(b)Anterior cord syndrome results in variable degrees of motor paralysis,
and loss of temperature and pain sensation below the level of the lesion. Its
hallmark is preservation of vibratory sensation and proprioception because of
an intact dorsal column. (c)Brown-Séquard syndrome results in ipsilateral
loss of motor strength, vibratory sensation, and proprioception, and con-
tralateral loss of pain and temperature sensation. (d)Transverse myelitis is an
inflammatory process that produces complete motor and sensory loss below
the level of the lesion. (e)Parkinson disease develops over years and does not
result in paralysis.
145.The answer is e.(American College of Surgeons Committee on
Trauma, pp 79-80.)The decision to begin blood transfusion in a trauma
patient is based on the initial response to crystalloid volume resuscitation.
Blood products should be administered if vital signs transiently improve
or remain unstable despite resuscitation with 2 to 3 L of crystalloid fluid.
However, if there is obvious major blood loss and the patient is unstable,
blood transfusion should be started concomitantly with crystalloid adminis-
tration. The main purpose in transfusing blood is to restore the oxygen-
carrying capacity of the intravascular volume. Fully cross-matched blood is
preferable (eg, type B, Rh-negative, antibody negative); however, this process
may take more than 1 hour, which is inappropriate for the unstable trauma
162 Emergency Medicine
ArmTrunkTrunkLegLegCervicalThoracicLumbarSacralPosterior hornDorsal column
(position, vibration, light touch)Lateral cortico-
spinal tract
(motor)Lateral spinothalamic
tract
(pain, temperature)Arm(Reproduced, with permission, from Schwartz DT.Emergency Radiology:Case Studies.
New York, NY: McGraw-Hill; 2007: chap V-4, Figure 15.)