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Acute Spinal Cord Infarction with Preferential Involvement of Ventral Gray Matter: An Autopsy Report
Shuta Toru1, Tetsuo Yamada2, Masako Suzuki1
1Department of Neurology, Nitobe Memorial Nakano General Hospital, 4-59-16, Chuo, Nakano-ku, Tokyo 164-8607, Japan.
Summary
Abdominal aortic thrombosis can rarely cause acute spinal cord infarction. Autopsy revealed aortic clot leading to ventral gray matter necrosis in the spinal cord, suggesting its vulnerability to ischemia.
Area of Science:
- Vascular Neurology
- Pathology
- Cardiovascular Medicine
Background:
- Acute spinal cord infarction is a rare neurological emergency.
- Abdominal aortic thrombosis is an uncommon cause of systemic ischemia.
- Vascular risk factors are prevalent in elderly populations.
Observation:
- A 78-year-old male presented with acute paraplegia, sensory/urinary deficits, and lower limb ischemia.
- Post-mortem examination revealed extensive abdominal aortic thrombosis distal to renal arteries.
- The spinal cord showed selective ventral gray matter necrosis (T6-S5).
Findings:
- Abdominal aortic thrombosis was identified as the cause of spinal cord infarction in this case.
- Atherosclerosis was widespread in major blood vessels.
- Spinal cord gray matter demonstrated greater vulnerability to ischemic injury compared to white matter.
Implications:
- Highlights a rare etiology for acute spinal cord infarction.
- Suggests selective vulnerability of spinal cord gray matter to ischemia.
- Underscores the importance of considering aortic pathology in ischemic myelopathy.
