Surf [Neurosurgery Wiki]

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=====Surf=====
Surfer's myelopathy is a rare, acute, atraumatic [[myelopathy]] that occurs in novice surfers.

Medical [[literature]] was queried for all reports of this condition, systematically abstracted, and analyzed. An illustrative case that provides the most definitive support for a vascular cause is presented. Treatment considerations based on prior cases and expert opinions are provided.

Sixty-four cases of surfer's myelopathy have been reported to date. This atraumatic thoracic/[[conus medullaris]] myelopathy with only a 42% neurological recovery rate almost uniformly affects young, healthy, novice surfers who have no pre-existent spinal disease. 

====Clinical features====
Symptoms usually start with back pain and rapidly progress to complete or incomplete myelopathy. 

====Diagnosis====
T2 magnetic resonance images show increased signal in the central spinal cord within 24 to 72 hours. Gadolinium enhancement and diffusion-weighted imaging are not helpful. Angiography has been underused. Angiogram in the case reported by Freedman et al showed the absence of a right T12 [[radicular artery]] and no [[artery of Adamkiewicz]], which, along with clinical findings, support the vascular origin theory. 

Incomplete cases often improve within 24 hours of onset, whereas no improvement has been reported for [[American Spinal Injury Association]] class A cases. Several acute interventions have been tried. [[Steroid]]s are most common, and patients receiving steroids improved 55% of the time with no reported adverse effects.

Surfer's myelopathy is a clinical entity associated with complete deficit in >50% of cases. Its prognosis is almost exclusively dictated by severity at presentation/nadir. Thus, publicizing this rare but serious condition (within and outside the medical literature) may be an effective intervention
((Freedman BA, Malone DG, Rasmussen PA, Cage JM, Benzel EC. Surfer's Myelopathy:
A Rare Form of Spinal Cord Infarction in Novice Surfers: A Systematic Review.
Neurosurgery. 2016 May;78(5):602-11. doi: 10.1227/NEU.0000000000001089. PubMed
PMID: 27082966.)).