A spinal cord infarction is based on an insufficient blood flow and a resulting undersupply of oxygen and glucose. The consequences are signs of paralysis, pain and a disturbed perception of temperature and pain. Treatment is symptomatic or manual therapy.
What is a spinal cord infarction?
A pathological blood flow that is no longer sufficient due to constrictions or occlusions leads to an undersupply of oxygen and glucose because arterial blood is no longer sufficiently supplied. This undersupply leads to a so-called spinal cord infarction, also known as ischemic myelopathy. For everything about leukopenia, please visit foodezine.com.
It should be borne in mind that certain segments of the spinal cord are particularly susceptible to ischemia due to the sometimes low collateral supply to the anterior spinal artery. The susceptibility relates to the 2nd and 4th collateral segments. Damage to an extravertebral, i.e. supplying, artery or the aorta leads to a spinal cord infarction more frequently than due to intrinsic disorders of the spinal arteries.
In short: If the blood flow to the spinal cord is stopped by a blocked vessel or a blood clot, the dreaded spinal shock occurs. Even the slightest suspicion of a spinal cord infarction must be treated immediately, neurologically or neurosurgically. The consequences of this disease can negatively affect the rest of your life. In the worst case, the spinal cord infarction ends fatally.
Causes
An aortic dissection and polyarteritis nodosa can be responsible for a spinal cord infarction. Diabetics are also often affected by neurological deficits caused by an infarction in the spinal cord. Older people are also at risk. At a young age, these symptoms rarely occur.
Arteriosclerosis or an embolism can restrict the blood supply to the anterior (belly) located anterior spinal artery and the posterior (back) located spinal artery. Since they are created in pairs, the cause is less likely to be found here. The fibrocartilline emboli from the intervertebral discs are considered a special feature and are more likely to be found in young and athletic patients.
However, pregnant women can also be affected. Not to be forgotten are the vascular malformations such as an arteriovenous dural fistula. It can also lead to an infarction in the spinal canal. A spinal cord infarction occurs much more frequently as a result of blockages in the arteries caused by tumors, aortic aneurysms or aortic dissections.
Spinal vascular involvement associated with vasculitis should also be considered as a cause. Thrombosis and polyarteritis (vasculitis of the medium-sized arteries) are considered to be rather unusual triggering factors.
Symptoms, Ailments & Signs
Anyone who is about to suffer a spinal cord infarction (spinalis anterior syndrome) feels a sudden pain in the back with a ring-shaped radiating tightness. This is followed within a few minutes not only by sensitive failures. Rather, there are also segmental signs of paralysis on both sides.
In addition, the perception of pain and temperature is significantly disturbed. These symptoms are based on a lack of or insufficient blood flow, which means that the spinal cord can no longer transmit signals from the brain. On the other hand, the sense of position and vibration as well as the ability to perceive light touches are relatively well preserved.
If the infarction is small and only affects the tissue furthest from the spinal cord, it may also be central spinal cord syndrome. Neurological deficits can then already recede in the next few days. Because of the variable location of the magna radicular artery, such an infarction as a complication of an operation on the thoracic aorta is known and feared.
Diagnosis & course of disease
The diagnosis is made by an MRI scan. In connection with a CSF examination, other diseases with similar symptoms can also be ruled out. These include acute transverse myelitis, spinal cord compression, and various demyelinating disorders. Diagnosis by means of MRI also enables the detection of lesions in most cases.
The further course depends largely on where the spinal cord infarction took place. The further it runs up to the cervical cord, the more bodily functions are affected and fail. Depending on the affected arteries, the clinical manifestations include the “anterior spinal artery syndrome” and the “posterior spinal artery syndrome”. This is a combination of sensory disturbances, pain and paralysis that usually appear suddenly.
Complications
A spinal cord infarction is an emergency and is a complication of various vascular diseases such as aortic aneurysms, arteriosclerosis or others. If treatment is started in time, there are good chances of recovery. This is always possible if the spinal cord is not completely damaged. Otherwise, there will be permanent damage up to paraplegia. Treatment is based on the underlying disease.
Among other things, emergency operations must be carried out on the injured or blocked artery in order to stop bleeding or to remedy the lack of blood supply in the event of ischemia. Then symptomatic treatment follows. The healing process occurs depending on the damage to the spinal cord. About 70 percent of affected patients are completely cured.
In around 30 percent of cases, the spinal cord is already so severely damaged that complete healing is no longer possible. The course of a spinal cord infarction also depends on the affected blood vessels. The so-called anterior spinal artery syndrome is characterized by a difficult and complicated course.
This syndrome is caused by a circulatory disorder in the anterior spinal artery. Spinal shock occurs with incomplete paralysis of both legs, which lasts for several months. The pain and numbness is usually belt-shaped. In addition, there are rectal and bladder disorders. Severe pressure ulcers of the skin, which can lead to necrosis, occur as a complication.
