Meningitic Disorders and Myelopathies

  • E. M. R. Critchley
Part of the Clinical Medicine and the Nervous System book series (CLIN.MED.NERV.)

Abstract

The spinal cord is that part of the central nervous system lying within the vertebral canal. It extends as an oval tube from the medulla oblongata at the foramen magnum to the L1–2 interspace or the upper part of the L2 vertebra. Its enveloping membranes are confluent with those covering the surface of the brain. The pia mater is intimately adherent to the cord with fine septa penetrating into the parenchyma. The arachnoid mater covers the cord more loosely, extending laterally over the dorsal ganglia and emergent roots, and downwards over the nerves of the cauda equina where it is attached to the sacrum at S2. CSF, secreted in the main by the choroid plexuses within the ventricular system of the brain, is contained within the transparent arachnoid membrane. Externally, the dura mater forms a tougher, opaque membrane over the surface of the brain and spinal cord. At spinal level it is tethered laterally by the dentate ligaments and ensheathes the arachnoid, pia, spinal cord and upper part of the cauda equina before ending at S2–3.

Keywords

Neuropathy Cavitation Vasculitis Dura Uveitis 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Adaros HL, Held JR (1971) Guillain-Barré syndrome associated with immunization against rabies: epidemiological aspects. In: Rowland LP (ed) Immunological disorders of the nervous system. Williams and Wilkins Co, Baltimore, pp 178–186Google Scholar
  2. Addy DP (1987) When to do a lumbar puncture. Arch Dis Child 62:873–875PubMedCrossRefGoogle Scholar
  3. Al Deeb SM, Yaqub BA, Sharif HS, Phadke JG (1989) Neuro-brucellosis: clinical characteristics, diagnosis and outcome. Neurology 39:498–501PubMedGoogle Scholar
  4. Amer MH, Al-Sarraf M, Baker LH, Vaitkevicius UK (1978) Malignant melanoma and central nervous system metastases. Incidence, diagnosis, treatment and survival. Cancer 42:660–668PubMedCrossRefGoogle Scholar
  5. Andrews JM, Cancilla PA, Kunin J (1970) Progressive spinal cord signs in a patient with disseminated lupus erythematosus. Bull Los Angeles Neurol Soc 35:78–85PubMedGoogle Scholar
  6. Andrianakos AA, Duffy J, Suzuki M, Sharp JT (1975) Transverse myelopathy in systemic lupus erythematosus: report of 3 cases and a review of the literature. Ann Intern Med 83:616–625PubMedGoogle Scholar
  7. April RS, VanSonnenberg E (1976) A case of neuromyelitis optica (Devic’s syndrome) in systemic lupus erythematosus: clinicopathologic report and a review of the literature. Neurology 26:1066–1070PubMedGoogle Scholar
  8. Behan PO, Currie S (1978) Clinical neurovirology. Saunders, London.Google Scholar
  9. Berger JR (1987) Neurologic complications of human immunodeficiency virus infection. Postgrad Med 81:72–79PubMedGoogle Scholar
  10. Berman M, Feldman S, Alter M, Zilker N, Kahama E (1981) Acute transverse myelitis: incidence and etiologic considerations. Neurology 31:966–971PubMedGoogle Scholar
  11. Bigner SH, Johnston WW (1981) Cytopathology of cerebrospinal fluid. Acta Cytol 25:461–479PubMedGoogle Scholar
  12. Bitzen M (1987) Rubella myelitis and encephalitis in childhood: report of 2 cases with magnetic resonance imaging. Neuropaediatrics 18:84–87CrossRefGoogle Scholar
  13. Boiardi A, Ferrante P, Porta E, Sghirlanzoni A, Bussone G (1986) Herpes zoster myelitis: nervous system complications. Ital J Neurol Sci 7:617–622PubMedCrossRefGoogle Scholar
