Nontraumatic spinal cord ischaemic syndrome

Rigney, Louise; Cappelen‐Smith, Cecilia; Sebire, Dale; Beran, Roy G.; Cordato, Dennis

doi:10.1016/j.jocn.2015.03.037

Cited by 33 publications

(23 citation statements)

References 24 publications

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“…In general, vascular compromise due to factors such as diabetes mellitus, hypertension, hyperlipidemia, peripheral vascular disease, prior cerebral infarction and age over 60 are thought to be involved in the pathogenesis of spinal cord ischemia. 18,22 The present case had four vascular risk factors. Millichap et al 22 suggested that, it is important to recognize the vascular risk factor to confirm the diagnosis of spinal cord infarction.…”

Section: Discussionmentioning

confidence: 59%

“…16,17 Generally, sharp pain and sensory symptoms are noted at the onset of spinal cord ischemia, followed by rapidly progressive motor weakness and potentially complete paralysis within hours. 15,18 The current case rapidly progressed to tetraplegia. The devastating clinical course suggested the diagnosis of spinal cord infarction.…”

Section: Discussionmentioning

confidence: 81%

“…14 The incidence of signal intensity changes caused by spinal cord ischemia has been reported to range from 45 to 100%, and increases with repeat MRIs. 18 Rubin et al 15 suggested that the main purpose of MRI in the acute phase is to identify a compressive lesion, which can be treated with decompression surgery. Indeed, in this case, we identified definitive ischemic changes based on spinal cord intensity changes on MRI images obtained after surgery.…”

Section: Spinal Cord Infarction With Chronic Compression a Tanida Et Almentioning

confidence: 99%

“…15 In contrast with cerebral and myocardial infarction, there is no consensus regarding the optimal anticoagulation therapy for spinal cord infarction and no treatment guidelines for its management. 18 …”

Section: Spinal Cord Infarction With Chronic Compression a Tanida Et Almentioning

confidence: 99%

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Spinal cord infarction at the level of ossification of the posterior longitudinal ligament

Tanida

Kamimura

Tanishima

et al. 2016

Spinal Cord Ser Cases

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INTRODUCTION:We report a case of acute tetraplegia, without any trauma or symptoms prior to onset, who presented with ossification of the posterior longitudinal ligament (OPLL) in the cervical spine with concomitant spinal cord infarction. CASE PRESENTATION: A 64-year-old man with a number of risk factors for vascular disease was admitted to our hospital with progressive motor weakness in the bilateral upper and lower extremities. He had initially felt numbness in his left upper extremity and had no previous neurological symptoms or trauma. The night after the initial symptoms, he developed spastic tetraplegia requiring respiratory support. Computed tomography images of the cervical spine demonstrated the segmental type of OPLL. Spinal cord compression and signal intensity changes were identified at the level of C3/4 on magnetic resonance imaging (MRI). He underwent emergency surgery consisting of posterior decompression with laminoplasty of C3-6. Despite the surgery, the patient's tetraplegia did not improve and he continued to require respirator support. There was still no improvement in his neurological status at 10 days postoperatively, and MRI demonstrated evidence of marked spinal cord infarction. DISCUSSION: Mechanical compression of spinal arteries by OPLL and pre-existing vascular compromise had a role in the pathogenesis of spinal cord infarction. Chronic spinal compression may be characterized by 3 important factors, namely an uncommonly devastating clinical course, vascular risk factors and persistent findings on MRI, and these might lead to early diagnosis of spinal cord infarction.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 81%

Section: Spinal Cord Infarction With Chronic Compression a Tanida Et Almentioning

confidence: 99%

Section: Spinal Cord Infarction With Chronic Compression a Tanida Et Almentioning

confidence: 99%

See 2 more Smart Citations

Spinal cord infarction at the level of ossification of the posterior longitudinal ligament

Tanida

Kamimura

Tanishima

et al. 2016

Spinal Cord Ser Cases

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“…Hypotension or neurologic conditions such as stroke, transient ischemic attack, hypoxic encephalopathy, spinal cord ischemia, and ischemic neuropathy due to dissection or occlusion of aortic branches supplying the brain, spinal cord or peripheral nerves develop in 17-29% of patients (1,3). Spinal cord ischemia is prevalent with anterior spinal artery syndrome characterized by paraplegia, areflexia, urinary retention, loss of pain, and temperature sensation, and preserved deep sensation (4). MRI is the preferred imaging method (5).…”

mentioning

confidence: 99%

Aortic Dissection Presenting with Transient Paraplegia

Yıldız¹,

Dönmez²,

Bolayir³

et al. 2017

tnd

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A 74-year-old man with a history of arterial hypertension presented with severe back pain and weakness in the legs. In the neurologic examination of patient, who had hypotension and bradicardia, paraparesis (1/5 muscle strength on the right and 2/5 on the left-muscle strength scale) and bilateral Babinski reflex positivity were detected; there was a loss of pain and temperature sensation below T12 level with preserved deep sensation. Contrast-enhanced spiral computed tomographic angiography revealed a minimal increase in the diameter of the ascending aorta (37 mm) and a noncalcific thrombus material surrounding the lumen of the descending aorta with a 7.5 mm size in the largest area ( Figure 1). In sagittal T2-weighted images of thoracic spinal cord magnetic resonance imaging (MRI), there was a hyperintense, "pencil-like" signal change on the anterior of the spinal cord at T8-12 levels (Figure 2A). In axial T2-weighted images, T2 hyperintense signal change patterns called "snake eyes" or "owl's eyes" were observed in the center of the spinal cord ( Figure 2B). The neurologic findings of the patient, who had been treated conservatively with a diagnosis of spinal cord ischemia secondary to type B aortic dissection, completely recovered within hours, but the patient died of sudden cardiac arrest a day after.

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