Board Review: Spinal Cord Syndromes

A 70-year-old woman presents after falling forward, causing her neck to bend backwards and hyperextend. She complains of burning sensation in both hands and weakness in his arms after a fall. Physical examination reveals 4/5 strength in both arms but otherwise no neurological deficits. Which of the following is the most likely diagnosis?

A. Anterior Cord Syndrome

B. Brown-Sequard Syndrome

C. Central Cord Syndrome

D. Complete Spinal Cord Syndrome

E. Cauda Equina Syndrome













Answer: C - Central Cord Syndrome

Mechanism: after fall or MVC resulting in neck hyperextension; elderly patients with DJD are more prone to bruising of ligamentum flavum with minor trauma.

Clinical: bilateral motor paresis where the upper extremities are affected more than the lower extremities; distal motor extremities affected more so than proximal; variable degree of burning paresthesias.

Anterior Cord Syndrome - complete loss of motor and pain/ temperature sensation below the lesion; from flexion or vascular injury; prognosis is poor.

Brown-Sequard Syndrome - from penetrating trauma; ipsilateral loss proprioception, motor and vibratory sensation with contralateral loss of pain and sensation.

Management: consult neurosurgery. steroids are no longer indicated for acute spinal cord injuries.