Only case reports suggest superiority of MRI over CT scan. Early consultation with appropriate subspecialty is encouraged to guide imaging studies. Immobilize spine if traumatic. Some might suggest methylprednisolone in a regimen similar to traumatic spinal cord injury, or another regimen of steroid for the acute syndrome. For penetrating trauma, steroids have not shown significant benefit.
Surgery is controversial.
The timing of decompression is controversial, with immediate, early, and late surgical decompression showing varying results. Early consultation regarding the use of steroids and any specific regimen is encouraged. Steroids have anti-inflammatory properties and cause profound and varied metabolic effects. In addition, these agents modify the body's immune response to diverse stimuli. They may decrease edema around nerve root segments.