Central spinal cord syndrome

Causes

• Syringomyelia
• Hydromyelia
• Hematomyelia
• Trauma
  • Hyperflexion injury
  • Hyperextension injury
  • Compression fracture
  • Fracture dislocation
• Intramedullary tumors

Clinical presentation

• Centripetally progressing pattern of bilateral symptoms/signs affecting upper extremity and upper trunk more than lower body
• Pain and thermal perception impairmen in a "vest-like" distribution often present earliest
• Relatively spared proprioception and vibration perception initially. Impairment of these modalities appears later
• Often spared sacral sensation even in later stages
• Flaccid weakness with arreflexia and muscle atrophy in the affected segments
• Spastic weakness with UMN signs below the affected segments
• Bladder dysfunction (retention)