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)
Pronounced: SEN-tral CORD SIN-droh-m
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.
CCS is caused by damage to the cervical spine, near the first seven vertebrae. This damage may occur when the neck is hyperextended. This can can be associated with:
- Loss of blood supply to the area
- Bleeding in the spinal cord
- Edema (swelling created by fluid in connective tissues)
Common causes of injury include:
- Trauma]]> (eg, car accident, sports injuries, falls)
- Degenerative condition of spine (often found in older people)
- Pre-existing condition, such as being born with a narrow spine
CSS can also be due to:
- Structural problems
- Tumors within the spinal cord
These factors increase your chance of developing CCS:
- Gender: male
- Age: over 50 (more likely to have arthritis of the neck and a fall)
- Autoimmune disorder (eg, multiple sclerosis]]>, neuromyelitis optica)
- Pre-existing condition (eg, narrow spinal canal, spinal cord disease, dysfunction)
- Participation in certain sports (eg, wrestling, diving)
Tell your doctor if you have any of these risk factors.
If you have any of these symptoms do not assume it is due to CCS. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:
- Inability to lift arms and hands completely, or numbness and tingling
- Difficulty with fine motor control (eg, buttoning a shirt)
- Muscle weakness in legs, difficulty walking
- Loss of bladder control
If CCS is due to trauma, symptoms usually come quickly. Sometimes, however, symptoms may come more gradually.
Your doctor will ask about your symptoms and medical history. In addition to doing a physical exam, she may also do a neurologic exam, which includes assessing:
- Mental state
Tests may include:
- MRI scan]]> —a test that uses magnetic waves to make pictures of structures inside the spinal cord
- ]]>CT scan]]> —a type of x-ray that uses a computer to make pictures of structures near and inside the spinal cord
- ]]>Myelogram]]> —imaging test that uses a special dye to view the spinal cord and the area surrounding it
- ]]>X-ray]]> —a test that uses radiation to take a picture of structures inside the body, especially bones
Talk with your doctor about the best treatment plan for you. If the injury is due to trauma, you may need to spend a number of weeks in the hospital. Rehab can take 1-2 months. If you are young and have more muscle tone at follow-up evaluation, you have a better chance of recovering. Other predictors of recovery are:
- Muscle function at the time of the injury
- Level of education
Treatment options include the following:
In most cases, surgery is not needed. Often treatment involves:
- Immobilizing the neck
- Giving steroids
- Doing physical and occupational therapy
Surgery is needed if there is significant compression of the spinal cord. At times, surgery may also be done after a period of recovery, for example, if you still have cord compression and no more recovery.
To help reduce your chance of getting a spinal cord injury, take the following steps:
- Avoid diving if you do not know how deep the water is.
- Always wear a seatbelt.
- Do not drink and drive. Do not ride with someone who has been drinking.
- Remove obstacles in your house, like throw rugs, that could cause falls.
- Use safe techniques and proper equipment when playing sports.
- Secure firearms.
Christopher and Dana Reeve Foundation
National Institute of Neurological Disorders and Stroke
National Spinal Cord Injury Association
Canadian & American Spinal Research Organization
Spinal Cord Injury Centre
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Last reviewed November 2009 by ]]> Rimas Lukas, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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