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Spinal Cord Infarct in Children: A Decade of Experience From a Tertiary Referral Center
Noa Ben-Artzi Cohen1,2, Dafna Guttman2,3, Sara Via Dorembus2,4
1Pediatrics A Department, Edmond & Llly Safra Children Hospital, Sheba Medical Center, Ramat Gan, Israel.
Insights
Pediatric spinal cord infarcts are rare but serious, often presenting with motor weakness and pain. Early diagnosis and multidisciplinary rehabilitation significantly improve functional outcomes and quality of life in affected children.
Area of Science:
- Neurology
- Pediatrics
- Vascular Medicine
Background:
- Pediatric spinal cord infarcts are infrequent but can cause significant disability.
- Early identification and management are crucial for optimizing patient outcomes.
Purpose of the Study:
- To investigate the clinical features, treatment strategies, and outcomes of spinal cord infarcts in children.
- To improve early diagnosis and management protocols for pediatric spinal cord infarcts.
Main Methods:
- Retrospective cohort study of pediatric patients (0-18 years) diagnosed with spinal cord infarct between 2012-2024.
- Magnetic resonance imaging (MRI) used for diagnosis; American Spinal Injury Association Impairment Scale (ASIA) for functional assessment.
Main Results:
- Thirteen children (median age 13) were included. Common symptoms included motor weakness (77%) and pain (61%).
- Anterior spinal artery syndrome occurred in 38%; fibrocartilage emboli in 30%. MRI confirmed infarct in 61%.
- Treatment involved antithrombotic therapy and rehabilitation, with 54% showing significant functional improvement.
Conclusions:
- Pediatric spinal cord infarcts require prompt diagnosis and comprehensive, multidisciplinary rehabilitation.
- Supportive care and early intervention are key to improving neurological recovery and quality of life.
- While often idiopathic, increased awareness and standardized management can enhance recovery prospects.
Aim:
To investigate the clinical presentation, therapeutic approaches, and outcomes of pediatric spinal cord infarcts to enhance early diagnosis and management.
Method:
This retrospective cohort study was conducted at Sheba Medical Center, focusing on pediatric patients aged 0-18 years diagnosed with spinal cord infarct between 2012 and 2024. Patients were identified throughmagnetic resonance imaging (MRI) findings and classified using the American Spinal Injury Association Impairment Scale upon admission and discharge from rehabilitation.
Results:
Thirteen children, with a median age of 13 years, were included in the cohort. Clinical presentations varied, with motor weakness (77%) and local pain (61%) being the most common. Anterior spinal artery syndrome was prevalent in 38% of cases. Fibrocartilage emboli were responsible for 30% of the infarcts. MRI was the primary diagnostic modality, with 61% showing definite infarct signs. Therapeutic management typically included antithrombotic therapy and rehabilitation. Notably, 54% of the patients demonstrated significant functional improvement.
Interpretation:
Pediatric spinal cord infarcts, while rare, lead to considerable morbidity, necessitating timely diagnosis and a comprehensive, multidisciplinary rehabilitation approach. This study underscores the importance of supportive care in improving neurological outcomes and quality of life in affected children. While most infarcts are idiopathic, better awareness and management protocols can enhance recovery prospects.
Conclusion:
Despite its rarity, spinal cord infarcts pose a significant risk to pediatric patients. Our findings highlight the resilience of children and emphasize the critical role of early rehabilitation in achieving favorable long-term outcomes.
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