Dr. Levine of the SUNY Health Science Center at Brooklyn has no relevant financial relationships to disclose.)
This article includes discussion of vascular disorders of the spinal cord, spinal cord hemorrhage, spinal cord stroke, 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.
The author provides updated information regarding newly described etiologies associated with spinal cord ischemia.
• Spinal cord strokes are relatively rare.
• The etiology is multifactorial, with ample representation of iatrogenic causes.
• Treatment remains supportive at this point, including management of complications.
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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