Spine Healing Therapy

Dorn Spinal Therapy

Dorn Spinal Therapy has been in uses in the past 40 years. The credit of this method goes to Dieter Dorn, who has made a significant impact in the medical field. DORN- Method has been used on various patients where results could get witnessed instants. Due to the impact, this method has brought in the country. It has been declared the standard practice in treating Pelvical Disorders, Spinal, and Back pain. Dieter Dorn first used this method on his family, which was a sign of confidence in a method, which later gained much attention from different people in the country and also globally. Every day Dorn was able to offer treatment to 15- 20 patients in a day. His services were purely free which attracted attention both in the local and also global. The primary treatment that DORN-Method which could be treated using this method include spine healing therapy, misalignments of the spine, resolving pelvis and joints, and also solving out significant problems which could get attributed to vertebrae.

Dorn Spinal Therapy Summary


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Are there Plastic Versus Stable Spines

In order to deal with the dilemma of permanent memory storage, several researchers have hypothesized that some spines are temporary and some permanent 63, 82, 115 . According to one view (see Kasai et al., 63 ), spines with large heads and possessing many AMPA receptors are stable and represent permanent memory storage, while learning is represented in small mobile spines that continuously form and retract. These smaller spines may be silent under physiological conditions, but nonetheless represent a reserve of spines, which can change into large spines if sufficient conditions are met. Although stable populations of large spines have been demonstrated in mouse neocortex,23 spines are generally thought to be in a constant state of flux and this is regulated by the various neurotransmitter receptors. Glutamate receptors play a prominent role. AMPA receptor activation is important in spine stability, and constant levels of activation within the physiological range must be maintained 29...

Virtual Definition of the Posterior Nasal Spine Landmark

Step 1 Define Posterior Nasal Spine on the exocra-nial skull base view of the 3-D hard tissue surface representation (Fig. 4.22). Step 2 Verify and correct the vertical position of Posterior Nasal Spine on the virtual lateral cephalogram (Fig. 4.23) which is linked to the 3-D hard tissue surface representation (Fig. 4.24). Fig. 4.22. Posterior nasal spine.Exocranial skull base view (3-D CT,patient K.C.) Fig. 4.22. Posterior nasal spine.Exocranial skull base view (3-D CT,patient K.C.) Fig. 4.23. Posterior Nasal Spine.Virtual lateral cephalogram linked to the 3-D hard tissue surface representation (3-D CT, patient K.C.) Fig. 4.23. Posterior Nasal Spine.Virtual lateral cephalogram linked to the 3-D hard tissue surface representation (3-D CT, patient K.C.) Fig.4.24. Posterior Nasal Spine.Virtual lateral cephalogram (3-D CT, patient K.C.)

Spinal cord tumors 293

Is about two-thirds of the way down the spine. Below this, the spinal cord splits to form several main nerves that continue within the spine, ending up at the legs and feet. Like the brain, the spinal cord contains both gray and white matter. The gray matter lies in the center of the cord and consists of thousands of the cell bodies of the motor neurons that pass signals to body muscles. A thick layer of white matter surrounds the gray matter white matter is made up primarily of axons (long, thin, wiry extensions of the cells) and contains the nerve fibers that pass signals to and from the brain. The spinal cord is almost totally enclosed by the spinal bones 31 pairs of large nerves called spinal nerves branch off the spinal cord at regular intervals and pass through the narrow gaps between the spinal bones. Each spinal nerve contains both sensory and motor neurons. Spinal nerves in the neck handle signals to and from the head, arms, and hands nerves in the chest lead to the chest...

Spinal Cord Injury Medicine

Patients who have suffered trauma to their spinal cord have special medical issues related to the level and severity of injury. Physiatrists trained in this subspe- Residency in physical medicine and rehabilitation requires 4 years of postgraduate training. There are currently 80 accredited programs. There are also several positions in combined PM&R programs with additional training in neurology, pediatrics, or internal medicine. All require a general internship year (PGY-1), which can be internal medicine, surgery, or transitional. In a typical program, residents gain experience in both inpatient and outpatient rehabilitation medicine. The amount of work hours varies per individual program. Overnight call usually only a few times per month is generally benign. Resident physicians have monthly rotations that provide training in gereral rehabilitation of neurological conditions, deconditioning, strokes and spinal cord and traumatic brain injuries as well as pediatric rehabilitation....

Spine Basics The Vertebrae Discs and Spinal Cord

Stacked on top of one another in the spine are more than 30 bones, the vertebrae, which together form the spine. They are divided into four regions Sacrum and coccyx, a group of bones fused together at the base of the spine. The column-like spinal cord is divided into segments similar to the corresponding vertebrae cervical, thoracic, lumbar, sacral, and coccygeal. The cord also has nerve roots and rootlets which form branch-like appendages leading from its ventral side (that is, the front of the body) and from its dorsal side (that is, the back of the body). Along the dorsal root are the cells of the dorsal root ganglia, which are critical in the transmission of pain messages from the cord to the brain. It is here where injury, damage, and trauma become pain.

Spinal meningitis See meningitis

Spinal tap The common name for a lumbar puncture, a procedure in which cerebrospinal fluid is removed by using a hollow needle inserted into the lower back, usually between the third and fourth lumbar vertebrae. The fluid is checked for appearance, white blood cells, sugar, and protein in a lab and is also sent for culture, which can help determine what sort of germ is causing symptoms. While some children fear the thought of a spinal tap, in fact the procedure is not terribly painful. It is a safe procedure when done in a large hospital

Monitoring of Spinal Cord Function 7231 Sensory Evoked Potentials

Popularized by Cunningham and associates in the early 1980s 25 , somatosensory-evoked potentials (SSEPs or SEPs) record cortical stimulations through the scalp after peripheral electrical stimulation of the posterior tibial or peroneal nerves. The signal is transmitted through the posterior and lateral columns of the spinal cord, and recorded at the contralateral postcentral gyrus. Ischemia of the spinal cord results in a decrease in amplitude and prolonged latency of these potentials. But although SSEPs have been widely applied clinically for intraoperative monitoring, it has been observed that some patients who develop paraplegia never exhibit changes in intraoperatively monitored SSEPs 26-28 . This limitation of SSEPs can be explained anatomically. Since SSEPs are transmitted through the posterolateral tracts, they primarily reflect ischemia in the region of the posterior spinal arteries. The SSEPs are neither a sensitive nor a specific monitor of the corticospinal tracts in the...

Cerebrospinal Fluid Pressure

The effective spinal cord perfusion pressure is the difference between the mean arterial pressure and the cerebrospinal fluid (CSF) pressure. Because the spinal cord is in a closed rigid cavity, spinal cord perfusion pressure falls as the CSF pressure increases. It is not certain exactly what level of perfusion pressure is necessary to obtain effective cord perfusion, but extrapolation from clinical observations suggests that perfusion pressure should be greater than 40 mmHg for adequate spinal cord perfusion 16 . CSF pressure is particularly relevant in the setting of aortic surgery because the CSF pressure rises during aortic cross-clamping 17 , and, since spinal arterial pressure is already decreased (because the distal aorta has been excluded with clamping), even small increases in CSF pressure may be sufficient to reduce spinal cord perfusion pressure below the limit required for autoregulation, resulting in reduced blood flow and spinal ischemia.

Selective Spinal Cord Perfusion

Some workers further attempt to reduce spinal cord ischemia by continuously perfusing the lower intercostal arteries. Experimentally, it has been demonstrated in pigs that segmental artery perfusion can protect the spinal cord for up to 60 min of ischemia 60 . But in this study, the control group had simple aortic cross-clamping without distal perfusion, which is not reflective of the clinical scenario, where adjuncts are frequently used. Selective spinal cord perfusion has been applied clinically utilizing special cannulae 61 , or through a Dacron graft 62 . Benefits of this approach have not been demonstrated. The lack of demonstrable additional benefit with intercostal artery perfusion adds to the debate regarding the value of interventions involving intercostal vessels as a means to prevent paraplegia. Retrograde spinal cord perfusion via the hemiaz-ygous system is also being investigated, but has also not been shown to be protective 63 .

Cerebrospinal Fluid Drainage

Drainage of CSF during aortic procedures was introduced to prevent the rise in CSF pressure (and consequent reduction in spinal perfusion pressure) that often occurs during aortic cross-clamping or in the early postoperative period. With this technique, a catheter is inserted into the lumbar spinal canal, and small amounts of spinal fluid (up to 50 ml prior to aortic clamping, 50 ml during aortic clamping and a maximum of 20 ml h in the postoperative period) are withdrawn on an intermittent basis to maintain CSF pressures below 10 mmHg. The rationale for using CSF drainage in clinical practice arises largely from a wealth of data from animal studies demonstrating improved spinal perfusion and less neurological injury when CSF drainage is utilized 34 . Drainage of CSF minimizes any deleterious effect caused by a rise in CSF pressure during clamping, optimizes spinal cord perfusion and ameliorates the potentially deleterious effect of spinal cord edema in the early postoperative period....

