Clinical core symptoms of posterior spinal artery ischemia.

Introduction: Ischemia in the distribution of the posterior spinal artery is rare. Methods: Between 2004 and 2008 we observed 4 patients with posterior spinal artery ischemia (PSAI). Results: All patients had the expected loss of posterior column function but also suffered from motor deficits which were severe, and the leading symptom in 2 patients. Severe pain, bowel and bladder dysfunction were other concomitant symptoms. In 3 of 4 patients, a follow-up spinal MRI was needed to show the cord infarct together with vertebral body ischemia in 2 patients. Conclusion: An acute onset of posterior column dysfunction with a variable degree of motor deficit and dorsalgia suggests PSAI.