Spinal cord compression Flashcards
How many neurones make up the corticospinal tract?
2
Where does an upper motor neurone connect in the corticospinal tract
From the motor cortex to the anterior grey horn
Where does the corticospinal tract decussate?
At a medullary level
Is the corticospinal tract ipsilateral or contralateral?
Ipsilateral
Features of UMN lesion?
Increased tone
No fasciculation
Hyper-reflexia
Features of LMN lesion
Weakness
Atrophy
Hyporeflexia
Fasciculation
Where does the spinothalamic tract decussate?
At the spinal level
Is the spinothalamic tract ipsilateral or contralateral?
Contralateral
Where do the dorsal columns decussate?
Medullary level
Are the dorsal columns ipsilateral or contralateral
Ipsilateral
What functions do the dorsal columns carry?
Fine touch
Proprioception
Vibration
What functions does the spinothalamic tract carry?
Pain
Temperature
Crude touch
Causes of acute spinal cord compression?
Trauma
Tumours
Infection
Spontaneous haemorrhage
Causes of chronic spinal cord compression?
Degenerative disease-Spondylosis
Tumours
Rheumatoid arthritis
What is a cord transection?
A complete lesion knocking out all motor and sensory modalities
Signs of cord transection?
Initially flaccid arreflexic paralysis
UMN sign appear later.
What is the Brown-Sequard syndrome?
Cord hemisection
Ispilateral motor level
Ipsilateral and dorsal column sensory level
Contralateral spinothalamic sensory level
What is central cord syndrome?
Hyperflexion or extension injury to already stenotic neck?
Features of central cord syndrome?
Predom. distal upper limb weakness
Cape like spinothalamic sensory loss
Lower limb power preserved
Dorsal columns preserved
Presentation of chronic spinal cord compression
Same as acute but UMN signs predominate
How can spinal canal stenosis cause Spinal cord compression
Ostephytes
Bulging of IV discs
Facet joint hypertrophy
Subluxation
Treatment of spinal cord compression
Immobilise
X ray/CT
Methylprednisolone
Decompress and stabilise
