Gardner's hydrodynamic theory of syringomyelia revisited.

Abstract:

:Several theories have been put forth to explain the pathogenesis of syringomyelia, the formation of longitudinal, fluid-filled cavities within the spinal cord. Chief among them is Gardner's hydrodynamic theory, widely accepted for more than two decades. Gardner attributed the genesis of syringomyelia to craniospinal pressure differentials in the setting of fourth ventricular outlet obstruction; these differentials favor cerebrospinal fluid shifts from the fourth ventricle of the brain through the central canal of the spinal cord. Gardner's theory has been questioned, and several alternative theories of syringomyelia have been proposed. Physiological data and new information from magnetic resonance imaging support many of Gardner's concepts; however, a more comprehensive elucidation of the pathophysiologic mechanisms of syringomyelia requires incorporating facets of the other theories. We propose a unified theory of the pathogenesis of syringomyelia based on recent experience with magnetic resonance imaging, and on elements of other current theories.

journal_name

Cleve Clin J Med

authors

Pillay PK,Awad IA,Hahn JF

doi

10.3949/ccjm.59.4.373

subject

Has Abstract

pub_date

1992-07-01 00:00:00

pages

373-80

issue

4

eissn

0891-1150

issn

1939-2869

journal_volume

59

pub_type

杂志文章,评审
  • Heart disease and depression: don't ignore the relationship.

    abstract::Evidence is mounting that depression is a risk factor for the development of cardiovascular disease and portends a worse outcome in cardiac patients. Depression can be easily diagnosed and safely treated in cardiac patients, but it is undertreated. ...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章,评审

    doi:10.3949/ccjm.70.9.745

    authors: Kemp DE,Malhotra S,Franco KN,Tesar G,Bronson DL

    更新日期:2003-09-01 00:00:00

  • HIV update 2005: origins, issues, prospects, and complications.

    abstract::Morbidity and mortality rates of human immunodeficiency virus (HIV) have plummeted where highly active antiretroviral therapy (HAART) is available. However, therapy is out of reach for most people who need it in developing nations, where the infrastructure to deliver care and resources for medications is lacking. Worl...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章,评审

    doi:10.3949/ccjm.72.1.73

    authors: Armstrong W,Calabrese L,Taege AJ

    更新日期:2005-01-01 00:00:00

  • Patient information. Cholesterol: what you need to know.

    abstract::Cholesterol is a fat-like substance that is in our blood. Our bodies naturally produce some cholesterol. The other portion comes from animal products such as meat, eggs, butter, cheese, and whole milk. Foods from plants do no contain cholesterol. When you have a high level of cholesterol in your blood, it builds up in...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章

    doi:10.3949/ccjm.68.7.623

    authors:

    更新日期:2001-07-01 00:00:00

  • Zika virus: A primer for clinicians.

    abstract::The ongoing outbreak of Zika virus infection that began in South America and Central America in 2014 is worrisome because of associations with fetal microcephaly and with Guillain-Barré syndrome. Here we summarize what has happened and what is known so far. As the outbreak continues to evolve, we urge clinicians to wa...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章,评审

    doi:10.3949/ccjm.83a.16027

    authors: Flores MS,Burgess TH,Rajnik M

    更新日期:2016-04-01 00:00:00

  • Patient and treatment perspectives: Revisiting the link between type 2 diabetes, weight gain, and cardiovascular risk.

    abstract::Lifestyle modifications in conjunction with antidiabetes medications can produce near-normal blood glucose concentrations in patients with type 2 diabetes mellitus (T2DM). Because these patients have increased cardiovascular morbidity and mortality, treatment strategies should also address the cardiovascular aspects o...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章,评审

    doi:10.3949/ccjm.76.s5.04

    authors: Peters AL

    更新日期:2009-12-01 00:00:00

  • AVP receptor antagonists as aquaretics: review and assessment of clinical data.

