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CC BY-NC-ND 4.0 · J Neuroanaesth Crit Care 2022; 09(02): 125-127
DOI: 10.1055/s-0042-1744397
Case Report

Postoperative Central Cord Syndrome: Physiologic Decapitation in the PACU

Sean M. Mock
1   Department of Anesthesia, Naval Medical Center San Diego, San Diego, California, United States
,
Hannah Harris
2   Department of Anesthesiology, Walter Reed National Military Medical Center, Maryland, United States
,
Thomas Kane
3   School of Medicine, Uniformed Services University of the Health Sciences, Maryland, United States
,
John Dunford
2   Department of Anesthesiology, Walter Reed National Military Medical Center, Maryland, United States
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Abstract

Central cord syndrome is a form of incomplete spinal cord injury appearing in the anesthesia literature primarily in trauma. Our institution recently managed a rare, life-threatening central cord syndrome following an uneventful anterior cervical discectomy and fusion which uniquely presented as respiratory depression progressing to quadriplegia. This patient's dramatic experience began nearly indistinguishably from more common etiologies of respiratory depression in the post-anesthesia care unit before blossoming swiftly into quadriplegia. We review the details of her presentation and pathophysiology with a message of vigilance to the anesthesia provider. Interpretation of her clinical exam and rapid intervention were key to preventing a lethal outcome. Central cord syndrome should be considered by anesthesiologists in the differential for respiratory depression following cervical spine surgery.

Keywords

hypercapnia - spinal cord anatomy - spinal cord blood flow

Note

The identification of specific products or scientific instrumentation is considered an integral part of the scientific endeavor and does not constitute endorsement or implied endorsement on the part of the author, Department of Defense, or any component agency. The views expressed in this article are those of the authors and do not necessarily reflect the official policy of the Department of Defense or the U.S. Government.




Publication History

Article published online:
21 August 2022

© 2022. Indian Society of Neuroanaesthesiology and Critical Care. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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