Central cord syndrome 1/2

Question 1

what is central cord syndrome?

Answer 1

most common Incomplete spinal cord lesion
30% of incomplete tetraplegia
Bleeding into central gray matter causes damage to centrally located cervical tracts

Question 2

What are common causes of central cord syndrome?

Answer 2

Cervical hyperextension injury, Damaging ligamentum flavum
Anterior compression of cord due to osteophytes
Fall, motor vehicle accident, Other trauma

Question 3

What is clinical presentation of central cord syndrome?

Answer 3

Motor loss greater in upper > lower extremities
Most severe distally in upper extremities, poor hand grasp
Some sensory loss below level of lesion, limited but variable
Sacral segments not affected since located laterally

Question 4

What are other contributing factors to development of central cord syndrome?

Answer 4

Most common is hyperextension injury to cervical spine
Other factors include
Cervical spondylosis
Narrowing or congenital defect of spinal canal
Rheumatoid arthritis
Syringomyelia
Tumor

Question 5

What is syringomyelia?

Answer 5

rare disorder in which a fluid-filled cyst forms within your spinal cord

Question 6

What imaging is used to diagnose central cord syndrome?

Answer 6

MRI - spinal cord impingement from bone or disc
CT scan - any spinal canal compromise and degree of impingement
X-ray - potential fractures, dislocation, degree of spondylitic deterioration

Question 7

What are some other potential side effects (besides motor and sensory loss) and complications of central cord syndrome?

Answer 7

Autonomic dysreflexia
Allodynia
Spasticity
Neurogenic bladder and bowel
Pressure ulcers

Question 8

What medication should be administered within eight hours of central cord syndrome injury to assist with neurologic recovery?

Answer 8

Methylprednisolone

Question 9

How quickly should methylprednisolone be administered to central cord syndrome injury to assist with neurologic recovery?

Answer 9

Within eight hours

Question 10

What medication may be used in the management of central cord syndrome?

Answer 10

methylprednisolone - immediate neurologic recovery
blood pressure medication - for autonomic dysreflexia
antispasticity medication
anticonvulsants - neurogenic pain
prophylactic anticoagulants
antidepressants

Question 11

What physical therapy interventions should be included when managing a patient with central cord syndrome?

Answer 11

Patient and caregiver education
Range of motion
Strengthening
Endurance
Balance retraining
Proximal stabilization exercises
Functional mobility based on current functional status
Adaptive devices

Question 12

What adaptive device attachment might be used for a central cord syndrome patient?

Answer 12

platform attachment walker - Due to poor hand grasp

Question 13

What is the physical therapy goal of a patient with central cord syndrome?

Answer 13

attain maximal functional outcome based on level and extent of injury

Question 14

What is the prognosis for a patient with central cord syndrome

Answer 14

younger better prognosis than older
77% will ambulate
53% gain bowel and bladder control
(55 to 85% bowel and bladder function resolve within 6 months)
42% regain some hand function

Question 15

What are some favorable long-term prognostic factors for good outcomes for central cord syndrome patients?

Answer 15

Early hand function
Improvement of strength in all extremities during inpatient stay
Little to no lower extremity involvement