Incomplete Cord Syndromes

This article is a stub.

See kunam et al for an open access review.

There are six patterns of deficit in the spinal cord:

• Ventral cord syndrome
• Central cord syndrome
• Dorsal cord syndrome
• Brown-Séquard syndrome
• Conus Medullaris Syndrome
• Cauda Equina Syndrome

Features

Summary of Incomplete Spinal Cord 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

• 

  Normal spinal cord

• 

  Ventral cord syndrome

• 

  Dorsal cord syndrome

• 

  Posterior spinal artery syndrome

• 

  Central cord syndrome

• 

  Brown Sequard syndrome

• 

  Multiple Sclerosis

See Also

• Cauda Equina Syndrome
• Conus Medullaris Syndrome

Literature Review

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,