title: Acute traumatic central cord syndrome: a comprehensive review.
abstract: Acute traumatic central cord syndrome (ATCCS) is the most common type of incomplete spinal cord injury, characterized by predominant upper extremity weakness, and less severe sensory and bladder dysfunction. ATCCS is thought to result from post-traumatic centro-medullary hemorrhage and edema, or, as more recently proposed, from a Wallerian degeneration, as a consequence of spinal cord pinching in a narrowed canal. Magnetic Resonance Imaging is the method of choice for diagnosis, showing a typical intramedullary hypersignal on T2 sequences. Non-surgical treatment relies on external cervical immobilization, maintenance of a sufficient systolic blood pressure, and early rehabilitation, and should be reserved for patients suffering from mild ATCCS. Surgical management of ATCCS consists of posterior, anterior or combined approaches, in order to achieve spinal cord decompression, with or without stabilization. The benefits of early surgical decompression in the setting of ATCCS remain controversial due to the lack of clinical randomized trials; recent studies suggest that early surgery (less than 72hours after trauma) appears to be safe and effective, especially for patients with evidence of focal anatomical cord compression.
authors.affiliation: Neurosurgical Unit, Faculty of Medicine, Geneva University Hospitals, rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland.
authors.forename: G
authors.initials: G
authors.lastname: Molliqaj
authors.affiliation: Neurosurgical Unit, Faculty of Medicine, Geneva University Hospitals, rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland; Neurosurgical Department, Hirslanden Klinik, Zurich, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Payer
authors.affiliation: Neurosurgical Unit, Faculty of Medicine, Geneva University Hospitals, rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland.
authors.forename: K
authors.initials: K
authors.lastname: Schaller
authors.affiliation: Neurosurgical Unit, Faculty of Medicine, Geneva University Hospitals, rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland. Electronic address: Enrico.Tessitore@hcuge.ch.
authors.forename: E
authors.initials: E
authors.lastname: Tessitore
mesh_terms: D000208:Acute Disease; D000818:Animals; D020210:Central Cord Syndrome / Q000175:diagnosis / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods; D004195:Disease Models, Animal; D006801:Humans; D013116:Spinal Cord / Q000601:surgery*; D013117:Spinal Cord Compression / Q000601:surgery*
keywords: Central cord syndrome; Cervical spinal cord injury; Décompression chirurgicale; Délais; Imagerie par résonnance magnétique; Lésion médullaire cervical; Magnetic resonance imaging; Surgical decompression; Syndrome centromédullaire; Timing; Traumatic; Traumatique