Questions and Answers
What are conditions that produce anterior cord syndrome symptoms?
An incomplete spinal cord lesion in which the anterior 2/3rd of the spinal cord is damaged, while dorsal columns are not affected. Mechanism of injury includes cervical flexion injury or infarction of the anterior spinal artery.
What is the etiology of anterior cord syndrome?
Traumatic incidents causing compression or damage to the anterior spinal artery, often associated with fracture or dislocation, but may also include atherosclerosis, external compression, and aortic pathologies.
What is the clinical presentation of anterior cord syndrome?
- Loss of motor function and pain/temperature sensation bilaterally below the level of the lesion due to damage to the corticospinal and spinothalamic tracts. Possible autonomic dysfunction.
Which of the following are primary risk factors for CVA? (Select all that apply)
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Which of the following are secondary risk factors for CVA? (Select all that apply)
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What labs or imaging are used for anterior cord syndrome?
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What neurological testing is performed to confirm anterior cord syndrome?
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What initial management is performed for anterior cord syndrome?
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What is acute PT intervention for anterior cord syndrome?
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What does rehabilitation PT for anterior cord syndrome involve?
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What is a transient ischemic attack (TIA)?
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How long do TIA symptoms resolve?
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A TIA most often occurs in the _____ and ______ arteries and may indicate a future CVA.
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What is a completed stroke?
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What is a stroke in evolution?
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What is an ischemic stroke?
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An _______ is the cause of 20% of ischemic CVAs.
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What is the most common artery affected by an embolus?
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Why can tissues distal to the infarction sustain higher permanent damage than thrombotic infarcts?
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An embolic CVA occurs ______ ______ and usually presents as a ______.
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What occurs during thrombus (CVA)?
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What kind of onset do thrombotic CVAs have?
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What percentage of CVAs are accounted for by hemorrhages?
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What is a hemorrhage (CVA)?
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Study Notes
Anterior Cord Syndrome
- Defined as an incomplete spinal cord lesion affecting the anterior 2/3 of the spinal cord, sparing the dorsal columns.
- Commonly caused by cervical flexion injuries or anterior spinal artery infarction.
Etiology of Anterior Cord Syndrome
- Triggered by traumatic incidents leading to compression or damage to the anterior spinal artery.
- Often associated with fractures or dislocations; can also result from atherosclerosis, external compression (disc protrusion or masses), and aortic issues.
Clinical Presentation
- Symptoms include loss of motor function and loss of bilateral pain and temperature sensation below the injury level, due to damage to corticospinal and spinothalamic tracts.
- May lead to autonomic dysfunction, impacting bowel and sexual functions, and possible respiratory issues depending on the injury level.
CVA Primary Risk Factors
- Hypertension, cardiac disease or arrhythmias, diabetes mellitus, cigarette smoking, transient ischemic attacks.
CVA Secondary Risk Factors
- Includes obesity, high cholesterol, hypertension-related behaviors (stress, excess salt intake), physical inactivity, and increased alcohol consumption.
Diagnostics for Anterior Cord Syndrome
- Utilizes MRI, X-rays, CT scans; CT scans are more sensitive than X-rays for detecting spinal injuries.
Neurological Testing
- Involves sensory and motor assessments and the ASIA impairment scale to evaluate the extent of the injury.
Initial Management
- Focuses on medical immobilization and stabilization; may use orthosis (e.g., halo, Minerva) for cervical fractures.
Acute PT Interventions
- Includes Range of Motion (ROM) exercises, respiratory management, pressure relief strategies, skin care education, and functional mobility training.
Rehabilitation PT
- Involves strengthening exercises, transfer training, and management for ambulation or wheelchair use.
Transient Ischemic Attack (TIA)
- Linked with atherosclerotic thrombosis, causing temporary blood supply disruption to the brain.
- Symptoms usually resolve within 24-48 hours.
TIA Locations
- Most frequently occurs in carotid and vertebrobasilar arteries, indicating a potential for future cerebrovascular accidents (CVAs).
Completed Stroke
- Characterized by total neurological deficits present at onset.
Stroke in Evolution
- Refers to a CVA from a thrombus that progresses gradually, with deficits appearing one to two days after onset.
Ischemic Stroke
- The most prevalent type of stroke in older adults, arising from blood flow blockage to the brain due to narrowed or obstructed carotid arteries.
Causes of Ischemic CVA
- An embolus accounts for approximately 20% of ischemic strokes.
Common Embolic Site
- The middle cerebral artery is the most frequently affected artery by an embolus.
Infarction Damage
- Tissues distal to the infarction may sustain higher permanent damage owing to the abrupt nature of occlusion.
Presentation of Embolic CVA
- Occurs suddenly and often features a headache.
Thrombus Formation
- A thrombotic CVA results from atherosclerotic plaque occluding an artery or its branches, leading to infarction.
Thrombotic Onset
- Onset can be highly variable, with symptoms emerging from minutes to several days, often occurring during sleep or post-surgery.
Hemorrhagic CVAs
- Account for 10-15% of all cerebrovascular accidents, involving abnormal bleeding in the brain due to ruptured blood vessels.
Hemorrhage Mechanism
- Causes disruption of oxygen supply to the brain and compression from blood accumulation.
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Description
This quiz explores the definition, etiology, and clinical presentation of Anterior Cord Syndrome. Participants will learn about the common causes and risk factors, particularly focusing on spinal cord injuries and their effects on motor and sensory functions. Ideal for medical students and professionals seeking to enhance their understanding of spinal cord disorders.
