Spinal Cord Compression Flashcards
the corticospinal tract is __lateral
ipsi
the spinothalamic tract carry sensation from the ___ side of the body
opposite
DCML pathway is __lateral
ipsi
the body’s main sensory tracts carry information from the __ side of the body
same
causes of acute spinal cord compression?
trauma esp to the neck
tumour
infection
spontaneous haemorrhage
what brain tumours are most likely to cause acute spinal cord compression
bony metastases
chronic spinal cord compression is caused by…
spondylosis
tumours
RA
C4/5 myotome
shoulder abduction
if a complete cord transection happens, nothing lower than the lesion will work T or F
T
describe spinal shock
flaccid areflexic paralysis
get hypotension
brown sequard syndrome is also known as…
cord hemisection (half of the spinal cord is injured)
what tracts are affected in BS syndrome?
DCML
spinothalamic
corticospinal
why will a patient with BS syndrome lose temperature and pain sensation on the right side but maintain fine touch on the right side and not the left?
patient must have a left sided lesion:
the spinothalamic tract is contralateral so will affect the opposite side to the lesion whereas DCML (for fine touch etc) will be preserved on the right as it only affects the side of the lesion
patient with a bump on the head, can’t move their hands, pins and needles…
central cord syndrome
patients with central cord syndrome present with mainly __ limb weakness
upper limb
“cape like spinothalamic sensory loss”
central cord syndrome
what tracts are preserved in central cord syndrome?
dorsal column
which part of the spinal cord is most vulnerable to ischaemic injury
central cord
___ limb fibres are most medial in the corticospinal tract
upper
why are the legs preserved in central cord syndrome?
they are located on the lateral aspect of the corticospinal tract in the spinal cord so will avoid the ischaemic injury
why do you get cape like spinothalamic sensory disturbance?
central cord is usually from a neck injury so only really affects the spinothalamic tract in the area of injury so only get sensory loss over a couple of cervical spinal levels
chronic spinal cord compression will present with ___ mtoor neurone signs
upper
what part of the brain do mets tend to go to?
extradural area
main mets sources?
lung
breast
kidney
prostate
what brain tumours arise intramedullary?
astrocytoma
what brain tumours arise extramedullary?
meningioma
schwannoma
what do you get hypertrophy of in spinal stenosis?
facet joints
bacterial sources of an epidural abscess?
staph from bloodborne infection
can be TB
immediate management of head trauma?
immobilise the head
investigate with CT/MRI (if interested in soft tissue)
decompress and stabilise
bolus of methylprednisolone if appropriate
what steroid should be given for brain/bone mets?
high dose dexamethasone IV
main Tx for spinal mets?
usually radiotherapy
may have chemo too
