Spinal Cord Syndromes
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Basics
Description
- Complete cord syndrome:
- Total loss of sensory, autonomic, and voluntary motor innervation distal to the spinal cord level of injury
- Usually caused by trauma, but other causes include infarction, hemorrhage, and extrinsic compression
- Symptoms that remain >24 hr are generally permanent
- Incomplete spinal cord lesions:
- Characterized by preservation of some spinal cord function
- 3 major types: Central cord syndrome, Brown-Séquard, and anterior cord syndrome
- Central cord syndrome:
- Most common of the incomplete spinal cord syndromes
- Classically occurs in elderly patients, with pre-existing cervical stenosis, who suffer a hyperextension injury in a fall
- Anterior cord syndrome:
- Most commonly associated with occlusion of the anterior spinal artery which can occur after aortic surgery or trauma. Other causes include hypotension and infection
- Brown-Séquard syndrome:
- Hemisection of the spinal cord, classically as a result of a penetrating injury
- Rarely unilateral cord compression
- Conus medullaris syndrome:
- Injury at the level of L1 or L2
- Causes include central disc herniation, neoplasm, and direct trauma
- Cauda equina syndrome:
- Injury to the nerve roots of the cauda equine and not the spinal cord itself
- Causes include central disc herniation and direct trauma
- Clinically, can resemble conus medullaris syndrome
Etiology
- Spinal cord syndromes result from localized disruption of neurotransmission and exhibit mixed motor and sensory deficits. The most common mechanism is trauma
- Patients with arthritis, osteoporosis, metastatic disease, or other chronic spinal disorders are at risk of developing spinal injuries as the result of minor trauma
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Basics
Description
- Complete cord syndrome:
- Total loss of sensory, autonomic, and voluntary motor innervation distal to the spinal cord level of injury
- Usually caused by trauma, but other causes include infarction, hemorrhage, and extrinsic compression
- Symptoms that remain >24 hr are generally permanent
- Incomplete spinal cord lesions:
- Characterized by preservation of some spinal cord function
- 3 major types: Central cord syndrome, Brown-Séquard, and anterior cord syndrome
- Central cord syndrome:
- Most common of the incomplete spinal cord syndromes
- Classically occurs in elderly patients, with pre-existing cervical stenosis, who suffer a hyperextension injury in a fall
- Anterior cord syndrome:
- Most commonly associated with occlusion of the anterior spinal artery which can occur after aortic surgery or trauma. Other causes include hypotension and infection
- Brown-Séquard syndrome:
- Hemisection of the spinal cord, classically as a result of a penetrating injury
- Rarely unilateral cord compression
- Conus medullaris syndrome:
- Injury at the level of L1 or L2
- Causes include central disc herniation, neoplasm, and direct trauma
- Cauda equina syndrome:
- Injury to the nerve roots of the cauda equine and not the spinal cord itself
- Causes include central disc herniation and direct trauma
- Clinically, can resemble conus medullaris syndrome
Etiology
- Spinal cord syndromes result from localized disruption of neurotransmission and exhibit mixed motor and sensory deficits. The most common mechanism is trauma
- Patients with arthritis, osteoporosis, metastatic disease, or other chronic spinal disorders are at risk of developing spinal injuries as the result of minor trauma
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