Spinal Stenosis

Spinal stenosis is when the spinal canal becomes narrow usually due to a herniated disk. Stenosis can also be caused by fracture, tumors, infection and deterioration. Symptoms include severe pain, weakness, numbness, tingling and paralysis. Spinal stenosis can occur anywhere along the spine but mostly occurs in the lower lumbar spine. Treatment for spinal stenosis includes physical therapy, epidural injections and surgery. Diagnosis of spinal stenosis includes x-ray exams, CT/MRI, mylograms, a bone scan, and electromyogram and nerve conduction series. Since spinal stenosis is usually caused by degeneration most cases are older patients. Congenital stenosis is rare and symptoms usually show up around the age range of 30 or 40s.

References:

www.spinalstenosis.net/

Hangman's Fracture

Hangman's fracture also known as traumatic spondylolisthesis of the axis, is when a fracture occurs usually on c2 at the posterior arch bilaterally. This type of fracture got its name obviously from what would happen back in the day when people were hung. Now days this type of common fracture is caused by MVAs and the patient hitting the dashboard or windshield causing compression and hyper extension of the neck. Implications of this type of fracture are lacerations to the face and head as well as neck pain. Treatment of this injury is determined by the severity of the injury and ranges from 8 to 12 weeks in a C-collar, traction and extension in a halo vest, or immediate surgery to stabilize c2 and c3. If the fracture extends into the transverse foramina, angiography may be performed to exclude vertebral artery dissection. Chances of neurological damage increases with the severity of the injury.

Reference:

http://images.google.com/imgres?imgurl=http://www.appliedradiology.com/Documents/Cases/images/Sirkis_figure01.jpg&imgrefurl=http://www.appliedradiology.com/case/case.asp%3FID%3D566%26SubCatID%3D291%26CatID%3D29%26ThreadID%3D&h=396&w=432&sz=59&hl=en&start=18&sig2=fUjtrT_C7c-s8AA4k3INew&um=1&tbnid=H5T2aqikdRk1QM:&tbnh=115&tbnw=126&ei=-QgMSIyCLpCeiwGno-n7Ag&prev=/images%3Fq%3Dct%2Bhangman%2527s%2Bfracture%26um%3D1%26hl%3Den%26rls%3Dcom.microsoft:en-US%26sa%3DX

Glomus Caroticum Tumor

The most common type of paraganglioma is the glomus caroticum tumor within the neck. They are slow growing tumors but can double in size within 4 years. Six to twelve percent of the cases are malignant. Given their location they are not the easiest to get to and are risky to perform surgery on. There are 3 treatment options that include surgery, radiation therapy, and just watch and see if it gets bigger. The cure rate for these tumors ranges from 89 to 100 percent however, 20 percent of them have cranial nerve damage. If the tumor grows to be 5cm or more intervention is considered. Risks of surgery include bleeding out and stroke from clamping the carotid artery. For very large tumors, multiple tumors and patients that are not good candidates for surgery, or due to the patients age, may require radiation therapy rather than surgery.

Reference:
http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijtcvs/vol10n2/nodule.xml

Ranula

Ranulas are termed as pseudocyts that are caused by blockage of flow of saliva or can be caused by trauma. Ranulas usually arise from the major salivary glands that can be found in the oral cavity or in the cervical area. Ranulas account for .2% per 1000 people. According to the Minnesota Oral Disease Prevalence Study randula occurrences are ranked 41st. They account for 6% of oral sialocysts. Ranulas on the cervical are considered rare. Ranulas are usually painless and are typically not life threatening. However, they may interfere with swallowing, chewing, speech and respiration functions. They tend to be more prevalent in males. Oral ranulas are usually under the tongue and are a bluish tint and can medially and superiorly displace the tongue. Causes can include traumas from birth from forceps or suction of the infants mouth, sucking on fingers, passing through the birth canal. Escaped mucus from an injured gland causing the raised bump. Treatment includes lancing the ranula and draining the fluid, surgical excision including the salivary gland associated, or an intracystic injection.

Refrences:

www.rad-pb.de/e1543/e1546/e2109/e2110/ranula.jpg

http://www.emedicine.com/derm/topic648.htm

http://www.learningradiology.com/caseofweek/caseoftheweekpix2/cow146.jpg