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Neuro > Spinal cord disorders > Flashcards

Spinal cord disorders Flashcards

1
Q

What is a spinal cord compression

A

Spinal cord compression (SCC) results from processes that compress or displace arterial, venous, and cerebrospinal fluid spaces, as well as the cord itself.

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2
Q

Spinal cord compression can lead to …

A
  • acute
  • sub- acute
  • chronic spinal cord injury
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3
Q

most common causes of SCC

A
  • Trauma- car accidents, falls
  • Vertebral compression fractures: osteoporosis
  • Disc prolapse
  • Tumors
  • Epidural haemotoma
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4
Q

Risk factors for SCC

A
  • Trauma
  • High risk sporting activity
  • high risk occupation
  • malignancy
  • age
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5
Q

Symptoms of SCC

A
  • acute onset
  • back pain
  • parasthesia
  • weakness
  • bladder or bowel dysfunction
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6
Q

Signs of SCC

A
  • upper motor neuron weakness below lesion
  • sensory deficit
  • spinal shock
  • neurogenic shock
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7
Q

What would UMN weakness show

A
  • Loss of muscle power
  • Increased tone
  • Hypereflexia
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8
Q

how would sensory deficit be presented

A

pinprick, fine-touch, vibration, temperature, joint-position sense

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9
Q

What are the different pattersn fo SCC

A
  • complete
  • central cord syndrome
  • anterior cord syndrome
  • brown sequard syndrome
  • posterior cord syndrome
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10
Q

features of complete spinal cord injury

A
  • All motor and sensory function below the SCI level
  • high cervical cord level - quadriplegia, respiratory insufficiency, loss of bladder and bowel function, neurogenic shock
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11
Q

features of central cord syndroem

A
  • Usually involves cervical spine
  • Weakness in upper extremities > weakness in lower extremities
  • Variable sensory loss below the level of injury
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12
Q

most common pattern of SCI

A

Central cord syndrome

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13
Q

Features of anterior cord syndrome

A
  • Disruption of anterior spinal cord or anterior spinal artery
  • Loss of motor function below the level
  • Loss of pain and temperature sensation (anterior column)
  • Preservation of fine touch and proprioception
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14
Q

Features of posterior cord syndrome

A
  • Disruption of posterior spinal cord or posterior spinal artery (rare)
  • Loss of fine touch and proprioception (posterior column)
  • Preservation of pain and temperature sensation
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15
Q

Features of brown sequard syndroem

A
  • Hemisection lesion of the spinal cord
  • Unilateral spastic paralysis
  • Ipsilateral loss of vibration and proprioception
  • Contralateral loss of pain and temperature sensation
  • Ipsilateral Hyperreflexia
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16
Q

Investigations for SCI

A
  • MRI whole spine
  • Full neurological examination: tone, power, sensation, reflexes, proprioception
17
Q

Management of SCI

A

If prescence of malignancy on MRI administer dexamethasone 16mg daily with PPI cover
Spinal chord decompression

18
Q

Define cauda equina

A

compression of the cauda equina

19
Q

What is cauda equina

A

collection of nerve roots which extend beyond the termination of the spinal cord at L1 to exit the spinal column in L and S region

20
Q

Mc cause of Cauda equina

A

The most common cause is lumbar disc herniation at the L4/5 and L5/S1 level.

21
Q

other causes of cauda equian

A

neoplasms (metastatic or primary),
abscesses and iatrogenic causes

22
Q

Clinical features of cauda equina

A
  • lower back pain with alternating or bilateral radicular pain and saddle anaesthesia
  • cant feel toilet paper when wiping - saddle paraesthesia
  • bladder and bowel disturbance
23
Q

management of cauda equia

A
  • urgent WHOLE SPINE MRI to surgically decompress in 48 hrs
24
Q

DD for cauda equina

A
  • connus medullaris syndrome
  • vertebral fracture
  • peripheral neuropathy
  • mechanical lower back pain
25
Q

management for cauda equian

A
    • Emergency decompressive laminectomy: surgery should be performed within24-48 hoursof symptom onset
      • All patients with suspected CES should be urgently referred to neurosurgery
      • Early treatment reduces the risk of permanent neurological deficit
  • Antibiotics are also needed for abscesses
  • Corticosteroids or radiotherapy: may be considered in certain patients with CES secondary to malignancy

Neuro (19 decks)

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