Spinal Strokes: Understanding The Deadly Risk

Spinal strokes are rare but life-threatening. They occur when the blood supply to the spinal cord is cut off, causing nerve damage and impairing the spinal cord's function. This can lead to severe and permanent physical and cognitive issues, including paralysis, and can be fatal.

• Muscle weakness in the legs or hands
• Problems controlling the bowel and bladder (incontinence)
• Loss of temperature sensation
• Tightness or pain in the chest
• Partial or full paralysis | | Causes | - Blockage in the blood vessels that supply blood to the spinal cord
• Atherosclerosis (build-up of plaque that narrows blood vessels)
• High blood pressure
• Bleeding from ruptured blood vessels
• Heart or aorta problems, e.g., low blood pressure or lack of blood flow through the aorta
• Abnormal connection between spinal arteries and veins (spinal vascular malformation)
• Tangled blood vessels
• Tumours | | Risk Factors | - High blood pressure
• Heart-related conditions
• Lack of physical exercise
• Excessive alcohol consumption
• High cholesterol
• Cardiovascular conditions
• Smoking | | Diagnosis | - MRI scan
• Check for inflammation in spinal fluid
• Check for serious spinal cord symptoms that developed in the last 12 hours | | Treatment | - Medication to thin the blood and reduce the risk of blood clots (e.g., antiplatelet and anticoagulant drugs, aspirin)
• Medication to control high blood pressure and cholesterol (e.g., statins)
• Physical and occupational therapy
• Surgical thrombectomy to remove blood clots | | Complications | - Breathing difficulties
• Bowel and bladder incontinence
• Pressure sores
• Muscle tone problems, such as spasticity or flaccidity
• Muscle, joint, or nerve pain
• Anxiety, depression, or PTSD | | Recovery | - 40-42% of people may recover enough function to stand and walk with aids within 3-4 years
• Paralysis may persist for weeks or be permanent |

Spinal strokes are rare but life-threatening

Spinal strokes are rare, accounting for only about 1% of all strokes. However, they are life-threatening and can lead to serious health complications or even death if not treated promptly.

A spinal stroke, or spinal cord infarction, occurs when the blood supply to the spinal cord is disrupted, resulting in a lack of oxygen and nutrients to the spinal tissues and cells. This can be caused by a blood clot (ischemic spinal stroke) or a bleed (hemorrhagic spinal stroke). The former is more common and is often the result of a build-up of plaque in the arteries, while the latter may arise from high blood pressure or a burst aneurysm.

The symptoms of a spinal stroke include severe neck or back pain, muscle weakness in the legs, problems with bladder control (incontinence), and partial or full paralysis. These symptoms can develop within minutes or a few hours after the stroke and tend to worsen over time.

The risk factors for a spinal stroke include high blood pressure, heart disease, lack of physical exercise, smoking, and excessive alcohol consumption. People with these risk factors are more likely to have narrowed or weakened arteries, which can lead to a blockage or bleed in the spinal cord.

If you suspect that you or someone else is experiencing a spinal stroke, it is crucial to seek immediate medical attention. Treatment options include medication to thin the blood and reduce blood clots, as well as physical and occupational therapy to improve movement and manage symptoms. In some cases, emergency surgery may be required to remove blood clots or relieve pressure on the spinal cord.

While many people make a full recovery from a spinal stroke, it can take months or even years. Some individuals may experience lasting complications, such as paralysis, muscle weakness, and difficulty breathing.

They are caused by blocked blood supply to the spinal cord

Spinal strokes, also known as spinal cord infarctions or spinal cord ischemia, are caused by blocked blood supply to the spinal cord. This blockage is often due to a blood clot or a bleed. Without a steady blood supply, the spinal cord is unable to receive the oxygen and nutrients it needs to function. This can lead to tissue damage and even death.

The spinal cord relies on a network of blood vessels to deliver oxygen and nutrients, which are essential for its function. Blood vessels carry oxygen-rich blood away from the heart to the spinal cord. However, when the walls of these arteries thicken or become too narrow, it restricts the blood flow, resulting in a spinal stroke. This condition is known as arteriosclerosis, specifically atheromatosis, which is characterised by plaque buildup inside the arteries.