Cervical Spine Disease

Cervical spine disease in elderly patients is most commonly caused by progressive arthritic narrowing of the spinal column. This is worsened by falls that cause hyperextension injuries, further compressing the cervical cord. Cervical myelopathies cause exclusively upper motor neuron weakness (brisk reflexes, upgoing toes) but also cause bladder difficulties (by interrupting descending tracts) and sensory loss (by affecting the posterior columns). Cervical spine disease can also result from tumor or injury. In younger patients, spinal cord disease can be caused by multiple sclerosis or isolated transverse myelitis, an acute immune-mediated process associated with cells in the cerebrospinal fluid. Transverse myelitis differs from spondylytic cervical myelopathy in its acute onset, younger age, and cellular cerebrospinal fluid. Usually, it occurs in the thoracic, rather than the cervical, spine. Like myopathies, cervical spine disease presents with proximal weakness. However, upper motor...

Virtual Definition of the Anterior Nasal Spine Landmark

Step 1 Define Anterior Nasal Spine on the virtual lateral cephalogram (Figs. 4.14,4.15). Step 2 Verify and correct the median position of Anterior Nasal Spine on the frontal view of the 3-D hard tissue surface representation (Fig. 4.16). Step 3 The position of Anterior Nasal Spine is verified on the left and right 3-D profile views of the 3-D hard tissue surface representations (Figs. 4.17,4.18.). Additionally Anterior Nasal Spine can be verified on the virtual frontal cephalogram linked to the 3-D hard tissue surface representation (Fig. 4.19). Fig. 4.19. Anterior Nasal Spine.Virtual frontal cephalogram linked to the 3-D hard tissue surface representation (3-D CT, patient K.C.) Fig. 4.19. Anterior Nasal Spine.Virtual frontal cephalogram linked to the 3-D hard tissue surface representation (3-D CT, patient K.C.) Posterior Nasal Spine PNS Definition of the Posterior Nasal Spine Landmark Posterior Nasal Spine is the most posterior midpoint of the posterior nasal spine of the palatine...

Spinal tap

The three most commonly used treatments are surgery, radiation, and chemotherapy. Doctors also may prescribe steroids to reduce the swelling inside the central nervous system. symptoms of spinal cord tumors generally develop slowly and worsen over time unless they are treated. The tumor may be classified as benign or malignant and given a numbered score that reflects how malignant it is. This score can help doctors determine how to treat the tumor and predict the likely outcome, or prognosis, for the patient. Researchers are studying the effectiveness of using small radioactive pellets implanted directly into the tumor, and advanced drugs and techniques for chemotherapy and radiation therapy. In gene therapy for spinal cord tumors, scientists insert a gene to make the tumor cells sensitive to certain drugs, to program the cells to self-destruct, or to instruct the cells to manufacture substances to slow their growth. scientists are also investigating why some genes become...

Contemporary Neuroscience

Rao, 2001 Neurobiology of Spinal Cord Injury, edited by Robert G. Kalb and Stephen M. Strittmatter, 2000 Cerebral Signal Transduction From First to Fourth Messengers, edited by Maarten E. A. Reith, 2000 Central Nervous System Diseases Innovative Animal Models from Lab to Clinic, edited by Dwaine F. Emerich, Reginald L. Dean, III, and Paul R. Sanberg, 2000 Mitochondrial Inhibitors and

Technical Considerations

Before discussing the distributions of orexin fibers and receptors throughout the central nervous system, a brief technical comment is warranted. There is a general scientific consensus on the areas of the brain thought to be innervated by orexin neurons. Orexin-expressing neurons may be visualized using routine in situ hybridization (mRNA detection) and immuno-histochemical (protein detection) techniques. Messenger RNA expression, as visualized using in situ hybridization and immunohistochemical staining for orexin peptides, is robust, which is consistent with the presumption that orexin peptides are produced in large amounts and secreted at axon terminals. Antisera to orexin peptides and to prepro-orexin have been generated and directly reconciled with prepro-orexin mRNA expression using in situ hybridization in both normal and orexin-deficient rodent and human tissue. The use of validated antisera has allowed the detection of orexin fibers and terminals throughout the brain and...

American Board of Neurological Microsurgery

Founded in 1977, the group strives to demonstrate expertise and capability in the field of neurological and orthopaedic medicine and surgery through written and oral certification exams. The group also conducts research and educational programs on neuromusculoskeletal disorders of the limbs and spine, and it maintains a library, biographical archives, and a hall of fame. it is allied with the AMERICAN academy of neurological and orthopaedic surgeons.

Orexin Neurons Project Diffusely

From a hypothalamic point of origin, orexin fibers project across the entire neuraxis from the cortex to the spinal cord (Fig. 1). The diffuse nature of orexin efferents has implicated the orexin neurons in a wide variety of physiological systems (5). The lateral hypothalamic area, the origin of orexin projections, has long been considered a master integration and command center for numerous homeostatic, autonomic, endocrine, and behavioral systems (25). For example, retrograde and anterograde tracing studies have shown that the LHA is a primary recipient of projections, presumably containing visceral sensory information, from the brain-stem (30) and provides a reciprocal descending projection to these brainstem regions (30). Similarly, the LHA both innervates and is innervated by the cortex (31,32). The LHA also innervates neuroendocrine control regions in the hypothalamus such as the arcuate nucleus (ARC) and the paraventricular hypothalamic nucleus (PVH) (33).

American Board of Orthopaedic Microneuro

American Paralysis Association A national support group for spinal cord-injured patients, their families, and other interested people to encourage and support research aimed at finding a cure for paralysis caused by spinal cord injury, head injury, or stroke. The group compiles statistics on spinal cord injuries and operates research seminars. Founded in 1979, the group publishes a quarterly newsletter and a bimonthly bulletin. For address, see Appendix I.

American Society for Stereotactic and Functional

American Spinal Injury Association A professional organization for health care professionals who have been trained in the care of spinal paralytic patients. They are either actively engaged in the field and acknowledged to be competent or have made a significant contribution to the advancement of the basic sciences or one of the clinical fields of practice as they are applicable to the treatment of the spine. The purposes of the association are to develop knowledge and investigation of the causes, cure, and prevention of spinal injury and related trauma to pursue excellence in patient care to promote and exchange ideas to standardize medical terminology in spinal cord injury to coordinate basic research to develop teaching material and to provide specialized training. Founded in 1973, the association publishes a semiannual bulletin and other publications.

Migration of Young Neurons

From the intermediate zone, the young neurons must migrate, often considerable distances, to take up their final position. How this happens varies from region to region. In some parts of the brain, such as the retina and spinal cord, cells migrate in response to chemical clues, both positive and negative, present in the area. In other parts of the brain, such as the cortex and cerebellum, specialized glial cells, called radial glial cells, provide a scaffolding along which the neurons migrate. The cell bodies of these glial cells reside in the germinal zone, but they extend a branch to the surface of the brain as shown in Figure 1-6.

Functional Implications

Orexin fibers innervate the paraventricular and arcuate hypothalamic nuclei, as well as the LHA itself. These hypothalamic nuclei have all been classically implicated in neuroendocrine, autonomic, and metabolic regulation. Orexin receptor mRNA, particularly OX2R mRNA, is expressed in these regions. Arcuate neurons in particular, some of which express NPY and are thought to be involved in the control of feeding and body weight homeostasis, are excited by orexin administration (70,71). Similarly, MCH neurons in the lateral hypothalamus are activated in response to application of orexins (47,72). Several hindbrain regions involved in central autonomic control and metabolic regulation are innervated by orexin neurons and include the dorsal motor nucleus of the vagus, the nucleus of the solitary tract, the nucleus ambiguous, and the rostral ventral lateral medulla. These regions express orexin receptor mRNA, and several studies have shown direct excitatory and in some cases inhibitory...

