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Incomplete Cord Syndromes: Difference between revisions
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See kunam et al for an open access review.<ref>{{#pmid:29995620}}</ref> | See kunam et al for an open access review.<ref name=":0">{{#pmid:29995620}}</ref> | ||
There are six patterns of deficit in the [[Spinal Cord|spinal cord]]: | There are six patterns of deficit in the [[Spinal Cord|spinal cord]]: | ||
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*[[Conus Medullaris Syndrome]] | *[[Conus Medullaris Syndrome]] | ||
*[[Cauda Equina Syndrome]] | *[[Cauda Equina Syndrome]] | ||
== Features == | |||
{| class="wikitable" | |||
|+Summary of Incomplete Spinal Cord Syndrome Features<ref name=":0" /> | |||
!Type | |||
!Tracts Involved | |||
!Lesion Location | |||
!Common Causes | |||
!Clinical Features | |||
|- | |||
|Central - small lesion | |||
|Anterior commissure where STT fibres cross | |||
|Near the central canal | |||
|Syringomyelia, intra-medullary tumour, hyperextension injury in cervical spondylosis | |||
|Suspected sensory deficit, classic cape distribution in lesion of cervical cord | |||
|- | |||
|Central - large lesion | |||
|Bilateral STT, CST, dorsal columns (variable), autonomic centre, and anterior horn cells | |||
|Large central lesion | |||
|Syringomyelia, intra-medullary tumour, hyperextension injury in cervical spondylosis | |||
|Disproportionate motor (UMN type) and sensory deficits: greater in upper extremities than in lower extremities, LMN deficit at level of lesion (anterior horn cells), variable loss of proprioception, autonomic dysfunction | |||
|- | |||
|Ventral cord | |||
|Bilateral STT, CST, and autonomic center | |||
|Ventral two thirds of cord | |||
|Spinal cord infarction, trauma, multiple sclerosis, disk herniation | |||
|Loss of pain and temperature sensations, weakness, bladder dysfunction | |||
|- | |||
|Dorsal cord | |||
|l Predominately dorsal columns; large lesions involve bilateral CST and bilateral autonomic fibers (to variable degree) | |||
|Dorsal one-third of cord | |||
|Vitamin B12 deficiency, multiple sclerosis, tabes dorsalis, AIDS* myelopathy, epidural metastases | |||
|Loss of proprioception and vibration sensations, sensory ataxia with positive Romberg sign, variable weakness, bladder dysfunction | |||
|- | |||
|Brown-Sequard | |||
|Unilateral STT, CST, and dorsal columns | |||
|Hemicord lesion | |||
|Knife or bullet injury, multiple sclerosis, transdural migration of spinal cord | |||
|Ipsilateral weakness (UMN type) and loss of proprioception, contralateral loss of pain and temperature sensations, small band of LMN and sensory deficits at level of lesion | |||
|- | |||
|[[Conus Medullaris Syndrome|Conus medullaris]] | |||
|Distal spinal cord containing lumbosacral segment | |||
|Spinal cord at level of T12 through L2 vertebrae | |||
|Disk herniation, trauma, tumors | |||
|Bladder or rectal dysfunction, saddle anesthesia, paraparesis (mixed UMN and LMN types) | |||
|- | |||
|[[Cauda Equina Syndrome|Cauda equina]] | |||
|Lumbosacral nerve roots in spinal canal | |||
|Lesion compressing or involving nerve roots of cauda equinaย | |||
|Disk herniation, arachnoiditis, tumor, lumbar spine stenosis | |||
|Asymmetric multiradicular pain, leg weakness (purely LMN) and sensory loss, bladder dysfunction, areflexia | |||
|} | |||
==Gallery== | ==Gallery== | ||
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==See Also== | ==See Also== | ||
*[[Cauda Equina Syndrome]] | *[[Cauda Equina Syndrome]] | ||
*[[Conus Medullaris Syndrome]] | |||
==References== | ==References== | ||
<references/> | <references/> | ||
{{Reliable sources}} | {{Reliable sources}} | ||
[[Category:Spine]] | [[Category:General Spine]] | ||
[[Category:Spinal Cord Disorders]] |
Latest revision as of 20:36, 11 March 2023
This article is a stub.
See kunam et al for an open access review.[1]
There are six patterns of deficit in the spinal cord:
- Ventral cord syndrome
- Central cord syndrome
- Dorsal cord syndrome
- Brown-Sรฉquard syndrome
- Conus Medullaris Syndrome
- Cauda Equina Syndrome
Features
Type | Tracts Involved | Lesion Location | Common Causes | Clinical Features |
---|---|---|---|---|
Central - small lesion | Anterior commissure where STT fibres cross | Near the central canal | Syringomyelia, intra-medullary tumour, hyperextension injury in cervical spondylosis | Suspected sensory deficit, classic cape distribution in lesion of cervical cord |
Central - large lesion | Bilateral STT, CST, dorsal columns (variable), autonomic centre, and anterior horn cells | Large central lesion | Syringomyelia, intra-medullary tumour, hyperextension injury in cervical spondylosis | Disproportionate motor (UMN type) and sensory deficits: greater in upper extremities than in lower extremities, LMN deficit at level of lesion (anterior horn cells), variable loss of proprioception, autonomic dysfunction |
Ventral cord | Bilateral STT, CST, and autonomic center | Ventral two thirds of cord | Spinal cord infarction, trauma, multiple sclerosis, disk herniation | Loss of pain and temperature sensations, weakness, bladder dysfunction |
Dorsal cord | l Predominately dorsal columns; large lesions involve bilateral CST and bilateral autonomic fibers (to variable degree) | Dorsal one-third of cord | Vitamin B12 deficiency, multiple sclerosis, tabes dorsalis, AIDS* myelopathy, epidural metastases | Loss of proprioception and vibration sensations, sensory ataxia with positive Romberg sign, variable weakness, bladder dysfunction |
Brown-Sequard | Unilateral STT, CST, and dorsal columns | Hemicord lesion | Knife or bullet injury, multiple sclerosis, transdural migration of spinal cord | Ipsilateral weakness (UMN type) and loss of proprioception, contralateral loss of pain and temperature sensations, small band of LMN and sensory deficits at level of lesion |
Conus medullaris | Distal spinal cord containing lumbosacral segment | Spinal cord at level of T12 through L2 vertebrae | Disk herniation, trauma, tumors | Bladder or rectal dysfunction, saddle anesthesia, paraparesis (mixed UMN and LMN types) |
Cauda equina | Lumbosacral nerve roots in spinal canal | Lesion compressing or involving nerve roots of cauda equina | Disk herniation, arachnoiditis, tumor, lumbar spine stenosis | Asymmetric multiradicular pain, leg weakness (purely LMN) and sensory loss, bladder dysfunction, areflexia |
Gallery
See Also
References
Literature Review
- Reviews from the last 7 years: review articles, free review articles, systematic reviews, meta-analyses, NCBI Bookshelf
- Articles from all years: PubMed search, Google Scholar search.
- TRIP Database: clinical publications about evidence-based medicine.
- Other Wikis: Radiopaedia, Wikipedia Search, Wikipedia I Feel Lucky, Orthobullets,