Spinal Cord Lesions: Anterior Cord, Posterior Cord, Central Cord, Brown-Séquard

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Ninja Nerds!
In this neuropathology lecture, Professor Zach Murphy discusses Spinal Cord Lesions, including Anterior Cord Syndrome, Posterior Cord Syndrome, Central Cord Syndrome, and Brown-Séquard Syndrome. This lecture gives you a strong framework to localize spinal injuries and understand how specific tracts produce predictable neurologic deficits.

We review the key ascending and descending spinal cord tracts—including the corticospinal tract, dorsal columns, and spinothalamic tract—to set the stage for lesion localization. Each spinal cord syndrome is then analyzed by its mechanism of injury, typical anatomical involvement, and clinical presentation.

Anterior cord syndrome, often due to anterior spinal artery infarction or trauma, results in bilateral motor paralysis and loss of pain and temperature below the lesion, while sparing vibration and proprioception. Posterior cord syndrome, more commonly caused by vitamin B12 deficiency, neurosyphilis, or trauma, leads to impaired proprioception and vibration sense, often with preserved motor and pain pathways. Central cord syndrome, frequently seen in hyperextension injuries in elderly patients with cervical stenosis, presents with greater motor weakness in the upper extremities than the lower, and variable sensory deficits. Brown-Séquard syndrome, from hemisection of the spinal cord, produces a striking pattern of ipsilateral motor and proprioceptive loss with contralateral pain and temperature loss below the lesion.

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