An Old aged patient sustained spinal cord injury? due to a fall and clinically characterized by isolated loss of proprioception and vibratory sensation. As is common for only one side of the cord. The diagnosis is
Correct Answer: Posterior cord syndrome
Description: (D) Posterior cord syndrome # Posterior cord syndrome (posterior spinal artery syndrome) is a rare syndrome associated with spinal cord injury. It is caused due to a lesion in the posterior column of spinal cord or occlusion of the posterior spinal artery.> The syndrome is clinically characterized by isolated loss of proprioception and vibratory sensation. As the posterior arteries are paired, it is common for only one side of the cord to be involved.> Central Cord Syndrome (CSS) is the most common type of incomplete spinal cord injury, accounting for -10% of all spinal cord injuries. As the name implies, this syndrome is the result of a contusion of the central portion of the cervical spinal cord.> Patients present with upper limb weakness, urinary retention (due to bladder dysfunction) and sensory loss below the level of the injury. The upper extremities are classically more affected than the lower extremities, with motor function more severely impaired than sensory function.> Anterior cord syndrome (Beck's syndrome or anterior spinal artery syndrome) is a clinical subset of spinal cord injury syndromes, due to ischaemia/infarction of the anterior two-thirds of the spinal cord, typically sparing posterior third.> Clinical presentation: Complete motor paralysis below the level of the lesion due to involvement of corticospinal tracts> Loss of pain and temperature at and below the level of injury due to involvement of lateral spinothalamic tract> intact 2-point discrimination, proprioception and vibratory senses due to intact posterior column> Autonomic dysfunction: Orthostatic hypotension bladder and bowel dysfunction and sexual dysfunction may arise depending on the level of the lesion.> Brown-Sequard syndrome (Hemiparaplegic syndrome, hemiplegia et hemiparaplegia spinalis, or spinal hemiparaplegia) is caused by damage to one half of the spinal cord, resulting in paralysis and loss of proprioception on the same (or ipsilateral) side as the injury or lesion, and loss of pain and temperature sensation on the opposite (or contralateral) side as the lesion.# Pure Brown-Sequard syndrome is associated with the following:> Interruption of the lateral corticospinal tracts: Ipsilateral spastic paralysis below the level of the lesion Babinski sign ipsilateral to lesion Abnormal reflexes and Babinski sign may not be present in acute injury.> Interruption of posterior white column: Ipsilateral loss of tactile discrimination, vibratory, and position sensation below the level of the lesion Interruption of lateral spinothalamic tracts: Contralateral loss of pain and temperature sensation. This usually occurs 2-3 segments below the level of the lesion.
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