  14. Britton CB, Masa-Tejada R, Fenoglio CM, Hays AP, Carvey GC, Miller JR (1985) A new complication of AIDS: thoracic myelitis caused by herpes simplex virus. Neurology 35:1071–1074PubMedGoogle Scholar
  15. Broadbent WW (1866) Zoster infections of the nervous system. Br Med J i:460CrossRefGoogle Scholar
  16. Brown K, Steer C (1986) Strategies in the management of children with acute encephalitis. In: Gordon N, McKinlay I (eds) Neurologically sick children, treatment and management. Blackwell, Oxford, pp 219–293Google Scholar
  17. Cliff J, Lundqvist P, Martensson J, Rosling H, Sorbo B (1985) Association of high cyanide and low sulphur intake in cassava-induced spastic paraparesis. Lancet 2:1211–1212PubMedCrossRefGoogle Scholar
  18. Critchley EMR (1988) Neurological emergencies. Saunders, LondonGoogle Scholar
  19. Delgado G, Tundu T, Gallago J, Villenerva JA (1985) Spinal cord lesions in heat stroke. J Neurol Neurosurg Psychiatry 48:1065–1067PubMedCrossRefGoogle Scholar
  20. Denning DW, Anderson J, Rudge P, Smith H (1987) Acute myelopathy associated with primary infection with human immunodeficiency virus. Br Med J 294:143–144CrossRefGoogle Scholar
  21. Ell JJ, Uttley D, Silver JR (1981) Acute myelopathy in association with heroin addiction. J Neurol Neurosurg Psychiatry 44:448–450PubMedCrossRefGoogle Scholar
  22. Foix C, Alajouanine T (1926) La myelite necrotique subaigue. Rev Neurol 2:1–42Google Scholar
  23. Foley KM, Beresford HR (1974) Acute poliomyelitis beginning as transverse myelopathy. Arch Neurol 30:182–183PubMedCrossRefGoogle Scholar
  24. Granger DP (1960) Transverse myelitis with recovery: the only manifestation of systemic lupus erythematosus. Neurology 10:325–329PubMedGoogle Scholar
  25. Hachen H, Chantraine A (1979–80) Spinal involvement in systemic lupus erythematosus. Paraplegia 17:337–346PubMedCrossRefGoogle Scholar
  26. Harriman DGF (1976) Infective diseases of the central nervous system. In: Blackwood W, Corseilles JAN (eds) Greenfield’s neuropathology. Arnold, London, pp 238–268Google Scholar
  27. Herbaut AG, Voordecker P, Monseu G, Germeau F (1987) Benign transient urinary retention. J Neurol Neurosurg Psychiatry 50:354–355PubMedCrossRefGoogle Scholar
  28. Hughes JT (1978) Pathology of the spinal cord, 2nd edn. Lloyd-Luke, LondonGoogle Scholar
  29. Itoyama Y, Minato S, Goto I, Okochi K, Yamamoto N (1988) Elevated serum antibody titers to Epstein-Barr virus in HTLV-1 associated myelopathy. Neurology 38:1650–1653PubMedGoogle Scholar
  30. Jakobsen J, Smith T, Gaub J, Helweg-Larsen S, Trojaborg W (1989) Progressive neurological dysfunction during latent HIV infection. Br Med J 299:225–228CrossRefGoogle Scholar
  31. Jellinek EH, Tulloch WS (1976) Herpes zoster with dysfunction of bladder and anus. Lancet 2:1219–1222PubMedCrossRefGoogle Scholar
  32. Kaye EM, Butler IJ, Conley S (1987) Myelopathy in neonatal and infantile lupus erythematosus. J Neurol Neurosurg Psychiatry 50:923–926PubMedCrossRefGoogle Scholar
  33. Kenik JG, Krohn K, Kelly RB, Bierman M, Hammeke MD (1987) Transverse myelitis and optic neuritis in systemic lupus erythematosus: a case report with magnetic resonance imaging findings. Arthritis Rheum 30:947–950PubMedCrossRefGoogle Scholar
  34. Kerr RSC, Marks SM, Sheldon PWE, Teddy PJ (1987) Schistosomiasis mansoni in the spinal cord: a correlation between operative and radiological findings. J Neurol Neurosurg Psychiatry 50:822–823PubMedCrossRefGoogle Scholar
