No abstract available.
Central Cord Syndrome ; Spinal Cord Diseases* ; Spinal Cord Ischemia

Atlantoaxial dislocations usually present with fatal brain injury, but rarely with clinical problems. With the development of newer imaging techniques, as well as improved preoperative and perioperative care, the likelihood of survival from an atlantoaxial dislocation has increased. Survivors usually suffer incomplete neurological deficits, including Brown-Sequard syndrome or central cord syndrome. The authors describe a distractive atlantoaxial dislocation, with neurological sequelae, in a younger patient who had been involved in a car accident. This case was treated surgically, but the patient suffered paraplegia due to thoracic myelopathy.
Arthrodesis ; Brain Injuries ; Brown-Sequard Syndrome ; Central Cord Syndrome ; Dislocations* ; Humans ; Paraplegia ; Perioperative Care ; Spinal Cord Diseases ; Survivors

Mongolism, which represents about 5% to 10% of all cases of mental deficiency, is a disease entity in which the mental development is associated in a unique way with a large number of physical defects including central nervous system. Tishler and Martel(1965) directed attention to anomalies of the cervical portion of the spine in mongologid patients. Ligament laxity or malformation of the transverse atlanta ligament may allow the CI vertebra to subluxate forward with or without spinal cord compression. The most proper management is reduction by skeletal traction and posterior spinal fusion(C1-2, C1-3, Occiput-C2).
Central Nervous System ; Child* ; Dislocations* ; Down Syndrome ; Humans ; Intellectual Disability ; Ligaments ; Spinal Cord Compression* ; Spinal Cord* ; Spine ; Traction

OBJECTIVE: The aim of this study was to identify factors influencing the degree of neurological injury, show the natural course of recovery, and evaluate the relationship between degree of neurological injury and functional recovery from traumatic central cord syndrome. METHOD: We reviewed 15 patients retrospectively and investigated their demographic and treatment data. Initial ASIA motor scales and functional recovery at 4 weeks and 8 weeks after injury were analyzed. RESULTS: The age of patients showed significant correlation with degree of neurological injury (r= 0.55145, p<0.05) while mechanism of injury, surgical intervention and gender difference showed no correlation. Only 2 patients (13.3%) ambulated independently at initial period but subsequently 13 patients (86.7%) at 8 weeks. The number of patients who independently voided increased from 2 (13.3%) to 11 (73.3%) during the 8 weeks. Early ASIA motor score differed significantly according to the degree of functional recovery of bladder and ambulation in 4 weeks, 8 weeks after injury (p<0.05). CONCLUSION: Only the age of patients related to the initial neurologic severity. Most patients regained their bladder and ambulatory functions considerably within 8 weeks, and the degree of early neurological injury by ASIA motor scale reflected the degree of functional recovery in 4 and 8 weeks after injury.
Asia ; Central Cord Syndrome* ; Humans ; Intraoperative Complications ; Retrospective Studies ; Spinal Cord Injuries ; Urinary Bladder ; Walking ; Weights and Measures

OBJECTIVE: Ossification of the posterior longitudinal ligament (OPLL) is a degenerative disorder of the spine which is related to cervical compressive myelopathy. We studied patients with central cord syndrome (CCS) to explore the implication of OPLL on clinical features and functional outcomes of CCS. METHOD: A retrospective study was conducted on 26 patients with CCS between 1998 and 2003. Demographic characteristics, mechanisms of injury, neurological impairments, main functional outcomes, and complications were identified. Clinical features and outcomes were compared between OPLL and non-OPLL group. RESULTS: Twenty patients with CCS had OPLL (12/17 with traumatic and 8/9 with non-traumatic CCS). The initial ASIA motor score of OPLL and non-OPLL patients was 67.8 and 65.3 and, at discharge, 82.8 and 78.5. There were no significant differences in gait, bladder management, length of stay, discharge disposition, and major complications between OPLL and non-OPLL group. Among OPLL patients, non- traumatic CCS patients showed higher ASIA motor score at discharge and had a tendency of better functional outcome than traumatic CCS patients. CONCLUSION: OPLL was commonly observed in CCS patients. Mechanism of injury rather than the presence of OPLL was a significant determinant of clinical features or functional outcomes of CCS.
Asia ; Central Cord Syndrome* ; Gait ; Humans ; Length of Stay ; Longitudinal Ligaments* ; Retrospective Studies ; Spinal Cord Compression ; Spine ; Urinary Bladder

The following report is a case of central cord syndrome in a seven-year-old girl. There was no history of major trauma except instances of standing on her head. Plain x-rays and CT myelography of the cervical spine revealed no abnormalities. Although she was apneic for 12 days and quadriparetic, the patient recovered and was able to walk on the 24th hospital day. Since central cord syndrome as a result of standing on head is unusual in children with a normal cervical spine, the arthors decided to report the above described case for medical interest.
Central Cord Syndrome* ; Child* ; Female ; Head* ; Humans ; Myelography ; Spinal Injuries ; Spine

Cruciate paralysis, an unusual clinical entity, is "frequently undiagnosed or misunderstood", and can simulate the acute cervical central-cord injury syndrome. This rare injury pattern is characterized by weakness of upper extremities with little or no compromise of lower limb function following trauma to the superior cervical cord. The pattern of injury and clinical findings support selective damage to the corticospinal tract or upper motor neurons subserving upper limb function with the pyramidal decussation. Authors experience a case of curciate paralysis due to type 2 odontoid fracture and atlas dislocation.
Central Cord Syndrome ; Dislocations* ; Lower Extremity ; Motor Neurons ; Odontoid Process* ; Paralysis ; Pyramidal Tracts ; Upper Extremity

OBJECTIVETo evaluate the effect of staged surgical treatment on central cord syndrome of the cervical spine.

