Vertebral body infarction indicating midthoracic spinal stroke

Börnke, Christian; Schmid, G.; Szymanski, Sandra; Schöls, Lüdger

doi:10.1038/sj.sc.3101285

Cited by 27 publications

(13 citation statements)

References 8 publications

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“…Most cervical lesions were at C4-C7, while the thoracolumbar lesions were at T9-T12. In line with previous studies [2,4,13,19,21,26], aortic diseases were often seen in our patients with mid-thoracic or thoracolumbar infarctions (p = 0.03, v 2 test). Nineteen (95%) patients had ASA infarctions, including 14 had anterior bilateral, three had anterior unilateral, and two had central cord infarctions.…”

Section: Clinical Findingssupporting

confidence: 91%

“…However, vertebral body infarction is not always seen in SCI. Only a few reports had discussed in the radiological findings of the spinal cord, vertebra, and vascular supply [2,6,17,30]. Our aims are to investigate the clinical features of SCI in Chinese and to elucidate the probable pathophysiology underlying concomitant spinal cord and vertebral body infarctions.…”

Section: Introductionmentioning

confidence: 98%

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Concomitant spinal cord and vertebral body infarction is highly associated with aortic pathology: a clinical and magnetic resonance imaging study

et al. 2009

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The purpose of this article is to investigate the relationship between clinical features and imaging characteristics of spinal cord infarction (SCI). Twenty patients (11 women/9 men) were diagnosed at the Chang Gung Memorial Hospital between March 1993 and March 2007. Data of clinical features, possible causes and imaging findings were collected and analyzed retrospectively. Their average age was 56.6 +/- 15.5 years. Possible causes of SCI were found in 16 patients (80%), including 8 (40%) who had a high risk of atherosclerosis, 5 (25%) who had aortic diseases, and 3 (15%) who had adjacent spinal diseases; the other 4 (20%) were cryptogenic. Seven patients had concomitant SCI and vertebral body infarctions, and four of them had aortic diseases. Most of the vertebral body infarctions were seen in the thoracolumbar regions (p = 0.008, chi(2) test) and were adjacent to their cord lesions. Twelve patients (60%) had poor outcomes (mortality, unable to walk, or able to walk with two aids). Younger patients (

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Section: Clinical Findingssupporting

confidence: 91%

Section: Introductionmentioning

confidence: 98%

Concomitant spinal cord and vertebral body infarction is highly associated with aortic pathology: a clinical and magnetic resonance imaging study

et al. 2009

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“…Vertebral body infarction mechanisms, including radicular arterial infarction, fibrocartilaginous embolism and aortic pathology, have been seen in previous studies [8, 10, 22]. In this examination, 3 patients had concomitant spinal cord and vertebral body infarctions in the thoracolumbar regions.…”

Section: Discussionmentioning

confidence: 66%

Spinal Cord Infarction in Chinese Patients

et al. 2008

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Background: The clinical presentations, MRI findings and outcomes for spinal cord infarction (SCI) are well documented in the West but scarce in the East. We investigated the clinical characteristics of SCI patients and further analyzed etiologies and prognostic factors in Chinese subjects. Methods: We reviewed all SCI patients from March 1993 to March 2007. Clinical symptoms, laboratory and imaging findings as well as outcomes were retrospectively analyzed. Results: Twenty-two patients (12 female) were identified; their mean age was 57.6 years. Nine patients (40.9%) had probable etiologies, while 13 were cryptogenic (59.1%). The primary etiologies were aortic diseases. Hypertension was the most common vascular risk factor (50%). Most patients (10/22 = 45.5%) had thoracolumbar lesions (mainly at T₉–L₁), while cervical lesions (9/22 = 40.9%) were the second most common (mainly at C₄–C₇). ‘Owl’s eyes’ signs were common with the anterior spinal artery (93.8%) and central cord infarctions (50%) but not in the posterior spinal artery or transverse spinal infarctions. After a mean follow-up of 18 months, only 10 patients (10/22 = 45%) had good outcomes (independent walking or walking with 1 aid). Conclusion: Most SCI patients had acute, monophasic symptoms, reaching nadir in <24 h. The subjects frequently had acute pain near their lesions before SCI signs/symptoms (16/22 = 72.7%). Initial severe weakness (Medical Research Council score ≤2) and a young age at onset (55 years old) are correlated with poor recovery of motor functions.

