Skip to main content
SpringerLink
Log in

Anterior spinal artery syndrome of the cervical hemicord

  • Original Articles
  • Published:
European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Summary

Three patients developed signs of a unilateral cervical cord lesion 6 to 36 h after the acute onset of severe cervico-brachial pain. The neurological deficit progressed over 6 to 18h. On the painful side a central Horner's syndrome, a hemiparesis with plegia of the hand, and a slight pallhypaesthesia were found. On the opposite side thermhypaesthesia and hypalgesia were noted with a level at the dermatome C5 or C6. T2-weighted MR images revealed in one patient a small area of increased signal intensity restricted to one half of the cervical cord, and electromyography in another patient showed after 6 months evidence of segmental chronic denervation. Both abnormalities were found at the clinically expected level. The findings are consistent with a small infarction of the cervical cord in the perfusion territory of a central (sulco-commissural) artery, a duplicated anterior spinal artery or an anterior spinal branch of the vertebral artery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Belkin RN, Hurwitz BJ, Kisslo J (1987) Atrial septal aneurysm: association with cerebrovascular and peripheral embolic events. Stroke 18:856–862

    PubMed  Google Scholar 

  2. Blankenhom D, Wolff HG (1948) Myelitis following the administration of neoarsphenamine. J Lab Clin Med 33:1165–1168

    Google Scholar 

  3. Blennow G, Starck L (1987) Anterior spinal artery syndrome. Pediatr Neurosci 13:32–37

    PubMed  Google Scholar 

  4. Bots GTAM, Wattendorf AR, Buruma OJS, Roos RAC (1981) Acute myelophathy caused by fibrocartilagineous emboli. Neurology 31:1250–1256

    PubMed  Google Scholar 

  5. Clinicopathologic Conference (1968) A sixty-six year old man with sudden onset of left-sided chest and arm pain, weakness of the extremities and urinary retention. Am J Med 44:430–440

    Google Scholar 

  6. Davies A, Solomon B, Levene A (1958) Paraplegia following epidural anesthesia. BMJ 2:654–657

    Google Scholar 

  7. Decroix JP, Ciando-Lacroix C, Lapresle J (1984) Syndrome de Brown-Sequard du a un infarctus spinal. Rev Neurol 140:585–586

    PubMed  Google Scholar 

  8. Di Pasquale G, Andreoli G, Grazi P, Dominici P, Pinelli G (1988) Cardioembolic stroke from atrial septal aneurysm. Stroke 19:640–643

    PubMed  Google Scholar 

  9. Ederli A, Sassaroli S, Spaccarelli G (1962) Vertebral angiography as a cause of necrosis of the cervical spinal cord. Br J Radiol 35:261–264

    PubMed  Google Scholar 

  10. Fiebrand H (1966) 2. Zur Pathogenese des Spinalis-anterior-Syndroms. Schweiz Arch Neurol Neurochir Psychiatr 97:227–233

    PubMed  Google Scholar 

  11. Foo D, Rossier AB (1983) Anterior spinal artery syndrome and its natural history. Paraplegia 21:1–10

    PubMed  Google Scholar 

  12. Garland H, Greenberg J, Harriman DGF (1966) Infarction of the spinal cord. Brain 89:645–662

    PubMed  Google Scholar 

  13. Grinker RR, Guy CC (1927) Sprain of cervical spine causing thrombosis of anterior spinal artery. JAMA 88:1140–1142

    Google Scholar 

  14. Gruner J, Lapresle J (1962) Etude anatomo-pathologique des médullopathies d'origine vasculaire. Rev Neurol 106:592–631

    Google Scholar 

  15. Hells CBC (1966) Clinical aspects of spino-vascular disease. Proc R Soc Med 59:790–796

    PubMed  Google Scholar 

  16. Henneaux J (1960) Etude clinique et anatomo-pathologique de deux cas de thrombose de l'artère spinale antérieure. Rev Neurol (Paris) 102:44–60

    Google Scholar 

  17. Ho KL, Gorell JM, Hayden MT (1980) Fatal spinal cord infarction caused by fibrocartilagineous embolization of the anterior spinal artery. Hum Pathol 11:471–475

    PubMed  Google Scholar 

  18. Howieson J, Megison LC Jr (1968) Complications of vertebral artery catheterization. Radiology 98:1108–1111

    Google Scholar 

  19. Hubert JP, Ectors M, Ketelbant-Balasse P, Flament-Durand J (1974) Fibrocartilagineous venous and arteriel emboli from the nucleus pulposus in the anterior spinal system. Europ Neurol 11:164–171

