Vascular disorders of the spinal cord

Enrique C Leira MD (Dr. Leira of the University of Iowa Hospitals and Clinics has no relevant financial relationships to disclose.)
Steven R Levine MD, editor. (Dr. Levine of the SUNY Health Science Center at Brooklyn has received honorariums from Genentech for service on a scientific advisory committee and a research grant from Genentech as a principal investigator.)
Originally released June 17, 1996; last updated June 14, 2016; expires June 14, 2019

This article includes discussion of vascular disorders of the spinal cord, spinal cord arteriovenous malformations, spinal cord hemorrhagic syndromes, spinal cord infarction, and transient cord ischemia. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.

Overview

The author provides updated information regarding newly described etiologies associated with spinal cord ischemia.

Historical note and terminology

Jackson reported the first nontraumatic spinal epidural hematoma in 1869. Adamkiewicz first described the blood supply of the spinal cord in 1882. In the same year, Bastian theorized that occlusion of spinal vessels was responsible for softening of the spinal cord. Singer in 1902 reported 2 cases of vascular myelopathy with pathological changes. Dejerine first described intermittent claudication of the spinal cord in 1906. In 1909, Spiller reported the first case of anterior spinal artery syndrome. The etiology in this particular case was syphilitic vasculitis. In 1912, Marie and Foix described the syndrome of "tephromalacie anterieure," ischemic lesions in the anterior horns due to small-vessel disease. In 1926, Foix and Alajouanine described a clinicopathological correlation between subacute myelopathy and spinal arteriovenous malformations in 2 cases. In 1968, Newton and Adams presented the first reports of angiographic embolization of spinal vascular malformations (Silver and Buxton 1974; Fieschi et al 1985; Mattle et al 1987; Muraszco and Oldfield 1990; Sliwa and Maclean 1992; Hodes et al 1994).

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