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Cord Disease (Syringomyelia (Cardinal Signs (Dissociated Sensory Loss…
Cord Disease
Syringomyelia
Characteristics
- Syrinx: tubular cavity in central canal of the cord.
- Symptoms may be static for yrs but then worsen fast
e.g. on coughing, sneezing as ↑ pressure → extension
- Commonly located in cervical cord
Syrinx expands ventrally affecting:
- Decussating spinothalamic neurones
- Anterior horn cells
- Corticospinal tracts
Causes
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Secondary to cord trauma, myelitis, cord tumours and AVMs
Cardinal Signs
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Preserved touch, proprioception and vibration.
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- Wasting/weakness of hands ± Claw hand
- Loss of reflexes in upper limb
- Charcot joints: shoulder and elbow
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Cord Compression
Cauda Equina Lesions
Pain
- Back pain
- Radicular pain down legs
Weakness
Bilateral flaccid, areflexic lower limb weakness
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Sphincters
- Incontinence / retention of faeces / urine
- Poor anal tone
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Causes
- Trauma: vertebral #
- Infection: epidural abscess, TB
- Malignancy: breast, thyroid, bronchus, kidney, prostate
- Disc prolapse: above L1/2
Ix
- MRI is definitive modality
- CXR for primaries
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Anterior Spinal Artery / Beck’s Syndrome
Infarction of spinal cord in distribution of anterior spinal artery: ventral 2/3 of cord.
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