CNS and spinal cord lesions Flashcards
Name ascending tacts
corticospianal: movement
Name descending tract
spinothalmaic: pain & temp
Dorsal column: proprioception and touch
Cross in medulla
Corticospinal
Dorsal column
Approach to neurp
- Have they had a stroke
- Are there cranial nerve signs → brain stem
- Are there upper motor neurone signs?
- Are there lower motor neurone
- Can I work a sensory level
Hyperreflexia - UMN or LMN sign
UMN
Upper motor signs
↑ tone, ↑ reflexes, ↑babinski
Lower motor sign
wasting, fasciculation decreased tone weak decreased reflexes ↓ sensation, ↓ co-ordination
Ipsilateral weakness
Ipsilateral ↓ vibration + proprioception
Contralateral ↓ pain and temperature
Brown-Sequard
Bilateral weakness
Bilateral ↓ pain and temp
Preserved vibration and proprioception
Anterior cord syndrome
Causes of anterior cord
Anterior spinal artery compression or occlusion
• Atherosclerosis
• Aortic aneurysm
- Motor preserved,
- bilateral loss of vibration, proprioception,
- pain and temp preserved
Posterior cord
Posterior cord causes
posterior spinal artery infarction, trauma
- Bilateral motor weakness
- variable bilateral sensory loss
- loss of vibration and proprioception
Central cord syndrome
Causes of Central cord syndrome
- Hyper extension injuries
- Syringomyelia → cape like
- Tumours
What is the triad for normal pressure hydrocephalus
Gait abnormality
Altered cognition
Loss of bladder control
