A 32-year-old man presents with sudden-onset severe neck pain and bilateral upper limb weakness after diving into a shallow pool. MRI shows a central cervical cord contusion at C5-C6 with no bony fracture. Which clinical syndrome best describes his deficits — greater weakness in arms than legs, sacral sensory sparing, and bladder dysfunction?

• A Anterior cord syndrome
• B Central cord syndrome ✓
• C Brown-Séquard syndrome
• D Posterior cord syndrome

Explanation

Central cord syndrome is the most common incomplete spinal cord injury syndrome. It results from central grey matter and central corticospinal tract damage, classically after hyperextension injuries in middle-aged or older patients with pre-existing cervical stenosis. Features: disproportionately greater weakness of arms than legs (because cervical cord somatotopy places arm fibres medially near the central lesion), variable sensory loss below the injury level, and bladder dysfunction (urinary retention). Sacral sensory sparing occurs because sacral fibres lie peripherally in the corticospinal tract. Anterior cord syndrome causes motor loss with preserved proprioception; Brown-Séquard involves ipsilateral motor/proprioception loss and contralateral pain/temperature loss.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.