It usually results from trauma which causes damage to the neck, leading to major injury to the central corticospinal tract of the spinal cord.

CCS also has a classic presentation of "dissociated sensory loss", specifically pain and temperature, due to involvement of the centrally-located anterior white commissure containing decussating fibers of the spinothalamic tract at the affected level.

More recently, autopsy studies have demonstrated that CCS may be caused by bleeding into the central part of the cord, portending less favorable prognosis.

Studies also have shown from postmortem evaluation that CCS probably is associated with selective axonal disruption in the lateral columns at the level of the injury to the spinal cord with relative preservation of the grey matter.

After entering the ICU, early immobilization of the cervical spine with a neck collar would be placed on the patient to limit the potential of further injury.

[citation needed] With respect to physical therapy interventions, it has been determined that repetitive task-specific sensory input can improve motor output in patients with central cord syndrome.

These activities enable the spinal cord to incorporate both supraspinal and afferent sensory information to help recover motor output.