From the Guidelines
A spinal cord stroke, also known as spinal cord infarction, occurs when the blood supply to the spinal cord is interrupted, leading to tissue damage and neurological dysfunction, with the anterior spinal artery being the most commonly affected vessel [27,28,45-47]. The mechanism of a spinal cord stroke involves the disruption of blood flow to the spinal cord, causing a lack of oxygen and nutrients to the tissue, which triggers a cascade of cellular damage, including excitotoxicity, free radical production, and inflammatory responses 49, 50. The clinical presentation of a spinal cord stroke depends on the location and extent of the damage, with symptoms potentially including sudden onset of weakness, sensory changes, and bowel or bladder dysfunction 1. Some of the key factors that contribute to the development of a spinal cord stroke include atherosclerosis, aortic surgery or dissection, hypotension, and vasculitis, which can all lead to the interruption of blood flow to the spinal cord 1. In terms of diagnosis, MRI is a useful tool for evaluating the spinal cord and surrounding tissues, particularly in cases where spinal cord ischemia is suspected, with diffusion-weighted imaging being able to show signal alteration in the spinal cord earlier after symptom onset compared to T2-weighted images 49, 50. The use of IV contrast can also be helpful in evaluating the spinal cord, particularly in cases where there is suspicion of an alternative inflammatory or infectious etiology 42, 43. Overall, the key to managing a spinal cord stroke is prompt recognition and treatment, with the goal of restoring blood flow to the affected area and minimizing tissue damage.
From the Research
Mechanism of Spinal Cord Stroke
The mechanism of a spinal cord stroke is not directly addressed in the provided studies. However, some studies discuss the management and treatment of acute spinal cord injury, which may be related to spinal cord stroke.
Pathophysiology of Spinal Cord Injury
- The pathophysiology of spinal cord injury involves damage to the spinal cord, which can result from trauma, compression, or other causes 2.
- The injury can lead to a range of symptoms, including neurological deficits, pain, and loss of motor function 3.
Diagnosis and Management of Spinal Cord Emergencies
- Spinal cord emergencies, including spinal cord stroke, require prompt diagnosis and treatment to prevent irreversible damage 3.
- Emergent magnetic resonance imaging (MRI) of the entire spine is the imaging modality of choice for nontraumatic spinal cord emergencies, and can help differentiate between extramedullary compressive causes and intramedullary etiologies 3.
Treatment of Acute Spinal Cord Injury
- The use of methylprednisolone sodium succinate (MPSS) in the treatment of acute spinal cord injury is a topic of debate, with some studies suggesting that it may not be effective in improving outcomes 4, 5, 6.
- Other treatment options, such as early surgical decompression and fixation, vasopressor medications, and corticosteroids, may be used to manage acute spinal cord injury 2.