Spinal Cord Ischemia – From Diagnosis to Treatment

Purpose: The aim is to outline the frequency of the occurrence, course, diagnosis and possible treatment of spinal cord ischemia (SCI) on the basis of a literature overview and to raise awareness of this rare yet devastating condition. Views: SCI, when compared to cerebral stroke, is a relatively rare disease, being diagnosed 100 times less often. The knowledge as to its root causes, proper treatment for it and long-term prognosis is still inconclusive. Magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) is a main tool with which to confirm SCI and rule out a broad spectrum of possible alternative diagnoses. SCI is a condition in which prompt recognition, accurate diagnostic steps, and reperfusion therapy are essential to ensure a desirable functional outcome and reduce mortality and disability. Although there are no specific guidelines regarding treatment, the administration of recombinant tissue plasminogen activator (rt-PA) might be an effective therapy for acute ischemic stroke, preventing permanent spinal dysfunction. In surgical causes close cooperation between a neurologist and a neurosurgeon is necessary to provide combined appropriate management promptly. Conclusion: Due to the relative rarity of SCI, multi-center studies of ischemia of the spinal cord and its treatment would be advisable in neurological practice to enhance current knowledge. A rapid diagnosis is crucial for appropriate care and desirable long-term outcomes.