About ICON Health Publications

The Official Patient's Sourcebook on Acute Disseminated Encephalomyelitis The Official Patient's Sourcebook on Agenesis of the Corpus Callosum The Official Patient's Sourcebook on Agnosia The Official Patient's Sourcebook on Arachnoid Cysts The Official Patient's Sourcebook on Arachnoiditis The Official Patient's Sourcebook on Binswanger's Disease The Official Patient's Sourcebook on Brain and Spinal Cord Tumors The Official Patient's Sourcebook on Cerebral Atrophy The Official Patient's Sourcebook on Coma The Official Patient's Sourcebook on Corticobasal Degeneration The Official Patient's Sourcebook on Empty Sella Syndrome The Official Patient's Sourcebook on Headaches The Official Patient's Sourcebook on Locked in Syndrome The Official Patient's Sourcebook on Occipital Neuralgia The Official Patient's Sourcebook on Olivopontocerebellar Atrophy The Official Patient's Sourcebook on Progressive Multifocal Leukoencephalopathy The Official Patient's Sourcebook on Pseudotumor Cerebri The...

Bacillary dysentery See shigellosis

When a backpack is too heavy, the child arches the back or leans the head and body forward to compensate for the weight of the bag. This stresses the muscles in the neck and back, increasing the risk of injury. Using only one strap, as many youngsters do, affects the spine's natural shock absorption abilities.

Hypocretin Modulation Of Synaptic Activity

Membrane potential oscillations might underlie the occurrence of synchronic firing in neurons connected by electrical junctions (45). Using dual cell recording, an increase in the synchrony of spikes was detected with the application of hypocretin to the LC cells (Fig. 10) (26). A similar hypocretin effect has been detected in the spinal cord (19). Here hypocretin increased the amplitude and frequency of membrane potential oscillation and induced synchronous discharge in electrically coupled pairs of spinal neurons previously silent. As hypocretin does not modify the number of coupling junctions in these cells, these results suggest that this peptide directly modulates synchronous firing in neural networks previously silent. In the spinal cord and brainstem, a number of different neuron types are excited by hypocretin. Hypocretin increases release of the inhibitory amino acid transmitter glycine, and the excitatory transmitter ATP in the dorsal horn of the spinal cord (20). Hypocretin...

Vitamin D and other aspects of health 3121 Behaviour

Specific vitamin D receptors are found in parts of the brain and spinal cord (Maxwell, 2001). Seasonal changes in 25-OHD and 1,25-OHD could have an effect on hormonal function, mood and behaviour. For example, seasonal affective disorders (SAD) appear to have a latitude gradient, with mood changes due to a reduction in daylight hours and altered circadian secretion of melatonin. Whether seasonal changes in UV light and vitamin D contribute is unknown.

Brain development in children

Unlike nerves in the limbs or trunk, nerve cells and tracts in the brain and spinal cord do not recover their function if they have been destroyed. However, there may be some improvement after brain damage as certain parts of the brain take over the function of damaged cells, for the loss. It is not fully understood how this occurs. The ability of a brain-damaged patient to recover depends on the cause and site of the damage and the individual's personality and motivation.

Chiropractic medicine

Chiropractic was founded in Davenport, Iowa, in 1895 by Daniel David (D. D.) Palmer, a grocery store owner who cured deafness in a man by manipulating his spine. The theory underlying chiropractic was that pressure on nerves irritated them and caused illness that could be corrected by manipulation to relieve the pressure. Palmer developed a school with its name derived from the Greek words cheir (hand) and praxis (use). His son, B. J. Palmer, developed and popularized the practice further. As it developed, chiropractic attracted practitioners with many different philosophies. Some have believed that all illness is the result of spinal irritation and can be cured by manipulation, but others have restricted their interest to problems affecting muscles and joints. Some chiropractors restrict their treatment to manipulation, but others have incorporated other alternative treatments

Amyloid precursor protein app Individuals with

Amyotrophic lateral sclerosis Lou Gehrig's disease motor neuron disease Progressive degenerative disease of motor neurons in the brain stem and spinal cord that leads to weakening of the voluntary muscles. Some (15-20 ) cases of familial amyotrophic lateral sclerosis (which is itself only 10 of all cases) are associated with mutations in the superoxide dismutase-1 gene. Susceptibility has also been associated with mutations in the genes encoding the heavy neurofilament subunit, peripherin, dynactin and angiogenin. Various other genes have also been implicated.

Neural Development And Brain Plasticity

For years and years scientists thought that the brain was unique in an important way only it and the spinal cord have permanent cells, cells that generally do not die or regenerate. How else would we learn or remember if the cells involved in those processes kept dying We now know that the brain is much more malleable and open to environmental influence much of the wiring (neural connections) in the brain requires experience to be formed. Experience literally shapes neural connections and hence the brain. In other words, the environmental is not completely separable from the biological.

Brain tissue transplants

From the spinal cord upward, the brain stem includes the medulla, the pons, and the midbrain. The medulla looks a bit like a thicker continuation of the spinal cord and contains the nuclei of the ninth, 10th, 11th, and 12 th cranial nerves. It is responsible for relaying taste sensations from the tongue and signals to muscles controlling speech, tongue, and neck movements. The medulla also houses groups of nerve cells that regulate heartbeat, breathing, blood pressure, and digestion and relaying information about these activities via the Running through the middle of the brain stem is a canal that widens into the fourth ventricle of the brain, home of the circulating cerebrospinal fluid.

Introduction Molecular Control of Development

Such cell-extrinsic signaling systems may involve the exchange of information between neighboring cells (short range signals), between distant cells or tissues (long range signals), or between cells and the extracellular surrounding space. Conserved signaling pathways, like the Wnt, Shh, TGF-3, or Delta Notch pathways form the molecular basis of cell-to-cell communication systems. Characteristically, a limited number of signaling systems is used repeatedly by an individual organism to regulate independent cellular events during embryonic development (Artavanis-Tsakonas et al. 1999 Massague et al. 2000 Peifer and Polakis 2000 Ingham and McMahon 2001 Anderson and Ingham 2003). Shh signals, for example, control via their specific receptors' patched and smoothened developmental events as diverse as pattern formation in the ventral spinal cord or the formation of teeth (Ingham and McMahon 2001). Particular signaling molecules, like the fibroblast growth factors (FGFs), neurotrophins, and...

Differential Diagnosis

Spasticity is a symptom of many different conditions. Spinal cord injury, brain injury, tumor, stroke, MS, and cerebral palsy can all be associated with spasticity. It can co-exist with many other conditions that easily confuse the examiner. Spasticity should be carefully distinguished from rigidity, dystonia, athetoid, chorea, ballisms, and tremor. Rigidity is involuntary bidirectional resistance to movement that does not change with velocity. It should be present at rest, whereas spasticity is always velocity-dependent. Dystonia is involuntary sustained contractures that can result in abnormal positions. Athetoid movement is involuntary irregular writhing movements, whereas chorea is similar to athetoid but more abrupt, rapid, and irregular in nature. Ballism is involuntary movements of the limbs or body in which large flinging motions are made, whereas tremor is an involuntary rhythmic repetitive oscillation that is not self-sustaining. Spasticity may also be mistaken for seizure...

Why study single neurons

Vallbo and colleagues (see Valbo, 1989) demonstrated that human subjects (actually, the experimenters themselves) can detect the occurrence of a single impulse in a single sensory fiber. They inserted a fine metal microelectrode, insulated up to its tip, into the nerve that runs from the hand to the spinal cord and then connects to the brain. With fortunate placement of the electrode it is possible to record the activity of just one fiber, and in such a case a certain region on the hand or finger may be found that, when touched, causes a succession of brief, equal-sized pulses to appear on the oscilloscope screen and to be heard through the loudspeaker as a volley of brief clicks. These action potentials come from a single sensory fiber, and one can reduce the intensity of the mechanical stimulus until it only causes, on average, a single action potential. Will this minimal response ever be felt For some types of touch receptors at the fingertip, it can it is felt as a brief and very...

Bottom mentality See bottom

Brain cancer Any primary cancerous tumor in the brain. Brain cancer is relatively rare. There are many different types of brain tumors, only some of which are cancerous. A malignant tumor can spread to other parts of the brain although a benign brain tumor does not spread, it can be equally devastating because the skull cannot expand to accommodate the mass growing inside. Some benign tumors become malignant. Two types of brain cancer affect HIV-infected people primary CENTRAL NERVOUS SYSTEM (CNS) LYMPHOMA and metastatic systemic lymphoma in the brain. Other brain cancers are extremely rare in HIV patients. The symptoms of a brain tumor can vary, depending on the part of the brain affected. The most frequent signs of a brain tumor are subtle changes in personality, memory, and intellectual performance that may not be noticed. A common symptom is a headache, not necessarily persistent or severe. Nausea and vomiting unrelated to food consumption occur in about a quarter of people with a...

