Spinal Cord Vascular Diseases
Spinal Cord
Spinal Cord Injuries
Vascular Diseases
Spinal Cord Diseases
Spinal Cord Compression
Spinal Cord Neoplasms
Peripheral spinal cord hypointensity on T2-weighted MR images: a reliable imaging sign of venous hypertensive myelopathy. (1/17)
BACKGROUND AND PURPOSE: MR findings reported in conjunction with spinal dural arteriovenous fistula (SDAVF) include cord swelling, increased T2 signal within the spinal cord, and parenchymal enhancement, each of which is nonspecific. Enlarged vessels on the cord surface, the most specific MR finding, is noted in only half of SDAVF patients. Nevertheless, we have frequently observed MR peripheral hypointensity of the spinal cord in SDAVF on T2-weighted images, which is not characteristic of nonvascular or nonhemorrhagic causes of myelopathy and which has not been described in association with SDAVF. We hypothesized that peripheral cord hypointensity might reliably suggest the diagnosis of SDAVF or other causes of venous hypertensive myelopathy. METHODS: We reviewed the MR findings in 11 consecutive cases of angiographically confirmed symptomatic SDAVF and in four cases of intracranial dural arteriovenous fistula with spinal drainage, a lesion that also causes spinal cord deficits mediated by venous hypertensive myelopathy. RESULTS: In each case, T2 hypointensity involving the cord periphery was present. This sign has not been previously described in association with either SDAVF or other causes of venous hypertensive myelopathy. It appears, however, to be a relatively constant imaging feature of SDAVF. CONCLUSION: In the absence of spinal hemorrhage, T2 hypointensity involving the periphery of the spinal cord suggests venous hypertensive myelopathy as a cause of spinal cord dysfunction. (+info)Neurovascular complications of marfan syndrome: a retrospective, hospital-based study. (2/17)
BACKGROUND AND PURPOSE: Small case series have associated Marfan syndrome with cerebral and spinal ischemia or hemorrhage. However, there has been no investigation of the frequency and etiology of neurovascular disorders in a large series of Marfan patients. METHODS: We conducted a retrospective, hospital-based study of all Marfan syndrome patients seen in an 8-year period. Records were reviewed in detail, and clinical characteristics of those with and without a neurovascular diagnosis compared. RESULTS: Of 513 patients, 18 (3.5%) had a neurovascular diagnosis, as follows: transient ischemic attack (11), cerebral infarction (2), spinal cord infarction (2), subdural hematoma (2), and spinal subarachnoid hemorrhage (1). A cardioembolic source was identified in 12 of 13 patients with cerebral ischemia, as follows: prosthetic heart valves (9), mitral valve prolapse (2), and atrial fibrillation (1). Chronic anticoagulant therapy was a likely cause in 2 of 3 patients with hemorrhagic events. Compared with other Marfan syndrome patients, those with neurovascular events were older (39.6 versus 31.7 years, P=0.04) and more likely to be in atrial fibrillation (22.2% versus 3.2%, P=<0.01), to have prosthetic heart valves (61.1% versus 7.7%, P=0.001), and to be taking anticoagulant therapy (72.2% versus 16.1%, P<0.001). Aortic disease, a putative factor in the etiology of neurovascular complications, was present in equal measure in Marfan patients with and without neurovascular complications (78% versus 65%, P=NS). CONCLUSIONS: Neurovascular complications of Marfan syndrome are rare during 8 years of follow-up, and generally are ischemic in nature. A high-risk cardiac source was identified in the majority. A significant association with vascular dissection was not established. (+info)Spinal tanycytic ependymoma with hematomyelia--case report--. (3/17)
A 58-year-old man presented with an extremely rare case of "pure type" spinal tanycytic ependymoma associated with hematomyelia manifesting as sensory disturbance of the bilateral hands and weakness of the right arm. Magnetic resonance imaging demonstrated a tumor in the spinal cord from C-2 to C-4 levels. The soft gelatinous tumor was subtotally resected and the adjacent chronic liquid hematoma was aspirated. The immunohistochemical and ultrastructural findings indicated a diagnosis of tanycytic ependymoma. (+info)Transient traumatic spinal venous hypertensive myelopathy. (4/17)
We present a case of a reversible spinal venous hypertensive myelopathy that occurred following a traumatic mediastinal hematoma. The mediastinal hematoma caused compression of the brachiocephalic vein, resulting in elevation of the venous pressures that ultimately resulted in dilation of the epidural venous plexus and spinal cord edema. The secondary neurologic deficits were the culmination of venous outflow obstruction at the level of the spinal cord that resolved on the resolution of the mediastinal hematoma. (+info)Usefulness of combined electrophysiological examinations for detection of neural dysfunction in cats with lumbar hematomyelia. (5/17)
