Pikija Slaven, Mutzenbach Johannes Sebastian, Kunz Alexander B, Nardone Raffaele, Leis Stefan, Deak Ildiko, McCoy Mark R, Trinka Eugen, Sellner Johann
Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria.
Department of Neurology, Franz Tappeiner Hospital, Merano, Italy.
Front Neurol. 2017 Apr 12;8:143. doi: 10.3389/fneur.2017.00143. eCollection 2017.
Lack of timely recognition and neuroimaging may be a barrier to reperfusion efforts in acute spinal cord infarction.
We performed a retrospective study of patients diagnosed with acute non-surgical spinal cord infarction at our tertiary academic center from 2001 to 2015. We studied parameters associated with time from symptom onset to initial hospital presentation and magnetic resonance imaging (MRI) of the spinal cord.
We identified 39 patients among whom anterior spinal artery syndrome was the most frequent presentation (87.2%) and atherosclerosis the most common etiology (56.4%). Nearly, half of the patients presented to the emergency department on the same day of symptom onset (48.7%) but only nine (23.1%) within the first 6 h. Average time from symptom onset to spinal cord MRI was 3.2 days. We could not identify clinical, radiological, or outcome patterns associated with early vs. delayed presentation and imaging.
Our study found a time lag from symptom onset to hospital presentation and spinal cord MRI in patients with acute spinal cord infarction. These findings point at low clinical suspicion of spinal cord syndromes and limited recognition as a potentially treatable medical emergency.
缺乏及时识别和神经影像学检查可能是急性脊髓梗死再灌注治疗的障碍。
我们对2001年至2015年在我们的三级学术中心被诊断为急性非手术性脊髓梗死的患者进行了一项回顾性研究。我们研究了从症状发作到首次入院以及脊髓磁共振成像（MRI）的相关参数。
我们确定了39例患者，其中脊髓前动脉综合征是最常见的表现（87.2%），动脉粥样硬化是最常见的病因（56.4%）。近一半的患者在症状发作当天到急诊科就诊（48.7%），但只有9例（23.1%）在发病后6小时内就诊。从症状发作到脊髓MRI的平均时间为3.2天。我们无法确定与早期或延迟就诊及影像学检查相关的临床、放射学或预后模式。
我们的研究发现急性脊髓梗死患者从症状发作到入院及脊髓MRI检查存在时间延迟。这些发现表明对脊髓综合征的临床怀疑度低，且对这一潜在可治疗的医疗急症认识有限。
