Central cord syndrome

Central cord syndrome 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.

Most often central cord syndrome occurs in older individuals with underlying cervical spondylosis. However, it may also be seen in younger persons who sustain trauma to the cervical spine, for example during forceful football tackling such as when a player "spears" another with their head. 

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.

Central cord syndrome by definition primarily affects the centre of the spinal cord and is frequently haemorrhagic.

A hyperextension cervical injury is the most common mechanism for central cord syndrome, however, it can be seen with other mechanisms including flexion. Occasionally it may be associated more chronically with syrinx and/or intramedullary spinal cord tumours 8.

May be normal, show spondylosis, acquired/congenital canal stenosis, or fracture. The presence of an extension teardrop fracture should be a warning sign.

Findings depend upon the severity of trauma and presence of pre-existing canal stenosis, following features can be seen 11:

  • T1:  the affected region is usually of isointense signal compared to rest of cord
  • T2: increased signal centrally within the cord at the affected level (oedema/contusion)

Central cord syndrome was first described by R C Schneider et al. in 1954 1.

Share article

Article information

rID: 17518
Section: Syndromes
Synonyms or Alternate Spellings:
  • Acute traumatic central cord syndrome (ATCCS)
  • ATCCS
  • Central Cord Syndrome (CCS)
  • Central cord syndrome (CSS)
  • Acute traumatic central cord syndrome

Support Radiopaedia and see fewer ads

Cases and figures

  • Drag
    High central cord...
    Case 1
    Drag here to reorder.
  • Drag
    Case 2
    Drag here to reorder.
  • Updating… Please wait.
    Loadinganimation

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.