    abstract::The antidiuretic hormone arginine vasopressin (AVP) is primarily responsible for regulating osmotic and volume homeostasis of body fluids, largely through binding to vasopressin type 1A (V(1A)) and type 2 (V2) receptors. Increased AVP secretion leads to decreased free water excretion with resulting water retention, an...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章,评审

    doi:10.3949/ccjm.73.suppl_3.s24

    authors: Verbalis JG

    更新日期:2006-09-01 00:00:00

  • Antiepileptic drug therapy in younger patients: when to start, when to stop.

    abstract::Decisions about whether and how long to treat seizures in children and adolescents should be based on rational criteria and knowledge of the natural history of epileptic syndromes, rather than on the presumption that all seizures should be treated at any cost. ...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章,评审

    doi:10.3949/ccjm.62.3.176

    authors: Zacharowicz L,Moshé SL

    更新日期:1995-05-01 00:00:00

  • Caring for women with HIV: Unique needs and challenges.

    abstract::Women infected with human immunodeficiency virus (HIV) have unique needs. Treatment recommendations are the same for men and women, but in women, fertility desires, pregnancy, contraception, and aging must be taken into account in their medical care. ...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章,评审

    doi:10.3949/ccjm.81a.14009

    authors: Short WR,Anderson JR

    更新日期:2014-11-01 00:00:00

  • Searching the Internet for medical information: practical tips.

    abstract::The Internet can be useful for physicians, but beginning users are apt to encounter two problems: too much irrelevant information, and difficulty finding the desired information. This paper offers some practical tips that can prevent frustration and wasted time when searching for medical information on the Internet. ...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章

    doi:10.3949/ccjm.66.9.543

    authors: Mehta N

    更新日期:1999-10-01 00:00:00

  • The two faces of the 'good' cholesterol.

    abstract::Although a low level of high-density lipoprotein (HDL) cholesterol is a useful clinical predictor of coronary heart disease, raising the HDL cholesterol level does not necessarily lower this risk. Part of the explanation for this paradox may be that, under certain conditions, HDL either can be less functional as an an...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章,评审

    doi:10.3949/ccjm.74.10.697

    authors: Ansell BJ

    更新日期:2007-10-01 00:00:00

  • HIV-associated PML: changing epidemiology and clinical approach.

    abstract::Despite the availability of highly active antiretroviral therapy (HAART) for the treatment of human immunodeficiency virus (HIV) infection, there has not been a dramatic decrease in the frequency of progressive multifocal leukoencephalopathy (PML) in the HIV-infected population. Usually a multifocal progressive diseas...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章

    doi:10.3949/ccjm.78.s2.06

    authors: Simpson DM

    更新日期:2011-11-01 00:00:00

  • Why treat anemia in the preoperative period of joint replacement surgery with erythropoietin? IMPACT consults. Proceedings of the 2nd Annual Cleveland Clinic Perioperative Medicine Summit.

    abstract::Treatment of anemia in the perioperative period of major orthopedic surgery decreases the need for blood transfusion and improves perioperative outcomes. Use of epoetin alfa in this setting is FDA-approved and provides significant benefit to qualified and carefully chosen patients. ...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章

    doi:10.3949/ccjm.73.electronic_suppl_1.s13

    authors: Kumar A,Dimov V

    更新日期:2006-09-01 00:00:00

  • Starting insulin in patients with type 2 diabetes: An individualized approach.

    abstract::Because type 2 diabetes mellitus is a progressive disease, most patients eventually need insulin. When and how to start insulin therapy are not one-size-fits-all decisions but rather must be individualized. This paper reviews the indications, goals, and options for insulin therapy in type 2 diabetes. ...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章,评审

    doi:10.3949/ccjm.82a.14069

    authors: Brateanu A,Russo-Alvarez G,Nielsen C

    更新日期:2015-08-01 00:00:00

  • Acute community-acquired bacterial meningitis in adults: an evidence-based review.

