A 30-year-old presents with acute central cord syndrome (CCS) following a hyperextension injury on a background of cervical spondylosis. The characteristic neurological pattern is:

• A Complete tetraplegia with loss of all modalities below the lesion
• B Weakness greater in upper limbs than lower limbs, with sacral sparing, and bladder dysfunction ✓
• C Ipsilateral motor loss and contralateral pain/temperature loss (Brown-Séquard)
• D Loss of motor function and all sensation below injury, with preserved perineal sensation

Explanation

Central cord syndrome is the most common incomplete spinal cord injury. It occurs typically in older patients with cervical spondylosis following a hyperextension injury. The central cord carries upper limb fibers (lateral corticospinal tract) medially and lower limb fibers laterally — central injury disproportionately affects the upper limbs more than lower limbs. Bladder dysfunction (typically urinary retention) and variable sensory loss below the level are also present with sacral sparing. Prognosis for walking recovery is good (>80% ambulate), but hand function recovery is poor.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.