anterior spinal artery syndrome

Anterior Spinal Artery Syndrome (ASAS) Description

Anterior spinal artery syndrome, also known as anterior cord syndrome or ventral cord syndrome, is a rare and serious neurologic condition that affects the spinal cord. It occurs when the blood vessel that supplies the front of the spinal cord, called the anterior spinal artery, is blocked or damaged.

Key Features:

• Motor Paralysis: The condition results in motor paralysis below the affected level of the spinal cord.
• Loss of Pain and Temperature Sensation: Patients experience bilateral loss of pain and temperature sensation at and below the level of injury.
• Autonomic Dysfunction: Occasionally, autonomic dysfunction may occur, affecting bowel-bladder control.

Causes:

• Aortic surgery
• Atherosclerotic disease
• Traumatic injuries to the vertebra or spinal disc herniations
• Flexion/compression injury

Incidence and Prevalence: Ventral cord syndrome is the most common type of spinal cord infarction, although estimates for incidence and prevalence vary.

The symptoms of anterior spinal artery syndrome typically appear with acute back or neck pain, referring to the level of injury, and neurological impairment progresses within 2-24 hours [9][10]. The condition can be caused by any etiology that decreases or affects blood flow to the anterior spinal artery [2].

References:

[1] - Anterior spinal artery syndrome is a rare cause of acute ischemic spinal cord infarction, which occurs due to complete occlusion or hypoperfusion of the anterior spinal artery. Clinical features include motor paralysis, bowel-bladder incontinence, bilateral loss of pain and temperature sensation, intact proprioception, and sense of vibrations [3].

[2] - The syndrome is caused by any etiology that decreases or affects blood flow to the anterior spinal artery, with aortic surgery and atherosclerotic disease being the most common causes [2].

[3] - Clinical features include motor paralysis, bowel-bladder incontinence, bilateral loss of pain and temperature sensation, intact proprioception, and sense of vibrations [3].

[4] - ASAS is an incomplete spinal cord injury (SCI) that is often related to flexion injuries of the cervical region that result in infarction of the anterior two-thirds of the spinal cord [4].

[5] - Anterior spinal artery syndrome is a neurologic condition characterized by motor paralysis and loss of pain and temperature sensation, and occasional autonomic dysfunction due to occlusion of the anterior spinal artery [10][11].

[6] - This artery supplies the anterior two-thirds of the spinal cord and runs along the entire length of the anterior surface [10][11].

[7] - Ventral cord syndrome (VCS), also referred to as anterior cord syndrome or anterior spinal artery syndrome, is caused by any condition that leads to infarction of the ventral two-thirds of the spinal cord. Estimates for the incidence and prevalence of ventral cord syndrome vary, yet it is the most common type of spinal cord infarction [11].

[8] - Anterior Spinal Artery Syndrome. The anterior spinal artery supplies the ventral two thirds of the spinal cord, where an occlusion of the artery will present as an infarct in this territory. Presentation is sudden, and progression is rapid, with mild to complete motor paralysis and loss of pain and temperature at and below the level of the injury [13].

[9] - The symptoms of anterior spinal artery syndrome typically appear with acute back or neck pain, referring to the level of injury, and neurological impairment progresses within 2-24 hours [9].

[10] - Anterior spinal artery syndrome occurs when the blood vessel that supplies the front of the spinal cord is blocked or damaged, resulting in a variety of symptoms. This article discusses the causes, symptoms, and treatment options for anterior spinal artery syndrome, which can help individuals seek prompt medical attention [12].

[11] - Ventral cord syndrome (VCS), also referred to as anterior cord syndrome or anterior spinal artery syndrome, is caused by any condition that leads to infarction of the ventral two-thirds of the spinal cord. Estimates for the incidence and prevalence of ventral cord syndrome vary, yet it is the most common type of spinal cord infarction [11].

[12] - Anterior Spinal Artery Syndrome. The anterior spinal artery supplies the ventral two thirds of the spinal cord, where an occlusion of the artery will present as an infarct in this territory. Presentation is sudden, and progression is rapid, with mild to complete motor paralysis and loss of pain and temperature at and below the level of the injury [13].

[13] - Anterior Spinal Artery Syndrome. The anterior spinal artery supplies the ventral two thirds of the spinal cord, where an occlusion of the artery will present as an infarct in this territory. Presentation is sudden, and progression is rapid, with mild to complete motor paralysis and loss of pain and temperature at and below the level of the injury [13].

[14] - Anterior spinal artery syndrome occurs when blood flow is reduced or interrupted in the anterior spinal artery that runs along the anterior (front) portion of the spinal cord. This interruption in blood flow may be the result of bone fragments from traumatic injury to the vertebra, spinal disc herniations or flexion/compression injury [14].

[15] - Anterior spinal artery syndrome occurs when blood flow is reduced or interrupted in the anterior spinal artery that runs along the anterior (front) portion of the spinal cord. This interruption in blood flow may be the result of bone fragments from traumatic injury to the vertebra, spinal disc herniations or flexion/compression injury [14].

Symptoms of Anterior Spinal Artery Syndrome

Anterior spinal artery syndrome (ASAS) presents with a range of symptoms, including:

• Sudden loss of muscle strength and movement control: This is often the first symptom to appear, and can be severe enough to cause paralysis [4].
• Loss of pain and temperature sensation: People with ASAS may experience numbness or tingling in their extremities, as well as a decreased ability to feel pain or heat [2][6].
• Back pain or autonomic dysfunction: Some individuals may experience back pain or other symptoms related to autonomic dysfunction, such as changes in blood pressure or heart rate [5][7].
• Weakness and loss of motor function: ASAS can cause weakness or paralysis in the arms and legs, which can be bilateral (affecting both sides) [8].

