Thanks Dr. does that mean there is a connection to trauma?
Or simply that an area is effected by, for instance a demylination incident?
That movement is only indicating an area is effected?
Trying to find ideas for dx tools I suppose by thinking this way.
Never happy just knowing it when something goes 'wrong', need to know why and if it can be fixed. Needing to know the variables so the fix is the best it can be with what I have, as all mechanics do.
I just happened to learn/study about people dynamics as well and because it interested me more, learning about my make-up about what makes us all tick/function and why and how, and then trying being a Mr. Fixit there too. Then my health issues gave my some purpose I guess.
How similar we are to computers, and we should be, we made them!
Back to painting my new hand rails for the front step.
Regards Nigel
CCSVI and CCVBP
This is interesting and could add some clues for some examples of flow issues.
http://www.thebarrow.org/Education_And_ ... rly/204853
Abstract
A 36-year-old hydrocephalic male became symptomatic with progressive cervical myelopathy caused by dilated epidural veins compressing the ventral surface of the upper cervical spinal cord. The veins were collaterals from the internal jugular veins, which were occluded bilaterally. The obstruction to venous outflow was treated with a sigmoid sinus-to-internal jugular vein bypass. The obstruction accounted for both the hydrocephalus and the myelopathy. The pathophysiology and treatment of this unique problem are reviewed.
Summary
We have presented a patient with progressive cervical myelopathy as a consequence of dilated epidural venous channels at the craniocervical junction. The obstruction of normal routes of venous outflow from bilateral jugular vein occlusion directed the venous return into the epidural venous plexus. Only the initial surgical approach yielded the diagnosis, which was not apparent from the patient’s preoperative MR imaging and CT studies. Angiography delineated the vascular anatomy and allowed treatment by creating an alternative, low-resistance circuit for venous egress.
http://www.thebarrow.org/Education_And_ ... rly/204853
Abstract
A 36-year-old hydrocephalic male became symptomatic with progressive cervical myelopathy caused by dilated epidural veins compressing the ventral surface of the upper cervical spinal cord. The veins were collaterals from the internal jugular veins, which were occluded bilaterally. The obstruction to venous outflow was treated with a sigmoid sinus-to-internal jugular vein bypass. The obstruction accounted for both the hydrocephalus and the myelopathy. The pathophysiology and treatment of this unique problem are reviewed.
Summary
We have presented a patient with progressive cervical myelopathy as a consequence of dilated epidural venous channels at the craniocervical junction. The obstruction of normal routes of venous outflow from bilateral jugular vein occlusion directed the venous return into the epidural venous plexus. Only the initial surgical approach yielded the diagnosis, which was not apparent from the patient’s preoperative MR imaging and CT studies. Angiography delineated the vascular anatomy and allowed treatment by creating an alternative, low-resistance circuit for venous egress.
Enjoy
http://www.ninds.nih.gov/disorders/hydr ... #173073125
Hydrocephalus Fact Sheet
Table of Contents (click to jump to sections)
What is hydrocephalus?
What are the different types of hydrocephalus?
Who gets this disorder?
What causes hydrocephalus?
What are the symptoms?
How is hydrocephalus diagnosed?
What is the current treatment?
What are the possible complications of a shunt system?
What is the prognosis?
What research is being done?
Where can I get more information?
What is hydrocephalus?
The term hydrocephalus is derived from the Greek words "hydro" meaning water and "cephalus" meaning head. As the name implies, it is a condition in which the primary characteristic is excessive accumulation of fluid in the brain. Although hydrocephalus was once known as "water on the brain," the "water" is actually cerebrospinal fluid (CSF) — a clear fluid that surrounds the brain and spinal cord. The excessive accumulation of CSF results in an abnormal widening of spaces in the brain called ventricles. This widening creates potentially harmful pressure on the tissues of the brain.
The ventricular system is made up of four ventricles connected by narrow passages.. Normally, CSF flows through the ventricles, exits into cisterns (closed spaces that serve as reservoirs) at the base of the brain, bathes the surfaces of the brain and spinal cord, and then reabsorbs into the bloodstream.
CSF has three important life-sustaining functions: 1) to keep the brain tissue buoyant, acting as a cushion or "shock absorber"; 2) to act as the vehicle for delivering nutrients to the brain and removing waste; and 3) to flow between the cranium and spine and compensate for changes in intracranial blood volume (the amount of blood within the brain).
The balance between production and absorption of CSF is critically important. Because CSF is made continuously, medical conditions that block its normal flow or absorption will result in an over-accumulation of CSF. The resulting pressure of the fluid against brain tissue is what causes hydrocephalus.
top
What are the different types of hydrocephalus?
