Lumbar Spondylosis
Lumbar Spondylosis Age-related degeneration leads to disc bulging and bony spurs, narrowing spinal canal (spinal stenosis); usually confined to one or two lumbar levels, most commonly L4 to L5. Most…
Cervical Spondylotic Myelopathy
Cervical Spondylotic Myelopathy Cord damage from compression by degenerated intervertebral discs, proliferation of surrounding bone, meninges, supporting tissues of spine. Incidence Radiographic evidence of cervical spondylosis increases in each decade:…
Intervertebral Discs and Radiculopathy
Intervertebral Discs and Radiculopathy Pathogenesis Displaced disc material bulges beneath annulus fibrosus or extrudes through tear in annulus, projecting directly into spinal canal (herniated disc). Compresses nerve roots, spinal cord,…
Spinal Injury
Spinal Injury Epidemiology Annual incidence of spinal injury: 15 to 50/1,000,000. Prevalence about 900/1,000,000. Mortality >50% at scene of accident; about 13% at one year for those who survive acute…
Head Injury
Head Injury Focus of chapter is on craniocerebral trauma, also referred to as traumatic brain injury (TBI). Epidemiology 2 million patients annually in the United States. 200,000/year die or permanently…
Spinal Tumors
Spinal Tumors Cell types similar to intracranial tumors. Arise from cord parenchyma, nerve roots, meninges, intraspinal blood vessels, sympathetic nerves, vertebrae. Intramedullary (10%), extramedullary (90%; intradural or extradural). Intramedullary more…
Metastatic Tumors
Metastatic Tumors Epidemiology Eight times more common than primary brain tumors. 25% of all patients with systemic cancer have intracranial metastases (15% brain, 5% meninges, 5% dura; Table 62.1). Brain…
Vascular Tumors and Malformations
Vascular Tumors and Malformations Vascular Malformations Most probably congenital, though may enlarge progressively. Some arteriovenous fistulas acquired, follow trauma or arterial or venous occlusion. Arteriovenous Malformations (AVMs) Affect brain more…
Congenital and Childhood CNS Tumors
Congenital and Childhood CNS Tumors Epidemiology Primary CNS tumors: 20% of all childhood cancers, second only to leukemia. Incidence 2.8 per 100,000 under 15 years. Relative frequency: see Table 60.1….
Pituitary Tumors
Pituitary Tumors Most are pituitary adenomas. Often asymptomatic. Peak ages 20 to 40. Classification Secreting tumors: produce one or more anterior pituitary hormones; prolactinoma most common. Mixed secretory tumors: 10%…
