Chiari Malformation

Chiari Malformation is a condition in which brain tissue protrudes into the spinal cord. This condition occurs when part of the skull is abnormally small, and is pressing on the brain and forcing it downward. Chiari malformation is an uncommon condition, but there have been more improved tests to diagnose this condition. Chiari malformation, in the adult form, is a type I condition, that develops as the skull and the brain are growing. The symptoms for the type I condition may not occur until late childhood or late adulthood. The type II Chiari malformation form is most common in pediatric patients, and they are present at birth. The type I symptoms for Chiari malformation are: headaches, also can have sudden coughing, sneezing, or straining. Some more symptoms that are involved would be: neck pain, problems with balancing, poor hand coordination, dizziness, numbness and tingling of the hands and feet, difficulty swallowing, slurred speech, and vision problems. People with less often occurrence of this condition is: ringing or buzzing in the ears, poor bladder control, chest pain, abnormal breathing, and the curvature of the spine related to spinal cord impairment. The causes for Chiari malfromation is when the cerebellum is pushed into the upper spinal canal, it can interfere with the normal flow of cerebrospinal fluid (CSF) that protects the brain and spinal cord. With the abnormal flow of CSF it can lead to blockage of signals that are transmitted from the brain to the body. Chiari malformation in some people can be a progressive disorder and that will lead to serious complications. In other people, there might not be any symptoms. Some complications that would be included is: hydrocephalus, paralysis, syringomyelia, and death. If a patient has any symptoms that consist of head pain, you will likely undergo an MRI scan of your skull. The procedure will consist of a 3-D, high resolution images of any structural abnormalities. Contrast can also be injected and once it reaches the brain, it will enhance the MRI images. A CT scan can also be done to scan sectional images of the bone tissue that surrounds the spinal column. A treatment that can be done is surgery. Having this surgery done and it is successful, then it will reduce the pressure on the cerebellum and the spinal cord, and it will restore the normal flow of the CSF. Some risks that can come with this surgery are the possibility of infection or problems with the healing wound. After having the surgery done, your doctor will want you to have follow-up exams done to follow the outcome of the surgery.

MayoClinic. (November 2008). Chiari Malformation. Retrieved from http://www.mayoclinic.com/health/chiari-malformation/DS00839

Chiari Malformation. Retrieved from http://westalneuro.com/images/resources/chiari-malformation.jpg

Carotid Body Tumor

A carotid body tumors (CBT) are rare neoplasms, but they respresent 65% of the head and neck paragangliomas. These tumors are slow growing that can remain asymptomatic for years. These tumors develop at the medial aspect of the carotid bifurcation. It is a small, reddish-brown, oval structure. A healthy gland measures 3 to 5 mm in diameter and weighs less than 15 mg on average. The gland is highly vascular and receives its blood supply from the feeder vessels that are running through the Mayer ligaments, primarly from the external carotid artery. The carotid body originates in the neural crest, it is important in the bodies acute adaptation to the concentrations of oxygen, carbon dioxide, and pH. The carotid body protects the organs from hypoxic damage by releasing neurotransmitters that increase the ventilatory rate when stimulated. There are three different types of carotid body tumors and those are: familial, sporadic, and hyperplastic. The familial form is most common in younger patients , 10 to 50%. The sporadic form is the most common type, it is approximately 85% of carotid body tumors. The hyperplastic form is is very common in patients with chronic hypoxia, which includes patients that live at high altitudes. A carotid body tumor can occur in children, but also CBT's are considered to be a disease of the middle age. About 5% of CBT's are bilateral and 5 to 10% are malignant, but these rates are much higher in the patients with inherited disease. It is stated that familial tumors are found to be 5.8 times more common in patients who have had carotid body tumors as compared with patients who have paragangliomas at other sites. Patients with chronic hypoxic conditions, such as the patients that live at higher altitudes or those who have COPD, or cyanotic heart problems. This can be too much for the carotid bodies, and lead to hypertrophy, hyperplasia, and neoplasia of the cells. Approximately 10% of cases that are present with cranial nerve palsy with paralysis of the hypoglossal, glossopharyngeal, recurrent laryngeal, spinal accessory nerve, or the involvement of the sympathetic chain. CBT's can be associated with pain, dysphagia, shoulder drop, Horner syndrome, and hoarseness. As the tumor gets larger and compresses on the carotid artery, and on the surrounding nerves. Other symptoms may occur such as: pain, tongue paresis, hoarseness, Horner syndrome, and dysphagia.

Chaaban, Mohamad MD. (May 2009). Carotid Body Tumor. Retreived from http://emedicine.medscape.com/article/1575155-overview

(May 2009). Carotid Body Tumor. Retreived from http://www.ajronline.org/cgi/content-nw/full/187/2/492/FIG8

Sjogren's Syndrome

Sjogren's syndrome is a disorder of a person's immune system. It is often defined by its two most common symptoms, which are dry eyes and dry mouth. If a person has dry eyes, then it feels like they are burning or itching. Also if the person has dry mouth, then it will feel like they have a cotton mouth. It makes it hard to swallow and speak when a person has dry mouth. Other symptoms that may go along with Sjogren's syndrome is: joint pain, swelling, stiffness, prolonged fatigue, consistent dry cough, vaginal dryness, skin rashes or dry skin, and swollen salivary glands. Sjogren's syndrome is a autoimmune disorder. This basically means that an autoimmune disorder is where your own immune system attacks their body's own tissues and cells. Sjogren's system is where your immune system will first attack the moisture, the secreting glands around the eyes and mouth. This disorder can also damage other body parts like: joints, thyroid, kidneys, liver, lung, skin, and nerves. Sjogren's syndrome, with this disorder anyone is able to develop it. People over the age of 40 are more likely to develop this disorder. Sjogren's syndrome actually occurs more in women than in men. It is very common for people with this disorder to rheumatic disease, such as rheumatoid arthritis or lupus. This disorder can also run in the family. Sjogren's syndrome can be very difficult to diagnose because the signs and symptoms can vary from person to person. There are a number of tests that can be done to pinpoint the disorder to Sjogren's Syndrome. Those tests may include: blood tests, eye tests, chest x-ray, a spit test, and a urine sample. Most people may think that they can get rid of their dry eyes and dry mouth by some over-the-counter drugs or just drinking more water, but most might have to have prescribed medications given or even surgery. Surgery would involve sealing off the tear ducts to drain the tears from your eyes.








MayoClinic. (June 2009). Sjogren's Syndrome. Retrieved from http://www.mayoclinic.com/health/sjogrens-syndrome/DS00147

Mavragani, Clio P. (2006). The Management of Sjogren's Syndrome. Retrieved from http://www.nature.com/.../fig_tab/ncprheum0165_F3.html