spinal cord syndromes

proprioception, vibration, pressures (dorsal column spared) light touch also

what is preserved in anterior cord syndrome?

none but differs bilaterally ipsilateral = motor, vibration, proprioception contralateral = pain and temperature (usually 2 levels below injury)

what is preserved in brown sequard syndrome?

proprioception, vibration, pressure (dorsal column spared)

what is preserved in central cord syndrome?

pain and light touch no motor deficits

what is preserved in posterior cord syndrome?

hemisection

what spinal cord areas are affected in brown sequard syndrome?

Posterior columns

what spinal cord areas are affected in posterior cord syndrome?

Corticospinal and spinothalamic tracts

what spinal tracts are affected in anterior cord syndrome?

bilateral central corticospinal and lateral spinothalamic tracts

what spinal tracts are affected in central cord syndrome?

anterior cord syndrome

motor and sensory deficits in LE

central cord syndrome

motor and sensory deficits in upper extremities in shawl distribution

MC after blowout of vertebral body burst fractures (flexion) anterior spinal artery injury or occlusion direct anterior spinal cord compression aortic dissection, SLE, AIDS

MOI in anterior cord syndrome

unilateral hemisection of spinal cord, MC after penetrating trauma +/- tumors rare injury

MOI in brown sequard syndrome

Hyperextension injury (e.g., car crash), associated with chronic cervical spondylosis Spinal cord compression

MOI in central cord syndrome

rare, damage to posterior cord or posterior spinal stenosis

MOI in posterior cord syndrome

the MVP on the winning side was oblivious 2 the stabbing heat of the pain of defeat from the losing side ipsilateral deficits (Motor, Vibratory, Proprioception), contralateral deficits (pain and temp occur 2 levels below injury) usually due to stabbing/penetrating mechanism

brown sequard syndrome mnemonic

ANT couldn't walk to bathroom in TeePee, he Peed His Pants when his bladder burst into flecks (Flex) couldn't walk = lower extremity motor deficit TeePee = loss of temp and pain sensation peed his pants = bladder dysfunction, lower extremity involvement flex = flexion compression injuries MC mechanism of injury

anterior cord syndrome mnemonic

because Maleficent developed frostbite when she Extended her hand to touch the cold window, she couldn't put her shawl on with her weak hands extension injury, loss of pain and temp sensation, upper extremity>lower extremity (hands), shawl distribution

central cord syndrome mnemonic

Definition: injury to the central region of the spinal cord (central corticospinal tracts and decussating fibers of the lateral spinothalamic tract) Epidemiology:Most common type of incomplete cord syndrome, Common in the elderly with preexisting degenerative changes in the cervical spine Etiology: syringomyelia, degenerative spine disease, cervical spondylosis, traumatic disc herniation, various hyperextension injuries (e.g., car crash → whiplash injury) Clinical features: Bilateral motor paresis (upper > lower extremities; distally > proximally) Variable sensory impairment, Sometimes burning pain in the arms, Sometimes loss of pain and temperature in the arms Diagnostics: CT and/or MRI to determine location, cause, and extent of neurological damage Prognosis: relatively good prognosis

central cord syndrome pearls

brown sequard syndrome

ipsilateral motor, vibratory, and proprioception deficits contralateral pain and temperature deficits