Thoracic Outlet Syndrome Syndromes arising from compression of brachial plexus or blood vessels in that area. Compression attributed to anatomic anomalies (cervical rib, fibrous bands) but evidence scarce. Symptoms and…

Cranial and Peripheral Nerve Lesions General Principles of Nerve Injury Injury to single nerve (mononeuropathy): most commonly follows trauma. Toxic or metabolic disorders affect many nerves (mononeuropathy multiplex or symmetric…

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 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 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 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 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 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 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 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…