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Secondary Spinal Cord Injury llI: Pathophysiology01:25

Secondary Spinal Cord Injury llI: Pathophysiology

Early Ischemia and Ionic ImbalanceWithin minutes of spinal cord injury, a secondary cascade begins, progressing over hours to weeks. Vascular damage reduces blood flow, causing ischemia and mitochondrial dysfunction. ATP depletion leads to ion pump failure, membrane depolarization, sodium influx, potassium efflux, and water accumulation, resulting in cellular swelling. Increased intracellular calcium further disrupts mitochondria and accelerates cellular injury.Excitotoxicity and Neuronal...
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The disease process of myasthenia gravis begins at the neuromuscular junction, where antibodies attack key proteins needed for muscle activation. This immune reaction weakens signal transmission, leading to the characteristic muscle fatigue and weakness that define the condition.Immune-Mediated DamageIn most individuals, antibodies target acetylcholine receptors (AChRs) on the postsynaptic membrane of muscle cells. By blocking acetylcholine binding, these antibodies prevent the nerve signal...
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Spinal cord injury progresses through two interconnected phases: primary injury and secondary injury.Primary InjuryPrimary injury happens at the moment of trauma and involves immediate mechanical damage to the spinal cord.Compression happens when broken vertebrae, herniated discs, or accumulating blood (such as a hematoma) press directly against the spinal cord, distorting its normal shape and function. In cases of contusion, the cord is bruised by a blunt force (like penetrating injuries or...
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Identifying, Diagnosing, and Grading Malignant Peripheral Nerve Sheath Tumors in Genetically Engineered Mouse Models
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Identifying, Diagnosing, and Grading Malignant Peripheral Nerve Sheath Tumors in Genetically Engineered Mouse Models

Published on: May 17, 2024

Neoplastic myelopathy.

Seema Nagpal1, Jennifer L Clarke

  • 1Division of Neuro-oncology, Department of Neurology, Stanford University, Stanford, California, USA.

Seminars in Neurology
|September 11, 2012
PubMed
Summary
This summary is machine-generated.

Neoplastic myelopathy, often caused by metastatic disease, presents diagnostic and therapeutic challenges. Treatment involves steroids, surgery, and radiation, with surgery being standard for primary spinal tumors.

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Area of Science:

  • Neurology
  • Oncology
  • Neurosurgery

Background:

  • Neoplastic myelopathy arises from spinal cord compression or direct tumor involvement.
  • Metastatic disease is the most frequent cause of compressive neoplastic myelopathy.
  • Primary intramedullary spinal tumors also contribute to neoplastic myelopathy.

Purpose of the Study:

  • To review the causes, diagnosis, and treatment of neoplastic myelopathy.
  • To discuss management strategies for compressive metastatic disease and primary intramedullary spinal tumors.
  • To highlight the challenges in diagnosing and treating neoplastic myelopathy.

Main Methods:

  • Literature review of neoplastic myelopathy.
  • Discussion of metastatic disease and primary intramedullary spinal tumors.
  • Analysis of treatment modalities including steroids, surgery, and radiation therapy.

Main Results:

  • Compressive metastatic disease requires prompt high-dose steroids, selective surgery, and radiation therapy.
  • Surgical resection is the primary treatment for most primary intramedullary spinal tumors.
  • Radiation may benefit specific cases, while chemotherapy is generally less effective for spinal tumors.

Conclusions:

  • Neoplastic myelopathy is a complex condition requiring multidisciplinary management.
  • Timely intervention with appropriate therapies is crucial for patient outcomes.
  • Referral to specialized centers is recommended for complex cases.