In some cases, a spinal stroke can be caused by a sudden bleed (hemorrhage) resulting from high blood pressure or a burst aneurysm. An aneurysm is a bulging in the blood vessel wider than half of its usual width. Additionally, an abnormal connection between spinal arteries and veins, known as a spinal vascular malformation, can also lead to a spinal stroke.

The risk factors for a spinal stroke include high blood pressure, heart-related conditions, lack of physical exercise, and excessive alcohol consumption. These factors put additional strain on the circulatory system, increasing the likelihood of damaged or dysfunctional blood vessels.

The symptoms of a spinal stroke include severe back pain, muscle weakness, numbness, and in severe cases, paralysis. It is important to seek immediate medical attention if you or someone you know is experiencing any of these symptoms, as a spinal stroke is a life-threatening condition.

Symptoms include severe pain, muscle weakness, and paralysis

Spinal strokes are rare but life-threatening. They occur when the blood supply to the spinal cord is cut off, starving the spinal cord of oxygen and nutrients, which can cause severe back pain, limb weakness, and loss of nerve sensation.

The symptoms of a spinal stroke depend on which section of the spinal cord is affected and how much damage is done. In most cases, the onset of a spinal stroke is accompanied by sudden and severe neck or back pain. Other symptoms include muscle weakness in the legs, changes in sensation in the lower half of the body, and problems with the bowel and bladder.

Muscle weakness in the legs can progress to complete loss of movement (paralysis) very quickly. People might experience muscle spasms (spasticity) and unusual feelings such as numbness, burning or tingling sensations, and the inability to feel temperature.

Bowel and bladder problems might include incontinence or increased urgency to use the toilet.

In severe cases, a spinal stroke can cause death. Approximately 20% to 25% of patients will die as a result of complications, such as deep vein thrombosis, which can lead to pulmonary embolisms.

Treatment includes medication and physical therapy

Spinal strokes are life-threatening and can be caused by blood clots or bleeding. Treatment for a spinal stroke depends on the underlying cause and aims to reduce symptoms. Medication and physical therapy are both used to treat spinal strokes and their symptoms.

Medication

If a spinal stroke is caused by a blood clot, medication such as antiplatelet and anticoagulant drugs (e.g. heparin and warfarin) can be prescribed to reduce the chance of another clot forming. If high or low blood pressure is the cause, medication can be used to normalise blood pressure. If a spinal stroke is caused by a tumour, corticosteroids can be used to reduce swelling before surgical removal.

Physical Therapy

Physical therapy is a vital part of the recovery journey for spinal stroke patients. It can help patients improve their strength, coordination, and balance, with the goal of helping them regain the ability to perform everyday activities. Physical therapy can also help to improve overall physical function, address limitations caused by the stroke, and help patients reach their recovery goals.

Physical therapy can also help to:

• Prevent muscle atrophy
• Improve mood
• Improve overall quality of life
• Improve blood flow to the brain
• Alleviate severe impairments
• Improve postural control and balance

Long-term complications can include muscle pain and mental health issues

Spinal strokes are rare, accounting for only 0.3% to 1% of all strokes. However, they can lead to severe long-term complications, including muscle pain and mental health issues. The specific complications depend on the extent of the damage and the location of the stroke.

Muscle pain and spasms are common long-term complications of spinal strokes. This can include muscle, joint, or nerve pain. The unusual feelings people experience can range from numbness and burning sensations to the inability to feel temperature differences. These sensations can be temporary or permanent. In some cases, muscle weakness in the legs can progress to complete loss of movement (paralysis) very quickly. Paralysis following a spinal stroke may last for a few weeks or be permanent.

Mental health issues, such as anxiety, depression, or post-traumatic stress disorder (PTSD), are also possible long-term complications of spinal strokes. The impact on mental health can be significant, and many people may require long-term treatment or lifestyle changes to manage these complications.

In addition to muscle pain and mental health issues, other long-term complications of spinal strokes can include bowel and bladder problems, pressure sores, and breathing difficulties.

While some people may make a full recovery from a spinal stroke, it can take months or even years. It is important to seek immediate medical attention and prompt diagnosis to improve the chances of recovery.

Frequently asked questions