3. Neoplastic

• Intramedullary: ependymoma, astrocytoma, metastases, glioma, dermoid cyst, epidermoid cyst

• Extramedullary–Intradural: meningioma, schwannoma

• Extradural: metastasis, lipoma

• Carcinomatous meningitis

4. Infectious / Inflammatory

• Spinal abscess

• Transverse myelitis

• Multiple sclerosis

• Neuromyelitis optica

• Spinal meningitis with pachymeningitis

• Viral infections

• Creutzfeldt–Jakob disease

5. Vascular

• Spinal cord infarction (ASA syndrome)

• Arteriovenous malformations (AVMs)

• Hemorrhage

• Radiation myelopathy

Diagnosis

• Complete history & clinical examination

• MRI (with and without contrast) – gold standard: delineates intramedullary vs. extramedullary lesions, cord edema, syrinx, hemorrhage

• CT / CT myelography

• CSF analysis – demyelinating disease, infection, neoplastic cells

• Electrophysiology (NCS, EMG) – functional assessment & prognosis

Management

Treatment depends on type of lesion and underlying pathology.

1. Surgical Removal

• Primary treatment for spinal cord tumors and AVMs

• Goal: complete excision if possible

2. Medical Therapy

• Antimicrobials – for infections

• Steroids / Plasma exchange – for autoimmune demyelination

• Anticoagulation / Endovascular procedures – for vascular lesions

3. Rehabilitation & Long-Term Care

• Physiotherapy & Occupational Therapy – neuroplasticity-driven functional recovery

• Bladder & Bowel management – intermittent catheterization, bowel regimens

• Spasticity control – baclofen, tizanidine, intrathecal baclofen pumps

• Assistive technology – wheelchairs, robotic exoskeletons, neuroprosthetics

• Psychological & Social rehabilitation