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Central Spinal Cord Syndrome
Bryson Borg, MD; Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Central cord syndrome (CCS), acute traumatic central cord syndrome (ATCCS)
          • Synonyms

            • Partial cord syndrome (subset of)
          • Definitions

            • Most common partial cord syndrome
            • Traumatic cord injury, with clinical syndrome of
              • Bilateral weakness, arms > legs
              • Bladder dysfunction
              • Variable sensory loss
            • Injury to central gray matter, corticospinal and spinothalamic tracts

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Nonvascular Interventions

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Aarabi B et al: Management of acute traumatic central cord syndrome (ATCCS). Neurosurgery. 72 Suppl 2:195-204, 2013
                                            2. Fehlings MG et al: Current practice in the timing of surgical intervention in spinal cord injury. Spine (Phila Pa 1976). 35(21 Suppl):S166-73, 2010
                                            3. Chen L et al: Effectiveness of surgical treatment for traumatic central cord syndrome. J Neurosurg Spine. 10(1):3-8, 2009
                                            4. Harrop JS et al: Central cord injury: pathophysiology, management, and outcomes. Spine J. 6(6 Suppl):198S-206S, 2006
                                            5. Uribe J et al: Acute traumatic central cord syndrome--experience using surgical decompression with open-door expansile cervical laminoplasty. Surg Neurol. 63(6):505-10; discussion 510, 2005
                                            6. Collignon F et al: Acute traumatic central cord syndrome: magnetic resonance imaging and clinical observations. J Neurosurg. 96(1 Suppl):29-33, 2002
                                            7. Guest J et al: Traumatic central cord syndrome: results of surgical management. J Neurosurg. 97(1 Suppl):25-32, 2002
                                            8. Hendey GW et al: Spinal cord injury without radiographic abnormality: results of the National Emergency X-Radiography Utilization Study in blunt cervical trauma. J Trauma. 53(1):1-4, 2002
                                            9. Dai L: Magnetic resonance imaging of acute central cord syndrome: correlation with prognosis. Chin Med Sci J. 16(2):107-10, 2001
                                            10. Jimenez O et al: A histopathological analysis of the human cervical spinal cord in patients with acute traumatic central cord syndrome. Spinal Cord. 38(9):532-7, 2000
                                            11. Kothari P et al: Injury to the spinal cord without radiological abnormality (SCIWORA) in adults. J Bone Joint Surg Br. 82(7):1034-7, 2000
                                            12. Newey ML et al: The long-term outcome after central cord syndrome: a study of the natural history. J Bone Joint Surg Br. 82(6):851-5, 2000
                                            13. An HS: Cervical spine trauma. Spine. 23(24):2713-29, 1998
                                            14. Chen TY et al: Efficacy of surgical treatment in traumatic central cord syndrome. Surg Neurol. 48(5):435-40; discussion 441, 1997
                                            15. Massaro F et al: Acute traumatic central cord syndrome. Acta Neurol (Napoli). 15(2):97-105, 1993
                                            16. Martin D et al: MRI-pathological correlations in acute traumatic central cord syndrome: case report. Neuroradiology. 34(4):262-6, 1992
                                            17. Quencer RM et al: Acute traumatic central cord syndrome: MRI-pathological correlations. Neuroradiology. 34(2):85-94, 1992
                                            18. Riviello JJ Jr et al: Delayed cervical central cord syndrome after trivial trauma. Pediatr Emerg Care. 6(2):113-7, 1990
                                            19. Zwimpfer TJ et al: Spinal cord concussion. J Neurosurg. 72(6):894-900, 1990
                                            20. Fox JL et al: Central spinal cord injury: magnetic resonance imaging confirmation and operative considerations. Neurosurgery. 22(2):340-7, 1988
                                            21. Merriam WF et al: A reappraisal of acute traumatic central cord syndrome. J Bone Joint Surg Br. 68(5):708-13, 1986
                                            22. Torg JS et al: Neurapraxia of the cervical spinal cord with transient quadriplegia. J Bone Joint Surg Am. 68(9):1354-70, 1986
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Pathology

                                                  • Clinical Issues

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Central cord syndrome (CCS), acute traumatic central cord syndrome (ATCCS)
                                                    • Synonyms

