Clinical Evaluation of Patients with Spinal Cord Infarction in Mashhad, Iran

Background. Spinal Cord Infarction (SCI) is a rare and disabling disease. This hospital-based study was conducted for clinical evaluation of SCI patients in east of Iran.Methods. Consecutive SCI patients admitted in Ghaem hospital,Mashhad during 2006–2010 were enrolled in a prospective clinical study. Diagnosis of SCI was made by neurologists and radiologists. Demographic features, clinical syndrome, and Magnetic Resonance Imaging (MRI) findings were recorded. All of the patients underwent a standard battery of diagnostic investigations. All of the patients suspected to SCI had MRI of spinal cord at the symptomatic level of cord with a 0.5 Tesla generation, Philips NT Intra, Netherland equipment. An equal number of patients with Brain Infarction (BI) were randomly selected from our stroke registry data bank. Etiology and degree of disability were compared between these groups of patients.Results. Fourteen SCI patients (9 females, 5 males) with mean age38.8±SD: 19.9 years were evaluated. Miscellaneous causes consisted 50% of etiologies in patients with SCI. Uncertain etiology, atherosclerosis, and cardioembolisms consisted 35.7%, 7.1%, and 7.1% of SCI causes, respectively. Distribution of etiologies was significantly different between SCI and BI patients,X2=12.94,df=3,P=.003. Difference in mean disability score at acute phase of stroke was not significant between two studied groups,z=1.54,P=.057. Difference in mean changes of disability score at 90 days postevent was significant in two groups of patients,z=2.65,P=.019.Conclusion. SCI is a rare disease with poor recovery. Distribution of etiologies of SCI patients is quite different than of BI patients.

Download Full-text

Acute to Subacute Spinal Cord Infarction Mimicking Acute Multiple Sclerosis: Usefulness of Diffusion-Weighted MRI for Diagnosis

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405618666220103105910 ◽

2022 ◽

Vol 18 ◽

Author(s):

Kyoung Yeon Lee ◽

Eun Kyung Khil ◽

Sang Won Jo ◽

Min Uk Jang ◽

Jung-Ah Choi ◽

...

Keyword(s):

Multiple Sclerosis ◽

Spinal Cord ◽

Brain Infarction ◽

Brain Magnetic Resonance Imaging ◽

Visual Field Defects ◽

Unknown Etiology ◽

Spinal Cord Infarction ◽

Mri Findings ◽

Subacute Phase ◽

Diffusion Weighted

Background: Spinal cord infarction (SCI) is difficult to diagnose because of its rarity, unknown etiology, and unestablished diagnostic criteria. Additionally, the timeline of SCI has not been studied in detail, as few studies using diffusion-weighted image (DWI) sequences of the spine of a small target population have been previously conducted. Case Study: A 56-year-old male with underlying arrhythmia suddenly developed visual field defects on the right side, pain in the left upper extremity, and a tingling sensation in the left hand. Brain Magnetic resonance imaging (MRI) revealed acute to subacute stages of multifocal brain infarction. On additional cervical spinal MRI, it showed atypical MRI findings of SCI, considered late acute to early subacute phase, which were similar to those seen in the acute phase of multiple sclerosis (MS). Additional DWI revealed restricted diffusion. From these findings, it could be inferred that the patient’s SCI occurred at the same time as the multifocal brain infarctions caused by atrial fibrillation. Conclusion: A DWI sequence of spine MRI could be helpful in the diagnosis of acute to subacute phase SCI and in differentiating with acute MS.

Download Full-text

MRI characteristics of suspected acute spinal cord infarction in two cats, and a review of the literature

Journal of Feline Medicine and Surgery ◽

10.1016/j.jfms.2004.08.001 ◽

2005 ◽

Vol 7 (2) ◽

pp. 101-107 ◽

Cited By ~ 22

Author(s):

Amy D. MacKay ◽

Claire Rusbridge ◽

Andrew H. Sparkes ◽

Simon R Platt

Keyword(s):

