Spinal Cord Syndromes

Question 1

Brown-Sequard

Cause

Presentation

Answer 1

Clean cut knife injury to the back

Paralysis and loss of propioception distal to the injury on the contralateral side. Loss of pain perception distal to the injury on the ipsilateral side.

Question 2

Anterior Cord Syndrome

Causes

Presentation

Answer 2

Caused by burst fractures of the vertebral bodies + anterior spinal artery occlusion.

Patients will present with paralysis and loss of pain perception distal to the lesion and typically maintenance of propioception. In occlusion of the Artery of Adamkiewicz there is often loss of urinary and fecal continence since it supplies much of the lumbo-sacral spinal cord.

Question 3

Central Cord Syndrome

Causes

Presentation

Answer 3

Caused by forced hyperextension or cervical syringomyelia (cyst). Typically in the cervical region.

Patients will have cape like distribution of burning and paralysis in the upper extremities and completely normal functioning in the lower extremities.

Question 4

Management of Spinal cord Syndromes:

Answer 4

Take MRI (or CT if you want to focus on the bone)

High dose corticosteroids immediately after the injury