Physiotherapy - Course I - Regione Molise – IRCCS Neuromed Pozzilli

Activity type

Scienze interdisciplinari e cliniche

SSD

MED/37

Year

N/D

Semester

N/D

CFU

2

Hours distribution

20 classroom hours

Lecturers

COSTANZA GIANNI'

Activity type

Scienze della fisioterapia

SSD

MED/50

Year

N/D

Semester

N/D

CFU

1

Hours distribution

10 classroom hours

Lecturers

MATILDE DI PALMA

Activity type

Scienze della fisioterapia

SSD

MED/48

Year

N/D

Semester

N/D

CFU

1

Hours distribution

10 classroom hours

Lecturers

STEFANIA FALCIGLIA

Activity type

Scienze interdisciplinari e cliniche

SSD

MED/27

Year

N/D

Semester

N/D

CFU

2

Hours distribution

20 classroom hours

Lecturers

VINCENZO ESPOSITO
SERGIO PAOLINI

At the end of the course, students will have acquired knowledge of the main neurosurgical disorders with neurorehabilitative implications, including their pathophysiology. They will be able to recognize the symptoms, assess their severity, and monitor disease progression following rehabilitative treatment, taking into account the various clinical conditions as well as prior medical and surgical interventions.

An appropriate knowledge of the anatomy and physiology of the central and peripheral nervous systems

Spinal Column, Spinal Cord, and Nerve Roots

The Stretch Reflex: Anatomy and physiology, the reflex arc, the neuromuscular spindle, skeletal muscle fibers.
Central and Peripheral Paralysis.
Functional Anatomy of the Spinal Cord: The corticospinal tract, dorsal columns, spinothalamic tract, anterior and posterior horns, anterior and posterior roots.
Functions of the Spine: Static, dynamic, and neuroprotective.


Diseases of the Spine and Spinal Cord.

Spinal Trauma: Epidemiology, causes, mechanisms.
Factors determining the variability of the clinical picture (level and structure involved, severity of injury, evolution over time).
Pathophysiology of Spinal Cord Injury: Primary and secondary damage.
Causes of spinal cord dysfunction: spinal shock, primary damage, secondary damage.
Level of lesion and resulting clinical syndromes.
Traumatic Spinal Cord Syndromes: Complete, central, anterior, posterior, hemisection (Brown-Séquard syndrome). Prognosis.
Surgical Evaluation: Vertebral stability, vertebral dislocation, spinal cord compression.
Neurological examination, motor and sensory assessment according to A.S.I.A. (American Spinal Injury Association).
Surgical and Conservative Treatment.
________________________________________
Degenerative Disease of the Spine
Normal anatomy and physiology of the intervertebral disc (annulus fibrosus, nucleus pulposus).
Degeneration of the intervertebral disc.
Radicular compression and radicular pain.
Degenerative Disease of the Lumbar Spine.
Lumbar Disc Herniation: Clinical features, physical examination, radiological assessment, conservative and surgical treatment.
Lumbar Spinal Canal Stenosis: Clinical features, physical examination, radiological assessment, conservative and surgical treatment.
Degenerative Disease of the Cervical Spine: Cervical myelopathy and radiculopathy.
Cervical Disc Herniation: Clinical features, physical examination, radiological assessment, conservative and surgical treatment.
Cervical Stenosis and Myelopathy: Clinical features, physical examination, radiological assessment, conservative and surgical treatment.
Thoracic Disc Herniation: Clinical features, physical examination, radiological assessment, conservative and surgical treatment.
Spondylolisthesis.
________________________________________
Spinal and Spinal Cord Neoplasms: Extradural tumors, intradural extramedullary tumors, intradural intramedullary tumors.
Clinical features, physical examination, radiological assessment, surgical treatment.
________________________________________
Intracranial Hypertension
Pathophysiology of Intracranial Hypertension.
Intracranial contents (brain, cerebrospinal fluid, blood).
The Monro–Kellie doctrine; compensated and decompensated intracranial hypertension.
Relationship among cerebral blood flow, mean arterial pressure, and intracranial pressure.
Brain Herniations: Cingulate gyrus herniation, transtentorial herniation of the temporal lobe uncus, herniation of the cerebellar tonsils through the foramen magnum.
Differences between supratentorial and infratentorial tumors.
Symptoms and Signs of Intracranial Hypertension: Headache, vomiting, papilledema, cognitive, behavioral, and mental dysfunctions, drowsiness, coma.
Cardiac, respiratory, and blood pressure dysregulation.
Treatment of Intracranial Hypertension: Surgical, pharmacological, and intensive care management.
________________________________________
Intracranial Neoplasms
Classification and the importance of molecular biology.
Symptoms and Signs: Epilepsy, neurological syndromes depending on tumor location, symptoms of intracranial hypertension.
Radiological Diagnosis of Intracranial Neoplasms: Magnetic resonance imaging and its various applications, CT, PET, angiography.
Treatment of Intracranial Neoplasms: Management of intracranial hypertension and epileptic seizures, surgical treatment.
Different growth patterns and localizations of intracranial tumors.
Neuropsychological assessment of cerebral functions.
Radiotherapy and chemotherapy.
Criteria for treatment based on the aggressiveness of the neoplasm.
________________________________________
Cranio-Cerebral Trauma
Epidemiology, causes, pathophysiological mechanisms.
The Glasgow Coma Scale (GCS).
Complications of Head Trauma: Infections, cerebrospinal fluid fistula, intracranial hemorrhages, cerebral ischemia, hydrocephalus, epilepsy, intracranial hypertension.
Types of Traumatic Brain Injury:
• Diffuse primary brain injury: Concussion, diffuse axonal injury, traumatic subarachnoid hemorrhage.
• Focal primary brain injury: Cerebral contusion, skull fracture, intracranial hematoma (acute epidural, acute subdural, acute intracerebral, chronic subdural).
• Secondary brain injury: Cerebral edema, ischemia, infection.
Surgical Treatment: Decompressive craniectomy.
________________________________________
Subarachnoid Hemorrhage
Definition and causes.
Definition of aneurysm, incidence, morphological classification, localization, pathogenesis of the aneurysmal sac.
Clinical presentation (hemorrhagic and non-hemorrhagic), warning signs, fully developed symptoms.
Diagnosis of Subarachnoid Hemorrhage: Etiological diagnosis.
Complications: Rebleeding, vasospasm, hydrocephalus.
Treatment of Cerebral Aneurysms: Ruptured and unruptured aneurysms; surgical and endovascular treatment.
________________________________________
Cerebrospinal Fluid Circulation Disorders
Hydrocephalus; Normal Pressure Hydrocephalus:
Clinical features, radiological diagnosis, treatment.

