Document Detail


Spinal cord ischemia: clinical and imaging patterns, pathogenesis, and outcomes in 27 patients.
MedLine Citation:
PMID:  16908737     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The natural history and pathogenesis of ischemic spinal cord infarction remain largely unknown because most clinical studies have included mostly patients with ischemic lesions associated with aortic surgery or prolonged arterial hypotension. OBJECTIVE: To assess the pathogenetic mechanisms and outcomes of these cord infarctions based on clinical findings and spinal vascular anatomy. DESIGN: Retrospective review. PATIENTS: We analyzed the clinical, laboratory, imaging, and outcome data for 27 patients with acute spinal cord infarction admitted between 1990 and 2003. There were 11 men and 16 women (age range, 19-80 years [mean age, 56 years]). RESULTS: Ten patients had anterior spinal artery patterns, 4 each had anterior and posterior unilateral patterns, 3 had central patterns, and 2 each had posterior spinal artery patterns, transverse syndromes, and unclassifiable clinical pictures. Twenty patients had no identifiable etiology. Patients with a central or transverse infarct showed a high frequency of peripheral vascular disease, and all transverse infarcts occurred following prolonged arterial hypotension. The onset of all other infarcts was associated with mechanical triggering movements (P = .02), and these patients frequently had diseases of the spine (P = .003) at the level of the spinal lesion, with the clinical data suggesting root involvement at the level of the spinal cord lesion and pointing to mechanical injury of a radicular artery. The outcomes were favorable, with only 13 patients showing significant gait impairment on leaving the hospital. CONCLUSIONS: There are 2 main types of spinal cord ischemia: (1) radicular artery territory infarct (bilateral anterior or posterior spinal artery infarcts and unilateral infarcts) and (2) extensive spinal cord hypoperfusion (central and transverse infarcts). Each type has characteristic clinical, imaging, pathogenetic, and prognostic features.
Authors:
Jan Novy; Alain Carruzzo; Philippe Maeder; Julien Bogousslavsky
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Archives of neurology     Volume:  63     ISSN:  0003-9942     ISO Abbreviation:  Arch. Neurol.     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-15     Completed Date:  2006-08-31     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372436     Medline TA:  Arch Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1113-20     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurology, Centre Hospitalier Universitaire Vaudois BH10, 1011 Lausanne, Switzerland. Jan.Novy@chuv.ch
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Diagnostic Imaging*
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Retrospective Studies
Risk Factors
Spinal Cord Ischemia / diagnosis*,  epidemiology*
Tomography, X-Ray Computed
Treatment Outcome

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