Chapter 17: Disorders of the Central and Peripheral Nervous Systems and Neuromuscular Junction

Specific injury types such as concussions, contusions, and diffuse axonal injury are explored with attention to their prognostic implications. Spinal cord trauma is presented through the lens of vertebral injury mechanisms, spinal shock physiology, and the permanent motor and sensory deficits associated with quadriplegia and paraplegia. Degenerative disc disease and herniated intervertebral discs are examined as chronic sources of neurologic compromise. Cerebrovascular disorders comprise a substantial portion of the chapter, encompassing transient ischemic attacks and both thrombotic and embolic ischemic strokes, with emphasis on underlying pathogenic mechanisms including atherosclerotic disease, cardiac arrhythmias, and hypertension. Hemorrhagic stroke, intracranial aneurysms, and arteriovenous malformations are detailed as structural vascular abnormalities predisposing to intracerebral bleeding, with subarachnoid hemorrhage highlighted as a particularly catastrophic presentation. Infectious and inflammatory conditions including bacterial, viral, and tuberculous meningitis, along with various forms of encephalitis, are described in terms of their inflammatory consequences and neurologic sequelae. Multiple sclerosis is presented as an autoimmune demyelinating disease characterized by relapsing or progressive neurologic deterioration. Guillain-Barré syndrome and myasthenia gravis are explained as postinfectious and autoimmune conditions respectively, affecting the peripheral nervous system and neuromuscular junction. The chapter concludes with an examination of primary and metastatic central nervous system tumors, including various glioma subtypes, meningiomas, and embryonal neoplasms, discussing their pathologic features, clinical presentations, and contemporary treatment approaches including surgical resection, radiation therapy, and chemotherapy.