Anterior spinal artery syndrome is ischemia or infarction of the spinal cord in the distribution of the anterior spinal artery, which supplies the ventral twothirds of the spinal cord and medulla causes. Nevertheless, the lateral spinal artery two, in fact left and right does exist, and is an important vessel from both embryologic and pathophysiologic perspectives. Spiller who described it 1909, however preobranshenski was the first to describe asas in 1904. The posterior spinal arteries arise from either the posterior inferior cerebellar or vertebral arteries v3 or v4 segments and runs the entire posterolateral aspect of the spinal cord. Two cases of anterior spinal artery ischemia syndrome asas were reported after surgery for the correction of scoliosis in a series of 54 patients and 72 operations. Anterior spinal artery syndrome asas or spillers syndrome is named for william g. Anterior spinal artery article about anterior spinal.
Med any combination of signs and symptoms that are indicative of a particular disease or disorder syndrome, mr. A clinical differential diagnosis was an intramedullary lesion. Clinical features include weakness and loss of pain and temperature. Posterior spinal artery infarctions are less common than anterior infarctions, but they do occur. In adults, where it is observed most frequently after resection of thoracoabdominal aortic aneurysms, spinal magnetic resonance imaging is considered the firstline investigation to confirm the. Occlusive vascular lesions affecting the spinal cord spinal stroke are diagnostic challenges.
This led to the clinical suspicion of an anterior spinal artery syndrome. In human anatomy, the anterior spinal artery is the artery that supplies the anterior portion of the spinal cord. Anterior spinal cord syndrome in a patient with behcets disease. Pcs is the least commonly occurring of the six clinical spinal cord injury syndromes, with an incidence rate of less than 1%. This syndrome manifests as a suspended pattern of total anesthesia at the affected level. The anterior spinal cord is at increased risk for infarction because it is supplied by the single anterior spinal artery, which has few collateral unlike the posterior spinal cord which is supplied by two posterior spinal arteries. The two vertebral arteries one of which is usually bigger than the other anastamose in the midline to form a single anterior spinal artery at the level of the foramen magnum. To describe a rare autopsy case of posterior spinal artery syndrome with marked swelling of the spinal cord, an unusually subacute onset and short clinical course. In vascular surgery, the risk of paralysis related to asas ranges from 0. Anterior spinal artery syndrome following coronary artery bypass. How are you going to revise the blood supply of the spinal cord.
Anterior spinal artery syndrome is a descriptor in the national library of medicines controlled vocabulary thesaurus, mesh medical subject headings. The anterior spinal artery is the main arterial supply to the spinal cord. Mechanisms and prevention of anterior spinal artery syndrome. Anterior spinal artery syndrome after aortic surgery in a child. Anterior spinal artery syndrome after aortic surgery in a. Find out information about anterior spinal artery syndrome. Clinical report by bulletin of the nyu hospital for joint diseases.
It arises from branches of the vertebral arteries and courses along the anterior aspect of the spinal cord. Anterior spinal artery occlusion syndrome concept id. Anterior spinal artery syndrome, which may result from arterial compression, hypotension, or embolization is characterized by a predominantly motor deficit, with or without loss of pain and temperature sensation, but with sparing of vibration and joint sensations, which are transmitted in the posterior. Background anterior spinal artery asa syndrome results in motor palsy and dissociated sensory loss below the level of the lesion, accompanied by bladder dysfunction. Anterior spinal artery syndrome from type a aortic dissection in a.
For specific syndromes, see under the name, such as adrenogenital syndrome or reyes syndrome. It is reinforced by several contributory arteries, especially the artery of adamkiewicz. The artery of adamkiewicz is an important supplier to the anterior. Anterior spinal artery syndrome is syndrome caused by ischemia of the anterior spinal artery. This condition is usually associated with atherosclerosis of the aorta and may result from dissection of an aortic aneurysm or rarely dissection of the anterior spinal artery. Anterior spinal artery definition of anterior spinal. Anterior spinal artery syndrome is rare in children. The paraplegia of case 1 was caused by ligation of the segmental vessels. Anterior spinal artery thrombosis following trivial trauma in a. Anterior cordanterior spinal artery syndrome youtube.
Anterior spinal cord syndrome in a patient with behcets. Pdf we report a case of a 66yearold female who burst into flaccid paralysis of the. The tendon and cutaneous reflexes for that specific spinal segment are abolished. The emergent computed tomography ct of the brain was done under the impression of a young stroke with unre. Anterior spinal artery ischemia syndrome springerlink. Pdf a case of paradoxical embolism causing anterior spinal. The diagnosis usually is made on the basis of clinical findings because the cause of the syndrome remains obscure in most cases 2. Additional supply is through paired posterior spinal arteries.
A case of posterior spinal artery syndrome in the cervical. A 63yearold woman developed neck pain, bilateral shoulder and arm numbness, and paraparesis after prolonged neck extension during a dental procedure. The posterior spinal arteries are a pair of arteries that supply the respective ipsilateral grey and white posterior columns of the spinal cord gross anatomy. Another cause for a subacute or delayed neurological presentation is the anterior spinal. Anterior spinal artery radiology reference article. Anterior spinal artery syndrome synonyms, anterior spinal artery syndrome pronunciation, anterior spinal artery syndrome translation, english dictionary definition of anterior spinal artery syndrome.
