SCI: Incomplete Lesions; Clinical Syndromes

Question 1

What is Brown-Sequard Syndrome and it presentation pattern?

Answer 1

From hemisection of the spinal (damage to one side)

Ipsilateral Side:
- Paralysis (Lateral Corticospinal tract)
- Sensory Loss; proprioception, light touch and vibratory sense (damage to the Dorsal Column).

Contralateral Side:
- Loss of pain and temperature (damage to the Lateral Spinothalamic Tract)

Question 2

What is the typical cause of Brown-Sequard Syndrome?

Answer 2

Penetration Wound: Gunshot or Stab

Question 3

What is Anterior Cord Syndrome and its presentation pattern?

Answer 3

Characterized by loss of motor function and loss of pain and temperature function below the level of the lesion.

(Corticospinal tract damage + Spinothalamic tract damage)

Question 4

What is the primary cause of Anterior Cord Syndrome?

Answer 4

Flexion injuries of the cervical spine. Leading to damage of the anterior cord, and/or its vascular supply of the anterior spinal artery.

Question 5

What is Central Cord Syndrome and its presentation pattern?

Answer 5

(Most common SCI syndrome.)

• UE involvement > LE involvement
• Complete preservation of sacral tracts.
• Typically recover the ability to ambulate.

Question 6

What is the primary cause of Central Cord Syndrome?

Answer 6

Hyperextension injuries to the cervical spine.

Question 7

Cauda Equina Injury and presentation.

Answer 7

Typically incomplete due to the great number of nerve roots.

• Impaired bowel and bladder function
• Saddle Anesthesia
• Can (but rarely) result in LE paralysis/paresis

Question 8

Is a Cauda Equina Lesion a UMN or LMN injury?

Answer 8

Lower Motor Neuron (LMN) Lesion, due to the Cauda Equina being peripheral nerves.