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Spinal cord ischemia: aetiology, clinical syndromes and imaging features

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Abstract

Introduction

The purpose of this study was to analyse MR imaging features and lesion patterns as defined by compromised vascular territories, correlating them to different clinical syndromes and aetiological aspects.

Methods

In a 19.8-year period, clinical records and magnetic resonance imaging (MRI) features of 55 consecutive patients suffering from spinal cord ischemia were evaluated.

Results

Aetiologies of infarcts were arteriosclerosis of the aorta and vertebral arteries (23.6 %), aortic surgery or interventional aneurysm repair (11 %) and aortic and vertebral artery dissection (11 %), and in 23.6 %, aetiology remained unclear. Infarcts occurred in 38.2 % at the cervical and thoracic level, respectively, and 49 % of patients suffered from centromedullar syndrome caused by anterior spinal artery ischemia. MRI disclosed hyperintense pencil-like lesion pattern on T2WI in 98.2 %, cord swelling in 40 %, enhancement on post-contrast T1WI in 42.9 % and always hyperintense signal on diffusion-weighted imaging (DWI) when acquired.

Conclusion

The most common clinical feature in spinal cord ischemia is a centromedullar syndrome, and in contrast to anterior spinal artery ischemia, infarcts in the posterior spinal artery territory are rare. The exclusively cervical location of the spinal sulcal artery syndrome seems to be a likely consequence of anterior spinal artery duplication which is observed preferentially here.

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Ethical standards and patient consent

We declare that due to the retrospective nature of this study, we did not apply for Ethics Committee approval.

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We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurology, Sankt Katharinen Hospital, Teaching Hospital of the Goethe – University, Frankfurt / Main, Seckbacher Landstraße 65, D 60389, Frankfurt / Main, Germany

    Stefan Weidauer

  2. Wellengang 21, D 23968, Wismar, Germany

    Michael Nichtweiß

  3. Institute of Neuroradiology, Goethe – University, Schleusenweg 2-16, D 60528, Frankfurt / Main, Germany

    Elke Hattingen & Joachim Berkefeld

Authors
  1. Stefan Weidauer
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  2. Michael Nichtweiß
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  3. Elke Hattingen
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  4. Joachim Berkefeld
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Correspondence to Stefan Weidauer.

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Weidauer, S., Nichtweiß, M., Hattingen, E. et al. Spinal cord ischemia: aetiology, clinical syndromes and imaging features. Neuroradiology 57, 241–257 (2015). https://doi.org/10.1007/s00234-014-1464-6

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  • DOI: https://doi.org/10.1007/s00234-014-1464-6

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