When should you go to the doctor?
The dreaded ischemic myelopathy can lead to symptoms of paralysis, a significantly disturbed temperature and pain perception as well as severe, ring-shaped radiating pain in the back. Since the cause lies in a sudden circulatory disorder of the spinal cord, there is an acute danger. The visit to the doctor must be made immediately. If the spinal cord infarction occurs as a result of an operation on the thorax, the patient is already in the hands of a doctor.
Spinal shock, which can result from a blocked vessel, requires immediate treatment. If left untreated, it can have dramatic consequences that reduce quality of life or lead to death. The patient should be referred to a neurologist or to neurosurgery immediately. A spinal cord infarction is a potentially fatal incident that cannot be delayed due to the severe consequences.
Typical for the spinal cord infarction – also known as spinalis anterior syndrome – is a strong back pain, which is accompanied by a ring-shaped feeling of tightness. Immediately afterwards, there are loss of sensitivity and signs of paralysis on both sides.
In addition, a significant perception disorder in terms of pain or temperature can be diagnosed. The emergency doctor should be notified immediately, since the damaged spinal cord can no longer transmit signals. A distinction must be made between small and large spinal cord infarctions. In the case of central spinal cord syndrome, the neurological deficits can recede after a few days.
Treatment & Therapy
Of course, the best therapeutic success turns out to be when the spinal cord has not been completely destroyed and has only ceased to function. Regeneration can be achieved with targeted exercise therapy lasting several weeks. If it is known that an aortic dissection or polyartritis nodosa is the trigger, these secondary diseases should be treated first and foremost. In most cases, symptomatic treatment is indicated.
If masses are detected in the MRI, surgical decompression must be initiated immediately. Subsequent treatment is symptomatic in most cases. However, it can also be based on the treatment measures that are customary for a transverse lesion.
The primary priority is to ensure existing or restore vital functions. Experienced and specialized physiotherapists and ergotherapists are the competent contact persons for this. Special physiotherapy exercises are used in order to maintain and, if necessary, improve any remaining mobility.
The TENS treatment and foot reflex zone treatments have also proven themselves. In this way, the dreaded muscle shortening and stiffening can be counteracted. It is not uncommon for patients to be in a wheelchair at the beginning of such therapy or need aids such as one or two walking sticks or a walker.
At the same time, neurological check-ups are carried out at regular intervals. These are necessary in order to avoid secondary consequential damage as far as possible. Then the cause needs to be treated.
Prevention
The most important preventive measure to prevent a spinal cord infarction from occurring is probably the stabilization of the back muscles. This can be done through age-appropriate sport that is practiced continuously. Swimming, floor exercises (gymnastics) and light adapted strength exercises are recommended in this context.
Aftercare
Those affected must undergo rehabilitation measures immediately after a spinal cord infarction. Thanks to the special therapy, most people can move like they did before the spinal cord infarction. Affected people should regularly do physiotherapy and occupational therapy exercises at home to improve their health. In addition, any kind of stress and strain should be avoided.
Those affected need sufficient rest and protection, especially in the first few weeks. Drugs that are readily available can speed healing. Recommended are globules and pain-relieving and calming teas. In addition, the diet after the spinal cord infarction should be changed and thus adjusted. Those affected should eat a very healthy diet and eat lots of fruit and vegetables.
In addition, the food should be very rich in vitamins. If those affected are addicted to alcohol or cigarettes, it is advisable to contact an addiction counseling service. The consumption of such means is to be omitted, since otherwise a spinal cord infarction can occur again.
If the spinal cord infarction had to be operated on, those affected are then dependent on a wheelchair or crutches. In this case, the help and support of family and relatives is needed because those affected can hardly move. In addition, the help of relatives with everyday tasks is also needed.
You can do that yourself
After a spinal cord infarction, rehabilitation measures must be started at an early stage. Appropriate therapy stimulates the muscles and the patients can often move as before. Part of the treatment are physiotherapy and occupational therapy exercises, which those affected can carry out themselves at home. At the same time, however, care should be taken to ensure sufficient protection. The back needs rest, especially in the first days and weeks after a heart attack.
The patient can take painkillers from homeopathy or the household, thereby promoting recovery. Globules have proven effective, as have pain-relieving teas with extracts of chamomile or lemon balm. Diet should also be adjusted after a spinal cord infarction. The most causative circulatory disorder of the spinal cord goes back to an unbalanced diet. Accordingly, a balanced diet with lots of fruit and vegetables is important after a medical emergency. It is best for smokers and alcoholics to contact an addiction counseling service. The triggers must be eliminated, otherwise repeated heart attacks can occur.
After an operation on the spinal cord, normal movement is usually not possible. The patient is dependent on crutches or a wheelchair, which must be organized at an early stage. He also needs the help of relatives and friends who should support him during the difficult time. The responsible doctor must decide in detail which accompanying measures make sense.
