Spinal Cord Hemorrhage

Shaban, Amir; Moritani, Toshio; Kasab, Sami Al; Sheharyar, Ali; Limaye, Kaustubh; Adams, Harold P.

doi:10.1016/j.jstrokecerebrovasdis.2018.02.014

Cited by 38 publications

(33 citation statements)

References 83 publications

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“…Though there exists no clearly established consensus about the treatment of this disease, most experts believe that surgical decompression should be performed as soon as possible to minimize the neurological injury. Besides, conservative management may be considered in those with mild symptoms and neurological rapid recovery, or as a bridge for surgical [1]. In this case, the surgery was of a great success, however, the patient died from complications.…”

Section: Discussionmentioning

confidence: 98%

“…Although the exact mechanism of spontaneous spinal intramedullary hemorrhage is still unclear, anticoagulation or antiplatelet is an independent risk factor [1,3]. Warfarin and aspirin have been administered to treat and prevent the thromboembolic disorders for a long time.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, warfarin and aspirin associated spinal intramedullary hemorrhage may be secondary to increased intra-abdominal and intrathoracic pressure leading to venous plexus and radicular arterioles rupture [1] and the patient's symptoms begin to worsen gradually. Thus, we can consider that the lowdose warfarin combined with low-dose aspirin may be associated with spinal intramedullary hemorrhage, even though, further studies are needed to elucidate the relationship.…”

Section: Discussionmentioning

confidence: 99%

“…The clinical presentations of spinal intramedullary hemorrhage depend on the location or level of hemorrhage [1]. The common feature is that a sudden onset of intense back or neck pain and the location of pain usually indicates the site of spinal intramedullary hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

“…Spinal intramedullary hemorrhage is a rare myelopathy, trauma and vascular malformations are the most common causes [1]. Anticoagulation-associated spinal intramedullary hemorrhage have been reported in few cases, but these patients have poorly controlled INR values [2][3][4][5][6]; furthermore, a few cases of antiplatelet-associated spinal epidural hematoma have been described [7][8][9][10], while antiplatelet-related spinal intramedullary hemorrhage has never been reported.…”

Section: Introductionmentioning

confidence: 99%

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Low-dose warfarin combined with low-dose aspirin associated Spinal intramedullary hemorrhage: a case report

Zhou

Liu

Zhang

et al. 2020

Preprint

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Background:Spinal intramedullary hemorrhage is a rare event, the disease still has not received enough attention and many characteristics of the disease have not been sufficiently explored. Due to its rarity, it can easily be forgotten or misdiagnosed. Case presentation:We report a case of 72-year-old male patient with a medical history of coronary heart disease, atrial fibrillation (AF), hypertension, cervical spondylosis, carotid and vertebral artery stenosis with low-dose anticoagulation combined with low-dose antiplatelet therapy who suffered from sudden posterior neck and back pain for 3 hours visited our emergency department (ED). The International Normalization Ratio (INR) were controlled well, and other laboratory tests were within normal limits or only slightly abnormal. However, the patient was diagnosed with spinal intramedullary hemorrhage and died finally. Conclusion:Anticoagulation combined with antiplatelet-associated rare and life-threatening complications should be paid more attention.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Low-dose warfarin combined with low-dose aspirin associated Spinal intramedullary hemorrhage: a case report

Zhou

Liu

Zhang

et al. 2020

Preprint

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IL‐12p40 promotes secondary damage and functional impairment after spinal cord contusional injury

Almanza

Stehlik

Page

et al. 2022

J of Neuroscience Research

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Secondary damage obstructs functional recovery for individuals who have sustained a spinal cord injury (SCI). Two processes significantly contributing to tissue damage after trauma are spinal cord hemorrhage and inflammation: more specifically, the recruitment and activation of immune cells, frequently driven by pro‐inflammatory factors. Cytokines are inflammatory mediators capable of modulating the immune response. While cytokines are necessary to elicit inflammation for proper healing, excessive inflammation can result in destructive processes. The pro‐inflammatory cytokines IL‐12 and IL‐23 are pathogenic in multiple autoimmune diseases. The cytokine subunit IL‐12p40 is necessary to form bioactive IL‐12 and IL‐23. In this study, we examined the relationship between spinal cord hemorrhage and IL‐12‐related factors, as well as the impact of IL‐12p40 (IL‐12/IL‐23) on secondary damage and functional recovery after SCI. Using in vivo magnetic resonance imaging and protein tissue analyses, we demonstrated a positive correlation between IL‐12 and tissue hemorrhage. Receptor and ligand subunits of IL‐12 were significantly upregulated after injury and colocalized with astrocytes, demonstrating a myriad of opportunities for IL‐12 to induce an inflammatory response. IL‐12p40−/− mice demonstrated significantly improved functional recovery and reduced lesion sizes compared to wild‐type mice. Targeted gene array analysis in wild‐type and IL‐12p40−/− female mice after SCI revealed an upregulation of genes associated with worsened recovery after SCI. Taken together, our data reveal a pathogenic role of IL‐12p40 in the secondary damage after SCI, hindering functional recovery. IL‐12p40 (IL‐12/IL‐23) is thus an enticing neuroinflammatory target for further study as a potential therapeutic target to benefit recovery in acute SCI.

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Vascular Injury of the Spinal Cord

Boban

Thurnher

2022

Emergency Radiology of the Head and Spine

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Spinal Cord Hemorrhage

Cited by 38 publications

References 83 publications

Low-dose warfarin combined with low-dose aspirin associated Spinal intramedullary hemorrhage: a case report

Low-dose warfarin combined with low-dose aspirin associated Spinal intramedullary hemorrhage: a case report

IL‐12p40 promotes secondary damage and functional impairment after spinal cord contusional injury

Vascular Injury of the Spinal Cord

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