An Overview of Spinal Lesions
∑ Pain and temperature nerves enter the spinal cord, ascend a few segments and then cross the centre of the cord to ascend in the contralateral anterior horn, so that lesions in the spinal cord cause contralateral deficits. Transverse section of the spinal cord Injury at a cervical level causes quadriplegia and total symmetrical anaesthesia. 7 rows†∑ Intrinsic disorders include spinal cord infarction, hemorrhage, transverse myelitis, HIV.
Disorders of the spinal cord. Spinal cord lesions. Spinal cord lesions usually produce upper motor neurone signs with associated sensory deficit see Fig.
Nerve roots at the level of the lesion may also be affected resulting in some lower motor neurone signs. Injury at a cervical level causes quadriplegia and total symmetrical anaesthesia. Injury at thoracic or lumbar levels causes paraplegia and bilateral symmetrical anaesthesia below the level of the lesion. Sensory : The sensory level, below which there is loss of cutaneous sensation, indicates the site of a spinal cord lesion.
Sphincter control : Loss of bladder and bowel control. Causes include fracture dislocation of vertebrae, penetrating trauma, transverse myelitis or compression due to a tumour.
Sensory: Below the level of the lesion there is ipsilateral vibration and proprioceptive loss, and contralateral loss of pain and temperature sensation. Light touch is often reduced. Causes include multiple sclerosis, trauma, tumour angioma and degeneration due to radiation.
Disease of the posterior columns causes an unsteady gait sensory ataxia due to loss of position sense in the legs and uncertainty of foot position. Sensation to light touch and proprioception are lost. Causes include:. There may be an associated peripheral neuropathy which may reduce or abolish tendon reflexes, masking the expected UMN findings.
It is characterised by shooting pains, with loss of proprioception, numbness or paraesthesia. Syringomyelia is a fluidfilled cavity in the spinal cord as sociated with ArnoldóChiari malformations, spinal cord tumours and trauma. Usually localised to a few segments, commonly affecting the cervical canal. Motor: Early anterior horn cells compressed at that level causing wasting and reduced reflexes; late corticospinal tracts involved, causing UMN signs below that level.
Sensory: Early decussating spinothalamic tracts affected, causing reduced pain and temperature sensation. Sensation in the lower limbs is preserved. Late posterior column involvement, when all levels below are affected. Motor: LMN signs, which may be unilateral ipsilateral to the lesion or bilateral.
Specific loss of these cells occurs in motor neurone disease see also below and poliomyelitis. The commonest pattern of MND affects the anterior horn cells and the lateral corticospinal tracts.
Patients often present with spastic quadriparesis, brisk reflexes and upgoing plantars UMN signsfasciculation may be present. With progression, muscle wasting and fasciculation may become more obvious. No what is the meaning of candy canes at christmas signs, although sensory symptoms may be reported. Motor disogder Flaccid paraplegia, urinary retention.
Sensory : Loss of pain and temperature sensation the dorsal column sensory pathways may be totally or only partly spared. It is associated with atherosclerosis and dissecting abdominal aortic aneurysm. BS Developed by Therithal info, Chennai. Toggle navigation BrainKart.
Home Medicine and disoeder Principles and practice of medicine and surgery Spinal cord lesions - Disorders of the sppinal cord. Spinal cord lesions usually produce upper motor neurone signs with associated sensory deficit. Disorders of the spinal cord Spinal cord lesions Disoredr cord lesions usually produce upper motor neurone signs with associated sensory deficit see Fig.
Transverse section of the spinal cord Injury at a cervical level causes quadriplegia and total symmetrical anaesthesia. Posterior columns Ahat of the posterior columns causes an unsteady gait sensory ataxia due to loss of position sense in the legs and uncertainty of foot position.
Central cord lesion syringomyelia Syringomyelia is a fluidfilled cavity in the spinal cord as sociated with ArnoldóChiari malformations, spinal cord tumours and trauma. Sensory: Early decussating spinothalamic tracts affected, causing reduced pain and temperature sensation, only in the affected segments or just below. Anterior horn cell syndrome Motor: LMN signs, which may be unilateral ipsilateral to the lesion or bilateral. Anterior spinal artery occlusion Motor : Flaccid paraplegia, urinary retention.
Migraine - CNS causes of headache. Tension headache - CNS causes of headache. Trigeminal neuralgia - CNS disprder of headache. Motor neurone disease. Spinal cord lesions - Disorders of the spinal cord. Spinal cord compression - Disorders what disorder causes lesions in the spinal cord the spinal cord. Syringomyelia and syringobulbia - Disorders of the spinal cord.
Transverse myelitis - Disorders of the spinal cord. Myotonic dystrophy - Muscular dystrophies. Myasthenia gravis - Neuromuscular junction disorders. Eaton-Lambert what is the average temperature on saturn in fahrenheit - Neuromuscular junction disorders.
