Spinal cord ischemia

Introduction A series of damaging biochemical changes caused by spinal cord ischemia will lead to intracellular calcium accumulation, increased oxygen free radical content, thereby damaging neurons in the spinal cord, causing irreversible damage to the spinal cord. Spinal cord ischemia is less common than cerebral ischemia. The main reasons are: spinal arteriosclerosis is less than cerebral arteries; spinal cord blood supply network is abundant; spinal cord has strong tolerance to ischemia. Spinal cord ischemia caused by lesions in the spinal cord itself, the symptoms may be transient or permanent. After the spinal cord ischemia is gradually severe, it can also be progressive paraplegia, resulting in a sensory loss plane and sphincter disorders such as the bladder.

Cause

Spinal cord ischemia can occur in the blood supply of aortic angiography or aortic aneurysm. Sometimes due to aortic atherosclerosis, spinal vascular malformations, microembolism, vasospasm and insufficient blood supply. Others such as syphilitic myelitis, lumbar spinal stenosis, spinal cord trauma, polycythemia, venous thrombosis, and hypotension caused by systemic diseases can cause spinal cord ischemia.

Less common causes of spinal cord ischemia than cerebral ischemia are: spinal arteriosclerosis is less than cerebral arteries; spinal cord blood supply network is abundant; spinal cord has strong tolerance to ischemia. Sex can also be permanent.

an examination

Related inspection

Spinal MRI examination of carcinoembryonic antigen (CEA)

1. Cerebrospinal fluid examination: The lumbar puncture of the spinal canal is generally free of obstruction, or incomplete spinal canal obstruction. The appearance of CSF is colorless, transparent or yellow, and the number of cells is normal. Sometimes the protein content is normal or slightly increased, and the number of cells is normal.

2. Other selective examination items: including blood electrolyte, blood sugar, urea nitrogen, carcinoembryonic antigen test.

Spinal cord iodine angiography or visible spinal cord has an amorphous stenosis, and magnetic resonance imaging of the spinal cord can also aid diagnosis. MRI manifests as thickening and swelling of the spinal cord in the acute phase, and spinal cord atrophy in the chronic phase.

Differential diagnosis

Transient spinal cord ischemia often needs to be distinguished from the following diseases.

1. Intermittent claudication caused by lower extremity atherosclerosis: This disease occurs in the elderly and has a clear history. After walking a short distance, there is more pain in one side of the lower limbs, numbness and weakness, so that you can not walk, you can continue to walk after rest. However, there are no symptoms of spinal cord damage at the time of onset.

2. Embolization vasculitis: more common in middle-aged men, no obvious peripheral arteriosclerosis, pain in the foot and calf at the time of onset, accompanied by a decrease in the skin temperature of the foot, disappearance of the dorsal artery of the foot, cyanosis of the toes, No signs of spinal cord damage.

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