  35. Lancet (1986) Acute transverse myelopathy. Lancet 1:20–21 (leading article)Google Scholar
  36. Lipton HL, Teasdall RD (1973) Acute transverse myelitis in adults: a follow-up study. Arch Neurol 28:252–257PubMedCrossRefGoogle Scholar
  37. Lowenstein DH, Mills C, Simon RP (1987) Acute syphilitic transverse myelitis: unusual presentation of meningovascular syphilis. Genitourinary Med 63:333–338Google Scholar
  38. Maravilla KR, Wernret JC, Suss R, Nunnally R (1984) Magnetic resonance demonstration of multiple sclerosis plaques in the cervical cord. Am J Neuroradiol 5:685–689Google Scholar
  39. Matthews WB, Miller H (1972) Diseases of the nervous system. Blackwell, OxfordGoogle Scholar
  40. Miller HG (1953) Prognosis of neurologic illness following vaccination against smallpox. Arch Neurol 69:695–706Google Scholar
  41. Moseley RP, Davies AG, Bourne SP, et al. (1989) Neoplastic meningitis in malignant melanoma: diagnosis with monoclonal antibodies. J Neurol Neurosurg Psychiatry 52:881–886PubMedCrossRefGoogle Scholar
  42. Newton RW (1987) Intracranial pressure and its monitoring in childhood: a review. J R Soc Med 80:566–570PubMedGoogle Scholar
  43. Norris FH (1979) Neurological manifestations of systemic disease. In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology, vol 38. North Holland, Amsterdam, pp 669–677Google Scholar
  44. Noseworthy J, Paty DW, Wonnacott J, Feasby T, Ebergs G (1983) Multiple sclerosis after the age of 50. Neurology 33:1537–1544PubMedGoogle Scholar
  45. Okada H, Aoki K, Ohno Y, Kitazawa S, Ohtani M (1984) Effects of metal containing drugs taken simultaneously with clioquinol upon clinical features of SMON. J Toxicol Sci 9:371–404CrossRefGoogle Scholar
  46. Olsen M, Chernik N, Posner J (1974) Infiltration of the leptomeninges by systemic cancer. A clinical and pathological study. Arch Neurol 30:122–137CrossRefGoogle Scholar
  47. Patel JK, Didolkar MS, Pickren JW, Moore RH (1978) Metastatic pattern of malignant melanoma. A study of 216 autopsy cases. Am J Surg 135:807–810PubMedCrossRefGoogle Scholar
  48. Pedersen C, Bonen H, Boesen F (1987) Transverse myelitis in mixed connective tissue disease. Clin Rheumatol 6:290–292PubMedCrossRefGoogle Scholar
  49. Petito CK, Navie BA, Cho ES, Jordan BD, George DC, Price RW (1985) Vacuolar myelopathy pathologically resembling subacute combined degeneration in patients with acquired immune deficiency syndrome. N Engl J Med 312:878–879CrossRefGoogle Scholar
  50. Piper PG (1953) Disseminated lupus erythematosus with involvement of the spinal cord. JAMA 153:215–217CrossRefGoogle Scholar
  51. Poser CM (1984) Taxonomy and diagnostic parameters in multiple sclerosis. Ann NY Acad Sci 436:233–245PubMedCrossRefGoogle Scholar
  52. Rich AR (1952) The pathogenesis of tuberculosis. Thomas, Springfield, IllinoisGoogle Scholar
  53. Rodgers-Johnson P. Morgan O Stc, Zaninovic V, et al. (1986) Treponematosis and tropical spastic paraplegia. Lancet 1:809PubMedCrossRefGoogle Scholar
  54. Roman GC (1987) Retrovirus associated myelopathies. Arch Neurol 44:659–663PubMedCrossRefGoogle Scholar
  55. Rosenberg NL, Coull BM (1982) Myelopathy after scorpion sting. Arch Neurol 39:127PubMedCrossRefGoogle Scholar
