Cases Of Central Cord Syndrome Research Articles

Central cord syndrome from blast injury after gunshot wound to the spine: a case report and a review of the literature.

Central Cord Syndrome (CCS) is the most common of the spinal cord injury syndromes. Few cases have been presented with gunshot wound (GSW) as a cause of a central cord syndrome, and none, to our knowledge, has been presented without any evidence of central canal bullet/bone fragments. A 27-year-old male suffered two close-range gunshot wounds, one to the left neck and one to the left shoulder. CT scan showed C5 spinous process fracture and paraspinal muscle hemorrhage without evidence of central canal stenosis or bullet/bone fragments. Physical examination showed severe weakness and dysesthesias in bilateral upper extremities and mild weakness in bilateral lower extremities. Diagnosis of central cord syndrome was made. He was treated conservatively and started inpatient rehabilitation. Four months post injury, the patient had almost full recovery with only left proximal arm and bilateral distal hand weakness. Only four cases of CCS caused by GSW have been reported in the literature. Some suggested algorithms exist regarding the management of these patients, but still cases should be individualized depending on the specific nature of their presentation. The prognosis for patients with CCS tends to be favorable in regaining sensory, bladder, bowel, gross motor function and ambulation, but fine motor skills may remain impaired.

Traumatic central cord syndrome after blunt cervical trauma: a pediatric case report.

Traumatic central cord syndrome (CCS) is the most frequently encountered incomplete spinal cord injury (SCI). The patient presents weakness, which is usually greater in the upper extremities than in the lower extremities, secondary to damage to the cervical spinal cord and anatomic distribution of the corticospinal tracts. CCS is seen commonly after a hyperextension mechanism in older patients with spondylotic changes. There are few literature reports regarding CCS in pediatric patients. We present an unusual case of traumatic CCS in a pediatric patient. A 15-year-old male patient, victim of bullying at school, received cervical blunt trauma with a plastic tube. Within 3 h, the patient developed generalized weakness, which was greater in the upper extremities than in the lower extremities. Upon evaluation, the patient was found with marked upper extremity weakness compared to the lower extremities, with a Manual Muscle Test difference of 11 points. Imaging studies showed contusive changes in the C4-C7 central spinal cord. After rehabilitation therapies the patient gained 23 points in MMT at the day of discharge. Different etiologies of CCS have previously been described in pediatric patients. However, this is the first case that describes a bullying event with cervical blunt trauma and subsequent CCS. In this case, history and physical examination, along with imaging studies, helped in the diagnosis, but it is important to be aware of the possibility of SCI without radiographic abnormalities, as it is common in the pediatric population. CCS occurs rarely in pediatric patients without underlying pathology. Physicians must be aware of the symptoms and clinical presentation in order to provide treatment and start early rehabilitation program.

Computed tomographic angiography of anterior spinal artery in acute cervical spinal cord injury

In addition to spinal fracture and/or dislocation, acute traumatic spinal cord injury (SCI) includes neural tissue and vascular damage at the site of contusion. Vascular damage results in spinal cord ischemia, which is a key factor that contributes to secondary pathogenesis. There is a need to identify spinal cord ischemia secondary to anterior spinal artery (ASA) rupture in acute cervical SCI. After admission, 20 patients with cervical SCI, including 10 cases of central cord syndrome (CCS), four cases of brown-sequard syndrome (BSS) and six cases of tetraplegia (ASIA A), had computed tomographic angiography (CTA) of ASA performed on them. ASA rupture or occlusion was observed. The ASA was visualized in all 20 patients. No ASA rupture was found in CCS and BSS patients, even for sever blunt cervical fracture and dislocation tetraplegia patients, except one stab-wound patient. CTA provides the most detailed, highest resolution imaging of ASA in acute cervical SCI. ASA rupture is not commonly seen in acute blunt cervical SCI.

A Case of Central Cord Syndrome Caused by Intubation: A Case Report

Following intubation for respiratory distress, a 42 year-old female patient sustained a hyperextension injury which produced a central cord syndrome. This paper illustrates an unusual mechanism whereby a central cord syndrome was caused by pure hyperextension without high velocity force. (J Spinal Cord Med 1997; 20:230-232)