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Neurology > Spinal Cord Compression > Flashcards

Spinal Cord Compression Flashcards

1
Q

the corticospinal tract is a _ neurone tract?

A

2

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2
Q

where does upper motor neurone of corticospinal tract begin and end?

A

from motor cortex to anterior grey horn

decussates (crosses over) at medullary level

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3
Q

what is the lower motor neurone?

A

anterior horn cell

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4
Q

is corticospinal tract contralateral or ipsilateral?

A

ipsilateral

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5
Q

what symptoms do you get with an upper motor neurone lesion?

A

increased tone
muscle wasting not marked
no fasciculation
hyper-reflexia

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6
Q

what symptoms do you get with a lower motor neurone lesion?

A

decreased tone
muscle wasting
fasciculation
diminished reflexes

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7
Q

what do spinothalamic tracts control?

A

pain
temperature
crude touch

this is a sensory pathway

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8
Q

is spinothalamic tracts contralateral or ipsilateral?

A

contralateral

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9
Q

where do spinothalamic tract decussate (cross over to other side of CNS)?

A

spinal level

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10
Q

what do dorsal columns control?

A

fine touch
proprioception
vibration

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11
Q

are dorsal columns contralateral or ipsilateral?

A

ipsilateral

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12
Q

where do dorsal columns decussate (cross over to other side of CNS)?

A

medullary level

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13
Q

what causes acute spinal cord compression?

A

trauma
tumour - haemorrhage or collapse
infection
spontaneous haemorrhage

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14
Q

what causes chronic spinal cord compression?

A

degenerative disease - spondylosis, spinal cord stenosis
tumours - slowly compress
rheumatoid arthritis

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15
Q

acute spinal cord compression can either be complete or incomplete, what does this mean?

A

complete - all motor and sensory modalities affected

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16
Q

what are symptoms of an acute cord transection?

A

initially a flaccid arreflexic paralysis - spinal shock

upper motor neurone signs appear later

17
Q

what occurs in brown-sequard syndrome (cord hemisection)?

A

no ipsilateral motor level

no ipsilateral dorsal column sensory level

no contralateral spinothalamic sensory level

18
Q

how does central cord syndrome occur?

A

hyperflexion or extension injury to already stenotic neck

19
Q

what are the symptoms of central cord syndrome?

A

predominantly distal upper limb weakness

“cape-like” spinothalamic sensory loss

lower limb power and dorsal columns preserved

20
Q

what are symptoms of chronic spinal cord compression?

A

same as acute except upper motor neurone signs predominate

21
Q

what kind of trauma causes spinal cord compression?

A

high energy injury

especially mobile segments of spine (cervical)

22
Q

what types of extradural tumours cause spinal cord compression?

A

usually mets - lung, breast, kidney, prostate

23
Q

what types of intradural tumours cause spinal cord compression?

A

extramedullary - meningioma, schwannoma

intramedullary - astrocytoma, ependymoma

24
Q

what causes spinal canal stenosis?

A

osteophyte formation
bulging of intervertebral discs
facet joint hypertrophy
subluxation

25
Q

what kind of infections can compress spinal cord?

A

epidural abscess - bloodborne staph or tuberculosis

surgery or trauma

26
Q

what types of haemorrhage can compress spinal cord?

A

epidural
subdural
intramedullary

27
Q

what can cause haemorrhage which suppresses spinal cord?

A

trauma
bleeding diatheses
anticoagulants
arterio-venous malformations

28
Q

how do you treat spinal cord compression caused by trauma?

A

immobilise
investigate
decompress + stabilise
? methylprednisolone

29
Q

what investigations should take place in spinal cord compression caused by trauma?

A

X-ray / CT

MRI

30
Q

how do you decompress + stabilise spinal cord compression caused by trauma?

A

surgery
traction
external fixation

31
Q

is the use of methylprednisolone in spinal cord compression caused by trauma disputed?

A

yes - this lecturer said probably no useful benefit

32
Q

how do you treat spinal cord compression caused by tumour?

A 
depends on pt and tumour
dexamethasone 
radiotherapy 
chemotherapy 
surgical decompression + stabilisation
33
Q

how do you treat spinal cord compression caused by infection?

A

antimicrobial therapy
surgical drainage
stabilisation where required

34
Q

how do you treat spinal cord compression caused by haemorrhage?

A

reverse anticoagulation

surgical decompression

35
Q

how do you treat spinal cord compression caused by degenerative disease?

A

surgical decompression +/- stabilisation

36
Q

is acute spinal cord compression an emergency?

A

yes

37
Q

chronic compression requires rapid treatment - true or false?

A

true

38
Q

what is usually the outcome of treatment of spinal cord compression?

A

prevents further deterioration

Neurology (32 decks)

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