Anterior spinal artery syndrome refers to the symptoms caused by reduced blood flow in the anterior spinal artery.
Historical background
Anterior spinal artery syndrome was first described in 1909 by William Spiller1.
Symptoms
The clinical presentation of anterior spinal artery occlusion varies according to the level of the causative ischemia. The syndrome is characterized by usually acute-onset paraparesis as well as disturbances of bladder and bowel function, which may vary in severity. Due to the anatomical proximity of the spinothalamic system to the pyramidal tract, deficits in pain perception may also accompany the motor deficits. Since the pathways of proprioception are not supplied by the anterior spinal artery, proprioception remains intact in anterior spinal artery syndrome2.
Causes
In a 1983 study of 60 patients with anterior spinal artery syndrome, the causes were distributed as follows3:
| Number of patients (Total n=60) | Cause |
|---|---|
| 14 | Unknown |
| 10 | Spinal cord angioma |
| 9 | Post-infarction or vaccination |
| 9 | Occlusive lesion of the anterior spinal artery |
| 5 | Aortic pathology |
| 2 | Dorsolumbar sympathectomy |
| 2 | Syphilis without spinal cord autopsy |
| 2 | Metastatic lesion in the spinal canal |
| 1 | Cervical spondylosis without thrombosis of the anterior spinal artery |
| 1 | Vertebral angiography |
| 1 | Spontaneous spinal epidural hemorrhage |
| 1 | Intravenous Neo-arsphenamine |
| 1 | Physical exertion |
References
Spiller, William G. "Thrombosis of the cervical anterior median spinal artery; syphilitic acute anterior poliomyelitis." The Journal of Nervous and Mental Disease 36.10 (1909): 601-613. ↩ ↩
Foo, Dominic, and Alain B. Rossier. "Anterior spinal artery syndrome and its natural history." Spinal Cord 21.1 (1983): 1-10. ↩ ↩ ↩ ↩