Chapter 34 Spinal strokes

Publisher Summary schemia and infarction of the spinal cord may develop at any age, but frequently affects people aged 41–60. The etiology of spinal infarctions is variable. The chapter presents the classification of obstructive arterial lesions, most often responsible for spinal ischemia and infarction. An obstructive lesion causing spinal cord ischemia can be situated anywhere from the aortic origin of the segmental arteries to the spinal arterioles. Compared with occlusive vascular disease of the brain, spinal cord vascular disease is not as common in clinical practice. Symptomatic aortospinal atherosclerosis does occur, and cord infarction, as well as transient ischemia with reversible neurological deficit, is recognized. Spontaneous and traumatic dissections of the aorta may cause occlusion of the ostium of segmental arteries and hence lead to development of spinal cord infarction. Pressure applied to the lumbar aorta to arrest uterine hemorrhage or contrast medium introduced into the aorta near the ostium of a segmental artery during renal or lumbar aortography might also cause acute ischemia of the spinal cord. The chapter discusses the causative factors of spinal cord strokes, origin and location of vascular lesions of the spinal cord, type of spinal strokes (spinal cord infarction and spinal cord hemorrhage), location of lesion of the spinal cord, features of clinical syndromes, and functional outcome of spinal cord strokes.