METHODSA retrospective analysis was conducted in 36 cases of central cord syndrome of the cervical spine treated with staged surgery. The patients (aged 50 to 79 years, mean 56.9 years) were divided into group A (50 to 64 years old, n=20) and group B (above 65 years old, n=16), and each group was further divided into 2 subgroups according to the range of decompression in the second stage, namely A1, B1 and A2, B2. ASIA motor score (AMS) was analyzed before the first-stage surgery, before the second-stage surgery and at the last follow-up after the second-stage surgery.

RESULTSAll the surgeries were performed successfully. The patients were followed up for 12 to 32 months (mean 18.4 months) after the second-stage surgery. After the first-stage surgery, the AMS was 75.8-/+14.6 in group A, 73.2-/+13.1 in group B, 78.5-/+10.2 in group A1, 76.8-/+9.5 in group A2, 72.2-/+12.6 in group B1 and 77.4-/+18.3 in group B2. The AMS at the last follow-up was 90.7-/+10.5 in group A, 89.5-/+12.4 in group B, 91.3-/+13.2 in group A1, 90.7-/+14.8 in group A2, 88.5-/+11.2 in group B1 and 92.4-/+13.6 in group B2. There was no significant difference between groups A and B or between the subgroups A1 and A2 and groups B1 and group B2. The AMS was 75.8-/+14.6 after the first-stage surgery and 90.7-/+10.5 at the last follow-up in group A, significantly higher than those in group B (73.2-/+13.1 and 89.5-/+12.4, respectively, P<0.05).

CONCLUSIONStaged surgery is effective for treatment of central cord syndrome of the cervical spine, and the effect of the surgery is not related to the patients' age or the range of decompression.

A 44-year-old woman with progressive cervical myelopathy and central cord syndrome was noted to have an extensive cervical intramedullary contrast-enhancing lesion on magnetic resonance imaging (MRI). The lesion resembled a spinal astrocytoma or ependymoma that required surgical intervention. She was subsequently diagnosed to have neuromyelitis optica (NMO), a rare idiopathic inflammatory demyelinating disorder, when the clinical examination revealed left optic atrophy. This was confirmed by a test showing seropositivity for NMO-immunoglobulin (IgG). Disease control was achieved with corticosteroids and immunosuppressive therapy. We report a rare case of a patient with NMO who had MRI features that could have easily led to the condition being misdiagnosed as a spinal cord tumor. The importance of careful history taking, awareness of typical radiological findings and the usefulness of serum NMO-IgG as a diagnostic tool are emphasized.
Adrenal Cortex Hormones ; Adult ; Astrocytoma ; Central Cord Syndrome ; Demyelinating Diseases ; Ependymoma ; Female ; Humans ; Magnetic Resonance Imaging ; Neuromyelitis Optica* ; Optic Atrophy ; Spinal Cord Diseases ; Spinal Cord Neoplasms*

PURPOSE: The purpose of this study was to determine the direction for treatment and to evaluate factors influencing improvement by comparison of neurologic and functional outcomes of surgical treatment and conservative treatment for traumatic central cord syndrome. MATERIALS AND METHODS: A total of 28 patients, who were available for follow-up for at least more than one year from January 2005 to December 2008, who were diagnosed as traumatic central cord syndrome were analyzed retrospectively. Fifteen patients underwent surgical treatment (group 1), and 13 patients received conservative treatment (group 2). Maximum canal compromise (MCC), and maximum spinal cord compression (MSCC) were used for radiologic assessment, and American Spinal Injury Association (ASIA) motor score, Japanese Orthopaedic Association (JOA) score, and neck disability index (NDI) were used for assessment of functional outcomes. RESULTS: The mean MCC was 47.2%, mean MSCC was 20.0%, and mean ASIA motor scale was 92.0 (group 1: 92.9, group 2: 90.9) at the final follow-up. The mean JOA score was 12.8 (group 1: 14.0, group 2: 11.4) and mean NDI was 25.0 (group 1: 25.7, group 2: 24.3) at the final follow-up. CONCLUSION: It is concluded that if a patient with traumatic central cord syndrome is young, with a high energy injury combined with fractures, and has severe spinal compression and mild initial neurologic defect, early surgical treatment would be needed as soon as possible.
Asia ; Asian Continental Ancestry Group ; Central Cord Syndrome* ; Follow-Up Studies ; Humans ; Neck ; Retrospective Studies ; Spinal Cord Compression ; Spinal Cord Injuries ; Spinal Injuries ; Treatment Outcome