Cord Damage

Question 1

C3 cord transection clinical features

Answer 1

Tetra/quadriplegia
Loss of sensation
No diaphragm function
Loss of bladder and bowel control

Question 2

T10 cord transection clinical features

Answer 2

Reasonable upper body control and sensation
Paraplegia
Loss of bladder and bowel function
Have balance when sat

Question 3

Brown-Sequard syndrome definition and clinical features

Answer 3

Penetrating cord hemisection-> cutting cord in half lengthwise

Ipsilateral deficit

• lateral corticospinal tract-> spastic paresis and babinski +
• dorsal columns-> loss of tactile discrimination and proprioception

Contra lateral deficit
-lateral spinothalamic tract-> loss of pain and temp (decusates in spinal cord)

99% become ambulatory

Question 4

Central cord syndrome clinical features

Answer 4

Incomplete lesion-> sacral sparing
Cord compression with central oedema-> damage to lateral corticospinal tract
Most common
Elderly with minor extension injuries

Weakness
Hyperpathia-> distal burning
Motor deficit, worse distal upper
Sacral sparing

Upper limb-> LMN
Lower limb-> UMN

Question 5

Anterior cord syndrome clinical features

Answer 5

Direct compression or anterior injury
LCT-> motor loss
LST-> loss of pain and temp

Dorsal column preserved
Worse in lower limbs
Poor prognosis

Question 6

Cord syndrome management

Answer 6

High does methyl prednisone within 8h
Acute closed reduction with axial traction
DVT prophylaxis
Cardiopulmonary management

Surgical decompression and stabilisation

Question 7

Cord syndrome complications

Answer 7

Pressure ulcers
VTE 
Urosepsis
Sinus bradycardia
Orthostatic hypertension 
Autonomic dysreflexia 
Depression