Spinal Cord Compression Flashcards Preview

Neurology > Spinal Cord Compression > Flashcards

Flashcards in Spinal Cord Compression Deck (21):
1

What will an UMN lesion cause?

Increased tone
Muscle wasting not marked
No fasciculation
Hyper-reflexia

2

What will an LMN lesion cause?

Decreased tone
Muscle wasting
Fasciculation
Diminished reflexes

3

What can cause acute spinal cord compression?

Trauma
Tumours- haemorrhage or collapse
Infection
Spontaneous haemorrhage

4

What can cause chronic spinal cord compression?

Degenerative disease- spondylosis
Tumour
Rheumatoid Arthritis

5

How does a complete cord transection present?

All motor and sensory modalities affected at particular level
Initially a flaccid arreflexic paralysis 'spinal shock'
UMN signs appear later

6

What is Brown-Sequard Syndrome?

Resulting condition from cord hemisection

7

What does cord hemisection effect?

Ipsilateral motor level
Ipsilateral dorsal column sensory level
Contralateral spinothalamic sensory level

8

How does central cord syndrome present?

Hyperflexion or extension injury to already stenotic neck
Predominantly distal upper limb weakness
'Cape-like' spinothalamic sensory loss
Lower limb power preserved
Dorsal columns preserved

9

What is the presentation of chronic spinal cord compression?

Same as acute except UMN signs predominate

10

What tumours can cause spinal cord compression?

Extradural- usually mets from lung, breast, kidney, prostate
Intradural- Extramedullary (meningioma, Schwannoma)
Intramedullary (astrocytoma, ependymoma)

11

How can tumours cause acute compression?

By collapse or haemorrhage

12

What occurs in degenerative disease to cause spinal canal stenosis?

Osteophyte formation
Bulging of IV discs
Facet joint hypertrophy
Subluxation

13

Where can infection come from to cause compression?

Epidural abscess- bloodborne, staph, tuberculosis
Surgery
Trauma

14

What types of haemorrhage can cause compression?

Epidural
Subdural
Intramedullary

15

What are some causes of spinal cord compression through haemorrhage?

Trauma
Bleeding diatheses
Anticoagulants
Arterio-venous malformations

16

What Ix are required to investigate trauma causing compression?

X-ray
CT
MRI

17

What should be given in trauma causing compression?

Methylprednisolone- bolus, 24 hr infusion

18

How should trauma causing compression be managed?

Immobilise
Investigate
Steroid
Decompress and stabilise- surgery, traction, external fixation

19

How could metastatic tumours causing compression be treated?

Depends on Patient and Tumour
Dexamethasone
Radiotherapy
Chemotherapy
Surgical decompression and stabilisation

20

How can haemorrhages causing compression be treated?

Reverse anticoagulation
Surgical decompression

21

How can degenerative disease causing compression be treated?

Surgical decompression +- stabilisation