Non-surgical spinal cord infarction: case series & long-term follow-up of functional outcome.

IF 0.7 Q4 CLINICAL NEUROLOGY
Fionán McBride, Jane Anketell, Gavin V McDonnell, Suzanne Maguire, Karen M Doherty
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Abstract

Introduction: Spinal cord infarction is a rare but often devastating disorder. The pathogenesis of most non-surgical cases involves atherothrombosis and treatment with anticoagulation and antiplatelet agents may be indicated. Functional recovery in most cases is poor. We describe five cases of spinal cord infarction and provide details on their functional outcomes after long-term (>10 years) follow-up.

Case presentation: A 28-year-old female presented at 16 weeks gestation with chest and back pain and paraesthesia in her fingers. Magnetic resonance imaging on admission revealed a spinal cord lesion extending from C5-T8. She was treated with anticoagulation and rehabilitation. Six years following presentation she was able to return to work. A 42-year-old male experiencing central chest pain and leg weakness was initially diagnosed as having acute coronary syndrome. Following discharge, he was re-admitted with urinary retention and leg weakness. Magnetic resonance imaging revealed a spinal cord lesion extending from T4 to T7. He was treated with anticoagulation, and eight months following presentation he regained full muscle strength but required intermittent self-catherisation. Three further cases are described.

Discussion: The aetiology of non-surgical spinal cord infarction is not always evident, but is commonly associated with atherothrombosis. There are often delays in making a diagnosis, but early recognition and prompt treatment of spinal cord infarction is essential. Long-term functional outcomes are often poor and typically reflect the severity of initial presentation. This case series is unique as it has one of the longest follow-up periods described in the literature.

非手术脊髓梗塞:病例系列和功能结果的长期随访。
简介脊髓梗死是一种罕见的疾病,但往往具有破坏性。大多数非手术治疗病例的发病机制涉及动脉粥样血栓形成,可能需要使用抗凝剂和抗血小板药物进行治疗。大多数病例的功能恢复较差。我们描述了五例脊髓梗死病例,并详细介绍了长期(超过 10 年)随访后的功能恢复情况:一名 28 岁女性在妊娠 16 周时因胸痛、背痛和手指麻痹就诊。入院时磁共振成像显示脊髓病变延伸至 C5-T8。她接受了抗凝和康复治疗。就诊六年后,她可以重返工作岗位。一名 42 岁的男性患者出现中央胸痛和腿部无力,最初被诊断为急性冠状动脉综合征。出院后,他因尿潴留和腿部无力再次入院。磁共振成像显示,脊髓病变从 T4 扩展到 T7。他接受了抗凝治疗,在发病八个月后,他恢复了全部肌力,但需要间歇性自我采集。本文还介绍了另外三个病例:讨论:非手术脊髓梗死的病因并不总是很明显,但通常与动脉粥样血栓形成有关。脊髓梗死的诊断往往存在延误,但早期识别和及时治疗至关重要。脊髓梗死的长期功能预后通常很差,而且通常反映了最初表现的严重程度。本系列病例是文献中描述的随访时间最长的病例之一,因此具有独特性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Spinal Cord Series and Cases
Spinal Cord Series and Cases Medicine-Neurology (clinical)
CiteScore
2.20
自引率
8.30%
发文量
92
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