Central Nervous System
Due to a central cord lesion, dissociative sensory loss seen due to (AIIMS NOV 2009)
|A||Decussating branches of lateral spinothalamic tract|
|C||Anterior spinothalamic tract|
Neurology in clinical practice - Page 360 4TH ED.
Dissociated sensory loss is a pattern of neurological damage caused by a lesion to a single tract in the spinal cord which involves selective loss of fine touch and proprioception without loss of pain and temperature, or vice-versa.
Central cord syndrome
a. Central cord syndrome(CCS) is an acute cervical spinal cord injury (SCI).
b. Central cord syndrome is observed most often in cervical spondylosis, syringomyelia, hydromyelia, and trauma.
c. Hemorrhage and intramedullary tumors such as central canal ependymoma are other causes.
d. Because central cord syndrome is more common in the cervical cord, the arms are often weak with preservation of strength in the legs ("man-in-a-barrel syndrome"). Considerable recovery is common.
e. This syndrome is associated with variable sensory and reflex deficits; often the most affected sensory modalities are pain and temperature because the lateral spinothalamic tract fibers cross just ventral to the central canal.
f. This is sometimes referred to as dissociated sensory loss and is often present in a capelike distribution.
g. Lateral extension can result in ipsilateral Horner syndrome (because of involvement of the ciliospinal center), kyphoscoliosis (because of involvement of dorsomedian and ventromedian motor nuclei supplying the paraspinal muscles) and spastic paralysis (because of corticospinal tract involvement).
h. Dorsal extension can result in ipsilateral position sense and vibratory loss due to involvement of dorsal column.