Spinal cord infarction in Chinese patients. Clinical features, risk factors, imaging and prognosis.
BACKGROUND
The clinical presentations, MRI findings and outcomes for spinal cord infarction (SCI) are well documented in the West but scarce in the East. We investigated the clinical characteristics of SCI patients and further analyzed etiologies and prognostic factors in Chinese subjects.


METHODS
We reviewed all SCI patients from March 1993 to March 2007. Clinical symptoms, laboratory and imaging findings as well as outcomes were retrospectively analyzed.


RESULTS
Twenty-two patients (12 female) were identified; their mean age was 57.6 years. Nine patients (40.9%) had probable etiologies, while 13 were cryptogenic (59.1%). The primary etiologies were aortic diseases. Hypertension was the most common vascular risk factor (50%). Most patients (10/22 = 45.5%) had thoracolumbar lesions (mainly at T(9)-L(1)), while cervical lesions (9/22 = 40.9%) were the second most common (mainly at C(4)-C(7)). 'Owl's eyes' signs were common with the anterior spinal artery (93.8%) and central cord infarctions (50%) but not in the posterior spinal artery or transverse spinal infarctions. After a mean follow-up of 18 months, only 10 patients (10/22 = 45%) had good outcomes (independent walking or walking with 1 aid).


CONCLUSIONS
Most SCI patients had acute, monophasic symptoms, reaching nadir in <24 h. The subjects frequently had acute pain near their lesions before SCI signs/symptoms (16/22 = 72.7%). Initial severe weakness (Medical Research Council score < or =2) and a young age at onset (55 years old) are correlated with poor recovery of motor functions.
Cheng
Mei-Yun
MY
Department of Neurology, Chang Gung Memorial Hospital and Chang Gung University, Taipei, Taiwan, ROC.
Lyu
Rong-Kuo
RK
Chang
Yeu-Jhy
YJ
Chen
Rou-Shayn
RS
Huang
Chin-Chang
CC
Wu
Tony
T
Lee
Tsong-Hai
TH
Lu
Chin-Song
CS
Ro
Long-Sun
LS
D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D044466:Asian People / Q000706:statistics & numerical data; D001416:Back Pain / Q000208:ethnology / Q000209:etiology; D002318:Cardiovascular Diseases / Q000150:complications / Q000208:ethnology; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D007238:Infarction / Q000208:ethnology* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010147:Pain Measurement; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013116:Spinal Cord / Q000098:blood supply*; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking