Tethered Spinal Cord

Tethered spinal cord syndrome is a disorder caused by tissue attachments that limit the movement of the spinal cord. This causes abnormal stretching of the spinal cord. Normally, the bottom of the spinal cord floats freely within a pool of spinal fluid.

The causes of tethered spinal cord are errors in normal development of the fetus. Many cases occur before a women knows she s pregnant.

Some symptoms of tethered spinal cord are, in children, lesions, hairy patches, dimples or fatty tumors on the back, foot and spinal deformities, scoliosis and low back pain. Sometimes children are born with an open defect in the back with elements of the spinal cord visualized at the skin.

If tethered cord is suspected, one or more tests may be performed. An MRI scan is usually the first. If the MRI does not confirm the tethered cord, a myelogram may be necessary. Sonography is also sometimes useful.

Treatment in children, if caught early, surgery is recommended to prevent further neurological damage. If surgery cannot be performed, spinal cord nerve roots may be cut to relieve pain.

For more information on tethered cord you can visit these sites, www.nature.com and www.backpain-guide.com

Multiple Sclerosis of Thoracic Spine

Multiple Sclerosis (MS) attacks the central nervous system. MS affects the areas of the brain and the spinal cord. MS destroys cells that help carry electrical signals. This condition can damage or block nerve signals that control muscle coordination, strength, sensation and vision. MS is an autoimmune condition. It is a chronic and debilitating disease.

Signs and symptoms may vary, depending on the location and area MS effects. Here are some common symptoms of MS:
numbness and weakness
partial or complete vision loss
tingling or pain in parts of the body
tremors, lack of coordination
fatigue
dizziness

Cause of MS is unknown. Women are affected twice as often as men.

MRI is great to detect lesions in the brain and spine.

At this time there is no cure for MS. There are medications that patients with MS can take to help with symptoms. Some patients take physical therapy. Steroids are given to patients with an acute MS attack.

To learn more about MS you can go to these sites:
www.hopkins-arthritis.org
www.thiome-connect.com

Cervical Spondylosis

Cervical Spondylosis also known as cervical osteoarthritis. This condition usually appears later in life, usually in early 30 to 40 years of age. This is an age-related wear and tear of the neck. as we age the cartilage gradually deteriorates. This is a common degenerative disease of the spine.

The common cause is just wear and tear as we age.

Some signs and symptoms are as follows:
Stiffness in the neck
Neck pain
Numbness in the arms, hands and legs
Tingling in the arms, hands and legs

Treatment depends on the severity on the spondylosis. In minor cases, people suffering from syondylosis wear a neck brace, take non steroidal anti-inflammatory drugs or some even do exercises. In severe cases, traction, muscle relaxants and surgery are options.

For more information on spondylosis you can visit these sites, www.cervical-spondylosis.com and www.medscape.com

Sjogren's Syndrome

Sjogren's syndrome is an autoimmune disease that produces extra antibodies in the blood that are directed against various tissues of the body. This illness causes inflammation in certain glands of the body.

The cause of Sjogren's syndrome is unknown. It is found more commonly in families that have members with other autoimmune illnesses. 90% patients with Sjogren's syndrome are female.

Symptoms of Sjogren's syndrome can involve the glands, but it also can involve other organs of the body. Some symptoms include:
- inflammation of the tear gland resulting in eye dryness
- inflammation of the salivary glands resulting in mouth dryness, swallowing difficulties,
dental decay and mouth sores

The diagnosis of Sjogren's syndrome involves detecting the features of dryness of the eyes and mouth.

The treatment of patient's with Sjogren's syndrome is directed toward the particular areas of the body that are involved. There is no cure for Sjogren's syndrome.

Arteriovenous Malformation

Arteriovenous Malformation or AVM can reduce the amount of oxygen received by brain tissues. Most People are born with Arteriovenous Malformation, however, symptoms usually don't occur until adulthood. The cause of Arteriovenous Malformation is unknown. Arteriovenous Malformation's vary in size and location within the brain.

The most common symptoms are as follows:
Headaches
Hemorrhage or bleeding into the brain
stroke
seizures
vision problems

There are different test that help to diagnose or identify the size, location and blood flow pattern of Arteriovenous Malformation. The two most common are CT and MRI.

There are different treatments for Arteriovenous Malformation. They are as follows:
surgery
emobilization
radiation therapy
radiosurgery-Gamma knife

Chronic Sinusitis

Chronic sinusitis can be caused by inflammation of the membranes of the sinus cavity or blockage of the sinus passage way from draining normally. Chronic sinusitis last longer than acute sinusitis. It is also less common than acute sinusitis. It can produce less severe symptoms, but can cause damage to the sinuses.

Some symptoms of chronic sinusitis are as follows:

-drainage of a thick, yellow or greenish discharge
-difficulty breathing through nose
-headache
-sore throat
-nasal congestion
-cough
-facial pain and pressure in forehead, temples, cheeks, nose and behind the eyes

There are some different treatments for chronic sinusitis, they are antibiotics, corticosteroids, decongestants, antihistamines, moisture and humidification.

Chronic sinusitis can be diagnosed several different ways. CT is a better diagnostic test for sinuses than MRI, however, MRI can be done. Nasal and sinus cultures can be done and an allergy test can be done.

For more images on chronic sinusitis go to www.uksdmc.co.uk

Optic Glioma

Optic glioma is one of two most common optic nerve tumors. The other common tumor is optic nerve meningioma. Optic glioma arises from the optic nerve. Optic glioma may only effect one optic nerve or both nerves. These are very uncommon and grow slowly. This type of tumor rarely turn into cancer and usually appear during childhood. Agressive glioma is most common in adults and benign optic glioma are most often in younger patients.

Symptoms are the following:
reduce vision
vision loss in one or both eyes
involuntary eye movement
one or both eyes may bulge out

MRI is better to demonstrate optic glioma but CT can also be used.

Treatment are the following:
Surgery
Radiation therapy
Chemotherapy

If you want to learn more about the above photos you can visit webeye.ophth.uiowa.edu and www.fleni.org.ar.

Pituitary Microadenoma

Pituitary Microadenoma

This type of pituitary tumor is a non-cancerous or benign growth. These tumors are smaller than 10 mm in size. Most pituitary tumors are usually microadenomas.

There are several types of Pituitary Microadenomas. They are broken down into two different categories, depending on if they produce hormones or not.
1. Functioning pituitary microadenoma
2. Nonfunctioning pituitary microadenoma

Functioning microadenomas produce one or more of the pituitary hormones. There are different types of Functioning Pituitary micradenomas and each type caused different symptoms.
ACTH producing
Thyroid hormone producing
Growth hormone producing
Prolactin producing

Nonfunctioning pituitary microadenomas do not produce hormones.

Symptoms range from anywhere to being tired, headaches, dizziness and vomiting. These will vary depending on the size of the microadenoma and the location.

MRI and CT scans are both good test, along with others to help diagnose pituitary microadenomas.

Treatment also varies on the type of microadenoma, hormone activity, how big it is and the location of it. Some treatment can include therapy, surgery and radiation therapy.

I have never seen this type of pathology while working in MRI. If you want more information about microadenoma and the pictures above, visit www.ghettodriveby.com,

Acoustic Neuroma

Acoustic Neuroma is a noncancerous or benign tumor of the 8th cranial nerve. Acoustic Neuroma is also called Vestibular Schwannoma. This type of tumor is usually slow growing. The exact cause of Acoustic Neuroma is unknown. The few patients I have seen in MRI that presented with hearing loss and ringing in their ear's turned out to be negative, which is great.

Other Symptoms include:

continuous inner ear problems
difficulty in balance
dizziness
ear pressure
hearing loss
ringing in ear (tinnitus)

MRI and CT are great test that patients with these symptoms can have to help diagnose Acoustic Neuroma.

Treatment can range from anywhere to just observation, to surgery or radiation therapy. Since these tumors are benign, some patients may just want to keep an eye on it over time depending on patients age and size of tumor. Other patients may choose to have surgery to remove the tumor. Some may choose radiation therapy, rarely does this get rid of the tumor but shrinks the tumor. Most patients that have radiation therapy have to follow-up because the tumor could continue to grow.

For more information on the images you can to these web sites: www.neuro.utmem.edu and www.cedars-sinai.edu.

Brain Mass Lesion

I saw an interesting case of patient with a brain mass lesion this week. The patient came into the hospital presenting with numbness in left arm and lack of coordination. The patient first had a CT, which showed a suspected 1.8 cm mass lesion at right frontal parietal lobe. Then an MRI was ordered, with and without contrast, which confirmed the mass lesion seen on CT. The patient has a history of renal cell carcinoma that was removed 13 months ago. The patients new symptoms confirmed brain metastasis. The patient was then scheduled for MRI Brain lab and taken to surgery the following day. The patient had a right frontoparietal craniotomy with gross total resection of the mass. The patient is scheduled to follow-up with radiation.

The above MRI images are examples of a brain mass lesion. For more information on mass lesion's you can go to: www.residentandstaff.com/.../2007-07_04.asp