We conducted combined electrophysiological examinations including F-wave, motor nerve conduction velocity (MNCV), spinal cord-evoked potential (SCEP), and needle electromyography (EMG) in two cats involved in traffic accidents that consequently developed hind limb paralysis caused by lumbar hematomyelia. F-wave could no longer be elicited within 3 days after the accident, and the MNCV and compound muscle action potential (CMAP) amplitude decreased in a time-dependent manner, with CMAP no longer being evoked after 7 or 8 days. EMG showed abnormalities such as fibrillation and positive sharp waves after 6 to 8 days. These results suggest that such combined electrophysiological examinations may provide objective, quantitative data for motor nerve dysfunction in cats with lumbar hematomyelia. (+info)Spinal arteriovenous shunts presenting as intracranial subarachnoid haemorrhage. (6/17)
BACKGROUND: In approximately 5% of patients with intracranial subarachnoid haemorrhage (SAH), the cause is another than a ruptured aneurysm or perimesencephalic haemorrhage. One of these causes is a spinal arteriovenous shunt (SAVS). The aim of this study was to investigate the characteristics of patients with SAVS who present with intracranial SAH without symptoms and signs suggesting a spinal cause. METHODS: We systematically reviewed the literature and searched the SAH database of the University Medical Center Utrecht, The Netherlands, for patients with SAVS presenting with intracranial SAH and studied the characteristics of patients with SAVS whose clinical presentation mimicked intracranial SAH caused by rupture of a saccular aneurysm. RESULTS: Thirty-five patients were identified after a review of the literature. In our SAH database, comprising 2142 patients included in the period 1985-2004, we found one patient (0.05%, 95 % CI 0.006- 0.3%). SAH due to SAVS occurred at any age (4-72 years). The SAVS was located at the craniocervical junction in 14 patients, at the cervical level in 11, and at the thoracolumbar level in the remaining 11 patients. The majority of patients (n = 26, 72%) had no disabling deficits at discharge or follow-up. CONCLUSION: Rupture of a SAVS presenting as intracranial SAH is rare and can occur at any age. The SAVS can be located not only at the craniocervical junction or cervical level but also in the thoracolumbar region. Most patients with SAVS presenting as intracranial SAH have a good recovery. (+info)Hematomyelia caused by ruptured intramedullary spinal artery aneurysm associated with extramedullary spinal arteriovenous fistula--case report. (7/17)
A 53-year-old woman presented with a ruptured intramedullary aneurysmal dilatation fed by the anterior spinal artery associated with an arteriovenous malformation located in the ventral cervical spinal cord. She developed tetraparesis and respiratory dysfunction. The neurological deterioration was caused by hematomyelia due to the ruptured aneurysmal dilatation and progression of edema in the upper cervical spinal cord due to venous hypertension associated with additional hematoma in the medulla oblongata. Endovascular embolization of both C-1 and C-2 radicular arteries was performed with Guglielmi detachable coils, but components fed by small branches such as the radiculo-pial artery were not obliterated. Surgery was performed for extirpation of the arteriovenous malformation and cervical intramedullary hematoma, and excision of the aneurysmal dilatation through a transcondylar approach combined with vertebral artery transposition. Postoperatively, she overcame several complications such as pneumonia and endocarditis, and had only moderate weakness of the right upper and lower limbs. This case indicates that surgical intervention for high cervical intramedullary lesion may be very effective. (+info)Intramedullary cavernoma presenting with hematomyelia: report of two girls. (8/17)
(+info)Spinal cord vascular diseases refer to a group of disorders that affect the blood vessels of the spinal cord. These conditions can result in insufficient blood supply to the spinal cord tissue, leading to ischemia (lack of oxygen) and infarction (tissue death). There are several types of spinal cord vascular diseases, including:
1. Spinal Cord Infarction: This is a rare condition that occurs due to the blockage or narrowing of the arteries supplying blood to the spinal cord. It can result in sudden onset of weakness, numbness, or paralysis in parts of the body served by the affected spinal cord region.
