Spinal Cord Syndromes

Anterior cord syndrome

Lesions disproportionately affecting the anterior spinal cord, commonly due to infarction (eg, caused by occlusion of the anterior spinal artery)

Malfunction of all tracts except the posterior columns, thus sparing position and vibratory sensation

Brown-Séquard syndrome (rare)

Unilateral spinal cord lesions, typically due to penetrating trauma

Ipsilateral paresis

Ipsilateral loss of touch, position, and vibratory sensation

Contralateral loss of pain and temperature sensation*

Central cord syndrome affecting the cervical spinal cord

Lesions affecting the center of the cervical spinal cord, mainly central gray matter (including spinothalamic tracts, which cross), commonly due to trauma, syrinx, or tumors in the central spinal cord

Paresis tending to be more severe in the upper extremities than in the lower extremities and sacral regions

Tendency to lose pain and temperature sensation in a capelike distribution over the upper neck, shoulders, and upper trunk, with light touch, position, and vibratory sensation relatively preserved (dissociated sensory loss)

Conus medullaris syndrome

Lesions around L1

Distal leg paresis

Perianal and perineal loss of sensation (saddle anesthesia)

Erectile dysfunction

Urinary retention, frequency, or incontinence

Fecal incontinence

Hypotonic anal sphincter

Abnormal bulbocavernosus and anal wink reflexes

Transverse myelopathy

Lesions affecting all or most tracts of the spinal cord at ≥ 1 segmental levels

Deficits in all functions mediated by the spinal cord (because all tracts are affected to some degree)