Spinal cord infarction

Introduction Spinal cord infarction is a stroke-like onset. Spinal cord symptoms often peak in a few minutes or hours. The anterior spinal artery syndrome occurs due to different occluded blood supply arteries. It is more common in the middle thoracic or lower thoracic segments. The first symptom is often root pain or diffuse pain in the corresponding part of the sudden emergence of the lesion level, a short-term delayed sputum, converted to spastic paralysis after the spinal shock period; conduction beam-type separation sensory disturbance, painful temperature sensation The deep feeling is retained (post-stubbing is not affected), the urinary dysfunction is more obvious; the posterior spinal artery syndrome, the posterior spinal artery is rarely occluded, even if it occurs, the symptoms of collateral circulation are lighter and recover faster; Root pain, deep sensory loss and sensory ataxia below the level of the lesion, pain temperature and muscle preservation, sphincter function is often unaffected; central artery syndrome, lower motor neuron sputum, muscle tone reduction at the corresponding stage of the lesion level Muscle atrophy, no sensory disturbance and pyramidal tract damage.

Cause

There are many causes of spinal cord infarction or ischemic lesions, which are roughly as follows.

1. Cardiovascular and spinal cord blood vessels themselves: such as aortic and spinal cord atherosclerosis, arteritis, phlebitis, thrombosis or embolism, aortic dissection, myocardial infarction, arrhythmia, etc.

2. The blood vessels that supply the spinal cord under pressure: such as disc herniation, spinal stenosis, intraspinal tumor, extraspinal tumor, tuberculosis, epidural inflammatory infiltration, adhesive spinal arachnoiditis, etc. Pressed and occluded.

3. Iatrogenic injury to the spinal cord blood supply artery such as surgery, angiographic injury.

an examination

Related examinations for spinal cord infarction: CT, magnetic resonance imaging (MRI), and spinal angiography.

1. CT and MRI can clearly observe the internal structural changes of the spinal cord and the compression of the spinal cord by other tissues.

2. MRI diagnosis of spinal cord hemorrhage is sensitive and accurate, and the lesion is more sensitive.

3. Spinal artery angiography is feasible when there is suspicion of vascular injury and failure to find a problem using conventional methods.

Differential diagnosis

Spinal cord compression: Spinal cord compression refers to a group of conditions in which the spinal cord, spinal nerve roots, and their supply vessels are compressed by lesions of various natures.

Transverse spinal cord injury: Spinal cord dysfunction caused by infection or infection-induced spinal cord dysfunction leads to nerve impulse blockade of all or most of the nerve bundles, limited to several segments of acute transverse spinal cord inflammation. Most are ill after acute infection or vaccination. It is characterized by paralysis of the limbs below the level of spinal cord lesions, loss of sensation and dysfunction of the bladder, rectum and autonomic nerves. It is one of the common spinal diseases. The onset can be seen in any season, but it is more common in late winter and early spring and late autumn and early winter.

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