Spinal cord stroke

Spinal vascular accidents, whether ischemic or hemorrhagic, are rare and not well understood. They represent medical emergencies, with their management poorly defined and typically based by consensus on the protocols for cerebral strokes, which are supported by solid evidence. For spinal infarcts, the primary goal is to exclude an embolic cause, aortic pathology, infectious, inflammatory, or hematological issues, myocardial infarction, spinal compression, or venous thrombosis.

These conditions include:

• Spinal arterial ischemic infarcts
• Spinal venous thromboses
• Non-traumatic intramedullary hemorrhages (hematomyelia)
• Non-traumatic subarachnoid hemorrhages (meningeal)

It's important to remember that, when faced with a (sub)acute onset of a spinal syndrome (see specific chapter), more common diagnoses that could potentially be treated medically and/or surgically on an urgent basis should be ruled out first.