Spinal Cord Compression Flashcards

1
Q

What will an UMN lesion cause?

A

Increased tone
Muscle wasting not marked
No fasciculation
Hyper-reflexia

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2
Q

What will an LMN lesion cause?

A

Decreased tone
Muscle wasting
Fasciculation
Diminished reflexes

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3
Q

What can cause acute spinal cord compression?

A

Trauma
Tumours- haemorrhage or collapse
Infection
Spontaneous haemorrhage

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4
Q

What can cause chronic spinal cord compression?

A

Degenerative disease- spondylosis
Tumour
Rheumatoid Arthritis

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5
Q

How does a complete cord transection present?

A

All motor and sensory modalities affected at particular level
Initially a flaccid arreflexic paralysis ‘spinal shock’
UMN signs appear later

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6
Q

What is Brown-Sequard Syndrome?

A

Resulting condition from cord hemisection

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7
Q

What does cord hemisection effect?

A

Ipsilateral motor level
Ipsilateral dorsal column sensory level
Contralateral spinothalamic sensory level

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8
Q

How does central cord syndrome present?

A
Hyperflexion or extension injury to already stenotic neck
Predominantly distal upper limb weakness
'Cape-like' spinothalamic sensory loss
Lower limb power preserved
Dorsal columns preserved
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9
Q

What is the presentation of chronic spinal cord compression?

A

Same as acute except UMN signs predominate

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10
Q

What tumours can cause spinal cord compression?

A

Extradural- usually mets from lung, breast, kidney, prostate
Intradural- Extramedullary (meningioma, Schwannoma)
Intramedullary (astrocytoma, ependymoma)

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11
Q

How can tumours cause acute compression?

A

By collapse or haemorrhage

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12
Q

What occurs in degenerative disease to cause spinal canal stenosis?

A

Osteophyte formation
Bulging of IV discs
Facet joint hypertrophy
Subluxation

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13
Q

Where can infection come from to cause compression?

A

Epidural abscess- bloodborne, staph, tuberculosis
Surgery
Trauma

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14
Q

What types of haemorrhage can cause compression?

A

Epidural
Subdural
Intramedullary

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15
Q

What are some causes of spinal cord compression through haemorrhage?

A

Trauma
Bleeding diatheses
Anticoagulants
Arterio-venous malformations

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16
Q

What Ix are required to investigate trauma causing compression?

A

X-ray
CT
MRI

17
Q

What should be given in trauma causing compression?

A

Methylprednisolone- bolus, 24 hr infusion

18
Q

How should trauma causing compression be managed?

A

Immobilise
Investigate
Steroid
Decompress and stabilise- surgery, traction, external fixation

19
Q

How could metastatic tumours causing compression be treated?

A
Depends on Patient and Tumour
Dexamethasone
Radiotherapy
Chemotherapy
Surgical decompression and stabilisation
20
Q

How can haemorrhages causing compression be treated?

A

Reverse anticoagulation

Surgical decompression

21
Q

How can degenerative disease causing compression be treated?

A

Surgical decompression +- stabilisation