Swelling of the spinal cord: treatment, diagnosis, symptoms
Swelling of the spinal cord is a process characterized by the accumulation of fluid in cells and intercellular space, resulting in the brain increases in volume. In medical literature there is no precise definition of «brain swelling». This phenomenon is described as «swelling and swelling of the brain.» The swelling refers to the splitting of the cells of the edematous fluid that entails a violation of intracellular metabolism, oxygen starvation of the cells and as a consequence their death. The increase in cell volume due to swelling is defined as «swelling».
Swelling of the spinal cord have several shapes. Each form has its own characteristics and causes. Brain edema is classified according to the cause of its formation: edema on the background of the tumor, after surgery, post-traumatic, toxic, ischemic, inflammatory, hypertensive.
Existing types of edema
There are three kinds of edema of the brain, depending on the pathogenesis:
Cytotoxic edema occurs most frequently after traumatic brain injury. During hypoxia in the cells is disturbed metabolism, and then they starts to accumulate sodium, which contributes to the accumulation of water in tissues. First, swollen astrocytes, which are closest to the blood vessels. Neurons begin to suffer from swelling after the surrounding cells die.
For violation of blood-brain barrier occurs vasogenic cerebral edema. Swelling is caused by disorders of the osmotic pressure, which are positive charged ions. Cellular barrier begins to flow, the ions, which leads to the increase in the number of interstitial fluid. By increasing the permeability of the blood brain barrier the amount of interstitial fluid begins to depend on blood pressure the higher it is, the faster the fluid accumulates. Vasogenic swelling occurs in the background of a brain tumor, if microemboli vessels or occlusion of the carotid arteries.
Vasogenic cerebral edema is the most common type of edema. When increased capillary permeability in the intercellular space begins to enter the liquid. Detect abnormalities using contrast-enhanced MRI is quite simple, as the capillaries pass and a contrast agent.
Interstitial edema occurs with hydrocephalus. In pathology of the disturbed outflow of cerebrospinal fluid, leading to increased intracranial pressure and the accumulation of water in tissues.
Arteriovenous malformation is a disease development of blood vessels, brain or spinal cord in utero. When malformations are not formed capillaries, so disturbed metabolism and oxygen exchange in cells.
AVM of the spinal cord shows impaired pain, temperature and vibration sensitivity in the lower and upper extremities. In severe cases may be diagnosed paralysis of the limbs. Arteriovenous malformation disrupts the blood supply to the brain or spinal cord and can lead to bleeding in the brain.
The diagnosis of AVM is put on the basis of an MRI or CT scan. Examination by the neurologist reveals the presence of lesions in the spinal cord or the brain. For the diagnosis of malformations also use contrasting in which the pathology is clearly demonstrated by radiography.
AVM of the spinal cord treated surgically. Endovascular treatment is a catheter and is to overlap the lumen of the artery. AVM small size removed with radiation radiation.
To prevent the pathology impossible, as it develops in utero at 1-2 months pregnant.
The symptoms of edema
Regardless of the reasons for the occurrence of cerebral edema, the clinical picture is almost always the same. Cerebral edema disorders of breathing, circulation, decreased pupillary response.
By increasing the amount of fluid in the cavities of the skull there is a feeling of «fullness» from the inside of the skull, accompanied by a severe headache. In acute pain there is a confusion, you may experience nausea and vomiting.
Treatment of brain edema is a considerable task even for a highly qualified specialist, because the problem is ginepraia.
First of all it is necessary to restore cerebral perfusion pressure, which depends on adequate nutrition of the neurons and increase circulation. To resolve intracranial pressure used:
With the ineffectiveness of conservative treatment, surgical intervention is necessary. To reduce intracranial pressure and remove a bone flap.
Treatment of edema of the spinal cord
Edema in the spinal cord similar processes, like edema of the brain. Swelling of the spinal cord can result from a spinal injury followed by hypoxia, vascular disorders and cancer. The only obvious difference may be spinal shock. Spinal shock occurs after trauma with rupture of the spine. Symptoms of spinal shock is manifested in a complete absence of sensation below the injury site. With proper and timely treatment, the process can become reversible, but in severe cases complete cure is impossible.
Spinal shock is treated surgically if:
Surgical treatment of hepatic, renal or cardiac insufficiency, and also for internal bleeding, hematoma of the brain and pulmonary embolism is contraindicated. To restore the volume of the spinal cord it is necessary to establish and electrolyte metabolism. To do this, are appointed by diuretics (diuretics).
To stabilize the cell membranes helps glucocorticoid therapy. It can prevent the accumulation of hormones in injured tissues that are involved in intercellular interactions.
Disturbed innervation in the spinal cord injury pressure sores arise. Faster bedsores occur when damage to the cervical or thoracic spine. Bed sores can cause sepsis quickly become infected. Treatment of sepsis is carried out antibacterial therapy.
Swelling spinal cord tumor
The tumor is formed from the medullary substance, or may be metastases from tumors of other body. There are two types: malignant and benign.
If the tumor was formed of a sheath of the spinal cord, it has a benign nature and is called meningioma. The tumor formed from the shells of nerves is the schwannoma and also refers to the benign type. Malignant tumors arise from glial cells or connective tissues of the spine.
If a tumor is compressed by the spinal cord, which explains all the symptoms. Clip the nerve roots of the spine causes pain, weakness and loss of sensation. Nerve compression causes muscle spasms, numbness, weakness and lack of coordination. A tumor in the lumbar spine may cause disruption of the internal organs — the bladder and intestines.
Still not able to ascertain why there is a spinal cord tumor, however, the factors that increase the risk of developing the disease:
Diagnosis of the disease
If the body is present with a malignant tumor of any organ and at the same time the patient complains of back pain, weakness, and paresthesia or lack of coordination, the doctor suggests the presence of a tumor of the spinal cord.
Tumor localization is determined by the functions that are disturbed in the body. The relationship of pain and swelling is confirmed by exclusion of other diseases with similar symptoms: circulatory disorders, inflammation of muscle tissue, vertebral fractures and injury of the intervertebral discs, infections caused by viruses, tuberculosis, syphilis, multiple sclerosis, or malignant disease of the blood.
To determine the exact localization of the tumor and its detailed consideration applied method of magnetic resonance imaging. To determine the type of tumor, a biopsy — removal of a small piece of tumor for research.
Treatment of tumors
Treatment of tumor of the spinal cord is carried out by two methods: surgical and conservative. Both methods can be used separately or in addition to each other. Conservative treatment is the use of radiation therapy. To reduce swelling prescribe corticosteroids that help reduce the amount of tissue the spinal cord and restore nerve function.
The effectiveness of treatment depends on the type of tumor and the extent of its impact on the integrity of the spinal cord. Some types of tumors can be completely eliminated. After treatment 50% of patients disappear symptoms.