Differential Diagnosis
- Single most likely diagnosis
- C) Central cord syndrome: This is the most likely diagnosis given the patient's inability to move his arms, decreased grip strength, and intact sacral sensation. Central cord syndrome typically presents with greater weakness in the upper limbs compared to the lower limbs, which is consistent with the patient's symptoms.
- Other Likely diagnoses
- A) Brachial plexus injury: Although less likely, a brachial plexus injury could also explain the patient's weakness in his arms. However, this would typically be associated with other symptoms such as numbness or tingling in the affected limbs.
- B) Brown-Séquard syndrome: This diagnosis is less likely as it typically presents with hemisection of the spinal cord, resulting in ipsilateral weakness and loss of proprioception, with contralateral loss of pain and temperature sensation. The patient's symptoms do not clearly fit this pattern.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Spinal epidural hematoma or other spinal cord injury: Although the CT scans of the head and cervical spine show no abnormalities, it is essential to consider other potential spinal cord injuries that may not be immediately apparent on imaging. These conditions can be life-threatening and require prompt diagnosis and treatment.
- Cervical spine fracture or instability: Similarly, a cervical spine fracture or instability may not be immediately apparent on CT scans, and it is crucial to consider this possibility to avoid further injury or complications.
- Rare diagnoses
- D) Cervical radiculopathy: This diagnosis is less likely as it typically presents with pain, numbness, or tingling in a specific dermatomal distribution, which is not clearly described in the patient's symptoms.
- E) Malingering: This diagnosis is unlikely as the patient's symptoms and physical examination findings are consistent with a traumatic injury, and there is no indication of factitious disorder or secondary gain.