinary tract infection.[ncbi.nlm.nih.gov]
  • […] of cryptogenic myelopathy, especially in patients with a long spinal cord lesion, as treatment with chenodeoxycholic acid and/or competitive inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase reverse the metabolic derangement and prevent[ncbi.nlm.nih.gov]
  • The results support the concept that performing in utero surgery could protect the exposed but initially well-developed and uninjured cord, prevent secondary neural injury, and preserve neural function in the human fetus with myelomeningocele.[ncbi.nlm.nih.gov]
  • The majority of spinal cord injuries are due to preventable causes such as road traffic crashes, falls or violence.[who.int]
  • Other emergency treatment involves maintaining breathing ability, preventing shock, keeping the neck immobilized, and preventing complications such as blood clots.[livescience.com]

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