Heckman Caroline A, Miller Derryl J, Kremer Kelly M, Martinez Mesha L, Jea Andrew H
Undergraduate, Indiana University Purdue University Indianapolis, Indianapolis, Indiana.
Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana.
Brain Circ. 2023 Jun 30;9(2):107-111. doi: 10.4103/bc.bc_80_22. eCollection 2023 Apr-Jun.
Spinal cord infarctions in children are rare and early magnetic resonance imaging studies are often negative. A high clinical suspicion must be maintained to identify stroke and initiate workup for underlying etiology to suggest appropriate treatment. We present two cases of spinal cord infarction without major preceding trauma. The first was caused by disc herniation and external impingement of a radiculomedullary artery and the second was due to fibrocartilaginous embolism with classic imaging findings of ventral and dorsal cord infarctions, respectively. These cases were treated conservatively with diagnostic workup and aspirin, though additional treatments which can be considered with prompt diagnosis are also explored in our discussion. Both cases recovered the ability to ambulate independently within months. Case 1 is attending college and ambulates campus with a single-point cane. Case 2 ambulates independently, though has some difficulty with proprioception of the feet so uses wheelchairs for long-distance ambulation.
儿童脊髓梗死较为罕见，早期磁共振成像检查结果常为阴性。必须高度保持临床怀疑，以识别中风并启动对潜在病因的检查，从而建议采取适当治疗。我们报告两例无重大既往创伤的脊髓梗死病例。第一例由椎间盘突出和神经根脊髓动脉外部受压引起，第二例是由于纤维软骨栓塞，分别具有典型的腹侧和背侧脊髓梗死影像学表现。这些病例采用诊断性检查和阿司匹林进行保守治疗，不过我们在讨论中也探讨了在及时诊断的情况下可考虑的其他治疗方法。两例患者均在数月内恢复了独立行走能力。病例1正在上大学，使用单拐在校园内行走。病例2能够独立行走，不过足部本体感觉存在一些困难，因此长途行走时使用轮椅。
