Spinal cord syndromes pdf

Learn More. A spinal cord injury encompasses a physical insult to the spinal cord. In the case of anterior spinal cord syndrome, the insult is a vascular lesion at the anterior spinal artery.

We present the cases of two year-old boys with anterior spinal cord syndrome, along with a review of the anatomy and vasculature of the spinal cord and an explanation of how a lesion in the cord corresponds to anterior spinal cord syndrome.

Anterior spinal cord syndrome ACS is a lesion affecting the anterior two-thirds of the spinal cord with loss of motor control below the lesion with intact crude sensation 1 , 2.

A true ACS results from a vascular lesion at the anterior spinal artery ASA resulting in ischemic injury to the respective area of the spinal cord. Patients present with complete motor defects below the lesion, along with sensory defects affecting pain and temperature sensation.

The intensity of the sensory deficits depends on the level of involvement in the spinal cord. Herein we present the cases of ACS in two year-old boys. At the end of a class period, a year-old boy was unable to get up from his chair. He was taken to the community hospital and found to have bilateral lower-extremity paralysis, without any signs or symptoms of infection.

Computed tomography of the head and laboratory results were within normal limits, and he was transferred to a tertiary care pediatric hospital. He had intact proprioception and vibration, with absent pain and temperature sensation. Diagnostic studies, including hematological workups and blood and spinal fluid cultures, were all negative except for elevated Factor VIII, Protein S, and Protein C, which was attributed to an acute inflammatory reaction.

Magnetic resonance imaging MRI of the spine showed increased T2 signal intensity in the anterior aspect of the spinal cord from approximately the T5 to T6 level through the mid-T8 level Figure 1. The patient was treated with a tapering schedule of high-dose corticosteroids. Upon stabilization, he was transferred to a pediatric specialty hospital for further rehabilitation and training.

MRI in case 1. An axial image shows increased T2 signal intensity in the anterior aspect of the spinal cord at the T6 level. His sensation to light touch and pinprick was altered below T5 with an absence of sensation around the perianal region. Over the course of his rehabilitation stay, the patient regained full control of his bladder function along with some lower-extremity muscle strength and was ambulating with moderate to maximum assistance with a walker.

His sensation to light touch and pinprick remained abnormal with inconsistent sensation to pinprick at the S2 and S3 levels. The inconsistency was due to the patient's comprehension of directions and poor attention to the lengthy evaluation process. Although the patient had pressure sensation on digital rectal exam, he lacked voluntary anal contraction and had an absent bulbocavernosus reflex.

His rehabilitation team consisted of physical therapy, occupational therapy, and psychology support under the supervision of a health care professional trained in caring for patients with a spinal cord injury. The patient and his family were educated on his diagnosis and associated complications. Journal of Neurology. View 1 excerpt, cites background. Neurological Aspects of Spinal Cord Tumors.

Spinal Cord Tumors. This chapter discusses neurological aspects of spinal cord tumors, including clinical symptoms and syndromes, examination techniques, and diagnostic modalities. An emphasis is placed on earlier … Expand. Spinal cord ischaemic injury while playing in a playground. BMJ Case Reports. Spinal cord infarction is extremely rare in children, and, similar to cerebrovascular infarcts, the pathogenesis is different from adults.

Spinal cord infarcts are most commonly reported in adults in … Expand. We report a case of a year-old woman with a subacute bilateral legs palsy due to venous congestion of the spinal cord caused by an arteriovenous fistula in the first lumbar vertebra which … Expand. Systemic thrombolysis in anterior spinal artery syndrome: what has to be considered? Journal of Thrombosis and Thrombolysis. View 1 excerpt. If there is high residual urine after bladder emptying, cystography and cystometry is done.

After 3 mths of bladder training, transurethral resection of the bladder neck or sphincterotomy may be done Callipers used to keep knees straight and feet plantigrade.

If flexion contracture develops, tenotomies are necessary. Painful flexion spasms are relieved by tenotomies, neurectomies, rhizotomies or intrathecal injection of alcohol.

Heterotopic ossification if interferes with function are excised once it is mature. If only deltoid and biceps are working c5,c6 , a posterior deltoid to triceps transfer using interposition tendon will replace elbow extension c7 fn If brachioradialis c6 is working, it can be transferred to become a wrist extensor. If extensor carpi radialis longus and brevis c7 are both available, one can be transferred into the flexor pollicis longus to provide active thumb flexion c8.

Constant enthusiasm and encouragement by doctors, physiotherapists and nurses is essential. Heather Carter Dec. Khuram Anayat Sep. Student at Jnv. Umair Mahmood Jul. KrinaRami Apr. Rohan Das Mar. Show More. Provenance and peer review Commissioned; externally peer reviewed. You will be able to get a quick price and instant permission to reuse the content in many different ways. Skip to main content. Log in via OpenAthens. Log in using your username and password For personal accounts OR managers of institutional accounts.

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