Vascular anatomy of the spinal cord

Santillán, Alejandro; Nacarino, V.; Greenberg, Edward; Riina, Howard A.; Gobin, Y. Pierre; Patsalides, Athos

doi:10.1136/neurintsurg-2011-010018

Cited by 120 publications

(99 citation statements)

References 30 publications

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“…although they have no precapillary connections, they have some overlapping anastomoses inside the spinal cord. the aSa is frequently duplicated for short distances in the cervical region, and central arteries that stem from a duplicated portion of the aSa supply only unilaterally [9][10][11] . Heterogeneity and laterality of the ischemic lesion in our cases might be caused by such anastomotic and anatomical variations.…”

Section: Resultsmentioning

confidence: 99%

Spinal Cord Infarction is an Unusual Complication of Intracranial Neuroendovascular Intervention

et al. 2013

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Spinal cord infarction is an unusual complication of intracranial neuroendovascular intervention. The authors report on two cases involving spinal cord infarction after endovascular coil embolization for large basilar-tip aneurysms. Each aneurysm was sufficiently embolized by the stent/balloon combination-assisted technique or double catheter technique. However, postoperatively, patients presented neurological symptoms without cranial nerve manifestation. MRI revealed multiple infarctions at the cervical spinal cord. In both cases, larger-sized guiding catheters were used for an adjunctive technique. Therefore, guiding catheters had been wedged in the vertebral artery (VA). The wedge of the VA and flow restriction may have caused thromboemboli and/or hemodynamic insufficiency of the spinal branches from the VA (radiculomedullary artery), resulting in spinal cord infarction. Spinal cord infarction should be taken into consideration as a complication of endovascular intervention for lesions of the posterior circulation.

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Section: Resultsmentioning

confidence: 99%

Spinal Cord Infarction is an Unusual Complication of Intracranial Neuroendovascular Intervention

et al. 2013

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“…In humans, the number of anterior and posterior radicular arteries was reported as varying between 2 to 17 and 11 to 25, respectively 37 and the variability of the venous system is reportedly higher than the arterial side. 28 The Dorsal Spinal Vein Serves as a Bidirectional Drain for the Mouse Spinal Cord and May Have a Role In Neurovascular Coupling Unlike veins in the periphery, the CNS (central nervous system) venous system does not contain one-way valves. This absence raises the possibility of bidirectional SCBF, which has been described for the arterial supply by a partial flow theory.…”

Section: The Mouse Dorsal Spinal Cord Vasculature Is Topologically Stmentioning

confidence: 99%

“…Its location also results in the dSV being injured in nearly every preclinical model of SCI, making an understanding of its blood flow patterns and their alterations after occlusion essential to understanding the secondary injury phase of SCI. Moreover, the human ortholog of this vein-the median posterior spinal vein-is similarly the most prominent vein in the human posterior SC 28 and its disruption is nearly certain in any SCI cases resulting in posterior compression of the SC. The pathologic consequence of such disruption will depend greatly on whether there exists redundancy in this flow network as there does in the surface arterioles 29 or collaterally-joined surface venules 30 of the cortex.…”

Section: Introductionmentioning

confidence: 99%

Characterization of Blood Flow in the Mouse Dorsal Spinal Venous System before and after Dorsal Spinal Vein Occlusion