    abstract::Community-acquired bacterial meningitis is still a significant cause of morbidity and mortality. Clinicians should know how to quickly diagnose it, perform a lumbar puncture, order the necessary tests, and start appropriate empiric therapy promptly. ...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章,评审

    doi:10.3949/ccjm.79gr.12003

    authors: Bhimraj A

    更新日期:2012-06-01 00:00:00

  • Innovative models of home-based palliative care.

    abstract::The focus of palliative care is to alleviate pain and suffering for patients, potentially while they concurrently pursue life-prolonging or curative therapy. The potential breadth of palliative care is recognized by the Medicare program, but the Medicare hospice benefit is narrowly defined and limited to care that is ...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章

    doi:10.3949/ccjm.80.e-s1.07

    authors: Labson MC,Sacco MM,Weissman DE,Gornet B,Stuart B

    更新日期:2013-01-01 00:00:00

  • Androgenesis and androdynamics in normal women.

    abstract::The effects of estrogenic steroid hormones in women are apparent, but the circulating androgen levels are much higher. Compared with serum estrone and estradiol levels, circulating testosterone levels are five to 10 times higher, androstenedione levels 30 times higher, dehydroepiandrosterone levels 100 times higher, a...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章,评审

    doi:10.3949/ccjm.57.2.161

    authors: Cumming DC

    更新日期:1990-03-01 00:00:00

  • Sleep apnea is linked to heart failure, but does treatment improve outcome?

    abstract::One of the factors that contribute to the progressively declining course of heart failure could be sleep apnea. Whether treating sleep apnea improves the clinical outcomes of patients with heart failure needs to be tested in randomized clinical trials. ...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章,评审

    doi:10.3949/ccjm.72.10.929

    authors: Wexler L,Javaheri S

    更新日期:2005-10-01 00:00:00

  • Viral infections and the kidney: HIV, hepatitis B, and hepatitis C.

    abstract::Infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV), or hepatitis C virus (HCV) can cause rapidly progressive renal disease, so prompt recognition and management are critical. Viral glomerulonephropathy can now often be successfully managed with a specific combination of antiviral therapy, immun...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章,评审

    doi:10.3949/ccjm.74.5.353

    authors: Appel G

    更新日期:2007-05-01 00:00:00

  • COX-2-selective inhibitors in the treatment of arthritis.

    abstract::Therapy with nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) has long been the cornerstone of pharmacologic management of patients with osteoarthritis (OA) and rheumatoid arthritis (RA). Many patients with OA or RA, however, are at increased risk of developing clinically significant adverse events associate...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章,评审

    doi:10.3949/ccjm.69.suppl_1.si20

    authors: Schnitzer TJ,Hochberg MC

    更新日期:2002-01-01 00:00:00

  • Information management for clinicians.

    abstract::Clinicians are bombarded with information daily by social media, mainstream television news, e-mail, and print and online reports. They usually do not have much control over these information streams and thus are passive recipients, which means they get more noise than signal. Accessing, absorbing, organizing, storing...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章,评审

    doi:10.3949/ccjm.83a.15001

    authors: Mehta NB,Martin SA,Maypole J,Andrews R

    更新日期:2016-08-01 00:00:00

  • Caring for VIPs: nine principles.

    abstract::Caring for very important persons (VIPs), including celebrities and royalty, presents medical, organizational, and administrative challenges, often referred to collectively as the "VIP syndrome." The situation often pressures the health care team to bend the rules by which they usually practice medicine. Caring for VI...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章

    doi:10.3949/ccjm.78a.10113

    authors: Guzman JA,Sasidhar M,Stoller JK

    更新日期:2011-02-01 00:00:00

  • Heart failure in women is different than in men; should treatment be different?

    abstract::Women with heart failure differ from their male counterparts in a number of ways, including etiology, pattern of cardiac remodeling, and prognosis. They may even respond differently to medical therapy. But until prospective, sex-specific studies show that we should do otherwise, we recommend that women with heart fail...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章,评审

    doi:10.3949/ccjm.74.6.423

    authors: Mezu U,Bott-Silverman C,Hsich E

    更新日期:2007-06-01 00:00:00

  • Delirium in hospitalized patients: Risks and benefits of antipsychotics.

