Acute central cord syndrome without bony injury

Three cases of acute central cord syndrome without bony injury are described. These injuries are not uncommon and an extensive literature is available on the subject. Nevertheless, the diagnosis is still often overlooked on initial examination. The relationship between facial injury and spinal paralysis, together with changes of cervical spondylosis, is stressed and should alert the examiner to the correct diagnosis. Because the hands are worst affected, these patients need special help. The residual paralysis in the upper limbs is of the lower motor neurone type and may be permanent.