Spinal cord strokes are caused by obstruction of blood flow in the spine, leading to pain, weakness, and possibly paralysis. Causes include atherosclerosis, chronic illnesses, infections, and injuries. Prompt medical attention and ongoing physical therapy can help, but severe damage may be irreversible. Emergency medical care should be sought at the first signs of a possible spinal cord stroke. Treatment focuses on improving blood flow and eliminating the underlying cause if possible.
A spinal cord stroke is a sudden, often severe, physical reaction to obstruction of blood flow in the spine. If the main spinal artery or one of the smaller blood vessels in the spine is blocked, blood cannot reach the delicate nerve structures in the spinal cord. The result is usually immediately radiating pain and weakness, followed shortly by lack of muscle control in the limbs and possibly paralysis. Many spinal cord strokes are reversible with prompt medical attention and ongoing physical therapy. If a major blockage occurs, however, a person may have lifelong difficulties despite all treatment efforts.
Many different conditions can precede a spinal cord stroke. People who have atherosclerosis, a buildup of cholesterol plaques in the arteries, are at higher risk of suffering a stroke. The spinal artery or the aorta that feeds it can narrow dangerously when plaque builds up along the inside walls. Total blockages can occur when cholesterol deposits break free and lodge in the smallest blood vessels in the spine.
Other potential causes of spinal cord strokes include chronic illnesses, acute infections, and injuries that cause damage to spinal blood vessels. Autoimmune conditions like lupus can damage an artery to the point where it ruptures and bleeds. Syphilis infections and diabetes can also impair blood vessel function. Injuries associated with major trauma to the spine and complications of spinal surgery can occasionally also lead to a stroke. In some cases, an underlying cause is never discovered.
When a spinal cord stroke occurs, a person typically feels immediate and severe pain and tension in the back. Burning and tingling sensations may radiate down the spine and into the legs. After a few minutes or hours, a person may lose all sensation and muscle control in the legs and lower torso. Bowel and bladder control are also often impaired. If the arterial blockage occurs near the top of the spinal cord, the arms may also be affected.
Emergency medical care should be sought at the first signs of a possible spinal cord stroke. A team of doctors can assess the severity of the situation and look for an underlying cause by taking imaging scans of the spine, doing blood tests, and asking about the onset of symptoms. MRI scans are usually effective at pinpointing the site of damage or blockage of blood vessels. Electromyography tests are also done to identify the extent of nerve involvement.
In most cases, severely damaged arteries and nerves around the spinal cord cannot be repaired. Treatment efforts generally focus on improving blood flow and eliminating the underlying cause if possible. Patients may be given aspirin and other blood thinners, as well as medications to fight infection or pain. Some spinal cord stroke patients regain sensation spontaneously, while others require several months or years of physical therapy to overcome persistent problems with muscle control.
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