White cord syndrome of acute tetraplegia after anterior. Spinal cord anatomy, localization, and overview of spinal. In the case of anterior spinal cord syndrome, the insult is a vascular lesion at the anterior spinal artery. For this view, the dura and arachnoid membranes have been cut longitudinally and. Spine and spinal cord injuries san francisco general. Overview of spinal cord disorders neurologic disorders. Spinal cord anatomy and clinical syndromes sciencedirect. In most cases, symptoms will appear suddenly, but they. This article provides contemporary and practical knowledge about the most common vascular myelopathies. Overview of spinal cord disorders brain, spinal cord.
The distinctive patterns of myelopathy disorder of the spinal cord and radiculopathy disorder of spinal roots are a direct consequence of the striking anatomy of the spinal cord. In 1916, spiller 15, a neurologist, described two adolescent patients who presented with symptoms of tethered cord syndrome. Lower motor neuron lmn signs table 1 are found in a limb if some of its muscles are innervated by anterior horn cells lower motor neurons affected at the level of the spinal cord lesion. Mri of a patient with preexisting spinal stenosis who suffered a fall, which resulted in central cord syndrome.
Spinal cord syndromes present with typical signs and symp. Spinal cord infarction neurologic disorders msd manual. This may occur as a result of vascular or atherosclerotic disease in the elderly, or iatrogenic secondary to cross clamping of the aorta. Anterior and posterior cord syndromes the anterior spinal cord is the front section of the structure, and the posterior spinal cord is the back.
Partial spinal cord injury and syndromes wheelchair. The diagnosis of these diseases depends on the ability to recognize a limited number of distinctive syndromes. Central cord syndrome is the most common form of incomplete spinal cord injury characterized by impairment in the arms and hands and to a lesser extent in the legs. We describe this occurrence as a white cord syndrome because of the postoperative appearance of a large area of cord. Spinal cord syndromes are unique clinical presentations that localize lesions to the spinal cord by their pattern of anatomic dysfunction while implying their underlying etiology. A subset of scis has been grouped by their clinical presentation into 6 sci syndromes. Incomplete spinal cord syndromes are caused by lesions of the ascending or descending spinal tracts that result from trauma, spinal compression, or occlusion. Clinical syndromes resulting from incomplete spinal cord injury central cord syndrome brownsequard syndrome anterior cord syndrome conus medullaris syndrome cauda equina syndrome.
Brownsequard syndrome of the cervical spinal cord after. After a spinal cord injury, a persons sensory, motor and reflex messages are affected and may not be able to get past the damage in the spinal cord. Spinal cord syndromes associated with systemic lupus erythematous. Anterior cord syndrome anterior cord syndrome often occurs as a result of flexion injury, or due to injury to the anterior spinal artery. Spinal cord syndromes syndrome area affected spinal. The clinical presentation of a spinal cord injury depends on whether the injury is complete or spares selected fiber tracts. Spinal cord covered with pia mater lumbar enlargement ll to s3 conus medullaris segment filum terminale figure 71 spinal cord. Neurologic dysfunction due to spinal cord disorders occurs at the involved spinal cord segment see table motor and reflex effects of spinal cord dysfunction by segmental level and at all segments below it. The most frequent type is anterior spinal artery syndrome.
Spinal cord syndromes associated with systemic lupus. Incidence and outcomes of spinal cord injury clinical. The upper border of the conus medullaris is often not well defined. Posterior view, showing cervical and lumbar enlargements. The exception is the central cord syndrome see table spinal cord syndromes.
Differentiating tethered cord syndrome, neurocraniovertebral syndrome, and filum disease author. A number of clinically characterized spinal cord syndromes may develop as a result of the involvement of different portions of the spinal cord. Central cord syndrome has been reported to be diagnosed in 4 to 35%of patients with spinal cord injury 1216. Incidence and outcomes of spinal cord injury clinical syndromes. If you continue browsing the site, you agree to the use of cookies on this website.
Incomplete spinal cord syndromes are caused by lesions of the ascending or descending spinal tracts that result from trauma, spinal compression, or occlusion of spinal arteries. Anterior spinal artery syndrome commonest of the vascular syndromes of the cord. Complete cord syndrome is caused by lesions involving a whole spinal cord. The most frequent type is anterior spinal artery syndrome, presenting with bilateral weak. We report a case of complete loss of somatosensory evoked potentials sseps during elective acdf at c45 and c56 followed by postoperative c6 incomplete tetraplegia without any discernable technical cause. Diseases of the central nervous system are often confined to the spinal cord. Recent studies show an increase in the proportion of patients with central cord syndrome. Spinal cord anatomy and syndromes litfl ccc trauma.
Anatomy and localization of spinal cord disorders uptodate. To study neurological and functional outcomes after traumatic central cord syndrome tccs. The symptoms of a spinal stroke depend on what part of the spinal cord is affected and how much damage is done to the spinal cord. Williams j, speyer c, kreps d, costenbader k, bhattacharyya s. Central cord syndrome, anterior cord syndrome, posterior cord syndrome, and brownsequard syndrome are the most common types of incomplete spinal cord syndromes. Each of these syndromes has a variety of causes and clinical manifestations. Central cord syndrome radiology reference article radiopaedia. These syndromes are most common in people with nontraumatic sci as opposed to traumatic sci.
Spinal cord anatomy, localization, and overview of spinal cord syndromes article in continuum lifelong learning in neurology 143 june 2008 with 503 reads how we measure reads. Retrospective analysis of inpatient stay and prospective followup. Paraplegia and spinal cord syndromes clinical gate. Recent findings new studies have provided additional information on the risk factors and impact of neurologic monitoring on perioperative spinal cord. Comments are turned off autoplay when autoplay is enabled, a suggested video will automatically play next. Basic facts spinal cord injury occurs when there is any damage to the spinal cord that blocks communication between the brain and the body. The fibrous extension of the cord, the filum terminale. Diseases that affect the spinal cord are discussed separately. The spinal cord ends at the intervertebral disc between the first and second lumbar vertebrae as a tapered structure called the conus medullaris, consisting of sacral spinal cord segments. Anterior cord syndrome causes complete loss of movement, and pain and temperature loss, but it preserves light touch sensations. Brownsequard hemisection injury of the spinal cord ipsilateral loss of motor control contralateral loss of pain and temperature sensation below the level of the lesion best prognosis figure 241. Central cord syndrome is the most common type of incomplete spinal cord syndrome, usually the result of trauma, accounting for 10% of all spinal cord injuries. Occurs due to syphilitic arteritis, aortic dissection, atherosclerosis of aorta. When disorders such as cervical spondylosis and hereditary spastic paraparesis slowly damage the spinal cord, they can cause paralysis with increased muscle tone and muscle spasms called spastic.
Anterior spinal cord syndrome of unknown etiology ncbi. We present the cases of two yearold boys with anterior. Woolsey and young 55 estimate that there are 30 disorders of the spinal cord. Disorders of the spinal cord and roots practical neurology. To examine and compare demographics and functional outcomes for individuals with spinal cord injury sci clinical syndromes, including central cord ccs, brownsequard bss, anterior cord acs, posterior cord. Having established that a patients clinical presentation localises to the spinal cord andor roots, clues to the pathological diagnosis emerge from the timing of the symptoms. Central cord syndrome is the most common of the acute and incomplete syndromes. The spinal cord ends at the intervertebral disc between the first and second lumbar vertebrae as a tapered structure called the conus medullaris, consisting of sacral spinal cord. In summary, a working knowledge of the spinal cord s anatomy is critical in understanding the various presentations of the spinal cord syndromes.
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