Cloaca Mesenchymal Structure

Fig. 7a, b Dorsolateral perineal complex in embryos of 10 mm t (a), and 12 mm t (b). In a the dorsolateral perineal complex (1) is shown between the tail (arrow) and the leg (arrowhead) 2, sacral plexus of spinal nerves 3, external iliac vein 4, autonomic nerve plexus. In b the dorsolateral perineal complex (1) shows its position by large future labial and muscular nerves (5) 4, autonomic nerve plexus 6, cloacal labia 7, anal compartment of the cloaca arrowhead, leg Fig. 7a, b Dorsolateral perineal complex in embryos of 10 mm t (a), and 12 mm t (b). In a the dorsolateral perineal complex (1) is shown between the tail (arrow) and the leg (arrowhead) 2, sacral plexus of spinal nerves 3, external iliac vein 4, autonomic nerve plexus. In b the dorsolateral perineal complex (1) shows its position by large future labial and muscular nerves (5) 4, autonomic nerve plexus 6, cloacal labia 7, anal compartment of the cloaca arrowhead, leg dicular to the epidermis and situated at the dorsal ends...

Center for Hyperactive Child Information A

Central nervous system (CNS) The collective term for the brain and the spinal cord, which is the two-way highway for messages between the brain and the rest of the body. The CNS is responsible for integrating all nervous activities and works together with the peripheral nervous system (pns), which consists of all the nerves that carry signals between the CNS and the rest of the body.

Sir Astley Paston Cooper 17681841

By means of my finger nail, I scratched through the peritoneum on the left side of the aorta, and then gradually passed my finger between the aorta and the spine, and again penetrated the peritoneum, on the right side of the aorta. The Lectures on the Principles and Practice of Surgery with Additional Notes and Cases by Frederick Tyrell, Vol. 2. Thomas and George Underwood, London (1824) (Description of the first ligation of the aorta in 1817 for left femoral aneurysm)

Glutamate Effects on Microtubules Mediated by AMPA Kainate mGlu and NMDA Receptors

Glutamate mediates sensory input to the cerebral cortex, where many of these excitatory presynaptic terminals contact spines. AMPA and kainate glutamate receptors respond quickly, within a few ms, altering ion conductances across the membrane (Na+ influx Ca2+ influx). Under physiological conditions, there are a few ways that AMPA receptors (and similarly kainate receptors) can influence microtubules (see Fig. 3.3). Fig. 3.3. AMPA receptor activation effects on microtubules. A population of AMPA receptors located on a dendrite spine is shown. Microtubules are diagrammed as orange polymers composed of tubulin. Pairs of MAP2 molecules link microtubules, whereas single MAP2 molecules are flexible enough to allow kinesin to walk over. The following responses are illustrated AMPA receptor activation opens sodium (Na+) channels and sodium ion influx increases the sodium ion concentration inside the neuron, adding to the potassium ion (K+) concentration (insert lists sodium and potassium...

Children and Adults with Attention Deficit Disorder

Children's Brain Tumor Foundation, The A nonprofit organization established in 1988 by parents, physicians, and friends dedicated to improving the treatment, quality of life, and long-term outlook for children with brain and spinal cord tumors. The foundation funds research for basic, clinical, and psychosocial research on pediatric brain and spinal cord tumors and their consequences. It offers support services and a parent-to-parent network, and publishes a free resource guide on pediatric brain and spinal cord tumors for families. The foundation also cosponsors conferences on pediatric brain tumors. For address, see Appendix I.

Children and Adults with Attention Deficit Hyperactivity Disorder

Children's Brain Tumor Foundation, The A nonprofit organization established in 1988 by parents, physicians, and friends dedicated to improving the treatment, quality of life, and long-term outlook for children with brain and spinal cord tumors. The foundation funds research for basic, clinical, and psychosocial research on pediatric brain and spinal cord tumors and their consequences. If offers support services and a parent-to-parent network and publishes a free resource guide on pediatric brain and spinal cord tumors for families. The foundation also cosponsors conferences on pediatric brain tumors. (For contact information, see Appendix I.)

Temporary Nature of Synaptic Change

Researchers have studied synaptic change with learning using either the electron microscope to visualize synapses or light microscopy to visualize spines. Numerous studies have found evidence for change in spine morphology with learning or enriched experiences (for a review, see Yuste and Bon-hoeffer 151 ). Regarding the more specific issue of synaptogenesis22, recent studies have shown that synapse and spine densities are altered following learning. In a recent study of associative learning, adult male rats trained on a trace eye-blink conditioning task showed increased the density of spines on basilar dendrites of pyramidal neurons in CA1 of hippocampus 75 . Apical and basilar dendrite lengths were not altered by the training, indicating that the increased spine densities represented increases in total numbers of spines and were not secondary to shrinkage of dendrites. NMDA antagonists blocked both acquisition of the conditioned response and the spine density changes, further...

Neurology and Pathology in Bats and Humans

ABLV has caused non-suppurative meningoencephalomyelitis in both bats and humans. When histology was performed on bats infected in the wild, eosinophilic cytoplasmic inclusions, known as Negri bodies typical of RABV infection, were often observed (Fraser et al. 1996 Gould et al. 1998 Hooper et al. 1999 Skerratt et al. 1998 Speare et al. 1997). Although no gross lesions in bats have been reported, the following have been described neuronal necrosis with some neuronophagia, focal gliosis, perivascular cuffing with lymphocytes, cytoplasmic vacuolization and subarachnoid lymphocytic meningitis (Hooper et al. 1999). The medulla oblongata and pons, hippocampus, thalamus and midbrain were most affected. Staining using an immunoperoxidase-labeled rabies-specific monoclonal antibody, HAM, is frequently observed throughout the brain and in particular the hippocampal region, medulla ob-longata and pons, thalamus and midbrain, although less commonly in the cerebrum and cerebellum (Fraser et al....

Central nervous system lymphoma See primary

Cerebrospinal fluid (CSF) The fluid found within the cavities of the brain and surrounding both the brain and the spinal cord. A sample of this fluid is often removed from the body for diagnosis purposes by a lumbar puncture (spinal tap). The fluid is analyzed for cancer cells or evidence of other disorders.

Cellular Correlates Of Brain Homeostasis 21 Neuroglia

Miniaturization of the vertebrate CNS occurred as a consequence of the necessity to protect the brain and spinal cord with a bony structure, limiting the overall volume available for cellular expansion. A consequence of this limiting factor is that the extracellular space in the brain is very small, amplifying the concentration changes occurring across the plasmalemma surrounding the cells (4). The size of the extracellular space is not homogeneous, and regional differences have been found, even within the contiguous CA1 and CA3 hippocampal regions (5). The possibility that these regional variations also relate to different glial subpopulations within the hippocampus has been proposed (6). There are numerous ways by which these vascular elements may cooperate with parenchymal glia toward the maintenance of a stable extracellular milieu. BBB endothelial cells are believed to control ionic homeostasis, by preventing equalization of plasma levels of ions with those present in the...

Microtubule Transport by Kinesin Participates in Learning

Polyribosomes and mRNAs for signal-transduction molecules critically involved in learning and memory have been found in dendrites 120 . These include mRNA for NMDA receptor, CaCMK II, and MAP2. Local translation of these proteins within the spine is made possible by shifts of polyribo-somes from dendrite shafts to spines following tetanic stimulation producing LTP 95 . These shifts among ribosomes further implicate transport as critical to learning. Other evidence suggests that kinesin plays a role in learning and plasticity. We have studied KIF17, NR2B and PSD-95 in rats for one week following training on the contextual fear task. In hippocampus CA1, contextual fear training decreased the binding of NR2 to kinesin and increased NR2 binding to PSD-95 (see Fig. 3.8).

Diagnostic Evaluation

The choice of imaging for evaluation for metastatic, recurrent, or progressive disease depends on the type of cancer and its location. Magnetic resonance imaging (MRI) is the test of choice for evaluating the spine, soft tissues of the head, and joints such as the shoulder. The addition of gadolinium contrast is needed when a brain metastases, intramedullary spinal tumor, or leptomeningeal disease are diagnostic possibilities. Gadolinium is also required when a post-operative or previously irradiated site is being evaluated to facilitate differentiation of tumor from a background of scar or fibrotic tissue. A computed tomography (CT) scan with contrast is usually the test of choice to evaluate the viscera of the chest, abdomen, and pelvis for metastatic or progressive disease. CT may also be used when MRI is contraindi-cated (pacemaker, aneurism clips, breast tissue expanders). A CT myelogram is indicated when metallic hardware, such as from previous spinal instrumentation, causes...

