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Anterior cord syndrome Central cord syndrome Brown Sequard syndrome Posterior cord syndrome - Bilateral spastic paralysis - Bilateral spastic paralysis that - Ipsilateralloss ofmotor - Loss of vibration and - Loss of pain,temperature, light affects the upper limbs more than function and co-ordination proprioception touch and pressure, withsome the lower limbs - Contralateral loss ofpain - All other senses and motor sacral sparing - Cape distribution and temperature control remain - Preservationof proprioceptionand - Sacral sparing. Reason – damageto one half of the Reason = only damage to DCML vibration Reason – centrally affects the cord, the spinal cord Causes = posterior tumour or Reason = damageof spinothalamic and dermatomesat the edge are least Cause – knife penetrating injury syphilis. corticospinal tracts.Preservationof DCML affected, see image above. pathway. Cause – hyperextension of theneck, Causes = ischaemiato anterior spinal artery, more common with cervical stenosis. aortic aneurysm, dissection. Management of spinal cord injuries - ABCDE approach. - If there is Spinal pain/ confusion / motorweakness / sensory abnormalities / past spinal problems, carry out full in-line spinal Cauda equina syndrome Spinal cord immobilisation. Presentation - Assess high/ low risk using Canadian C-spine rule forcervical and - Back pain with radicular leg pain. pathologies - Reduced perianal (saddle) sensation nice guidelinestfor thoracic/ lumbar ByndegorRamage - Morphine = 1 line analgesia for spinal injury. - Pooranal tone. Fact checked by - CT =1 line if spine injury is highly suspected, ifthere is a - Incontinence/retention Shla di a iom Joi a neurological abnormality preform MRI after CT. - Paralysis +- sensory loss. - Refer to specialized spinal team. Causes = most commonly prolapse orherniationof n lumbardiscs -Autonomic dysreflexia Management = Do a PR exam to check for anal tone. - Occurs inthose with spinal lesions above T6 – the sympathetic If suspectedMRI within 4 hours and referralto outflow neurosurgery. Treatedwith spinal decompressionin - Patient may have a headache, anxiety, sweating, blotchy skin surgery. above the lesion. - Results in vasoconstriction and hypertension that can cause Cord compression seizures/ intracranial haemorrhage, becausethe sympathetic Presentation– Root pain with lower motor neuron response cannot pass down the spinal c rd. signs at the level of the lesion andupper motor - Most commonly caused by a blocked catheter. neuron signs with sensory changes below the leson. - Treatment= sit the patient upright and give nifedipine with Causes = disc prolapse, tumour, abscess and glyceryl trinitrate. haematoma.