A spinal cord injury encompasses a physical insult to the spinal cord. In the case of anterior spinal cord syndrome, the insult is a vascular lesion at the anterior. Anterior spinal artery syndrome (also known as "anterior spinal cord syndrome") is a medical condition where the anterior spinal artery, the primary blood supply to the anterior portion of the spinal cord, is interrupted, causing ischemia or infarction of the spinal cord in the anterior two-thirds of the spinal cord ‎Signs and symptoms · ‎Causes. The anterior spinal artery syndrome in three patients is described and from the literature 6o additional patients were collected. Motor recovery.


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These include aortic aneurysmsdissectionsdirect trauma to anterior spinal artery syndrome aorta, surgeries, and atherosclerosis. Acute disc herniationcervical spondylosiskyphoscoliosisdamage to the spinal column and neoplasia all could result in ischemia from anterior spinal artery occlusion leading to anterior cord syndrome.

Other causes include vasculitispolycythemiasickle cell diseasedecompression sicknessand collagen and elastin disorders.

Anterior spinal artery syndrome - Wikipedia

CASE 1 At the end of a class period, a year-old boy was unable to get up from his chair. He was taken to the community hospital and found to have bilateral lower-extremity paralysis, without any signs or symptoms of infection. Computed tomography of the head and laboratory results were within normal limits, and he was transferred to a tertiary care pediatric hospital.

In anterior spinal artery syndrome surgery, the risk of paralysis related to ASAS ranges from 0. As the patient presented beyond the therapeutic window anterior spinal artery syndrome thrombolysis, conservative measures were continued.

Anterior spinal artery syndrome and its natural history. - PubMed - NCBI

Routine blood work up, ANA profile, Anti phospholipid antibody screen, Anterior spinal artery syndrome electrophoresis, 2D ECHO, ultrasound abdomen, chest roentgenogram, thrombophilia work up were performed to identify any underlying abnormality but delivered negative results.

After 10 days of treatment, flicker of contractions was noted in the lower limbs, while truncal movement and upper limb power also showed mild degree of improvement.


Discussion ASA syndrome refers to the typical neurological syndrome of acute painful flaccid paralysis with bladder involvement secondary to occlusion of the anterior spinal artery. As evidenced in the present case, the manifestations are secondary to infarction anterior spinal artery syndrome the antero-lateral and central cord which comprises the anterior horn cells, cortico-spinal and spinothalamic tract along with fibers sub-serving higher control of bladder function.

In addition these patients would have severe pain which can have features of radicular or tract pain. Posterior column sensations are characteristically preserved. A diligent search was made for any medullary involvement in view of giddiness and vomiting but repeated brain imaging did not reveal any diffusion restriction.

MRI of anterior spinal artery syndrome.

Fulminant infarction of the higher cervical cord can produce postural hypotension due to autonomic involvement which could be an alternate explanation for these symptoms [ 3 - 5 ]. Apart from this classical presentation, the clinical setting anterior spinal artery syndrome which the event occurred in the present patient was also quite unique.

Thrombogenesis in our patient is most likely the result of shear stress resulting in endothelial injury to the anterior spinal artery.

Radicular and medullary arteries are as a result of endothelial inury. Anterior spinal artery syndrome other causes of this devastating syndrome include hypercoagulable states, anti-phospholipid antibody syndrome, Sickle cell anemiaDown syndromeatlanto-axial dislocation, embolism and vasculitis which were ruled out by appropriate investigations.

Spinal anatomy: Anterior spinal artery syndrome

Adult patients usually have risk factors like hypertensiondiabetes, smoking, hypercholesterolemia or degenerative spine disease. Aortic dissection and anterior spinal artery syndrome surgeries can result in fulminant ASA thrombosis [ 3 - 5 ].

After the initiation of injury, the profound impact of the thrombosis needs to be explained This in turn is determined by the support offered to the ASA in supplying the cervical cord by the radiculo-medullary arteries predominantly arise from the vertebral and costo-cervical trunk.

The largest of these branches is the artery of the cervical enlargement described by Lazorthes [ 78 ]. During angiography, we studied vertebral arteries, costocervical trunk, thyrocervical trunk, subclavian and the intercostals to search for the artery of Lazorthes which was conspicuously absent.

The only other supply was from the right ASA arising from the lower segment of vertebral.