Hydrocephalus may be congenital or acquired. Congenital hydrocephalus is present at birth and may be caused by either events or influences that occur during fetal development, or genetic abnormalities. Acquired hydrocephalus develops at the time of birth or at some point afterward. This type of hydrocephalus can affect individuals of all ages and may be caused by injury or disease.
Hydrocephalus may also be communicating or non-communicating. Communicating hydrocephalus occurs when the flow of CSF is blocked after it exits the ventricles. This form is called communicating because the CSF can still flow between the ventricles, which remain open. Non-communicating hydrocephalus - also called "obstructive" hydrocephalus - occurs when the flow of CSF is blocked along one or more of the narrow passages connecting the ventricles. One of the most common causes of hydrocephalus is "aqueductal stenosis." In this case, hydrocephalus results from a narrowing of the aqueduct of Sylvius, a small passage between the third and fourth ventricles in the middle of the brain.
There are two other forms of hydrocephalus which do not fit exactly into the categories mentioned above and primarily affect adults: hydrocephalus ex-vacuo and normal pressure hydrocephalus.
Hydrocephalus ex-vacuo occurs when stroke or traumatic injury cause damage to the brain. In these cases, brain tissue may actually shrink. Normal pressure hydrocephalus can happen to people at any age, but it is most common among the elderly. It may result from a subarachnoid hemorrhage, head trauma, infection, tumor, or complications of surgery. However, many people develop normal pressure hydrocephalus even when none of these factors are present for reasons that are unknown.
top
Who gets this disorder?
The number of people who develop hydrocephalus or who are currently living with it is difficult to establish since there is no national registry or database of people with the condition. However, experts estimate that hydrocephalus affects approximately 1 in every 500 children.
top
What causes hydrocephalus?
The causes of hydrocephalus are still not well understood. Hydrocephalus may result from inherited genetic abnormalities (such as the genetic defect that causes aqueductal stenosis) or developmental disorders (such as those associated with neural tube defects including spina bifida and encephalocele). Other possible causes include complications of premature birth such as intraventricular hemorrhage, diseases such as meningitis, tumors, traumatic head injury, or subarachnoid hemorrhage, which block the exit of CSF from the ventricles to the cisterns or eliminate the passageway for CSF into the cisterns.
top
What are the symptoms?
Symptoms of hydrocephalus vary with age, disease progression, and individual differences in tolerance to the condition. For example, an infant's ability to compensate for increased CSF pressure and enlargement of the ventricles differs from an adult's. The infant skull can expand to accommodate the buildup of CSF because the sutures (the fibrous joints that connect the bones of the skull) have not yet closed.
In infancy, the most obvious indication of hydrocephalus is often a rapid increase in head circumference or an unusually large head size. Other symptoms may include vomiting, sleepiness, irritability, downward deviation of the eyes (also called "sunsetting"), and seizures.
Older children and adults may experience different symptoms because their skulls cannot expand to accommodate the buildup of CSF. Symptoms may include headache followed by vomiting, nausea, papilledema (swelling of the optic disk which is part of the optic nerve), blurred or double vision, sunsetting of the eyes, problems with balance, poor coordination, gait disturbance, urinary incontinence, slowing or loss of developmental progress, lethargy, drowsiness, irritability, or other changes in personality or cognition including memory loss.
Symptoms of normal pressure hydrocephalus include, problems with walking, impaired bladder control leading to urinary frequency and/or incontinence, and progressive mental impairment and dementia. An individual with this type of hydrocephalus may have a general slowing of movements or may complain that his or her feet feel "stuck." Because some of these symptoms may also be experienced in other disorders such as Alzheimer's disease, Parkinson's disease, and Creutzfeldt-Jakob disease, normal pressure hydrocephalus is often incorrectly diagnosed and never properly treated. Doctors may use a variety of tests, including brain scans (CT and/or MRI), a spinal tap or lumbar catheter, intracranial pressure monitoring, and neuropsychological tests, to help them accurately diagnose normal pressure hydrocephalus and rule out any other conditions.
The symptoms described in this section account for the most typical ways in which progressive hydrocephalus manifests itself, but it is important to remember that symptoms vary significantly from one person to the next.
top
How is hydrocephalus diagnosed?
Hydrocephalus is diagnosed through clinical neurological evaluation and by using cranial imaging techniques such as ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), or pressure-monitoring techniques. A physician selects the appropriate diagnostic tool based on an individual’s age, clinical presentation, and the presence of known or suspected abnormalities of the brain or spinal cord.
top
What is the current treatment?