Neuromuscular Reanimation

Various approaches to stimulating muscles include transcutaneous and percutaneous electrodes and surgically implanted multichannel stimulators with electrodes attached to nerves and muscles. BION implants are shown as they would be injected into muscles through a 12-gauge hypodermic needle. Each implant receives power and digitally addressed and encoded commands from an external controller and transmission coil. This system is in clinical trials to prevent disuse atrophy and related complications of upper motor paralysis, such as stroke and spinal cord injury. In principle, coordinated stimulation of many muscles could reanimate a paralyzed limb, but this will require substantial advances in sensing command and feedback signals from the patient and in emulating the complex and poorly understood control circuitry of the brain and spinal cord. Various approaches to stimulating muscles include transcutaneous and percutaneous electrodes and surgically implanted multichannel stimulators...

Other Neurological Illnesses

Any illness that affects the brain can also impair memory. Less common neurological illnesses include encephalitis (an inflammation of the brain caused by a virus or microorganism), normal pressure hydrocephalus (an excess of cerebrospinal fluid in the ventricles of the brain), Huntington's disease (a genetically transmitted degenerative brain disorder), meningitis (an inflammation of the membranes surrounding the brain and spinal cord), and primary and metastatic brain tumors. These conditions are usually diagnosed quickly, as the initial symptoms are readily recognizable.

Orexins And Cardiovascular And Sympathetic Functions In Vitro

Parvocellular neurons of the PVN send long descending projections to several areas within the CNS that are known to be important in cardiovascular function (28,29). These regions include the NTS, where baroreceptor and chemorecepor afferents terminate, and the vagal complex present in the dorsomedial medulla, the RVLM, which is probably the major site for generation of sympathetic tone for the vasculature, and the IML cell column of the thoraco lumbar spinal cord, which is the site of sympathetic preganglionic neurons (SPNs) involved in the regulation of HR and BP. To examine whether orexins affect PVN neurons directly, the changes in membrane potential induced by application of orexins on the PVN neurons of a rat hypothalamic slice were studied (30,31). About 70-80 of magnocellular and parvocellular neurons in the PVN responded to orexin-A or -B. Orexin-A produced a depolarization accompanied by an increase in action potential firing in a dose-dependent manner and also produced...

Fellowships And Subspecialty Training Pain Management

The multidisciplinary field of pain medicine applies the principles of anesthesi-ology outside of the operating room. Both acute and chronic pain is an extremely common complaint of patients. As such, there is a rapidly growing demand for specialists who can manage different pain syndromes. A typical patient is often an injured employee on workers' compensation. Anesthesiologists who specialize in pain management solely see patients in a clinic setting, such as a freestanding pain center. Here, the continuity of care lends itself to a more traditional doctor-patient relationship. They diagnose the etiology of pain syndromes and treat these problems with medication or procedural therapy (injections of local anesthetics, peripheral and central nerve blocks under fluoroscopy, implantation of spinal cord stimulators and intrathecal pumps, and transcutaneous nerve stimulation). In pain management, you can also earn certification in performing acupuncture.

Fluent aphasia See Wernickes aphasia fluid balance See thirst

Folic acid A B vitamin found in many foods, that is essential to the production of red blood cells by the bone marrow. This vitamin plays a particularly important role in the development of the fetal nervous system and formation of fetal red blood cells. its lack during pregnancy has been linked to neural tube defects. (Neural tube defects are a devastating birth disorder that takes place when the spinal column fails to close early in pregnancy the condition can cause a baby to be born with part of its brain missing.)

Encephalitis eastern equine 171

When an infected mosquito bites a child, the virus passes into the blood and then travels to the brain and spinal cord. It multiplies in the central nervous system, inflaming and damaging nerve cells, interfering with signals sent from the brain to other parts of the body.

Brainderived neurotrophic factor bdnf bdgf

Brain regions The central nervous system of mammals is complex and the terminology often confusing. In development, the brain is generated from the most anterior portion of the neural tube and there are three main regions the fore-, mid- and hindbrain. The lumen of the embryonic nervous system persists in the adult as the cerebral ventricles, filled with cerebrospinal fluid, which are connected to the central canal of the spinal cord. The forebrain develops to produce the cerebral hemispheres and basal ganglia and the diencephalons, which forms the thalamus and hypothalamus. The cerebrum consists of two hemispheres connected by the corpus callosum, the outer part being greatly expanded in man with the increased surface being thrown into fold (ridges are gyri, valleys are sulci). The outer layer (cerebral cortex) is responsible for so-called higher-order functions such as memory, consciousness and abstract thought the deeper layers (basal ganglia) include the caudate nucleus and...

Discovery And Properties Of The Hypocretins

Immunocytochemical mapping using antisera against chemically synthesized hypocretin peptides has shown that hypocretin neurons project their terminals throughout the brain (7). Within the synaptic terminals of these fibers, hypocretin immunoreactivity is associated with dense core secretory vesicles (5). Afferents of hypocretin neurons include an ascending pathway that projects to the basal forebrain, septum, and cerebral cortex a very dense intrahypo-thalamic network and a descending pathway that connects the lateral hypothalamus with brainstem nuclei and the spinal cord (7). Both hypocretin peptides (1 and 2) are neuroexcita-tory (5,8) and bind to postsynaptic hypocretin receptors (1 and 2) with different selective affinities (9). The distribution of hypocretin fibers matches that of the hypocretin receptors described (10) and suggests that the hypocretins interact with multiple neurotransmitter networks involved in different functions. The studies showing that hypocretin mRNA is...

Suicide and Medical Disorders

Medical disorders associated with an elevated risk of suicide are AIDS, cancer (especially head and neck), Huntington disease, multiple sclerosis, peptic ulcer disease, end-stage renal disease, spinal cord injury, and systemic lupus erythematosus. Any serious medical illness can raise the risk of suicide in elderly Caucasian men. In most cases, suicide in the context of a medical disorder occurs in conjunction with a depressive disorder or a history of alcohol abuse, or both.

Ventilator Supported Speech Production

Many medical conditions can cause severe respiratory insufficiency requiring ven-tilatory support. Examples include cervical spinal cord injury (rostral enough to impair diaphragm function), muscular dystrophy, amyotrophic lateral sclerosis, and chronic obstructive pulmonary disease.

Project Title Developmental Plasticity And Chronic Epilepsy

Summary The effects of early-life seizures on the developing nervous system remain controversial. Clinical indications are that severe and repeated seizures may contribute to chronic epilepsy and impairment of learning in children. However, few experimental studies have explored this possibility. Recent studies obtained in rats suggest this may be the case since tetanus toxin-induced seizures in infancy lead of chronic focal epilepsy in hippocampus and impairment in the acquisition of spatial memory. In other experiments, recordings in adulthood from in vitro slices demonstrate abnormal epileptiform discharges arising from hippocampal area CA 3C. Morphological studies show a dramatic loss of dendritic spines on CA 3C pyramidal cells in these same chronically epileptic rats. Surprisingly the alterations seen in adulthood are not present in early- life when recurrent seizures are so frequent. These and a number of other observations lead us to propose a two hit model of epileptogenesis....

Habits vs Mental Problems

Haemophilus influenzae type B (Hib) A type of rod-shaped bacterium not to be confused with the influenza virus that causes the flu. Haemophilus influenzae type B (Hib) is a bacterium that causes potentially deadly meningitis, pneumonia, and blood infection (bacterial sepsis). H. flu meningitis is a serious infection characterized by inflammation of the brain and spinal cord that may be fatal.

Cell and molecular mechanisms underlying the patterning and formation of the optic chiasm

Netrin Deleted in Colorectal Cancer Netrins are a family of secreted guidance molecules that can both promote and inhibit outgrowth of different types of neurons. Deleted in Colorectal Cancer (DCC) is an immunoglobulin superfamily member that appears to act as a netrin receptor (Culotti and Merz, 1998). In the developing eye, DCC is expressed by RGCs and netrin-1 is strongly expressed around the optic disc and at the junction of the optic nerve and brain. However, in contrast to the spinal cord, no netrin-1 expression is found at the diencephalic midline (Deiner and Sretavan, 1999 Deiner et al., 1997 Hopker et al., 1999). In vitro, netrin-1, acting through DCC, can promote RGC axon outgrowth (de la Torre et al., 1997 Wang et al., normally (Deiner and Sretavan, 1999). The netrin-1- and DCC-deficient mice also exhibit defects in the formations of other hypothalamic axon pathways and in the location of specific subpopulations of neurons, raising the possibility that the abnormal...

