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Summary. The anterior spinal artery syndrome in three patients is described and from the literature 60 additional patients were collected. Motor recovery in the following groups of patients was noted: (I) Partial loss of motor function and pain sensation-70'4 per cent (19/27); (2) Complete motor loss but partial loss of pain-83 3 per cent (5/6); (3) Paresis but pain sensation absent-66'7 per cent (6/9); and (4) Absent motor function and pain-38-9 per cent (7/18). Motor recovery was also found to vary according to aetiology: (A) Unknown cause-92'9 per cent (13/14); (B) Post-infection or vaccination-88'9 per cent (8/9); (C) Anterior spinal artery occlusion-33'3 per cent (3/9); CD) Spinal cord angioma-20 per cent (2/10); and (E) Aortic lesion-20 per cent (1/5).Patients with sparing of motor function or pain sensation below the lesion do better than those without both functions. Neurological return also varies with the aetiology of the syndrome.

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Five patients with vertebral fracture and spinal epidural hematoma (SEH) are described. Another 58-year-old man developed a post-traumatic SEH without bony damage. From the literature, 38 patients (31 male, 4 female, and 3 unknown) were collected. Ankylosing spondylitis or rheumatoid arthritis was noted in 9 of 12 subjects between 50 and 75 years of age. Two groups of patients were identified: Group 1--16 patients with spinal fracture (aged 23 to 63 years), and Group 2--22 patients without spinal fracture (the age was less than 18 years in 12 subjects). In Group 2, a coagulation defect or spinal epidural vascular malformation resulted in a SEH in 6 patients. The preoperative myelopathy was complete in 3 patients each from Group 1 (23.1%) and Group 2 (16.7%). Of the 31 patients operated upon, 9 of the 13 from Group 1 (69.3%) and 6 of the 18 from Group 2 (33.3%) underwent laminectomy within 1 week after the onset of symptoms. Postoperative neurological return was observed in 38.5% (5 of 13) and 88.9% (16 of 18) of these two groups of patients, respectively. Post-traumatic SEHs, predominant in the male population, are often associated with vertebral disease in elderly patients. In the very young patient, there is usually no fracture/dislocation of the spine. A predisposing lesion may be present when spinal fracture is not evident. The prognosis after surgical intervention is better in patients without spinal fracture than in those with vertebral damage, probably because of less contusion to the spinal cord and the presence of very young subjects in the former group of patients.

SummaryWithin a period of 12 years 466 patients with acute spinal cord injury were admitted to our Centre, seven of these having ankylosing spondylitis (AS), A history of alcohol consumption preceding the accident was present in five patients, and in four there was a history of neurological deterioration before their admission. An epidural hematoma was found in one patient and four expired within 3 months of their injury,The incidence of ankylosing spondylitis in cervical cord injury was 1.5°,,, and an associated epidural hematoma was present in some 14% of the patients, The mortality rate was 57%, There was a high incidence of alcoholic use before the accident. Neurological deterioration commonly occurred before admission,