Anterior spinal artery syndrome
The Arteria spinalis anterior syndrome is caused by a circulatory disorder of the anterior spinal artery, which occurs mostly acute or subacute and without warning.
Clinical symptoms
Clinically the disease manifests acutely with a spinal shock for a period of weeks to months with paraparesis below the lesion. Frequently Beltlike paresthesia and pain are given. In addition, a dissociated sensory disturbance occurs ( damage to the spinothalamic tract or spinothalamischer fibers in the anterior commissure with disturbed pain and temperature sensation with preservation of touch and vibration sensation), initially flaccid, later spastic paresis in Lesion, trophic disturbances, and bladder and bowel disorder. Position, vibration and sense of touch are not affected, since their paths ( posterior funiculus ) are not within the coverage area of the affected artery.
Diagnosis
In addition to the typical clinic various instrumental tests to clarify the causes, to the exclusion of possible differential diagnoses and to confirm the diagnosis can be performed. The blood disorder is usually detected using magnetic resonance imaging and is the drug of choice to confirm the diagnosis. By computed tomography causing spinal changes, herniated discs and tumors can be detected.
Therapy
For processes that cause local compression of the anterior spinal artery, which may be the case for herniated discs and tumors, for example, immediate surgery is necessary. When the circulatory disturbance caused by systemic changes in the vessels, conservative therapy is performed. These include the drug treatment with heparin for thromboprophylaxis and corticosteroids for suppression of inflammation. Physiotherapy and regular repositioning are important measures for decubitus prophylaxis. Spinalis the anterior syndrome is at risk of developing a pressure ulcer is increased.
Swell
- K. Poeck, W. Hacke: Neurology. Springer - Verlag 2006, 12th edition. ISBN 3-540-29997-1
- Cerebrovascular disorder
- Spinal cord