This is a basic article for medical students and other non-radiologists
Cauda equina syndrome (CES) is the compression of nerve roots within the cauda equina and a medical emergency that requires prompt diagnosis, investigation and treatment if the prognosis is to be anything other than bleak 1.
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This is a summary article; read more in our article on cauda equina syndrome.
Summary
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questions
- is it really cauda equina syndrome?
- main diagnostic symptoms are:
- bladder, bowel and/or sexual dysfunction
- saddle/perianal parasthesia
- symptoms develop over hours
- treatment needs to be prompt to minimise morbidity
- main diagnostic symptoms are:
- is there a history of lumbar spine disease?
- is there a history of cancer?
- is it really cauda equina syndrome?
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investigations
- cauda equina syndrome is an emergency
- urgent imaging is required and must be with MRI
- what lesion is causing the symptoms
- disc/vertebral fracture/metastatic deposit
- the level of the lesion
- physical examination should help determine this
- if there is multi-level disease
- what lesion is causing the symptoms
- if MRI is not available locally, the patient will need to be transferred
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making the request
- features of cauda equina syndrome
- expected level of disease (from physical examination)
- onset of symptoms
- urgency of imaging
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common pathology
- disc protrusion
- vertebral fractures/collapse
- malignant infiltration
- disc/vertebral infection