Greenberg, Handbook of Neurosurgery
Adams & Victor, Principles of Neurology

Module: Neuroradiology
N/D
Module: APPLIED MEDICAL TECHNICAL SCIENCES
N/D
Module: REHABILITATIVE NEUROPSYCHIATRIC AND NURSING SCIENCES
N/D
Module: NEUROSURGERY
N/D

The lectures will address in detail each of the pathologies described in the program, with particular emphasis on pathophysiological mechanisms and clinical aspects, strongly correlated with the knowledge of the anatomy and physiology of the Central and Peripheral Nervous Systems.

Attendance is highly recommended, as the lectures will present the topics in an analytical and interactive manner, greatly facilitating the learning of a rather complex subject.

In the oral examination, candidates will be asked to present neurosurgical and neurorehabilitative disorders, detailing their causes, pathophysiological basis, symptoms and signs, and treatment methods.

Brown-Séquard syndrome (hemisection of the spinal cord), with particular emphasis on its anatomical and physiological foundations and how these explain its clinical manifestations.

Differences between central and peripheral paralysis, with special attention to their anatomical and physiological bases.

Clinical features of cervical myelopathy; effects on the upper and lower limbs.

• Anatomy and Physiology of the Spine, Spinal Cord, and Nerve Roots
  • Books: Greenberg, Handbook of NeurosurgeryAdams & Victor, Principles of Neurology


• Spinal Trauma
  • Books: Greenberg, Handbook of NeurosurgeryAdams & Victor, Principles of Neurology


• Degenerative Disease of the Lumbar Spine
  • Books: Greenberg, Handbook of NeurosurgeryAdams & Victor, Principles of Neurology


• Degenerative Disease of the Cervical and Dorsal Spine. Spinal tumors
  • Books: Greenberg, Handbook of NeurosurgeryAdams & Victor, Principles of Neurology


• Intracranial Hypertension
  • Books: Greenberg, Handbook of NeurosurgeryAdams & Victor, Principles of Neurology


• Intracranial Neoplasms
  • Books: Greenberg, Handbook of NeurosurgeryAdams & Victor, Principles of Neurology


• Subarachnoid Hemorrhage
  • Books: Greenberg, Handbook of NeurosurgeryAdams & Victor, Principles of Neurology


• Disorders of Cerebrospinal Fluid Circulation
  • Books: Greenberg, Handbook of NeurosurgeryAdams & Victor, Principles of Neurology