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Spinal Infarcts

  • Michael Mull
  • Armin Thron
Part of the Medical Radiology book series (MEDRAD)

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.

Keywords

Spinal Cord Ischemia Lumbar Artery Anterior Spinal Artery Spinal Cord Infarction Spinal Angiography 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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© Springer-Verlag Berlin Heidelberg 2006

Authors and Affiliations

  • Michael Mull
    • 1
  • Armin Thron
    • 1
  1. 1.Department of Neuroradiology, Clinic for Diagnostic RadiologyUniversity Hospital of the Technical UniversityAachenGermany

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