Hydrocephalus is most often treated by surgically inserting a shunt system. This system diverts the flow of CSF from the CNS to another area of the body where it can be absorbed as part of the normal circulatory process.
A shunt is a flexible but sturdy plastic tube. A shunt system consists of the shunt, a catheter, and a valve. One end of the catheter is placed within a ventricle inside the brain or in the CSF outside the spinal cord. The other end of the catheter is commonly placed within the abdominal cavity, but may also be placed at other sites in the body such as a chamber of the heart or areas around the lung where the CSF can drain and be absorbed. A valve located along the catheter maintains one-way flow and regulates the rate of CSF flow.
A limited number of individuals can be treated with an alternative procedure called third ventriculostomy. In this procedure, a neuroendoscope — a small camera that uses fiber optic technology to visualize small and difficult to reach surgical areas — allows a doctor to view the ventricular surface. Once the scope is guided into position, a small tool makes a tiny hole in the floor of the third ventricle, which allows the CSF to bypass the obstruction and flow toward the site of resorption around the surface of the brain.
top
What are the possible complications of a shunt system?
Shunt systems are not perfect devices. Complications may include mechanical failure, infections, obstructions, and the need to lengthen or replace the catheter. Generally, shunt systems require monitoring and regular medical follow up. When complications occur, the shunt system usually requires some type of revision.
Some complications can lead to other problems such as overdraining or underdraining. Overdraining occurs when the shunt allows CSF to drain from the ventricles more quickly than it is produced. Overdraining can cause the ventricles to collapse, tearing blood vessels and causing headache, hemorrhage (subdural hematoma), or slit-like ventricles (slit ventricle syndrome). Underdraining occurs when CSF is not removed quickly enough and the symptoms of hydrocephalus recur. In addition to the common symptoms of hydrocephalus, infections from a shunt may also produce symptoms such as a low-grade fever, soreness of the neck or shoulder muscles, and redness or tenderness along the shunt tract. When there is reason to suspect that a shunt system is not functioning properly (for example, if the symptoms of hydrocephalus return), medical attention should be sought immediately.
top
What is the prognosis?
The prognosis for individuals diagnosed with hydrocephalus is difficult to predict, although there is some correlation between the specific cause of the hydrocephalus and the outcome. Prognosis is further complicated by the presence of associated disorders, the timeliness of diagnosis, and the success of treatment. The degree to which relief of CSF pressure following shunt surgery can minimize or reverse damage to the brain is not well understood.
Affected individuals and their families should be aware that hydrocephalus poses risks to both cognitive and physical development. However, many children diagnosed with the disorder benefit from rehabilitation therapies and educational interventions and go on to lead normal lives with few limitations. Treatment by an interdisciplinary team of medical professionals, rehabilitation specialists, and educational experts is critical to a positive outcome. Left untreated, progressive hydrocephalus may be fatal.
The symptoms of normal pressure hydrocephalus usually get worse over time if the condition is not treated, although some people may experience temporary improvements. While the success of treatment with shunts varies from person to person, some people recover almost completely after treatment and have a good quality of life. Early diagnosis and treatment improves the chance of a good recovery.
top
What research is being done?
The National Institute of Neurological Disorders and Stroke (NINDS) and other institutes of the National Institutes of Health (NIH) conduct research related to hydrocephalus in laboratories and clinics at the NIH and support additional research through grants to major medical institutions across the country. Much of this research focuses on finding better ways to prevent, treat, and ultimately cure disorders such as hydrocephalus. The NINDS also conducts and supports a wide range of fundamental studies that explore the complex mechanisms of normal and abnormal brain development.
http://www.ninds.nih.gov/disorders/hydr ... #173073125
Hydrocephalus Fact Sheet
Table of Contents (click to jump to sections)
What is hydrocephalus?
What are the different types of hydrocephalus?
Who gets this disorder?
What causes hydrocephalus?
What are the symptoms?
How is hydrocephalus diagnosed?
What is the current treatment?
What are the possible complications of a shunt system?
What is the prognosis?
What research is being done?
Where can I get more information?
What is hydrocephalus?
The term hydrocephalus is derived from the Greek words "hydro" meaning water and "cephalus" meaning head. As the name implies, it is a condition in which the primary characteristic is excessive accumulation of fluid in the brain. Although hydrocephalus was once known as "water on the brain," the "water" is actually cerebrospinal fluid (CSF) — a clear fluid that surrounds the brain and spinal cord. The excessive accumulation of CSF results in an abnormal widening of spaces in the brain called ventricles. This widening creates potentially harmful pressure on the tissues of the brain.
