Hemisection sign of the spinal cord

　　The hemisection sign of the spinal cord is only a syndrome, not a specific etiology. All diseases that can cause hemisectional lesions of the spinal cord can cause the hemisection syndrome of the spinal cord. Common causes include external compression and internal changes in the spinal cord.

　　The causes of external oppression include unilateral intervertebral disc herniation caused by spinal degeneration, spinal cord injury caused by unilateral compression due to spinal fracture, hematoma compressing one side of the spinal cord, hemisection of the spinal cord caused by intraspinal tumors, and knife wounds on one side of the spinal cord.

　　Spinal cord lesions include myelitis, dysfunction of spinal cord vessels, multiple sclerosis, early radiation myelopathy, etc.; in addition, subacute spinal cord necrosis disease caused by paraneoplastic syndrome may also manifest as the hemisection sign of the spinal cord.

　　The common complications of this disease are similar to those of spinal cord injury, and deep vein thrombosis, bedsores, urinary tract infection may occur in the early stage; later, long-term bed-related complications may also occur, including urinary tract stones, pulmonary infection, body temperature disorder, etc.; patients with the hemisection sign of the spinal cord may also experience psychological depression and disorders.

　　The hemisection sign of the spinal cord is a syndrome of paresis of upper motor neurons below the level of injury caused by external compression and internal lesions of the spinal cord, and the general symptoms of this disease are as follows:

　　1. Spinal cord symptoms

　　The disappearance of motor and deep sensation in the ipsilateral limb below the level of injury, and the disappearance of pain and temperature sensation in the contralateral limb are the clinical characteristics of this disease.

　　2. Symptoms of primary disease

　　If it is caused by a knife wound, there will be skin and muscle knife wound; if it is caused by spinal fracture and dislocation, the symptoms will appear suddenly, with a history of trauma, accompanied by neck pain, limited movement, etc.; patients with intraspinal tumors have a longer course of disease, and the appearance of clinical symptoms has a process, and the symptoms gradually progress; patients caused by hematoma compression have a history of hematoma formation, such as recent surgical history, spontaneous hemorrhagic history, etc.; patients with myelitis have rapid onset of symptoms, with a history of fever, and patients with dysfunction of spinal cord vessels have a short course of disease and an acute onset, multiple sclerosis has a long course of disease, and radiation myelopathy has a special history of radiation exposure, etc.

　　Reasonable prevention is the key to reducing the incidence of disease. The daily preventive measures for the hemisection sign of the spinal cord are as follows:

　　1. People engaged in high-risk professions (such as high-altitude workers and drivers) should avoid neck trauma.

　　2. For patients with a history of cervical spine disease, regular follow-up should be carried out to detect the potential compression of the spinal cord early, and attention should be paid to avoid neck trauma.

　　3. Pay attention to keeping warm in daily life, reduce the chance of catching a cold and upper respiratory tract infection, and reduce the possibility of spinal cord inflammation.

　　It is relatively difficult to prevent the hemisection sign of the spinal cord. The most important thing is to make an early diagnosis and treatment when symptoms occur.

　　The application of the existing examination conditions should be comprehensive in diagnosing the causes of the hemisection sign of the spinal cord. For patients with spinal cord injury, cervical X-ray films, CT, and MRI should be performed, and if necessary, the nerve evoked potential examination of the limbs should be carried out to determine whether there is compression and edema hemorrhage of the spinal cord; at the same time, these examinations can also observe the condition of the spinal cord and the intraspinal canal, thereby distinguishing it from intraspinal and spinal cord tumors. If there is a suspicion of myelitis, routine and biochemical examinations of cerebrospinal fluid can be performed. If there is a suspicion of vascular factors, DSA or MRA examination of the spinal cord vessels can be performed.

　　A reasonable diet is the key to disease recovery. Generally, patients with spinal cord hemisection should pay attention to the following in their daily diet:

　　1. Do not eat or eat less egg yolks, animal brains and viscera, and crustaceans such as clams, snails, and crabs to control cholesterol.

　　2. Do not eat or eat less animal oil, and eat more vegetable oil, peanut oil, sesame oil, corn oil (oil food) and other vegetable oils to control fat.

　　3. Do not eat or eat less candy and other foods with high sugar content to control sugar intake. And as cardiovascular disease patients, they can choose their favorite foods according to their own condition.

　　4. Eat more nuts, small fish, and small shrimps to increase calcium intake.

　　5. Choose low-sodium, low-fat, low-cholesterol foods rich in vitamins and high in potassium and calcium, increase dietary fiber intake, eat small and frequent meals, and avoid overeating and binge eating.

　　The treatment of spinal cord hemisection mainly includes conservative treatment and surgical treatment, and the specific treatment methods are as follows:

　　1. Conservative Treatment

　　For spinal cord inflammation, multiple sclerosis, and other intrinsic lesions, there is no external compression and intramedullary tumor, conservative treatment can be provided. Conservative treatment includes: using external fixation such as neck collars and traction; using medication, mainly including neurotrophic drugs, nerve function protective drugs, and nerve decongestants; other treatment methods can also be used, such as hyperbaric oxygen therapy.

　　2. Surgical Treatment

　　If there is external compression on the spinal cord, such as fractures and dislocations, intramedullary tumors, intervertebral disc herniation, hematoma compression, and other reasons, surgery is often required to remove the compression. Otherwise, the spinal cord will remain in a compressed state and cannot recover. However, the specific surgical method should be determined according to the different causes. Some fractures and dislocations may not be found to have compression after examination, but there is instability in the spine, which causes compression of the spinal cord at the moment of injury. This situation also requires surgical treatment. The surgery mainly involves the removal of the compressive object, and at the same time, internal fixation of the spine and other stable surgical treatments are given to enhance the therapeutic effect.