Farrar

Rubin

Diago

et al. 2015

J Cereb Blood Flow Metab

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The availability of transgenic strains has made the laboratory mouse a popular model for the study of healthy and diseased state spinal cord (SC). Essential to identifying physiologic and pathologic events is an understanding of the microvascular network and flow patterns of the SC. Using 2-photon excited fluorescence (2PEF) microscopy we performed in vivo measurements of blood flow in the lower thoracic portion of the mouse dorsal spinal vein (dSV) and in the first upstream branches supplying it, denoted as dorsal ascending venules (dAVs). We found that the dSV had large radiculomedullary veins (RMVs) exiting the SC, and that flow in the dSV between pairs of RMVs was bidirectional. Volumetric flow increased in each direction away from the point of bifurcation. Flow in the upstream dAVs varied with diameter in a manner consistent with a constant distal pressure source. By performing ex vivo 2PEF microscopy of fluorescent-gel perfused tissue, we created a 3-D map of the dorsal spinal vasculature. From these data, we constructed a simple model that predicted changes in the flow of upstream branches after occlusion of the dSV in different locations. Using an atraumatic model of dSV occlusion, we confirmed the predictions of this model in vivo.

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“…Along its long course, additional blood supply to the PSA originates from posterior radiculomedullary arteries at various levels. The PSAs supply the posterior one-third of the spinal cord, including the dorsal surface of the medulla, posterior columns and dorsal gray matter [9,13]. Pial plexus formed by effective anastomoses, which directly connects the ASA and PSA at the conus medullaris, is an extensive arterial network on the entire surface of the spinal cord.…”

Section: Introductionmentioning

confidence: 99%

“…Along its long course, additional blood supply to the ASA originates from anterior radiculomedullary arteries. Blood supply to the ASA via radiculomedullary arteries originates from three major regions: cervicothoracic, midthoracic and thoracolumbar [9][10][11][12][13]. ASA supplies the ventral surface of the medulla and the anterior two-thirds of the spinal cord [14].…”

Section: Introductionmentioning

confidence: 99%

Exclusively Epidural Spinal Arteriovenous Malformation: A Short Review

Wang¹,

Wang²

2017

Neuropsychiatry

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The incidence of exclusively epidural spinal arteriovenous malformation (EESAVM) is extremely low and there are only a few case-reports in literature. Early, correct recognition of the pathology is mandatory to halt the progression of the disease and minimize permanent spinal cord injury. This review depicts EESAVM's characteristics, from the aspect of pathophysiology, clinical presentation, treatment strategies, and outcome. EESAVMs are located entirely in the epidural space and fed by radicular vessels or segmental arteries. The nidus of EESAVM purely locates in the spinal epidural space. The drainage of nidus flows into the epidural venous plexus or intradural vein. The retrograde blood flow from the AVM results in a diminished intramedullary blood flow and symptoms due to spinal cord ischemia and myelopathy. There is no gender predilection (male 52.9%), age distribution by the time of diagnosis shows most cases are younger than 20-year (64.7%), most cases present as spontaneous epidural hematoma (64.7%), and the majority of those lesions are located on cervicothoracic junction or upper thoracic segment (75%). Generally, the clinical presentation of EESAVM is slighter than intradural/intramedullary AVMs. Unruptured EESAVM may symptomless, or present as protracted, progressive neurological decline. Ruptured EESAVM may present acute back or thoracic pain subsequently with paraplegia. Epidural haemorrhage is common and urgent condition for EESAVM. Up to now, spinal angiography remains the gold standard and the first choice for diagnosis and characterization of spinal vascular lesion. The best management for EESAVM is still surgical operation. Prompt diagnosis and emergency surgical treatment are crucial. Long-term functional prognosis of EESAVM is good, but delayed surgical operation leave residual symptoms.

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Vascular anatomy of the spinal cord

Abstract: In this article, a detailed description of the normal arterial supply and venous drainage of the spinal cord is provided, and the role of catheter angiography and MR angiography in depicting the vascular anatomy of the spinal cord is discussed.

Cited by 120 publications

References 30 publications

Spinal Cord Infarction is an Unusual Complication of Intracranial Neuroendovascular Intervention

Spinal Cord Infarction is an Unusual Complication of Intracranial Neuroendovascular Intervention

Characterization of Blood Flow in the Mouse Dorsal Spinal Venous System before and after Dorsal Spinal Vein Occlusion

Exclusively Epidural Spinal Arteriovenous Malformation: A Short Review

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