The ventricular system is made up of four ventricles connected by narrow passages.. Normally, CSF flows through the ventricles, exits into cisterns (closed spaces that serve as reservoirs) at the base of the brain, bathes the surfaces of the brain and spinal cord, and then reabsorbs into the bloodstream.
CSF has three important life-sustaining functions: 1) to keep the brain tissue buoyant, acting as a cushion or "shock absorber"; 2) to act as the vehicle for delivering nutrients to the brain and removing waste; and 3) to flow between the cranium and spine and compensate for changes in intracranial blood volume (the amount of blood within the brain).
The balance between production and absorption of CSF is critically important. Because CSF is made continuously, medical conditions that block its normal flow or absorption will result in an over-accumulation of CSF. The resulting pressure of the fluid against brain tissue is what causes hydrocephalus.
top
What are the different types of hydrocephalus?
Hydrocephalus may be congenital or acquired. Congenital hydrocephalus is present at birth and may be caused by either events or influences that occur during fetal development, or genetic abnormalities. Acquired hydrocephalus develops at the time of birth or at some point afterward. This type of hydrocephalus can affect individuals of all ages and may be caused by injury or disease.
Hydrocephalus may also be communicating or non-communicating. Communicating hydrocephalus occurs when the flow of CSF is blocked after it exits the ventricles. This form is called communicating because the CSF can still flow between the ventricles, which remain open. Non-communicating hydrocephalus - also called "obstructive" hydrocephalus - occurs when the flow of CSF is blocked along one or more of the narrow passages connecting the ventricles. One of the most common causes of hydrocephalus is "aqueductal stenosis." In this case, hydrocephalus results from a narrowing of the aqueduct of Sylvius, a small passage between the third and fourth ventricles in the middle of the brain.
There are two other forms of hydrocephalus which do not fit exactly into the categories mentioned above and primarily affect adults: hydrocephalus ex-vacuo and normal pressure hydrocephalus.
Hydrocephalus ex-vacuo occurs when stroke or traumatic injury cause damage to the brain. In these cases, brain tissue may actually shrink. Normal pressure hydrocephalus can happen to people at any age, but it is most common among the elderly. It may result from a subarachnoid hemorrhage, head trauma, infection, tumor, or complications of surgery. However, many people develop normal pressure hydrocephalus even when none of these factors are present for reasons that are unknown.
top
Who gets this disorder?
The number of people who develop hydrocephalus or who are currently living with it is difficult to establish since there is no national registry or database of people with the condition. However, experts estimate that hydrocephalus affects approximately 1 in every 500 children.
top
What causes hydrocephalus?
The causes of hydrocephalus are still not well understood. Hydrocephalus may result from inherited genetic abnormalities (such as the genetic defect that causes aqueductal stenosis) or developmental disorders (such as those associated with neural tube defects including spina bifida and encephalocele). Other possible causes include complications of premature birth such as intraventricular hemorrhage, diseases such as meningitis, tumors, traumatic head injury, or subarachnoid hemorrhage, which block the exit of CSF from the ventricles to the cisterns or eliminate the passageway for CSF into the cisterns.
top
What are the symptoms?
Symptoms of hydrocephalus vary with age, disease progression, and individual differences in tolerance to the condition. For example, an infant's ability to compensate for increased CSF pressure and enlargement of the ventricles differs from an adult's. The infant skull can expand to accommodate the buildup of CSF because the sutures (the fibrous joints that connect the bones of the skull) have not yet closed.
In infancy, the most obvious indication of hydrocephalus is often a rapid increase in head circumference or an unusually large head size. Other symptoms may include vomiting, sleepiness, irritability, downward deviation of the eyes (also called "sunsetting"), and seizures.
Older children and adults may experience different symptoms because their skulls cannot expand to accommodate the buildup of CSF. Symptoms may include headache followed by vomiting, nausea, papilledema (swelling of the optic disk which is part of the optic nerve), blurred or double vision, sunsetting of the eyes, problems with balance, poor coordination, gait disturbance, urinary incontinence, slowing or loss of developmental progress, lethargy, drowsiness, irritability, or other changes in personality or cognition including memory loss.
Symptoms of normal pressure hydrocephalus include, problems with walking, impaired bladder control leading to urinary frequency and/or incontinence, and progressive mental impairment and dementia. An individual with this type of hydrocephalus may have a general slowing of movements or may complain that his or her feet feel "stuck." Because some of these symptoms may also be experienced in other disorders such as Alzheimer's disease, Parkinson's disease, and Creutzfeldt-Jakob disease, normal pressure hydrocephalus is often incorrectly diagnosed and never properly treated. Doctors may use a variety of tests, including brain scans (CT and/or MRI), a spinal tap or lumbar catheter, intracranial pressure monitoring, and neuropsychological tests, to help them accurately diagnose normal pressure hydrocephalus and rule out any other conditions.
