Spinal cord injury: Difference between revisions
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**Can only be assessed AFTER spinal shock has ended, ie after return or bulbocavernosus/cremasteric reflexes | **Can only be assessed AFTER spinal shock has ended, ie after return or bulbocavernosus/cremasteric reflexes | ||
**Sacral sparing manifests as intact great toe flexor function, perianal sensation, rectal motor function | **Sacral sparing manifests as intact great toe flexor function, perianal sensation, rectal motor function | ||
===[[Brown-Sequard syndrome]]=== | ===[[Brown-Sequard syndrome]]=== |
Revision as of 14:35, 4 February 2015
Background
Anatomy
- Dorsal columns
- Proprioception, vibration
- Decussation at medulla
- Corticospinal Tract
- Voluntary motor
- Upper extremity fibers more central, lower extremity fibers more lateral
- Decussation at medulla
- Voluntary motor
- Spinothalamic
- Crude touch, pressure, pain, temperature
- Decussates 1-2 levels above entry point to spinal cord
Spinal Cord Syndromes
Spinal Cord Syndromes
- Complete spinal cord transection syndrome
- Anterior cord syndrome
- Central cord syndrome
- Brown-Séquard syndrome
- Epidural compression syndromes
Complete spinal cord transection syndrome
- Higher lesions are a/w spinal shock and autonomic dysfunction
- Priapism implies a complete injury
- Sacral sparing excludes complete transection
- Can only be assessed AFTER spinal shock has ended, ie after return or bulbocavernosus/cremasteric reflexes
- Sacral sparing manifests as intact great toe flexor function, perianal sensation, rectal motor function
Brown-Sequard syndrome
- Etiology
- Transverse hemisection of spinal cord
- Unilateral cord compression
- Symptoms
- Ipsilateral spastic paresis
- Ipsilateral loss of proprioception, vibration but contralateral loss of pain, temperature (ie 'sensory dissociation')
- Good prognosis
Cauda Equina
- Epidural compression syndromes
- Spinal cord compression
- Cauda equina syndrome
- Conus medullaris syndrome
See Also
Source
- Tintinalli
- SAEM
- eMedicine