spinal cord injuries

Question 1

central cord syndrome

Answer 1

Different syndromes / patterns of injury exist depending on the area of the cord injured:

Central cord syndrome is the most common injury pattern and usually occurs with a hyperextension injury in a cervical spine with osteoarthritits. Often there is no associated fracture or dislocation (Spinal Cord Injury Without Radiographic Abnormality, SCIWORA). Paralysis of the arms more than the legs occurs due to the corticospinal (motor) tracts of the upper limbs being more central and those for the lower limbs being more peripheral in the cord. Sacral sparing is typically present.
Different syndromes / patterns of injury exist depending on the area of the cord injured

Question 2

anterior cord syndrome

Answer 2

Anterior cord syndrome results in loss of motor function (corticospinal tracts) as well as loss of coarse touch, pain and temperature sensation (lateral spinothalamic tract) whilst proprioception, vibration sense and light touch are preserved (dorsal columns).

Question 3

posterior cord syndrome

Answer 3

Posterior cord syndrome with loss of dorsal column function (proprioception, vibration sense and light touch) is rare.

Question 4

brown-sequard syndrome

Answer 4

Brown‐Sequard syndrome results from hemisection of the cord usually from penetrating injury eg stab wound. Ipsilateral paralysis and loss of dorsal column sensation occurs with contralateral loss of pain, temperature and coarse touch sensation. This is due to nerve fibres of the spinothalamic tracts crossing to the other side of the cord one or two levels above their entry into the cord whilst the nerve fibres of the other tracts cross higher up in the medulla.