The symptoms described in this section account for the most typical ways in which progressive hydrocephalus manifests itself, but it is important to remember that symptoms vary significantly from one person to the next.
top
How is hydrocephalus diagnosed?
Hydrocephalus is diagnosed through clinical neurological evaluation and by using cranial imaging techniques such as ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), or pressure-monitoring techniques. A physician selects the appropriate diagnostic tool based on an individual’s age, clinical presentation, and the presence of known or suspected abnormalities of the brain or spinal cord.
top
What is the current treatment?
Hydrocephalus is most often treated by surgically inserting a shunt system. This system diverts the flow of CSF from the CNS to another area of the body where it can be absorbed as part of the normal circulatory process.
A shunt is a flexible but sturdy plastic tube. A shunt system consists of the shunt, a catheter, and a valve. One end of the catheter is placed within a ventricle inside the brain or in the CSF outside the spinal cord. The other end of the catheter is commonly placed within the abdominal cavity, but may also be placed at other sites in the body such as a chamber of the heart or areas around the lung where the CSF can drain and be absorbed. A valve located along the catheter maintains one-way flow and regulates the rate of CSF flow.
A limited number of individuals can be treated with an alternative procedure called third ventriculostomy. In this procedure, a neuroendoscope — a small camera that uses fiber optic technology to visualize small and difficult to reach surgical areas — allows a doctor to view the ventricular surface. Once the scope is guided into position, a small tool makes a tiny hole in the floor of the third ventricle, which allows the CSF to bypass the obstruction and flow toward the site of resorption around the surface of the brain.
top
What are the possible complications of a shunt system?
Shunt systems are not perfect devices. Complications may include mechanical failure, infections, obstructions, and the need to lengthen or replace the catheter. Generally, shunt systems require monitoring and regular medical follow up. When complications occur, the shunt system usually requires some type of revision.
Some complications can lead to other problems such as overdraining or underdraining. Overdraining occurs when the shunt allows CSF to drain from the ventricles more quickly than it is produced. Overdraining can cause the ventricles to collapse, tearing blood vessels and causing headache, hemorrhage (subdural hematoma), or slit-like ventricles (slit ventricle syndrome). Underdraining occurs when CSF is not removed quickly enough and the symptoms of hydrocephalus recur. In addition to the common symptoms of hydrocephalus, infections from a shunt may also produce symptoms such as a low-grade fever, soreness of the neck or shoulder muscles, and redness or tenderness along the shunt tract. When there is reason to suspect that a shunt system is not functioning properly (for example, if the symptoms of hydrocephalus return), medical attention should be sought immediately.
top
What is the prognosis?
The prognosis for individuals diagnosed with hydrocephalus is difficult to predict, although there is some correlation between the specific cause of the hydrocephalus and the outcome. Prognosis is further complicated by the presence of associated disorders, the timeliness of diagnosis, and the success of treatment. The degree to which relief of CSF pressure following shunt surgery can minimize or reverse damage to the brain is not well understood.
Affected individuals and their families should be aware that hydrocephalus poses risks to both cognitive and physical development. However, many children diagnosed with the disorder benefit from rehabilitation therapies and educational interventions and go on to lead normal lives with few limitations. Treatment by an interdisciplinary team of medical professionals, rehabilitation specialists, and educational experts is critical to a positive outcome. Left untreated, progressive hydrocephalus may be fatal.
The symptoms of normal pressure hydrocephalus usually get worse over time if the condition is not treated, although some people may experience temporary improvements. While the success of treatment with shunts varies from person to person, some people recover almost completely after treatment and have a good quality of life. Early diagnosis and treatment improves the chance of a good recovery.
top
What research is being done?
The National Institute of Neurological Disorders and Stroke (NINDS) and other institutes of the National Institutes of Health (NIH) conduct research related to hydrocephalus in laboratories and clinics at the NIH and support additional research through grants to major medical institutions across the country. Much of this research focuses on finding better ways to prevent, treat, and ultimately cure disorders such as hydrocephalus. The NINDS also conducts and supports a wide range of fundamental studies that explore the complex mechanisms of normal and abnormal brain development.
Hello Dr. Flanagan,
No xrays of those regions to my knowledge although might have taken them day of accident in 05. I have the xrays from them but does she need new ones? Should she them taken by her Primary Care doctor or by the new chiropractor when we get an appointment? She is hoping to see her AO tomorrow if possible.
NZeri thank you for your thoughts. It is hard to keep a 32 year old (today) at home I can tell you and even harder trying to emphasize the 'being gentle.' She does not live with us but has been here since the accident to recover and is now back in NYC where she lives.
