Flashcards in Spinal Cord Compression Deck (21)
What will an UMN lesion cause?
Muscle wasting not marked
What will an LMN lesion cause?
What can cause acute spinal cord compression?
Tumours- haemorrhage or collapse
What can cause chronic spinal cord compression?
Degenerative disease- spondylosis
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
What is Brown-Sequard Syndrome?
Resulting condition from cord hemisection
What does cord hemisection effect?
Ipsilateral motor level
Ipsilateral dorsal column sensory level
Contralateral spinothalamic sensory level
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
What is the presentation of chronic spinal cord compression?
Same as acute except UMN signs predominate
What tumours can cause spinal cord compression?
Extradural- usually mets from lung, breast, kidney, prostate
Intradural- Extramedullary (meningioma, Schwannoma)
Intramedullary (astrocytoma, ependymoma)
How can tumours cause acute compression?
By collapse or haemorrhage
What occurs in degenerative disease to cause spinal canal stenosis?
Bulging of IV discs
Facet joint hypertrophy
Where can infection come from to cause compression?
Epidural abscess- bloodborne, staph, tuberculosis
What types of haemorrhage can cause compression?
What are some causes of spinal cord compression through haemorrhage?
What Ix are required to investigate trauma causing compression?
What should be given in trauma causing compression?
Methylprednisolone- bolus, 24 hr infusion
How should trauma causing compression be managed?
Decompress and stabilise- surgery, traction, external fixation
How could metastatic tumours causing compression be treated?
Depends on Patient and Tumour
Surgical decompression and stabilisation
How can haemorrhages causing compression be treated?