Anterior spinal artery syndrome udiya ak, shetty gs. A 40 year old theatre nurse who recently had a longhaul flight woke up at 2 am complaining of back pain, chest pain and bilateral leg weakness. Anterior spinal artery syndrome in a girl with down syndrome ncbi. However, children, even neonates, can develop spinal cord infarction in specific circumstances. We report a case of anterior spinal artery syndrome due to aortic dissection in a patient with marfan syndrome caused by a novel brillin. Anterior spinal artery syndrome article about anterior. Posterior spinal artery an overview sciencedirect topics. Asas is thrombosis ventral to the spinal cord causing blockage of the anterior spinal artery asa and an infarction of the areas supplied. The anterior spinal artery supplies the anterior portion of the spinal cord and arises from the vertebral artery in the region of the medulla oblongata. An 84yearold japanese woman presented with bilateral muscle weakness of the. We describe a patient with posterior spinal artery psa syndrome due to vertebral artery va dissection. Posterior cord syndrome pcs, also known as posterior spinal artery syndrome psa, is a type of incomplete spinal cord injury. Anterior spinal cord asa infarction is a rare devastating disorder.
Pdf anterior spinal artery syndrome following abdominal. Anterior spinal artery syndrome associated with severe stenosis of the vertebral artery article pdf available in american journal of neuroradiology 197. Truth be told, most confusion regarding the lateral spinal artery is unnecessary, and is artificially created by somewhat pretentious nomenclature. Atypical anterior spinal artery infarction due to left vertebral artery. When the cervical spine is involved, breathing disorders may be observed. Treatments for anterior spinal artery syndrome including drugs, prescription medications, alternative treatments, surgery, and lifestyle changes. Anterior spinal artery syndrome associated with severe. Anterior spinal artery syndrome definition of anterior. Anterior spinal artery syndrome anterior cord syndrome. Anterior spinal cord syndrome comprises ischemia or infarction of the spinal cord in the distribution of the anterior spinal artery, which supplies the ventral twothirds of the spinal cord. Posterior spinal arteries radiology reference article. Descriptors are arranged in a hierarchical structure, which enables searching at various levels of specificity.
Back or neck pain often accompanies spinal cord ischemia, and has been reported in as many as 70 percent of patients, typically occurring at the level of the lesion. As the name suggests, cst involves the cavernous sinus source transcavernous repair of carotid cavernous fistula. These vessels enter through the intervertebral foramina as spinal arteries to penetrate the meninges and run along the nerve roots, and are derived from various parent vessels depending on the level vertebral, costocervical, posterior intercostal, lumbar, lateral sacral. This operation was at least 50% more difficult than the average complex joint skull base chondrosarcoma in that it extended from the level of the cavernous sinus down the foramen magnum via the petroclival region.
The anterior spinal artery syndrome was first described by spiller 1 in a case of thrombosis of this artery. As is the case for the more common cerebrovascular accident affecting cerebral circulation, an acute onset is a clue to the diagnosis. Three major vessels arising from the vertebral arteries in the neck supply the spinal cord. Anterior spinal artery an overview sciencedirect topics. A group of symptoms that collectively indicate or characterize a disease, disorder, or other condition considered abnormal. Infectious endocarditis ie typically occurs in the setting of intravenous drug use, prosthetic heart valves, or rheumatic heart disease. A case of anterior spinal artery syndrome caused by. Posterior spinal artery syndrome showing marked swelling.
Ischemia or infarction of the spinal cord in the distribution of the anterior spinal artery, which supplies the ventral twothirds of the spinal cord. Based on the symptom, clinical diagnosis of anterior spinal artery syndrome was considered. Infarct of the anterior spinal artery is the most common subtype of spinal. Between january 1, 1980, and june 30, 1989, 9 patients 6 males and 3 females developed ischemic injury to the spinal cord or lumbosacral plexus following 3,320 operations on the abdominal aorta. In the cervical and upper thoracic cord, contributions to the anterior spinal artery are from the vertebral, cervical, and superior intercostal arteries. Read more about symptoms, diagnosis, treatment, complications, causes and prognosis. Pdf anterior spinal artery syndrome associated with. Anterior spinal artery asa syndrome is a rare and devastating neurological syndrome which can be recognized clinically. Case report a 55yearold man with a 10year history of diabetes and hypertension experienced pain and paresthesia in his shoul. Anterior spinal artery syndrome manifests as flaccid paralysis of the lower extremities and bowel and bladder dysfunction with sparing of proprioception and sensation, due to the selective ischemia to the anterior portion of the cord. In our search results, no study specifically addressed the prevalence of central cord syndrome. The anterior spinal artery of adamkiewicz which supplies this region of the spinal cord is susceptible to occlusion in the midlumbar region as the radicular artery supplying it is an end artery with no collateral circulation. There are many causes for an anterior spinal artery syndrome, for example, mikroangiopathia, duralavfistula, vasculitis, or the injuryembolism of.
But no case of reversible anterior spinal artery syndrome after balloon kyphoplasty is to be found in the literature as yet. Objective to describe the polysomnographic findings in a patient with cervical asa syndrome complicated by a sleep breathing disorder. In this regard, we think that the vasculitis of the anterior spinal artery or its branches. This condition is usually associated with atherosclerosis of the aorta and may result from. Anterior spinal artery syndrome the most common clinical presentation of a spinal cord infarction is anterior spinal artery asa syndrome. Anterior spinal artery syndrome complicated by the ondine. Anterior spinal artery syndrome is an extremely rare cause of acute ischemic cord infarction in children. The typical presentation of ascs is an acute and painful myelopathy. Anterior spinal artery syndrome is the most common form of spinal cord infarction.
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