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
