Spinal Cord Ischemia: A review of clinical and imaging features, risk factors and long-term prognosis

  • Vasiliki Batsou
  • Ioannis S Benetos
  • Ioannis Vlamis
  • Spiridon Pneumaticos
Keywords: Spinal Cord Ischemia, Spinal Cord Vascular Diseases, Anterior Spinal Artery Syndrome, Posterior Spinal Artery Syndrome


Spinal cord ischemia is a rare disorder carrying a high rate of morbidity. However, only a few case series concerning it have been published in the literature. The aim of this study was to determine the causes, the clinical characteristics, the functional outcomes and the prognostic indicators of spinal cord ischemia. For this reason, a review of the current literature was performed by following the PRISMA guidelines and by using the online PubMed database and the keywords “Spinal cord ischemia” and “Spinal cord infarction”. Fourteen studies with a substantial total number of patients (526 patients) were finally included in this review, providing accurate and conductive results regarding spinal cord ischemia. The clinical presentation is nonspecific and characterized by rapid decline of function with a severe neurologic deficit. The cause remains unknown for half of the patients although multiple traditional cardiovascular risk factors are recognized. MRI is the imaging modality of choice for suspected spinal cord ischemia and a variety of characteristic MRI signs have been described such as the “pencil-like” zone and “owl’s eye” sign. In contrast to cerebral ischemic infarction, in which guidelines for management are well-established, no consensus guidelines exist for the management of acute spinal cord ischemia. 


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