#centralcordsyndrome

[neurologyteachingclub]

Central cord syndrome For discussion of these images, follow 'Clinical neurology with KD' podcast episode five in Apple podcast, Spotify or Google podcast. Full notes are available on the neurologyteachingclub.com website. The spinal cord is damaged by a lesion starting from the centre of the cord, expanding outwards. Syringomyelia and intramedullary tumours like ependymoma are typical examples. The bladder fibres are located in the centre of the cord and are involved early. The exemption is syringomyelia, where bladder fibres are not involved early. After the bladder, the fibres involved are crossing over pain and temperature at that level in front of the central canal. This results in suspended pain and temperature loss at that level on both sides, with normal pain sensations above and below. The suspended sensory loss is a classical feature of an intramedullary lesion. There is dissociated sensory loss with pain involved but not touch and vibration. As the tumour increase in size, the corticospinal tract will be affected. In the corticospinal tract, the cervical fibres are medial, so they are involved first. The damage to anterior horn cells in the ventral horn can present as weakness and wasting of the upper limbs. As the lesion increase in size, the dorsal column and spinothalamic tract get involved. The sacral fibres are most laterally placed in the lateral spinothalamic tract and the last involved. #clinicalneurologywithkd #neurologyteachingclub #neurologypodcast #NTC #neurology #neurosciences #neuro #clinicalneurology #medicine #clinicalmedicine #kdpodcast #mbbs #medicos #doctors #neuroanatomy #casediscussion #medicineresidents #residency #medschool #futureneurologist #neuroimages #NEET #finalmbbs #neetpg #neetsuperspeciality #neetmedicine #eanneurology #syringomyelia #spinalcord #centralcordsyndrome https://www.instagram.com/p/CYoCGqoPcy2/?utm_medium=tumblr

[orthopedics]

A 40 year-old man sustains an AO Type C cervical spine injury from a high-energy motorcycle injury (top left). Subaxial cervical spine injury classification score of 9 (4-2-3). We operated on him after reducing the unilateral facet dislocation C4-C5 with application of skull traction (top right). The intervertebral disc shows cord compression at the level C5 consistent with clinical presentation on T1-weighted imaging (bottom left). Immediate postoperative radiograph of anterior decompression cervical fusion (middle). C2 lamina fracture was left alone. Bottom right picture shows fusion at 26 weeks postoperatively. Oswestry Disability Index greatly improved. #orthopaedics #aotrauma #aospine #centralcordsyndrome #adcf

[orthopedics]

A 48 year-old man sustains an AO Type C cervical spine injury from a high-energy motorcycle injury three months ago (left). He presents at the clinic with weak upper extremities and inability to walk despite good muscle grades on both lower limbs. Hoffman and Babinski appreciated. Subaxial cervical spine injury classification score of 10 (4-3-3). Anterior C6 corpectomy was facilitated by good exposure. The attempt to reduce the posterior elements was challenging. Used a 42mm three-level anterior cervical plate with 12mm screws and 2 cms. of mesh cage with bone graft for the C5-C7 fusion (right). Patient happy. Surgeon happy. #orthopaedics #aotrauma #aospine #centralcordsyndrome