spinal cord disease Flashcards
causes of acute spinal cord compression
trauma
tumours
haemorrhage/collapse
infection (abscess)
common metastatic tumours in spinal cord
lung
breast
kidney
prostate
chronic causes of cord compression
degenerative disease (spondylosis, stenosis, osteoporosis, rheumatoid arthritis)
clinical features of cord compression
spine or root pain may precede
leg weakness and sensory loss
arm weakness less severe
bladder and anal sphincter involvement is late
arm weakness and back pain suggests
cervical cord lesion
all motor and sensory modalities are affected in
complete lesion of spine
name for the condition of hemi-section of the spinal cord (lesion on half of the spinal cord)
brown-sequard syndrome
clinical manifestations of brown-sequard syndrome
ipsilateral motor signs (weakness)
ipsilateral loss of proprioception and vibration
contralateral loss of pain and temperature
explain the clinical manifestations of brown-sequard syndrome in relation to the spinal tracts
corticospinal (motor) and DC (proprioception and vibration) don’t cross until medulla - symptoms on same side as lesion
spinothalamic (pain and temp) have already crossed over in spinal cord - symptoms on contralateral side
what is central cord syndrome
hyperflexion/extension injury to an already stenoic neck
clinical manifestations of central cord syndrome
distal upper limb weakness
‘cape-like’ spinothalamic sensory loss (pain and temp)
lower limb and dorsal column preserved
treatment for cord compression syndrome due to trauma
immobilise + imaging
methylprednisolone
surgery - decompression, stabilise, traction and external fixation
treatment for cord compression syndrome due to infection
surgical drainage
anti-biotics
treatment of cord compression due to haemorrhage
reverse anti-coagulation
surgical decompression
