Question 4

With respect to pathological conditions of the spinal cord, list two causes of, and the clinical findings for each of the following syndromes:

a) Complete cord transection.

b) Cord hemisection.

c) Central cord syndrome.
c) Anterior cord syndrome (anterior spinal artery syndrome). 

d) Cauda Equina syndrome.

You may tabulate your answer.

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College answer

Not available.


This question is identical to Question 5 from the first paper of 2010 and Question 15 from the first paper of 2015.

Causes and Characteristic Features of Spinal Cord Syndromes


Characteristic features


There are some causes which are generic for all these syndromes, and they will not be repeated in each box. These are:

  • Trauma
  • Infarction
  • Abscess
  • Tumour or metastatic compression
  • Haematoma
  • AVM/haemorrhage

Any of these can cause any of the spinal syndromes, anywhere. Instead of these, the causes listed below are the characteristic pathological processes which usually give rise to a specific spinal cord syndrome, eg. anterior spinal artery occlusion causing anterior spinal syndrome.

Cord transection

  • Lost bilateral motor
  • Flaccid areflexia
  • Lost bilateral sensory
  • Transverse Myelitis

Cord hemisection

  • Lost ipsilateral motor
  • Lost ipsilateral proprioception
  • Lost ipsilateral light touch
  • Lost contralateral pain and temperature
  • Penetrating spinal injury
  • Radiation inury
  • Spinal metastases

Anterior cord injury

  • Preserved bilateral proproception
  • Lost bilateral pain, temperature, touch
  • Lost bilateral motor control

Interruption of the blood supply to the anterior spinal cord:

  • Aortic dissection
  • IABP complication

Posterior cord injury

  • Lost proprioception
  • Other sensation preserved bilaterally
  • Preserved power bilaterally
  • Ataxia results
  • Hyperextension injury
  • Posterior spinal artery injury
  • Tertiary syphilis
  • Friedrich's ataxia
  • Subacute degeneration (Vitamin B12 deficiency)
  • Atlantoaxial subluxation

Central cord syndrome

  • Sacral sensation preserved
  • Greater weakness in the upper limbs than in the lower limbs.
  • Hyperextension injury with pre-existing canal stenosis
  • Ependymoma
  • Syringomyelia

Conus medullaris syndrome

  • symmetrical paraplegia
  • Mixed upper and lower motor neuron
  • The same sort of pathologies can give rise either to a cauda equina syndrome or a conus medullaris syndrome; the difference is the level.

Cauda Equina syndrome

  • asymmetrical, lower motor neuron lower limb weakness
  • saddle area paraesthesia
  • bladder and bowel areflexia


Oh's Manual: Chapter 78 (pp. 795) Spinal injuries by Sumesh Arora and Oliver J Flower

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