Central cord syndrome

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Central cord syndrome
Synonyms	CCS
Pronounce	N/A
Specialty	Neurology, Neurosurgery
Symptoms	Weakness in the arms, loss of sensation below the site of injury
Complications	N/A
Onset	Sudden
Duration	Varies
Types	N/A
Causes	Trauma, hyperextension injury
Risks	Cervical spondylosis, older age
Diagnosis	MRI, CT scan
Differential diagnosis	Anterior cord syndrome, Brown-Séquard syndrome
Prevention	N/A
Treatment	Physical therapy, occupational therapy, surgery
Medication	N/A
Prognosis	Varies; often good with rehabilitation
Frequency	Most common incomplete spinal cord injury
Deaths	N/A

Central Cord Syndrome

Diagram of the spinal cord showing the central region affected in central cord syndrome.

Central cord syndrome is a type of incomplete spinal cord injury characterized by impairment in the arms and hands and, to a lesser extent, in the legs. It is the most common form of cervical spinal cord injury and is often associated with cervical spondylosis and hyperextension injuries.

Pathophysiology

Central cord syndrome occurs when there is damage to the central part of the spinal cord, typically in the cervical region. This damage often results from a hyperextension injury, which can compress the spinal cord against the vertebrae. The central part of the spinal cord contains the nerve fibers that control the arms, which is why the arms are more affected than the legs.

Clinical Presentation

Patients with central cord syndrome typically present with greater motor impairment in the upper extremities than in the lower extremities. There may also be varying degrees of sensory loss below the level of injury. The syndrome is more common in older adults due to the presence of cervical spondylosis, which can narrow the spinal canal and predispose individuals to injury.

Diagnosis

Diagnosis of central cord syndrome is primarily clinical, supported by imaging studies such as magnetic resonance imaging (MRI) or computed tomography (CT) scans. These imaging modalities can help identify the extent of spinal cord compression and any associated injuries.

Treatment

The management of central cord syndrome involves both surgical and non-surgical approaches. Initial treatment may include immobilization and corticosteroids to reduce inflammation. Surgical intervention may be necessary to relieve compression on the spinal cord, especially if there is significant spinal instability or if symptoms do not improve with conservative management.

Prognosis

The prognosis for central cord syndrome varies depending on the severity of the injury and the patient's age. Younger patients tend to have better outcomes, with many regaining significant function. However, older patients or those with severe initial deficits may have a more limited recovery.

See also

• Spinal cord injury
• Cervical spondylosis
• Hyperextension injury
• Incomplete spinal cord injury