Hope life is being good to you.
No xrays of those regions to my knowledge although might have taken them day of accident in 05. I have the xrays from them but does she need new ones? Should she them taken by her Primary Care doctor or by the new chiropractor when we get an appointment? She is hoping to see her AO tomorrow if possible.
NZeri thank you for your thoughts. It is hard to keep a 32 year old (today) at home I can tell you and even harder trying to emphasize the 'being gentle.' She does not live with us but has been here since the accident to recover and is now back in NYC where she lives.
Hope life is being good to you.
Spinal Cord Herniation
Spinal Cord Herniation: A Missing Piece in the Pathogenesis of Amyotrophic Lateral Sclerosis and Multiple Sclerosis?
Abstract
Background: Idiopathic spinal cord herniation (SCH) is a rare and often misdiagnosed condition characterized by displacement of the spinal cord through an anterior defect of the dural sac. This condition determines continuous focal trauma of the spinal cord, causing slowly progressive myelopathy. The peculiar MR scan findings, particularly sagittal T(2)-weighted images, allow its recognition. Objective: Herein, we report 3 cases of SCH and suggest a possible association with trauma-related neurodegenerative or chronic inflammatory diseases. Methods: We reviewed the clinical files of all patients admitted to our hospital with a history and signs of progressive myelopathy (paraparesis and/or lower extremity hypoesthesia) who were diagnosed with SCH by MRI. Results: We found 3 female patients (37, 69 and 68 years of age) with a diagnosis of SCH. Two of them presented with concomitant, relatively rare disabling neurological diseases, namely amyotrophic lateral sclerosis and multiple sclerosis. The third patient underwent surgery and gradually recovered over 6 months. Conclusions: Persistent central nervous system trauma due to idiopathic SCH might provide an unexpected hint about the pathogenesis of amyotrophic lateral sclerosis and multiple sclerosis.
http://www.ncbi.nlm.nih.gov/pubmed?term ... lerosis%3F
Abstract
Background: Idiopathic spinal cord herniation (SCH) is a rare and often misdiagnosed condition characterized by displacement of the spinal cord through an anterior defect of the dural sac. This condition determines continuous focal trauma of the spinal cord, causing slowly progressive myelopathy. The peculiar MR scan findings, particularly sagittal T(2)-weighted images, allow its recognition. Objective: Herein, we report 3 cases of SCH and suggest a possible association with trauma-related neurodegenerative or chronic inflammatory diseases. Methods: We reviewed the clinical files of all patients admitted to our hospital with a history and signs of progressive myelopathy (paraparesis and/or lower extremity hypoesthesia) who were diagnosed with SCH by MRI. Results: We found 3 female patients (37, 69 and 68 years of age) with a diagnosis of SCH. Two of them presented with concomitant, relatively rare disabling neurological diseases, namely amyotrophic lateral sclerosis and multiple sclerosis. The third patient underwent surgery and gradually recovered over 6 months. Conclusions: Persistent central nervous system trauma due to idiopathic SCH might provide an unexpected hint about the pathogenesis of amyotrophic lateral sclerosis and multiple sclerosis.
http://www.ncbi.nlm.nih.gov/pubmed?term ... lerosis%3F
-
uprightdoc
- Family Elder
- Posts: 1995
- Joined: Thu Sep 30, 2010 2:00 pm
- Location: USA
- Contact:
Nigel, Lehermitte's sign can be caused by different factors such as spondylosis (degenerative changes) and stenosis in the intervertebral foramen where the nerve roots exit, or in the central canal which contains the cord. I suspect it is also caused by compression of the belly side of the brainstem against the clivus portion of the base of the skull.
Great case studies on the role of epidural venous dilation in cervical myelopathy (cord compression).
Great case studies on the role of epidural venous dilation in cervical myelopathy (cord compression).
-
uprightdoc
- Family Elder
- Posts: 1995
- Joined: Thu Sep 30, 2010 2:00 pm
- Location: USA
- Contact:
Drury,
It doesn't matter if her PCP, an orthopedic surgeon or the new chiropractor takes them. Preferrably, they should be taken standing up against an upright bucky rather than lying down on a table bucky. Curves and compression problems increase in the upright position.
If you want to me to take a quick look at her posture you can send me a private email with a picture of her from behind. If you do, the best way is to have her to wear exercise clothes such as a halter top and stretch type pants or shorts. Also tie up her hair so I can see her neck.
It doesn't matter if her PCP, an orthopedic surgeon or the new chiropractor takes them. Preferrably, they should be taken standing up against an upright bucky rather than lying down on a table bucky. Curves and compression problems increase in the upright position.
