Spinal cord lesions Flashcards
Presentation of poliomyelitis?
LMN signs - anterior horns affected.
Presentation of Brown Sequard syndrome (spinal cord hemisection)
Ipsilateral spastic paresis below lesion,
Ipsilateral loss of proprioception and vibration sensation.
Contralateral loss of pain and temperature sensation.
Presentation of anterior spinal artery occlusion?
Bilateral spastic paresis.
Bilateral loss of pain and temperature sensation
What are the risk factors for C-spine injury?
Motor vehicle collision,
Falls from height,
Diving accidents,
Sports related injury,
Direct impact to head/neck,
Gun shot wounds/stabbings.
What are the signs and symptoms of C spine injury?
Neck pain,
Reduced ROM in the neck,
Focal neurological deficits - weakness/numbness in arms or legs.
Signs of spinal shock eg, flaccid paralysis and loss of bowel/bladder control
What is the NEXUS criteria?
Used to identify low risk pts and clear a C-spine. All following must be met:
1. Normal level of alertness
2. No evidence of intoxiciation
3. No painful distracting injuries,
4. No focal neurological deficits,
5. Absence of midline cervical tenderness.
What are the investigations for suspected C spine injury?
History and examination.
NEXUS criteria.
Imaging - Preferably CT C-spine
What is the management of C-spine injury?
Airway management - Jaw thrust instead of head tilt-chin lift.
Sized semi-rigid collar to immobilise C-spine.
Secure head with blocks and tape.
What are the causes of cauda equina syndrome?
Most common - central disc prolapse.
Tumours,
Infection,
Trauma,
Haematoma
Presentation of cauda equina syndrome?
Low back pain,
Bilateral sciatica,
Reduced sensation/ pins-and-needles in perianal area,
Decreased anal tone,
Urinary dysfunction
Ix and Rx for cauda equina syndrome?
Ix - urgent MRI.
Rx - Surgical decompression
Red flag symptoms for back pain?
Trauma
Unexplained weight loss
Neurological weight loss
Age > 50,
Fever
IVDU,
Steroid use,
History of cancer
