Document Detail

Long-term outcome of acute spinal cord ischemia syndrome.
MedLine Citation:
PMID:  14726546     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: Current knowledge of long-term outcome in patients with acute spinal cord ischemia syndrome (ASCIS) is based on few studies with small sample sizes and <2 years' follow-up. Therefore, we analyzed clinical features and outcome of all types of ASCIS to define predictors of recovery. METHODS: From January 1990 through October 2002, 57 patients with ASCIS were admitted to our center. Follow-up data were available for 54. Neurological syndrome and initial degree of impairment were defined according to American Spinal Injury Association (ASIA)/International Medical Society of Paraplegia criteria. Functional outcome was assessed by walking ability and bladder control. RESULTS: Mean age was 59.4 years; 29 were women; and mean follow-up was 4.5 years. The origin was atherosclerosis in 33.3%, aortic pathology in 15.8%, degenerative spine disease in 15.8%, cardiac embolism in 3.5%, systemic hypotension in 1.8%, epidural anesthesia in 1.8%, and cryptogenic in 28%. The initial motor deficit was severe in 30% (ASIA grades A and B), moderate in 28% (ASIA C), and mild in 42% (ASIA D). At follow-up, 41% had regained full walking ability, 30% were able to walk with aids, 20% were wheelchair bound, and 9% had died. Severe initial impairment (ASIA A and B) and female sex were independent predictors of unfavorable outcome (P=0.012 and P=0.043). CONCLUSIONS: Considering a broad spectrum of clinical presentations and origins, the outcome in our study was more favorable than in previous studies reporting on ASCIS subgroups with more severe initial deficits.
Krassen Nedeltchev; Thomas J Loher; Frank Stepper; Marcel Arnold; Gerhard Schroth; Heinrich P Mattle; Matthias Sturzenegger
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2004-01-15
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  35     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-02-03     Completed Date:  2004-04-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  560-5     Citation Subset:  IM    
Department of Neurology, University Hospital of Bern, Inselspital, Bern, Switzerland.
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MeSH Terms
Acute Disease
Disability Evaluation
Follow-Up Studies
Gait Disorders, Neurologic / etiology
Magnetic Resonance Imaging
Middle Aged
Neurologic Examination
Outcome Assessment (Health Care) / statistics & numerical data*
Recovery of Function
Risk Factors
Severity of Illness Index
Sex Factors
Spinal Cord Ischemia / complications,  diagnosis*,  physiopathology*
Urinary Bladder, Neurogenic / etiology

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