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Thread: Physicians specializing in Spinal Strokes?

  1. #1

    Physicians specializing in Spinal Strokes?

    My 38-year old son is suffering from severe nerve damage and spinal strokes following 3 Chiari Malformation repair surgeries, shunt insertion, meningitis, a diagnosis of Arachnoiditis. The physician who performed an angiogram of his spine and brain at Vanderbilt University Medical Center advised that we may need to go somewhere else since it seems they cannot find the cause of the inflammation that is eating up the blood vessels in his spinal cord (and possibly the lower portion of his brain).

    He is permanently disabled: no feeling or coordination of right arm and hand, both legs and feet, and no feeling or sensation in his lower left arm and hand although he can still use that hand. He still has good muscle usage in all the extremities.

    He is constantly in severe pain from nerve damage in his left shoulder and upper arm. Pain medicines are being provided by a Pain Management Clinic in our area.

    Does anyone know of a physician/medical center that provides treatment and research into the cause of the spinal strokes.

  2. #2
    Quote Originally Posted by nicholsang View Post
    My 38-year old son is suffering from severe nerve damage and spinal strokes following 3 Chiari Malformation repair surgeries, shunt insertion, meningitis, a diagnosis of Arachnoiditis. The physician who performed an angiogram of his spine and brain at Vanderbilt University Medical Center advised that we may need to go somewhere else since it seems they cannot find the cause of the inflammation that is eating up the blood vessels in his spinal cord (and possibly the lower portion of his brain).

    He is permanently disabled: no feeling or coordination of right arm and hand, both legs and feet, and no feeling or sensation in his lower left arm and hand although he can still use that hand. He still has good muscle usage in all the extremities.

    He is constantly in severe pain from nerve damage in his left shoulder and upper arm. Pain medicines are being provided by a Pain Management Clinic in our area.

    Does anyone know of a physician/medical center that provides treatment and research into the cause of the spinal strokes.
    nicholsang,

    I am afraid that I don't know any center that actually specializes in the treatment of spinal stroke. However, if I had to name a neurosurgical center that understands ischemia of the spinal cord, it is the Barrows Neurosurgical Institute in Phoenix. Bob Spetzler is the neurosurgeon and medical director. He is perhaps the best vascular neurosurgeon in the world.

    It seems to me, however, that your son's problems are more than spinal stroke. The problems that bother him the most are probably his neuropathic pain and the aftermath of surgery for his Chiari syndrome and the subsequent arachnoiditis and cerebrospinal fluid obstruction. Did he have brachial plexus injury as well?

    Arachnoiditis causes adhesions and obstruction of cerebrospinal fluid flow. That combined with the the fact that your son had Arnold-Chiari Malformation and three surgeries to correct it would suggest that he has adhesions all over the central nervous system and CSF obstruction that would explain his progressive neurological loss and neuropathic pain.

    The choroid plexus located in the fourth ventricle makes approximately 2 liters of cerebrospinal fluid per day. Half of it goes down the spinal cord. The other half goes up to the brain. All this fluid must be absorbed by the arachnoid lining the brain and spinal cord. Anything that obstructs the flow of the cerebrospinal fluid or slows down the absorption of the fluid will cause syringomyelic cysts and enlargement of the cerebral ventricles.

    If arachnoiditis is his problem, MRI should show the presence of syringomyelia or enlarged ventricles. In that case, the solution may be careful and judicious neurosurgery to remove adhesions and restore cerebrospinal flow. Note that surgery itself and any manipulation of the tissues may make things worse. I suggest that you go to Barrows to get a second opinion.

    If the opinion is that no neurosurgery is warranted, I suggest going to the Mayo Clinic in Rochester for an opinion. It is possible that your son has another neurological problem aside from the Chiari, arachnoiditis. Mayo has astute and experienced neurologists. In particular, I respect Moses Rodriguez there.

    Wise.

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