Blood supply to the spinal cord

Spinal cord infarction Infarct of the spinal cord – uncommon The region fron T4 to T8 contains few anastomoses – the gratests ischemic risk, especially in patients with systemic hypotension Causes: hypoxia, ischemia cardiogenic embolism, vasculitis, AS, hypercoaguloability

Spinal cord infarction clinical findings Sudden onset of symptoms Moderate to severe back pain followed within inutes by paraparesis or paraplegia Loss of pain sensation below the level of infarction bilaterally Loss of bladder control

Spinal cord infarction diagnostic studies and therapy CSF - hyperproteinorhachia MRI and CT – negative during 24 hours MRI – few days later – focal cord swelling Liečba – therapy of the cause, antiagregant therapy, prognosis is not very good

Spinal cord infarction - MRI T2-weight picture

Hematomyelia Bleeding to the spinal cord Bleeding from AVM Coagulopathy Myelitis Bleeding to spinal cord tumors Traumatic bledding

Hematomyelia Sudden onset of symptoms Moderate to severe back pain followed within inutes by paraparesis or paraplegia Loss of pain sensation below the level of infarction bilaterally Loss of bladder control Therapy – conservative or surgery

Hematomyelia - MRI