Spinal Cord Injury Lesions

There are many effects and ways to categorize the effects of spinal cord injury (SCI) lesions. For example, there are different syndromes that may stem as a result of an SCI lesion, such as Central Cord Syndrome, Brown-Sequard Syndrome, Anterior Cord Syndrome, Cauda Equina Syndrome, and Conus Medullaris. In order to assess the differing degrees and residual function after SCI, the American Spinal cord Injury Association (ASIA) Impairment Scale is utilized. It ranges from Level A to Level E with Level A being the most severe, indicating a complete SCI and no motor or sensory function in the lowest sacral segment of the spinal cord, and Level E indicates normal sensory and motor function with no spinal cord lesion. Depending on where the lesion occurs, upper and lower motor neuron (U/LMN) signs may be present. UPN originate from the brain and are responsible forsending signals to LMN. LMN are also known as spinal nerves and send the received signals directly to the desired target (e.g. muscle). If an UPN lesion occurs, one may experience spasticity below the level of the lesion and paralysis. On the other hand, one may experience hypotonicity (low muscle tone), muscle atrophy, and partial to no motor reflexes if the LMN is affected. A couple other hallmark conditions associated with SCI include neurogenic shock and autonomic dysreflexia. One may experience neurogenic (or spinal) shock immediately following a SCI leading to a loss of motor pathways, tendon reflexes, autonomic function, as well as causing flaccid paralysis. Neurogenic shock may last for hours, days, or weeks before spinal activity returns. Upon the return of this activity and usually at a SCI at T6 or above, autonomic reflexes return and may result in exaggerated sympathetic reflex responses known as autonomic dysreflexia. Signs associated with this include severe hypertension, profuse sweating, bradycardia, and vasodilation. Autonomic dysreflexia is considered to a clinical emergency that can result in death - when it occurs, it is crucial to immediately stop the individual’s activity, elevate his/her head to avoid excessive blood pressure to the brain, and loosen clothing and other constrictions.

~ Pam ♡

Image retrieved from: https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Spinal-Cord-Injury