Acute traumatic non-haemorrhagic central cord syndrome

Case contributed by Dr Henry Knipe

Presentation

Fall in shower at home with headstrike. Weakness bilateral upper limbs (distal more than proximal) and hyperreflexia.

Patient Data

Age: 60 years
Gender: Female

No fracture or malalignment. No prevertebral soft tissue swelling. Posterior osteophytes and posterior longitudinal ligament ossification at the level of C5 results in severe canal stenosis.

Marked central canal stenosis at C5 and C6 secondary to OPLL. There is severe cord compression with high T2 signal from C4/5 to C6. No cord haemorrhage

High T2 signal is also demonstrated within the interspinous ligaments particularly at C4/5, C5/6 and C6/7, with a small amount of abnormal T2 signal also seen in the prevertebral soft tissues. No fractures or convincing disc injury is evident. The anterior longitudinal ligament, ligamentum flavum, and supraspinous ligament/nuchal ligament appear intact.

Case Discussion

The MRI findings are consistent with a hyperextension injury and accounts for the patient's central cord syndrome.

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Case information

rID: 39562
Case created: 9th Sep 2015
Last edited: 13th Jul 2017
Inclusion in quiz mode: Included

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