Anterior Cord Syndrome

FACTS

  • most commonly 2/2 disruption of anterior spinal artery or Artery of Adamkiewicz, which arises from T9-T12
  • affects anterior 2/3 of spinal cord
    • majority of the anterior and lateral white matter funiculi
    • central gray matter
    • bilateral lateral and anterior horns
    • bases of the posterior horns.

    HPI

     
    PHYSICAL EXAM
    • bilat loss of motor function (flaccid paralysis at level of lesion and spastic paralysis below the lesion)
    • loss of pain and temparature
    • maintenance of proprioception/vibration (posterior columns)
    • from loss of the corticospinal tract and anterior horn, bilateral loss of pain and temperature one level below the lesion from loss of the spinothalamic tract, and sexual dysfunction and urinary and fecal incontinence from loss of descending autonomic tracts. Sensations of touch, vibration, and proprioception remain intact since the posterior white matter columns are spared.

    IMAGING

     
    A/P