scholarly journals Restricted Diffusion in Spinal Cord Infarction Demonstrated by Magnetic Resonance Line Scan Diffusion Imaging

Stroke ◽  
2012 ◽  
Vol 43 (2) ◽  
pp. 532-535 ◽  
Author(s):  
Raul G. Nogueira ◽  
Rafael Ferreira ◽  
P. Ellen Grant ◽  
Stephan E. Maier ◽  
Walter J. Koroshetz ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Magnetic Resonance ◽  
Resonance Line ◽  
Diffusion Imaging ◽  
Restricted Diffusion ◽  
Spinal Cord Infarction ◽  
Line Scan

scholarly journals Acute spinal cord ischemic stroke; A rare but potentially devastating stroke emergency in young healthy adults

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Liaquat Ali ◽  
◽  
Ahmad Muhammad ◽  
Islam Ahmed ◽  
Khawaja Hassan Haroon ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Magnetic Resonance ◽  
Vertebral Artery ◽  
Early Recognition ◽  
Case Series ◽  
Abrupt Onset ◽  
Restricted Diffusion ◽  
Artery Dissection ◽  
Spinal Cord Infarction ◽  
Common Cause

Introduction: Acute spinal cord infarction represents 1% of all strokes. The neurological presentation of spinal cord infarction is defined by vascular territory i.e. anterior or posterior spinal arteries. A broad spectrum of diseases can cause spinal cord infarction, most common cause is surgical repair or diseases of the thoracoabdominal aorta. MRI of the spine shows hyperintensities on T2WI, restricted diffusion on DWI and vertebral body infarction adjacent to a cord signal abnormality. Poor prognostic factors for recovery are severe impairment at presentation, female sex, advanced age, and lack of improvement in the first 24 hours. We describe clinical presentation, radiological findings and 3-month outcome of four patients who presented with ischemic spinal cord infarction. Methods: We retrospectively analysed our prospectively collected data and found four cases of spinal cord infarction for the period of May 2020 to April 2021. Total of 1,326 stroke patients (1125 i.e. 85% ischemic and 201 i.e. 15% haemorrhagic) were admitted in Hamad General Hospital. At our centre, spinal cord infarction accounts 0.30% of total stroke and 0.35% of ischemic strokes. We describe four young patients, presented with abrupt onset of focal neurologic deficit. Their MRI of the spine revealed hyperintensity signals in T2WI, restricted diffusion on DWI of spinal cord. Two patients had vertebral artery occlusion or dissection. One patient was discharged home and three patients underwent multidisciplinary rehabilitation program. Discussion: Spinal cord infarction may present with acute paraparesis or quadriparesis with devastating consequences. Blood flow to the spinal cord is influenced by perfusion pressure. The most common cause of spinal cord infarction in this case series was vertebral artery dissection or occlusion. Our case series suggests early recognition of spinal cord stroke, appropriate investigations and early treatment with further rehabilitation could improve patient outcome. Conclusion: Spinal cord infarction, a rare but devastating condition, represents 1% of all strokes but 0.3% of total strokes at our centre. Early recognition of spinal cord ischemia especially when presenting with abrupt onset focal neurological deficit, focus on underlying pathology with appropriate imaging and further investigations, secondary stroke prevention and rehabilitation are vital factors to improve neurological recovery. Future randomized trails are needed to establish the efficacy and safety of drug therapy including rt-PA in spinal cord infarction. Abbreviations: ASA: Anterior spinal artery; PSA: Posterior spinal artery; MRI: Magnetic resonance imaging; MRA: Magnetic resonance arteriogram; DWI: Diffusion weighted imaging; ICP: Intra-cranial pressure.

scholarly journals Acute Partial Brown-Séquard Syndrome Secondary to Intraforaminal Disc Prolapse and Spinal Cord Infarction

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Athanasios Astreinidis ◽  
Stephanos Finitsis ◽  
Xanthippi Mavropoulou ◽  
Elisavet Psoma ◽  
Panagiotis Prassopoulos
Keyword(s):  
Spinal Cord ◽  
Abdominal Pain ◽  
Magnetic Resonance ◽  
Restricted Diffusion ◽  
Spinal Cord Infarction ◽  
Disc Prolapse ◽  
Hyperintense Lesion ◽  
Lateral Cord ◽  
Brown Sequard Syndrome

We report the case of a 45-year-old female who presented with acute left abdominal pain and subsequently developed a left partial Brown-Séquard syndrome. Spinal fluid, inflammatory and prothrombotic tests were unremarkable. Magnetic resonance showed a left intraforaminal disc prolapse at the T9–T10 level and a hyperintense lesion on T2-weighted images in the left postero-lateral cord at the T8–T9 level with restricted diffusion on DWI imaging. A diagnosis of spinal cord infarction due to compromise of the left T8 thoracic radicular artery was made. The patient was managed conservatively and at the 3 months follow-up, she was ambulant and able to walk small distances without a walker.

