Fact-sheet: Spinal cord infarction - stroke

Updated on 10/04/2019 at 9:04 AM

Note : 10/10 ( 1 note )

Definition

Ischemic vascular event of the spinal cord

ARTERIAL SPINAL CORD VASCULARIZATION:

Anterior spinal artery (more common): supplies the anterior two-thirds of the spinal cord At the cervical level: arises from the vertebral arteries
At the thoracic level: arises from the intercostal arteries
At the lumbar level: artery of Adamkiewicz (variable origin)
Posterior spinal territory (less common), supplies the posterior third

ETIOLOGIES:

Iatrogenic causes ++ Surgical: aortic surgery for aortic aneurysms, spine or spinal cord surgery
Complications of spinal X-Ray Angiography or of treatment
Complications of epidural anesthesia
Aortic disease Atherosclerosis
Dissection
Vertebral artery occlusion (dissection)
Spinal cord embolism Embolic cardiopathies
Decompression sickness (diving)
Fibrocartilaginous embolism (migration of disc material)
Systemic diseases (infectious, inflammatory, or hematologic)

Sudden or rapidly progressive onset:

Anterior spinal territory: pain, flaccid paralysis with dissociated sensory loss (thermoalgesic anesthesia) below the lesion, most often bilateral, sometimes associated with bladder-sphincter dysfunction
Posterior spinal territory: sensory disturbances most often bilateral, predominant impairment of proprioception (proprioceptive ataxia)

LP: mild elevation of CSF protein

ACUTE STAGE:

Diffusion hyperintensity with decreased ADC

T2 hyperintensity predominating in the gray matter with an "owl's eye" appearance, respecting a vascular territory:

SUBACUTE STAGE: possible contrast enhancement

CHRONIC STAGE: localized atrophy