Anterior spinal artery syndrome

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Classification according to ICD-10
G95.1 Vascular myelopathies
M47.0 + Anterior spinal artery compression syndrome and vertebral artery compression syndrome
G99.2 * Myelopathy in Diseases Classified Elsewhere
ICD-10 online (WHO version 2019)

The anterior spinal artery syndrome is caused by a circulatory disorder of the anterior spinal artery , which usually occurs acutely or subacutely and without any precedent.

Clinical symptoms

Clinically, the disease manifests itself acutely with a spinal shock for a period of weeks to months with paraparesis below the lesion. Belt-shaped paresthesia and pain are often reported. In addition, there is a dissociated sensory disorder (damage to the spinothalamic tract or spinothalamic fibers in the anterior commissure with impaired pain and temperature sensation with preserved touch and vibration sensation), initially flaccid, later spastic paresis at the level of the lesion, trophic disorders as well as bladder and rectal disorders . Position, vibration and touch sensation are not impaired, as their tracts (posterior cord tracts) are not in the supply area of ​​the affected artery.

diagnosis

In addition to the typical clinic, various apparatus-based examinations are carried out to clarify the causes, to rule out possible differential diagnoses and to confirm the diagnosis. The circulatory disorder is usually detected with the help of magnetic resonance imaging and is the means of choice for confirming the diagnosis. Through a computerized causing spinal changes can herniated discs and tumors are detected.

therapy

Immediate surgery is necessary for processes that locally lead to compression of the anterior spinal artery, which can be the case, for example, with herniated discs and tumors. If the circulatory disorder is caused by systemic changes in the vessels, conservative therapy is carried out. These include drug treatment with heparin for thrombosis prophylaxis and corticosteroids for anti-inflammatory purposes. Physiotherapy and regular repositioning are important measures for pressure ulcer prophylaxis . With anterior spinal syndrome, the risk of developing pressure ulcers is increased.

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