Neurological Investigations
John Greene, Ian Bone in Understanding Neurology a problem-orientated approach, 2007
Knowledge of spinal cord blood supply is helpful in the diagnosis of ‘spinal stroke’ but also in the interpretation of spinal angiography, a highly specialized infrequently performed investigation (43, 44). Two paired posterior spinal arteries supply the spinal cord, arising from the posterior inferior cerebellar artery and merging to form a plexus of vessels on the posterior surface of the cord. This rich blood supply ensures protection against ischaemia and explains the relative sparing of the posterior spinal cord (dorsal columns) in spinal strokes. The arterial blood supply to the anterior two-thirds of the spinal cord is much more vulnerable, being through a single vessel. The anterior spinal artery arises by fusion of a branch from each vertebral artery. Seven to 10 unpaired radicular arteries leave it as it descends the cord. The largest, variably arising between T9–T12 levels, is called the artery of Adamkiewicz. This less efficient circulation renders the spinal cord most vulnerable to ischaemia at the ‘watershed level’ T8.
Spinal Cord Disease
Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw in Hankey's Clinical Neurology, 2020
Anterior spinal artery syndrome: Weakness below the level of the lesion.Flaccid/areflexic acutely, progressing to spastic weakness: Sensory loss below the level of the lesion.Loss of pain, temperature, light touch.Preserved discriminating touch, vibration, proprioception.
Cerebrovascular Disease
John W. Scadding, Nicholas A. Losseff in Clinical Neurology, 2011
Spinal cord infarction is a rare disorder and is usually caused by occlusion of the anterior spinal artery, which supplies the anterior two-thirds of the cord. Most patients with anterior spinal artery occlusion have multiple risk factors, especially hypertension and diabetes. The anterior spinal artery is also vulnerable to aortic dissection. The dorsal columns are spared by anterior spinal artery occlusion thanks to a rich plexal supply. The resultant clinical picture is therefore an acute areflexic paraplegia characterized by dissociated sensory loss: that is, striking preservation of joint position and vibration sense, with marked loss of pinprick and temperature sensation in the lower limbs and trunk. No effective acute treatment is known, but rehabilitation is very helpful to the patient.
Paraplegia following transarterial chemoembolisation for hepatocellular carcinoma: a case report
Published in Acta Chirurgica Belgica, 2021
The risk of spinal cord injury associated with ICA intervention exists because the spinal cord artery originates from the proximal ICA. The spinal cord is supplied primarily by one anterior and two posterior spinal arteries, which are augmented by radicular arteries derived from spinal branches of cervical, intercostal, and lumbar arteries [9]. The anterior spinal artery (ASA) supplies blood to the anterior two-thirds of the cord, including the anterior horns of the grey matter, spinothalamic tracts, and corticospinal tracts, which primarily dominate the motor nuclei. The two posterior spinal arteries (PSA) supply the dorsal columns and the posterior horns, which mainly process sensory information [10]. Therefore, because of anatomy and neurological distribution, the embolic materials created as part of TACE may bring about an embolic event with possible serious manifestations, even though the blood supply network of the spinal cord encompasses multiple anastomoses.
Spinal cord involvement in COVID-19: A review
Published in The Journal of Spinal Cord Medicine, 2023
Ravindra Kumar Garg, Vimal Kumar Paliwal, Ankit Gupta
The spinal cord predominantly receives blood from three main arteries – the anterior spinal artery and two posterior spinal arteries. Reinforcement of blood supply comes from the ascending cervical arteries (branches of the thyrocervical trunk), radicular-medullary branches (branches of the aorta), and the artery of Adamkiewicz (a branch of the aorta) at the level of the lower thoracic or lumbar vertebra. The occlusion of the artery of Adamkiewicz can result in spinal cord ischemia in the thoracolumbar region. Predominantly, this infarction is caused by aortic disease, thoracolumbar surgery, sepsis, hypotension, and thromboembolic disorders. Therefore, we suggest that spinal cord infarction because of hypercoagulability can lead to myelopathy in patients with COVID-19.46,47
The comparison of recovery patterns between ischemic spinal cord injury and traumatic spinal cord injury from acute to chronic phase
Published in The Journal of Spinal Cord Medicine, 2021
Jin Young Ko, Hyunsu Choi, Jee Hyun Suh, Kyung Seok Park, Joon Woo Lee, Ju Seok Ryu
Ischemic spinal cord injury (ISCI), also called spinal cord infarction, usually develops from acute occlusion of anterior and posterior spinal arteries, and account for 0.3–1% of all infarctions.1,2 Although ISCI is frequently caused by complications of aortic surgery, many of them occur spontaneously in clinical settings.3–5 ISCI is characterized by sudden onset and rapid progression of symptoms. Clinical manifestation of ISCI is defined by the vascular territory of the artery involved. Anterior spinal artery syndrome is characterized by severe sharp pain, paralysis, loss of sphincter control, and deficit of thermal sense with relative preservation of position and vibratory sense. Conversely, posterior spinal artery syndrome is characterized by a significant loss of proprioception and vibratory sense and less severe weakness.6
Related Knowledge Centers
- Artery of Adamkiewicz
- Filum Terminale
- Foramen Magnum
- Medulla Oblongata
- Pia Mater
- Spinal Cord
- Vertebral Artery
- Artery
- Body
- Artery of Adamkiewicz
- Anterior Median Fissure of Spinal Cord