    abstract::Consensus panel guidelines advocate for the judicious use of antipsychotic drugs to manage delirium in hospitalized patients when nonpharmacologic measures fail and the patient is in significant distress from symptoms, poses a safety risk to self or others, or is impeding essential aspects of his or her medical care. ...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章,评审

    doi:10.3949/ccjm.84a.16077

    authors: Thom RP,Mock CK,Teslyar P

    更新日期:2017-08-01 00:00:00

  • New insights into ischemic heart disease in women.

    abstract::Coronary artery disease is different in women than in men in its pathogenesis, symptoms, and prognosis. Needed is a strategy for detecting and assessing coronary disease specifically in women. This review highlights recent evidence on sex differences in coronary artery disease. ...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章,评审

    doi:10.3949/ccjm.74.8.585

    authors: Bellasi A,Raggi P,Merz CN,Shaw LJ

    更新日期:2007-08-01 00:00:00

  • Pharmacotherapy for obesity: What you need to know.

    abstract::Weight-loss drugs are being evaluated for their role in obesity management. This article reviews the available weight-loss drugs, their efficacy and side effects, and their best clinical use. ...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章,评审

    doi:10.3949/ccjm.84a.16094

    authors: Bersoux S,Byun TH,Chaliki SS,Poole KG

    更新日期:2017-12-01 00:00:00

  • Back pain made simple: an approach based on principles and evidence.

    abstract::In cases of low back pain, the goal is to detect serious problems and to prevent the pain from becoming chronic by promptly detecting risk factors. The authors lay out a simple, evidence-based approach to low back pain. ...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章,评审

    doi:10.3949/ccjm.76a.08099

    authors: Bhangle SD,Sapru S,Panush RS

    更新日期:2009-07-01 00:00:00

  • Medical devices and conflict of interest: unique issues and an industry code to address them.

    abstract::Development of medical devices requires interaction between physicians and industry that is considerably more intimate than that in pharmaceutical development. Progress in procedure-based medicine would be stalled if this collaboration were eliminated. This degree of interaction, however, creates conflicts of interest...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章

    doi:10.3949/ccjm.74.suppl_2.s26

    authors: LaViolette PA

    更新日期:2007-03-01 00:00:00

  • Home testing for HIV: hopefully, a step forward.

    abstract::An over-the-counter at-home test for human immunodeficiency virus (HIV) infection has been approved and will likely be available soon. It is intended to decrease the percentage of HIV-infected people unaware of their infection (estimated at 18% of the 1.2 million people infected in the United States). Since early and ...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章,评审

    doi:10.3949/ccjm.79a.12128

    authors: Koval CE

    更新日期:2012-10-01 00:00:00

  • Renal disease in small-vessel vasculitis.

    abstract::Glomerulonephritis (GN) is a common manifestation of the antineutrophil cytoplasmic antibody-associated systemic vasculitides (AASV), which include granulomatosis with polyangiitis and microscopic polyangiitis. The level of renal involvement at presentation is highly predictive of survival and should be assessed early...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章

    doi:10.3949/ccjm.79.s3.05

    authors: de Groot K

    更新日期:2012-11-01 00:00:00

  • Paget disease of bone: diagnosis and drug therapy.

    abstract::Paget disease of bone is a focal disorder of aging bone that may be asymptomatic or may present with pain, bowing deformity, fracture, or a nonspecific rheumatic complaint. It is the second most common disease of bone in the elderly after osteoporosis, and the loss of structural integrity in affected bone conveys a ri...

    journal_title:Cleveland Clinic journal of medicine

    pub_type: 杂志文章,评审

    doi:10.3949/ccjm.80a.12142

    authors: Seton M

    更新日期:2013-07-01 00:00:00