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C. Anterior Cord Syndrome

The document describes various spinal cord syndromes. It indicates that the information provided is consistent with central cord syndrome. Central cord syndrome is characterized by disproportionate weakness in the upper extremities compared to the lower extremities, with varying sensory loss. It typically occurs after hyperextension injuries in patients with preexisting cervical stenosis and results from vascular compromise of the central portions of the spinal cord. Recovery follows a pattern with the lower extremities recovering strength first and the hands recovering last.

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85 views1 page

C. Anterior Cord Syndrome

The document describes various spinal cord syndromes. It indicates that the information provided is consistent with central cord syndrome. Central cord syndrome is characterized by disproportionate weakness in the upper extremities compared to the lower extremities, with varying sensory loss. It typically occurs after hyperextension injuries in patients with preexisting cervical stenosis and results from vascular compromise of the central portions of the spinal cord. Recovery follows a pattern with the lower extremities recovering strength first and the hands recovering last.

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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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34. A 40-y.

o woman restrained driver is transported to the emergency department in full


spinal immobilization. She is hemodynamically normal and found to be paraplegic at the
level of T10. Neurologic examination also determines that there is loss of pain and
temperature sensation with preservation of proprioception and vibration. These findings are
consistent with the diagnosis of:
a. central cord syndrome
b. spinal shock syndrome
c. anterior cord syndrome
d. complete cord syndrome
e. brown-sequard’s syndrome
central cord syndrome is characterized by a disproportionately greater loss of motor strength
in the upper extremities than in the lower extremities, with varying degrees of sensory loss.
Usually this syndrome occurs after a hyperextension injury in a patient with preexisting
cervical canal stenosis (often due to degenerative osteoartritic changes), and the history is
commonly that of a forward fall that resulted in a facial impact. Central cord syndrome is
thought to be due to vascular compromise of the cord in the distrbution of the anterior spinal
artery, this artery supplies the central portions of the cord. Because the motor fibers to the
cervical segments are topographically arranged toward the center of the cord, the arms and
hands are the most severely affected.
Central cord syndrome may occur with or without cervical spine fracture or dislocation.
Recovery usually follows a characteristic paatern, with the lower extremities recovering
strength first, bladder function next, and the proximal upper extremities and hands last. The
prognosis for recovery in central cord injuries is somewhat better than with other incomplete
injuries.
Spinal shock refers to the flaccidity (loss of muscle tone) and loss of reflexes seen after spinal
cord injury. The “shock” to the injured cord may make it appear completely nonfunctional,
although the cord may not necessarily be destroyed.
Anterior cord syndrome is characterized by paraplegia and a dissociated sensory loss with a
loss of pain and temperature sensation. Dorsal column function (position, vibration, and deep
pressure sense) is preserved. Usually, anterior cord syndrome is due to infarction of the cord
in the territory supplied by the anterior spinal artery. This syndrome has the poorest prognosis
of the incomplete injuries.
Brown sequard syndrome result from hemisection of the cord, usually as a result of a
penetrating trauma. Although this syndrome is rarely seen, variations on the classic picture
are nor uncommon.

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