spinal cord lesions

Question 1

cord transection

Answer 1

complete lesion - all motor + sensory modalities affected
- sensory + motor level

initially a flaccid areflexic paralysis - spinal/neurogenic shock
- UMN signs appear later

Question 2

brown-sequard syndrome

Answer 2

lateral hemisection of spinal cord - penetrating injury

• Ipsilateral motor level – weakness below lesion
• Ipsilateral dorsal column sensory level – loss of proprioception + vibration sensation
• Contralateral spinothalamic sensory level – loss of pain + temp sensation

Question 3

central cord syndrome

Answer 3

often on preexisting spinal cord stenosis - falls over / (hyperflexion or extension of head injusry to already stenotic neck or syringomyelia tumour)

predominantly distal upper limb weakness
- cape-like spinothalamic sensory loss

lower limb power preserved, dorsal columns preserved
predominantly bilateral upper limb weakness > lower limb

Question 4

anterior cord syndrome

Answer 4

block of anterior spinal artery
tracts affected:
- lateral corticospinal tracts
- lateral spinothalamic tracts

presents:
- bilateral spastic paresis
- bilateral loss of pain + temp sensation

Question 5

differentiating between osteomyelitis + tumour of spine

Answer 5

starts in disc - osteomyelitis
starts in bone - tumour