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Handout for the lectures by james g. Smirniotopoulos, m. D. viagra without a doctor prescription , the 29th annual international diagnostic course in davos, switzerland april 6 - 11, 1997 watch for the next neuroradiology course in davos, april 2000 please read disclaimer spinal masses:intradural lesions spinal masses intramedullary -masses intrinsic to the cord intradural/extramedullary -masses in the subarachnoid space extradural -masses outside the thecal sac localization spinal masses primary neoplasms secondary neoplasms congenital traumatic/degenerative infectious/inflammatory vascular/ischemic intraspinal neoplasms women 5/million/yr men 3/million/yr intraspinal neoplasms intramedullary expanded cord effaces the csf fusiform (often) long segment (often) tapered (usually) expanded cord primary & secondary neoplasms myelitis, abscess granuloma acute ms syringohydromyelia (primary/secondary) infarct, edema intramedullary primary neoplasms ependymoma astrocytoma other gliomas (incl. Gbm, oligo, etc. ) hemangioblastoma paraganglioma ependymoma most common primary neoplasm of cord two "flavors" - solid and myxopapillary 60% - 70% of all cord, 90% of cauda equina middle age (40's) younger for cauda equina (20's) and cervical spine hemorrhage/hemosiderin watch for sah (mimic aneurysm) "cap sign" dark rim top/bottom of lesion enhance heterogenously +/- tumor cyst and/or syringohydromyelia surgical cure more likely than for astrocytoma neurologic neoplasms expanded cord primary & secondary neoplasms myelitis, abscess granuloma acute ms syringohydromyelia(primary/secondary) infarct, edema hematoma, contusion, edema syringohydromyelia gr. "syrinx' a pipe or straw (hollow reed) a fluid-filled cavity within the cord usually central hydromyelia = ependymal-lined (an enlarged central canal) often the ependyma is destroyed loss of pain&temperature fibers (quien es mas macho? ) syringohydromyelia idiopathic (congenital? 365 pills viagra )do not enhance, smooth associated w/chiari malformations - chiari 1 (30%) chiari 2 (60%) (myelomeningocele) associated w/neoplasms intramedullary primary neoplasms ependymoma astrocytoma other gliomas (incl. http://sweet-vibrations.com/tkj-generic-viagra-online-canada-cost-bk/ Gbm, oligo, etc. buy viagra ) hemangioblastoma paraganglioma astrocytoma 2nd most common (30%) children, young adult unlike brain, low grade most common unlike brain, enhance even if low grade cervical cord > thoracic,lumbar intramedullary primary neoplasms ependymoma astrocytoma other gliomas (incl. viagra yellow pills Gbm, oligo, etc. viagra for sale ) hemangioblastomaparaganglioma hemangioblastoma synonyms: h... viagra over the counter in france Endothelioma, angioblastic meningioma, lindau tumor cell of origin: vascular, endothelial? buy viagra cheap Associations: von hippel-lindau (20%), (multiple in 5%, w/o vhl) incidence: 1-3% of all intracranial age: 30-45 (peak 33/35) sex: 1-2m/1f location: subpial crbll > medulla > spinal treatment: surgery, radiation prognosis: 92% at 5yrs. viagra yellow pills (small series) hemangioblastoma 1-15% of cord tumors 85-90% are intramedullary 10-15% occur in nerve roots 50% thoracic, 15% cervical 20% multiple 1/3 of pts. buy generic viagra online Will have vhl suggest. viagra yellow pills