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“…Farklı bir çalışmada, ASAs'lı 5 hastada 9-46 saat içerisinde elde edilen DAG'larda rezolüsyonu düşük olmakla beraber "görünen difüzyon katsayısı (ADC)" görüntüleri ile onaylanmış difüzyon kısıtlılığının olduğu görülmüştür (20 (23). Farklı raporlarda, bir dışlama tanısı olarak nitelenen ASAs' da, klinik olarak enfarkt şüphesi olan hastalarda spinal MRG'lerde dikkate değer bir şey görülmezse spinal kord ile aynı damarsal sahadan kanlanması üzerine geliştiği düşünülen eş zamanlı vertebral gövde enfarktının tanıda tek doğrulayıcı işaret olabileceği belirtilmektedir (24,25). Önceki çalışmalara benzer şekilde hastamızın MRG'sinde vertebral kemik ve kemik iliği değişikliklerinin olduğunu gözlemledik, bu bulgunun ayırıcı tanıda önemli olabileceğini düşünmekle beraber gelecekte yapılacak geniş vaka serilerine ilişkin raporların gerekli olduğunu düşünmekteyiz.…”

Section: Introductionunclassified

Acute anterior spinal artery occlusion: Temporal evolution of diffusion MRI lesion characteristics

Önder¹,

Arsava²,

Göçmen³

et al. 2016

Türk Beyin Damar Hast Derg

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ÖZETAnterior spinal arter oklüzyonu veya diğer adıyla spinal strok tanısında difüzyon ağırlıklı görüntüleme (DAG) yararlı olmakla birlikte spinal kordun akson yoğunluklu yapısı nedeniyle lezyonların DAG ve ADC (apparent diffusion coefficient) karakteristikleri diğer stroklardan önemli farklılıklar gösterir ve sinyal özelliklerinin zaman içindeki değişimi de yeterince çalışılmamıştır. Bu olgu raporunda spinal iskeminin difüzyon karakteristikleri ve bunların zamansal değişimi demonstre edilmiş, ve klinik önemi ile fizyopatolojisi tartışılmıştır. Anahtar Sözcükler: Spinal stroke, difüzyon, akson, manyetik rezonans. ACUTE ANTERIOR SPINAL ARTERY OCCLUSION: TEMPORAL EVOLUTION OF DIFFUSION MRI LESION CHARACTERISTICS ABSTRACTDiffusion weighted imaging (DWI) is useful in the diagnosis of anterior spinal artery occlusion, also called as acute spinal stroke. Because of higher density of axonal structures in spinal cord, DWI and ADC (apparent diffusion coefficient) imaging characteristics of ischemic lesions show important differences from strokes occurring in other territories. Furthermore, DWI signal changes over time has not been studied sufficiently in spinal strokes. We herein present a case vignette with acute spinal stroke to remind imaging features and to describe imaging follow-up enabling us to discuss on the pathophysiology of this entity. Key Words: Spinal stroke, diffusion, axon, magnetic resonance. GİRİŞAnterior spinal arter sendromu (ASAs) spinal kordun iskemisine bağlı gelişen, akut başlangıçlı ve genellikle ağrının eşlik ettiği bir miyelopati tablosudur. Sıklıkla gaita ve idrar inkontinansı eşlik edebilmektedir. Lezyon seviyesinin altında ağrı ve ısı hissi kayıptır. Temelde iatrojenik olanlar ve iatrojenik olmayanlar şeklinde sınıflandırılabilen ASAs'lar arasında en sık bildirileni iatrojenik bir neden olan aortik cerrahi sonrası gelişen ASAs vakalarıdır. ASAs'nın diğer tanımlanmış nedenleri arasında ateroskleroz, diabetik arteriopati (1), vaskülit, aort hastalığı (2), anemi, orak hücreli anemi, polisitemi, foramen ovaleye bağlı parodoksal emboli (3), atlantoaksiyel dislokasyon (4), servikal spondiloz (5), servikal spinal travma (6, 7), bazı enfeksiyonlar (tüberküloz, şistozomiazis ve Neisseria menenjiti) sayılabilir (8)(9)(10)(11)

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Vertebral body infarction indicating midthoracic spinal stroke

Cited by 27 publications

References 8 publications

Concomitant spinal cord and vertebral body infarction is highly associated with aortic pathology: a clinical and magnetic resonance imaging study

Concomitant spinal cord and vertebral body infarction is highly associated with aortic pathology: a clinical and magnetic resonance imaging study

Spinal Cord Infarction in Chinese Patients

Acute anterior spinal artery occlusion: Temporal evolution of diffusion MRI lesion characteristics

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