[Spinal cord infarction/ischemia]

Vascular pathology is considered to be uncommon, with a much lower incidence than cerebral vascular pathology.

We reviewed the clinical histories of patients with a clinical diagnosis of spinal cord infarction-ischemia attended by the Neurology Department and the Neuropaediatric section at our centre between 1990 and 1997. We analyzed the clinical and investigational findings and compared them with those in the literature.

We studied the cases of 12 patients (nine adults and three children). There was only one case in which no etiological factor of any type was found to justify the spinal vascular condition. All the children had had surgery to repair coarctation of the aorta. The most frequent clinical presentation was of paraparesis-paraplegia with signs of involvement of the anterior spinal artery. MR was done in all cases, except in that of an adult who was diagnosed on arteriography. The adults were studied by means of MR during the first 24-48 hours after onset of the condition. In five cases this was normal. In two of the latter cases, MR was repeated and alterations were seen in one whilst the other was not satisfactory. In the other three cases MR was not repeated since in two there was clinical improvement and in the other excessive technical problems. On discharge the children had not improved at all although the six adults improved completely or almost completely.

In general, our findings are comparable to those in the literature. We consider that the diagnosis is basically clinical and differential diagnosis should be made with other spinal disorders. MR is helpful, although early use does not show changes which help in diagnosis.