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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]
  • OBJECTIVE: 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]
  • 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]
  • We report a patient who presented with atypical clinical manifestations including worsening abdominal pain from an intramedullary spinal cord lesion.[ncbi.nlm.nih.gov]
  • CONCLUSIONS: 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
  • incontinence, erectile dysfunction, loss of rectal tone, abnormal bulbocavernosus and anal wink reflexes).[msdmanuals.com]
  • The most important factors are the spasm, decubitus nature, insufficient motivation, deformity, urinary and fecal incontinence.[boneandspine.com]
Back Pain
  • 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]
  • 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]
  • Some of the anatomic and physiologic considerations pertinent to an understanding of disorders of the cord and of the spine can be found in Chaps. 3 , 9 ( Figs. 9-5 and 9-7 ), and Chap. 11 , on motor paralysis, somatic sensation, and back pain, respectively[accessmedicine.mhmedical.com]
  • Symptoms Patients with injuries to the sacral nerve roots may experience: Lack of control of bowels or bladder Lower back pain Leg pain, which may radiate down the back of the leg(s) Sensory issues in the groin and buttocks area Causes The most common[spinalcord.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]
Muscle Spasticity
  • 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]
Social Isolation
  • Age, sex and social isolation have no direct influence on the result with regard to functional status.[ncbi.nlm.nih.gov]
Hyperreflexia
  • Abstract Autonomic hyperreflexia is a serious peripartum complication associated with spinal cord lesions.[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]
  • After days or weeks, upper motor neuron dysfunction evolves into spastic paresis (increased muscle tone, hyperreflexia, and clonus). Extensor plantar responses and autonomic dysfunction are present.[msdmanuals.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
  • 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]
Neglect
  • Our findings suggest that rehabilitation outcome could be improved through an early multidisciplinary approach and better continuity between acute and rehabilitation care, especially for the 'neglected' NT SCL patients.[ncbi.nlm.nih.gov]
Spastic Gait
  • The patient, a 46-year-old Japanese male, developed sensory disturbance of the lower legs at 39 and spastic gait at 46 years of age.[ncbi.nlm.nih.gov]
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]
  • 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]

Workup

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). MAIN OUTCOME MEASURE: Reduction in spasticity and spasms.[ncbi.nlm.nih.gov]
  • CONCLUSIONS: 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]
  • Treatment and prognosis Prognosis of anterior cord syndrome is worst among all other spinal cord injury syndromes 5 . It is associated with high mortality and poor functional outcome in terms of poor recovery of motor power and coordination.[radiopaedia.org]
  • Treatment and prognosis Prognosis of anterior cord syndrome is worst among all other spinal cord injury syndromes 5. It is associated with high mortality and poor functional outcome in terms of poor recovery of motor power and coordination.[radiopaedia.org]

Etiology

  • CONCLUSIONS: 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]
  • Ventral cord syndrome encompasses all causes of damage to the anterior spinal cord regardless of etiology (see below).[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]

Epidemiology

  • CONCLUSION: 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]
  • He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education.[lifeinthefastlane.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]
  • The pathophysiological implication of these dysfunctions is represented by the increased production of the reactive species that are extremely aggressive to the surrounding tissue.[ncbi.nlm.nih.gov]

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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