2. Spinal Cord Aneurysm: This is a localized dilation or bulging of a weakened area in the wall of a blood vessel that supplies the spinal cord. If an aneurysm ruptures, it can cause bleeding into the spinal cord tissue, leading to neurological deficits.
3. Spinal Cord Arteriovenous Malformations (AVMs): These are abnormal connections between the arteries and veins in the spinal cord. AVMs can lead to bleeding, ischemia, or both, resulting in various neurological symptoms.
4. Spinal Cord Dural Arteriovenous Fistulas (dAVFs): These are abnormal communications between the spinal artery and a vein located outside the dura mater (the protective covering of the spinal cord). dAVFs can cause venous congestion, leading to ischemia and neurological dysfunction.
5. Spinal Cord Vasculitis: This is an inflammation of the blood vessels in the spinal cord, which can lead to narrowing or blockage of the affected vessels. It can result in various neurological symptoms, such as weakness, numbness, or pain.
Treatment for spinal cord vascular diseases depends on the specific condition and its severity. Treatment options may include medications, surgery, endovascular procedures, or a combination of these approaches.
The spinal cord is a major part of the nervous system, extending from the brainstem and continuing down to the lower back. It is a slender, tubular bundle of nerve fibers (axons) and support cells (glial cells) that carries signals between the brain and the rest of the body. The spinal cord primarily serves as a conduit for motor information, which travels from the brain to the muscles, and sensory information, which travels from the body to the brain. It also contains neurons that can independently process and respond to information within the spinal cord without direct input from the brain.
The spinal cord is protected by the bony vertebral column (spine) and is divided into 31 segments: 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 1 coccygeal. Each segment corresponds to a specific region of the body and gives rise to pairs of spinal nerves that exit through the intervertebral foramina at each level.
The spinal cord is responsible for several vital functions, including:
1. Reflexes: Simple reflex actions, such as the withdrawal reflex when touching a hot surface, are mediated by the spinal cord without involving the brain.
2. Muscle control: The spinal cord carries motor signals from the brain to the muscles, enabling voluntary movement and muscle tone regulation.
3. Sensory perception: The spinal cord transmits sensory information, such as touch, temperature, pain, and vibration, from the body to the brain for processing and awareness.
4. Autonomic functions: The sympathetic and parasympathetic divisions of the autonomic nervous system originate in the thoracolumbar and sacral regions of the spinal cord, respectively, controlling involuntary physiological responses like heart rate, blood pressure, digestion, and respiration.
Damage to the spinal cord can result in various degrees of paralysis or loss of sensation below the level of injury, depending on the severity and location of the damage.
Spinal cord injuries (SCI) refer to damage to the spinal cord that results in a loss of function, such as mobility or feeling. This injury can be caused by direct trauma to the spine or by indirect damage resulting from disease or degeneration of surrounding bones, tissues, or blood vessels. The location and severity of the injury on the spinal cord will determine which parts of the body are affected and to what extent.
The effects of SCI can range from mild sensory changes to severe paralysis, including loss of motor function, autonomic dysfunction, and possible changes in sensation, strength, and reflexes below the level of injury. These injuries are typically classified as complete or incomplete, depending on whether there is any remaining function below the level of injury.
Immediate medical attention is crucial for spinal cord injuries to prevent further damage and improve the chances of recovery. Treatment usually involves immobilization of the spine, medications to reduce swelling and pressure, surgery to stabilize the spine, and rehabilitation to help regain lost function. Despite advances in treatment, SCI can have a significant impact on a person's quality of life and ability to perform daily activities.
Vascular diseases are medical conditions that affect the circulatory system, specifically the blood vessels (arteries, veins, and capillaries). These diseases can include conditions such as:
1. Atherosclerosis: The buildup of fats, cholesterol, and other substances in and on the walls of the arteries, which can restrict blood flow.
2. Peripheral Artery Disease (PAD): A condition caused by atherosclerosis where there is narrowing or blockage of the peripheral arteries, most commonly in the legs. This can lead to pain, numbness, and cramping.
