5.3 Spinal cord compression

Question 1

all motor and sensory modalities affected

inital: flaccid arreflexic paralysis
later: upper motor neurone signs

Answer 1

complete cord trandsection

Question 2

spinal shock

Answer 2

inital flaccid arreflexic paralysis - response to trauma

Question 3

ipsilateral motor level
ipsilateral dorsal column sensory level (proprioception, vibration)
CONTRALATERAL spinothalamic sensory level (pain, temperature)

Answer 3

Brown-sequard syndrome

cord hemisection

Question 4

mechanism of injury in central cord syndrome

Answer 4

hyperflexion or extension injury to stenosed neck

Question 5

predominantly distal UPPER LIMB WEAKNESS
cape like spinothalamic sensory loss (pain, temperature)
lower limb power preserved
dorsal columns preserved (proprioception, vibration)

Answer 5

central cord syndrome

lower limb power preserved because lower limb lateral corticospinal tract is more lateral than upper limb (more in the middle)

Question 6

how does chronic spinal cord compression present?

Answer 6

same as acute; upper motor neuron signs predominate

• increased reflexes
• increased tone
• no muscle wasting, fasciculation

Question 7

common causes of extradural tumours

Answer 7

metastasis from lung, breast, kidney, prostate

Question 8

common causes of intradural, extramedullary tumours

Answer 8

meningioma

schwannoma

Question 9

common caues of intradural, intramedullary tumours

Answer 9

astrocytoma

ependymoma

Question 10

management of traumatic spinal cord injury

Answer 10

immobilise
investigate-xray, CT, MRI
methylprednisolone- bolus/24H infusion +lansoprazole
decompress and stabilise- sx, traction, external fixation