Inflammation And Neurodegenerative Disorders

(NFT)-containing and damaged neurons in brains of Down's syndrome and AD patients exhibit high expression of COX-2 (80-82). Furthermore, up-regulation of COX-2 was found to precede the appearance of NFT-containing neurons and neurodegeneration in patients with Fukuyama-type congenital muscular dystrophy, a neurodegenerative disorder transmitted through autosomal recessive inheritance (83). When compared to control brains, the substantia nigra in parkinsonian brains contain higher levels of PGE2, which is symptomatic of an increased COX activity (84 85). Moreover, a marked increase in COX-2 levels was detected in the spinal cord of ALS patients (86). A transgenic mouse model of ALS expressing the superoxide dismutase mutation G93A in the spinal cord also exhibits COX-2 up-regulation (90). Moreover, COX-2 specific inhibitors confer neuroprotection in an MPTP-mouse model of PD (91). Recent studies demonstrated that JNK-mediated induction of COX-2 is indispensable for MPTP-induced...

Memory trace See engram

Meninges The three membranes that cover and protect the brain and spinal cord, guarding against shocks, knocks, and vibrations. The tough leathery outer membrane (dura mater) lines the inside of the skull, draping loosely around the spinal cord. Next comes the arachnoid mater, an elastic weblike substance that is separated by the fluid-filled arach

Genes Chromosomes And

What color is the light, Linda Two days into their cross-country road trip, ten-year-old Linda had lost track of how many times her adored grandfather had asked her this. As they approached a red traffic light, she smiled at his little game and said, red. He carefully slowed down and stopped to wait for the light to turn green again. At the next green light, feeling bored, she answered, red, so he smiled indulgently in her direction and slowed to a stop. He waited patiently until she told him the light was green and he started up again. What child would not be charmed by a grandfather who would accommodate her whims and stop anyway when she answered with the wrong color Later that day, as he made his same query at a red light, she said, green, with a little secret smile and he pulled right on through the intersection, which was fortunately free of other cars. Linda was just sure that she had the coolest, funniest grandfather in the state of Ohio, until years later when someone...

Pathogenesis of BEFV Infection

The available evidence indicates that the clinical signs of BEFV infection are due primarily to a vascular inflammatory response. In experimental infections, the incubation period is usually only from 2 to 4 days, and viraemia and clinical signs are of short duration, persisting for only 1-3 days (Mack-erras et al. 1940 St. George et al. 1984 Uren et al. 1989, 1992). There is no evidence of extensive tissue damage other than a vasculitis affecting the endothelium of small vessel synovial membranes, tendon sheaths, muscles, fascia and skin (Mackerras et al. 1940 Basson et al. 1969 Kirkland 2002). Although the initial site of infection following transmission is not known, the virus is subsequently detected primarily in leucocytes and blood plasma (Mackerras et al. 1940 Young and Spradbrow 1980 St George 1993). The onset of fever and other clinical signs is accompanied by a marked leucopoenia, relative neutrophilia, elevated plasma fibrinogen, biochemical imbalance including...

Definition of Disease

The diagnosis of the case presented above was secondary syphilis with concurrent neurosyphilis. As mentioned, neurosyphilis is no longer considered to be a distinct phase of disease. It is a manifestation of infection that can occur early with the appearance of the chancre, late in disease when blindness and dementia have set in, or at any point in between. Up to 10 of individuals with neurosyphilis will be asymptomatic, and symptomatology may be different depending on the stage of disease with which it is associated.1 The possible symptoms of neurosyphilis include cognitive dysfunction, motor or sensory nerve deficits, ocular or auditory deficits, cranial nerve palsies, meningitis, or seizures, although rare.1 Early neurosyphilis typically presents as meningitis with or without cranial nerve or ocular involvement. Late neurosyphilis involves the brain and spinal cord, leading to general paresis, rapid progressive dementia with episodes of psychosis, bowel and bladder dysfunction, and...

Brief History of Pain

The Greeks and Romans were the first to advance a theory of sensation, the idea that the brain and nervous system have a role in producing the perception of pain. But it was not until the Middle Ages and well into the Renaissance-the 1400s and 1500s-that evidence began to accumulate in support of these theories. Leonardo da Vinci and his contemporaries came to believe that the brain was the central organ responsible for sensation. Da Vinci also developed the idea that the spinal cord transmits sensations to the brain.

Special Procedures In Neurology

Similar to most subspecialties of internal medicine, neurology is particularly rewarding for aspiring doctors who prefer using their minds more often than their hands. Regardless, there are several important procedures that all neurologists perform on a daily basis. The most common is the famous spinal tap (lumbar puncture). During this procedure, the physician carefully inserts a needle into the thecal sac below the termination of the spinal cord to withdraw cerebrospinal fluid. Unchanged for the past hundred years, this technique can diagnose patients with certain acute infections, particularly meningitis, as well as multiple sclerosis, intracranial bleeding, and neuropathies. Furthermore, the spinal tap can also serve as a therapeutic measure by removing fluid to relieve conditions such as hydrocephalus (water on the brain) or increased intracranial pressure. It also provides a means by which the physician directly injects chemotherapeutic agents or antibiotics to treat infections...

National Alliance for the Mentally Ill NAMI A

National Ataxia Foundation A professional organization open to any individual who wishes to contribute to the eradication of ataxia, a genetic disease characterized by the degeneration of the nerves in the spinal cord and the cerebellum, causing a loss of coordination. The foundation, which was founded in 1957, provides information and referrals and publishes various materials, including a quarterly newsletter, videos, and brochures.

The Screening Neurologic Evaluation

What anatomic hypotheses need to be considered For a first approximation, it is sufficient to consider six major neuroanatomic possibilities. Working from the periphery inward, the physician should consider whether the primary problem is in (1) skeletal muscle, (2) the neuromuscular junction, (3) peripheral nerves, (4) the spinal cord, (5) the posterior fossa (brainstem and cerebellum), or (6) the telencephalon (cortex, deep white matter,

National Neurofibromatosis Foundation A

National Spinal Cord Injury Association National support organization for patients with spinal cord injury and for health care professionals. The group supports research for a cure for paralysis from spinal cord injury, provides education programs and services, and helps individuals reach their personal goals. The association sponsors In Touch With Kids, a network of parents of children with spinal cord injury or disease. The group also conducts recreation, advocacy, support groups, and peer counseling programs and maintains a placement service. Founded in 1948, the group publishes an annual directory, a quarterly journal, and a variety of fact sheets. For address, see Appendix I. (See also american paralysis associa tion AMERICAN SPINAL INJURY ASSOCIATION SPINAL CORD SOCIETY.)

Link Between Innate And Adaptive Responses

Ependymal cells lining the ventricles32 is likely to facilitate the peripheral activation of adaptive immune responses by antigen drainage into the CLN via the cerebral spinal fluid.4' 5 The early detection of cells with a dendritic cell-like phenotype in the CNS parenchyma and CLN alternatively supports acquisition of viral antigens in the CNS by antigen presenting cells, followed by migration to CLN.25 Activation of adaptive immune components alters both the composition of CNS infiltrating cells and chemokine expression. Although CXCL9, CCL2, CCL3, CCL4, CCL5, and CCL7 are expressed during acute infection, CXCL10 is the most prominent and sustained chemokine.12 In addition to attracting NK cells,24 CXCL9 and CXCL10 recruit activated T cells33' 34 and potentially plasmablasts,35 via the CXCR3 receptor. Increasing T-cell accumulation coincides with a decline in neutrophils and NK cells however, macrophages persist in the CNS.21 The T cell-mediated reduction in CNS viral burden results...

More Than Just Brain Surgery

Neurologic surgery involves the diagnosis, treatment, and management of patients with diseases or injuries to the brain, spinal cord, or peripheral nerves. Neurosurgeons thrive upon the elegant complexity of the nervous system. They love being able to correct abnormalities of this organsystem by using their hands, surgical instruments, and the latest operative technology. This specialty deals with the entire nervous system not simply the anatomic region of the body where its primary components (brain and spinal cord) are located. In a given week, a neurosurgeon might operate on a patient's brain, spine, face, arms, or legs. Their patients may range in age from newborns to adults.

Cerebrovascular Neurosurgery Operating on the Blood Vessels of the Brain

Cerebrovascular neurosurgery uses a surgical approach to treating vascular diseases of the brain and spinal cord. Intracranial aneurysms, arteriovenous malformations, arterial dissections, and occlusions of the extracranial carotid arteries are just a few of the many disease processes with which the cerebrovascular surgeon is confronted. As you might imagine, virtually all vascular diseases of the central nervous system are serious and potentially deadly. The vessels are of small diam

Differential Sensitivity Of Groups Of Neurons

A number of interesting studies suggest that certain types of neurons may be more vulnerable to proteasomal inhibition. An attempt has been made to correlate this selective vulnerability with the specific neuronal subtypes that degenerate in particular neurodegenerative diseases. Cultured motor neurons of the anterior horn were more sensitive to cell death compared to other neurons in spinal cord cultures (64). In two studies, dopaminergic neurons of embryonic or post-natal rat ventral midbrain cultures were more sensitive to lactacystin- or MG132-induced death compared to GABAergic neurons (65, 7). An in vivo study confirmed selective vulnerability of dopaminergic neurons in the substantia nigra following striatal microinjections of a proteasomal inhibitor. Selective toxicity in this model was dependent on the endogenous dopamine content (9). Another recent study reported remarkable selectivity of neuronal death induced by systemic administration of pharmacological proteasomal...

