Current and emerging treatment options for spinal cord ischemia

Nardone, Raffaele; Pikija, Slaven; Mutzenbach, Johannes Sebastian; Seidl, M.; Leis, Stefan; Trinka, Eugen; Sellner, Johann

doi:10.1016/j.drudis.2016.06.015

Cited by 30 publications

(34 citation statements)

References 115 publications

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“…The clinical presentation, however, might be misjudged as radicular nerve compression, cardiac emergency, or aortic pathology. The reported delays are unfortunate, as spinal cord infarction is associated with detrimental functional outcome (29). Further, timely admission to the stroke unit might be associated with better outcome and thrombolytic therapies appear to have a logical role in the management of spinal cord infarction (6, 29).…”

Section: Discussionmentioning

confidence: 99%

“…The reported delays are unfortunate, as spinal cord infarction is associated with detrimental functional outcome (29). Further, timely admission to the stroke unit might be associated with better outcome and thrombolytic therapies appear to have a logical role in the management of spinal cord infarction (6, 29). Stroke unit care has been shown to be beneficial regardless of the stroke etiology following acute ischemic and hemorrhagic stroke (30).…”

Section: Discussionmentioning

confidence: 99%

“…Stroke unit care has been shown to be beneficial regardless of the stroke etiology following acute ischemic and hemorrhagic stroke (30). Beyond the established stroke unit standards of care, initiation of antiplatelet therapy or heparin would be the obvious consequence with the presence of vascular risk factors or potentially progressive etiologies of spinal cord infarction such as vertebral artery dissection (29). In traumatic spinal cord injury, higher blood pressure correlated with better neurological recovery (31).…”

Section: Discussionmentioning

confidence: 99%

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Delayed Hospital Presentation and Neuroimaging in Non-surgical Spinal Cord Infarction

et al. 2017

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BackgroundLack of timely recognition and neuroimaging may be a barrier to reperfusion efforts in acute spinal cord infarction.MethodsWe performed a retrospective study of patients diagnosed with acute non-surgical spinal cord infarction at our tertiary academic center from 2001 to 2015. We studied parameters associated with time from symptom onset to initial hospital presentation and magnetic resonance imaging (MRI) of the spinal cord.ResultsWe identified 39 patients among whom anterior spinal artery syndrome was the most frequent presentation (87.2%) and atherosclerosis the most common etiology (56.4%). Nearly, half of the patients presented to the emergency department on the same day of symptom onset (48.7%) but only nine (23.1%) within the first 6 h. Average time from symptom onset to spinal cord MRI was 3.2 days. We could not identify clinical, radiological, or outcome patterns associated with early vs. delayed presentation and imaging.DiscussionOur study found a time lag from symptom onset to hospital presentation and spinal cord MRI in patients with acute spinal cord infarction. These findings point at low clinical suspicion of spinal cord syndromes and limited recognition as a potentially treatable medical emergency.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Delayed Hospital Presentation and Neuroimaging in Non-surgical Spinal Cord Infarction

et al. 2017

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“…Deshalb wird die therapeutische Gabe von Heparin für die ersten 3 Monate nach festgestelltem neurologischem Defizit empfohlen. Im Falle eines liegenden Spinalkatheters erfolgt die erste Gabe frühestens 1 h nach Entfernung [28]. Entsprechend der aktuellen Studienlage ist nicht zu beantworten, inwieweit dies auch prophylaktisch nach ausgedehnten Operationen an der thorakoabdominellen Aorta zu empfehlen ist [28].…”

Section: Antikoagulationunclassified

Prophylaxe der Rückenmarkischämie bei Therapie von Aortenaneurysmen

Aspern¹,

Etz²

2017

Gefäßmedizin Scan

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“…Spinal cord ischemia-reperfusion injury (SCII) is a serious complication that commonly occurs following thoracoabdominal aortic surgery and results in severe neurological deficits 1 . There are two main types of spinal cord ischemia: infarction of the radicular arteries and extensive spinal cord hypoperfusion 2 . SCII during surgeries of the thoracoabdominal vasculature could result in severe complications, such as paraplegia 3 .…”

Section: Introductionmentioning

confidence: 99%

The transcription factor Foxd3 induces spinal cord ischemia-reperfusion injury by potentiating microRNA-214-dependent inhibition of Kcnk2

Zhao

Ruan

et al. 2020

Exp Mol Med

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Spinal cord injury after surgical repair of the thoracic or thoracoabdominal aorta is a devastating complication that is associated with pathological changes, including inflammation, edema, and nerve cell damage. Recently, microRNA (miRNA)-modulated control of spinal cord injury has been actively investigated. This study aims to clarify the regulatory effect of miR-214-mediated inhibition of Kcnk2 following spinal cord ischemia-reperfusion injury (SCII) and the possible underlying mechanisms. SCII was induced in rats by occluding the aortic arch followed by reperfusion. Gain-of-function and loss-of-function experiments were conducted to explore the modulatory effects of Foxd3, miR-214 and Kcnk2 on PC12 cells under hypoxia/reoxygenation (H/R) conditions. MiR-214 and Kcnk2 were poorly expressed, while Foxd3 was highly expressed in the rat spinal cord tissues and H/R-treated PC12 cells. Kcnk2 overexpression enhanced the viability and inhibited the apoptosis of the H/R-treated PC12 cells. Notably, Foxd3 activated miR-214, and miR-214 targeted Kcnk2. In addition, upregulation of Kcnk2 or knockdown of Foxd3 promoted the cell viability and reduced the apoptosis of the H/R-treated PC12 cells. Overall, our study identified a novel mechanism of Foxd3/miR-214/Kcnk2 involving SCII, suggesting that either Foxd3 or miR-214 may be a novel target for the treatment of SCII.

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Current and emerging treatment options for spinal cord ischemia

Cited by 30 publications

References 115 publications

Delayed Hospital Presentation and Neuroimaging in Non-surgical Spinal Cord Infarction

Delayed Hospital Presentation and Neuroimaging in Non-surgical Spinal Cord Infarction

Prophylaxe der Rückenmarkischämie bei Therapie von Aortenaneurysmen

The transcription factor Foxd3 induces spinal cord ischemia-reperfusion injury by potentiating microRNA-214-dependent inhibition of Kcnk2

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