Spinal Cord Ischemia

What is Spinal Cord Ischemia? Spinal cord ischemia is an infarction of the blood supply to the spinal cord. Spinal cord ischemia is rare, accounting for less than 2% of all strokes. As the anterior spinal artery provides most of the arterial supply, acute ischemia involving the vessel is more common than the posterior spinal artery, presenting as bilateral flaccid paralysis, loss of pain and temperature sensation, autonomic dysfunction, and rapid decline. Ischemias involving the posterior spinal artery or both arteries are less common and less severe. Ischemias involving the venous supply of the spine are rare and the presentation is often indolent.

What causes Spinal Cord Ischemia?

Spinal cord ischemia in adults is most commonly caused as a consequence of atherosclerosis and includes many of the traditional risk factors of cardiovascular diseases. Other etiologies include:

  • Thoracoabdominal aneurysms
  • Aortic surgery
  • Embolic disease
  • Arterial dissection 
  • Systemic hypotension
  • Spinal arteriovenous malformations
  • Diving
  • Coagulopathies
  • Cocaine abuse
  • Sickle cell disease

Source: Yadav et al. (2018). Spinal Cord Infarction: Clinical and Radiological Features. Journal 

of Stroke and Cerebrovascular Diseases, 27(10), 2810–2821. https://doi.org/10.1016/j.jstrokecerebrovasdis.2018.06.008