American Medical Association Family Medical Guide - American Medical Association [425]
Spinal Cord Tumor
The spinal cord may be compressed by bone tumors or tumors of the nerve coverings (sheaths). Tumors of the spinal cord itself are rare growths that may be benign (noncancerous) or malignant (cancerous). Spinal cord tumors must be treated immediately because an expanding tumor can press on the nerves in the spinal cord and cause severe, sometimes incapacitating, symptoms.
Symptoms
The symptoms of a spinal cord tumor depend on which part of the spinal cord and which nerves are damaged by the tumor. Persistent, worsening back pain is the most common symptom. Other symptoms include numbness, tingling, and loss of the sensations of hot and cold below the level of the tumor; muscle weakness (especially in the legs); difficulty urinating; or loss of bladder or bowel control.
Diagnosis
To diagnose a spinal cord tumor, your doctor will perform a thorough physical examination and may refer you to a neurologist (a doctor who specializes in disorders of the nervous system). The neurologist will order an MRI (see page 113) and may perform a procedure called myelography, in which a contrast medium (dye) that can be seen on X-rays is injected into the cerebrospinal fluid (the liquid that surrounds the brain and spinal cord) to highlight the areas of obstruction, such as a tumor, in the spinal cord. While performing the myelograph, the neurologist may take a sample of cerebrospinal fluid from your spine to look for cancer cells.
Treatment
Surgery is the most common treatment for a tumor that is pressing on the spinal cord, although tumors inside the spinal cord usually cannot be removed completely. Corticosteroids are given to reduce swelling. Removing all or part of the tumor can help relieve pressure on the spinal nerves and reduce pain and other symptoms. For tumors that have spread from elsewhere in the body (secondary tumors) to the bones of the spine, or for tumors inside the spinal cord that cannot be removed surgically, a doctor may use radiation therapy (see page 23) to destroy the tumor cells. Depending on the type of tumor, chemotherapy (see page 23) may also be recommended.
Disorders of Brain Function
Although some brain disorders have an identifiable underlying cause, such as an infection, a tumor or other growth, or a blocked artery, the causes of other brain disorders, such as migraine and epilepsy, are less well understood and are often difficult to diagnose. Most of these disorders result from problems with how the brain and its blood vessels function.
Tension Headaches
A tension headache (also called a muscle contraction headache) is the most common type of headache. Tension headaches usually result from strain on muscles in the face, neck, or scalp, and can be triggered by factors such as anxiety, stress, eyestrain, a noisy environment, or too little sleep. They can also result from overeating, drinking too much alcohol, or heavy smoking. Prolonged coughing or sneezing, a head or neck injury, or poor posture can bring on a tension headache. Tension headaches that occur nearly every day are called chronic daily headaches.
Symptoms
The pain of a tension headache is usually aching and can be mild to moderate and widespread or limited to a specific area. Chronic daily headaches can cause fatigue, depression, or difficulty sleeping.
Diagnosis
A tension headache is diagnosed by a person’s symptoms and by a neurological examination that rules out other, more serious, possible causes. A doctor may perform diagnostic tests to rule out other possible causes of headaches.
Treatment
The pain of a tension headache can usually be relieved with over-the-counter pain relievers such as aspirin, acetaminophen, ibuprofen, or naproxen. These medications are most effective when taken at the onset of symptoms. For some people, relaxation techniques (see page 59) such as deep breathing, meditation, or yoga may help. Getting a good night’s sleep (see page 57) may also be helpful. Doctors sometimes prescribe antidepressants (see page 712) or muscle relaxants to treat