Spinal Cord ◽

Diagnostic Value ◽

Acute Onset ◽

Clinical Syndrome ◽

Spinal Cord Infarction ◽

Mri Findings ◽

Blood Contamination ◽

Physical Examinations ◽

Magnetic Resonance Imaging Mri ◽

Mri Characteristics

A 10-year-old neutered male Persian cat and a 4-year-old spayed female domestic shorthair (DSH) cat were evaluated for acute-onset severe lateralising tetraparesis and hemiplegia, respectively. Both cats also had left-sided Horner's syndrome. Neurological examination of the cats localised the lesion to cranial to C5 in the Persian and the left cervical intumescence (C6–T2) in the DSH. Physical examinations were otherwise generally unremarkable. Routine laboratory tests and spinal radiography were normal for the Persian cat and were not performed for the DSH cat. A cerebrospinal fluid (CSF) tap was attempted for the Persian cat but aborted because of gross blood contamination, and was not performed for the DSH cat. Magnetic resonance imaging (MRI) of the Persian cat revealed a lesion within the spinal parenchyma at segments C1 to C3 (slightly more left-sided) which was iso- to hypointense on T1-weighted scans and hyperintense on T2-weighted scans, and which enhanced slightly with gadolinium. MRI of the DSH cat revealed a lesion within the spinal parenchyma at segment C7 (predominantly left-sided) which was hypointense on T1-weighted scans and hyperintense on T2-weighted gradient echo scans. Contrast was not administered. The MRI findings in both cases were highly suggestive of acute spinal cord infarction, based upon comparison to human cases. Both cats made full neurological recoveries with supportive treatment only. This paper describes two cases of suspected acute spinal cord infarction in the cat, demonstrates the potential diagnostic value of MRI, and discusses the clinical syndrome of this condition with a brief review of published cases.

Download Full-text

Specific MRI findings help distinguish acute transverse myelitis of Neuromyelitis Optica from spinal cord infarction

Multiple Sclerosis and Related Disorders ◽

10.1016/j.msard.2016.04.005 ◽

2016 ◽

Vol 9 ◽

pp. 62-67 ◽

Cited By ~ 22

Author(s):

I. Kister ◽

E. Johnson ◽

E. Raz ◽

J. Babb ◽

J. Loh ◽

...

Keyword(s):

Spinal Cord ◽

Neuromyelitis Optica ◽

Transverse Myelitis ◽

Spinal Cord Infarction ◽

Mri Findings ◽

Acute Transverse Myelitis

Download Full-text

Spinal Cord Infarction

10.32388/989624 ◽

2019 ◽

Author(s):

Keyword(s):

Spinal Cord ◽

Spinal Cord Infarction

Download Full-text

Faculty Opinions recommendation of Clinical evaluation of a newly developed catheter (SpeediCath Compact Male) in men with spinal cord injury: residual urine and user evaluation.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.9737956.10425054 ◽

2011 ◽

Author(s):

Jean-Jacques Wyndaele

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Clinical Evaluation ◽

User Evaluation ◽

Residual Urine ◽

Cord Injury

Download Full-text

Retrospective analysis on the effect of spinal cord stimulation on opioid consumption

Pain Management ◽

10.2217/pmt-2020-0016 ◽

2020 ◽

Author(s):

Awinita Barpujari ◽

Michael A Erdek

Keyword(s):

Spinal Cord ◽

Chronic Pain ◽

Retrospective Analysis ◽

Spinal Cord Stimulation ◽

Alternative Therapy ◽

Opioid Consumption ◽

Opioid Use ◽

Number Of Patients ◽

Chronic Pain Conditions ◽

Post Trial

Aim: Spinal cord stimulation (SCS) is used to clinically manage and/or treat several chronic pain etiologies. A limited amount is known about the influence on patients' use of opioid pain medication. This retrospective analysis evaluated SCS effect on opioid consumption in patients presenting with chronic pain conditions. Materials & methods: Sixty-seven patients underwent a temporary trial device, permanent implant or both. Patients were divided for assessment based on the nature of their procedure(s). Primary outcome was change in morphine equivalent dose (MED), ascertained from preoperative and postoperative medication reports. Results: Postoperative MED was significantly lower in patients who received some form of neuromodulation therapy. Pretrial patients reported an average MED of 41.01 ± 10.23 mg per day while post-trial patients reported an average of 13.30 ± 5.34 mg per day (p < 0.001). Pre-implant patients reported an average MED of 39.14 ± 13.52 mg per day while post-implant patients reported an average MED of 20.23 ± 9.01 mg per day (p < 0.001). There were no significant differences between pre-trial and pre-implant MED, nor between post-trial and post-implant MED. Of the 42 study subjects who reported some amount of pre-intervention opioid use, 78.57% indicated a lower MED (n = 33; p < 0.001), 16.67% indicated no change (n = 7) and 4.76% (n = 2) indicated a higher MED, following intervention. Moreover, SCS therapy resulted in a 26.83% reduction (p < 0.001) in the number of patients with MED >50 mg per day. Conclusion: Spinal cord stimulation may reduce opioid use when implemented appropriately. Neuromodulation may represent alternative therapy for alleviating chronic pain which may avoid a number of deleterious side effects commonly associated with opioid consumption.

Download Full-text