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spinal cord patholog

CNS spinal cord

a localized tubercular abscess in L3 vertebral body can cause what? cauda equina areflexia of LE numbness of BLE flaccid weakness of both legs
which spinal cord tract runs contralateral to the body half it serves? spinothalamic tract
where does the spinal cord end? L1-L2
what can a cervical cord transection cause? ventilator dependence autonomic instability sex dysfunction brisk reflexes bilateral involvement sensory "level" spasticity/UMN signs
how does a cauda compression present? pain flaccid bilat LE weakness/sensory loss areflexia bladder/bowel/sex dysfunction
what's the ddx of myelopathy? trauma spondylotic cord compression transverse myelitis neoplasm infectious vascular hereditary metabolic syringomyelia
why should you do a stat spinal cord MRI emergently in pt w/ acute myelopathy? r/o cord compression
what is consistent w/ transverse myelitis due to MS? band like sensation around abdomen asymmetric cross sectional inflammation only 1 ovoid periventricular brain lesion loss of pin in R leg w/ loss o vibratory sense in L leg
do you give glucocorticoids in spinal cord trauma? no
what happens if you have a complete injury above C4? vent dependent
what are the most common causes of epidural cord compression? cancer: vert metastasis, path features hematoma: anticoag, bleeding d/o, instrumentation abscess: bacterial, TB, fungal
how does transverse myelitis develop? evolves over hours - days no apparent trigger or trauma
what demographic does transverse myelitis present in? young ppl
how does transverse myelitis present? LE +/- UE weakness band like sensation pain sensory loss/level bladder & autonomic
how do you dx transverse myelitis? inflammation by imaging (+gad < 2 segments) CSF (protein, WBC)
if transverse myelitis is due to MS, what does it look like? 2 vert segments or less and often asymmetric
if there are brain lesions w/ transverse myelitis, what becomes more likely? MS
what's the treatment for transverse myelitis? high dose IV steroids
how does TM recovery look like? happens over many weeks at least partial
what infections can cause anterior horn neuronitis? Polio West Nile Coxsackie Enterovirus 71
how do you dx acute viral myelitis? CSF pleocytosis or MRI findings
which viruses can present like Transverse Myelitis? HSV VZV CMV EBV Hep C
what usually causes a cord infarct? aortic pathology surgery
what's the exam in cord infarct? pinprick diminished weak vibration preserved
what are other causes for cord infarcts? systemic hypotension conventional athero/embolism
what a is involved in a cord infarct? anterior spinal a.
which chronic myelopathy is the most likely to fluctuate? spinal dural AV fistula
how does lumbar spinal stenosis present? gluteal/LE pain relieved by sitting/bending. worse w/ walking
what's the tx for lumbar spinal stenosis? sx
how does cervical spondylotic myelopathy present? LMN UE signs + UMN LE signs
what metabolic deficiencies can cause chronic myelopathies? vit B12 copper deficiency
which infections can cause chronic myelopathies? HIV myelitis HTLV-1 (tropical spastic paraparesis) tertiary neurosyphilis
what's the most common AVM of the spine? dural AV fistula
how do dural AV fisulas present? myelo-radicular symptoms that may initially fluctuate
how ddx AV fistula? spinal angiogram
what intramedullary tumors cause chronic myelopathies? primary CNS (ependymoma, astrocytoma) systemic cancer mets
what are the types of hereditary spastic paraplegia? uncomplicated: LE spasticity/weakness, mild bladder dysfunction, vibration loss complicated: cognitive, visual, auditory, speech, extrapyramidal
what are the inherited myelopathies? hereditary spastic paraplegia adrenomyeloneuropathy friedreich ataxia
what's the problem in adrenomyeloneuropathy? very long chain fatty acid deficiency
how is adrenomyeloneuropathy inherited? what are ass illnesses? X linked leukodystrophy associated: adrenal dz, peripheral neuropathy
how does Friedreich ataxia present? areflexic w/ upgoing toes sensory degeneration w/i cord
what are the associated diseases w/ Friedreich ataxia? diabetes cardiomyopathy scoliosis
what is a syringomyelia? fluid-filled longitudinal cavity, in cervical or upper thoracic cord may involve brainstem
what is ass pathology w/ syringomyelia? Chiari 1 (most common) prior infection inflammation trauma tumor
what are symptoms of syringomyelia? central cord syndrome: suspended pain/sensory at that level
what are other myelopathies not covered? tethered cord syndrome paraneoplastic radiation-induced hepatic cirrhosis electrocution lathyrism (overeating certain legumes- Fava)
Created by: Syndenham
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