Spinal Cord Compression Flashcards
What will an UMN lesion cause?
Increased tone
Muscle wasting not marked
No fasciculation
Hyper-reflexia
What will an LMN lesion cause?
Decreased tone
Muscle wasting
Fasciculation
Diminished reflexes
What can cause acute spinal cord compression?
Trauma
Tumours- haemorrhage or collapse
Infection
Spontaneous haemorrhage
What can cause chronic spinal cord compression?
Degenerative disease- spondylosis
Tumour
Rheumatoid Arthritis
How does a complete cord transection present?
All motor and sensory modalities affected at particular level
Initially a flaccid arreflexic paralysis ‘spinal shock’
UMN signs appear later
What is Brown-Sequard Syndrome?
Resulting condition from cord hemisection
What does cord hemisection effect?
Ipsilateral motor level
Ipsilateral dorsal column sensory level
Contralateral spinothalamic sensory level
How does central cord syndrome present?
Hyperflexion or extension injury to already stenotic neck Predominantly distal upper limb weakness 'Cape-like' spinothalamic sensory loss Lower limb power preserved Dorsal columns preserved
What is the presentation of chronic spinal cord compression?
Same as acute except UMN signs predominate
What tumours can cause spinal cord compression?
Extradural- usually mets from lung, breast, kidney, prostate
Intradural- Extramedullary (meningioma, Schwannoma)
Intramedullary (astrocytoma, ependymoma)
How can tumours cause acute compression?
By collapse or haemorrhage
What occurs in degenerative disease to cause spinal canal stenosis?
Osteophyte formation
Bulging of IV discs
Facet joint hypertrophy
Subluxation
Where can infection come from to cause compression?
Epidural abscess- bloodborne, staph, tuberculosis
Surgery
Trauma
What types of haemorrhage can cause compression?
Epidural
Subdural
Intramedullary
What are some causes of spinal cord compression through haemorrhage?
Trauma
Bleeding diatheses
Anticoagulants
Arterio-venous malformations
