Spinal Cord Infarct in Children: A Decade of Experience From a Tertiary Referral Center

AIM: To investigate the clinical presentation, therapeutic approaches, and outcomes of pediatric spinal cord infarcts to enhance early diagnosis and management. METHOD: This retrospective cohort study was conducted at Sheba Medical Center, focusing on pediatric patients aged 0-18 years diagnosed with spinal cord infarct between 2012 and 2024. Patients were identified throughmagnetic resonance imaging (MRI) findings and classified using the American Spinal Injury Association Impairment Scale upon admission and discharge from rehabilitation. RESULTS: Thirteen children, with a median age of 13 years, were included in the cohort. Clinical presentations varied, with motor weakness (77%) and local pain (61%) being the most common. Anterior spinal artery syndrome was prevalent in 38% of cases. Fibrocartilage emboli were responsible for 30% of the infarcts. MRI was the primary diagnostic modality, with 61% showing definite infarct signs. Therapeutic management typically included antithrombotic therapy and rehabilitation. Notably, 54% of the patients demonstrated significant functional improvement. INTERPRETATION: Pediatric spinal cord infarcts, while rare, lead to considerable morbidity, necessitating timely diagnosis and a comprehensive, multidisciplinary rehabilitation approach. This study underscores the importance of supportive care in improving neurological outcomes and quality of life in affected children. While most infarcts are idiopathic, better awareness and management protocols can enhance recovery prospects. CONCLUSION: Despite its rarity, spinal cord infarcts pose a significant risk to pediatric patients. Our findings highlight the resilience of children and emphasize the critical role of early rehabilitation in achieving favorable long-term outcomes.