Flashcards in Cord compression Deck (26):
Name of the main spinal motor tract
Corticospinal tracts (anterior and lateral)
Where does the corticospinal tract decussate?
At the medulla- tract is ipsilateral
Signs of upper motor neurone lesion (4)
Muscle wasting not marked
Signs of lower motor neurone lesion (4)
Absent or reduced reflexes
Name of the sensory pathway carrying information relating to pain, temperature and crude touch
Where does the spinothalamic tract decussate?
At the spinal level
Name of the sensory pathway carrying information relating to proprioception, pressure and light touch
Dorsal column/medial lemniscus
Where does the dorsal column decussate?
Four causes of acute spinal cord compression (4)
Tumours (collapse or haemorrhage)
Three causes of chronic spinal cord compression (3)
Initial signs in acute cord transection
Spinal shock- flaccid arreflexic paralysis
Describe the symptoms of Brown-Sequard syndrome (3)
Ipsilateral motor level (UMN weakness)
Ipsilateral dorsal column level (proprioception, pressure, light touch)
Contralateral spinothalamic level (pain, temperature, crude touch)
How is sensory loss classically experienced in central cord syndrome?
"Cape-like" spinothalamic sensory loss, with preservation of the dorsal columns
What usually causes central cord syndrome?
Hyperflexion or extension injury to an already stenotic neck
How does central cord syndrome usually present?
Distal upper limb weakness
How is traumatic spinal cord damage treated? (4)
Decompress and stabilise
Commonest cause of cord compression
Management of spinal cord compression due to malignancy
Dexamethasone whilst considering further treatment e.g. radio, chemo, surgical decompression
What is syringomyelia?
Expansion of the central cord canal due to CSF blockage, causing slowly progressive sensory and motor symptoms
Symptoms of syringomyelia
Cape-like distribution of pain/temperature sensation loss
LMN signs in upper limbs
Spastic paraparesis of low limbs
What is a malformation commonly underlying syringomyelia?
Chiari malformation- extension of the lower part of the brain into the spinal cord
Signs suggestive of a root compression (radiculopathy)
Dermatomal distribution of sensory disturbance (pain/tingling/numbness)
LMN pattern of weakness for muscles innervated by the root
Below the level of a compressed root, what signs might there be? (2) What do these suggest?
UMN signs (spastic weakness, hyperreflexia, upgoing plantars)
These suggest cord compression starting below the radiculopathy
Neck flexion producing tingling down the spine- suggestive of cervical spondylosis
Worrying symptoms in suspected cord compression (3)