Orthopedics Book


Central Cord Syndrome

Aka: Central Cord Syndrome, Central Spinal Cord Syndrome
  1. See Also
    1. Complete Cord Syndrome
    2. Spinal Cord Hemisection (Brown-Sequard Syndrome)
    3. Anterior Cord Syndrome
    4. Posterior Cord Syndrome
    5. Spinal Cord Syndrome
    6. Cervical Spine Injury
  2. Epidemiology
    1. Most common Partial Cord Syndrome
  3. Pathophysiology
    1. Hyperextension of the Cervical Spine (e.g. fall onto face)
    2. Edema and Hemorrhage into the central cord (gray matter and lateral Corticospinal tracts)
    3. Images
      1. CordSyndrome.jpg
  4. Precautions
    1. Have a high index of suspicion in Trauma
    2. Findings may initially be subtle and mistakenly attributed to peripheral injury
  5. Causes
    1. Older patients (most common)
      1. Cervical Spondylosis
      2. Cervical SpineOsteoarthritis
    2. Athletes
      1. Hyperextension with ligamentum flavum buckling
    3. Other mechanisms
      1. Unrestrained in Motor Vehicle Accident
  6. Signs
    1. Bilateral motor weakness
      1. Upper extremities affected more than the lower extremities
      2. Distal extremities affected more than proximal extremities
    2. Sensory deficiency
      1. Variable
      2. Hyperesthesia may be present
  7. Imaging
    1. MRI Spine without contrast (preferred)
    2. CT Spine
      1. Typically performed as initial study in Trauma
      2. May demonstrate Fracture or spinal subluxation
      3. However, CT is unlikely to identify cord compression
  8. Management
    1. Consult Neurosurgery
    2. Decompression Surgery
      1. In acute Trauma-related cases, may result in better neurologic outcomes
      2. Anderson (2015) Neurosurgery 77(suupl 4):S15-32 [PubMed]
  9. Prognosis
    1. Better than with other Partial Cord Syndromes
  10. References
    1. Broder (2022) Crit Dec Emerg Med 36(3): 25
    2. Decker in Chorley and Bachur (2014) Overview of Cervical Spinal Cord Injuries..., UpToDate, Wolters-Kluwer
    3. Wagner (1997) Emerg Med Clin North Am 15:699-711 [PubMed]

Central Cord Syndrome (C0560651)

Definition (MSH) A syndrome associated with traumatic injury to the cervical or upper thoracic regions of the spinal cord characterized by weakness in the arms with relative sparing of the legs and variable sensory loss. This condition is associated with ischemia, hemorrhage, or necrosis involving the central portions of the spinal cord. Corticospinal fibers destined for the legs are spared due to their more external location in the spinal cord. This clinical pattern may emerge during recovery from spinal shock. Deficits may be transient or permanent.
Concepts Injury or Poisoning (T037)
MSH D020210
SnomedCT 282787000
Dutch central cord syndrome, Centrale-ruggenmergsyndroom, Syndroom, centrale-ruggenmerg-
French Syndrome central moelle, Syndrome central de la moelle épinière, Syndrome central de la moelle, Syndrome centro-médullaire, Syndrome centromédullaire, Syndrome syringomyélique
German Central Cord Syndrom, Chorda zentralis-Syndrom
Italian Sindrome del canale centrale midollare, Sindrome da lesione del midollo spinale centrale, Sindrome del midollo spinale centrale
Portuguese Síndrome central da medula espinhal, Síndrome da Medula Espinhal Central, Síndrome da Medula Espinal Central, Síndrome Medular Central
Spanish Síndrome de la médula espinal, síndrome de cordón espinal central (trastorno), síndrome de cordón espinal central, Síndrome del Cordón Central
Swedish Bröstryggmärgssyndrom
Japanese セキズイチュウシンショウコウグン, 脊髄中心症候群, 中心性脊髄症候群, 中心索症候群
Czech centrální syndrom míšní, Syndrom centrální míšní šedi
Finnish Sentraalinen selkäydinoireyhtymä
English Central Cord Injury Syndrome, Central Spinal Cord Syndrome, Central Cord Syndrome, Central Cord Syndrome [Disease/Finding], central cord syndrome, central spinal cord syndrome, central cord syndrome (diagnosis), Central cord syndrome, Central cord syndrome (disorder)
Polish Zespół części środkowej rdzenia
Hungarian Gerincvelői syndroma
Norwegian Sentromedullært syndrom
Derived from the NIH UMLS (Unified Medical Language System)

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