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 no relevant financial relationships to disclose.

Originally released June 17, 1996; last updated August 25, 2020; expires August 25, 2023


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

Key points


• 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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