Spinal Cord Infarction: Case Report and Literature Review
DOI:
https://doi.org/10.25759/spmfr.255Keywords:
Disability Evaluation, Infarction, Spinal Cord, Spinal Cord Ischemia/rehabilitationAbstract
Introduction: Acute spinal cord ischemia syndrome or spinal cord infarction is a rare condition, accounting for 1- 2% of all stroke admissions. Several mechanisms can cause impaired perfusion of the spinal cord, and in a few cases no etiology can be found. We present two case reports with acute spinal cord ischemia syndrome admitted at a Rehabilitation Department, and compare their clinical features with current literature studies.
Case Report: The first case was a 55-year-old woman with a C8 incomplete tetraplegia AIS C, after medullar infarction of unknown etiology. The second case was a 58-year-old man who developed a sudden neurologic status of a C6 incomplete tetraplegia AIS C, after a heart attack. In both cases the spine magnetic resonance identified a medullar lesion of ischemic characteristics. After rehabilitation treatment they presented a good functional and neurologic development. At discharge, both patients were independent, at daily life activities, and walked with gait devices.
Discussion: Acute spinal cord ischemia syndrome has a wide variety of clinical syndromes, depending on the lesion level and the vascular territory affected. The two presented cases are suggestive of an anterior spinal artery syndrome, and are in concordance with the latest literature findings. The recent studies agree that the main prognostic factor is the impairment status at admission, determined by the American Spinal Injury Association Impairment Scale. Regarding the outcome, they reveal a good functional and neurologic recovery when the patient is submitted to an individual and holistic rehabilitation program.
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