Clinical manifestations, discrepancy between ESR and WBC, plain radiographs and PCR are keys to a correct diagnosis of TVO.

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Study design: Compact literature review to provide basic knowledge of the reticular formation (RF) for clinicians. Setting: United Kingdom. Materials and methods: The anatomical findings were collected from very recently published and well-edited books on neuroscience instead of hundreds of articles that contain materials still requiring test of time and difficult for busy clinicians to digest. Other individual references on specific issues such as a micturition centre, source of sildenafil citrate and so on are added. Clinical considerations discus commonly encountered problems of spinal cord injury service and science. Every clinical condition is discussed in conjunction with the anatomy and physiology of the RF. Results: This section involves anatomy. (1) The core RF is located in the brain stem. The RF proper is divided into three longitudinal zones: the lateral (sensory), the medial (motor) and the midline (all others) zone. The midline zone is essential for wakefulness and consciousness. (2) Other brain stem structures sharing functions of the RF proper: periaqueductal grey (PAG), red nuclei, inferior olivary nucleus and precerebellar nucleus. PAG is almost related to all functions of the central nervous system, whereas the others are more connected to cerebellar functions of movements. (3) Spinal cord RF is located in the intermediolateral zone. It sends ascending and receives descending signals to coordinate and modulate motor, sensory and other functions. Discussion: This section involves clinical consideration. Multisystem damage, muscle contraction, upper urinary tract, sexual behaviour, skin trophic, pain, sleep apnoea, cross-system damages, spinal cord repair and comprehensive management are discussed to enlighten the clinical importance of the RF.

Study design: Literature review. Objective: To study the progress that has been made in neural plasticity for the past few decades. Setting: United Kingdom/China. Methods: An electronic search of relevant publications through PubMed was conducted using two key words: 'axonal regeneration' and 'neural plasticity'. The search included publications of the past three decades of all languages and of both animal and human studies. After confirmation of immense increase of publications on neural plasticity, reviewing of neural plasticity alone was conducted. The review covered only the most important and clinically relevant publications. For convenience of reading by busy clinicians, discussions focused on cellular and functional levels, and only the most investigated molecules were mentioned. The size of references is also planned to be concise rather than comprehensive into three digits. Results: Neural plasticity is about memory and learning. The entire process of neural plasticity is presented in the sequence of (1) lesion-induced plasticity, (2) clearance of debris, (3) collateral sprouting (4) potentiation. The recent discovery and understanding of the important role of Chondroitinase in clearance of debris is discussed in detail. Conclusion: Neural plasticity has enormous potentials in facilitating functional recovery. It is a realistic target than structural axonal regeneration at current level of neuroscience.

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