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Central Cord Syndrome

(CCS; Central Cervical Cord Syndrome; Central Cord Injury; Injury, Central Cord; Paralysis, Upper Extremity; Syndrome, Central Cord; Syndrome, Central Cervical Cord; Upper Extremity Paralysis; Acute Central Cord Syndrome)

Definition

Central cord syndrome (CCS) is a type of incomplete spinal cord injury. CCS is marked by damage to the nerve fibers that bring messages from the brain to the body. This condition affects how you can use your arms and hands, and in some cases, your legs. There may be a loss of sensation and motor control.
Spinal Cord
Spinal Cord
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Causes

CCS is caused by damage to the central part of the spinal cord. This damage may occur when the neck is hyperextended. This can be associated with:
Common causes of injury include:
CSS can also be due to:

Risk Factors

Males over 50 are more likely to have this condition. Other factors that increase your chance of CCS include:

Symptoms

Symptoms of CCS may include:
If CCS is due to trauma, symptoms usually come quickly. Sometimes, however, symptoms may come more slowly.

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. A neurologic exam may also be done.
Images may be taken of your spinal cord. These can be done with:

Treatment

Talk with your doctor about the best treatment plan for you. Rehab can take a long time for some people. If you are young and have more muscle function, you have a better chance of recovering.
Treatment options include the following:

Nonsurgical Treatment

In most cases, surgery is not needed. Often treatment involves:
  • Restricting neck movement
  • Giving steroids
  • Doing physical and occupational therapy

Surgery

Surgery is needed if there is a large compression of the spinal cord fibers. Surgery may also be done after a period of recovery. For example, if you still have cord compression after a recovery period.

Prevention

To help reduce your chance of a spinal cord injury:

RESOURCES

Christopher and Dana Reeve Foundation http://www.christopherreeve.org

National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov

CANADIAN RESOURCES

Canadian Spinal Research Organization http://www.csro.com

Spinal Cord Research Centre http://www.scrc.umanitoba.ca

References

Cortez R, Levi AD. Acute spinal cord injury. Curr Treat Options Neurol. 2007;9(2):115-125.

Finnoff JT, Midlenberger D, Cassidy CD.. Central cord syndrome in a football player with congenital spinal stenosis. Am J Sports Med. 2004;32(2):516-521.

McKinley W, Santos K, Meade M, Brooke K.Incidence and outcomes of spinal cord injury clinical syndromes. J Spinal Cord Med. 2007;30(3):215-224.

NINDS central cord syndrome information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/central%5Fcord/central%5Fcord.htm. Updated October 24, 2014. Accessed November 20, 2014.

Older adult falls. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/homeandrecreationalsafety/falls/index.html. Accessed November 20, 2014.

Rich V, McCaslin E. Central cord syndrome in a high school wrestler: a case report. J Athl Train. 2006;41(3):341-344.

Spinal cord injury—acute management. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 10, 2014. Accessed November 20, 2014.

Spinal cord injury—chronic management. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 11, 2014. Accessed November 20, 2014.

Traumatic brain injury. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/TraumaticBrainInjury/index.html. Updated November 4, 2010. Accessed November 20, 2014.

Visocchi M, Di Rocco F, Meglio M. Subacute clinical onset of post-traumatic myelopathy. Acta Neurochir (Wein). 2003;145(9): 799-804.

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