Central Cord Syndrome Clinical Presentation

Updated: Apr 25, 2022
  • Author: Michelle J Alpert, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
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  • Symptoms of central cord syndrome occur following trauma (most commonly falls) and consist of upper and lower extremity weakness, with varying degrees of sensory loss.

  • Pain and temperature sensations, as well as the sensation of light touch and of position sense, may be impaired below the level of injury.

  • Neck pain and urinary retention are common.



Physical findings related to central cord syndrome are limited to the neurologic system and consist of upper motor neuron weakness in the upper and lower extremities. This impairment can be described as follows:

  • Impairment in the upper extremities is usually greater than in the lower extremities and is especially prevalent in the muscles of the hand.

  • Sensory loss is variable, although sacral sensation is usually present. Anal wink, anal sphincter tone, and Babinski reflexes should be tested.

  • Muscle stretch reflexes may initially be absent but will eventually return along with variable degrees of spasticity in affected muscles.



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  • The most common cause of central cord syndrome (CCS) is trauma.

  • In older adults, premorbid cervical spondylosis is a significant risk factor.

  • Accordingly, even minor falls may result in tetraplegia in populations with a narrowed spinal canal.

  • In younger age groups, CCS results from major trauma, such as that associated with cervical fracture/subluxations. [20, 21]