NEUROLOGY + NEUROSURGERY
CORD COMPRESSION
PromptCauses of cord compression and risk factors
ResponseMetastatic - History of cancer (lung, prostate, lymphoma)
Haematoma - Meds (anticoagulation/antiplatlet), Bleeding diathesis, liver failure
Acute disc herniation - Preceeding myelopathy/radiculopathy. Improvement when recumbent.
Infection/abscess - Fever, IVDU, immunosuppression (DM, Chemo, EtOH)
RA - Known hx of RA
Osteoporosis - previous crush #, long term steroid use, advanced age
Haematoma - Meds (anticoagulation/antiplatlet), Bleeding diathesis, liver failure
Acute disc herniation - Preceeding myelopathy/radiculopathy. Improvement when recumbent.
Infection/abscess - Fever, IVDU, immunosuppression (DM, Chemo, EtOH)
RA - Known hx of RA
Osteoporosis - previous crush #, long term steroid use, advanced age
PromptSpinal cord compression clinical features
ResponseNo prodrome
Examination
UMN - hyperreflexia, Hypertonia, spastic paralysis, upgoing plantars, disuse atrophy
Motor and Sensation impaired, sensory level
Fixed level
No respiratory muscle involvement unless above C5
bowel/bladder dysfunction - Bowel incontinence, bladder retention
MRI shows lesion
Normal CSF
Examination
UMN - hyperreflexia, Hypertonia, spastic paralysis, upgoing plantars, disuse atrophy
Motor and Sensation impaired, sensory level
Fixed level
No respiratory muscle involvement unless above C5
bowel/bladder dysfunction - Bowel incontinence, bladder retention
MRI shows lesion
Normal CSF
PromptCord compression management
ResponseSpine precautions, cervical immobilisation
Monitor ventilation parameters
Urgent MRI
Thorough documentation of neurologic examination
Discssion with appropriate teams
Monitor ventilation parameters
Urgent MRI
Thorough documentation of neurologic examination
Discssion with appropriate teams
- Spine surgery (ortho/neurosurg)
- Rad onc if malignant (?steroids also)
PromptUpper vs Lower motor neuron findings
(table from google)
(table from google)
Response