                                                      • Partial cord syndrome (subset of)
                                                    • Definitions

                                                      • Most common partial cord syndrome
                                                      • Traumatic cord injury, with clinical syndrome of
                                                        • Bilateral weakness, arms > legs
                                                        • Bladder dysfunction
                                                        • Variable sensory loss
                                                      • Injury to central gray matter, corticospinal and spinothalamic tracts

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • CT Findings

                                                          • MR Findings

                                                            • Nonvascular Interventions

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Staging, Grading, & Classification

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Aarabi B et al: Management of acute traumatic central cord syndrome (ATCCS). Neurosurgery. 72 Suppl 2:195-204, 2013
                                                                                      2. Fehlings MG et al: Current practice in the timing of surgical intervention in spinal cord injury. Spine (Phila Pa 1976). 35(21 Suppl):S166-73, 2010
                                                                                      3. Chen L et al: Effectiveness of surgical treatment for traumatic central cord syndrome. J Neurosurg Spine. 10(1):3-8, 2009
                                                                                      4. Harrop JS et al: Central cord injury: pathophysiology, management, and outcomes. Spine J. 6(6 Suppl):198S-206S, 2006
                                                                                      5. Uribe J et al: Acute traumatic central cord syndrome--experience using surgical decompression with open-door expansile cervical laminoplasty. Surg Neurol. 63(6):505-10; discussion 510, 2005
                                                                                      6. Collignon F et al: Acute traumatic central cord syndrome: magnetic resonance imaging and clinical observations. J Neurosurg. 96(1 Suppl):29-33, 2002
                                                                                      7. Guest J et al: Traumatic central cord syndrome: results of surgical management. J Neurosurg. 97(1 Suppl):25-32, 2002
                                                                                      8. Hendey GW et al: Spinal cord injury without radiographic abnormality: results of the National Emergency X-Radiography Utilization Study in blunt cervical trauma. J Trauma. 53(1):1-4, 2002
                                                                                      9. Dai L: Magnetic resonance imaging of acute central cord syndrome: correlation with prognosis. Chin Med Sci J. 16(2):107-10, 2001
                                                                                      10. Jimenez O et al: A histopathological analysis of the human cervical spinal cord in patients with acute traumatic central cord syndrome. Spinal Cord. 38(9):532-7, 2000
                                                                                      11. Kothari P et al: Injury to the spinal cord without radiological abnormality (SCIWORA) in adults. J Bone Joint Surg Br. 82(7):1034-7, 2000
                                                                                      12. Newey ML et al: The long-term outcome after central cord syndrome: a study of the natural history. J Bone Joint Surg Br. 82(6):851-5, 2000
                                                                                      13. An HS: Cervical spine trauma. Spine. 23(24):2713-29, 1998
                                                                                      14. Chen TY et al: Efficacy of surgical treatment in traumatic central cord syndrome. Surg Neurol. 48(5):435-40; discussion 441, 1997
                                                                                      15. Massaro F et al: Acute traumatic central cord syndrome. Acta Neurol (Napoli). 15(2):97-105, 1993
                                                                                      16. Martin D et al: MRI-pathological correlations in acute traumatic central cord syndrome: case report. Neuroradiology. 34(4):262-6, 1992
                                                                                      17. Quencer RM et al: Acute traumatic central cord syndrome: MRI-pathological correlations. Neuroradiology. 34(2):85-94, 1992
                                                                                      18. Riviello JJ Jr et al: Delayed cervical central cord syndrome after trivial trauma. Pediatr Emerg Care. 6(2):113-7, 1990
                                                                                      19. Zwimpfer TJ et al: Spinal cord concussion. J Neurosurg. 72(6):894-900, 1990
                                                                                      20. Fox JL et al: Central spinal cord injury: magnetic resonance imaging confirmation and operative considerations. Neurosurgery. 22(2):340-7, 1988
                                                                                      21. Merriam WF et al: A reappraisal of acute traumatic central cord syndrome. J Bone Joint Surg Br. 68(5):708-13, 1986
                                                                                      22. Torg JS et al: Neurapraxia of the cervical spinal cord with transient quadriplegia. J Bone Joint Surg Am. 68(9):1354-70, 1986