Spinal cord injuries

Manifestations of brown sequard syndrome include

-S&S on Same as the side lesion (ipsilateral) - Loss of motor function, position, vibration sense, and vasomotor paralysis

6 syndromes associated with Incomplete lesions

1. Central cord syndrome 2.Anterior cord syndrome 3.Posterior cord syndrome 4.Brown-Sequard syndrome 5.Conus Medullaris Syndromes/6.Cauda Equina Syndrome

Manifestations in posterior cord syndrome include:

1. Loss of proprioception (position sense)- indicated by positive (+) Romberg test, 2. Loss of sense of vibration and crude touch 3.Pain, temperature sensation and motor function BELOW the level of the lesion remain intact.

Pain, temperature sensation and motor function BELOW the level of the lesion REMAIN INTACT with ...

posterior cord syndrome (this is different!)

Opposite side of lesion (contralateral) -typically results from penetrating (trauma)

-Loss of pain and temperature sensation

C1- C3=

- Cannot shrug shoulders. -movement of neck and above -often fatal - long term vent. -absence of independent respiratory fxn.

Conus Medullaris Syndrome/ Cauda Equina Syndrome manifestations include:

- Flaccid paralysis of the lower limbs -Areflexic (flaccid limbs) bladder and bowel Ask questions such as are you having issues voiding, and rectal exam to ensure vagus nerve is NOT RELAXED

Anterior cord syndrome manifestions :

- Sensations of touch, position, vibration and motion remain intact

Anterior cord syndrome has loss of :

- loss of pain and temperature sensation below the level of injury - motor paralysis

Manifestations of central cord syndrome include:

-Complete loss of movement and sensation Below the level of injury -Motor weakness and sensory in both the upper and lower extremities -Upper extremities more affected

Posterior cord syndrome:

-Compression or damage to the posterior spinal artery--> dorsal columns are damaged

American Spinal Injury Association (ASIA) Scale graded:

A--> E (gradual increase as you move down the alphabet. A is the worse) A= complete- no motor or sensory fxn is preserved in the sacral segments s4-5 E= Normal - motor and sensory function are normal

C5

Full neck, partial shoulder

Brown- Sequard Syndrome

Damage to one half of the spinal cord (ipsilateral)

Anterior cord syndrome

Damage to the anterior spinal artery--> compromised blood flow to the anterior spinal cord.

CENTRAL CORD SYNDROME

Damage to the central spinal cord most commonly occurs in the cervical cord region

Conus Medullaris Syndrome/ Cauda Equina Syndrome

Damage to the very lowest portion of the spinal cord. -Lumbar nerve roots -Conus Medullaris

C4 injury-

Tetraplegia results in complete paralysis below the neck

In anterior cord syndrome, posterior cord tracts

are not injured

Anterior cord syndrome can be caused by

flexion injury

c4

greatest level of paralysis - Sensation of movement in neck and above -May be able to breath without a ventilator