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  #1  
Old 07-18-2012
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Question Spinal cord syndrome

please give reason for your answer

A 35-year-old man is brought to the emergency department after he jumped from the fourth floor of a burning
building. His temperature is 36.9C (98.5F), blood pressure is 90/40, pulse is 90/min, and respirations are
20/min. Examination shows a fracture of the right tibia. He is conscious and his pupils are bilaterally equal
and reactive to light and accommodation. His neurological examination shows paraplegia, with loss of pain
and temperature in both legs but normal proprioception. Upper extremities do not show any neurological
deficits. Passive straight leg raising test is negative. A CT scan of the spine shows a burst fracture at the
level of the fourth thoracic vertebra W hich of the following is the most likely diagnosis?
A Central cord syndrome
B. Anterior cord syndrome
C. Brown Sequard syndrome
D. Acute disk prolapse
E. Cauda equine syndrome
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  #2  
Old 07-18-2012
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B. Anterior cord syndrome

Last edited by mbbs2010; 07-18-2012 at 02:49 PM.
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Old 07-18-2012
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from the vignette...the upper extremity findings are normal...hence it CANNOT be central cord syndrome

Burst fractures are associated with anterior cord syndrome...the corticospinal tracts in the spinal cord are more anteriorly placed and he has lost pain and temperature sensation (anterior spinothalamic tracts) which are anteriorly placed in the spinal cord.

Preservation of propioception - no damage to post spinal cord which RULES OUT brown sequard.

Negative straight leg raising RULES OUT disk prolapse

and of course no history of bowel or bladder incontinence RULES OUT cauda equina syndrome..

ANS is B...Anterior cord syndrome
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Old 07-18-2012
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Quote:
Originally Posted by stfidel View Post
from the vignette...the upper extremity findings are normal...hence it CANNOT be central cord syndrome

Burst fractures are associated with anterior cord syndrome...the corticospinal tracts in the spinal cord are more anteriorly placed and he has lost pain and temperature sensation (anterior spinothalamic tracts) which are anteriorly placed in the spinal cord.

Preservation of propioception - no damage to post spinal cord which RULES OUT brown sequard.

Negative straight leg raising RULES OUT disk prolapse

and of course no history of bowel or bladder incontinence RULES OUT cauda equina syndrome..

ANS is B...Anterior cord syndrome
yup ........ its .....B.........
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Old 07-18-2012
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Quote:
Originally Posted by stfidel View Post
and of course no history of bowel or bladder incontinence RULES OUT cauda equina syndrome..
is that so ? rules out ? i thought loss of bowel|bladder supports cauda equina but does not knew it rules out...thnaks for info
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Old 07-18-2012
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Quote:
Originally Posted by stfidel View Post
from the vignette...the upper extremity findings are normal...hence it CANNOT be central cord syndrome

Burst fractures are associated with anterior cord syndrome...the corticospinal tracts in the spinal cord are more anteriorly placed and he has lost pain and temperature sensation (anterior spinothalamic tracts) which are anteriorly placed in the spinal cord.

Preservation of propioception - no damage to post spinal cord which RULES OUT brown sequard.

Negative straight leg raising RULES OUT disk prolapse

and of course no history of bowel or bladder incontinence RULES OUT cauda equina syndrome..

ANS is B...Anterior cord syndrome
Wow...........Very impressive
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Old 07-27-2012
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Quote:
Originally Posted by stfidel View Post
from the vignette...the upper extremity findings are normal...hence it CANNOT be central cord syndrome

Burst fractures are associated with anterior cord syndrome...the corticospinal tracts in the spinal cord are more anteriorly placed and he has lost pain and temperature sensation (anterior spinothalamic tracts) which are anteriorly placed in the spinal cord.

Preservation of propioception - no damage to post spinal cord which RULES OUT brown sequard.

Negative straight leg raising RULES OUT disk prolapse

and of course no history of bowel or bladder incontinence RULES OUT cauda equina syndrome..

ANS is B...Anterior cord syndrome
NICE!
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