  56. Shibasaki H, McDonald WI, Kuroiwa Y (1981) Racial modification of clinical picture of multiple sclerosis: comparison between British and Japanese patients. J Neurol Sci 49:253–271PubMedCrossRefGoogle Scholar
  57. Shyamalan NC, Singh SS (1964) Transverse myelitis after vaccination. Br Med J i:434–435CrossRefGoogle Scholar
  58. Siebold JR, Buckingham RD, Medsger JA, Kelly RA (1982) Cerebrospinal immune complexes in systemic lupus erythematosus involving the central nervous system. Semin Arthritis Rheum 12:68–76CrossRefGoogle Scholar
  59. Siekert RG, Clark EC (1955) Neurologic signs and symptoms as early manifestations of systemic lupus erythematosus. Neurology 5:84–88PubMedGoogle Scholar
  60. Slovick DI (1986) Treatment of acute myelopathy in systemic lupus erythematosus with plasma exchange and immunosuppression. J Neurol Neurosurg Psychiatry 49:103–105PubMedCrossRefGoogle Scholar
  61. Spencer PS, Roy DN, Ludolph A, Hugon J, Dwived MP, Schaumburg HH (1986) Lathyrism: evidence lor the role of the neuroexcitatory aminoacid BOAA. Lancet 2:1066–1067PubMedCrossRefGoogle Scholar
  62. Spitzer PG, Tarsy D, Eliopoulos GM (1987) Acute transverse myelitis during disseminated cytomegalovirus infection in a renal transplant recipient. Transplantation 44:151–153PubMedCrossRefGoogle Scholar
  63. Suchet I, Klein C, Horwitz T, Lalla S, Doodha M (1987) Spinal cord schistosomiasis: a case report and review of the literature. Paraplegia 25:491–496PubMedCrossRefGoogle Scholar
  64. Tamura Z (1975) Clinical chemistry of clioquinol. Jpn J Med Sci Biol 28:(suppl) 68–77Google Scholar
  65. Tandon PN, Pathak SN (1973) Tuberculosis of the central nervous system. In: Spillane JD (ed) Tropical neurology, Oxford University Press, Oxford, pp 37–51Google Scholar
  66. Thomas PK (1984) Neurotoxicity of halogenated hydroxyquinolones: non-Japanese cases. Acta Neurol Scand 70:(suppl 100) 155–158Google Scholar
  67. Toro G, Vergara I, Roman G (1977) Neuroparalytic accidents of antirabies vaccination with suckling mouse brain vaccine. Arch Neurol 34:694–700PubMedCrossRefGoogle Scholar
  68. Tyler KL, Gross RA, Cascino GD (1986) Unusual viral causes of transverse myelitis: hepatitis A virus and cytomegalovirus. Neurology 36:855–858PubMedGoogle Scholar
  69. Vanneste JAL, Karthaus PPM, Davies G (1980) Acute urinary retention due to sacral myeloradiculitis. J Neurol Neurosurg Psychiatry 43:954–956PubMedCrossRefGoogle Scholar
  70. Walton JN (1977) Brain’s diseases of the nervous system. Churchill Livingstone, LondonGoogle Scholar
  71. Wells CEC (1971) Neurological complications of so-called “influenza”: a winter study in southeast Wales. Br Med J i:369–373CrossRefGoogle Scholar
  72. Weng C, Huang CY, Chan PH, Preston P, Chen PY (1987) Transverse myelitis associated with larva migrans: finding of larvae in cerebrospinal fluid. Lancet 1:423Google Scholar
  73. Wiley CA, Van Patten PD, Carpenter PM, Powell HC, Thal LJ (1987) Acute ascending necrotizing myelopathy caused by herpes simplex virus type 2. Neurology 37:1791–1794PubMedGoogle Scholar
  74. Wood M, Anderson M (1988) Neurological infections. Saunders, LondonGoogle Scholar
  75. Yagi K, Ohishi S, Ohtsuka K (1978) Effects of clioquinol on the cultured retinal nerve cells. Reports of SMON research commission, 94–96. (in Japanese, quoted by Okada et al. 1984)Google Scholar

Copyright information

© Springer-Verlag London Limited 1992

Authors and Affiliations

  • E. M. R. Critchley

There are no affiliations available

Personalised recommendations