3. Coronary Artery Disease (CAD): Atherosclerosis of the coronary arteries that supply blood to the heart muscle. This can lead to chest pain, shortness of breath, or a heart attack.
4. Carotid Artery Disease: Atherosclerosis of the carotid arteries in the neck that supply blood to the brain. This can increase the risk of stroke.
5. Cerebrovascular Disease: Conditions that affect blood flow to the brain, including stroke and transient ischemic attack (TIA or "mini-stroke").
6. Aneurysm: A weakened area in the wall of a blood vessel that causes it to bulge outward and potentially rupture.
7. Deep Vein Thrombosis (DVT): A blood clot that forms in the deep veins, usually in the legs, which can cause pain, swelling, and increased risk of pulmonary embolism if the clot travels to the lungs.
8. Varicose Veins: Swollen, twisted, and often painful veins that have filled with an abnormal collection of blood, usually appearing in the legs.
9. Vasculitis: Inflammation of the blood vessels, which can cause damage and narrowing, leading to reduced blood flow.
10. Raynaud's Phenomenon: A condition where the small arteries that supply blood to the skin become narrowed, causing decreased blood flow, typically in response to cold temperatures or stress.
These are just a few examples of vascular conditions that fall under the umbrella term "cerebrovascular disease." Early diagnosis and treatment can significantly improve outcomes for many of these conditions.
Spinal cord diseases refer to a group of conditions that affect the spinal cord, which is a part of the central nervous system responsible for transmitting messages between the brain and the rest of the body. These diseases can cause damage to the spinal cord, leading to various symptoms such as muscle weakness, numbness, pain, bladder and bowel dysfunction, and difficulty with movement and coordination.
Spinal cord diseases can be congenital or acquired, and they can result from a variety of causes, including infections, injuries, tumors, degenerative conditions, autoimmune disorders, and genetic factors. Some examples of spinal cord diseases include multiple sclerosis, spina bifida, spinal cord injury, herniated discs, spinal stenosis, and motor neuron diseases such as amyotrophic lateral sclerosis (ALS).
The treatment for spinal cord diseases varies depending on the underlying cause and severity of the condition. Treatment options may include medication, physical therapy, surgery, and rehabilitation. In some cases, the damage to the spinal cord may be irreversible, leading to permanent disability or paralysis.
Spinal cord compression is a medical condition that refers to the narrowing of the spinal canal, which puts pressure on the spinal cord and the nerves that branch out from it. This can occur due to various reasons such as degenerative changes in the spine, herniated discs, bone spurs, tumors, or fractures. The compression can lead to a range of symptoms including pain, numbness, tingling, weakness, or loss of bladder and bowel control. In severe cases, it can cause paralysis. Treatment options depend on the underlying cause and may include physical therapy, medication, surgery, or radiation therapy.
Spinal cord neoplasms refer to abnormal growths or tumors within the spinal cord. These can be benign (non-cancerous) or malignant (cancerous). They originate from the cells within the spinal cord itself (primary tumors), or they may spread to the spinal cord from other parts of the body (metastatic tumors). Spinal cord neoplasms can cause various symptoms depending on their location and size, including back pain, neurological deficits, and even paralysis. Treatment options include surgery, radiation therapy, and chemotherapy.
Peripheral Vascular Diseases (PVD) refer to a group of medical conditions that affect the blood vessels outside of the heart and brain. These diseases are characterized by a narrowing or blockage of the peripheral arteries, which can lead to reduced blood flow to the limbs, particularly the legs.
The primary cause of PVD is atherosclerosis, a buildup of fats, cholesterol, and other substances in and on the walls of the arteries, forming plaques that restrict blood flow. Other risk factors include smoking, diabetes, hypertension, high cholesterol levels, and a family history of vascular disease.
Symptoms of PVD can vary depending on the severity of the condition but may include leg pain or cramping during exercise (claudication), numbness or tingling in the legs, coldness or discoloration of the feet, sores or wounds that heal slowly or not at all, and in severe cases, gangrene.
PVD can increase the risk of heart attack and stroke, so it is essential to diagnose and treat the condition as early as possible. Treatment options include lifestyle changes such as quitting smoking, exercising regularly, and maintaining a healthy diet, medications to control symptoms and reduce the risk of complications, and surgical procedures such as angioplasty or bypass surgery to restore blood flow.