hemisection syndrome
Introduction
Introduction to spinal cord hemisection syndrome Spinal cord hemisection syndrome, spinal cord lesions and other causes of motor neuron paralysis on the ipsilateral limb below the lesion plane, deep sensory disappearance, fine tactile dysfunction, vasomotor dysfunction, contralateral limb pain and temperature disappearance, bilateral tactile retention The clinical syndrome occurs mainly in the cervical spine. The resulting movement disorder can affect the patient's walking, and the sensory disorder can cause the patient to easily cause damage, especially the skin sensory disorder can cause skin burns and the like, seriously affecting daily life and causing the patient's disability. The spinal cord is distributed with an upward conduction beam that governs the lower extremity and trunk sensation, and a downward conduction beam that governs motor function. The descending conduction beam distributed over the cervical vertebra includes a thin bundle of wedges, located in the posterior cord, conducting the proprioception and fine tactile sense from the ipsilateral body. The lateral branch of the spinal thalamus is located in the lateral cord. Because it crosses in the spinal cord, it transmits the pain and temperature sense of the contralateral body. The anterior bundle of the spinal thalamus is located in the anterior cord, and partially crosses up to the opposite side, transmitting the rough touch of the limbs of both sides. basic knowledge The proportion of illness: 0.006% Susceptible people: no special people Mode of infection: non-infectious Complications: venous thrombosis
Cause
The cause of spinal cord hemisection syndrome
Cause (30%):
The spinal cord is distributed with an upward conduction beam that governs the lower extremity and trunk sensation, and a downward conduction beam that governs motor function. The descending conduction beam distributed over the cervical vertebra includes a thin bundle of wedges, located in the posterior cord, conducting the proprioception and fine tactile sense from the ipsilateral body. The lateral branch of the spinal thalamus is located in the lateral cord. Because it crosses in the spinal cord, it transmits the pain and temperature sense of the contralateral body. The anterior bundle of the spinal thalamus is located in the anterior cord, and partially crosses up to the opposite side, transmitting the rough touch of the limbs of both sides.
Prevention
Spinal cord hemisection syndrome prevention
For people engaged in high-risk occupations (high altitude, drivers), care should be taken to avoid trauma to the neck.
1. For patients with cervical spondylosis in the past, regular review should be conducted to detect potential spinal cord compression early. In addition, attention should be paid to avoid neck trauma.
2, usually should pay attention to keep warm, reduce the chance of cold, upper respiratory tract infection, reduce the possibility of spinal cord inflammation.
3, prevention of spinal cord hemisection syndrome is more difficult, the most important is to have early diagnosis and early treatment of symptoms.
Complication
Complications of spinal cord hemisection syndrome Complications, venous thrombosis
Early stage may occur deep vein thrombosis, hemorrhoids, urinary tract infections, etc., long-term bed complications, including urinary stones, lung infections, body temperature disorders, etc., patients with spinal cord hemisection syndrome may also have psychological depression And obstacles, etc.
Symptom
Symptoms of spinal cord hemisection syndrome Common symptoms Head and neck activity restricted deep sensory disturbance
(1) Spinal cord symptoms: the movement and deep feeling of the ipsilateral limb below the injury plane disappear, and the pain and disappearance of the contralateral limb are clinical features.
(2) Symptoms of the primary disease: If the knife is stabbed, there will be skin and muscle stab damage. If it is caused by spinal fracture and dislocation, the symptoms will suddenly appear, there is a history of trauma, accompanied by neck pain and limited activity. Other manifestations, patients with intraspinal tumors have a longer course of disease, there is a process of clinical symptoms, the symptoms gradually progress, patients with hematoma compression, there is a history of hematoma formation, such as the recent history of surgery, spontaneous blood disease history.
Examine
Examination of spinal cord hemisection syndrome
The existing examination conditions should be comprehensively applied to find the cause of the symptoms of spinal cord hemisection. For example, in patients with spinal injury, cervical X-ray, CT, MRI should be performed. If necessary, nerve evoked potential examination of the extremities should be performed to determine the presence or absence of spinal cord compression and edema bleeding. At the same time, spinal cord and The condition within the spinal canal is thus differentiated from intraspinal and intraspinal tumors. If it is suspected to be myelitis, routine and biochemical examination of cerebrospinal fluid may be performed. When suspected of vascular factors, DSA or MRA examination of spinal cord blood vessels is feasible.
Diagnosis
Diagnosis and diagnosis of spinal cord hemisection syndrome
1. Spinal shock: also known as ridge shock. When the spinal cord is disconnected from the high center, the phenomenon that the spinal cord temporarily loses its ability to reflect and enters an unresponsive state is called spinal shock. The animal whose spinal cord is separated from the high center is called a vertebrate.
2. Intermittent spinal cord breakage: manifested as asymptomatic on the beginning of walking, to a certain distance (about 1-5 minutes), one or both sides of the lower extremity weakness, improved after a break. Found in spinal arterial endarteritis, spinal cord dysplasia, spinal stenosis.
3. Transverse spinal cord injury: Spinal dysfunction caused by infection or infection-induced spinal cord dysfunction leading to nerve impulse blockade of all or most of the nerve bundles, limited to several segments of acute transverse spinal cord inflammation. Most are ill after acute infection or vaccination. It is characterized by paralysis of the limbs below the level of spinal cord lesions, loss of sensation and dysfunction of the bladder, rectum and autonomic nerves.
