Another quick reference since these seem to show up on board exams from time to time. The bottom line in any suspected spinal cord injury is immobilization of the C spine with a semirigid collar, and keeping the patient supine. Steroids haven’t been proven to be necessarily beneficial, and MRI is the imaging test of choice.
Central cord syndrome
- Incomplete spinal cord injury
- Weakness in the arms with relative sparing of the legs with variable sensory loss
- Ischemia, hemorrhage, or necrosis involving the central portions of the spinal cord
- May be seen in recovery from spinal shock due to prolonged swelling around or near the vertebrae, causing pressure on the cord. Can be transient or permanent.
Anterior cord syndrome
- Associated with flexion type injuries to the cervical spine
- Damage to the anterior portion of the spinal cord and/or anterior spinal artery
- Below the level of injury motor function, pain sensation, and temperature sensation are lost
- Touch, position and vibration are intact
Posterior cord syndrome
- Posterior portion of the spinal cord and/or posterior spinal artery
- Loss of proprioception and epicritic sensation (e.g. stereognosis, graphesthesia) below the level of injury
- Motor, pain, and sensitivity to light touch are intact
Brown-Séquard syndrome
- Hemisectioned or lateral injury side (penetrating trauma)
- Ipsilateral side loss of motor function, proprioception, vibration, and light touch
- Contralateral side loss of pain, temperature, and crude touch sensations
