anterior spinal artery syndrome in children
Introduction
Introduction to pediatric spinal anterior artery syndrome Anteriorspinalarteria syndrome (also known as Beck syndrome, Davison syndrome, anterior spinal artery occlusion syndrome, etc.). The clinical features of this disease are the involvement of the distribution of the anterior spinal artery, causing paralysis of the limbs, pain, temperature, and rectal bladder sphincter. basic knowledge The proportion of sickness: 0.00012% Susceptible people: children Mode of infection: non-infectious Complications: urinary retention constipation acne
Cause
Causes of anterior spinal cord syndrome in children
(1) Causes of the disease
This disease is caused by stenosis or occlusion of the anterior spinal artery and its related blood vessels. It is also seen in infection, spinal cord trauma, tumor compression, arteriosclerosis, vascular malformation, etc. In one of the foreign data, one patient was yawned. The cases of cervical dislocation caused by over-extension of the cervical spine caused the disease. Nearly half of the pediatric cases reported by Zhou Huaiwei and others were caused by strenuous exercise or cervical spine trauma, suggesting that the cervical spinal cord is the most frequently affected part.
(two) pathogenesis
The anterior spinal artery supplies blood to the ventral 2/3 region of the spinal cord. When the blood vessels are occluded, it causes damage to the ventral and lateral cords of the spinal cord.
Pathological changes:
It can be seen by the naked eye that the ventral and lateral sides of the spinal cord are softened and shrunk and the color is lightened. In the early part of the spinal cord, congestion and edema may occur in one part or several segments. In the same patient, the softening area of each segment is not consistent, because each The segmental circulation of the segments is different and the local vascular anatomy is different. The softened area has a typical infarct change.
Microscopically, the central part of the spinal cord softening lesion was necrotic, surrounded by glial cell hyperplasia, neuronal degeneration, loss of myelin, and lattice cells.
Prevention
Prevention of anterior spinal cord syndrome in children
Prevent strenuous exercise and prevent cervical spondylolisthesis, prevent and treat various infectious diseases, and prevent various diseases that can cause stenosis or occlusion of the anterior spinal artery.
Complication
Complications of anterior spinal cord syndrome in children Complications, urinary retention, constipation, hemorrhoids
It can occur sputum, urinary retention, constipation, hemorrhoids, secondary infections, etc.
Symptom
Symptoms of anterior spinal cord syndrome in children Symptoms Common symptoms Motor dysfunction, abnormal sweating, sensory dysfunction, sphincter dysfunction, cervical disc degeneration, nerve root stimulation, paraplegia, quadriplegia
According to the clinical manifestations of this disease, it can be divided into four types: upper neck, lower neck, chest and lumbosacral.
1. Sudden onset: Symptoms and signs appear quickly.
2. The first symptom: the main symptoms of nerve root stimulation.
3. Impaired expression of the anterior spinal artery distribution area: motor dysfunction, such as quadriplegia or paraplegia; isolated sensory disturbance, such as pain, temperature and normal touch; sphincter dysfunction, such as rectum, bladder sphincter, can occur Urinary retention, etc.
4. Others: In addition, it can be autonomic symptoms such as hemorrhoids, abnormal sweating and cold and hot feeling.
Examine
Examination of anterior spinal cord syndrome in children
Laboratory tests showed no specific results, and the results of cerebrospinal fluid examination were mostly in the normal range, and occasionally the total amount of protein increased.
Do X-ray, angiography, CT and MRI examinations.
Diagnosis
Diagnosis and diagnosis of anterior spinal cord syndrome in children
diagnosis
Diagnosis based on the above clinical manifestations, spinal angiography contributes to the diagnosis of this condition.
Differential diagnosis
In the diagnosis process, the focus should be differentiated from subacute necrotizing myelitis syndrome.