Prediction And Adaptation

Fixed action patterns Motor Programs Preprogrammed movements Movement Primitives. Spencer proposed that reflexes were the atoms of the psyche, the psyche was an assemblage of reflexes, and instincts were reflex assemblies consolidated by repetition and transmitted in an hereditary manner (Spencer 1855). The idea of stored motor programs or subroutines has been reiterated many times since (review Prochazka et al. 2000). The spinal central pattern generator is essentially an example of this idea. The tripping reaction may be another example. Bosco and Poppele on the signaling of derived variables by spinocerebellar tract neurons is therefore of great interest (Bosco and Poppele 2000 Bosco et al. 2000 Bosco and Poppele 2001). It has also been suggested that motor cortical activity may be viewed as a summing junction for feedforward signals providing visuospatial information about the environment and feedback signals providing information on the state of the interneuronal pattern...

Trials of folic acid in pregnancy

The example of the trials into folic acid in pregnancy illustrate the puzzle of whether or not to use placebo controls (Scott et al., 1994). If, in the early days of pregnancy, the neural plate of the fetus does not close to form the neural tube which encompasses the spine and the brain, either spina bifida results, if the spine is not properly enclosed, or anencephaly, if the brain is not properly enclosed. It was thought that if the mother took folic acid she could help prevent the tragedy of neural tube defects. A research project was proposed to test folic acid against placebo to see if the hypothesis was correct. But the research ethics committee which had to give the study its approval decided that it was unethical to deny folic acid to anyone, because there were many indications that folic acid did indeed make a considerable difference to the development of the fetus. In the event, the control group consisted of those mothers not in the trial. Interpretation of the results was...

Neurologic Disorders Associated with Weakness

Weakness can be either asymmetrically localized to one part of the body or generalized. Weakness limited to a few muscle groups of one limb can result from a lesion of a nerve root exiting the spine, the lumbar or brachial plexus at the base of the limb, or a single peripheral nerve within the affected limb itself. Nerve root disease is often associated with pain in the back or neck and is discussed in Chapter 11. Compression of single peripheral nerves is frequently associated with numbness or tingling and is discussed in Chapter 13. Weakness affecting one side of the body results from lesions of the spinal cord or brain. When this occurs abruptly, it is most often due to a stroke.

Alternative Medical Systems

Naturopathic medicine is based on the theory that disease is a manifestation of alterations in the processes by which the body naturally heals itself and emphasizes health restoration rather than disease treatment. Naturopathic physicians employ an array of healing practices, including the following diet and clinical nutrition, homeopathy, acupuncture, herbal medicine, hydrotherapy (the use of water in a range of temperatures and methods of applications), spinal and soft-tissue manipulation, physical therapies (such as those involving electrical currents, ultrasound, and light), therapeutic counseling, and pharmacology.

Materials And Methods

Demyelination was analyzed in at least 10 sections of spinal cord from each animal and five to eight mice were examined in each of two separate experiments. Percent demyelination was calculated by counting quadrants of cross-sectioned spinal cord that was stained with the myelin specific dye, luxol fast blue. A neuropathologist examined the spinal cords to determine the severity score which was from 0 to 5 with 5 being the most severe demyelination.2

Motor Neuron Diseases

Motor neuron diseases are almost exclusively due to amyotrophic lateral sclerosis (ALS), a sporadic and rare condition that is easily diagnosed because it is a disease of spinal and cortical motor neurons. This combination causes the classic picture of lower motor neuron signs (atrophy, fascic-ulations), as well as upper motor neuron signs (brisk reflexes and upgoing toes). Sensation is normal, as this is strictly a disease of the motor system. Its cause is unknown.

Central Nervous System Development

Analogous to their essential functions in the development of Schwann cells, Neuregulin-1 ErbB signals have been implicated in the control of oligodendrocyte development (Barres and Raff 1999). In vitro, type II Neuregulin-1 (glial growth factor, GGF) promotes survival of oligodendrocytes and the proliferation of oligodendrocyte precursor cells purified from cortical cultures (Canoll et al. 1996 Fernandez et al. 2000 Calaora et al. 2001). GGF has also been reported to promote oligodendrocyte differentiation (Vartanian et al. 1994). In contrast, genetic studies failed to demonstrate unambiguously an essential function of Neuregulin-1 in oligodendrocyte development in order to circumvent perinatal lethality Riethmacher and coworkers transplanted neural stem cells from ErbB3 mutant mice into the retina of newborn mice demonstrating that development of stem-cell-derived, ErbB3-deficient oligodendrocytes in vivo was normal (Schmucker et al. 2003). In addition, oligodendrocyte development is...

How to Recognize and Classify Seizures and Epilepsy

Summary How to Recognize and Classify Seizures and Epilepsy, a 25-minute video produced by the Epilepsy Foundation of America, is a resource for physicians and other health professionals which details the different types of seizures and depicts their effects using taped segments of persons experiencing epileptic seizures. Epilepsy can be diagnosed by obtaining a thorough medical history talking with the patient, family, and other observers electroencephalography (EEG) and magnetic resonance imaging. In symptomatic epilepsy, the epilepsy arises from an underlying condition blood and cerebral spinal fluid studies may provide evidence of infection or other inflammatory processes that can be treated with antibiotics or other anti-inflammatory drugs. The International Classification of Epileptic Seizures divides them into two major categories (1) Partial, which is characterized by focal onset that may or may not affect consciousness and may be simple, i.e., motor, somatosensory, psychic,...

Synaptic organization of the entorhinaldentate projection

In the molecular layer of the dentate gyrus in the rat, the terminals of the perforant path fibers in the outer two-thirds of the molecular layer make up at least 85 of the total synaptic population (Nafstad, 1967 Matthews et al., 1976). Entorhinal fibers form mainly, if not exclusively, asymmetric synapses (Nafstad, 1967 Matthews et al., 1976 Deller and Leranth, 1990 Leranth et al., 1990). These occur most frequently on the dendritic spines of dentate granule cells, although a small proportion of perforant path fibers terminate on non-spiny dendrites of presumed interneurons. These include parvalbumin GABA-immunoreactive (Zipp et al., 1989), som-atostatin-positive, and NPY-positive neurons with cell bodies located in the hilus and apical dendrites which extend into the outer portions of the molecular layer (Scharfman, 1991 Soriano and Frotscher, 1993). Since at least half of the NPY-positive neurons also stain for somatostatin (Swanson and Kohler, 1986) and some co-localization of...

Bones Muscles And Joints The Heart Of Orthopedic Surgery

The specialty of orthopedics basically involves the care of the musculoskeletal system, which includes care of most disorders and injuries in the upper and lower extremities as well as the spine. As such, future orthopedic surgeons need a thorough knowledge of the anatomy, mechanics, and physiology of this body system. You master everything there is to know about each muscle, nerve, and blood vessel within all parts of the musculoskeletal system. In addition, proper diagnosis and management of orthopedic injuries requires a solid grasp of forensics and physics to understand the mechanisms of injury.

Referral to a Neurologist

As a rule, most organic weakness of neurologic origin is due to a stroke, a neuromuscular disease, or spinal cord disease. Strokes are usually fairly easy to distinguish, since they have a sudden onset and fit easily identified patterns. Recent advances in stroke management dictate prompt referral for emergency diagnosis and treatment. The primary care physician should usually refer patients with spinal or neuromuscular causes of weakness to a neurologist because their rarity makes pattern recognition somewhat more difficult. Additionally, many of these neuromuscular diseases should be treated with significant immunosuppression, itself a specialist skill. Therefore, the role of the primary care physician is to establish the presence of organic weakness and its time course. Generalized weakness progressing over one to three weeks should be referred to an emergency room because of the possibility of spinal cord disease or Guillain-Barr syndrome. Subacute weakness should be referred, in...

David J Warren Richard A Normann and Alexei Koulakov

Chapter with a discussion of the use of these microelectrode arrays as a means for restoring a lost sensory sense in those with profound blindness. When implanted in motor pathways, these arrays could also enhance limited or lost motor function in individuals with spinal cord injury or with demyelinating disorders.

