Lynch Karen, Oster Joel, Apetauerova Diana, Hreib Kinan
Department of Neurology, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA.
Case Rep Neurol Med. 2012;2012:706780. doi: 10.1155/2012/706780. Epub 2012 Jun 13.
Spinal cord infarction is an uncommon disease and as such is often a diagnostic challenge for clinicians. It can vary in its onset, severity, outcome, and recovery from patient to patient. Treatment options for this relatively rare condition also remain elusive. Current consensus recommendations are antiplatelet therapy and the symptomatic management of associated complications such as paraplegia and thromboembolic disease. There are multiple studies in surgical literature of a variety of interventions and adjuncts used for reducing the risk of ischemic spinal cord neurological injury, seen most often in the setting of thoracoabdominal aortic repair operations. We report two cases of acute non-surgical-related spinal cord infarcts, where early diagnosis was made and aggressive, early treatments instituted. With often devastating outcomes, we highlight the need for early detection and that interventions, commonly used in preventing neurological injury after high-risk aneurysm repairs, may be beneficial in treating and reducing the severity of disability in acute spinal cord stroke.
脊髓梗死是一种罕见疾病，因此对临床医生来说常常是一项诊断挑战。其发病、严重程度、预后及恢复情况在不同患者之间存在差异。针对这种相对罕见病症的治疗方案也尚不明确。目前的共识性建议是抗血小板治疗以及对诸如截瘫和血栓栓塞性疾病等相关并发症进行对症处理。外科文献中有多项关于多种用于降低缺血性脊髓神经损伤风险的干预措施和辅助手段的研究，这种损伤最常见于胸腹主动脉修复手术中。我们报告两例急性非手术相关的脊髓梗死病例，这两例均得以早期诊断并采取了积极的早期治疗措施。鉴于通常会出现严重后果，我们强调早期检测的必要性，并且常用于预防高危动脉瘤修复术后神经损伤的干预措施可能有助于治疗急性脊髓卒中并减轻残疾严重程度。
