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Spinal cord infarction: MR imaging and clinical features in 16 cases.
Neuroradiology. 2002 Oct; 44(10):851-7.N

Abstract

Spinal cord infarctions are rare and due to heterogeneous etiologies. The aim of the study was to analyze the MR imaging findings and evaluate their correlations with clinical symptoms in ischemic spinal cord lesions. MR images and clinical features of 16 patients (11 male, 5 female) with typical sudden onset of neurological deficits caused by spinal cord ischemia were evaluated. MR imaging was performed within 2 h to 14 days after the initial neurological symptoms. Eight patients had follow-up examinations including contrast-enhanced MR imaging. MR abnormalities were best demonstrated on sagittal T2-weighted images, with "pencil-like" hyperintensities (16/16) and cord enlargement (9/16). Axial T2-weighted images showed bilateral (13/16) and unilateral (3/16) hyperintensities according, in 15 patients, to anterior spinal artery (ASA) territory, with three of them located particularly in the spinal sulcal artery territory. In one patient only the posterior spinal artery (PSA) territory was involved. Spinal cord was affected at the cervical level (especially C2-C3) in seven patients, at the upper thoracic level (T3-T5) in two patients and at the thoracolumbar region including the conus medullaris (T10-L1) in seven patients. Presumed etiologies were vascular surgery (3 patients), infrarenal aortic aneurysm (1 patient), bilateral vertebral artery dissection (1 patient), hypotension (1 patient), spine operation (1 patient), excessive cocaine misuse (1 patient) and cardioembolic vertebral artery occlusion (1 patient); six of seven patients with unclear etiologies had vascular risk factors such as hypertension, diabetes and cigarette smoking. MR imaging is therefore useful in detecting spinal cord infarction, with axial T2-weighted images showing hyperintensities in the ASA territory in 15 of 16 patients. Contrary to the presumed spinal cord watershed at the lower cervical and upper thoracic level, and despite numerous central arteries in the cervical cord, our data suggest a high ischemic vulnerability of the cervical spinal cord at level C2-C3.

Authors+Show Affiliations

Institute of Neuroradiology, Johann Wolfgang Goethe-Universität Frankfurt, Schleusenweg 2-16, 60528 Frankfurt, Germany. Weidauer@em.uni-frankfurt.deNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12389137

Citation

Weidauer, Stefan, et al. "Spinal Cord Infarction: MR Imaging and Clinical Features in 16 Cases." Neuroradiology, vol. 44, no. 10, 2002, pp. 851-7.
Weidauer S, Nichtweiss M, Lanfermann H, et al. Spinal cord infarction: MR imaging and clinical features in 16 cases. Neuroradiology. 2002;44(10):851-7.
Weidauer, S., Nichtweiss, M., Lanfermann, H., & Zanella, F. E. (2002). Spinal cord infarction: MR imaging and clinical features in 16 cases. Neuroradiology, 44(10), 851-7.
Weidauer S, et al. Spinal Cord Infarction: MR Imaging and Clinical Features in 16 Cases. Neuroradiology. 2002;44(10):851-7. PubMed PMID: 12389137.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spinal cord infarction: MR imaging and clinical features in 16 cases. AU - Weidauer,Stefan, AU - Nichtweiss,Michael, AU - Lanfermann,Heinrich, AU - Zanella,Friedhelm E, Y1 - 2002/09/21/ PY - 2002/03/18/received PY - 2002/05/30/accepted PY - 2002/10/22/pubmed PY - 2003/2/7/medline PY - 2002/10/22/entrez SP - 851 EP - 7 JF - Neuroradiology JO - Neuroradiology VL - 44 IS - 10 N2 - Spinal cord infarctions are rare and due to heterogeneous etiologies. The aim of the study was to analyze the MR imaging findings and evaluate their correlations with clinical symptoms in ischemic spinal cord lesions. MR images and clinical features of 16 patients (11 male, 5 female) with typical sudden onset of neurological deficits caused by spinal cord ischemia were evaluated. MR imaging was performed within 2 h to 14 days after the initial neurological symptoms. Eight patients had follow-up examinations including contrast-enhanced MR imaging. MR abnormalities were best demonstrated on sagittal T2-weighted images, with "pencil-like" hyperintensities (16/16) and cord enlargement (9/16). Axial T2-weighted images showed bilateral (13/16) and unilateral (3/16) hyperintensities according, in 15 patients, to anterior spinal artery (ASA) territory, with three of them located particularly in the spinal sulcal artery territory. In one patient only the posterior spinal artery (PSA) territory was involved. Spinal cord was affected at the cervical level (especially C2-C3) in seven patients, at the upper thoracic level (T3-T5) in two patients and at the thoracolumbar region including the conus medullaris (T10-L1) in seven patients. Presumed etiologies were vascular surgery (3 patients), infrarenal aortic aneurysm (1 patient), bilateral vertebral artery dissection (1 patient), hypotension (1 patient), spine operation (1 patient), excessive cocaine misuse (1 patient) and cardioembolic vertebral artery occlusion (1 patient); six of seven patients with unclear etiologies had vascular risk factors such as hypertension, diabetes and cigarette smoking. MR imaging is therefore useful in detecting spinal cord infarction, with axial T2-weighted images showing hyperintensities in the ASA territory in 15 of 16 patients. Contrary to the presumed spinal cord watershed at the lower cervical and upper thoracic level, and despite numerous central arteries in the cervical cord, our data suggest a high ischemic vulnerability of the cervical spinal cord at level C2-C3. SN - 0028-3940 UR - https://www.unboundmedicine.com/medline/citation/12389137/Spinal_cord_infarction:_MR_imaging_and_clinical_features_in_16_cases_ L2 - https://dx.doi.org/10.1007/s00234-002-0828-5 DB - PRIME DP - Unbound Medicine ER -