title: Hemodynamic infarction of the spinal cord: involvement of the gray matter plus the border-zone between the central and peripheral arteries.
abstract: OBJECTIVE
  Hemodynamic infarction of the spinal cord that affected an 81-year-old female having a dissecting aortic aneurysm is presented. During the graft replacement operation, systemic hypotension occurred and the patient was subsequently complicated with paraplegia of the lower limbs. The patient died 2 weeks after the surgery due to gastrointestinal bleeding. An autopsy, which did not include the brain, was performed and the spinal cord was sampled. The aim of this report is to describe the pathologic profile of the spinal cord of the patient, and to gain insight into the pathogenesis of the lesion.
  
  
  METHODS
  Histochemical and immunohistochemical methods were employed to study the spinal cord ranging from the lower thoracic to sacral segments.
  
  
  RESULTS
  The whole central areas of the spinal cord showed coagulation and/or liquefaction necroses, while the white matter on the circumference of the cord remained unaffected, thus exhibiting a 'ring-like' appearance.
  
  
  CONCLUSIONS
  This case is an example of hemodynamic infarction of the spinal cord involving the gray matter that is supplied by the central artery, plus the border-zone that is supplied by both the central and peripheral arteries. The former is probably associated with selective vulnerability of the gray matter to ischemia, while the latter is probably associated with intrinsic vulnerability of the border-zone to systemic hypotension or low blood-flow states.
authors.affiliation: Department of Pathology, Saitama Medical School, Saitama, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Ishizawa
authors.forename: T
authors.initials: T
authors.lastname: Komori
authors.forename: T
authors.initials: T
authors.lastname: Shimada
authors.forename: E
authors.initials: E
authors.lastname: Arai
authors.forename: K
authors.initials: K
authors.lastname: Imanaka
authors.forename: S
authors.initials: S
authors.lastname: Kyo
authors.forename: T
authors.initials: T
authors.lastname: Hirose
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000209:etiology / Q000473:pathology*; D015703:Antigens, CD / Q000378:metabolism; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism; D001014:Aortic Aneurysm / Q000209:etiology / Q000473:pathology*; D001921:Brain / Q000378:metabolism / Q000473:pathology; D005260:Female; D006651:Histocytochemistry / Q000379:methods; D006801:Humans; D007238:Infarction / Q000209:etiology / Q000473:pathology*; D013119:Spinal Cord Injuries / Q000150:complications / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D000097382:CD68 Molecule
chemical_list: D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; C067980:CD68 antigen, human; D000097382:CD68 Molecule