Spinal cord ischemic disease
Introduction
Introduction to spinal ischemic diseases Spinal cord ischemic disease is caused by severe hypotension caused by myocardial infarction, cardiac arrest, aortic rupture, aortic angiography, thoracic cavity and spinal surgery, as well as atherosclerosis, syphilitic arteritis, tumor, arachnoid adhesion, etc. Caused by, can be divided into transient ischemic attack of the spinal cord and spinal cord infarction, the anterior spinal artery syndrome, posterior spinal artery syndrome and central artery syndrome occur due to different arteries with occlusion. Spinal ischemia is seen in aortic atherosclerosis. A transient ischemic attack of the spinal cord (TIA) manifests as a sudden paraplegia that lasts for a few minutes or hours and fully recovers. If several segments of the spinal cord are completely infarcted, root pain, lower extremity spasms, all sensory loss and dysfunction are present. The treatment of ischemic spinal cord disease is similar to that of ischemic cerebrovascular disease. Vasodilators and drugs that promote the recovery of nerve function can be used. Those with hypotension should correct blood pressure. Those with obvious pain can give sedative painkillers. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: pneumonia, acne, urinary tract infection
Cause
Causes of spinal ischemic diseases
(1) Causes of the disease
Spinal cord ischemia can occur in the blood supply of aortic angiography or aortic aneurysm. Sometimes due to aortic atherosclerosis, spinal vascular malformations, microembolism, vasospasm and insufficient blood supply. Others such as syphilitic myelitis, lumbar spinal stenosis, spinal cord trauma, polycythemia, venous thrombosis, and hypotension caused by systemic diseases can cause spinal cord ischemia.
(two) pathogenesis
A series of invasive biochemical changes caused by spinal cord ischemia will lead to intracellular calcium accumulation, increased oxygen free radical content, thereby damaging neurons in the spinal cord, causing irreversible spinal cord dysfunction. Foreign scholars found in rabbit spinal cord ischemia model. Apoptotic bodies in damaged neurons suggest that apoptosis promotes neuronal cell death.
Prevention
Spinal cord ischemic disease prevention
1. The limbs should be passively exercised and massaged in the early stage to improve blood circulation, prevent hemorrhoids, turn over regularly, massage the pressed parts, and keep the skin clean.
2. Prevent respiratory infections and keep warm.
3. Early prevention and treatment can lead to diseases of spinal cord ischemia, such as spinal cord compression.
Complication
Spinal cord ischemic disease complications Complications pneumonia acne urinary tract infection
Mainly the primary manifestations of extra-spinal spinal cord, as well as secondary pneumonia, hemorrhoids, urinary tract infections caused by progressive paraplegia.
Symptom
Symptoms of ischemic spinal cord symptoms common symptoms spinal ischemic sensory disturbance lower extremity muscle spasm
Spinal ischemia is seen in aortic atherosclerosis. A transient ischemic attack of the spinal cord (TIA) manifests as a sudden paraplegia that lasts for a few minutes or hours and fully recovers. If several segments of the spinal cord are completely infarcted, root pain, lower extremity spasms, all sensory loss and dysfunction are present.
Examine
Examination of spinal ischemic diseases
1, cerebrospinal fluid examination: spinal cord arachnoid hemorrhage CSF bloody; CSF protein increased in spinal canal obstruction, low pressure.
2. MRI can show local thickening, hemorrhage or infarction of the spinal cord, and vascular malformation may be found after enhancement. Myelography can determine the location of the hematoma, showing the location and extent of the deformed blood vessels on the surface of the spinal cord, but not distinguishing the type of lesion. Selective spinal digital subtraction angiography (DSA) is valuable for the diagnosis of spinal vascular malformation. It can clearly show the size, shape, location, extent, type, blood supply artery and drainage vein of the deformed blood vessel. It is very helpful for guiding surgery or radiotherapy. helpful. The type of lesion cannot be distinguished. Selective spinal digital subtraction angiography (DSA) is valuable for the diagnosis of spinal vascular malformation. It can clearly show the size, shape, location, extent, type, blood supply artery and drainage vein of the deformed blood vessel. It is very helpful for guiding surgery or radiotherapy. helpful.
Diagnosis
Diagnosis and diagnosis of ischemic spinal cord disease
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
Transient spinal cord ischemia often needs to be distinguished from the following diseases.
1. Intermittent claudication caused by lower extremity atherosclerosis This disease occurs in the elderly and has a clear history. After walking a short distance, there is more pain in one side of the lower limbs, numbness and weakness, so that you can not walk, you can continue to walk after rest. However, there are no symptoms of spinal cord damage at the time of onset.
2. Embolism vasculitis is more common in middle-aged men. There is no obvious peripheral arteriosclerosis. Pain in the feet and calves during the attack, accompanied by a decrease in the skin temperature of the foot, disappearance of the dorsal artery of the foot, cyanosis of the toes, no Signs of spinal cord damage.