Early diagnosis of spinal cord infarct using magnetic resonance diffusion imaging

Neurology ◽  
2003 ◽  
Vol 61 (11) ◽  
pp. 1622-1622 ◽  
Author(s):  
I. Sibon ◽  
P. Menegon ◽  
C. T.W. Moonen ◽  
V. Dousset
Keyword(s):  
Spinal Cord ◽  
Magnetic Resonance ◽  
Early Diagnosis ◽  
Diffusion Imaging ◽  
Spinal Cord Infarct

Vertebral Body Signal Changes in Spinal Cord Infarction: Histopathological Confirmation

2007 ◽  
Vol 20 (5) ◽  
pp. 580-585 ◽  
Author(s):  
S.G. Srikanth ◽  
H.S. Chandrashekhar ◽  
J.J.S. Shankar ◽  
S. Ravishankar ◽  
S.K. Shankar
Keyword(s):  
Computed Tomography ◽  
Spinal Cord ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Vertebral Body ◽  
Spinal Cord Infarction ◽  
Guided Biopsy ◽  
Signal Changes ◽  
T2 Hyperintensity

Spinal cord infarctions are rare. They are difficult to diagnose clinically and remain undiagnosed even after extensive investigations. Magnetic Resonance (MR) features include hyperintensity of the cord on T2W images. Few cases of spinal cord infarction associated with vertebral body infarction are reported in the literature. We describe another five cases of spinal cord infarction with histopathological confirmation of the vertebral body signal changes. MR examinations of five patients who presented with acute spontaneous spinal cord syndrome were reviewed. Abnormal MR features of the spinal cord included signal changes within the parenchyma, best demonstrated on T2W images. These cord changes were associated with vertebral body T2 hyperintensity in all the patients and in one patient, the computed tomography guided biopsy of vertebral body lesion reported infarction. MR is sensitive to detect spinal cord infarctions and associated vascular and bony changes. The associated signal abnormalities in the bone marrow are a corroborative sign in the diagnosis of spinal cord infarction which was proved by histopathology.

Magnetic resonance imaging of human spinal cord infarction

1991 ◽  
Vol 35 (5) ◽  
pp. 368-373 ◽  
Author(s):  
Chikao Nagashima ◽  
Ritsuko Nagashima ◽  
Nobuhito Morota ◽  
Shigeru Kobayashi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Spinal Cord Infarction ◽  
Resonance Imaging ◽  
Human Spinal Cord

Acute Quadriparesis in a Smoker

2021 ◽  
pp. 238-241
Author(s):  
Nicholas L. Zalewski
Keyword(s):  
Magnetic Resonance Imaging ◽  
Risk Factors ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Vascular Risk Factors ◽  
Spinal Cord Infarction ◽  
Imaging Findings ◽  
Vascular Risk ◽  
Resonance Imaging ◽  
High Doses

A 51-year-old woman was seen for evaluation of transverse myelitis. Pertinent medical history included hypertension, hyperlipidemia, and 50 pack-years of cigarette smoking. Two months earlier, she was shopping and suddenly had excruciating pain in her upper back. Two hours later, severe weakness of both hands developed abruptly. Over the next 8 hours, severe paraparesis and urinary retention developed, with inability to lift legs against gravity, and she reported a T1 sensory level. Review of the outside magnetic resonance imaging noted key imaging findings, including initially normal magnetic resonance imaging within the first 12 hours of symptom presentation, and subsequent magnetic resonance imaging on day 3 showing anterior pencil-like hyperintensity on sagittal view and anterior U- or V-shaped pattern on axial view (termed U/V pattern), without associated gadolinium enhancement. Diffusion-weighted imaging was not obtained. Given the rapid, severe deficits with pain, spinal cord infarction was considered most likely, and the magnetic resonance imaging findings were typical. Magnetic resonance angiography of the neck with T1-fat-saturated views was obtained and did not show dissection. Laboratory evaluation showed a low-density lipoprotein value of 124 mg/dL and hemoglobin A1c of 6.2%. The patient was diagnosed with probable spontaneous spinal cord infarction on the basis of diagnostic criteria. The patient was counselled on smoking cessation, started on an aspirin and statin regimen, and followed up by a primary care provider for management of vascular risk factors. Residual neuropathic pain was treated with high doses of gabapentin. Importantly, unnecessary additional immunotherapy was avoided by establishing the correct diagnosis. Spontaneous spinal cord infarctions are an underrecognized cause of acute myelopathy. Spinal cord infarctions generally occur in older persons, with most cases associated with typical vascular risk factors, arterial dissection, and fibrocartilaginous embolism; historically, cases were often secondary to syphilis.

scholarly journals Postoperative Paraplegia Coincident with Single Shot Spinal Anaesthesia

2007 ◽  
Vol 35 (4) ◽  
pp. 605-607 ◽  
Author(s):  
B. W. Laferlita
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Spinal Anaesthesia ◽  
Spinal Cord Infarction ◽  
Single Shot ◽  
Resonance Imaging ◽  
Anterior Spinal Artery Syndrome ◽  
Magnetic Resonance Imaging Evidence ◽  
Neurologic Function

Paraplegia is a rare but serious complication of spinal anaesthesia. We report an 83-year-old patient who developed anterior spinal artery syndrome resulting in paraplegia some 24 hours after undergoing spinal anaesthesia for a Moore's hemiarthroplasty. Return of neurologic function was documented prior to the onset of paralysis, with magnetic resonance imaging evidence suggestive of spinal cord infarction.

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