Anterior spinal cord syndrome

Causes

• Ischemia
  • Aortic pathology (dissection, aneurysm, thrombosis, iatrogenic injury)
  • Anterior spinal artery dissection (traumatic, iatrogenic)
  • Fibrocartilaginous embolism from intervertebral disk
  • Cholesterol embolism
  • Vasculitis
  • Hypertensive small vessel disease
  • Sickle cell anemia
  • SLE
  • Atrial myxoma
  • Intra-aortic balloon pump
  • Lumbar artery compression
• Disk herniation
• Neoplasm
• Penetrating trauma
• Spinal fracture dislocation
• Epidural abscess or hematoma
• Carcinomatous meningitis
• Subarachnoid hemorrhage
• Thoracotomy and thoracoplasty
• Esophageal surgery
• Lumbar sympathectomy
• Celiac plexus block

Clinical presentation

• Complete flaccid, areflexic paralysis and muscle atrophy in the affected segments
• Spastic weakness below the affected segments
• Impaired pain and temperature perception below affected segments
• Autonomic dysfunction, orthostatic hypotension, bladder and bowel dysfunction
• Intact proprioception and vibration perception
• Sudden onset neck and back pain may be an initial symptom.