Inferior additional anterior root spinal artery ischemia syndrome
Introduction
Introduction of the lower anterior root spinal cord ischemia syndrome The lower anterior root spinal cord artery originates from the first branch of the internal iliac artery, the lumbar branch of the iliac artery. It is also called the lower additional root artery. It mainly constitutes the blood supply of the spinal cord below the 3rd segment, and may also participate in the large root of the lumbar region. The composition of the artery. basic knowledge The proportion of illness: 0.002% Susceptible people: no specific population Mode of infection: non-infectious Complications:
Cause
The lower part of the anterior root spinal cord ischemia syndrome
(1) Causes of the disease
Most of the root arteries or large tumors with additional root arteries can be caused by accidental injury.
(two) pathogenesis
1. Vascular disease is caused by vascular sclerosis due to hardening of the arteries and atherosclerosis.
2. Surgical accidental injury Because the lower root artery is mostly from the internal iliac artery of the iliac artery, the lumbar branch of the iliac artery is easy to be mistaken when it is applied to the site (especially when it encounters uncontrollable major bleeding during surgery).
3. Tumor compression is relatively rare, mainly because the abdominal cavity is relatively empty, unless a huge tumor, it is generally not easy to form pressure on the blood vessel.
4. Other traumas are often associated with pelvic injuries and should be noted.
Prevention
Lower anterior root spinal cord ischemia syndrome prevention
The key to this disease is prevention, especially when the operation is performed on this part (especially the tumor resection). Do not arbitrarily ligature the blood vessels during surgery. Because the disease has less influence on the plane of the spinal cord, the urgency of the operation is not as good. Large root arterial ischemic syndrome with thoracic and lumbar spinal cord blood supply should still emphasize the basic principle of prevention.
Complication
Lower anterior root spinal cord ischemia syndrome complications Complications
Can be combined with lower limb paralysis.
Symptom
Lower anterior root spinal cord ischemia syndrome symptoms common symptoms sensory disturbance
The anatomical features of the blood vessels and the different blood vessels or lesions have different effects on the blood supply range of the spinal cord. Therefore, the symptoms vary greatly. If the blood vessels participate in the composition of the large root artery of the lumbar region, the chest can be displayed below 12 to 5 Spinal cord ischemic sign, mainly in the lower extremity spasm; otherwise, the main effect is less than 3, the symptoms are obviously light, but they all cause sensory disturbance in the saddle area and pelvic visceral dysfunction, of which the loss of control is more common.
Examine
Examination of the lower anterior root spinal cord ischemia syndrome
1. Electrophysiological examination 1 visual evoked potential (VEP) is normal, can be differentiated from optic neuromyelitis and MS; 2 lower limb somatosensory evoked potential (SEP) amplitude can be significantly reduced; motor evoked potential (MEP) abnormality, can be used to judge efficacy and prognosis The indicator; 3 EMG showed denervation.
2. The lumbar puncture and neck test is unobstructed. In a few cases, the spinal cord edema is severe and may not be completely obstructed. The cerebrospinal fluid examination pressure is normal, the appearance is colorless and transparent, and the cell number and protein content are normal or slightly increased.
3. Imaging examination of the spine X-ray film is normal. MRI typical shows that the spinal cord of the lesion is thickened, and there are multiple flaky or spotted lesions in the intramedullary segment, which are T1 low signal, high T2 signal, uneven intensity, and may be fused.
Diagnosis
Diagnosis and differentiation of the lower anterior root spinal cord ischemia syndrome
Mainly based on a clear cause and clinical symptoms, those with sudden lower extremity paralysis and incontinence should be considered for obvious reasons, especially after the lower abdomen.
