by George » Wed May 20, 2009 1:38 pm
They don't have a solid medical handle on this very rare occurrence but below is some of the possibilities:
Classifying the causes of spinal cord infarction according to the location of the vascular pathology is convenient and systematic. The pathology may involve the aorta or an intervening arterial feeder (eg, thoracic, intercostal, or cervical branch from subclavian or vertebral artery), or the radicular artery may affect the anterior spinal artery and intrinsic arterial vessels within the spinal cord. Spinal venous pathology may produce spinal infarction, although this is clinically rare.
* Involvement of intrinsic cord vessels has been reported with arteritis, both in systemic lupus erythematosus and granulomatous arteritis, and from emboli of atheroma or even from compression by or emboli of intervertebral disk fragments.
* Anterior spinal artery occlusion has been reported with arteritis, including that associated with syphilis and diabetes mellitus; after trauma; spontaneously or without recognized cause; and as a complication of spinal angiography, cervical spondylosis, spinal adhesive arachnoiditis, administration of intrathecal phenol, and spinal anesthesia.
* Aortic disease has produced spinal infarction in a variety of situations including dissecting aneurysm; aortic surgery, especially with aortic cross-clamping above the renal artery (below that level anastomotic flow via the artery of Adamkiewicz usually provides protective circulation); aortography; atherosclerotic embolization; and aortic thrombosis.
* Uncommon causes include decompression sickness, which has a predilection for spinal ischemic damage; complications of abdominal surgery, particularly sympathectomy; circulatory failure as a result of cardiac arrest or prolonged hypotension; and vascular steal in the presence of an arteriovenous malformation, or vascular compression by tumors in the spinal canal, vertebral fracture, or a herniated intervertebral disk. In 2000, Vijayan and Peacock reported a spinal cord infarct that occurred after treatment of a migraine headache with zolmitriptan.
Courtesy: Emedicine-Medscape
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