How is it diagnosed?
If a spinal cord stroke is suspected, a rapid neurological examination should be performed, followed by magnetic resonance imaging with and without contrast medium. This can reveal circulatory disorders, but also masses or changes in the spinal cord. A vascular imaging (angiography) of the spinal cord should also be performed.
A sonography or computed tomography of the abdomen to exclude a disease of the aorta would follow. In order to exclude other inflammatory or autoimmune diseases, a blood sample can be taken and a neural fluid examination can be performed. More information about diagnostic procedures can be found in the next article: MRI of the spinal column
I recognize a stroke in the spinal cord by these symptoms
In the case of a circulatory disorder in the front part of the spinal cord (arteria spinalis anterior syndrome), the symptoms appear suddenly and begin with tingling, “formication” and numbness at the level of the stroke. Within the first hour, other symptoms suddenly appear, such as flaccid paralysis and a disturbed feeling of pain and temperature. In addition, bladder and rectum paralysis with urinary and stool retention occurs.
If the circulatory disorder affects the posterior region of the spinal cord (arteria spinalis posterior syndrome), other symptoms develop. Here, depth sensitivity, i.e. the perception of the body’s position and posture, is impaired, leading to gait disorders (ataxia). Paralysis also occurs here.
In the case of a major stroke, all these symptoms can occur simultaneously and thus cause paraplegia. If one of these symptoms occurs, immediate medical attention is very important. Are you more interested in this topic?
Treatment options for stroke
The treatment always depends on the cause. A stroke of the spinal cord is an absolute emergency and must be diagnosed and treated immediately, as the circulatory disorder causes nerve tissue to die. In the case of diseases of the aorta, for example a tear in the wall due to a bulge, immediate surgical treatment is necessary.
In case of inflammation in the course of an autoimmune disease, both the aorta and smaller vessels can be affected. Cortisone is used to treat the autoimmune disease and aspirin is given to thin the blood.In the case of an arteria spinalis anterior syndrome, a so-called thrombocyte aggregation inhibition, i.e. a thinning of the blood, by means of 100mg ASS (aspirin) daily, is usually also carried out. In case of urinary retention, it is very important to insert a bladder catheter so that the bladder does not have to bear any consequences.
If a tumor or a herniated disc is the reason for the circulatory disorder, then surgical treatment should be considered. In general, a cross-sectional view requires thrombosis prevention by means of blood thinners. You can read more detailed information on this topic in the next article: Therapy of a strokeIn the case of a stroke of the spinal cord, just like any other stroke, the time until the start of therapy is crucial. The faster the cause is eliminated, the faster the tissue can recover and the symptoms disappear again. The exact duration of the symptoms is difficult to predict in general, as it varies from individual to individual and depends on the extent of the stroke.