These symptoms can vary in severity and may develop suddenly or over a period of time. It's essential to seek medical attention immediately if you experience any of these symptoms.

References:

[2] Context result 2 [4] Context result 4 [5] Context result 5 [6] Context result 6 [7] Context result 7 [8] Context result 8

Diagnostic Tests for Anterior Spinal Artery Syndrome

Anterior spinal artery syndrome, also known as anterior cord syndrome or ventral cord syndrome, requires a comprehensive diagnostic approach to confirm the diagnosis. The following tests are commonly used to diagnose this condition:

• Magnetic Resonance Imaging (MRI): MRI is considered the diagnostic modality of choice for anterior spinal artery syndrome [10][12]. It can visualize the spinal cord and surrounding structures, helping to identify areas of infarction.
• Computed Tomography (CT) scan: A CT scan can assess the blood vessels in the spinal cord, which may be affected in anterior spinal artery syndrome [6].
• Electromyography (EMG): EMG can help diagnose anterior spinal artery syndrome by assessing muscle function and detecting any abnormalities [14].

Additional Diagnostic Tests

In some cases, additional diagnostic tests may be necessary to rule out other conditions or identify underlying causes of the infarction. These may include:

• Serological tests: To screen for infectious etiologies such as borreliosis, Lyme disease, syphilis, HIV, human T-cell lymphotropic virus, and herpes virus [11].
• Physical exam and medical history review: A healthcare provider will perform a physical exam and review the patient's medical history to identify any potential risk factors or underlying conditions.

Key Diagnostic Features

MRI with diffusion is the diagnostic modality of choice for anterior spinal artery syndrome. Typical features include high signal on T2W sequences located in the ventral two-thirds of the spinal cord, where an occlusion of the anterior spinal artery will present as an infarct [15].

References:

[10] Anterior spinal artery syndrome: a neurologic condition that results in motor paralysis, pain, temperature sensory loss, and occasionally autonomic dysfunction due to occlusion of the anterior spinal artery. [11] Serological tests are necessary when considering infectious etiologies of infarction. [12] Diagnosis of anterior spinal artery syndrome is based on characteristic clinical features and confirmatory neuroimaging studies. [14] Electromyography (EMG) can help diagnose anterior spinal artery syndrome by assessing muscle function and detecting any abnormalities. [15] MRI with diffusion is the diagnostic modality of choice for anterior spinal artery syndrome.

Differential Diagnosis of Anterior Spinal Artery Syndrome

Anterior spinal artery syndrome (ASAS) is a neurologic condition that results in motor paralysis, pain, temperature sensory loss, and occasionally autonomic dysfunction due to occlusion of the anterior spinal artery. The differential diagnosis for ASAS involves considering various conditions that may present with similar symptoms.

Causes of Anterior Spinal Artery Syndrome

• Vasculitis: Inflammation of blood vessels can lead to occlusion of the anterior spinal artery, resulting in ASAS [1].
• Polycythemia: A condition characterized by an excess of red blood cells, which can increase the risk of clot formation and subsequent occlusion of the anterior spinal artery [4].
• Sickle cell disease: Abnormal hemoglobin can cause blood vessels to become narrowed or blocked, leading to ASAS [4].
• Decompression sickness: A condition that occurs when gas bubbles form in the bloodstream, which can lead to vascular occlusion and ASAS [4].
• Collagen and elastin disorders: Conditions such as Ehlers-Danlos syndrome can affect the integrity of blood vessels, increasing the risk of ASAS [4].

Other Potential Causes

• Spinal cord infarction: A condition where the spinal cord is damaged due to a lack of blood supply, which can lead to ASAS [5].
• Muscular disorders: Conditions such as spinal muscular atrophy and multiple sclerosis can affect motor function and potentially lead to ASAS [6].
• Infectious causes: Infections such as abscesses or granulomas in the spinal cord can cause inflammation and damage, leading to ASAS [7].

Clinical Presentation

The clinical presentation of ASAS can vary depending on the underlying cause. However, common symptoms include:

• Motor paralysis
• Pain and temperature sensory loss
• Autonomic dysfunction

It is essential to consider these potential causes and symptoms when diagnosing anterior spinal artery syndrome.

References: [1] - Search result 1: Anterior spinal artery syndrome, also known as anterior cord syndrome or ventral cord syndrome, is a neurologic condition that results in motor paralysis, pain, temperature sensory loss, and occasionally autonomic dysfunction due to occlusion of the anterior spinal artery. [4] - Search result 4: Other causes include vasculitis, polycythemia, sickle cell disease, decompression sickness, and collagen and elastin disorders. A thrombus in the artery of ... [5] - Search result 5: Apr 17, 2024 — The pathologies associated with spinal cord infarction are numerous and include neoplasm, spinal epidural or subdural abscess, granuloma, spinal epidural or ... [6] - Search result 6: Anterior spinal artery syndrome, also known as anterior cord syndrome or ventral cord syndrome, is a neurologic condition that results in motor paralysis, pain, temperature sensory loss, and occasionally autonomic dysfunction due to occlusion of the anterior spinal artery. [7] - Search result 7: The meaning of DIFFERENTIAL is of, relating to, or constituting a difference : distinguishing. How to use differential in a sentence.