Myelopathy

MYELOPATHY
1-Definition: Means any disease affecting spinal cord intrinsic or extrinsic.

TYPES:
1-Intramedullary lesions:
A-Astrocytoma: commonest site cervical (swollen cord)

B-Ependymoma: commonest site conus
*common with NF type2
C-Cord cysts
*Types
-Syringes due tumors or post-traumatic (focal myelomalacia)
-Hydromyelic cyst (chiari 1 malformation)
-Tumor cyst
D-Drop metastases
E-Multiple sclerosis (swollen cord)
Expanded, swollen cord could be due to gliomas or M.S.
For differentiation we should do sagital T2 or fast flair sequence to the brain
F-ADEM
G-Fungal infection
H-Post-radiation enhancement
N-Guillan-Barre syndrome
M-Traumatic myelopathy
*Blant contusion
*Hemorrhagic cord contusion
2-Spinal dysraphism
*Spina bifida occulta
*Dermal sinus
*Tethering of cord with thickening of filum terminale with an associated subcutaneous intraspinal lipoma
*Split cord (Diastematomyelia)
3-Vascular malformation
-Intra-medullary vascular malformation (AVM).
-Extra-medullary radiculo meningeal AVM.
-Cavernous angiomas of the cord.
4-External compression of the spinal cord
-Acute: as in trauma with retropulsion or disc herniation.
-Chronic as in
*Tumors in extramedullary intra dural or extradural spaces such as meningioma and neurofibroma.
*Extra tissue in the epidural spaces such as abscess, lipomatosis and extramedullary Hematopoeisis.
*Bony spinal Stenosis (common cause).
5-Intradural extramedullary tumors
-Neurofibroma.
*Dumbbell neurofibroma.
*Plexiform neurofibroma.
*Neurofibromatosis
$-NF1 (PERIPHERAL FORM)
$-NF2 (CENTRAL FORM)

-Schwannomas:
-Meningioma:
6-Extra-dural tumors
-Osseous metastasis (commonest cause)
-Lymphoma: is the only which can affect epidural space directly with or without bone affection.
-Epidural lipomatosis
-Extra medullary Hematopoeisis