Central cord syndrome

Background

Spinal cord tracts

• Most common incomplete spinal cord injury

Etiology

• Hyperextension injury of cervical spine
• 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)

Clinical Features

• Quadriparesis (characteristically with worse function in the UL than in the LL)
• Possible loss of pain and temperature sensation, also greater in upper extremities

Differential Diagnosis

Spinal Cord Syndromes

• Complete spinal cord transection syndrome
• Anterior cord syndrome
• Central cord syndrome
• Brown-Séquard syndrome
• Epidural compression syndromes
  • Spinal cord compression (non-traumatic)
  • Cauda equina syndrome
  • Conus medullaris syndrome
  • Epidural abscess (spinal)
  • Epidural hematoma (spinal)

Management

• Good prognosis
• Tx and work-up - consider IV methylprednisolone within 8 hrs of injury, surgery consultation, and cervical MRI