Olfactory cauzes I lesion - Disorders of cranial nerves.
Jan 07, †∑ Multiple sclerosis is characterized by lesions in the CNS, particularly the brain and spinal cord. Spinal lesions can indicate MS, but sometimes they do ctcwd.com: Alex Snyder. Atlantoaxial subluxation and other craniocervical junction abnormalities may cause acute, subacute, or chronic spinal cord compression. Lesions that compress the spinal cord may also compress nerve roots or, rarely, occlude the spinal cordís blood supply, causing spinal cord infarction. May 22, †∑ A person with MS may have lesions in parts of the brain, spinal cord, or optic nerve. Limited research suggests that having these lesions on the spine may lead to .
Various lesions can compress the spinal cord, causing segmental sensory, motor, reflex, and sphincter deficits. Diagnosis is by MRI. Treatment is directed at relieving compression. Compression is caused far more commonly by lesions outside the spinal cord extramedullary than by lesions within it intramedullary.
Trauma eg, vertebral crush fracture with displacement of fracture fragments, acute disk herniation , severe bone or ligamentous injury causing hematoma, vertebral subluxation or dislocation.
It is occasionally due to abscess and rarely due to spontaneous epidural hematoma. Acute compression may follow subacute and chronic compression, especially if the cause is abscess or tumor.
Bony protrusions into the cervical, thoracic, or lumbar spinal canal eg, due to osteophytes or spondylosis, especially when the spinal canal is narrow, as occurs in spinal stenosis.
Compression can be aggravated by a herniated disk and hypertrophy of the ligamentum flavum. Less common causes include arteriovenous malformations and slow-growing extramedullary tumors. Atlantoaxial subluxation and other craniocervical junction abnormalities may cause acute, subacute, or chronic spinal cord compression.
Acute or advanced spinal cord compression causes segmental deficits, paraparesis or quadriparesis, hyporeflexia when acute followed by hyperreflexia, extensor plantar responses, loss of sphincter tone with bowel and bladder dysfunction , and sensory deficits.
Subacute or chronic compression may begin with local back pain, often radiating down the distribution of a nerve root radicular pain , and sometimes hyperreflexia and loss of sensation. Sensory loss may begin in the sacral segments. Complete loss of function may follow suddenly and unpredictably, possibly resulting from secondary spinal cord infarction.
Spinal percussion tenderness is prominent if the cause is metastatic carcinoma, abscess, or hematoma. Intramedullary lesions tend to cause poorly localized burning pain rather than radicular pain and to spare sensation in sacral dermatomes. These lesions usually result in spastic paresis. Spinal cord compression is suggested by spinal or radicular pain with reflex, motor, or sensory deficits, particularly at a segmental level. Image the spinal cord immediately if patients have sudden spinal or radicular pain with reflex, motor, or sensory deficits, particularly at a segmental level.
MRI is done immediately if available. If MRI is unavailable, CT myelography is done; a small amount of iohexol a nonionic, low osmolar radiopaque agent is introduced via a lumbar puncture and allowed to run cranially to check for complete CSF block. If a block is detected, a radiopaque agent is introduced via a cervical puncture to determine the rostral extension of the block. If traumatic bone abnormalities eg, fracture, dislocation, subluxation that require immediate spinal immobilization are suspected, plain spinal x-rays can be done.
However, CT detects bone abnormalities better. Treatment of spinal cord compression is directed at relieving pressure on the cord. Incomplete or very recent complete loss of function may be reversible, but complete loss of function rarely is; thus, for acute compression, diagnosis and treatment must occur immediately. If compression is due to a tumor, IV dexamethasone mg is given immediately, followed by 25 mg every 6 hours and immediate surgery or radiation therapy.
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Learn more about our commitment to Global Medical Knowledge. This site complies with the HONcode standard for trustworthy health information: verify here. Common Health Topics. Videos Figures Images Quizzes. Commonly Searched Drugs. Symptoms and Signs. Key Points. Spinal Cord Disorders. Test your knowledge. Numbness is defined as loss of sensation, either partial or complete.
Numbness can occur from dysfunction anywhere along the pathway from the sensory receptors up to the cerebral cortex. A patient with dysfunction in which of the following CNS areas is most likely to present with facial and body numbness on the same side, plus an inability to perceive multiple stimuli of the same type simultaneously? More Content. Click here for Patient Education. Acute compression develops within minutes to hours. It is often due to. Subacute compression develops over days to weeks.
It is usually caused by. A metastatic extramedullary tumor. Chronic compression develops over months to years. It is commonly caused by. MRI or CT myelography. Relief of compression. Neurologic deficits worsen despite nonsurgical treatment. An abscess or a compressive subdural or epidural hematoma is suspected. Spinal cord compression is usually secondary to an extrinsic mass. To relieve pressure on the cord, do surgery or give corticosteroids as soon as possible.
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