Causes Of Spinal Stroke: Symptoms, Diagnosis And Treatment

Spinal stroke occurs when the blood flow to the spinal cord is blocked or interrupted. Anterior and posterior spinal arteries carry blood to the spinal cord. A blockage in these arteries can diminish oxygen and other nutrients carried by blood. As a result the tissue dies. This can lead to sudden paralysis.

The most common cause of spinal stroke is blockage caused due to a blood clot. Other causes such as hemorrhage, aortic aneurysm surgery etc are also likely causes. The symptoms of spinal stroke begin as sudden back pain, which may be followed by weakness of muscles in legs and loss of sensation.

Spinal stroke which is also called as spinal artery syndrome (SAS) is rare as compared to incidence of brain stroke. Paralysis due to spinal stroke is permanent. The main aim of treatment is to address the underlying cause and to provide supportive care. Physiotherapy and occupational therapy are started soon to preserve the muscular function as much as possible.

What Causes A Spinal Cord Stroke?

Spinal stroke usually develops in old people. It occurs as a result of disruption in the blood flow to spinal cord. The spinal arteries supply blood to spinal cord.

There are two main arteries called anterior and posterior spinal arteries. Damage in these arteries can lead to spinal stroke. Damage can occur due to:

  • Blood clot: A blood clot either arising in the spinal artery or a clot that forms somewhere else and gets lodged in the spinal artery can block the flow of blood to the spinal cord. Blood clot usually forms from a narrowed vessel due to build of fatty deposit in the lumen of blood vessel. The condition is also called atherosclerosis. People with high blood pressure, high cholesterol, or diabetes have an increased risk.
  • Aortic disease: Spinal stroke can be one of complications of repair of aortic aneurysm. The spinal arteries branch out directly from the aorta. When the wall of aorta is damaged, it results in balloon like projection at some weak point. This is called aneurysm. The flow of blood may be diminished due to repair of the anomaly.
  • Trauma: Traumatic injury to spine can cause damage to the arteries. This may lead to bleeding and hemorrhage compromising blood flow to spinal cord. Mostly vehicular trauma is responsible for this catastrophic occurrence.
  • Inflammation of arteries: Inflammation of arteries can reduce or block the supply of blood to spinal cord. Conditions such as syphilis, diabetes mellitus, systemic lupus arteries etc can cause inflammatory changes in the arterial wall.
  • Compression: Pressure on the arteries due to tumor or an abscess in spine can disrupt blood flow to the spinal cord.
  • Hypo-tension: Blood flow is reduced due to severe fall in blood pressure. It can affect blood supply to spinal cord.

Symptoms Of Spinal Stroke

The symptoms of spinal stroke depends on the level at which the spinal cord is affected due to lack of blood supply. Principle symptom of spinal stroke is sudden onset of paralysis. This may begin as sudden pain in back which may radiate to the area innervated by the nerves of spinal cord.

Gradually there is weakness of muscles and loss of sensation to cold, heat and touch. There may be unusual tingling and numb feeling in the lower half of body.

Along with paralysis of lower limbs there may be associated loss of bladder and bowel control. There may be associated loss of erection in males and person may have sexual problems.

Diagnosis And Treatment For Spinal Stroke

Diagnosis of disease is possible with the help of MRI (magnetic resonance imaging). Sometimes a spinal tap may be needed for analysis of cerebrospinal fluid and to rule out other causes that are known to produce similar symptoms.

Treatment of spinal stroke is symptomatic. The main aim of treatment is to address the underlying cause and manage its complications such as paralysis. Physiotherapy and occupational therapy are started as soon as possible to preserve muscle function.

If a clot or thrombus is obstructing blood flow, blood thinners and other medications are given to the patient that dissolves the clot. As there is impairment of bladder function, a retention catheter is introduced in the bladder through the urethra for easy drainage of urine.

In most cases paralysis is permanent. Good nursing care is required daily to prevent bed sores.