Flashcards in Spinal Cord Compression Deck (38):
the corticospinal tract is a _ neurone tract?
where does upper motor neurone of corticospinal tract begin and end?
from motor cortex to anterior grey horn
decussates (crosses over) at medullary level
what is the lower motor neurone?
anterior horn cell
is corticospinal tract contralateral or ipsilateral?
what symptoms do you get with an upper motor neurone lesion?
muscle wasting not marked
what symptoms do you get with a lower motor neurone lesion?
what do spinothalamic tracts control?
this is a sensory pathway
is spinothalamic tracts contralateral or ipsilateral?
where do spinothalamic tract decussate (cross over to other side of CNS)?
what do dorsal columns control?
are dorsal columns contralateral or ipsilateral?
where do dorsal columns decussate (cross over to other side of CNS)?
what causes acute spinal cord compression?
tumour - haemorrhage or collapse
what causes chronic spinal cord compression?
degenerative disease - spondylosis, spinal cord stenosis
tumours - slowly compress
acute spinal cord compression can either be complete or incomplete, what does this mean?
complete - all motor and sensory modalities affected
what are symptoms of an acute cord transection?
initially a flaccid arreflexic paralysis - spinal shock
upper motor neurone signs appear later
what occurs in brown-sequard syndrome (cord hemisection)?
no ipsilateral motor level
no ipsilateral dorsal column sensory level
no contralateral spinothalamic sensory level
how does central cord syndrome occur?
hyperflexion or extension injury to already stenotic neck
what are the symptoms of central cord syndrome?
predominantly distal upper limb weakness
"cape-like" spinothalamic sensory loss
lower limb power and dorsal columns preserved
what are symptoms of chronic spinal cord compression?
same as acute except upper motor neurone signs predominate
what kind of trauma causes spinal cord compression?
high energy injury
especially mobile segments of spine (cervical)
what types of extradural tumours cause spinal cord compression?
usually mets - lung, breast, kidney, prostate
what types of intradural tumours cause spinal cord compression?
extramedullary - meningioma, schwannoma
intramedullary - astrocytoma, ependymoma
what causes spinal canal stenosis?
bulging of intervertebral discs
facet joint hypertrophy
what kind of infections can compress spinal cord?
epidural abscess - bloodborne staph or tuberculosis
surgery or trauma
what types of haemorrhage can compress spinal cord?
what can cause haemorrhage which suppresses spinal cord?
how do you treat spinal cord compression caused by trauma?
decompress + stabilise
what investigations should take place in spinal cord compression caused by trauma?
X-ray / CT
how do you decompress + stabilise spinal cord compression caused by trauma?
is the use of methylprednisolone in spinal cord compression caused by trauma disputed?
yes - this lecturer said probably no useful benefit
how do you treat spinal cord compression caused by tumour?
depends on pt and tumour
surgical decompression + stabilisation
how do you treat spinal cord compression caused by infection?
stabilisation where required
how do you treat spinal cord compression caused by haemorrhage?
how do you treat spinal cord compression caused by degenerative disease?
surgical decompression +/- stabilisation
is acute spinal cord compression an emergency?
chronic compression requires rapid treatment - true or false?