SPINAL-CORD INFARCTION - ETIOLOGY AND OUTCOME

We reviewed 44 cases of ischemia and infarction of the spinal cord at two university hospitals, Three patients experienced transient ischemi c attacks. Etiologies of completed strokes were diverse and included r upture and surgical repair of aortic aneurysms, aortic dissection, aor tic rupture and thrombosis, global ischemia, anterior spinal artery em bolism, repair and thrombosis of spinal arteriovenous malformations, h ematomyelia, epidural hematoma, cervical osteophytosis, celiac plexus block, systemic lupus erythematosus, coagulopathy, and decompression s ickness. Motor function improved in 12 patients, was substantial in on ly one, and occurred largely within the first 2 to 4 weeks, Favorable ambulatory outcome correlated with improving neurologic examinations a nd relatively preserved strength in hip abductors and knee extensors. More extensive deficits without initial improvement portended a more s evere prognosis. Autonomic dysfunction, pain, paresthesia, and depress ion were common and impeded recovery in some patients. The mean level of deficit was at T-8 and in cases of global ischemia was at T-9, whic h leads us to dispute the classical view of a midthoracic watershed zo ne of ischemic vulnerability near T-4.