Walking with difficulty

Mohammed, 19 years olds
Anatomy of the skull
Tractology
1. Sensory
  1. Dorsal White Column
    1. Nucleus gracilis
    2. Nucleus cuneatus
  2. Ventral & Lateral spinothalamic tract
  3. Dorsal & Ventral spinocerebeller tract
2. Motor
  1. Lateral corticospinal (pyramidal) tract
  2. Anterior corticospinal tract(pyramidal)
  3. Vestibulospinal tract
  4. Descending autonomic tracts
Lesions:
Physiology of pain and temperature:
Syringomyelia:
1. Clinical presentation:
  1. Muscle weakness
    1. Evaluation of the patient:
      1. 1- History
      2. 2- Physical examination
      3. 3- Localizing the lesion:
      4. 4- Determine the cause of the lesion:
  2. Gait abnormalities
    1. Hemiplegic gait (spastic gait)
      1. Seen in stroke
    2. Parkinsonian gait
    3. Atexia gait
    4. Diplegic Gait(Scissors gait)
      1. Seen in cerebral palsy
    5. Myopathic Gait (waddling gait)
    6. Neuropathic Gait (Steppage Gait)
  3. Loss of reflexes
  4. Loss of pain, temperature & crude touch sensation
2. Pathophysiology:
  1. Congenital
    1. Arnold-Chiari malformation II.
  2. Acquired
    1. Complication of:
      1. Trauma
      2. Meningitis
      3. Hemorrhage
      4. Tumor
  3. is the development of a fluid-filled cyst (syrinx) within the spinal cord. Over time, the cyst may enlarge, damaging the spinal cord.
3. Treatment
  1. If not causing any S&S:
    1. monitoring with periodic MRI and neurological exams
  2. If causing any S&S yet discovered on MRI for unrelated reason:
    1. monitoring with periodic MRI and neurological exams
  3. Causing S&S:
    1. Surgery:
      1. remove the pressure the syrinx places on the SC
      2. restore the normal flow of CSF
      3. help improve the symptoms and nervous system (neurological) function
  4. Treat Chiari Malformation
  5. Drain syrnix
  6. Removing obstruction
  7. Correcting the abnormality
Radiological investigation of SC:
1. MRI
  1. T1
    1. darker; fluid is hypointense (black)
  2. T2
    1. brighter; fluid is hyperintense (white)
Medical report:
1. It should include:
  1. Laboratory test results
  2. Medical images
  3. A history of your treatments
  4. Your response to treatments
  5. Documentation of any medications
  6. Documentation of your diagnosis
  7. An overview of your medical history
  8. A history of hospitalizations
  9. Findings of physical and mental examinations
  10. Statements confirming your limitations and abilities

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Walking with difficulty

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