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