Extra medullary compression of the spinal cord. For discussion of these images, follow episode five and six of podcast ‘Clinical neurology with KD’ in Apple podcast, Spotify or Google podcast. An extramedullary compressive lesion goes through three stages, according to Oppenheim. An initial stage of radicular pain and segmental motor and sensory symptoms. The initial phase is followed by a Brown-Sequard syndrome and finally a complete transection of the cord. The rapidity of development of these stages depends on the aetiology and can be acute or chronic. Some of the cardinal features of extramedullary compression include Radicular or root pain, which is a unilateral lancinating pain down the dermatome on coughing, straining, or Valsalva. The patient will have early corticospinal tract involvement with lower limb spasticity more than the upper limb. The leg is more involved as leg fibres are laterally placed in the corticospinal tract than arm fibres. The LMN findings are rare and, if present, occur at the segmental level at the site of compression. The patient will have only late bladder involvement. They have ascending paresthesia as sacral fibres are laterally placed in the spinothalamic tract. Funicular or tract pain is less common. The patient can have vertebral pain and tenderness, which suggest extramedullary extradural lesion. #clinicalneurologywithkd #neurologyteachingclub #paediatricneurology #NTC #neurology #neurosciences #neuro #clinicalneurology #medicine #clinicalmedicine #criticalcaremedicine #mbbs #medicos #doctors #neuroanatomy #casediscussion #medicineresidents #residency #medschool #futureneurologist #neuroimages #NEET #finalmbbs #neetpg #neetsuperspeciality #neetmedicine #eanneurology #nejm #emergencymedicine #spinalcord https://www.instagram.com/p/Cds4asLpst1/?igshid=NGJjMDIxMWI=