    PubMed  Google Scholar 

  20. Hughes JT (1989) Vascular disorders of the spinal cord. In: Handbook of Clinical Neurology, vol 11 (55): vascular diseases, Part II Elsevier

  21. Hughes JT, Macintyre AG (1963) Spinal cord infarction occurring during thoraco-lumbar sympathectomy. J Neurol Neurosurg Psychiatr 26:418–421

    PubMed  Google Scholar 

  22. Kase CS, Varakis JN, Stafford JR, Mohr JP (1983) Medial medullary infarction from fibrocartilagineous embolism to the anterior spinal artery. Stroke 14:413–418

    PubMed  Google Scholar 

  23. Khang-Loon Ho, Gorell JM, Tan Hayden M (1980) Fatal spinal cord infarction caused by fibrocartilagineous embolization of the anterior spinal artery. Hum Pathol 11:471–475

    PubMed  Google Scholar 

  24. Laguna J, Cravioto H (1973) Spinal cord infarction secondary to occlusion of the anterior spinal artery. Arch Neurol 28:134–136

    PubMed  Google Scholar 

  25. Lyon LW (1971) Transfemoral vertebral angiography as a cause of an anterior spinal artery syndrome. J Neurosurg 35:328–330

    Google Scholar 

  26. Mody CK, Miller BL, McIntyre HB, Cobb SK, Goldberg MA (1988) Neurologic complications of cocaine abuse. Neurology 38:1189–1193

    PubMed  Google Scholar 

  27. Nairman JL, Donohue WL, Prichard JS (1961) Fatal nucleus pulposus embolism of spinal cord after trauma. Neurology 11:83–87

    PubMed  Google Scholar 

  28. Netsky MG (1953) Syringomyelia. Arch Neurol 70:741–777

    Google Scholar 

  29. Peterman AF, Yoss RE, Corbin KB (1958) The syndrome of occlusion of the anterior spinal artery. Proc Mayo Clin 33:31–37

    PubMed  Google Scholar 

  30. Rao KR, Donnerfeld H, Chusid JG, Valdez S (1982) Acute myelopathy secondary to spinal venous thrombosis. J Neurol Sci 56:107–113

    Article  PubMed  Google Scholar 

  31. Schaller WF, Roberts AM, Stadtherr EM (1932) Acute myelitis (myelomalacia): Syndrome of occlusion of the anterior spinal artery at the fifth cervical cord segment. JAMA 99:1573–1575

    Google Scholar 

  32. Schiffter R (1985) Neurologie des vegetativen Systems. Springer, Berlin Heidelberg New York

    Google Scholar 

  33. Spiller WG (1909) Thrombosis of the cervical anterior median spinal artery: Syphilitic acute anterior poliomyelitis. J Nerv Ment Dis 36:601–613

    Google Scholar 

  34. Srigley JR, Lambert CD, Bilbao JM, Pritzler KPH (1981) Spinal cord infarction secondary to intervertebral disc embolism. Ann Neurol 9:296–301

    Article  PubMed  Google Scholar 

  35. Steegmann AT (1952) Syndrome of the anterior spinal artery. Neurology 2:15–35

    PubMed  Google Scholar 

  36. Takahashi M, Wilson G, Hanafee W (1969) Catheter vertebral angiography: A review of 300 examinations. J Neurosurg 30: 722–731

    PubMed  Google Scholar 

  37. Totoki T, Kato TA, Nomoto Y, Kurakazu M (1979) Anterior spinal artery syndrome. A complication of cervical intrathecal phenol injection. Pain 6:99–104

    Article  PubMed  Google Scholar 

  38. Turnball IM (1972) Blood supply of the spinal cord. In: Handbook of Clinical Neurology, vol 12: vascular diseases of the nervous system, part II Elsevier

  39. Van Orman CB, Darwish HZ (1988) Harrington rod instrumentation: A cause of Brown-Séquard syndrome. Can J Neurol Sci 15:44–46

    PubMed  Google Scholar 

  40. Van Wieningen A (1968) An unusual cause of occlusion of the anterior spinal artery. Eur Neurol 1:363–374

    PubMed  Google Scholar 

  41. Whiteley AM, Hauw JJ, Escourolle R (1979) A pathological survey of 41 cases of acute intrinsic spinal cord disease. J Neurol Sci 42:229–242

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, University Hospital, Zürich, Switzerland

    Ralf W. Baumgartner & Walter Waespe

Authors
  1. Ralf W. Baumgartner
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Walter Waespe
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Baumgartner, R.W., Waespe, W. Anterior spinal artery syndrome of the cervical hemicord. Eur Arch Psychiatry Clin Nuerosci 241, 205–209 (1992). https://doi.org/10.1007/BF02190254

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02190254

Key words

Search

Navigation