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Magnetic Resonance Imaging in Ischemic Stroke pp 251–267Cite as

Spinal Infarcts

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Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

17.7 Summary

In the last decade typical signs of spinal cord ischemia have been reported. Confirming and supporting signs of acute ischemic myelomalacia are vertebral body infarction and the pathognomonic contrast enhancement of the cauda equina in the course of the disease. Moreover, bone infarction strongly indicates the proximal occlusion and the level of the affected segmental artery. Cartilaginous disc embolism, embolism following periradicular nerve root therapy and compression of a lumbar artery are underestimated causes of spinal cord ischemia.

In most cases a long, extending cord lesion in the presence of perimedullary veins favors spinal dural AV fistulas as an underlying disorder which has to be confirmed by spinal angiography and separated from perimedullary AV fistulas. Up to now, it is not possible to differentiate local arterial from venous occlusion in the intravital diagnostic work-up. MRI, MR angiography and spinal DSA are complementary diagnostic tools in vascular diseases of the spinal cord which help us to confirm the diagnosis and to come to a better understanding of these rare disorders.

In summary, important advances have been made in our understanding of the underlying pathogenetic mechanism in spinal cord ischemia. This condition remains a diagnostic and therapeutic challenge, but improved diagnosis may result in better treatment in the future.

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  1. Department of Neuroradiology, Clinic for Diagnostic Radiology, University Hospital of the Technical University, Pauwelsstr. 30, 52074, Aachen, Germany

    Michael Mull MD & Armin Thron MD

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  1. Michael Mull MD
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  2. Armin Thron MD
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Editors and Affiliations

  1. Department of Neuroradiology, University of Technology Dresden, Fetscherstr. 74, 01307, Dresden, Germany

    RÜdiger von Kummer MD

  2. Department of Neurology University Hospital Mannheim, Ruprecht-Karls University Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany

    Tobias Back MD

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Mull, M., Thron, A. (2006). Spinal Infarcts. In: von Kummer, R., Back, T. (eds) Magnetic Resonance Imaging in Ischemic Stroke. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-27738-2_17

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