Initial Assessment and Management

The first priority in treating patients with suspected spinal injuries is to identify life-threatening conditions that must be treated immediately. During medical stabilization, the patient is immobilized so that assessment and treatment can be safely performed. The patient is placed on a firm 'back board' and sandbags are placed beside the head and neck to immobilize the cervical spine. A hard cervical collar may also be applied. Complaints of pain should raise the suspicion of spinal injury. Even with low-energy trauma, fracture can occur in patients with poor-quality bone. Care must be taken to rule out injury, particularly in patients with an altered level of consciousness or intoxication. In these individuals, symptoms may be masked by the mental state and catastrophic events may occur if the injury is not identified. Facial lacerations and fractures are often associated with cervical spine injuries (Bohlman 1979). Rib cage injuries, multiple rib fractures, or sternal injury may...

Primary visual cortex

There is no evidence in PLS of the degeneration of spinal motor neurons or muscle wasting that occurs in a similar disorder called amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease). In fact, for the first few years after symptoms begin, there is a possibility that the true diagnosis is ALs, which can have some of the same symptoms as PLS. For this reason, most neurologists follow a patient for a few years before making a diagnosis of PLS.

Nerve cell See neuron

Neurologic, neurological Relating to the nervous system, including the brain and spinal cord. other problems in HIV encephalopathy include vascular myelopathy, a degeneration of the spinal cord that leads to leg weakness, stiffness, sensory loss, imbalance, and sphincter dysfunction. Small holes, or vacuoles, develop in the middle part of

Neurologic dysfunction

The spinal cord, which controls the lower part of the body, and become larger over time. myelin, the protective coating around nerve fibers, is slowly destroyed. As more and more fibers die, the brain's signals are short-circuited, thereby blocking communication with the lower body. Myelopathy can occur at any time in HIV disease and up to 55 percent of HIV-positive people at autopsy show some degree of myelopathy. Primary central nervous system (CNS) lymphoma occurs in about 2 percent of HIV disease patients. CNS lymphoma is a tumor of a form of white blood cells called lymphocytes. Lymphomas can occur anywhere in the lymph system and often spread to the nervous system. Primary CNS lymphoma refers to a form of lymphoma that is confined to the brain, spinal cord, their lining, and or the inside of the eye. Irradiation is sometimes successful as treatment. It has been shown to increase in effectiveness when combined with the drug methotrexate. neuromuscular therapy Physical therapy...

Nongovernmental organization NGO

Primary CNS lymphoma is a cancer of the brain and or spinal cord and nervous system. It is called primary because it has started in the brain and not moved there from other regions of the body. Systemic means the cancer has spread throughout the body, though it started in the lymph glands. Non-Hodgkin's lymphoma is the most common lymphoma that affects people with HIV AIDS. It

Rebound headaches See headaches

The simplest sort of reflex involves a sensory nerve cell at the skin surface that reacts to a stimulus (such as touching a finger to a hot pan). The cell sends a signal along its nerve fiber to the spinal cord messages are conveyed to neurons in the central gray matter of the cord, where they split up and follow two paths. One path follows a short reflex loop through the spinal cord via relay neurons and back out along motor neurons. Almost immediately muscles contract to pull the finger away. Some other messages travel the second path up the spinal cord to the brain once in the brain, awareness of the stimulus dawns, but by this time the finger has already been pulled away.

Image not available

Resulting from a brainstem lesion involving the connections of cranial nerve V and the adjacent ascending tracts from the opposite side of the body (e) Brown-Sequard syndrome, a pathognomic pattern resulting from hemisection of the thoracic spinal cord, interrupting the uncrossed large-fiber tracts in the posterior columns and the crossed small-fiber spinothalamic fibers (f) suspended sensory cape resulting from a central cord lesion that interrupts crossing small fibers but spares posterior columns and spinothalamic tracts that had already crossed at more caudal levels. The author thanks Dr. Neil Holland for permission to modify his drawings for this figure.

Reticular activating system 267

One of the best-known reflexes is the simple knee-jerk reflex. When a rubber hammer taps the knee just below the knee cap, it stretches a tendon of one of the thigh muscles a signal passes via a sensory neuron to the spinal cord, which activates a pool of motor neurons these neurons cause the muscle to contract, jerking the lower leg.

Life And Death Of Neurons In The Aging Cerebral Cortex

The transition from age-associated memory impairment (AAMI) to the dramatic loss of cognitive abilities accompanying Alzheimer's disease (AD) requires progressive development of neocortical pathology that results in neuron death. The selective vulnerability of this neuron death is reflected in the characteristics of cortical pyramidal neurons that are prone to form neurofibrillary tangles. Loss of the neurons that form long corticocortical projections in the association neocortex emerges as the pathological outcome most directly related to the dementia observed in AD. AAMI likely involves alterations of neuronal spines and synapses without neuron death. Interestingly, the same circuits that are vulnerable to degeneration in AD are vulnerable to synaptic alterations short of neuron death. These synaptic alterations likely impact cognitive function in normal aging in a manner consistent with the more modest cognitive decline typically seen in aging. Estrogen levels affect spine density...

Muscular Dystrophy Association

The association supports more research on neu-romuscular diseases than any other private organization in the world. MDA scientists have uncovered the genetic defects responsible for several forms of muscular dystrophy, including Charcot-Marie-Tooth disease, a form of amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease), childhood spinal muscular atrophy, and several other neuromuscular conditions.

Neurobiological Introduction

Synaptic contacts take place in dendritic spines, which are small sac-like organelles, projecting from the dendritic trunk. Dendritic spines are more abundant in highly arborized cells such as pyramidal neurons and scarcer in lowly interconnected smaller-sized dendritic tree interneurons. The number of excitatory inputs can be linearly correlated with the number of spines present in the dendrite. How information is processed in a dendritic spine, is still a matter of current study 78, 141 . Dendritic spines contain ribosomes and cytoskeletal structures, including actin, and a- and -tubulin. As in other parts of the neuronal structure, cytoskeletal components are highly relevant in the structure function of the neuron. The axonal hillock contains large parallel bundles of microtubules. Axons are also located with other cytoskeletal structures, such as neurofilaments, which are more abundant in axons than in dendrites. The axon hillock is the region where the action potential is...

Dendritic Cytoskeleton Computation Vision of Integration

Fig. 8.13 focuses on the dendritic shaft. The MTs are decorated by C-termini and interconnected by MAP2 (thick line). Connections between MTs and actin filaments are shown as well. Two types of synaptic bindings are depicted. On the upper left side, actin bundles bind to the postsynaptic density (PSD) of a spineless synapse. On the lower right hand, a spiny synapse is shown where the actin bundle enters the spine neck and binds to the PSD, which at the other end, is connected to the MTN. This is further detailed in Fig. 8.13, right, showing the actin bundle linked to the PSD.

Operative Decision Making with Neurological and Biomechanical Goals

The objectives of care of the spinal-injured patient are to have a stable, pain-free spine, to prevent increased neurological deficit, and to provide conditions for the improvement of neurological deficit. The neurological and biomechanical goals are separate but interrelated and must be thought of in a parallel rather than a sequential fashion. Rehabilitation of the patient will be optimal if these objectives can be met. One should strive to achieve these goals while also preventing unnecessary surgery. There are clear indications for surgical treatment of spinal injury. Progressive neurological deficit is an emergency situation, and its cause should be expe-ditiously identified by imaging of the spinal canal with MRI (or with CT-myelography if MRI is not available). If compression of neurological structures is demonstrated, decompression is done on an emergency basis. Stabilization is done in conjunction with decompression, since the stability of the spine is often compromised by...

Neurocutaneous syndromes

Neurocutaneous syndromes A group of genetic neurological skin disorders affecting the brain, spine, and peripheral nerves that can cause tumors to grow inside the brain, spinal cord, organs, skin, and skeletal bones. The most common syndromes involving children include neurofibromatosis, sturge-weber syndrome, tuberous sclerosis, ataxia-telangiectasia, and von hippel-lindau disease.

Neurofibromatosis 365

Neurofibromatosis type 2 is less common, occurring in about one in 140,000 births. Also known as bilateral acoustic NF, it is characterized by multiple tumors on the cranial and spinal nerves, and by other lesions of the brain and spinal cord. Tumors affecting both of the auditory nerves are the hallmark. Another common symptom of NF1 is Lisch nodules (tiny, benign tumors on the iris of the eye that do not cause problems but that can help confirm the diagnosis). Tumors along the optic nerves can rarely occur, and they will affect vision. Benign tumors called neurofibromas are found on or under the skin or along the nerves of the body and usually appear at puberty. Bone deformities may also occur, as can curvature of the spine (scoliosis). as eighth cranial nerve tumors) affect the head and neck unless they grow large enough to push on the brain stem and affect the body also. Those that grow on the nerves as they exit the spinal cord may cause numbness of a part of the body some tumors...