No abstract available.
Anterior Spinal Artery Syndrome ; Hemiplegia ; Infarction ; Paresis ; Spinal Cord

Selective cervical nerve root block is executed for patients who have symptoms of cervical radiculopathy for diagnostic and therapeutic purposes. However several catastrophic complications caused by this procedure have been reported including neurological complications. A 43-year-old male received a C5 selective cervical nerve root block procedure due to continuous radiating pain even after cervical discectomy and interbody fusion was performed. At the time of the procedure, the contrast outline revealed reflux of the nerve root and epidural space. But after the procedure was performed, the patient experienced decreased sensation in the upper and low extremities as well as motor paralysis of both extremities. Our sspecting diagnosis was anterior spinal artery syndrome but both sensory and motor functions were subsequently recovered within a few hours after the procedure was completed. Due to the difficult nature of this case, we reported these complications and reviewed current literature related to this study.
Adult ; Anterior Spinal Artery Syndrome ; Diskectomy ; Epidural Space ; Extremities ; Humans ; Injections, Spinal ; Male ; Paralysis ; Quadriplegia ; Radiculopathy ; Sensation ; Spinal Nerve Roots

We present a patient with metastatic colon carcinoma who developed paraplegia following a neurolytic splanchnic block. A 41-year old man with metastatic adenocarcinoma of the colon received a splanchnic neurolytic block using alcohol because of severe abdominal pain. Bilateral motor weakness and a sensorial deficit in both legs developed after the procedure. Diffusion magnetic resonance imaging revealed spinal cord ischemia between T8 and L1. The motor and sensorial deficits were almost completely resolved at the end of the third month. We think that anterior spinal artery syndrome due to reversible spasms of the lumbar radicular arteries using alcohol have resulted in transient paraplegia. The retrograde spread of alcohol to neural structures may have also contributed.
Abdominal Pain ; Adenocarcinoma ; Anterior Spinal Artery Syndrome ; Arteries ; Colon ; Diffusion Magnetic Resonance Imaging ; Humans ; Leg ; Paraplegia ; Spasm ; Spinal Cord Ischemia

Antibodies to cardiolipin and other phospholipid have been associated with recurrent thrombotic events, including ischemic strokes, especially in children and young adults. Recently it has been shown that anti-beta2-glycoprotein I antibodies may be more specific in predicting thrombosis. We report a case of anterior spinal artery syndrome with elevated titer of antibodies to beta2-glycoprotein I in young adult.
Anterior Spinal Artery Syndrome ; Antibodies ; Antiphospholipid Syndrome ; beta 2-Glycoprotein I ; Cardiolipins ; Child ; Humans ; Stroke ; Thrombosis ; Young Adult

Anterior spinal artery syndrome, also known as Beck's syndrome, is defined as ischemia or infarction of the spinal cord. Beck's syndrome occurs from aortic thrombus, embolism, or dissection blocking the blood flow to the great radicular artery (GRA) of Adamkiewicz. Abdominal artery embolism due to trauma is relatively rare and urgent detection of vascular injury is substantial to fair clinical outcome of the patient, therefore, we report on a case of traumatic artery dissection presenting as lower leg weakness.
Anterior Spinal Artery Syndrome ; Arteries ; Automobiles ; Embolism ; Humans ; Infarction ; Ischemia ; Leg ; Paresis ; Spinal Cord ; Spinal Cord Ischemia ; Thrombosis ; Vascular System Injuries

BACKGROUND: The anterior spinal artery infarction constitutes a classical syndrome of vascular myelopathy. The causes of the anterior spinal artery syndrome are various, but most episode probably occur as the result of atherosclerosis or dissection of the aorta and its branches. However, few cases reported developed with spinal structural abnormalities. CASE: A 65-year-old man presented with sudden paraparesis. There was no evidence of hypertension, diabetes and smoking. Motor weakness was more prominent on the left side and progressed. Loss of pain and temperature senses were shown at the level of 71 with preservation of touch, joint perception and vibration senses. The DTR's of legs were depressed and extensor toe signs were presented. A C-spine MRI showed high signal intensity on 72 weighted image and low signal on 71 weighted image(C6-71) with cervical spinal stenosis at the C4-C7 spinal level and mild cervical disc protrusion (C6-C7, C7-T1). After three months later, follow up cervical MRI showed somewhat decreased size of high signal intensity on 72 weighted image and more prominent low signal on 71 image. DISCUSSION: In our case, we could not find any usual cause of anterior spinal artery infarction. However only cervical spinal stenosis associated with mild cervical disc protrusion was present. In stenotic cervical canal, the anterior spinal artery can be more vulnerable to extrinsic compression and the infarction may early develop with insignificant trigger event, such as disc protrusion. We concluded that the ischemic change of anterior two thirds of cervical spinal cord might develop due to the compression of the anterior spinal artery by cervical stenosis and mild cervical intervertebral disc protrusion.
Aged ; Anterior Spinal Artery Syndrome* ; Aorta ; Arteries ; Atherosclerosis ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Hypertension ; Infarction ; Intervertebral Disc ; Joints ; Leg ; Magnetic Resonance Imaging ; Paraparesis ; Smoke ; Smoking ; Spinal Cord ; Spinal Cord Diseases ; Spinal Stenosis* ; Toes ; Vibration

