Central Cord Syndrome CAT

Question 1

What is central cord syndrome?

Answer 1

• Incomplete spinal cord lesion
• Often results from a central hyperextension injury
• Symptoms come from damage to central part of the central cord

Question 2

What structures are damaged with central cord syndrome?

Answer 2

Bleeding into central gray matter

Question 3

Most common MOI for CCS

Answer 3

Hyperextension of the cervical spine

Question 4

Demographics most impacted by CCS

Answer 4

• 50+ years old
• Men > female

Question 5

Most likely clinical presentation for CCS

Answer 5

• Motor loss that is greater in the upper extremities than lower extremities
• Motor loss more severe distally in UE

Question 6

Order of motor tracts in the spinal cord lateral to medial

Answer 6

Lumbar –> thoracic –> cervical

Question 7

Role of imaging with management of CCS

Answer 7

• MRI to assess spinal cord impingement
• CT scan to assess spinal canal compromise
• X-rays to assess potential fractures, dislocations, and degree of spondylotic deterioration

Question 8

Potential additional findings w/ CCS

Answer 8

• Autonomic dysreflexia
• Spasticity
• Neurogenic bladder and bowel
• Allodynia
• Pressure ulcers

Question 9

Pharmacological management of CCS

Answer 9

• Methylprednisolone w/in 8 hours to aid neurologic recovery
• BP medication to combat autonomic dysreflexia
• Antispasticity meds
• Anticonvulsants
• Prophylactic anticoagulants
• Antidepressants if warranted

Question 10

Likely outcome of physical therapy for CCS

Answer 10

Maximize functional outcome based on level and extent of injury

Question 11

Central cord syndrome vs anterior cord syndrome

Answer 11

• ACS affects 2/3 of spinal cord
• Occurs after cervical flexion injury or anterior spinal artery embolization
• Complete loss of motor function as well as pain and temperature below level of the lesion