Complete transaction of spinal
Spinal epidural haematoma
Post vaccinial syndromes.
All ascending tracts from below and
descending tracts from above are interrupted.
• Affects motor sensory and autonomic
all sensations are affected.
Pin prick test is very valuable.
Sensory level is usually 2 segments below the
level of lesion.
Segmental paresthesia occur at the level of
Motor-paraplegia due to corticospinal tract.
First spinal shock-followed by hypertonic
Loss of abdominal and cremastric reflexes.
At the level of lesion LMN signs occur.
AutonomicUrinary retention and constipation.
Anhidrosis ,trophic skin changes, vasomotor
instability below the level of lesion.
Sexual dysfunction can occur.
• Due to damage to one lateral half of spinal
• Ipsilateral loss of proprioception due to post
• Contralateral loss of pain and temperature due
to .involvement of lateral spinothalamic tract.
• MOTOR-Ipsilateral spastic weakness due to
descending corticospinal tract involvement
• LMNsigns at the level of lesion.
• Caused by extramedullary lesions
• Usually caused by penetrating trauma or
CENTRAL CORD SYNDROME
• Most common cause is syringomyelia.others
hyperextension injuries of neck,intramedullary
• Associated with chiari type 1 and 2.and dandy
• Pain and temperature are affected.
• Touch and proprioception are preserved.
• Dissociative anaesthesia.
• Shawl like distribution of sensory loss.
• Upper limb weakness >lowerlimb
• Other features;
– Horners syndrome
– . Sacral sparing
– Neuropathic arthropathy of shoulder and elbow
– Prognosis is fair.
Occurs due to neurosyphilis,diabetes mellitus
Usually occurs 10 to 20 yrs after infection
Impaired position and vibration sense in LL
Tactile and postural hallucinations can occur.
Numbness or paresthesia are frequent
Positive rhomberg sign.
Positive sink sign
Positive lhermittes sign.
Abadie’s sign positive.
Absent knee and ankle jerk.(areflexia,hypotonia)
Abdominal and laryngeal crisis can occur.
miotic and irregular pupil not reacting to light.
Argyl robertson pupil
POSTERO LATERAL COLUMN
HTLV ASSOCIATED MYELOPATHY.
Paresthesia in feet
Loss of proprioception and vibration in legs
• positive rhomberg sign
• Bladder atony
• Corticospinal tract
,bilateral Babinski sign.
• Aids:associated dementia and spastic
bladder is present
• HTLV associated myelopathy;slowly
progressive paraparesis increase in csf igG
with antibodies to HTLV1.
ANTERIOR HORN CELL
• CAUSED BY SPINAL MUSCULAR
• weakness ,atrophy and fasciculations.
• Hypotonia,depressed reflexes.
• Muscles of trunk and extremities are
• Sensory system is not affected.
Ant horn cell and pyramidal tract
• Occurs in amytrophic lateral sclerosis.
• Affects the ant horn cells and corticospinal
• Both lmn and umn sign occur.
• Ant horn cell-paresis ,atrophy,and
• Corticospinal tract –paresis ,spasticity and
extensor plantar response.
• its usually unilateral with muscle
• Reflexes are often exaggerated.
• Bulbar and pseudo bulbar involvement
• Sensory system is not affected.
• Superficial reflex-abdominal reflex is
VASCULAR SYNDROMES OF
• Mostly occurs due to anterior spinal artery.
• conus medullaris is frequently involved.lies
opposite to vertebral bodies T12 and L1.
• Neck pain of sudden onset.
• Flaccid and areflexic paraplegia
Loss of pain and temperature.
Preservation of positon and vibration.
Spinal cord infarction usually occurs in
T1 to T4 segment.and L1
• Occurs due to syphilitic arteritis ,aortic
aorta,SLE ,AIDS,AV malformation
• POST SPINAL ARTERY SYNDROME
• Loss of proprioception and vibratory
• Pain and temperature is preserved.
• Absence of motor deficit.
• Contributes to 25%spinal cord injuries.
• Lies opposite to vertebral bodies of T12
• Caused by flexion distraction injuries and
• Both UMN and LMN deficits occur.
• Development of neurogenic bladder.
CAUDA EQUINA SYNDROME.
Begins at L2 disk space distal to conus
Flaccid lower extremities.
Knee and ankle jerk absent.
SENSORY-Asymmetrical sensory loss
Loss of sensation around
AUTONOMIC-Loss of bladder and bowel
Occurs due to acute disk herniation epidural
Usually caused by hyperflexion injuries.
Paralysis below the level of lesion.
Pain and temperature loss.
Dorsal column is preserved.
Prognosis is poor.
Area supplied by anterior spinal artery is