History of infarction of the spinal cord

In 1825 Astley Cooper described the first account of ligation of the abdominal aorta. The patient developed loss of feeling in his lower limbs, incontinence of urine and died after several days. A post mortem was carried out but not, unfortunately, of the spinal cord. This case was recorded again by Astley Cooper, by Brock in 1940-41, and again by Ellis in 1994. Whilst there was early recognition of infarction of the brain, infarction of the spinal cord was thought to be almost unknown by Charcot in 1883 but it was recorded in the English literature by Bastian in 1886 and Williamson in 1894. There were isolated case reports but it was the advent of major surgery upon the aorta in the Second World War that drew attention to the frequency of this condition. The subsequent evolution of our recognition of infarction of the cord is described. The present situation, where it can be caused by a fall in blood pressure without there being direct interference to the blood supply, is evaluated.