Which of the following deficits below the level of injury is consistent with anterior cord syndrome?

  1. Loss of total sensation and motor function
  2. Bladder and bowel incontinence and loss of motor function
  3. Loss of motor function only
  4. Loss of vibration and position sensation and motor function
  5. Loss of pain and temperature sensation and motor function

 

 

 

 

 

 

 

 

Answer: E  Loss of pain and temperature sensation and motor functio

  • Anterior cord syndrome – most commonly occurs in hyperflexion injures where herniated vertebral discs or body fragments compress the anterior aspect of the spinal cord or anterior spinal artery. The anterior spinal artery supplies the anterior 2/3 of the spinal cord which is comprised of the spinothalamic tract containing pain and temperature sensory input and the corticospinal tract which carries descending voluntary motor signals.

  • Complete cord syndrome (transaction of the cord) results in complete loss of motor, sensation and autonomic  function below the level of lesion
  • Central Cord Syndrome–  this is seen in older patients with degenerative spinal disease and cervical spondylosis or traumatic with hyperextension mechanism (athletes), disc herniation, trivial trauma or hyperflexion. Findings of bilateral motor weakness upper > lower extremities; distal > proxima with variable sensory involvement.

  • Brown-Sequard syndrome–  hemisection caused by penetrating trauma most commonly, also blunt trauma, disc or bone herniation, hematoma and tumors or as a complication of decompression sickness. Ipsilateral loss of motor function, vibration and proprioception but contralateral pain and temperature

  • Cervical Cord Neurapraxia– transient quadriparesis or neurapraxia seen in axial loading injuries with flexion or extension (football players who lead with their head). Thought to be a “concussion” of the cervical spinal cord.