Spinal Cord Lesions / Brainstem Sections

You should know this

Polio
-viral causative
-attacks LMN ventral horn
a. flaccid paralysis
b. muscle atrophy
c. fasiculations
d. areflexive

Tabes Dorsalis
-syphilis
-pain, parathesia, polyuria, Robertson Pupils
a. bilateral dorsal column below lesion
b. late stage syphilus, romberg sign

ALS - Amyotrophic Lateral Sclerosis
-beings lower limb up
-corticospinal / LMNs
a. progressive spinal muscular atrophy (ventral horn)
b. primary lateral scelrosis (corticospinal tract)
-spastic paralysis
-increased tone reflexes
flaccid paralysis in upper limbs

Anterior spinal artery occlusion
-DC spared
-All else bilateral signs

Subacute combined degeneration
-B12 defficiency
-dorsal columns
-spinocerebellar tracts
-corticospinal tracts

Springomyelia
-dissociation sensory loss
-cavitation of the cord (cervicle)
-bilateral loss of P/T at lesion level
-muscle weakness; flaccid paralysis and atrophy of upper lumb muscles due to destruction of ventral horn cells

Brown-Sequard Syndrome
-hemisection of spinal cord
-dissocation of function between conscious proprioception & P/T as well as UMN, LMN & autonomic presentations
a.DC ipsi loss
b.STT - contra
c.CST - ispi
d.LMN
e.descending hypos ipsi horners if above T1
-facial hemianhydrosis
-ptosis
-miosis

Complete Transection
-followed by a period of attenuated or complete spinal areflexia below level (spinal shock)
-lasts between 1-6 weeks before slow recovery occurs
-bladder & bowel functions are impaired due to autonomic disruptions

Medulla - caudal

Medulla

Medulla - rostral

medulla - pons

Pons

Pons - rostral

Midbrain

Midbrain - rostral