When there is a disruption to the blood supply for the spinal cord, the result is what is known as a spinal stroke. The definition of a spinal stroke is the loss of blood supply to the spinal cord. Spinal stroke, also known as spinal cord trauma, is a very rare condition: Only 1.25 percent of all strokes are estimated to be spinal strokes.
Without blood, the body’s tissues cannot work properly. Furthermore, with prolonged loss of blood supply, tissues can become injured – or worse – severely damaged. In severe cases, this may result in symptoms such as severe pain, paralysis, incontinence, and even death.
Anatomy of spinal blood vessels
The spinal cord is supplied with blood from the anterior spinal artery and two smaller postural spinal arteries. The anterior spinal artery supplies between two thirds to 75 percent of the blood; the postural arteries supply the remaining 25–33 percent. If these arteries are blocked somehow, then the resulting decrease in oxygen supply and vital nutrients is what damages spinal cord tissues.
What are the causes and risk factors of spinal stroke?
The main causes of spinal stroke are direct impact and compression of the spinal cord that results in blockage of blood supply. While there could be many reasons for this, including herniation, tumors, and spinal artery rupture, the main cause of spinal strokes tends to be blood clots.
Many age-related diseases can lead to a spinal stroke. Primarily among this is the narrowing of arteries that occurs in some people as they age like those with high blood pressure, high cholesterol. Those who smoke or have a family history of heart ailments are at a higher risk of having blocked arteries. Spinal infraction as a result of narrowing of the arteries is known as an ischemic spinal stroke.
A hemorrhagic spinal stroke is caused when there is a bleed from blood vessels bursting. High blood pressure, which weakens arteries, can often be a culprit of aneurysms. Another cause is spinal arteriovenous malformations (AVM), a rare occurrence when there is a tangle of blood vessels in or near the spinal cord, can also cause a spinal stroke.
There are many causes of spinal stroke. The risk factors for spinal stroke include the following:
A direct impact on the spine can cause a spinal stroke. Types of trauma that may result in this include gunshots, physical assault, a severe fall, sports injuries, being in a car accident, or an industrial accident.
Diseases resulting in spinal cord compression
Diseases that can cause spinal cord compression include osteoporosis – the collapse of the spinal canal; rheumatoid arthritis, which results in the partial dislocation of vertebrae; and spinal stenosis, or when the spinal canal shielding becomes too narrow and is more easily prone to injury.
The herniation of the spine’s discs can cause an injury to the spinal arteries. Penetration by disc fragments is also a cause of large disc herniation. The enlargement of certain connective tissue within the spine, known as large hypertrophy of ligamentum flavum, is a cause of spinal nerve compression, common to the lumbar and cervical regions of the back.
There are essentially two types of spinal tumors that can end up causing a compression of the spinal cord that will result in a spinal stroke. The first is a bone tumor, which could come from the bone-derived cells and tissues (primary) or could be the result of a secondary tumor, which originated in other sizes and metastasized to the spine. The other kind of tumor is a spinal cord or spinal nerve tumor, which can cause obstruction of the spinal artery that will result in stroke.
An epidural abscess – when infected material and germs accumulate between the covering of the brain and spinal cord – or epidural bleeding the results in epidural blood clot can also be causes of a spinal stroke.
What are spinal stroke signs and symptoms?
The signs and symptoms of spinal stroke will be different contingent on the area of the spine (cervical, thoracic or lumbar) where an injury has occurred. Loss of feeling and weakness is a typical symptom of affected areas.
The main symptoms include acute and strong neck and back pain; other symptoms include muscle weakness in the legs, unusual feelings in the lower half of the body, and incontinence (loss of bladder/bowel control). Feelings such as numbness, burning, or tingling sensations can also be signs of a spinal stroke.
A feeling of tightness surrounding the middle of the body, an indicator of a disrupted blood supply to the spinal cord, is a good indicator for spinal stroke. Also pay attention if there is an inability to understand the leg’s position within the joint which interferes with the ability to walk.
It’s also worth noting that the symptoms of spinal stroke can appear very quickly – within hours or minutes.
Diagnosis of spinal stroke
Besides undergoing a full physical examination, the main test that can help diagnose a spinal stroke is a magnetic resonance imaging scan, more commonly known as an MRI. Very detailed pictures of the spine can find abnormalities that could be causing pressure on the spinal cord like a disc herniation, abscess, inflammation, or tumors.
An MRI can also find out whether the blood supply has been disrupted by a blockage or bleed.
How to treat spinal stroke
Due to the many different effects of a spinal stroke, spinal stroke treatment will vary depending on symptoms. It’s also very critical that medical care is sought out immediately in order for treatment to commence quickly.
Drugs like corticosteroids can reduce swelling and inflammation. Surgery is also an option to reduce pressure on the spinal cord. Surgery will be necessary if there is epidural abscess or blood clots that need to be removed, a spinal tumor that needs to be removed, the vertebrae require realignment, spinal bones are broken and need to be fused, or there are disk or bone fragments that need to be removed. The sooner this is done, the more it will prevent permanent damage to the spinal cord or associated conditions like spinal stroke.
Those who had spinal strokes as a result of blockage of the arteries may be given blood thinners to reduce the potential of future blood clots. There is also medication available to treat both high blood pressure and high cholesterol.
A healthy lifestyle, consisting of exercise, a healthy balanced diet, and moderation of tobacco products and alcohol will pay dividends when it comes to regaining mobility lost through spinal stroke. Those with spinal cord injuries can have spastic hyperreflexia (overactive reflexes), which impair motor functions such as walking. Rehabilitation treatments like neuromotor retraining and stretching, and medications such as baclofen or botulinum toxin can treat overall motor functions.
According to studies, recovery from impairment is possible after spinal stroke. The time for spinal stroke recovery varies, with most people reporting regained functions within the first six months and gradual recovery taking place over a much longer time period thereafter.
Although rare, a spinal stroke can have debilitating consequences for you. The narrowing of arteries or any trauma to the spine that results in decreased blood flow can cause serious tissue damage. If untreated, the resulting loss of bodily functions, potential for paralysis, and threat of death are severe consequences. However, when there is a swift response to potential symptoms of spinal stroke, the long-term damage is reduced.
Care must be taken to avoid high-risk activities that can injure the spine or workplace accidents where the spine could be injured. Nutrition and exercise that promotes cardiovascular health is also important to reduce damage to the arteries that can cause blood supply disruption.
If you are experiencing any of the symptoms mentioned, consult with a medical doctor immediately.