If you want to me to take a quick look at her posture you can send me a private email with a picture of her from behind. If you do, the best way is to have her to wear exercise clothes such as a halter top and stretch type pants or shorts. Also tie up her hair so I can see her neck.
-
uprightdoc
- Family Elder
- Posts: 1995
- Joined: Thu Sep 30, 2010 2:00 pm
- Location: USA
- Contact:
-
blossom
- Family Elder
- Posts: 1394
- Joined: Thu Dec 03, 2009 3:00 pm
- Location: south western pa.
- Contact:
CCSVI
hi dr. flanagan, thought i'd touch base. fri. i see my pcp.hope to get my mri soon. everything takes me so long and sometimes i feel i'm running out of time.
my chiro. did something to just see what would happen but would not say what and he wanted my feedback. let me tell you, i never had this happen before. everytime i moved my head a certain way it felt almost like i had pockets of fluid moving between my skull and my brain at onetime i swear it was like a bubble on top. couldn't see it but i sure felt it. and with these fluid moving feeling i'd get that bruised bad ach feeling there. especially if say i was putting pressure on my arms trying to stand. in bed turning was the worst and my head did not do well all night. the ache i have gotten for yrs. at the base of my skull seemed to radiate all over my head. it's very hard to explain. also my middle r.side back was intense.
my arms were my legs weaker. when i would first lay flat the swooshing sound of my blood pumping through neck was pretty intense.
when i explained today to him he said he did that to see if he is going in the right direction. something about he put the blocks different. i'm probably not explaining what he said right. but, he readjusted and the head thing is much better but the burning intense below the r. shoulder blade was helped some but not much. hopefuly fri.
i had not gained much of any symptom relief yet and am hoping to at least get the pelvis and thoracic as good as we possibly can so if there is a plan b i can see from there which way to go.
have you ever had anyone tell you about the head feelings i just said? oh,and my face felt warmer than usual. i'll tell you what it was weird. i was not dizzy. sounds nuts i know to say stuff like my brain felt like it was floating and loose and bruised and aching. it did not turn me against chiro. in the least. on the contrary it made a lot of sence to try that but for sure not again. i know for sure the spine has everything to do with the flow of things. i just hope it's not too late for me. and others!
my chiro. did something to just see what would happen but would not say what and he wanted my feedback. let me tell you, i never had this happen before. everytime i moved my head a certain way it felt almost like i had pockets of fluid moving between my skull and my brain at onetime i swear it was like a bubble on top. couldn't see it but i sure felt it. and with these fluid moving feeling i'd get that bruised bad ach feeling there. especially if say i was putting pressure on my arms trying to stand. in bed turning was the worst and my head did not do well all night. the ache i have gotten for yrs. at the base of my skull seemed to radiate all over my head. it's very hard to explain. also my middle r.side back was intense.
my arms were my legs weaker. when i would first lay flat the swooshing sound of my blood pumping through neck was pretty intense.
when i explained today to him he said he did that to see if he is going in the right direction. something about he put the blocks different. i'm probably not explaining what he said right. but, he readjusted and the head thing is much better but the burning intense below the r. shoulder blade was helped some but not much. hopefuly fri.
i had not gained much of any symptom relief yet and am hoping to at least get the pelvis and thoracic as good as we possibly can so if there is a plan b i can see from there which way to go.
have you ever had anyone tell you about the head feelings i just said? oh,and my face felt warmer than usual. i'll tell you what it was weird. i was not dizzy. sounds nuts i know to say stuff like my brain felt like it was floating and loose and bruised and aching. it did not turn me against chiro. in the least. on the contrary it made a lot of sence to try that but for sure not again. i know for sure the spine has everything to do with the flow of things. i just hope it's not too late for me. and others!
-
uprightdoc
- Family Elder
- Posts: 1995
- Joined: Thu Sep 30, 2010 2:00 pm
- Location: USA
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Blossom,
Were you face up or face down on the blocks? The face up position is use for acute and chronic strains and sprains of the pelvis, which is a possibility in your case because of your history of trauma. The face down position is used for herniated lumbar discs and cord type problems. You clearly have signs of cord problems. Scoliosis can be associated with musculoskeletal and cord related problems.
Were you face up or face down on the blocks? The face up position is use for acute and chronic strains and sprains of the pelvis, which is a possibility in your case because of your history of trauma. The face down position is used for herniated lumbar discs and cord type problems. You clearly have signs of cord problems. Scoliosis can be associated with musculoskeletal and cord related problems.
Thanks for that tip Dr. good to know.
