Cord Pathologies

Question 1

Elderly women presents with weakness in her arms particularly her hands finds it harder to hold things. On neuro examination you find she has lost pain and temperature sensation to her upper shoulders, upper back and upper torso. She mentions she fell in the last week which is when this all started. Likely diagnosis?

Answer 1

Central cord syndrome effecting the spinothalamic and corticospinal tracts showing ‘cape loss of pain and temperature sensation’

Question 2

Man presents in AE with multiple back stab wounds, on neurological examination he has lost motor function to the left leg with sensation, and the left leg has lost sensation to pain and temperature. What is the likley diagnosis?

Answer 2

Brown sequard syndrome (cord hemisection

‘Stab wounds buzz word’
As takes out the entire left side of the spinal cord which effects the same side corticospinal but as the spinothalamic crosses immediately it will effect the contralateral sensation of the right side.

Question 3

Your called to a man on the ward who has suddenly become incredibly rigid with his legs, arms extended by huis sides and his wrists flexed. What is this presentation known as? What is it due to?

Answer 3

Decorticate rigidity from corticospinal tract becoming damaged near cerebral hemispheres

Question 4

Youre called to a man on the ward whoe has suddenly became very stiff. He has his jaw clenched, arm adducted, forearm flexed with flexed wrists and extended legs. What is this presentation known as? What is the pathology behind it?

Answer 4

Decerebrate rigidity.

Due to damge to the midbrain/pons so wiping out the motor tracts except the reticulospinal tract