First described by Schneider in 1954, the syndrome of acute central cervical spinal cord injury is characterized by disproportionately greater motor impairment in the upper compared to the lower extremities, bladder dysfunction and a variable degree of sensory loss below the level of injury. The syndrome has a good prognosis for neurologic and functional recovery. Spontaneous improvement of function is typical. Ten cases are reported. Clinical features, diagnosis and management are discussed.