From the Research
Anterior spinal artery syndrome presents with distinct early and late features due to ischemia in the territory supplied by the anterior spinal artery, with early features including sudden onset of bilateral motor weakness, loss of pain and temperature sensation, and bladder and bowel dysfunction, as reported in a case study published in 2020 1. The early features of anterior spinal artery syndrome include:
- Sudden onset of bilateral motor weakness below the level of the lesion
- Loss of pain and temperature sensation below the lesion due to involvement of the spinothalamic tracts
- Bladder and bowel dysfunction
- Radicular pain at the level of the lesion These features are a result of ischemia in the territory supplied by the anterior spinal artery, which can be caused by various factors such as aortic surgery, severe hypotension, embolic events, atherosclerosis, and trauma, as discussed in a study published in 2020 2. The late features of anterior spinal artery syndrome develop as the condition progresses and include:
- Spastic paraparesis or quadriparesis depending on the level of injury
- Hyperreflexia
- Positive Babinski signs
- Muscle atrophy
- Autonomic dysfunction with persistent bladder and bowel incontinence
- Neuropathic pain syndromes A study published in 2024 3 highlights the importance of recognizing the potential for spinal cord infarction secondary to spinal anesthesia, which can lead to anterior spinal artery syndrome. Management of anterior spinal artery syndrome focuses on treating the underlying cause, maintaining spinal cord perfusion, and rehabilitation, as reported in a case study published in 2020 1. Prognosis depends on the extent of ischemia, with complete occlusions generally having poor outcomes for motor recovery, as discussed in a study published in 2000 4.