A question, I read a while back about neuroplasticity that pain signals are a matrix of signals that are processed and a 'decision' is made to indicate what is happening, eg move to protect rapidly or that your arm is now missing.
In all signals of sensory nature is it the same process. Everything that is sent to the brain is being constantly balanced and understood by experiences from the past to get an accurate indication within ones consciousness ?
This would help me understand why in MS there are so many different impressions of what symptoms I have. All the impressions are because of the confused signals my brain is processing. A few missing pieces or intermittent inputs will make the resultant assessment confused.
At one level I can see that the feeling could not be correct, at another the body has made adjustments in the autonomic system to protect or adjust to the signals it gets. So the disruption to the system in general creates a fatigue. That fatigue is exacerbated by many factors that are things such as heat, mental overload, life stresses, lack of data input and so much more.
In essence I have realized lately how much we are like computers which we of course designed anyway.
We have to have assess codes to get information, (marriage is dependent on this, I have realized graphically), and there is total dependence on a fully working system of inputs to be able to get accurate outputs and optimum performance. The output will only be as good as the inputs.
PS
I'm doing well in life in general, these types of understandings work for me to rebuild my confidence in myself and understand that I'm not responsible for everything in my world, I can influence it and it has many players in the game of my life.
Enjoy your day,
Nigel
A question, I read a while back about neuroplasticity that pain signals are a matrix of signals that are processed and a 'decision' is made to indicate what is happening, eg move to protect rapidly or that your arm is now missing.
In all signals of sensory nature is it the same process. Everything that is sent to the brain is being constantly balanced and understood by experiences from the past to get an accurate indication within ones consciousness ?
This would help me understand why in MS there are so many different impressions of what symptoms I have. All the impressions are because of the confused signals my brain is processing. A few missing pieces or intermittent inputs will make the resultant assessment confused.
At one level I can see that the feeling could not be correct, at another the body has made adjustments in the autonomic system to protect or adjust to the signals it gets. So the disruption to the system in general creates a fatigue. That fatigue is exacerbated by many factors that are things such as heat, mental overload, life stresses, lack of data input and so much more.
In essence I have realized lately how much we are like computers which we of course designed anyway.
We have to have assess codes to get information, (marriage is dependent on this, I have realized graphically), and there is total dependence on a fully working system of inputs to be able to get accurate outputs and optimum performance. The output will only be as good as the inputs.
PS
I'm doing well in life in general, these types of understandings work for me to rebuild my confidence in myself and understand that I'm not responsible for everything in my world, I can influence it and it has many players in the game of my life.
Enjoy your day,
Nigel
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uprightdoc
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Nigel,
Pain perception in the brain is definitely a mix of signals but the flexor withdrawl crossed extensor reflex to pain occurs in the cord well before it even reaches the brain. If you step on a nail you flex your leg and withdraw it from the nail and extend and brace your oppoiste leg to compensate. Fear, fright and memories of pain can provoke a similar pain withdrawl reflex even without being threatened. Pain is a complex subject.
I suspect your fatigue is more due to reduced blood flow. Stressful circumstances such as what you are going through are draining to the entire system, especially the heart and lungs. I am glad to hear you are on the mend.
Pain perception in the brain is definitely a mix of signals but the flexor withdrawl crossed extensor reflex to pain occurs in the cord well before it even reaches the brain. If you step on a nail you flex your leg and withdraw it from the nail and extend and brace your oppoiste leg to compensate. Fear, fright and memories of pain can provoke a similar pain withdrawl reflex even without being threatened. Pain is a complex subject.
I suspect your fatigue is more due to reduced blood flow. Stressful circumstances such as what you are going through are draining to the entire system, especially the heart and lungs. I am glad to hear you are on the mend.
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uprightdoc
- Family Elder
- Posts: 1995
- Joined: Thu Sep 30, 2010 2:00 pm
- Location: USA
- Contact:
Blossom,
Pelvic blocks are used to counter-strain (twist) the misalignment of the lumbopelvic spine. The entire spine from head to tail is linked together by paraspinal muscles. Switching block positions can definitely aggravate the entire spine right up to the skull. The position of the high and low blocks is determined by x-rays, postural analysis, leg checks and particular physical exam findings for the face up and face down positions.
Did the doctor do anything else different?
Pelvic blocks are used to counter-strain (twist) the misalignment of the lumbopelvic spine. The entire spine from head to tail is linked together by paraspinal muscles. Switching block positions can definitely aggravate the entire spine right up to the skull. The position of the high and low blocks is determined by x-rays, postural analysis, leg checks and particular physical exam findings for the face up and face down positions.
Did the doctor do anything else different?