Spinal cord infarction, especially anterior spinal artery syndrome, is a relatively rare disease. We report a case of spinal cord infarction caused by thoracoabdominal aortic aneurysm with intraluminal thrombus. A 52-year-old man presented with sudden onset paraplegia. At first, he was diagnosed with cervical myelopathy due to a C6-7 herniated intervertebral disc, and had an operation for C6-7 discetomy and anterior interbody fusion. Approximately 1 month after the operation, he was transferred to the department of rehabilitation in our hospital. Thoracoabdominal aortic aneurysm with intraluminal thrombus was found incidentally on an enhanced computed tomography scan, and high signal intensities were detected at the anterior horns of gray matter from the T8 to cauda equina level on T2-weighted magnetic resonance imaging. There was no evidence of aortic rupture, dissection, or complete occlusion of the aorta. We diagnosed his case as a spinal cord infarction caused by thoracoabdominal aortic aneurysm with intraluminal thrombus.
Animals ; Anterior Spinal Artery Syndrome ; Aorta ; Aortic Aneurysm ; Aortic Aneurysm, Thoracic ; Aortic Rupture ; Cauda Equina ; Horns ; Humans ; Infarction ; Intervertebral Disc ; Magnetic Resonance Imaging ; Middle Aged ; Paraplegia ; Rare Diseases ; Spinal Cord ; Spinal Cord Diseases ; Thrombosis

We present a case of paraplegia, compatible with spinal cord ischemia, following percutaneous nephrolithotomy in a 58-year-old male under the diagnosis of left renal stone. After retroperitoneal operative procedures in the prone position, sensory loss below the level of T4, paraplegia and transient loss of visual acuity were developed. These clinical findings reflect ischemia of the anterior spinal cord with complete motor paralysis and sensory loss to T4 dermatomal level resulting from an anterior spinal artery syndrome. The initial treatment was started with intravenous heparin and corticosteroid. At present, sensory loss is almost recovered and motor deficit is remarkably improved to a level of ambulation with cane. The patient is still treated with oral coumadine and neuromotor rehabilitation. The cause of spinal cord ischemia is unknown, but we speculate ischemia of the spinal cord was associated with embolism and spasm or trauma of feeding artery (ies) of Adamkiewicz.
Anesthesia, General* ; Anterior Spinal Artery Syndrome ; Arteries ; Canes ; Diagnosis ; Embolism ; Heparin ; Humans ; Ischemia ; Male ; Middle Aged ; Nephrostomy, Percutaneous* ; Paralysis ; Paraplegia* ; Prone Position ; Rehabilitation ; Spasm ; Spinal Cord ; Spinal Cord Ischemia ; Surgical Procedures, Operative ; Visual Acuity ; Walking ; Warfarin

Anterior spinal artery syndrome refers to the paralysis of the bilateral upper extremities, bladder dysfunction and the sensory deficit of pain and temperature below the level of injury. A 64 year-old female got a cardiac arrest event after stent insertion into the coronary artery. After CPR, she underwent the motor deficit (Z-T) of the bilateral upper extremities without any sensory deficit; proprioception, vibration and pain. The brain MRI showed no abnormality, but high signal intensity was detected in C3-C7 level by T2 sagittal plane and at the anterior horn area of gray matter by axial view of spine MRI. The ventilator has been applied after CPR. By the fluoroscopy, the movement of the diaphragm was decreased, and the nerve conduction study of both phrenic nerves showed no responses.
Animals ; Anterior Spinal Artery Syndrome ; Brain ; Cardiopulmonary Resuscitation ; Coronary Vessels ; Diaphragm ; Female ; Fluoroscopy ; Heart Arrest ; Horns ; Humans ; Neural Conduction ; Paralysis ; Phrenic Nerve ; Proprioception ; Respiratory Paralysis ; Spinal Cord ; Spinal Cord Ischemia ; Spine ; Stents ; Upper Extremity ; Urinary Bladder ; Ventilators, Mechanical ; Vibration