[Acute ischemic spinal cord disease. Spinal cord infarction. A clinical study and MRI in 8 cases].
Acute spinal cord infarction (ASCI) occurs infrequently and may have diverse causes. The diagnosis of ASCI, and particularly of an anterior spinal artery syndrome (ASAS) can be confirmed nowadays by MRI, whereas in the past only necropsy confirmation was possible. Pathophysiology and long-term prognosis may be better known at present and treatments more consistent. We present the longitudinal study and clinical features of 8 patients suffering from ASCI. All of them were personally studied and had MRI examinations, often with sequential studies. three groups must be considered: one included 4 cases of ASAS at cervical level, the second 2 cases of ASAS at thoracic level and the third group with infarction of the conus medullaris (ICM), one of them developed during surgical repair of an infrarenal aortic aneurysm. Motor and sensory sequelae were assessed in each case together with possible etiological factors. In conclusion, recovery after ASAS tends to be dependent on the severity of the initial deficit. At cervical level, clinical and morphological findings argue in favour of an extrinsic selective compression of the C7 right radiculo-medullary artery as responsible for the ASA. At thoracic level, the artery preferentially occluded seems to be the sulco-commisural artery as a consequence of disc compression. Finally, an underlying peculiarity of the pattern of arterial supply is a probable predisposing factor for ICM. Generally, the long-term prognosis of ASCI is not necessarily bad.
Pau Serradell
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Servei de Neurologia, Hospital del Mar. Unisersitat Autònoma de Barcelona, España.
D000328:Adult; D000368:Aged; D001158:Arteries; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007238:Infarction / Q000150:complications / Q000175:diagnosis*; D007511:Ischemia / Q000150:complications / Q000175:diagnosis*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000209:etiology; D010291:Paresis / Q000209:etiology; D011379:Prognosis; D013116:Spinal Cord / Q000098:blood supply*; D013118:Spinal Cord Diseases / Q000175:diagnosis / Q000209:etiology*
Myélopathies aiguës d'origine ischémique. Infarctus médullaires. Etude clinico-évolutive, et IRM de 8 cas.