Tumor Myelum

Tumor Myelum starting from the foramen magnum (C2) and ends at the L1 vertebra. In humans there are ascenden medulare so in adults myelum tumor in vertebral space will rise and stop at the L1 vertebra. Therefore myelum shorter than the vertebrae, then the high segment of the nerve discharge is different from vertebral bodies.

Clinically the most important of myelum is anterior cornua and three tracts which, among other kortikospinalis tract (pyramidal tract), tract spinotalamikus (carry impulses of pain and temperature) and posterior funikulus (take a deep impulse Sensibility).

Spinotalamikus cause disturbances in the contralateral tract and cause disturbances in funikulus posterior lateral homo disorder.

Myelum tumors were classified according to its location as extramedular or intramedular. Extramedular tumors can be classified into the extra dural (vertebrae sarcoma, fibroma, lipoma, angiolipoma, neurinoma) or intradural (meningioma, neurinoma, ependimoma ectopic). Most tumors are gliomas intramedular, ependimoma, or angioma.

Examination that must be examined is to determine the lesion boundary. Sensibility should be reviewed thoroughly. Should be compared between normal areas and areas that hurt. Limits lesions can determine the position of the segment myelum. Spastic motor abnormalities that disrupted usually due to a disturbance in the pyramidal tract. Examination of the autonomic nervous to do with prespirasi test.

In these patients the initial clinical diapatkan get only a mild paresthesias in the inferior extremities. Then after 3 years later the patient became parese in the inferior extremities progressively, so that patients become paralyzed in the last 6 months.

In retensio get urine and retensio alvi. And obtained a decrease of sweat production in the umbilicus toward the distal. So it can be concluded there are lesions in the thorax of autonomous regions as high as 10.

Of the complaints in getting rapid progression for 4 years. So it can in getting assesement which is a neoplasm as high as 10 extrameduler thoracic intradural meningioma dd dd schwanoma.

History of the disease initially suppress tumor anterolateral tract spinotalamicus anterior regions that are increasingly larger and pressing the pyramidal tract and 6 months of progressive emphasis achieve proprius tract area as a result of compression of the spinal cord so that the gain and retention of urine retention in the thoracic alvi 10.

The main therapy for this case is the operation (dekompressive laminectomi). Keep in mind that Ca cells after surgery is often recurrent.

The prognosis depends on early diagnosis and tumor location. For extramedular intradural tumor type, prognosis is better than intramedular therefore difficult surgery. Metastases may be a determinant in the prognosis of patients.