Quadriplegia is caused by damage to the brain or spinal cord at a high cervical level (C1-C5). It can result from traumatic spinal cord injury, infection, tumors, or vascular accidents affecting the spinal cord in the neck region. Quadriplegia is classified as complete or incomplete based on the preservation of motor and sensory function below the neurological level according to the American Spinal Injury Association scale. Management involves immobilization, imaging, steroids, surgery if needed for decompression, and long-term rehabilitation and physiotherapy.

1. TOPIC
QUADRIPLEGIA

3. Quadriplegia is caused by damage to the brain or the spinal cord at a high level
at lower Medulla, at level of crossing over of motor fibres , or direct injury at C1-
C5 levels
Pathophysiologically
1) Direct spinal cord injury
eg Traumatic spinal cord injury
a) Complete spinal cord lesion
b) Incomplete spinal cord lesion
2)Posterior circulation infract extending into high up spinal cord
3)Infective processes affecting cords in high up cirvival levels eg Potts spine
4)Neoplastic destruction of cervical cord at high level C1-C5
5)Ant spinal artery infraction at higer level C1-C5

4. Spinal cord injuries are classified as complete and incomplete by
the American Spinal Injury Association (ASIA)
American Spinal Injury Association Impairment Scale[2]
A Complete
No motor or sensory function is preserved in the sacral
segments S4–S5.
B Incomplete
Sensory function preserved but no motor function is
preserved below the neurological level and includes the
sacral segments S4–S5.
C Incomplete
Motor function is preserved below the neurological level;
more than half of key muscles below the neurological
level have a muscle grade less than 3.
D Incomplete
Motor function is preserved below the neurological level;
at least half of key muscles below the neurological level
have a muscle grade of 3 or more.

13. Management
1) Immobalisation by cervical support/ rigid neck collor as soon as signs of
quadriplegia are recognised to prevent lethal brain stem injury that can
cause immediate death
2) Imaging modality like MRI brain and Cervical cord. CT/MR angiography
may be indicated if initial scans fails to clinch diagnosis
3) Steroids coverage , in initial state reduce local inflammation , swelling and
compression feature, helpful
4) Patient evaluated for Surgical intervention as requried to rapidly
decompress spinal cord and to remove external objects / bone fragments
5) Long term rehablitation and physiotherapy is indicated in such patients

14. Thank you