A case with angiographic demonstration of isolated anterior spinal artery occlusion.

Anterior spinal artery syndrome (ASAS) is a rare syndrome which occurs due to thrombosis of anterior spinal artery (ASA) which supplies anterior two thirds of the spinal cord. A 27-year-old female patient was admitted to emergency clinic with sudden onset neck pain, sensory loss and weakness in proximal upper extremities which occurred at rest. Thrombophilia assessment tests were negative. Echocardiography was normal. Serum viral markers were negative. In cerebrospinal fluid (CSF) examination, cell count and biochemistry was normal, oligoclonal band was negative, viral markers for herpes simplex virus (HSV) type-1 and type-2, Brucella, Borrellia, Treponema pallidum, Tuberculosis were negative. Diffusion restriction which reveals acute ischemia was detected in Diffusion weighted MRI. Digital subtraction angiography (DSA) was performed. Medical treatment was 300mg/day acetilsalycilic acid. Patient was discharged from neurology clinics to receive rehabilitation against spasticity.

Thrombolysis in anterior spinal artery syndrome.

Anterior spinal artery syndrome (ASAS) is often a devastating spinal stroke occurring when the anterior spinal artery or one of its supplying anterior medullary arteries are occluded. The most common causes are arteriosclerosis, dissection of the abdominal aorta, cardiac embolism and degenerative spine disease, and the major risk factors are smoking, hypertension, diabetes and hypercholesterolaemia. The treatment has generally been supportive. We believe thrombolysis should be considered in the acute phase of this condition, and present a case with ASAS who experienced partial recovery after treatment given 4.5 h after symptom onset.

Delayed onset of anterior spinal artery syndrome after repair of aortic coarctation.

STUDY DESIGN: A case report. OBJECTIVE: We report a case of delayed anterior spinal artery syndrome after repair of aortic coarctation in which the symptoms did not appear until 6 months after surgery. SUMMARY OF BACKGROUND DATA: Residual dilatation of the anterior spinal artery after surgery can mimic a dilated intraspinal vein, which could lead to the erroneous diagnosis of spinal arteriovenous malformation as the cause for anterior spinal artery syndrome. METHODS: A 40-year-old man with a history of hypertension underwent surgical bypass of the left subclavian artery to descending thoracic aorta to treat coarctation of the thoracic aorta and had an uncomplicated postoperative course. Six months later, he developed numbness and weakness in his hands. Magnetic resonance image showed abnormal signal within the cervicothoracic spinal cord and prominent flow voids within the ventral spinal canal. Spinal digital subtraction angiography revealed slow flow in a dilated intraspinal vessel. Given the history of aortic coarctation repair, the possibility that this represented a residually dilated anterior spinal artery rather than an arteriovenous malformation was considered and confirmed on magnetic resonance imaging. RESULTS: In our patient, institution of an anticoagulation medication regime resulted in rapid improvement of neurological symptoms, underscoring the importance of the awareness of this phenomenon. CONCLUSION: Delayed anterior spinal artery syndrome after aortic coarctation repair because of anterior spinal artery thrombosis can manifest even 6 months postoperatively. Careful analysis of pre- and postoperative cross-sectional imaging should provide the correct diagnosis. Spinal digital subtraction angiography is probably unnecessary and must be interpreted with caution.

Anterior spinal artery syndrome in a 16-year-old male.

Spinal cord infarction is a relatively uncommon condition in young children and adolescents, however, it should be included in the differential diagnosis of acute cord compression. Depending on the vessel involved, the clinical presentation may differ. The degree of recovery in spinal cord infarcts varies from one individual to another. Recovery of motor function is progressive in most of the patients, with the deficit being maximal at the onset. For successful outcome, it is imperative that these patients get access to approriate rehabilitation very early in the course of the disease. Prevention and early treatment of specific complications, especially chronic pain, is of vital importance in young patients. This article describes our experiences diagnosing and treating a 16-year-old boy with anterior spinal artery syndrome.

Neurophysiological findings in a case of cervical anterior spinal artery syndrome: compound muscle action potentials, a marker for prognosis.

We report a case of cervical anterior spinal artery syndrome (ASAS). MRI showed abnormal hypointense on T1-weighted images and hyperintense on T2-weighted images from vertebrae C2 to T3. The lesion involved the anterior two-third bilaterally. Spinal angiography showed the superior segmental obstruction of the anterior spinal artery. Regarding nerve conduction studies, no CMAP (the compound muscle action potentials) could be obtained in either median nerves or ulnar nerves, and F-waves were absent. Six months after the onset, there was no any recovery of strength in both arms of the ASAS patient. In our opinion, CMAP could be seen a marker of prognosis for ASAS patients, and absent CMAP might forecast the bad prognosis.