Specific Types of Injuries

Stretching, crushing, compression and vascular compromise account for most of the injury mechanisms to the spinal cord. A subset of spinal cord injured patients would then have findings on initial neurological examination consistent with a specific syndrome that provides more predictive prognostic accuracy.

Hemisection of the spinal cord, usually as a result of some penetrating injury or a stab wound, leads to the Brown-Sequard syndrome. Clinically, patients present ipsilateral motor and proprioceptive loss below the level of the lesion and contralaterally dissociated sensory loss, i.e. loss of pain and temperature sensation, caudal to the lesion. Preservation of light touch is due to the redundancy of the fibers from the anterior spinothalamic tract. Out of all the incomplete syndromes, this one has the better prognosis, with over 90% of patients regaining the ability to ambulate independently.

The most common cervical cord syndrome is usually seen in males, middle-aged or older. It is known as the central cord syndrome, which is usually seen after a hyperextension injury in patients with cervical stenosis, consisting clinically of motor weakness that is greater in the upper extremities than the lower extremities. It involves the distal muscle groups more than it does the proximal groups and the degree of sensory disturbance varies below the level of the lesion. About 50% of patients recover enough function in the lower extremities to ambulate [12]. Upper extremity function, with the ability to exercise fine motor control, is also uniformly poor. Bowel and bladder function, if involved initially, usually recovers. Correlation of MRI findings with both ante-mortem and postmortem analysis has shown that it is the buckling of the hypertrophied ligamentum flavum which occurs as a result of the hyperextension, which creates a shear type of injury pattern to the spinal cord.

In patients who have suffered a vertical compression or hyperflexion type of injury, cord ischemia in the territory supplied by the anterior spinal artery leads to the anterior cord syndrome. Clinically, the patients have motor and sensory loss below the level of the lesion, but with intact posterior column function. This syndrome has the poorest prognosis for recovery, as only 10-20% of patients recover functional

Cure Your Yeast Infection For Good

Cure Your Yeast Infection For Good

The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.

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