Jefferson Fracture

A Jefferson fracture is typically caused by an axial-loading force on the occiput of the head. It involves fractures of the anterior arch of c1 on both sides and the posterior arch of c1 on both sides. C1 usually will widen when it is fractured, so there are no cord compression. Patients will usually present with upper neck pain following a trauma, the neurological exam is usually normal. In conventional radiography the open-mouth (odontoid) will show a bilateral, lateral offset of c1 on c2. CT will demonstrate the number of fractures, their locations and degree of displacement of fragments. Treatment will depend on whether there is damage to the transverse ligament and the degree of offset of c1 on c2. Treatments include collar or brace for 3 months all the way through cranial traction.

BOW HUNTER'S SYDROME

Bow Hunter's syndrome or stroke, is when the arteries of the neck are obstructed and not allowing normal blood flow to the brain. This type of stroke falls under the category of an ischemic stroke. Treatment for bow hunter's vary depending on how severe the symptoms are and how much blood is being restricted from flowing to the brain. They try and minimize any head movements and prescribe an anticoagulant to reduce the chance of a clot forming. Due to the rarity of this type of stroke ,it has been difficult to determine the long-term outcome of the patients that have been treated.

CEREBRAL ANEURYSM

A cerebral aneurysm is a bulging or ballooning out of a blood vessel a weak point in the latter's wall. The bigger the aneurysm gets the weaker the vessel becomes causing it to rupture. The symptoms are sudden severe headache, stiff neck, nausea,vomiting, vision and speech impairment. There can also be seizures, sensitivity to light, and loss of consciousness. Diagnosing is usually done with a MRA or a CTA. Recovery varies from patient, to what artery was affected.

Sinusitis

Sinusitis is inflammation of your sinuses. Symptoms of sinusitis is determined on which sinus is affected. For example, if the maxillary sinus were affected then you would have pain and tenderness over the cheek area. Ethmoid inflammation could cause loss of smell and stuffy nose. There are many causes for sinusitis, such as allergies, hay fever, pollen and dog dander. Treatment of sinusitis will depend on cause and severity of the infection. Doctors often prescribe decongestants to reduce congestion, antibiotics to control bacterial infection, and steroid nasal spays to help reduce the congestion, swelling and inflammation of the sinuses.

Coat's disease

Coat's disease is a rare eye disorder that can cause full or partial blindness. It is characterized by abnormal development of blood vessels behind the retina. The cause is unknown at this time, but has been described as a manifestation of facioscapulohumeral dystrophy,(form of muscular dystrophy).Patients usually presents with blurred vision in one eye and is more pronounced when the unaffected eye is covered. This can also cause depth perception, floaters, and flashes of light. Initially these can be mistaken for hallucinations, but are the result of retina detachment.

Treatment is laser surgery or cryotherapy (freezing) to destroy abnormal blood vessels, halting progression of the disease. These treaments are risky cause if the blood vessels are leaking and are clustered around the nerve it can cause permanent blindness. Although, cases have been documented where the disease has stop progressing on it's own and in somes cases had reversed itself.

The image is an angiogram that shows areas of capillary non-perfusion and dilation together with fusiform aneurysom formation.

Prolactinoma

Prolactinoma is a benign tumor of the pituitary gland. It gets it's name from the hormone that stimulates the breast to produce milk durning pregnancy, called prolactin. Symptoms are caused by too much prolactin in the blood. In women, it can often cause infertility and changes in menstruation. In men, the most common problem is impotence, many men wait so long before going to the doctor they begin to have headaches or eye problems due to the enlarged pituitary gland pressing against nearby eye nerves. When diagnosing a doctor will test thyroid functions, and also MRI scans. Since dopamine is the chemical that nomally inhibits prolactin secrection, doctors may treat prolactinomas with bromocriptine or cabergoline, drugs that act like dopamine. Surgery is also and option if the medical treatment fails to get prolactin secretion to normal levels, shrink the tumor, and restore normal reproduction and pituitary functions.

Mastoiditis

Mastoiditis is a bacterial infection of the mastiod air cells. The image above is a coronal MRI after gadolinium. Complications of mastoiditis is temporal lobe abscess, and that is also shown in the image above. Signs and symptoms include, swelling and tenderness of the postauricular, hearing loss, fever, and a unresolved otitis media. Lab work such as a complete blood count (CBC) helps aide in the diagnosis and treatment of the condition. Most effective diagnosising tool is imaging of the mastoid area. Treatment of mastoiditis is being admitted for IV antibiotics course for 21 days, or having a myringotomy (tubes in the middle ear), although 50% of cases has to have mastoidectomy (removes infected bone or mucosa).

Cerebrovascular Accident (CVA)

CVA or stroke is the third leading cause of death and the number one cause of disability in the US. There are two forms of a stroke, ischemic and hemorrhagic. An ischemic is when there is a lack of blood supply to a certain part of the brain, usually caused by a thrombosis or embolism. A hemorrhagic is when a blood vessel in the brain ruptures. A stroke is a medical emergency and can cause permanent damage to brain tissue and death, if not promptly diagnosed and treated. Ischemic strokes usually only affects regional areas of the brain perfused by the blocked artery, whereas hemorrhagic can affect local areas but can be more global due to increased intracranial swelling. Signs and symptoms of a stroke are numbness on one side, weakness of the face and trouble walking. Symptoms can vary depending on area of brain affected.Strokes are diagnosed through several techniques, but are most often found on CT w/o enhancement and then followed up with an MRI. Early recognition of a stroke is generally regarded as important for a good prognosis. Treatment for ischemic stroke would be the patient would be given antiplatelet or an anticoagulant medication, whereas with a hemorrhagic stroke that treatment would be harmful to the patient. A hemorrhagic stroke must be treated with neurosurgical evaluation to detect and treat the cause of the bleeding.Disability affects 75% of stroke survivors enough to decrease their employability. A stroke can affect patients physically, mentally, emotionally, or a combination of all three. Dysfunctions corresponds to areas in the brain that have been damaged