Subacute posttraumatic ascending myelopathy after spinal cord injury

Belanger, Eric C.; Picard, Claude; Lacerte, Daniel; Lavallée, Pierre; Levi, Allan D.

doi:10.3171/spi.2000.93.2.0294

Cited by 32 publications

(77 citation statements)

References 19 publications

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“…However, a spinal angiogram was not performed on their patient. Angiographic study of the present patient, as well as the patient with an L1 injury reported by Belanger et al, 7 showed no evidence of thrombus in the GAA.…”

Section: Discussionsupporting

confidence: 71%

“…6 They all had fractures of the lower thoracic spine, except one patient with a T5 fracture. More recently, Belanger et al, 7 reported ascending neurological deficit in three patients with spine injuries, starting 7-13 days after injury. 7 Similar to the present patient, one of their cases had a Low baseline blood pressures were noted in their patient, and on postinjury day 12, she developed scapular pain and paresthesia in the upper limbs whenever she sat upright for physiotherapy.…”

Section: Discussionmentioning

confidence: 95%

“…More recently, Belanger et al, 7 reported ascending neurological deficit in three patients with spine injuries, starting 7-13 days after injury. 7 Similar to the present patient, one of their cases had a Low baseline blood pressures were noted in their patient, and on postinjury day 12, she developed scapular pain and paresthesia in the upper limbs whenever she sat upright for physiotherapy. Two days later her sensory level ascended to the T3 level and an MRI showed increased T2-weighted signal between C3 and T1.…”

Section: Discussionmentioning

confidence: 95%

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Subacute delayed ascending myelopathy after low spine injury: case report and evidence of a vascular mechanism

Schmidt

2005

Spinal Cord

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Study design: Case report of a patient with subacute delayed myelopathy after an acute low thoracic spine injury. Objectives: To draw awareness to a rarely described complication with potential to add devastating neurological insult to the original spinal cord injury, and to discuss evidence supporting a vascular mechanism. Setting: Health Science Centre, Winnipeg, Manitoba, Canada. Case report: A 35-year-old woman developed clinical and MRI evidence of ascending myelopathy, extending up to C5, 16 days after a T11/12 fracture dislocation. The distribution of MRI signal abnormality, MRI evidence of prominent venous markings, and association with upright mobilization and the wearing of a thoraco-lumbo-sacral orthosis, suggest that elevated spinal venous pressure in conjunction with low arterial pressure may have induced impaired spinal cord vascular perfusion. Conclusion: After recent spinal cord injury, factors exacerbating spinal venous hypertension and/or arterial hypotension may in some patients lead to impaired spinal cord perfusion. These factors should be considered and corrected if symptoms or signs of progressive myelopathy emerge in the first few days or weeks after injury.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 95%

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Subacute delayed ascending myelopathy after low spine injury: case report and evidence of a vascular mechanism

Schmidt

2005

Spinal Cord

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“…1 Several factors in our cases implicate a vascular mechanism, as with reports by Aito et al, 2 and Schmidt. 3 Case 1 had an injury at the thoraco-lumbar junction, where the artery of Adamkiewicz frequently enters, a potential area of intra-operative interference and ischaemia.…”

Section: Discussionsupporting

confidence: 86%

“…Subacute delayed ascending myelopathy (SDAM) is a rare, underrecognised neurological complication of spinal cord injury (SCI), defined as a delayed, subacute loss of spinal cord and nerve root function greater than four spinal segments above the original lesion unrelated to mechanical instability 1 (Supplementary Table).…”

Section: Introductionmentioning

confidence: 99%

Subacute delayed ascending myelopathy: not just a post-traumatic disorder

Tan

Newey

et al. 2014

Spinal Cord

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Study design: Case report. Objectives: Subacute delayed ascending myelopathy (SDAM), also known as subacute post-traumatic ascending myelopathy, is a rare early neurological complication of spinal cord injury (SCI), and the aetiology, pathogenesis and optimal management of this condition are poorly understood. The radiological features together with the clinical picture appear to be the most useful. We aim to increase awareness and further characterise SDAM. Setting: Spinal Cord Injuries Unit, Royal North Shore Hospital, Sydney, Australia. Methods and Results: We report two cases with radiological findings consistent with SDAM, and review the literature. Only a small number of cases have been reported and importantly, we report the first case occurring following a non-traumatic SCI. There are several hypotheses regarding pathogenesis, with several factors in our cases implicating a vascular mechanism. Conclusion: There is a lack of data characterising SDAM, and ascending myelopathy in a stable SCI should alert the clinician. Importantly, we propose that SDAM is the appropriate terminology.

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