dDx of Common Neurosurgical Presentations

Disorders of the Spine

Extradural

• Degenerative:

  • disc herniation,

  • canal stenosis,

  • spondylolisthesis/spondylolysis

• Infection/inflammation:

  • osteomyelitis,

  • discitis

• Ligamentous:

  • ossification of posterior longitudinal ligament (OPLL)

• Trauma:

  • Mechanical compression/instability,

  • hematoma

• Tumours (55% of all spinal tumours):

  • lymphoma,

  • metastases (lymphoma, lung, breast, prostate),

  • neurofibroma

Intradural extramedullary

• Vascular:

  • Dural arterio-venous fistula,

  • Subdural hematoma (especially if on anticoagulants)

• Tumours (40% of all spinal tumours):

  • meningioma,

  • schwannoma,

  • neurofibroma

Intradural intramedullary

• Tumours (5% of all spinal tumours):

  • astrocytomas and ependymomas most common;

  • also hemangioblastomas and dermoids

• Syringomyelia (common causes: trauma, congenital, idiopathic)

• Infectious/inflammatory:

  • TB,

  • sarcoid,

  • transverse myelitis

• Vascular:

  • AVM,

  • ischemia

Peripheral Nerve Lesions

Neuropathies

• Traumatic

• Entrapments Iatrogenic

• Inflammatory

• Tumours