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
|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|
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