Spinal cord injury: Difference between revisions

Revision as of 00:34, 14 August 2014

Doral columns
- Proprioception, vibration touch
- Decussation at medulla
Corticospinal Tract
- Voluntary motor
  - Upper extremity fibers more central, lower extremity fibers more lateral
- Decussation at medulla
Spinothalamic
- Pain, temp, touch
- Decussates one level above entry point to spinal cord

Higher lesions are a/w spinal shock and autonomic dysfunction
Priapism implies a complete injury
Sacral sparing excludes complete transection
- Perianal sensation, rectal tone, bulbocavernosus/cremasteric reflexes

Etiology
- Direct anterior cord compression
- Flexion of cervical spine
- Thrombosis of anterior spinal artery
Symptoms
- Complete paralysis below the lesion with loss of pain and temperature sensation
- Preservation of proprioception, vibration, and light touch
Prognosis poor

Etiology
- Hyperextension
- Disruption of blood flow to the spinal cord
- Cervical spinal stenosis
- Typically elderly patient with significant DJD (ligamentum flavum compresses cord, causing contusion to central portion of spinal cord)
Symptoms
- Quadriparesis (upper extremities > lower extremities)
- Some loss of pain and temperature sensation also greater in upper extremities
Prognosis good
Tx and work-up - consider IV methylprednisolone within 8 hrs of injury, surgery consultation, and cervical MRI

Etiology
- Transverse hemisection of spinal cord
- Unilateral cord compression
Symptoms
- Ipsilateral spastic paresis
- Loss of proprioception and vibratory sensation
- Contralateral loss of pain and temperature sensation
Prognosis good

Tintinalli

Authors:

@@ Line 34: / Line 34: @@
 **Disruption of blood flow to the spinal cord
 **Cervical spinal stenosis
+**Typically elderly patient with significant DJD (ligamentum flavum compresses cord, causing contusion to central portion of spinal cord)
 *Symptoms
 **Quadriparesis (upper extremities > lower extremities)