Incidence of Non-Traumatic Spinal Cord Stroke
Spinal cord infarction (spinal cord stroke) without traumatic injury is rare, accounting for only 0.3-1% of all strokes. 1
Epidemiological Context
- Non-traumatic spinal cord stroke represents an uncommon but devastating neurological emergency, with an incidence far lower than cerebral stroke 2, 1
- The condition is often a diagnostic challenge for clinicians due to its rarity and variable presentation 2
- Spinal cord infarction patients tend to be younger and more often women compared to cerebral infarction patients, with traditional cerebrovascular risk factors being less relevant 1
Clinical Significance Despite Low Incidence
While the absolute number of cases is small compared to traumatic spinal cord injury (which has an annual incidence of 10-85 cases per million persons) 3, non-traumatic spinal cord stroke carries important clinical implications:
- Patients present with severe initial deficits but often show good functional improvement over time 1
- On long-term follow-up, spinal cord infarction patients have lower mortality and higher emotional well-being scores compared to cerebral infarction patients 1
- Approximately 20% of patients experience biphasic spinal cord strokes, presenting initially with acute or transient sensory deficits often preceded by radiating pain between the shoulders, which should be treated as imminent spinal cord strokes 1
Diagnostic and Prognostic Factors
- On admission, younger age, male gender, hypertension, diabetes mellitus, and elevated blood glucose indicate more severe spinal cord strokes 1
- Emergent MRI of the entire spine is the imaging modality of choice for diagnosing non-traumatic spinal cord emergencies 4
- Despite the severity of initial presentation, spinal cord infarction patients are more likely to be discharged home and show better improvement after initial treatment compared to cerebral infarction patients 1
Key Clinical Pitfall
The rarity of this condition (0.3-1% of all strokes) means it is frequently not considered in the differential diagnosis of acute neurological deficits, leading to delayed recognition and treatment 2, 1. Early detection is critical, as neurologic deficits may quickly become irreversible 4.