Pain and Phantom Sensation

Abstract

Anatomic postmortem studies of cord injuries have shown that changes are initially more prominent in the center of the cord, as initially small gray matter hemorrhage and edema which progress through to central necrosis, white matter edema, and demyelination. Finally, massive injuries, transversely involve the entire cord. A tapered cone of destruction exists above and below the major transection. The zone of destruction may then involve all or part of the documented tract systems subserving pain, segmentally, intersegmental, or suprasegmentally. Complete transection is rarely seen, and even in fibrous segments anatomically intact fibers can be differentiated.